EPIDEMIC ON TRANSPORT.

Poverty Bay Herald, Volume XLV, Issue 14712, 18 September 1918, Page 4

EPIDEMIC ON TRANSPORT.

SIX OF THE.O^2W SUCCUMB

(Per Press Association.) v *"" . .^•DUNEi'DlN'.ithis day. In. addition. to the deaths ,-on the.troopship aiuiiouijcedibv the Defence authoi'ities, six of <tliej;«hip s crew succumljedj; to tliio malady ,'i'tlie* reported names bjeing,: C. Tenndait, ,'foija^Ji engineer, of Tiftiaru; D. Fishery assiitant carpentea-, Wellington; D. Caimioliael, A.8., Dunedin; ;P £ r. J. Xnglis, . trimmer, Victoria; ■> Heijip; Phillips, i sliip's baker, Christclnu-oh ; aiid J. Hayden, trimmer, Liverpool. ?

-'* mI i*^ l pe * I * r^ ss Association.) • : -'- f-iiP $ WELLINGTON, Vast nightA A | reporter i who t inquired: 4as to ; the precautions/ taken «• before a ■' transport usedl fo'r?i reinforcements ' was ;\ assured that every* care^was i taken , #> see > that th*e.'. slup Av:as j thoroughly clean. '. /The Director-General of < Medical Services .. (Surgeon-General Henderson), stated tliat "he inspected, the vgss^bl, and. 1 noted! ..any J stioictural? altei'atioiisior refitting* required in^the interest of 'the troops. There' was j a ? thorough cleaning, of <the' ship ..so> y that? tboj.ri^wj. troops might" inciu*> no ;. danger of ani'egtion. ■ ■' v James Allen has received the following report from the Director-General of Medical Services here on ,tue epidemic,, amongst the 40th Reinforcements. Diuring the period of their training here there was very little . sickness amongst the 40tk Reinforcements, only one infectious case of scarlet fever having occurred amongst them. ,' At- the first' two ports of call, we had .reports from tlhe ship, and up till- then the health was good 1 . From this it is obvious that no infection was carried from New Zealand, since as five weeks Jiad elapsed from the departure to the port , of call any outbreak would have had full time for development. Nor can there be anything inherent m -the sanitary condition of tlie ship, otherwise the effects would have been apparent before reaching the port of call. The earliest death occurred nearly iihree "weeks after leaving that port of call.

In view' of.' the., seriousness of the influenza epidemics which haß carried off ai "number of our 1 Neat Zealand boys, a medical friend sends ms the following article received from a. f riend of his m England avlio is a liigh authority on the subject : — ' ;

First, a word to leaders who know all about influenza, who ihave had. it "heaps of times," and refuse to recognise their familial* enemy m this sudden paralysing plague which hit's one while he is boasting his immunity,, knocks over men and women m the factories and children m the schools, and brings a stupor and ache and vomiting such as the inveterate Victim of the disease never experienced before: You have had influenza of &> kind ; , and colds which Avere diignified with a name to Avhich they Avere a?ot entitled, you have suffered mildly around the fringes of a great reality, , had symptoms produced by attenuated specimens of the influenza t baccilus or even gentler germs, and you' never knew th© power of tho microbe m its pristine virulence!- Tlie Russian influenza lias been but a. name to you. Even doctors •have almost forgotten — the younger ones maybe never , knew — Avhat . influenza could do. And now come® the awakening.' Noav you are to know it for (what medical text-books haye — unheeded — called- it' these many years) "a pandemic, disease . . . oruvracterised by. extraordinary rapidity of extension arid the large number of people attacked ... 1 protean .. . highly contageous .. m. dependent of all seasons and meteorological conditions." And you who have known only ai variety of influenza, tlie respiratory type,, are to know that there are at least three other types — tlie simple febrile,, the ncutrotac, and, often iv evidence m Uho present epidemic, the gastrb-intestinal. SYMPTOMS. The disease- doe 3 not spread 1 more rapidly than is possible by distribution from person to person. There is nothing mysterious or uncanny m that aspect of it. But whore other epidemic diseases, onoc . the germs have gained entrance, into .tlie body, take from oije to three weeks,, to hatch, out -or /incubate, influenza, takes only a matter of a day or so — maybe only a few hours. Sir J. W. Moore, of Dublin, has noted an instance Arhere "a lady visited; a friend ill of influenza at 2 p.m. Three hours later she Avas attacked." And a doctor iii Wales was himself ill with the disease an hour after seeing "his first influenza patient" m an epidemic' As eachpatient is soon breathing and sneezing and ooughingj andi expectorating baccilS innumerable into tlie atmosphere, there is little mystery (when these are vigorous and virulent) about whence the infection comes.

