DISTRIBUTION IN THE BODY. 433 



followed by tubercular affection, in which cases both influenza 

 and tubercle bacilli may be found in the sputum. In such a con- 

 dition the prognosis is very grave. Regarding the presence of 

 influenza bacilli in the other pulmonary complications following 

 influenza, much information is still required. Occasionally in 

 the foci of suppurative softening in the lung the influenza bacilli 

 have been found in a practically pure condition. In cases of 

 empyema the organisms present would appear to be chiefly 

 streptococci and pneumococci ; whilst in the gangrenous condi- 

 tions, which sometimes occur, a great variety of organisms has 

 been found. 



As above stated, Canon described the bacilli as occurring in 

 the blood during life, and Pfeiffer, on examining Canon's prepa- 

 rations, admits that the bacilli shown resembled the influenza 

 bacilli. His own observations on a large series of cases con- 

 vinced him that the organism was very rarely present in the 

 blood, that in fact its occurrence there must be looked upon as 

 exceptional. The conclusions of other observers have, on the 

 whole, confirmed this statement. The organism has been regu- 

 larly found in enormous numbers in the sputum in influenza, but 

 only occasionally and in small numbers in the blood. It is prob- 

 able that the chief symptoms in the disease are due to toxins 

 absorbed from the respiratory tract (vide infra], 



We cannot yet speak definitely with regard to the relation of 

 the bacillus in other complications in influenza. Pfeiffer found 

 it in inflammation of the middle ear, but in a case of meningitis 

 following influenza, Fraenkel's diplococcus was present. In a 

 few cases of meningitis, however, the influenza bacillus has been 

 found, sometimes alone, sometimes along with pyogenic cocci 

 (Pf uhl and Walter, Cornil and Durante) ; Pfuhl considers that 

 in these the path of infection is usually a direct one through the 

 roof of the nasal cavity. This observer also found post mortem, 

 in a rapidly fatal case with profound general symptoms, influenza 

 bacilli in various organs, both within and outside of the vessels. 

 In a few cases also the bacilli have been found in the brain and 

 its membranes, with little tissue change in the parts around. 



Experimental Inoculation. There is no satisfactory evidence 

 that any of the lower animals suffer from influenza in natural 

 conditions, and accordingly we cannot look for very definite 

 results from experimental inoculation. Pfeiffer, by injecting 



