The pneumonia which occurred at Camp Funston is of special interest to our commission because we were for a time stationed at this camp and had the opportunity of following in the excellent records of the hospital the history of the occurrence of pneumonia during the year following the establishment of the camp in September, 1917. Stone, Phillips and Bliss[[77]] have described the outbreak of pneumonia which occurred in March, 1918. At this time there was, the authors state, severe pneumonia with frequent empyemas due to hemolytic streptococci. This condition which did not follow measles was responsible for the greatly increased death rate in March; 9 deaths occurred in February, 45 in March, 25 in April and 14 in May. They found during March 26 instances of multiple pulmonary abscess. In 29 autopsies they found a pleural lesion which they designate “subcostosternal pus pockets”; it occurs only in association with empyema caused by hemolytic streptococci.
Our commission[[78]] has shown that an epidemic of influenza, well characterized by its epidemiology and symptoms, preceded and accompanied the outbreak of pneumonia just described. Between March 4 and 29 1,127 men from Camp Funston, which then contained 29,000 men, were sent to the base hospital with influenza and many more were treated in the infirmaries of the camp; on March 11 107 patients with influenza were admitted to the hospital. The greatest incidence of pneumonia in the history of the encampment up to this time occurred between March 9 and 29, immediately following the outbreak of influenza, the maximum incidence of pneumonia occurring five days after the maximum for influenza.
The foregoing observations are cited to prove that streptococcus pneumonia, which occurred during the spring of 1918 at Camp Funston and doubtless at other camps, had its origin in influenza and did not differ in character from that which occurred on a much larger scale in the fall of 1918.
Table of Autopsies.—In order to present as briefly as possible the data upon which the present study has been based, autopsies have been assembled in tabular form in the order of their performance (Table XXVII). During the early period of the epidemic autopsies were performed on all who died with pneumonia, but later, with increase in the number of deaths, this became impossible and autopsies were performed on all those who died in certain wards.
Comparison of charts representing incidence of influenza and of deaths from pneumonia furnishes evidence that fatal pneumonia during the period of investigation was with few exceptions referable to influenza. During two weeks, namely, from September 1 to 14, before the presence of the epidemic was evident, there were only 2 fatal cases of pneumonia. In most instances the relation of pneumonia to influenza is established by a definite history of influenza having its onset during the epidemic. Bronchopneumonia usually develops gradually as a sequence of influenza in which purulent bronchitis has occurred. Lobar pneumonia may develop in cases of influenza complicated by purulent bronchitis. In some instances there is apparent recovery from influenza indicated by return of temperature to normal; after from one to three days of normal temperature there is typical lobar pneumonia with rusty sputum. In many instances of pneumonia having their onset at the height of the epidemic of influenza, the history indicates that pneumonia was present immediately after the onset of symptoms, so that the onset resembled that of pneumonia rather than of influenza.
Cases of pneumonia following measles have been excluded from the table in order that they may be studied separately and compared with the pneumonias of influenza. It is noteworthy that the lesions of pneumonia following measles have shown a very close resemblance to the pneumonias of influenza, with regard both to pathologic characters and to bacteriology.
Five instances of pneumonia following typhoid fever (Autopsies 245 and 329), scarlet fever (Autopsy 311) or mumps (Autopsies 403 and 417) have been excluded from the table. These secondary pneumonias are grouped as an appendix to the section on pneumonia following measles. It is not improbable that individuals with the diseases named are just as susceptible as others to influenza. Included in the table is an instance (Autopsy 487) in which a definite attack of influenza preceded scarlet fever.
