The best protective against the disease is a state of vigorous health. The respiratory or gans particularly should be kept in the best pos sible health and that is secured by plenty of outdoor air, especially in the sunlight. People who are run down in health should avoid com ing in contact with patients affected by the dis ease, though apparently the presence of tuber culosis in the lungs, in spite of its consumptive effect, helps to protect against rather than pre dispose to the disease, for tuberculosis patients do not suffer much from influenza. The mouth and nose should be kept clean, but rough cleans ing or the use of strong antiseptics will prob ably do more harm than good. The cells of the mucous membrane of the mouth and nose may be rendered less capable of resisting invasion. The use of chemical protectives and the car rying of camphor and other odoriferous mate rials with the thought that they protect against the disease is without confirmation in experi ence. The treatment of the disease is that of fevers in general but with an abundance of fresh air. During the epidemic of the '90's the coal-tar products, antipyrin, acetanilid and other similar materials were used in large quantities because they reduced the fever and made the patient more comfortable by their anodyne ef fects. They have a tendency to favor the de struction of red blood corpuscles and as the dis ease has a similar tendency, the combined re sult was often serious for the patient. They probably did much more harm than good. The pains in the bones at the beginning of influenza represent the effect of the disease on the blood forming marrow of the flat bones and the con sequent blood deterioration predisposes to heart and other complications, hence the necessity for rest, once the fever declares itself, which should be continued until the extreme feeling of pros tration often associated with the disease is re lieved. The individual must be helped by gen
eral supporting treatment until the tissues are able to throw off the disease. Without com plications the fever usually comes down on the fourth or fifth day, hut the patient often has to stay in bed for nearly a week longer. When pneumonia occurs it is lobular, attacking the lobules and not the lobes of the lungs and ends by lysis, that is, by gradual absorption of the effusion, and not by crisis as in ordinary pneu monia. Supporting treatment is extremely im portant. The bowels must he kept regular so as not to interfere with movements of the dia phragm, and above all, the patient's mind must be set at rest as far as possible. Discourage ment is a serious element for the prognosis and patients must not be told of the death of rela tives or friends. Alcohol has been used with reported benefit, but the only good effect it may have is by lessening the dread of the af fection which in some people's minds amounts to a serious pathological factor.
After previous epidemics of influenza, the disease has always become endemic, that is, sporadic cases of it have occurred years after ward, sometimes almost in epidemic form. This will almost surely happen at this time also, so that respiratory affections, especially in the changeable seasons of the year, will take on a special influenza) character. The particular strain of the bacillus whose evolution has been fostered by war conditions will gradually lose virulence, but continue with us for some time.
James J. WALSH, M.D.