Renal congestion and inflammation of frequent recurrence in the course of in fluenza; diagnosis greatly facilitated by the use of the centrifuge. These condi tions appear at the same time as those that occur in the course of diphtheria and typhoid fever, and are in each in stance probably due to the toxins of the respective diseases. Microscopically the urine under these circumstances contains a small amount of blood, with hyaline casts strewn with granular matter and epithelial cells, and also granular casts of the thin variety. In the nephritis of scarlatina, on the contrary, the casts are of the wider variety. In the majority of case recovery ensues in from two or three weeks to two or three months. Some, however, pursue a chronic course. A. Jacobi (Med. News, June 8, '95).
Renal lesions are not infrequent fol lowing influenza. Besides transient al buminuria has been observed acute degeneration of the kidney, acute in flammation, both forms of chronic diffuse nephritis, acute limorrhagic nephritis, and persistent albuminuria not belonging to any of these groups. The number of applicants rejected for life-insurance has perceptibly increased since the advent of influenza in epidemic prevalence. G. Baumgarten (Med. News, June 8, '95).
Several cases of albuminuria in pa tients free from renal trouble before in fluenza. So-called healthy albuminuria becomes more serious after influenza, and casts appear in the urine. James Tyson (Univ. Jour., July, '95).
The poison acts very often on kidneys. In the simplest cases of influenza there is sometimes severe inflammation of glom eruli, with slight albuminuria, which lasts for several days, then disappears. In other cases it produces serious ne phritis, which from the start exposes the patients to renal insufficiency and death from urrnia. Lamarque (L'Union Med., Sept. 2S, '95).
A chronic form of influenza must be recognized which consists of two types: (1) a type characterized by permanent fever of a remittent or intermittent char acter. that is prolonged for several months, and followed by (2) a return of the disease for brief periods of time. Chronic influenza may also develop with out the least elevation of temperature. Nil Filatow (Annales de Med. et Chin Infantiles, Apr. 1 and 15. '99).
In influenza rapid dilatation of the heart frequently occurs within a day or two after the onset of the disease, and it sometimes causes fatal syncope. It is certain that the dilatation caused by in fluenza may remain as a permanent dila tation, and may give rise to very seri ous symptoms. Thrombosis is also of
frequent occurrence after influenza: probably due, in part at least, to the en feeblement of the heart. Minor de grees of dilatation may cause merely a feeling of incapacity for exertion. Act ive exertion may do such a patient much harm, and any prolonged strain may he followed by an acute breakdown. D. B. Lees (N. Y. Med. Jour., Jan. 19, 1901).
Series of 139 eases of influenza ob served, 138 in the non-gravid and 21 in the pregnant condition. Of the latter. pregnancy was interrupted in 17 cases, and in 4 continued its course. The 138 non-gravid cases showed in all, with the exception of 3, alterations in the gener ative functions—partly by menorrhagia, partly by metrorrhagia, partly by ex acerbations of already-existing sexual pains. Ilniorrhagie form of endome tritis set in which led, in the pregnant state, to abortion or interruption of the pregnancy. Muller (Minch. med. Woch., Oct. 8, '95).
Of the four clinical forms—the purely febrile, the nervous, the catarrhal, and the gastric—women suffer most from the first two. Symptoms connected with the genital organs are very common, and menorrhagia and intermenstrual dis charge are frequent. Pre-existent dis eases, such as endometritis, congestive or infectious, show exacerbations.
In a school, chlorotie and ancemic girls in whom menstruation was irregular, the flow became and continued regular after an attack of influenza.
Pregnancy and labor were commonly gravely affected, and many abortions and premature labors occurred during the several epidemics. Labor-pains were weak and specially painful, and the con finement was prolonged. Gabriel v. Engel (Wiener med. Press; Nos. 43, 44, '96).
Attention called to the fact that, dur ing the 1890 influenza epidemic, the number of births in Hungary was 41, 866 less than during previous years, and during the following three years; during September and October alone in 1890, there were 19,768 less children born than in the same months of other years. Engel (Centralb. f. No. 24, '97).
When influenza attacks a Woman about to be confined, the labor fre quently proves a very tedious one, with considerable uterine inertia. Excessively bloody mid offensive lochia at times con tinue for weeks beyond the normal dura tion, induced, very likely, by a diminu tion of the normal postpartum involu tion of the uterus. Ameiss (Amer. Jour. of Obstet., Apr., '99).