| Table XXVII | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NO. OF AUTOPSY | RACE | LENGTH OF MILITARY SERVICE | DURATION OF ILLNESS | DURATION OF PNEUMONIA | CLINICAL DIAGNOSIS | PURULENT BRONCHITIS | LOBAR PNEUMONIA | PERIBRONCHIOLAR CONSOLIDATION | HEMORRHAGIC PERIBRONCHIOLAR CONSOLIDATION | LOBULAR CONSOLIDATION | PERIBRONCHIAL CONSOLIDATION | ABSCESS | INTERSTITIAL SUPPURATIVE PNEUMONIA | MULTIPLE ABSCESSES IN CLUSTERS | EMPYEMA | BRONCHIECTASIS | UNRESOLVED BRONCHOPNEUMONIA | ORGANIZING BRONCHITIS | BACTERIA IN SPUTUM | BACTERIA IN BRONCHUS | BACTERIA IN LUNG | BACTERIA IN BLOOD OF HEART |
| 229 | W | 1m | 12+ | 12+ | L | P | + | Pn. I. B. inf. | 0 | |||||||||||||
| 231 | W | 2m | 13 | 4 | B | P | + | |||||||||||||||
| 232 | W | 14d | 9 | 6? | B | + | Pn. IIa. B. inf. | Pn. IIa. | Pn. IIa. | |||||||||||||
| 233 | C | 11m | 5 | 2 | L | + | Pn. IIa. | Pn. | ||||||||||||||
| 236 | W | 3w | 8 | 7+ | L | + | Pn. IV. B. inf. | B. inf. Staph. | 0 | |||||||||||||
| 237 | W | 10d | 8 | 2 | L | + | + | N | E | St. h. | St. h. | |||||||||||
| 238 | W | 2d | 8 | 5 | L | + | Pn. IV. B. inf. | Pn. IV | ||||||||||||||
| 239 | W | 11d | 9 | 5 | L | + | Pn. II. | Pn. II. B. inf. | Pn. II. | |||||||||||||
| 240 | W | 13d | 8 | 4 | L | + | M | + | Pn. IV. | B. inf. | Pn. IV. | |||||||||||
| 241 | W | 14d | 5 | 5 | L | + | Pn. IV. B. inf. | Pn. IV. | ||||||||||||||
| 242 | C | 14d | 7 | 4 | L | P | + | + | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||||
| 243 | W | 15d | 5 | 5 | L | + | M | Pn. IV. | ||||||||||||||
| 244 | C | 1m | 6 | 3 | B | P | M | + | + | + | Pn. IV. B. inf. | Pn. IV. B. inf. | 0 | |||||||||
| 246 | C | 2m | 6 | 3 | L | P | + | M | Pn. IIa. B. inf. | 0 | ||||||||||||
| 247 | W | 10d | 10 | 5 | L | P | M | + | + | Pn. IV. B. inf. | Pn. IV. | |||||||||||
| 248 | W | 1m | 4 | 2+ | I | + | E | St. h. | St. h. | St. h. | ||||||||||||
| 249 | W | 15d | 12 | 6+ | L | M | + | Pn. III. | ||||||||||||||
| 250 | W | 14d | 11 | 7 | L | M | + | E | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||||
| 251 | W | 25d | 7 | 1 | B | P | + | + | + | + | St. h. | St. h. | ||||||||||
| 252 | W | 21d | 14 | 12 | B | P | M | + | Pn. II. B. inf. St. v. | Pn. II. B. inf. | 0 | |||||||||||
| 253 | W | 12d | 19 | 12+ | B | M | + | + | E | Pn. Ia. | Pn. II. B. inf. Staph. | Pn. II. B. inf. | Pn. II. | |||||||||
| 254 | W | 21d | 7 | 6+ | B | P | + | M | + | Pn. I. B. inf. | Pn. I. Staph | 0 | ||||||||||
| 255 | W | 12d | 5 | 4? | B | P | M | + | + | + | E | St. h. Pn. IIa. Staph. | St. h. | St. h. | ||||||||
| 256 | W | 17d | 8 | 4 | B | P | + | M | Pn. Staph. | Pn. IIa. | Pn. IIa. | |||||||||||
| 257 | C | 21d | 10 | 7+ | L | P | + | B. inf. Staph | Pn. I. | |||||||||||||
| 258 | W | 1m | 6 | 2+ | B | M | + | + | E | St. h. Pn. IV. B. inf. | St. h. | |||||||||||
| 259 | W | 3m | 4 | 1 | B | + | + | + | St. h. Pn. III. Staph. | St. h. | ||||||||||||
| 260 | W | 1m | 2 | 1 | L | + | 0 | |||||||||||||||
| 261 | W | 2m | 7 | 5+ | B | P | + | B. inf. Pn. IV. | 0 | |||||||||||||
| 262 | W | 12d | 5 | 4? | B | + | + | E | St. h. B. inf. | St. h. | St. h. | |||||||||||
| 263 | W | 21d | 7 | 5 | L | P | + | + | E | St. h. B. inf. Staph. | St. h. Staph. | |||||||||||
| 264 | W | 21d | 10 | 7 | L | + | Pn. IV. Staph. | St. h. Staph. | St. h. | St. h. | ||||||||||||
| 265 | W | 14d | 7 | 6+ | L | + | St. h. Staph. inf. | Pn. IV. B. inf. | St. h. | |||||||||||||
