Review of the Literature on Respiratory Diseases From January, 1920, to June, 1921

Abstract

NEW YORK CITY PNEUMONIA Pathogenesis.\p=m-\The studies on experimental pneumonia of Cecil and Blake63 comprise an unusually important series of articles. These articles deserve a very careful reading as does also a single article by Cecil64 which gives a short and excellent exposition of the bacteriology and mode of infection of pneumonia. These investigators concluded that while the pneumococcus is the specific cause of lobar pneumonia, it is unable to initiate an infection of the normal mucous membranes of the upper respiratory tract, or to produce pneumonia following intravenous injection, but it must gain access to the lower respiratory tract by way of the trachea in order to cause pneumonia. Lobar pneumonia is therefore bronchiogenic in origin, the invasion of the bloodstream by pneumococci in this disease being secondary to the invasion of the lungs. The pneumococcus primarily invades the lung tissue at some point or points near the root of the lobe, and thence spreads throughout the lobe by way of the perivascular, peribronchial and septal tissues, and the lymphatic system. The alveolar structure