184 Influenza of Horses. 



breathing, friction sounds, and if a pleuritic exudate forms also 

 l)y dullness below a horizontal line (see Vol. 2, chapter on Pleu- 

 ritis.) 



In the Prussian army, in the years of 1899 to 1908, out of 9462 cases in which 

 3198 were affected with pleuro-pneumonia, in 1817 eases pneumonia on the right, 

 and in 17S0 pneumonia on the left side, in 1336 double pneumonia, and in 100 

 cases pleurisy only was present. In the clinics of Budapest, in the years of 1904 



and 19(16, in 169 cases the pneumonia was unilateral, in 195 cases it was bilateral, 



while in 106 cases pleuropneumonia was established. 



In association with the pneumonia gangrene of the lungs 

 develops subsequently with relative frequency, and to a certain 

 degree this is characteristic of the lung affections in influenza. 

 In such cases the symptoms consist of a disagreeable odor of 

 the exhaled air, cavity formations in the hepatized lung tissue, 

 high fever, weak heart action, etc., which usually develop in 

 the course of the second week of the affection. A nasal dis- 

 charge is observed in almost every case. The secretion con- 

 sists first of only yellowish drops, later it becomes more profuse 

 and purulent, or rust-colored, and tenacious, in exceptional 

 cases it may also be bloody. After the appearance of gangrene 

 the discharge becomes of a greenish-brown color, and has an 

 intensely disagreeable odor. 



The urine invarial)ly contains albumen, sometimes also 

 blood. During the incipient stage of the pleuro-pneumonia the 

 quantity of chlorine salts is diminished, but it increases again 

 at the convalescing period as a result of the absorption of 

 the exudate. The appetite is entirely absent, the chemical re- 

 action of the urine is acid. Microscopically the sediment shows 

 epithelial cells from the urinary passages, sometimes hyaline 

 or granular casts, and even red blood corpuscles. 



The number of lymphocytes in the l)lood increases from the 

 beginning of the disease, and by the fifth to seventh day may 

 exceed the normal number by 40%. After recovery has taken 

 place, normal relation is not established until a long time after 

 the disappearance of the clinical symptoms (Sturhan). 



The patients become emaciated in the course of the dis- 

 ease as a result of the fever and inappetence. They usually 

 do not lie down, or in the presence of a painless pure pneumonia 

 they lie only on the affected side, and in the unfavorably ter- 

 minating cases they succumb as a result of septicemia or 

 asphyxiation. 



Complications occur quite frequently in the course of the 

 disease, and may lead the otherwise mild affection to a fatal 

 termination. Of relatively small importance are the inflam- 

 mations of the tendons and tendon sheaths of the extremities, 

 especially of the flexor tendons, also inflammations of the sensi- 

 tive lamina of the hoof; this applies also to the edematous 

 swellings of the skin, wiiich may appear as long as the heart's 

 action is sufficiently strong, as these processes soon disappear 

 after the improvement of the inflammation of the respiratory 

 organs (Frohner observed in the later stages of contagious 