| 266 | W | 1m | 7 | 2 | L | + | + | St. h. | St. h. B. inf. | St. h. | St. h. | |||||||||||
| 267 | W | 2m | 22 | 10 | B | + | Pn. IV. | Pn. II. B. inf. | Pn. II. | Pn. II. | ||||||||||||
| 268 | W | 2m | 6 | 4? | L | + | Pn. III. B. | Pn. III. B. inf. St. h. | Pn. III. B. inf. St. h. | 0 | ||||||||||||
| 269 | W | 25d | 8 | 2 | L | + | Pn. IV. B. | Pn. IV. Staph. | Pn. IV. | 0 | ||||||||||||
| 270 | W | 17d | 18 | 3 | L | + | h | St. h. B. inf. Staph. | St. h. Staph. | St. h. | ||||||||||||
| 271 | W | 2d | 12 | 5 | L | P | + | St. h. Pn. IV. B. inf. | St. h. | St. h. | ||||||||||||
| 272 | W | 3m | 7 | 2 | L | + | St. h. | |||||||||||||||
| 273 | W | 1m | 8 | 4+ | L | + | + | N | E | St. h. B. inf. Staph. | St. h. Pn. IV. Staph. | St. h. | ||||||||||
| 274 | W | 2w | 9 | 5 | B | + | N | Pn. IV. | St. h. Staph. | St. h. | St. h. | |||||||||||
| 275 | W | 4m | 9 | 4 | L | M | + | + | N | St. h. B. inf. Staph. | St. h. B. inf. Staph. | St. h. Pn. IV. | ||||||||||
| 276 | W | 1m | 6 | 4+ | L | + | St. h. Staph B. inf. | St. h. Pn. IV. B. inf. | St. h. | |||||||||||||
| 277 | W | 21d | 10 | 3 | L | + | St. h. Staph | St. h. Staph | St. h. | |||||||||||||
| 278 | W | 2m | 16 | 6+ | L | + | E | St. h. B. inf. | St. h. | St. h. | ||||||||||||
| 279 | W | L | + | Pn. IV | Pn. IV. | |||||||||||||||||
| 280 | W | 21d | 8 | 8 | L | + | + | + | St. h. B. inf. Staph. | St. h. | St. h. | |||||||||||
| 281 | W | 21d | 9 | 5 | L | + | + | h | St. h. B. inf. | St. h. | ||||||||||||
| 282 | W | 1m | 10 | ? | B | + | + | E | Pn. IV. B. inf. | St. h. B. inf. Pn. II Staph. | St. h. Pn. II. | St. h. Pn. II. | ||||||||||
| 283 | W | 7d | 19 | 8 | B | P | + | + | + | M | + | B. inf. Pn. IV. Staph. | Staph. B. inf. | Pn. IV. | ||||||||
| 284 | W | 21d | 11 | ? | B | P | + | + | E | St. h. B. inf. Staph. | St. h. | St. h. | ||||||||||
| 285 | W | 11 | 9? | B | P | M | + | E | Pn. IIa. B. inf. | St. h. B. inf. | St. h. | St. h. | ||||||||||
| 286 | W | 20d | 9 | 4+ | L | P | M | + | Pn. IV. B. inf. Staph. | 0 | Pn. IV. | |||||||||||
| 287 | W | 3m | 12 | 4 | L | P | + | + | + | Pn. IV. B. inf. Staph. | Pn. IV. B inf. Staph. | Pn. IV. | ||||||||||
| 288 | W | 1m | 10 | 5 | B | P | M | + | h | + | E | + | St. h. B. inf. | St. h. B. inf. | St. h. | St. h. | ||||||
| 289 | W | 19d | 12 | 7 | B | P | M | + | M | + | Pn. IV. B. inf. Staph. | Pn. IV. | Pn. IV. | |||||||||
| 290 | W | 1m | 3+ | 3+ | B | + | St. h. B. inf. | St. h. | St. h. | |||||||||||||
| 291 | W | 2w | 18 | 11 | B | P | + | + | M | + | Pn. IV. B. inf. | B. inf. Staph. | 0 | 0 | ||||||||
| 292 | W | 3m | 5 | 5 | L | + | E | St. h. B. inf. | St. h. | |||||||||||||
| 293 | W | 2m | 3+ | 3+ | L | P | + | Pn. III. B. inf. | Pn. III. B. inf. | Pn. III. | ||||||||||||
| 295 | W | 1m | 12 | 5 | L | P | + | + | E | + | Pn. IV. St. h. | St. h. B. inf. | St. h. | |||||||||
| 296 | W | 16d | 18 | 3 | L | P | + | + | E | + | St. h. B. inf. | St. h. B. inf. | St. h. | |||||||||
| 297 | W | 1m | 5 | ? | I | P | + | B. inf. Pn. IV. St. h. | Pn. IV. B. inf. | 0 | ||||||||||||
| 298 | C | 21d | 13 | 10 | B | P | + | Pn. IIa. B. inf. | Pn. IIa. | |||||||||||||
| 299 | W | 28d | 9 | 3 | L | P | + | B. inf. Pn. IV. Staph. St. h. | ||||||||||||||
| 300 | C | 22d | 16 | 12+ | L | P | + | M | h | Pn. IIa. B. inf. | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||
