434 INFLUENZA. 



up a marked leucocytic emigration in the peribronchial 

 tissue, the leucocytes passing in large numbers into the 

 lumen of the tubes and sometimes taking up the bacilli. 

 Other organisms also, especially Fraenkel's pneumococcus, 

 may be concerned in the pneumonic conditions following 

 influenza. 



In some cases influenza occurs in tubercular subjects, or 

 is followed by tubercular affection, in which cases both 

 influenza and tubercle bacilli may be found in the sputum. 

 In such a condition the prognosis is very grave. Regard- 

 ing 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 organ- 

 isms present would appear to be chiefly streptococci and 

 pneumococci ; whilst in the gangrenous conditions, which 

 sometimes occur, a great variety of organisms has been 

 found. 



As above stated, Canon described the bacilli as occur- 

 ring in the blood during life, and Pfeiffer, on examining 

 Canon's preparations, admits that the bacilli shown re- 

 sembled the influenza bacilli. His own observations on a 

 large series of cases convinced him that the organism was 

 very rarely present in the blood, that in fact its occurrence 

 there must be looked upon as exceptional. The conclu- 

 sions of other observers have, on the whole, confirmed this 

 statement. It has been regularly found in enormous 

 numbers in the sputum in influenza, but only occasionally 

 and in small numbers in the blood. It is probable that the 

 chief symptoms in the disease are due to toxines absorbed 

 from the respiratory tract (vide infra], 



We cannot yet speak definitely with regard to the 

 relation of the bacillus to other complications in influenza. 

 Pfeiffer found it in inflammation of the middle ear, but 

 in a case of meningitis following influenza Fraenkel's diplo- 

 coccus was present. In a few cases of meningitis, however, 

 the influenza bacillus has been found, sometimes alone, 



