Page:The New International Encyclopædia 1st ed. v. 10.djvu/705

* INFLUENZA. 619 INFLUENZA. in 1889, when the disease overflowed the whole globe. Since that date the country has hardly been free from intlucnza, for the epidemic of lS!t3- 94 must Ijc i:'ved as a reciudescence of the for- mer epidemic, individual cases or small epidemics having been separately observed. The iiandemic of 1889 originated in Cential Asia. P'roni Uok- liara it was traced successively to Siberia, Euro- pean Russia, Sweden, Denmark, France, Ger- many, Uclgium, and England ; Asia Minor, Italy, Turkey, and Greece being attacked simultaneous- ly with Germany and England. Shortly there- after it appeared in Tuni.s, later in ilexico, South America, and Australia. It invaded Boston at the same lime London was attacked, and San I'rancisco contemporaneously with Buenos Ayres. It appears to invade trading centres and railroad towns much earlier than sjKirscly settled districts in the same locality. Human intercourse and especially conunerce appear to be the determin- ing factors in its dis.semination. Caise. The aerobe causing influenza is called Pfeiffer's bacillus. It was discovered in 1891 by Pfeiffer, Kitasato, and Canon, working independ- ently. It is a bacillus occurring singly, in pairs, or chains, or clumps, appearing as a straigiit rod with rounded ends, non-motile, and not forming spores. It is best stained by a weak solution of carbol-fuchsin applied for at least ten minutes. The bacillus grows best on glycerin-agar smeared with blood, at body temperature. The bacilli are found chiefly in the respiratory passages, mixed with other organisms, in the nasal mucus, or in the sputum from the bronchi, and even penetrat- ing to the submucous stratum of the mucous membrane. Tlicy are occasionally found in the blood in small numbers. They are found in the secretion in grippal middle-ear inflammation, and also in the exudate in cases of grippal menin- gitis. The chief s nptoms of the disease arc due to toxins resident in the bodies of the bacilli or produced by tiiem as excretory matter, and ab- sorbed by the victim from the respiratoiy tract. The bacillus has not Ix?en found in any other dis- ease, but is always present in the secretions of the respiratory tract in true influenza. Experi- mental inoculation of monkeys has caused high fever, followed by death, no definite results being reached. But there is no evidence that any of the lower animals suflfer from influenza under natural conditions. Symptoms. The symptoms of a typical at- tack of influenza are headache with especially severe pain in the orbits and at the base of the occiput : fever, with a temperature of 102° or 103°, generally following an initial chill; great prostration and weakness with mental depression : pain in many of the joints and bones, and tenderness in the muscles : swell- ing of the mucous lining of the nasal pas- sages with increased flow of mucus: cough, with expectoration of small masses of thick, yellow- ish or greenish mucus, accompanied liy tender- ness in the region of the breastbone; rapid and generally weak pulse; buzzing noises in the ears; and slight tremor of the whole body. There is an inflammation of the throat, its mucous lining being congested and the palatal folds swollen and rigid. There may be sudden attacks of vertigo or of sjTicope, or of unconsciousness resembling that due to apoplex'y. In some cases, in the place of severe catarrhal symptoms, an eruption, resem- bling an urticaria, appears on the body. In Vol. X— to. others, the most severe symptoms are referable to the gastro-intestinal tract; the tongue being coaled, the breath foul, the abdomen very tender on pressure, vomiting occurring, and the action of the bowels being irregular. In still other cases the headache, backache, neuralgia (trigeminal, occipital, cervicobrachial or intercostal), my- algia, insomnia, syncope, and vertigo arc the most prominent symptoms. The predominance of sets of symptoms in certain classes of cases has led to the attempt by some phvsicians to divide influenza into respiratory. gastro-int«s- tinal, and nervous forms, of which the last has been fairly adopted. In all cases there is danger of pneumonia (q.v. ). Both pleurx' and lungs are involved with surprising rapidity very early in some cases, with or without bronchial im- plication. The pneumonia is lobular in vari- ety, disseminated in separate areas throughout the lungs, with irregular and atypical invasion. It resolves by lysis and not by crisis, and predictions of its termination are impossible. The grippe- pneumonia is much more fatal than the ordinary lobar pneumonia. The only safe j)lace for a pa- tient with influenza is in bed, during the attack, lest myocaiditis (q.v.) or pneumonia should sud- denly appear, and the patient's life be actually jeopardized, and lest the efTort to continue one's vocation in spite of undermined strength result in a protracted neurasthenia as a sequel to the attack. Tre.tmk.n"T. The treatment of epidemic influ- enza consists in rest in bed, as has been said, as scon as the prostration supervenes, or the tem- per.ature rises above the normal. Among drugs, quinine occupies the front rank. It is of great value in every case, not in large doses and not necessarily proloiigid. Other drugs of value, at difleient stages or in dilVi'icnt types of the dis- order, are antipyrin, plu-nacetin. salipyrin, sal- icylate of .sodium, iodine, digitalis, benzol, car- bolic acid, ipecacuanha, camphor, alcohol, and strvchnine. Several of these remedies being pow- erful and dangerous drugs, they should not be in- discriminately used, or used at all without a pliysician's advice. A weak heart may be crip- pled by the unintelligent use of a depressant or an over-stimulating drug. PROPJIYI.AXI.S. The contagium of the disease is carried by the sputa and the nasal mucus, and pi-ecautionary measures should be employed, where possible, to limit the disease. Grippt pa- tients in hotels, sanitariums, and schools should be isolated. Their t^ible utensils and beil-linen and body-clothes should be disinfected with boil- ing water. Prevention should be secured of the deposition of secretions upon carpets or furni- ture. Gargle, nasal sprays, and mouthwashes prevent infection by clearing out mucus that might form a nidus for the disease in a healthy mouth. Quinine internally is a good prophy- lactic. The bacillus has been found dead after two hours' exposure to sunlight or dry air. in nosal mucus. Infection of another may occur from the moisture in the breath of a patient, who coughs out a spray of fine mucus into the at- mosphere. Reinfection of a convalescing patient frequently occurs. Patients should therefore cough into a moist handkerchief: avoid kissing others; use separate utensils at table; sterilize these and all clothing of body and bed: spit into a cup containing water, this cup to be cleansed frequently ^vith very hot water; or if in a school.