| 301 | W | 1m | 7 | 5 | B | + | Pn. IV. B. inf. Staph. St. h. | Pn. IV. | ||||||||||||||
| 302 | C | 5d | 6 | 3+ | B | + | Pn. IV. B. inf. | Pn. IV. | ||||||||||||||
| 303 | W | 1m | 7 | 3+ | L | + | Staph. Pn. IV. B. inf. | Pn. IV. B. inf. | ||||||||||||||
| 304 | W | 4m | 10 | 2? | L | + | St. h. B. inf. | St. h. B. inf. | ||||||||||||||
| 305 | W | 5m | 3+ | 3+ | L | + | B. inf. St. h. Pn. IV. Staph. | B. inf. St. h Pn. IV. Staph. | ||||||||||||||
| 306 | W | 1y | 6+ | 3 | B | + | B. inf. Pn. IV. Staph. | 0 | 0 | |||||||||||||
| 308 | W | 1m | 6 | 6 | L | + | + | Pn. IV. B. inf. St. h. Staph. | St. h. | Pn. IV. | ||||||||||||
| 309 | W | 1m | 4 | 2? | L | + | E | St. h. | St. h. | |||||||||||||
| 310 | W | 21d | ? | 3? | L | + | Pn. III. B. inf. Staph. | Pn. III. Pn. IV. B. inf. | ||||||||||||||
| 312 | W | 1m | 17 | 7 | L | P | M | + | h | N | + | Pn. IV. B. inf. St. h. | St. h. B. inf. Staph. | St. h. B. inf. | St. | |||||||
| 313 | W | 1y | 5 | 2 | B | + | St. h. B. inf. Staph. | St. h. | St. h. | |||||||||||||
| 314 | W | 1m | 3+ | 3+ | L | P | + | + | Pn. IV. B. inf. Staph. | Pn. IV. | Pn. IV. | |||||||||||
| 315 | W | 1m | 9 | 2 | B | + | Pn. IV. B. inf. Staph. | Pn. IV. | ||||||||||||||
| 316 | W | 1m | 11 | 4 | L | + | B. inf. | Pn. III. B. inf. | Pn. III. | |||||||||||||
| 317 | W | 13d | 9 | 2 | L | + | Pn. IV. B. inf. | Pn. IV. | ||||||||||||||
| 318 | W | 2m | 8 | 3 | L | + | Pn. IV. B. inf. | Pn. IV. B. inf. | ||||||||||||||
| 319 | W | 1m | 4+ | 4+ | B | P | + | St. h. Staph. | St. h. B. inf. Staph. | St. h. | ||||||||||||
| 320 | C | 5m | 1+ | 1+ | L | + | Pn. IIa. | Pn. IIa. | Pn. IIa. | |||||||||||||
| 321 | W | 28d | 4+ | 4+ | L | + | E | B. inf. | Pn. IV. B. inf. | Pn. IV. | ||||||||||||
| 322 | W | 10d | 8 | 6 | L | P | + | + | + | Pn. IV. | Pn. III. Staph. aur. | 0 | ||||||||||
| 323 | W | 2m | 12 | 4 | B | + | Pn. IV. B. inf. Staph. | 0 | ||||||||||||||
| 324 | W | 22d | 9 | 6 | B | + | Pn. I. B. inf. | 0 | Pn. I. | |||||||||||||
| 325 | W | 1m | 8 | 8 | B | P | M | N | + | + | St. h. B. inf. Staph. | St. h. | St. h. | |||||||||
| 326 | W | 1m | 5+ | 2 | B | P | + | h | St. h. B. inf. Staph. | St. h. B. inf. | St. h. | |||||||||||
| 327 | W | 1m | 4 | ? | B | + | ||||||||||||||||
| 328 | W | 5m | 13 | 3+ | L | P | + | Pn. III. Pn. IV. B. inf. Staph. | Pn. III. Pn. IV. B. inf. | Pn. III. | ||||||||||||
| 330 | W | 1m | 10 | 3 | L | M | N | + | E | Pn. IV. | Pn. IV. | |||||||||||
| 331 | W | 1m | 12 | 11+ | B | P | + | Pn. IV. | ||||||||||||||
| 332 | W | 1m | 17 | 3 | L | P | + | M | h | 0 | ||||||||||||
| 333 | W | 19d | 15 | 7 | L | P | M | + | + | + | Staph. aur. B. inf. St. h. | Staph. aur. Pn. IIa. St. h. | Pn. IIa. | |||||||||
| 334 | W | 14d | 16 | 5 | B | M | N | + | E | St. h. Staph | St. h. | |||||||||||
| 335 | W | 1m | 7 | ? | ? | + | St. v. B. inf. Staph. Pn. IV. | Pn. IV. | ||||||||||||||
| 336 | W | 2m | 12 | 6 | B | P | M | + | + | 0 | ||||||||||||
| 337 | W | 1m | 9 | 2? | L | + | Pn. IV. | |||||||||||||||
| 338 | W | 1m | 7 | 5+ | B | + | Pn. IV. | |||||||||||||||
| 339 | W | 2m | 9 | 6? | L | + | Pn. IV. | |||||||||||||||
| 340 | W | 35d | 8 | 3 | L | P | + | + | 0 | |||||||||||||
| 341 | W | 3m | 6 | 4+ | + | 0 | ||||||||||||||||
| 342 | W | 2m | 9 | 3? | L | P | + | + | ||||||||||||||
| 343 | W | 1m | 11 | 1? | L | + | E | Pn. IV. | Pn. IV. | |||||||||||||
