Studies of influenza in hospitals of the British armies in France, 1918.

Date:
1919
Catalogue details

Licence: Public Domain Mark

Credit: Studies of influenza in hospitals of the British armies in France, 1918. Source: Wellcome Collection.

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    weeks to recover. Unfortunately the pressure just before death was not taken in any of these cases., In two cases of post-influenzal depression or psychasthenia the pressure was 10 mm. below normal as much as eight ‘weeks after the attack of influenza. - Dilatation was found in 188 cases. Myocardial pallor or softening or both in 135 cases. In many cases the endocardial half of the muscle was very noticeably paler than the outer half. This was much more marked in some cases than in others, and was found especially in early fatal cases, and in those showing the greatest dilatation. The reason is pre- sumably to be found in the vascular supply to the heart muscle— the smaller branches of the coronary: arteries bemg furthest from the vessels’ origin on the outside of the heart, and the part supplied by them on the inner side most affected. The heart, like the lungs, showed subserous haemorrhages, but by-no means so commonly. They were noticed in sixteen cases, in the form of small discrete rounded subpericardial haemorrhages. Occasionally small endocardial haemorrhages of a similar type were found, but with a tendency to be more irregular, or flame shaped, resembling those found in the retina in other conditions. | Pericarditis and endocarditis were not found at all. The average heart weight was 12 oz. The largest 16 oz. and the smallest 8 oz. VI... Lesions or tHE Liver. In most cases there was found some fatty change in the liver, often taking the form of irregular areas, visible beneath the capsule, and on section, of yellowish colour, and surrounded by normal looking liver. In some cases the whole liver was pale and very obviously fatty-enlarged, and with a rounded instead of a sharp anterior edge. In some cases the left lobe seemed more affected than the right, but usually they were affected equally. In a considerable number congestion was present—doubtless accompanying a a gradually failing heart, and when present together a ‘nutmeg’ appearance was produced. Nothing abnormal was noticed in the gall bladder or bile ducts. Fatty change in the liver was found in 130 cases, congestion in | forty-nine cases, and both were present in thirty-eight cases. The average liver weight was 68 oz.—the largest being 109 oz. and the smallest 41 oz. | | Jaundice of a non-obstructive type was found in five cases. These all showed evidences of severe toxaemia. Jaundice was not deep in any of them. . VII. Lesions or THE SPLEEN. The condition of the spleen is always very difficult to describe, but two main types can be mentioned in this series of cases apart from congestion, which may be present as well. (1) The malpighian bodies may stand out prominently on cut section, as in the ‘sago’ spleen, the rest of the organ being either pale or congested, which latter makes the pallor of these bodies