GRIPPE OR INFLUENZA
SINCE the earlier editions of this book were written the worst epidemic of influenza within modern times has visited all parts of the civilised world. and seems to demand some notice in a treatise on colds, especially as we are not yet by any means rid of the disease, and may at any time find ourselves face to face with a fresh outbreak.
In order to distinguish it from the “Influenza Colds,” which we have always with us, the malady is sometimes called “Siberian” or “Russian” influenza, since the epidemics have always begun in the northern part of the Russian Empire. Corresponding to its chilly origin one of the features of the disease is to cause an intense chilliness, alternating with fever, and to leave the patient excessively sensitive to cold for a very long time after. Many persons who have never before required or even tolerated woolen clothing next the skin have been compelled to adopt it after undergoing an attack. In this respect it is like the malarial fevers, and some have on this account given it the name “malarial catarrh.”
But it is clearly distinguished from true malaria by its infectious character. the poison of ague is obviously of earth and after origin,. and when a person has contracted ague in a malarial district and has an attack of ague, he does not communicate the disease to others. Influenza, whatever may be its origin, certainly does spread from the person to another by direct infection. But here again is a peculiarity : it has fixed period of development, and there is no certainly of its developing at all. Some persons have been struck down within an hour or two after exposure to infection.
Others have gone days,. and have only been affected when they have “caught cold,” the chill having the effect of lowering the vitality, and giving the poison the opportunity of developing. The explains how it is the elaborate precautions for avoiding infection have not been of much use. In the height of an epidemic the infection is probably every where. Every person has the germs in him, but it requires some exciting cause to rouse them into activity. When a person becomes infected with small-pox, for instance, within a fortnight the disease will appear. It requires no additional impetus to start it into life; and so it is with all the eruptive fevers. But with influenza it is very different.
The poison may be dormant for an indefinite time,. and may show itself after the person has been exposed to a chill, a wetting, an overstrain of any kind, or an accident.
The forms which influenza may take are protean. there is no one symptom that is common to all, or even to the majority of cases. Some people think it necessary for there to be rise or temperature; that unless there is fever it cannot be influenza. I have seen many cases of unmistakable influenza in which the temperature has been all the time subnormal.
The classical type of influenza is marked by severe pains and soreness all over, especially in the back and head, and frequently setting in quite suddenly. Repeated chills are followed by high fever, with increase of the pains. The eyes are bleary, the intellect dulled, and a sleepy, heavy nasal catarrh, which persists long after the acute symptoms have passed off. The tongue is foul; appetite lost. The throat is generally inflamed, and with al there is great prostration and mental depression. the pulse is as often slow as frequent, and does not correspond to the temperature. The attack may last from one to several days. This is the classical type, but the departures from it are innumerable.
It may attack the chest, the heart, the bowels, or the brain. To describe them all would require a treatise on almost all the disease that exist, for there is hardly any disease that influenza will not take the form of.
In fact, one of he great predisposing factors to an attack of influenza is a constitutional weakness of some kind. Gout is one of its favourite bases. Influenza very readily combines with gout, and aggravates every gouty manifestation a patient may have had before, whether it be a skin affection, joint pains, catarrh, or any other of the innumerable expressions of the gouty diathesis.
One attack of the disease has no effect in protecting against a second, and, on the contrary, it seems rather to predispose to it. Relapses are very frequent. In many cases it seems as if recovery was never quite complete, the poison being always in the system, and ready to be excited to activity by any lowering cause. These cases require the most persistent and patient constitutional treatment to restore them to Health. And the same may be said of the consequences which influenza leaves behind in the shape of neuralgias, sciatic, nervous breakdown (or “neurasthenia” as it is now the fashion to call it), mental depression, and heart weakness and irritability, of which every practitioner has seen so much since the epidemic appeared.
In these case it is often impossible to succeed, unless the patient can be persuaded to submit to period of absolute rest. The general is, that as soon as they gather an amount of strength-feeling better-patients want to spend it. If they do, they soon drop down into the lowest depths again.