| 344 | W | 4m | 13 | 6 | L | + | + | E | St. h. | |||||||||||||
| 345 | W | 1d | ? | 7 | L | P | + | + | + | E | Pn. III. St. h Staph. | |||||||||||
| 346 | W | 26d | 16 | 10 | B | P | + | M | + | N | B. inf. Pn. IV. | St. h. B. inf. | St. h. B. inf. | St. h. | ||||||||
| 347 | C | 3d | 10 | 3 | L | P | + | h | St. h. | |||||||||||||
| 348 | C | 4d | 8 | 8 | B | P | + | Pn. IIa. | ||||||||||||||
| 349 | W | 2d | 12 | 6 | L | P | + | Pn. III St. h | Pn. I. | |||||||||||||
| 350 | W | 2m | 6 | 2? | B | + | St. h. | |||||||||||||||
| 351 | C | 4m | 4 | 3+ | L | P | + | |||||||||||||||
| 352 | C | 2m | 8 | 4 | L | P | + | + | + | + | Pn. IIa. | |||||||||||
| 353 | C | 6m | 18 | 18 | L | P | + | E | Pn. I. B. inf. | B. inf. Pn. | Pn. IIa. | Pn. IIa. | ||||||||||
| 354 | W | 15d | 2+ | 2 | L | P | M | h | + | E | St. h. B. inf. Staph. | St. h. | St. h. | |||||||||
| 355 | W | 21d | 7 | 7 | B | P | + | + | E | St. h. B. inf. Pn. IV. Staph. | St. h. B. inf. Staph. | 0 | ||||||||||
| 356 | C | 5d | 8 | 4 | L | + | Pn. IV. | |||||||||||||||
| 357 | W | 1m | 10 | 6+ | L | + | + | + | Pn. IV. B. inf. | Pn. IV. | ||||||||||||
| 358 | W | 1m | 15 | 6? | L | + | E | Pn. IIa. | ||||||||||||||
| 359 | W | 1m | 7+ | ? | L | M | h | + | Pn. IV. | |||||||||||||
| 360 | W | 36d | 10 | 3 | L | P | + | + | + | 0 | ||||||||||||
| 361 | W | 3m | 8 | 2 | L | + | Pn. IV. | |||||||||||||||
| 362 | W | 4m | 15 | 13+ | L | + | St. h. | |||||||||||||||
| 363 | W | 3m | 8 | 1+ | L | P | + | Pn. IV. | ||||||||||||||
| 364 | W | 6d | 9 | 5+ | B | + | St. h. | |||||||||||||||
| 365 | W | 2m | 11 | 2 | B | + | + | + | Pn. IV. | Pn. IV. | ||||||||||||
| 366 | W | 6d | 8 | 1+ | B | + | M | Pn. IV. | ||||||||||||||
| 367 | W | 22d | 15 | 8+ | L | + | Pn. IV. | |||||||||||||||
| 368 | C | 4d | 15 | 11+ | L | P | + | M | Pn. I. | |||||||||||||
| 369 | W | 68d | 7+ | 4 | B | P | + | + | N | + | E | St. h. | St. h. | St. h. | ||||||||
| 370 | W | 17d | 17 | 14 | L | P | + | + | + | + | + | [No. St. h.] | Staph. aur. Pn. IV. B. inf. | Staph. aur | 0 | |||||||
| 372 | W | 1m | 17 | 5 | L | P | + | + | Mh | + | ||||||||||||
| 373 | W | 4d | 11 | 1? | B | + | St. h. | |||||||||||||||
| 374 | C | 4d | 10 | 5 | L | P | + | + | + | Pn. IV. | ||||||||||||
| 375 | C | 4d | 12 | 6 | L | P | + | + | + | 0 | ||||||||||||
| 376 | W | 1m | 10 | 7+ | B | P | + | + | M | + | E | + | [No. St h.] | St. h. B. inf. Staph. aur. | St. h. | St. h. | ||||||
| 377 | W | 1m | 7 | 4? | B | P | + | + | Pn. IV. | |||||||||||||
| 378 | W | 1m | 28 | 7 | B | P | + | + | E | + | St. h. B. inf. Pn. IIa. | St. h. B. inf. Pn. IIa. | Pn. IIa. | |||||||||
| 379 | W | 11m | 7 | 1 | B | + | + | E | B. inf. + | ? | Pn. IIa. | |||||||||||
| 380 | W | 3m | 11 | ? | B | P | + | + | + | Pn. III. | Pn. III. | |||||||||||
| 381 | W | 21d | 13 | 9? | L | P | + | + | E | + | St. h. Pn. II. Pn. IV. Staph. aur. | St. h. | ||||||||||
| 382 | W | 1m | 9 | 6+ | L | P | + | 0 | ||||||||||||||
| 383 | W | 2m | 9 | 2 | L | + | + | B. inf. Pn. III. St. h. | Pn. III. | |||||||||||||
| 384 | W | 1m | 13 | 5 | L | + | Pn. IV. | |||||||||||||||
| 385a | W | 3w | 12 | 6? | B | P | + | + | E | St. h. | St. h. | |||||||||||
| 385b | W | 2m | 11 | 4 | L | + | Pn. IV. | |||||||||||||||
| 385c | W | 24d | 17 | 10 | B | P | M | + | + | + | + | St. h. B. inf. | St. h. | |||||||||
