INFLUENZA IN PARIS

Dominion, Volume 12, Issue 89, 9 January 1919, Page 6

INFLUENZA IN PARIS

A FAMOUS PHYSICIAN'S VIEWS. Sir,—The following article, contributed to "Le Matin" of October 26, by the famous Paris physipian, Dr.- Ox, may still have some interest for us:— ..',,. "I am sorry to say the worst of this j epidemic is not'yet-past. It continues to' j be more'than ever a burning reality, as ■ the cold season into which we are now ( entering provides a new spring-board for j tho malady. Talking of it will not do | much good unless words are translated . into deeds. In this- resect much re- f mains to be done in the nmtter ot edu- ] eating the public; for it cannot be-.too f oft repeated that the strictest hygiene ] and personal precautions aic the best , preventive measures, ami no ■ atlininistra- ( tive action can take their place. , "I have/often asked myself whether it j is not a very great mistake to bundle so ( many of our cases oil to hospital, and ( whether by much the greater number ot j those who were evacuated .could not have ( beeiii much l)etter treated in their- own -, homes. Why, then, have so many cases £ been token out of their homes f. In the E first place'our civilian doctors are com- ( pletely overpowered, and betimes they . have a tendency-only too natural—to wnd tlieir excess of patients to hospital. There is also a large number of the patients themselves who ask to be sent to hospital through B belief in the magical £

powers of the administration. Agunst this double tendency it appears to mo there is great need for reaction; and for the following reasons:— "1. Just as nieiLslcs, which is easily dealt with in the honie whilst the ■ mortality from this disease is very , much higher in the hospitals owing to secondary infections; so also, influenza, in its simple form, comparatively benign, becomes particularly grave when complications supervene. The broncho-pneumonia that many pa--tients .contracted in the hospital itself, through promiscuous mixing with other patients, might easily .' have been avoided had they been nursed in their own homes. "2. Add to this the'danger of a chill to patients taken from warm beds during their transit to hospitnls, and the frequent shuttling to and fro from institute to institute, owing to the congestion in our hospitals. "Consequently it would appear that wherever possible patients should keep their beds and be treated in their homes. By these means the attack has every chance of being much less severe. As regards the danger to other members ot the family, contamination generally already taken place, and consequently removal'of the patient to the -hospital'-19 no safeguard. Besides, it is quite possible Vq avoid contagion—provided the precautions we hnvo so frequently indicated bo observed—by having only one person to look after the patient, and if it is impossible to provide a separate room for the patient, then by surrounding the bed with a screen. '■: "I have discussed this subject with -jr. Mesureur,. chairman of the Charitable Aid Board of Paris, and this is what lie"nays: Tor the very reasons you have given I fully share your views. If people would only'restrain the exaggerated tendency to bundle every case of influenza off to some hospital ■ it would be a great tU'nl' better both for those who could be nursed in their own -homes and for the others, and also our hospitals would be less terribly congested: To give you some idea of that congestion I will simply state.that on the 22nd of this month: (October) we had 2700 adults and 800 children, a total of 3500, all suffering from the disease. In addition to that there were 3MO ,of our hospital occupied by sick and convalescent soldiers, makins in all nen.rly 7030.beds occupied by patients in excess of our ordinary sick. To ease this state of affairs we have within the last few days furnished 1000 new beds, and over and above that the military authorities have restored to civilian use some 1100 beds requisitioned for their cases,- making in all 2100 nracticnlly new beds to meet the crush. But this congestion may recur, and to avoid grave consequences it must be emphasised to the public that all possible cases should be cared for at home. Of course we shall continue to receive, as is our bounden duty, any patients that may be sent to us.' ".'I may add,' said M.' Mcsureur, 'that no special treatment ho? been prescribed by the hospital authorities, each practising physician l>eing given an absolutely free hand; in fact, as regards all questions such as tlio precautionary steps to be taken by the hospital- siafF, etc., is concerned, I have given tho. ..Medical Board an absolute dictatorship, practically putting the hospitals entirely under the board's'orders. , ■ ' ' "31. Mesureur did not'hide the fact that, despite -what has .been said putside, the epidemic shows no signs' yet of subsiding. The pfross average of death* from hillucn'zn. in all t\\e Hospitals during the- past 'w>k lias been over one hundred a day. Here is a curious fact: Of nil these afinclrwl by Vflie. disease/ the mortality is '50 per cent, less amongst children than omong adults.. Of tV cusps treated in the hospitals the percentage of child rlonth is 10 per cent, less than adult. When you consider that in normal times the'average'doily' deaths in all the Paris hospitals is fifty, you will see that at present influenza is responsible fora" increase of 210 ner rpiit. in our total death-rate. ' As the present fissures nre just on a par with ,Hi» minimum of the great enidemic ,o/ IRWMS9O. let us -hope thar Hie leth.-l curve will soon have reached its cul■m'".itin? npint.' ■ _ ■ ' ' . "I cannot'finish without m""tioninir the warm enconiiims of prai.*» V. Afepnreur the personnel of the .Paris' lio«nita.!s—more than 25 per cent, of thoir total number wns smitten, down, nevertheless rj>» diminished '*t"ff « ,; 'l '"ore. than douTilp the amount of their _ normal ivnrV : without' ii "mvrrrrnr'.■ "Tt >s'.' al*o jmtif.ving to know thit the Munieinnl roiinnil line r nc olved to irrant n i"njn« to n" tlio=" who. have been tendin™ tho vintitna of the plnirue." ,' *. In the vipivs of IV. Of for lmlv. I'Vntinn ithave no- ''esire to raise n coi-.' troversv—rVrimi'<ntioiiK iare iiq"' ; l v a.l,'wavs vain—but T nny V nennil-t-pil ; to mnV«i inst ono rpinnrV: The very obvious lmv=o *pwr\ ij Dr. ("WVtwn renins rn■i'l«? us to flistjn.itiiisli a good.'deal ill the restrospect.—l an>. »*».. ,T. HUTCHESON.