In measles there is a longer prodromal period, the reaches its height in three to four days, the presence of Koplik's spots, the severe conjunctivitis, the sneezing, etc., all speak against influenza.. Typhoid is recognized by the enlarged spleen, roseola, and diazo and Widal reactions. The possibility of miliary tuberculosis may come in ques tion for a few days.
The pathology of influenza has nothing distinctive. There may be the characteristic appearance of pulmonary complications with small areas of consolidation which, deeply congested or lnemorrhagic, arc about the yellow stained bronchi and separated by rather firm round cell infiltration of the connective tissue. Abscess and necrosis of the lung are not uncommon.
There are no distinctive changes in the spleen, heart, liver and kidneys except that the influenza bacillus can be cultivated from them. The other changes such as inflammation of the gastric mucous membrane are purely symptomatic.
The prophylaxis depends upon avoidance of cold and exposure and removal from a locality or school where influenza is epidemic. Children at such times should be kept away from crowds, meetings, and public conveyances.
The treatment is in a great measure purely symptomatic. The
management of complications such as pneumonia, otitis, meningitis, etc., is described in detail in other chapters.
The child must be kept in bed. The diet should be generous, not a starvation diet, but one rich in carbohydrates, poor in proteids and pref erably fluid at first. Nursing infants should not be taken away from the breast. Older children take with benefit copious amounts of water, lemonade, fruit juices, etc. Hydrotherapy is of great advantage espe cially in young children. Cold packs with lukewarm baths and rubbing are helpful. Heubner advises placing the child in a warm bath and pour ing cold water on the chest to overcome the intense stupor in some cases. Cold baths should be employed to reduce the fever.
There are no specific drugs in influenza. The salicylate of quinine in small closes is of benefit. Aspirin and the benzoate of soda are useful in older children. The benzoate of soda is both antiseptic and antipy retic and has no unfavorable after-effects. Inhalation of the tincture of benzoin is very soothing to the inflamed mucous membrane. For the bronchitis and diarrhoea small doses of tinetura opii benzoica are useful. Antineuralgic drugs may be employed to ease the earache.