INFLUENZA SO-TERMED.

New Zealand Mail, Issue 931, 3 January 1890, Page 15

INFLUENZA SO-TERMED.

That influenza ia epidemic has been abundantly proven by past severe visitations, but vre never beard of such havoc committed by it as is described in our cable messages. Here in the colonies many outbreaks of the complaint have occurred, and our readers are sufficiently familiar with the symptoms. But such results as those now ensuing in the Old World scarcely come within colonial apprehension. However, we find on consulting “ Qnain’s Dictionary of Medicine ” that there is a complaint known as •‘epidemic catarrhal fever, with predominant pulmonary affection,” that is classed with influenza, but it is a very aggravated form of it. It is possible that this is what is affecting Europe and America, or it may be something much worse. The description of the disease by Quain is as follows, and is bad enough iu all conscience : It has already been noticed that some amount of soreness of the throat, and uneasiness or pain in the chest, with cough and expectoration and slight bronchitic signs, are observed in the cases of the epidemic -which might be considered as assuming the simple form. Not unfrequently, however, the symptoms of affection of the aerial mucous membrane are more marked, there being decided quinsy, laryngeal symptoms, croup, bronchitis, or pneumonia. Of these, however, the most frequent and important are the bronchitic and pneumonic complications. The bronchitis has especially the tendency to assume the acute capillary form. Iu case of acute capillary bronchitis occurring as a complication of influenza, there is usually in the early stage increased frequency and some difficulty of breathing, coustrictioa of the chest, and soreness or stiffness of the throat. The cough, though slight, is troublesome from its frequency. The expectoration, if there be any, is scanty and of a glairy character. The tongue is usually red at tho tip and edges, and covered at the dorsum with a creamy mucous, or with a whitybrown fur • occasionally it is morbidly red throughout. The pulse is accelerated, beating generally 110 to 112, or 116 in the minute,; and occasionally more. The skin is not usually hot, except it be at the commencement of the attack, and if so, it usually becomes cooler in two or three days. With these symptoms there are the marked prostration of strength, the severe frontal headache, the general soreness of the body, and the pain in the back and limbs, which characterise the ordinary casus of influenza.

When the cheat is examined in this stage of the disease the only morbid signs detected are a roughness of the inspiratory sound, particularly when a forced inspiration is drawn ; some slight crepitation audible, more particularly toward the lower part of each dorsal region ; feebleness of the vesicular murmur, and perhaps slight sibilant rhonchus in front. The respiration is, however, quicker and shorter than natural, averaging 2S, 32, or 40 in the minute ; the dyspnoea is greater than is explained by the obvious physical signs, and most generally there is some lividity of the face. In the second stage all these symptoms are much aggravated. The respiratory acts are performed quickly and imperfectly, the respirations to the minute varying from 30 to 40 or 50. The cheek are much flushed, and the lips of a somewhat purple colour. Generally there is not acute pain in the chest, but rather a sense of constriction and soreness ; the cough, though frequent and occurring in paroxysms, is not usually severe. The expectoration still continues scanty, and. consists of small yellowishwhite pellet*, forming tenacious masses of a peculiar nodulated or botryoiaal form, very much resembling, when floating in water, fragments of some of the large oolitic limestones. The tongue is mostly covered with a thick whity-brown fur, and somewhat dry and often red at the tip and edges, or morbidly red and glazed. The pulse is much accelerated, beating 120, 130, or 140 times in the minute, but it is generally small and very compressible. In some instances, after being low and feeble at the onset of the disease, it acquires a more sthenic character in the second stage. The skin is rarely dry or much above the natural temperature, and the bands and feet are . generally cool. The skin of the extremities | is also much congested, so that when blanched by pressure the colour does not readily return. The prostration of strength also becomes greater, and there is much headache, and often transient delirium, especially during the night. On percussion, the ohest does not present any marked alteration of resonance, unless there exists some other diseases of the lung, and on auscultation, crepitation of a more or less fine character is audible with the inspiration, first in the inferior part of one or both dorsal regions, then spreading rapidly higher up in the back, and toward the bases of the lungs in front, whilst sibilant rhonchus ia heard in other parts of the chest.

The third part of the disease is marked by the dyspnoea becoming so severe that the patients are compelled to sit constantly upright in bed, or to lean forward, resting on their arms and elbows, whilst at intervals the respiration bscomes very laborious. The lividity of the cheeks, lips, and hands is increased ; the eyes become prominent; and the expression of countenance is extremely anxious. The cough is frequent, and of a short abortive character, giving the impression of viscid secretion in the lung, which the patient has not power to expectorate ; whilst it is aggravated by paroxysms, which cause pain in the head, and increased lividity. The sputum now becomes large in quantity; it is of a greenish-yellow colour, very viscid, contains little air, and is occasionally streaked with blood. The respirations are very frequent, 50 to 60, or even more ; and expiration is very laboured and prolonged. The pulse is very feeble, and either extremely quick—l4o, 150, or 160 in the minute —or intermittent, so as to number only 100 or 120 beats. The tongue is covered with a thick yellowish-white or brown fur, and is generally dry ; sordes also form upon the teeth. The general surface of the body becomes cool and bathed in prespiration ; and the hands and feet de-

cidedly cold. The delirium is more constant ; with the decaying strength the cough declines j the expectoration ceases or becomes slight ; and the patient sinks.