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Published pathologic and/or bacteriologic findings from the 1918–1919 influenza pandemic. Although the cause of influenza was disputed in 1918, there was almost universal agreement among experts [e.g., 20, 27–33] that deaths were virtually never caused by the unidentified etiologic agent itself, but resulted directly from severe secondary pneumonia caused by well-known bacterial “pneumopathogens”; that colonized the upper respiratory tract (predominantly pneumococci, streptococci, and staphylococci). Without this secondary bacterial pneumonia, experts generally believed that most patients would have recovered [20]. In type, pattern, and case-fatality rate, influenza-associated bacterial pneumonia was typical of pneumonia that was endemic during periods when influenza was not prevalent [25, 28, 33, 34]. As described above, in cases for which a single lung pathogen was recovered from culture, the anatomical-pathological type of the pneumonia usually corresponded to what was expected. Bacteria were commonly observed in cases of pneumonia caused by each of these pathogens. Such findings reflect the characteristic pathology of bacterial pneumonia [10, 25, 27].