| 386 | W | 1m | ? | 5 | L | P | + | + | Pn. III. B. inf. Staph. aur. | Pn. III. | ||||||||||||
| 387 | W | 3w | 19 | 9 | B | P | + | + | + | + | E | + | St. h. B. inf. Staph. aur. Pn. | Staph. alb Pn. II. B. inf. | St. h. | |||||||
| 388 | W | 3m | 11 | 7 | L | P | + | Pn. IV. | ||||||||||||||
| 389 | W | 1m | 15 | 15 | L | P | + | + | E | + | St. h. | St. h. | ||||||||||
| 391 | W | 25d | 13 | 13 | L | P | + | + | + | h | + | Pn. IV. | Pn. IV. | |||||||||
| 392 | W | 1m | 12 | 8+ | L | P | + | M | + | Pn. II. | ||||||||||||
| 393 | W | 1m | 20 | 4 | L | + | Pn. IV. | |||||||||||||||
| 394 | W | 21d | ? | ? | L | P | + | + | h | + | St. h. | |||||||||||
| 395a | W | 1m | 19 | 11? | L | P | M | + | + | E | + | St. h. B. inf. | St. h. | |||||||||
| 395b | W | 3m | 12 | 3? | B | P | + | h | E | Pn. IIa. | Pn. IIa. | |||||||||||
| 396 | W | 2m | 7 | 1+ | B | + | 0 | |||||||||||||||
| 397 | W | 21d | 22 | 14 | B | P | M | + | + | E | St. h. B. inf. | St. h. | ||||||||||
| 398 | W | 1m | 16 | 6? | B | P | + | M | + | + | 0 | |||||||||||
| 399 | W | 1m | 18 | 4 | L | + | Pn. IIa. | |||||||||||||||
| 400 | W | 1m | 15 | 11+ | L | + | Pn. IV. | |||||||||||||||
| 401 | W | 1m | 13+ | 9 | B | P | + | M | h | + | Pn. IV. | |||||||||||
| 402 | W | 1m | 14 | 8 | B | P | M | + | + | E | + | + | + | Pn. IV. St. h. | ||||||||
| 404 | B | P | + | + | ||||||||||||||||||
| 405 | W | 21d | 13 | 11+ | B | + | M | Pn. | ||||||||||||||
| 406 | C | 2d | 18 | 15? | L | P | + | + | E | Pn. IV. | ||||||||||||
| 408 | C | 1m | 13 | ? | L | P | + | + | 0 | |||||||||||||
| 409 | C | 6d | 12 | 9+ | L | P | + | + | M | 0 | ||||||||||||
| 410 | W | 35d | 13+ | 13+ | L | P | + | + | M | + | E | + | St. h. B. inf. Staph. aur. | |||||||||
| 411 | W | 3m | 16 | 2 | B | P | + | + | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||||
| 412 | W | 1m | 15 | 13? | L | + | M | + | Pn. II. B. inf. | Pn. II. | ||||||||||||
| 413 | C | 2m | 13 | 8+ | L | P | + | + | Pn. III. B. inf. | Pn. III. | ||||||||||||
| 414 | C | 7d | 18 | 4 | L | P | + | Pn. IIa. B. inf. | Pn. IIa. | |||||||||||||
| 415 | C | 16d | 8 | 6+ | L | P | + | + | + | St. h. | 0 | |||||||||||
| 416 | C | 7d | 14 | 6? | L | P | + | Pn. IV. | Pn. IV. | Pn. IV. | ||||||||||||
| 418 | W | 2m | 19 | 4 | B | + | Pn. IIa. St. v. B. inf. | Pn. IIa. | ||||||||||||||
| 419 | W | 4m | 20 | ? | L | P | + | + | M | + | Pn. II. B. inf. | Pn. II. B. inf. | 0 | |||||||||
| 420 | W | 1m | 11 | 3 | B | P | + | M | + | E | + | + | St. h. B. inf. Staph. aur. | St. h. | ||||||||
| 421 | W | 21d | 19 | 15? | B | P | + | M | + | + | + | Pn. IV. St. h. | St. h. | |||||||||
| 422 | W | 3m | 11+ | 11+ | B | P | + | + | M | + | + | Pn. IIa. B. inf. | 0 | |||||||||
| 423 | W | 1m | 16 | 12? | B | P | + | M | E | + | + | St. h. B. inf. | St. h. | |||||||||
| 424 | W | 5y | 14 | 6 | L | P | + | + | Pn. IV. | |||||||||||||
| 425 | W | 1m | 29 | 14 | B | P | + | + | M | + | + | + | St. h. B. inf. Staph. alb. | St. h. | ||||||||
| 426 | W | 4m | 20 | 13 | ? | + | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||||||
| 427 | W | 1m | 16 | ? | L | P | + | + | St. h. | St. h. | ||||||||||||
| 428 | W | 3w | 25 | 21 | L | P | M | + | + | E | + | St. h. B. inf. | St. h. B. inf. | St. h. | ||||||||
| 429 | C | 2m | 7+ | 5 | L | P | + | + | + | B. inf. Staph. alb | 0 | |||||||||||
| 430 | W | 2m | 16+ | 7 | L | P | + | + | N | St. h. B. inf. Staph. aur. | St. h. | |||||||||||
