Table IV includes specimens obtained at the Magee Hospital from patients diagnosed as pneumonia. The results among these young students were very similar to those of the previous chart, where all ages were included. However, casts and red blood cells were more regularly noted.
From the four tables, we are able to note one or two common facts. In acute uncomplicated influenza albuminuria occurred 57 times in 447 specimens, or 13 per cent., at the Magee Hospital. Here we dealt entirely with the young adult. At the Mercy Hospital 88 positive results of albumin in 344 specimens, or 26 per cent., from patients of all types were recorded. The common total would be 781 specimens examined, and 141, or 17 per cent., showing albumin.
With the advent of pneumonia the incidence of albuminuria was increased. At the Magee Hospital it was seen 49 times in 70 examinations, or 70 per cent.; while at the Mercy Hospital 106 positive results were found in 133 specimens examined, a percentage of 79. The combined figures, therefore, would show 155 out of 203, or 76 per cent.
The incidence of albuminuria for the epidemic in all its phases would be, from our figures, 400 in 994 specimens, or 40 per cent.
Red blood cells were present in 5 per cent. of the influenza cases, and in 11 per cent. of the pneumonias. This was always a microscopic observation, save in the case of a slightly smoky urine. Even microscopically the red cells were not numerous. We noted them at times quite early in the disease in some of the severe cases which presented epistaxis and hematemesis. Possibly one might consider the early presence of red blood cells in the urine as a condition analogous to those just mentioned, although we never saw anything suggesting free hemorrhage from the kidney. It is probably better to regard the red cells as a manifestation of an acute nephrosis of toxic origin.
Casts were found in 35 per cent. of the cases showing albuminuria. We are inclined to feel that this observation is somewhat low, but at the same time we have noted that in uncomplicated influenza one frequently sees albumin without casts. We were also impressed with the fact that casts were not as prominent a feature in the influenzal pneumonias as they are in frank lobar pneumonia of essentially pneumococcic origin.