In the district prison at Freiburg: Of 406 prisoners, 35 per cent. were stricken ; of those in solitary confinement, 30 per cent.; of those in the common wards, 50 per cent.; of those in communication with the outer world, 70 per cent. The restriction of the outbreak to different corridors shows that it was not due to a miasmatic influence. Kim (Aerztliche Mittheil. ans Baden, Karlsruhe, vol. xliv, No. 7, '90).
Influenza is a paresis, or partial paraly sis, of the pneumogastric nerve, depend ing- probably on such a sudden change in the atmosphere as involves an increased expenditure of force in maintaining circu lation and respiration. The best remedies are strong excitomotor stimulants, chief among them strychnine, caffeine, alcohol, and ammonia. Morris (Jour. Amer. Med. Assoc., Jan. 3, '91).
Operation on the nose should not be performed during an epidemic of influ enza, as operations usually cause a re lapse, with marked depression. The wound invites infection. Delavan (N. Y. Med. Jour., June S, '95).
There can be no influenza without Pfeiffer's bacillus. De Renzi (La Clin. Mod., Dec., '95).
The influenza bacillus is capable of giv ing rise to fibrous, serous, or even hmmor rhagic, exudate in the lungs, which may become purulent. When the sinuses com municating with the nose are inflamed it is nearly always a result of infection with the influenza bacillus. Lindenthal (Wien. klin. Woch., Apr. 15, '97).
The influenza bacillus, 0.5-1 x3 microns, reacts peculiarly to staining agents, the poles being deeply stained, with an un stained equator, thus causing a close re semblance to a diplococens. It is readily stained with dilute carbol-fuchsin, or L6ifier's blue solution. It is difficult of cultivation, but there can be no diffi culty in detecting it on cover-slips of the catarrhal secretion. Eugene Wasdin (Penna. Med. Jour., Nov., '97).
Relative rarity of cases in which the influenza bacillus can now be demon strated as compared to earlier epidemics. The diagnosis cannot be made to depend on the sputum examination, though the Pfeiffer bacillus should be carefully looked for. In the latest Freiburg epi demic the type of disease observed was chiefly pneumonic, the pure toxic, the gastrointestinal, nervous, being absent. Clemens (Mtinchener med. Woeh., No. 27, 1900).
In the influenza cases with pneumonia observed in 1899 the influenza bacilli were found in very scanty numbers, and soon disappeared. Nevertheless severe
toxic symptoms followed, the heart, muscles, and lungs being involved. In such cases partial immunity from pre vious infection probably exists. The germs develop, but break down rapidly.
Their toxic substances are thus set free, with dangerous results. Wasser mann (Dent. med. Woeh., No. 28, 1900).
The bacillus of Pfeiffer found in 12.6 per cent. of the cases examined. The seasonal incidence of the disease shown, the majority of cases falling between the end of November and the end of April. Clemens (Miinchener med. 1Voch., July 3, 1900).
The following conditions tend to in crease the prevalence of influenza: (1) abnormal increase in the barometric pressure and in the absolute range be tween the highest and lowest pressures for the epidemic months; (2) sudden frequent and extreme alterations of ab normally high and low temperature ranges; (3) comparatively lower rela tive humidity during the prevalence of sharply epidemic influenza; (4) dimin ished precipitation, but short periods of unusual fogginess alternating with periods of dryness; (5) marked prev alence of strong northerly winds, fre quently alternating with very calm weather; (6) predominance of rela tively clear and sunshiny days during exacerbations of influenza) attack (these attacking periods having invariably been preceded by sudden thaws and rela tively warm, damp. murky weather).
H. S. Anders (Medical News, Nov. 9, 1901).
Infection with influenza bacilli is prevalent apart from an epidemic of in fluenza. Influenza bacilli have been found in the sputa of fifty of one hun dred unselected cases with cough. In about one-half of these sixty cases the influenza bacilli were in practically pure culture. There is nothing distinctive in the clinical manifestations of influenza apart from epidemics, and the diagnosis can with certainty be made only by the examination of the sputum for influenza bacilli. The duration of the cough and expectoration after an attack of acute influenza does not usually exceed six weeks, but in some cases the duration is for months or years. Many of the cases formerly classed as chronic bronchitis are chronic influenza. Cases of chronic influenza with paroxysmal dyspncea may closely resemble asthma. Chronic in fluenza is not infrequently mistaken for pulmonary tuberculosis. F. T. Lord (Boston Med. and Surd. Jour., Dec. 18, 1902).