| 431 | W | 21d | 23 | 18 | L | P | + | + | + | + | 0 | 0 | ||||||||||
| 432 | W | 42d | 19 | 12+? | L | P | + | E | B. inf. Pn. IIa. | Pn. IIa. | ||||||||||||
| 433 | W | 1m | 19 | 17 | B | P | M | + | M | + | E | + | St. h. B. inf. Staph. aur. | 0 | ||||||||
| 434 | W | 4m | 14+ | 10 | L | + | + | E | St. h. B. inf. Staph. aur. | St. h. Staph. aur. | St. h. | |||||||||||
| 435 | W | 1m | 16+ | 2? | B | + | St. h. B. inf. | B. inf. + | St. h. | |||||||||||||
| 436 | C | 11m | 5 | 3+? | B | + | Pn. IIa. B. inf. Staph. aur. | Pn. IIa. | Pn. IIa. | |||||||||||||
| 437 | C | 5m | 11 | 7? | L | P | + | + | 0 | |||||||||||||
| 440 | W | 1m | 19 | 12? | L | P | + | + | + | M | + | + | B. inf. Staph. aur. | B. inf. Staph. aur. | 0 | |||||||
| 445 | W | 1m | 27 | 16? | P | M | h | + | + | Staph. aur. | Staph. aur. Pn. IV. | St. h. | ||||||||||
| 446 | W | 8d | 13 | ? | P | + | + | 0 | ||||||||||||||
| 447 | W | 8d | 10 | 2 | B | + | Staph. aur. | B. coli. Staph. aur. | 0 | |||||||||||||
| 448 | W | 70d | 17 | 14+ | L | P | + | + | Mh | + | 0 | 0 | 0 | |||||||||
| 449 | W | 2m | 27 | 13+ | B | P | + | + | + | E | + | + | St. h. B. coli. | St. h. B. coli. | St. h. | |||||||
| 452 | W | 4m | 14 | 9 | B | P | M | + | E | St. h. B. inf. | St. h. B. inf. | St. h. | ||||||||||
| 451 | C | 2m | 7 | 3+ | B | + | E | B. coli. Staph. St. v. | Pn. IIa. B. inf. | Pn. IIa. | ||||||||||||
| 455 | C | 26 | 22+ | B | + | + | E | St. h. B. inf. | St. h. | St. h. | ||||||||||||
| 456 | W | 1m | 23+ | 20+ | L | P | + | E | B. coli. | St. h. | ||||||||||||
| 457 | W | 17m | 17+ | 17+ | B | + | + | + | + | + | Pn. IV. B. inf. | |||||||||||
| 458 | W | 11m | 10 | 8+? | L | + | + | Pn. IV. B. inf. St. v. | 0 | |||||||||||||
| 459 | C | 10d | 6 | 3 | B | P | + | + | Staph. aur. Pn. IV. | 0 | ||||||||||||
| 460 | W | 1m | 17 | 17 | L | P | + | + | M | + | E | + | St. h. B. inf. Staph. | St. h. B. inf. | St. h. | |||||||
| 461 | C | 5d | 14 | 8+ | L | P | + | M | + | Staph. aur. Pn. I. St. h. | Pn. I. | |||||||||||
| 462 | C | 5d | 15+ | 12 | B | + | 0 | |||||||||||||||
| 463 | W | 3m | 20 | 12 | B | P | + | + | Mh | + | + | B. inf. Staph. | B. inf. Staph. | 0 | ||||||||
| 464 | C | 21d | 24 | 17? | L | P | + | B. inf. Pn. I. Staph. | B. inf. Pn. I. | 0 | ||||||||||||
| 465 | W | 1m | 24+ | 11 | LB | P | M | + | E | + | St. h. B. inf. Staph. St. v. | St. h. | St. h. | |||||||||
| 466 | W | 2d | 13 | 3 | B | + | + | Pn. IIa. | Pn. IIa. | Pn. IIa. | ||||||||||||
| 467 | W | 3m | 30 | 25? | B | P | + | + | + | E | + | St. h. B. inf. | 0 | St. h. | ||||||||
| 468 | W | 1m | 22+ | 6 | L | P | + | + | + | Staph. aur. B. inf. St. v. | B. inf. St. v. | 0 | ||||||||||
| 469 | W | 1m | 25 | 12 | B | P | + | + | + | |||||||||||||
| 471 | C | 6+? | 4 | L | P | + | Pn. IV. B. inf. Staph. aur. | Pn. I. Pn. IV. B. inf. | 0 | |||||||||||||
| 472 | W | 1m | 37 | 21 | B | P | + | + | + | + | E | + | + | B. coli. | St. h. B. coli. | St. h. | ||||||
| 473 | W | 2w | 28+ | 24 | B | P | + | + | E | + | + | + | B. inf. St. v. Staph. M. cat. | St. v. | Pn. III. | |||||||
| 474 | W | 1m | 36 | 31+ | L | + | + | E | St. v. B. inf. M. cat. | St. h. | St. h. B. inf. | |||||||||||
| 476 | W | 7d | 6 | 2 | B | P | M | + | 0 | |||||||||||||
| 477 | W | 5d | 9 | 5 | B | + | + | N | St. h. B. coli. | St. h. B. coli. | St. h. | |||||||||||
