Twenty-one cases of influenza observed in a maternity clinic during pregnancy and labor. One case ended in abortion. In 10 instances the labor came on during an attack of influenza, and in 5 of these at the beginning of the ninth month. The uterus is likely to be quickly ex hausted and it must be stimulated. Puerperal lnmnorrhage was common. G. Moller (Dent. med. Woch., July 19, 1900).
Influenza in ehildbed generally ap- • pears in a mild form about the third or fourth day after presumable infection, but occasionally later,—up to the ninth day. Its course may be marked by slight, moderate, or high fever, and each type, especially in ehildbed, is prone to two or more relapses. The frequency of the pulse corresponds with the height of the temperature, yet does not become extreme save in cases of serions pul monary affection. When there are no marked local symptoms it may, es pecially in mild cases, be mistaken for puerperal fever, the comparative slow ness of the pulse and the occurrence of a relapse may be of service in the dif ferential diagnosis; foetid lochia, sub involution, and tenderness on pressure. are commonly met with in influenza, and therefore are not important in this respect. If no culture research can be made, information as to the existence of a prevailing epidemic or pandemic is often indispensable for correct diagno sis. Stolz (Mounts. f. Geb. u. Gyn., Bd. xiii, II. 6, 1901).
One of the most constant and impor tant influences accompanying epidemics of influenza is a marked impairment of vitality or vital resistance, as shown in continued loss of strength and endur One writer states that, in 27 cases of the disease occurring in pregnant women under his observation, abortion or mis carriage took place in 17.
anee, mental despondency, and increased attacks of bronchitis, pneumonia, and tuberculosis, not only during its active prevalence, but for many months there after.
Influenza is responsible for none of the cases of true psychoses, inasmuch as in 104 cases only 21 were found in which neither hereditary tendencies nor alco holism nor neurotic temperament was absent. Jolly (Deutsche med. Woch., Mar., '91).
Neuritis of the optic nerve due to is grippe is of relatively rare occurrence; it may affect one or both eyes, and may produce partial transient impairment of vision, partial permanent impairment of vision, or absolute permanent blindness.
Failure of vision begins from three to fourteen days after the commencement of the attack of la grippe, and proceeds rather rapidly. It is always preceded by intense frontal or circumorbital cephal algia. Treatment has but little effect to promote a cure. If recovery follows, it takes place spontaneously and accom panies improvement in the patient's general condition. Weeks (N. Y. Med. Jour., Aug. 8, '91).
Fifty-four cases of insanity following influenza. About one-fourth may be classed among the cases of febrile de lirium. They begin as acute hallucina tory confusion, contemporaneous with the fever, and disappear several weeks after the latter has subsided. The post febrile cases may be divided into three classes. 1. Asthenic psychoses with hal lucinations and delusions, sometimes ex altative, at others depressive. 2. Melan cholias, from simple neurasthenic or hypochondriac disturbance to profound stuporose conditions. 3. The manias. The prognosis is good. Kirn (Allgemeine Zeitsch. f. Psy. u. Psy.-gerichtliche Med., B. 48, '92).
From the study of twenty-seven re ported cases of papillary and retrobulbar neuritis, following influenza, the follow ing conclusions are drawn: 1. The virus of influenza may attack the optic nerve in its papillary or in its retrobulbar por tion. 2. The ocular lesions of influenza may be divided into those produced by infection from the exterior and those caused by metastasis. 3. The papillitis, due to influenza, appears in from three to fourteen days after the commence ment of the disease. 4. Retrobulbar neu ritis is more common than papillitis or neuroretinitis. It differs from the neu ritis due to alcohol, tobacco, or lead, in that it presents an acute or a subacute form, marked by a rapid and progressive diminution of vision. Prognosis should be guarded, improvement being slow, sometimes, though exceptionally, being complete. During the acute stage leeches to the temples, absolute rest, in jections of pilocarpine, quinine, and salic ylates internally should be employed. In the later stages iodide of potassium, the continuous current, injections of strychnine into the temples, and mer cury are indicated. Antonelli (Hemel' d'Ophtal., June, '92).