SCIENTIFIC PROCEEDINGS 



Abstracts of Communications. 

 Ninety-eighth meeting. 



Schcrmcrhorn Hall, Columbia University, March ig, igip. 

 President Calkins in the Chair. 

 51 (1426) 



The influenza epidemic of 1918 in the American Expeditionary 

 Forces in France and England 1 



By W. J. MacNeal. 



[From the Laboratory Division, Office of Chief Surgeon, A.E. F.] 



A disease, clinically recognized as influenza, became epidemic 

 in the American Expeditionary Forces in France in May, 191 8. 

 Since August, 1918, the epidemic, previously mild, has assumed a 

 more malignant character, often leading to a fatal broncho-pneu- 

 monia. In the fatal cases the lungs have presented a picture of 

 malignant coalescing broncho-pneumonia frequently associated 

 with hemorrhagic tracheo-bronchitis. The changes have varied 

 considerably according to chronicity of the disease and the nature 

 of the secondary infections. Influenza bacilli in large numbers 

 have been found in the bronchi in fulminant cases. At most of 

 the autopsies a mixture of bacteria was found in the respiratory 

 tract, including pneumococci of various types, streptococci and 

 sometimes staphylococci. Blood cultures during life were usually 

 negative but showed pneumococci or streptococci in some cases. 



Over work, exposure to cold and wet, inadequate nourish- 

 ment, poor ventilation, inhalation of dust and general physical 

 discomfort have diminished the natural resistance to the disease. 

 The contagion spreads rapidly by distribution in the secretions of 

 the nose and mouth, not only of the sick but of many other in- 



1 Publication authorized by the Surgeon General, U. S. Army. The full paper 

 will be published elsewhere. 



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