Physical examination shows evidences of bilateral bronchitis in the medium sized tubes, in the moist stage. At times there are evidences of bronchitis of the larger tubes. The larynx is not implicated in the majority of cases; when the trachea can be seen it is not uncommon to find its mucous membrane injected. With these symptoms there is present an abnormality in body-tem perature. It may be as low as 90° F. in the morning, and an evening tempera ture of from 99° to 100° F. or more (registered under the tongue or in the rectum). The pulse may be abnormally slow, normal, or rapid. The length of the attack varies. With proper treat ment, begun at the proper time, the average duration commonly will not ex ceed two weeks. F. Forchheimer (Med. News, June I, 1901).
Abductor laryngeal paralysis fre quently presents great difficulty as re gards determining the etiology; but a number of cases have been observed in which a paralysis of one cord, lasting sometimes for years, was undoubtedly due to a post-influenzal neuritis. St. Clair Thomson (Brit. Med. Jour., Sept. 29, 1901).
Prognosis.—The mortality from un complicated cases of influenza is very small, probably not exceeding 0.25 of 1 per cent. While this is true, it is equally true that during the prevalence of an influenza epidemic the mortality from tuberculosis, pneumonia, bronchitis, and typhoid fever is greatly increased.
[Of 528 deaths attributed to influenza, 46 resulted from the uncomplicated dis ease, 39 from senility, 49 from phthisis, 273 from croupous and broncho-pneu monia, 81 from other affections of the lungs, 5 from pleurisy, and 2 from em pyema. Thirty-three deaths were noted from cerebral affections in the course of influenza. AXEL LTLBIK, Corr. Ed., An nual, '91.] During the three months—January, February, and March, 1890—constitut ing the period of active prevalence of the epidemic for that year the number of deaths reported to the Register of Vital Statistics of Chicago, from the four dis eases just named, were nearly 100 per cent. greater than during the correspond ing months of the preceding year. The effect in diminishing the normal vita] re sistance is longer manifest in regard to typhoid fever and tuberculosis than in any other general diseases. One attack affords no immunity to subsequent at tacks of the influenza, and there are no known prophylactic measures of value.
The influenza bacillus, like the strepto coccus. the diplococcus. and a few other pathogenic bacteria, is of such a nature that immunity cannot be attained.
Delius and Rolle (Zeit. f. Hyg. u. Infect., Apr. 13, '07).
The rate of relapse in influenza is not less than 10 per cent. A previous attack rather predisposes than immunizes, and, if protection be afforded, it is so short as to be clinically negligible. Turney (Lan cet, Feb. 5, '9S).
Prevention of influenza possible by the constant daily use of a 1 in 200 to 1 in 300 carbolic solution as a mouth-and-nose wash. From a teaspoonful to a table spoonful, according to the sensitiveness of the mucous membrane, in a large tumbler of water, as hot as can be borne, should be used for repeated gargling, rinsing out of the mouth, and sniffling up the nose. Laborde (Bull. de FAcad. de Med., Feb. 27, 1900).
Treatment. — The discovery of the bacillus by Pfeiffer as the supposed spe cific cause of influenza has not been fol lowed by the discovery of a special rem edy, either for its destruction or for reliably counteracting its effects upon the human system. Consequently we must be guided in our choice of reme dies by the prominent functional dis turbances presented in each case. These are generally diminished eliminations from the skin and kidneys; congestion of the mucous membranes, especially of the nasal and respiratory passages; and severe pains and soreness throughout the nervous and muscular structures of the body. To allay the pains and soreness and restore more active eliminations from the skin, kidneys, and intestines are the rational indications to guide us in the choice of remedies. If called in the early stage of the disease, in all the milder cases a single powder—contain ing from 15 to S grains of Dover's pow der, 3 grains of calomel, and 3 grains of pulverized gum-camphor--given at bed time and followed in the morning by a saline laxative sufficient to produce two or three intestinal evacuations has very generally relieved all the more important symptoms; and by giving 3 grains of quinine sulphate three times a day for three or four days the convalescence has been complete.
At the outset of an epidemic every member of his battalion given grains of sulphate of quinine daily, and ma noeuvres in the open air forbidden. This was continued for twelve days. While the epidemic spread in the immediate vicinity of the barracks, few of the sol diers were affected. Similar good re sults, however, were not had when the disease already existed. Then antipyrine rendered the greatest service. Tranjen (Berl. klin. Woch., Feb. 17, '90).