In mild cases the patient usually quickly recovers his health and strength,. but in those of greater severity, though the general febrile symptoms disappear at the end of the first week, the inflam mation of the mucous membrane of the air-passages continues, perpetuating copious muco-purulent discharges from the nostrils, with some cough and expec toration, and the patient remains debili tated several weeks or even months.
In influenza of childhood there is a period of depression with some nasal catarrh, and slight dry cough preceding the onset of the fever. It may last eight or ten days. The onset of the pyrexia is marked by shivering, the voice becomes hoarse, deglutition is sometimes painful, the nasal catarrh increases, and there is some dyspncea. Constipation is the rule, and in many cases there is severe head ache, though, in infants, this may be replaced by convulsions. Furst (Scalpel, No. 16, '97).
Seven eases of influenza in adults, dis tinguished by extremely-copious sweats and a marked tendency to the formation of adipose tissue. The cases commenced with bronchial disturbances; some were accompanied by distressing cardiac pal pitations, all with constipation, lack of appetite, and scantiness of urine. The sweats continued for months and left a neurasthenic condition, which in some cases persisted for years. The sweats and bronchial disturbances alternated, one diminishing as the other increased, and vice versa. Marquie (Jour. de Mod. de Bordeaux, Apr. 16. '96).
Epidemic of influenza, affecting 70 per cent. of the inhabitants of a rural district in Italy containing 2000 inhabitants in which, prior to the epidemic, only 2 or 3 cases of pneumonia were observed. Nineteen out of 3G cases of pneumonia braved fatal; in these the hremorrhagic tendency was marked. Epistaxis was observed in many eases. Menorrharria was common even in virgins; some pa tients previously suffering from amenor Theca sought treatment for menorrhagia. V. Grossnle (Gaz. d. Osp. e Belle No. 27, 1900).
In severe cases, when at the climax of the active stage, the inflammation often extends through the bronchial tubes to the air-cells and connective tissues of the lungs, thereby developing all the symp toms of bronchopneumonia as a compli cation of the original disease.
The relation of influenza to pneumonia is that of a predisposing factor only. Prudden (lied. Record, Feb. 15, '90).
The course of pneumonia complicating influenza is seldom that of the typical disease; it rarely sets in with a decided rigor, and the inflammatory symptoms, notably the pain in the side, are but little marked. The local processes arc not characteristic. Local signs are not detectable before the third or fourth day.
Crepitation will be heard over a consider able area, soon disappearing and becom ing evident at another. Not often does the process reach hepatization with defi nite dullness. Typical rusty sputum seldom observed. Crises are rare. The course of inflammation is milder, dysp tuen and rapid infiltration being want ing. Leyden (Berliner klin. Woch., No. 10, '90).
Malignancy found characteristic of the pneumonia complicating influenza, seven of fourteen cases terminating fatally. Sokolowski (Inter. knit. Ruud., Apr. 13, '90).
Pneumonia of influenza considered as a bronchopneumonia. It presents the following distinctive features: 1. Evi dence of a preceding influenza is generally present. 2. Percussion-dull ness may be absent or only present for a short time, shifting its position; bron chial breathing may be the only physical sign; moist sounds are most constantly present. 3. The sputum is never typic ally rusty. 4. The fever usually sets in without shivering, and the temperature rises gradually. 5. The course is less acute, the infiltration disappears slowly, and convalescence is retarded. Albu (Deutsche med. Woch., Feb. 15, '94).
Three cases of influenza-pnemnonia which progressed to gangrene. Rhyner (Minch. med. Woch., Nos. 9, 10, '95).
Case of influenza-pneumonia followed by unmistakable signs of abscess of the lung, in which Pfeiffer's bacillus was the only organism found in the sputum. Hitzig (Munch. med. Woch., No. 35, '93).
Peculiarities of broncho-pneumonias of influenza in children: (1) slight eleva tions of temperature seem to point to pa ralysis of thermogenic centres; (2) early tendency to bronchoplegia and pulmo nary collapse due to depression of vital powers; (3) extraordinary slowness of course of disease. Ferreira (Revue Men. des Mal. de l'Enfance, Mar., '95).