A rigor or shivering fit is the first indication of . influenza. Then comes feyerishness, intolerable headache, stupidity, depression of the mind and weak, ness- of the body, aches m the back and limbs, '..burning .throat, bad taste m the mouth, and a breath ofi' a peculair and unpleasant,, but , most characteristic, odour. There may be sneezing, hoarseness, cough, and pain on taking a deep or sudden breatib. There may be intense nausea, with or without vomiting, and aches m the stomach and abdomen generally, and diarrhoea. There may be neuralgia and numbness of various kinds', also rheumatic signs and symptoms. According to which of these groups of symptoms — indicating an attack directed 1 •especially upon the respiratory organs, or on the digestive apparatus, or on the brain, and nerves — is most m evidence tile type of influenza present may be reaognised. In the epidemic now upon us many cases have oeen of the gastro-intestinal type (a comparatively rare experience .which may account for the hesitation m vome quarters about plaiing a'iabel upon the epidemic), but m all great 'outbreaks 'of the acute' form of the disuse every type can be found ; and probably m all, also, the majority .of cases •exhibit symptoms of a respiratory or catarral order. That means that such cases need orticujar . care if gross damage to broncluaj. tubes and lung, tissue, bronchitis and pneumonia, are to L»e avoided. The leas 6 recklessness during the attack or a too speedy return to work may have the gravest consequences. Most of the fatalities m influenza came through such complications as bronchitis and vneuinoni.i cauglit by carelessness, but even if the effect 'of carelessness be only to produce a relapse, mere repetition of all ,the symptoms of influenza, these are usually i more severe and punishing tlian' they were originally. TREATMENT. . , | The best part of treatment is behavior, and unqualified surrender to the disease enables one to come out conqueror m the shortest space ot time with the least amount of damage. - A wise patient goes meekly to bed as soon as his symptoms. notify the fact that he) has,.influenza, and he remains quietly there; until every vestige of -fever and ache and catarrh has disappeared, and until his doctor or his own inclination (not a sensitive sense of duty) urges him to be up and doing. One great essential to kee pwarm all the time, and the more briskly the patient can sweat the better for him. Food should be> fluid, and warm for preference; but if there foe a craving' for cold drinks these may bo taken m sips slowly. Milk and soda water or kali or plain watm.*., or barley water, gruel, thin cornflour, beerjtoa, or the meat extracts — these forrii the best diet during the) early, important days; and for drinks, over and above those named, home-made lemona.de,. limb juice, and Russian tea (with a slice of lemon m place of milk or cream) quench the thirst best. It is important to get the bowel« well opened at the outset and regularly throughout . the course of the disease* And as laxative either a seidlitz powder or syrup of senna or salts, or, for once, a calomel powder will suit. Further medication, until the doctor arrives to take the case m hanu, may. bo (for. adults, remember) one five-grain aspirin /tafeJet every four hours (when the patient must not take kali or'sbda within half • an hour of his tablet) or half a teaspoonful of ammoniated tincture of quinine m water at the same intervals. POINTS TO NOTE. Be careful to observe any cautions tko

doctor "may give about your k heart. ? In any' case, but especially where fever has run high or the symptoms have verged on the rheumatic, your heart may be affected either m the efficiency of its valves (when the damage is likely to be permanent) or the .ability of its muscles (and exercise too early or too severe may mean sudden death or permanent disablement where patience would have won complete recovery). Always influenza means great weakness and debility, extraordinary for the duration of the attack; hencei care must be taken to aid convalescence m every possible way — much rest, suitable food, the lightest work, and a good tonicchange of air, too, if possible. But there is no need for despair about one's weakness or depression — as the poisons of the disease eliminated from the system the accustomed vigor and ability are bound to return. This is a fact. And I state it because (for want of faith m this respect) not a few suicides liave occurred. "A FRIGHTFUL THING." . One of the notable things about pandemic influenza, the type which sweeps far and wide like a plague, is that always among lay folks and professional alike, there exists a doubt for some time as to whether influenza can really hit so hard, so terribly. In the last great outbreak, the Russian influenza of WB9-1890, many scientists regarded the disease as dengue, not influenza. But as each epidemic woars to its close opinion clarities and recognition becomes almost unanimous. Since the isolation of the proper bacillus, too, bacteriologists have been able to settle tha problem beyond question. The Pfeiffer bacillus was present m the Spanish cases of the present outbreak,* and is active m our own.