| 478 | W | 2m | 9 | 3 | L | + | St. h. | St. h. | ||||||||||||||
| 479 | C | 8d | 29 | 15 | L | P | + | M | N | B. inf. St. h. Staph. M. cat. | St. h. Staph. aur. | St. h. | ||||||||||
| 480 | W | 4m | 31+ | 29 | B | + | + | E | Staph. aur. St. v. | Staph. aur. B. inf. St. v. | B. coli. St. | |||||||||||
| 482 | W | 2m | 11 | 5+ | B | P | + | + | + | M | + | B. inf. Pn. IV. St. h. | B. inf. Pn. IV. | 0 | ||||||||
| 485 | W | 3d | 9+ | 3+ | B | P | M | + | E | St. h. B. inf. Staph. aur. B. coli. | St. h. | St. h. | ||||||||||
| 487 | W | 21d | 55 | 40 | B | P | + | + | E | + | + | B. inf. St. h. | B. inf. | St. h. | ||||||||
| 488 | W | 4d | 16 | 8 | L | P | M | + | E | + | St. h. Pn. IIa. | St. h. | St. h. | |||||||||
| 489 | C | 8d | 11 | 4 | B | P | + | + | M | + | B. inf. Pn. IV. | Pn. IV. B. inf. | 0 | |||||||||
| 494 | W | 2m | 11 | 3 | L | + | h | + | E | St. h. B. inf. | St. h. B. inf. | St. h. | ||||||||||
| 498 | W | 1y | 6 | 1? | L | + | N | St. v. | St. v. Staph. aur. Staph. alb. | St. v. | ||||||||||||
| 499 | W | 5m | 36 | 5 | B | P | M | E | + | St. h. B. inf. | 0 | St. h. | ||||||||||
| 504 | W | 3m | 6 | 3 | L | M | + | E | St. h. B. inf. Staph. | St. h. | St. h. | |||||||||||
| 506 | W | 8m | 7+ | 2? | B | + | Pn. IV. B. inf. Staph. aur. M. cat. | Pn. IV. Staph. aur. | Pn. IV. | |||||||||||||
In successive columns the table gives the autopsy number, race, and length of military service. These factors have had an important influence upon the incidence of influenza and pneumonia and have been discussed in a preliminary report.[[79]] The duration of illness (4th column of table), counted from the date of onset of symptoms of influenza or in some instances, when the earliest symptoms were those of pneumonia, from onset of pneumonia, can usually be determined accurately. The duration of pneumonia (5th column of table) is much more uncertain, because its determination dates from the first recognition of the physical signs of pneumonia.
Clinical Diagnosis.—The clinical diagnosis recorded upon the clinical history of the patient is given in column 6. Many clinicians have been impressed with the difficulty of determining during life the type of pneumonia associated with influenza. The occurrence of purulent bronchitis, the frequent coexistence of lobar and bronchopneumonia and an atypical onset often make the recognition of lobar pneumonia more difficult than usual. The diffuse consolidation of confluent lobular pneumonia increases the difficulty of recognizing bronchopneumonia. In the table (column 6) lobar pneumonia is indicated by L., bronchopneumonia by B. Among 227 autopsies the clinical diagnosis agreed with the condition found at autopsy in 109 instances (48 per cent); in 35 instances (15.4 per cent) both lobar and bronchopneumonia were found at autopsy and a diagnosis of one or other was made during life. In 83 instances (36.6 per cent) the diagnosis made during life was incorrect. Cases admitted to the base hospital at Camp Pike were as carefully studied as the conditions in a base hospital during an epidemic permitted and diagnosis of pneumonia was doubtless as accurate as in other base hospitals. Statistics from military and other hospitals based upon clinical diagnosis of the pneumonias of influenza are probably subject to an error of at least 1 in 3 cases, and conclusions based upon them are almost valueless.