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Influenza (Epidemic Catarrh—The Grip).— This is an affection similar in its general char acters to the disease described as catarrh (p. 214) or common cold-in-the-head. Indeed, to cold-in-the-head, when accompanied by sharp fever, pains in the bones, and sickness, the name influenza is often applied. The true influenza is, however, remarkably infectious, which common catarrh never is. In fact, in fluenza is one of the most remarkable of epi demic diseases, capable of running through a whole community with marvellous rapidity. Thus one epidemic of it, in 1782, spread over all Europe, missing no country of it, affecting more than half of the people, and killing many. Many epidemics of it have occurred since then. The infection is due to an organism conveyed by the air, which flourishes in the blood of the patient and is abundant in the spit.

Its symptoms begin with fever, pain in the head and eyeballs, a feeling of general soreness, and severe pain in the back and limbs. Its attack is very sudden, and is accompanied by great depression of spirits, general weakness, and frequently great weakness of the heart. There is usually some soreness of throat, which is un duly red, but not greatly swollen, and the eyes are red and tender. The tongue may be at first quite clean, but the sickness and vomiting of ordinary catarrh are usually absent. The chief features are the sudden onset, high fever, great prostration and intense headache, and pain in back and limbs. Complications are common, specially if the patient has not at once been confined to bed. The usual complication is catarrh of the air-passages, with cough and pain in the chest, or pneumonia, or catarrh of the bowels, or the complication may be of a nervous type with a tendency to neuralgic pains, delirium or stupor. A number of blebs occur on the lips very often. In about three or seven days the attack passes off; usually with free sweating, leaving the patient extremely weak and afflicted with troublesome cough. It is usually from such complications that death occurs.

The influenza! poison has a special tendency to attack the heart and leave a degree of heart weakness. One attack seems to make a person rather more than less liable to a second.

Treatment.--The patient must be kept in bed in a room kept at a moderate and regular warmth. Nourishing but easily digested food should be given frequently, and nothing is better than a tumblerful of hot milk and a breakfast cup of hot clear soup given alternately every two hours, that is each is given every four hours. To the milk, if prostration is

great, a dessert-spoonful of whisky may be added. Sips of plain or aerated water may be given for thirst. If the hot milk is disliked, or stomach symptoms are present, the milk may be given cold or iced, but only in sips.

The patient usually demands relief for the aching head and back. This will infallibly be relieved by 10 grains antipyrin with 10 drops of laudanum and 1 grain citrate of caffein, if given early. The author usually gives a second similar dose one hour after the first, and a third four hours after the second. A fourth dose in 24 hours and a fifth 6 hors later will usually be sufficient; but only to an adult. To a child 2 grains antipyrin in 15 drops liquor acetate of ammonia and a dessert-spoonful of water, repeated every three hours for four doses.

For several days after the fever and pain have disappeared, the patient should be kept in bed, getting small quantities of nourishing food frequently, till full diet is restored. A tonic quinine and iron helps the restoration to health and strength.

Whooping-Cough.—This is specially a dis ease of children, though grown-up people may also be affected with it. Girls suffer more than boys. It is extremely common in children, standing next to scarlet fever as a cause of death. The greatest number of cases occurs in children under eight years of age, and it is more fatal in spring and autumn than at other seasons of the year. It is the most fatal of all diseases to children under one year of age, and three-fourths of all the deaths from it are of children under two years, while only six per cent of the deaths occur above five years. It is, therefore, a disease from which children under five years of age should be most carefully guarded. It is an infectious disease, the cause of the disease being given off in the breath of the person suffering from it, and being capable of conveyance by the air and by clothes also. It is specially infectious in the early period of the attack. One attack almost perfectly pro tects against another. Now taking these two facts together—the terribly fatal character of the disease among young children, and its extremely infectious nature,—how great should be the care taken by mothers and nurses to prevent its spread and to protect their children from it I Yet it is the commonest thing pos sible to find mothers carrying children affected by it in public conveyances; and very insuffi cient pains are taken, when it appears in a household, to separate the affected child from the others.

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