And the severity of the symptoms, the depth of the succeeding depression, has often been remarked. Towards the end of his life Robert Buchanan took influenza complicated by double pneumonia, and during convalescence h& wrote to a friend that he had never had an illness m which he "was so completely incapable of thought oi any kind. I suppose it was fundamentally influenza, but, if so, Influenza is a frightful thing." Charles Lamb painted the after-apathy m vivid words m a letter to Bernard Barton — "My fingers drag heavily over this paper, and to my thinking it is three-and-twenty furlongs from here to the end of this" demi-sheet — I have not a thing to say . , . my eyes are not iv my head — my brains are gone out to see a .poor relation to Moorfields, and they did not say when they'd come back

again — my skull is a. Grub Street Attic, to let . . . my hand writes, not I, from habit, as chickens run about a little when their heads are off — O for a vigorous fit of gout, colic, toothache —

an earwig m my auditory, a fly m my visual organs — pain, is life — the sharper, the more evidence of life — but this apathy, this death. - ." These symptoms, which to a sensitive individual accustomed to feel and enjoy

and suffer everything m a. superlative degree, are mystifying and menacing (so that, as I hinted, he may feel tempted to a desperate deed because, life. seems suddenly to have become stale and unattractive and terrible), solely from the poisons or to tbxius -manufactured by the bacillus. These poisons seek put nervous tissue? and. work their mischief on it— hence the disproportionate effect of ithe disease, for ! you live by the activity of your brain, and nerves and that which interferes with their fine efficiency alters the whole complexion of existence. CONVALESCENCE. But — the great fact to cling to — once you have overcome 'the 'microbes, passed on beyond tfti© stage of fever and sweating and acute symptoms the final elimination of 'their bequest of poison is 'certain. It may take time, but it is bound to take place. And as thei toxins disappear, the old 1 ability, the dear zest, will come again. That fact is certain. Let it be your guide-post m the difficult ways of the 1 disease. A good doctor, skilled' nursing], sunshine, suitable food, change of air — all these and things like these will 'hasten' the coming freedom, but your own system, wlhach has conquered the germs, does most of the salvage work. Hence every honest mcdi. cal man must feel a- twinge of conscience when ho reads the article: "To the Influenza," which Barrie (then Gavin Ogilvy, and just recovering from the Russian epidemic)) ended with a tribute to his doctor : "He has altered the faces of the various visitors who whispered to each other m my presence, and nodded at me and said; aloud that I would soon be right again, and then said something else on the other side of tii© door. He lias opened my windows and set'tke sparrows si-chirping again, and he has turned on the sunshine. . ." It is grand that patients should be grateful, but (for the sake of dubious souls who suffer agonies of apprehension) let us be frank and confess that, once the corner .has been turned, any man whether lie leans on a. doctor or not, can find his war assuredly to the sunshiVie again. The main necessity is to keep pressing onwards : — ''Keep on lookin' for the bright, bright skies, Keep on hopin' that the sun will rise, Keep on singin' when the whole world ' sighs, And you'll get there m the mornin'." PREVENTION, There are fashions m pvo\e»tion. Sometimes oil of cinnamon is regarded as at specific, and one will be assured . that two drops on sugar taken twice or I thrice -daily will prevent influenza, or. nip it -m- the, bud. Sometimes the cure for the early symptoms is reckoned to be camphor, and from four to six drops of spirits of camphor m a. little water, taken every fifteen minutes for the first hour, and subsequently ono an hour, are suggested as a certain , treatment to arrest the disease, while camphor worn m a muslin bag, or sniffed as spirits from tihe handkerchief, is credited with lessoning the liability to infection. Sometimes prevention"' and cure art judged' to be best attained by oil of eucalyptus sniffed and swallowed like the camphor and oil of cinnamon resjiectively. But at present quinine seems the favoritle; and the easiest way to eniploy it as protection is to buy 3-gi'ain tablets and swallow 'one twice or thrice daily. Regarding the efficiency of quinino hi: tjhis affair of influenza Sir William Broadbent wrote about ten years ago : "In ; a< large public .sdhool quinine was ordered to be Jtaken every . -jnorjiSrig during an epidemic. Some of the boys m the school were homo boarders, and it Mas found that while the boarders at the school took the quinine m the presence of a. maxster every morning, there were scarcely any .oases of- m- 1 fiuenza- among them, although the home j boardei'H suffered nearly as much as be- ,. fore;. In a." large girls' school neav London the same thing avjis ordered!, and the girls and mistresses t6ok their morning- dose, but the servants we're forgotten. The result was that scarcely , any girl or mistress suffered, while the servants were all down with influenza." Tfc is essential to consider all cases aa highly infectious, and treat them as

far y« possible on the lines laid down for tho isolation of other infectious patients. Similarly one should not rashly walk into possibilities of infection. ., — • WARNING. In many quarters alcohol is vaunted as a. cure m incipient cases. My own experience contradicts this view. The notion which links rum, and influenza is "pure nonsense. But, instead of giving my views*, let me quote Sir Jphn Moore, M.D. "A word of warning," lie wrote. "The prescribing of alcoholstimulants m influenza demands - more tKan ordinary circumspection.. \£he mental state m this malady is so excitable, so unstable, so impressionable — m a, word, so neurotic, that the seeds of intemperance may be sown T>y following the unthinking advice to take wine or spirits as a stay m weakness. My conviction is that alcoholic stimulants are, generally, not only unnecessary, but positively harmful m the treatment of influenza."