Albumosuria and peptonuria were frequently observed (Dochmann, Hofmeister, Meixner, Alison), which is not surprising considering the frequency of purulent inflammations in the lung, bronchi, and pleura. Indican in the urine was often observed by Senator and Gautrelet. The Ehrlich diazo reaction was never found by Goldschmidt and Baumler, but frequently by Senator and Gutmann, sometimes as marked as in enteric fever.

Simple hemorrhage from the bladder (Swiss report) and also simple hemorrhage from the kidney were observed by Leyden, Frantzel, Bernhard, Eichhorst, Krannhals, Engel-Bey, and others.

The present specializing age has produced an extensive literature on the influence of influenza upon the female sexual organs. The principal points can be easily rendered in a few words, and agree entirely with the reports of observers of the earlier epidemics, from the fifteenth to the eighteenth century.

The following facts have been established: The influenza attack very often gives rise to a premature menstrual period, and occasionally causes its recurrence after it has normally ceased a few days previously. The menses are often unusually profuse, and may sometimes increase to true menorrhagia. In some women who have already passed the climacteric there occasionally occurs, as I can confirm, renewed unexpected hemorrhages from the uterus as a result of influenza (Pip ingskold).

Of more importance is the well known fact, mentioned in older works on influenza,* namely, that influenza often leads to abortion. This undoubtedly occurs much more frequently as a result of hemorrhages into the membranes than, as has been supposed, of any oxytocic influence of the influenza toxins.

Abortion, judging from the reports, occurs equally frequently at all periods of pregnancy; it occurs most often in severe attacks of influenza, particularly in those complicated by diffuse capillary bronchitis, dyspnea, cyanosis, spasmodic attacks of cough, and especially in those complicated by pleuropneumonia. Abortion occurring during influenza pneumonia makes the prognosis considerably more grave. The hemorrhages occurring from abortion are sometimes of an alarming degree.

The experience of some large lying in institutions, that, in spite of the extensive infection of influenza, no premature births occurred, does not in any way overthrow the fact, established in the history of influenza from the earliest epidemics to the present day, that influenza very frequently causes premature births. This appears also, as we have shown above (p. 568), from the marked decrease in the birth rate during the months following the pandemic.

But the assertion, based on very doubtful statistics, that pregnant women are especially predisposed to influenza, lacks all foundation.

As far as the male genital organs are concerned, simple influenzal orchitis is the most frequently mentioned (Dind and Roux in Lausanne, C. Barnes, Jozefowicz, Fiessinger, Scheller, Zampetti). Kottmann reports a case terminating in suppuration, and Biingner a similar case terminating in gangrene of the scrotum. Walker describes a case of "suppurative periorchitis with gangrene of the testicle." Cases of "gangrene of the penis" are reported by Johannsen and by Devrient.

The English influenza epidemics, 1732-1733 and 1737-1738, were characterized by a frequency of complication with "inflammations of the testicle and parotid," which makes one think that the influenza epidemic was accompanied by a concurrent epidemic of parotitis with frequent secondary infections. In the English epidemic of 1580 the frequency of parotitis is also mentioned. (Compare p. 671.)