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THE INFLUENZA.

THAT this country, in common with nearly or quite all others of the civilized world, is now passing through an epidemic of influenza, is beyond reasonable doubt.

Although the most common name is the one above given, synonyms are not lacking. "La Grippe" is the present popular term, from the Polish grypka, or perhaps from gripper, to seize. It has been called Modefieber, or the fashionable fever: Schapshustensheep cough: Blitzkatarrh-lightning cough. The Russians call it, Chinese disease; the French allude to it as Italian or Spanish disease, the name identifying it with the country from whence it was derived. Sydenham and Boerhave designated it as peri-pneumonia notha; Huxham as peri-pneumonia catarrhalis; Stoll as pleuritis humida. The Italians called it influenza, from its being influenced by the stars; in old English writings it was designated as pose, from the Anglo-Saxon gepose, heaviness; the Germans, ziep, probably from zreppen, to pipe or chirp. The epidemic on this continent which occurred during President Tyler's administration, was popularly known as "the Tyler grip."

The authentic history of influenza dates back to 1239; though there is no reason to doubt its having occurred much earlier than that. We find accounts of nearly a hundred epidemics, the principal ones occurring in 1239, 1311, 1323, 1482, 1557, 1675, 1729, 1775, 1790, 1800, 1830, 1847, 1860 and 1870.

The present epidemic seems to have originated in St. Petersburg about the middle of November. It soon spread to Paris and London,

and reached this country about the middle of December. The disease was first recognized in Boston December 19. It was reported at other points several days earlier than that date. Physicians in this city were loathe to acknowledge its presence, but were soon compelled to do sɔ. My first cases occurred on December 19th, in the eastern part of the city, a husband and wife being both seized with the disease within an hour or two. I did not at the time admit that the cases were of influenza, but subsequent events showed that they were.

There is no other disease which spreads as rapidly as does influenza, and this makes its etiology difficult to explain. It effects whole communities at once. In the epidemic of 1833, Watson says all London was smitten with the disease in two days. On one of these days a vessel named the "Stag" arrived off the coast at two in the afternoon with all on board well. The breeze was blowing from the land. In half an hour forty men were down with influenza, and the number increased to one hundred and twenty during the next twenty-four hours. Another curious thing about influenza is its breaking out at different points at about the same time. An instance of this kind is related by Fagge. In 1782, Kempenfelt's squadron sailed from Spithead on May 2 to cruise in the English Channel. On the twenty-ninth of the month, there having been no communication with the shore, the influenza attacked the crew of one of the ships and soon spread to the other vessels, disabling so many of the men that the fleet was obliged to return to port. Lord Howe had sailed with another fleet in the meantime for the Dutch coast. Toward the end of the month of May influenza appeared on several of his vessels, although there had been no communication with the land.

The chief symptoms are usually chills, or chilly sensations, great prostration, severe headache and backache, rather high fever, and pains in the muscles and bones. In addition there may be tenderness of the fauces, hoarseness-frequently accompanied by an harassing cough,-shortness of breath, perverted taste, disordered stomach, and coryza of more than ordinary severity. Occasionally the danger is much increased by the onset of an acute bronchitis, and even pneumonia. The fever comes on suddenly, and often reaches 104 or 105° or even 106°, on the first day. The febrile condition rarely continues more than forty-eight hours, when it sub

sides or it may terminate in an attack of diarrhea, profuse sweating or diuresis.

Three forms of invasion are pretty generally recognized, although most cases present more or less admixture.

Ist. The Nervous Form. In this, headache and general neuralgic pains are most prominent. The headache may be so severe as to lead to a hasty diagnosis of commencing meningitis, or typhoid fever.

2d. The Form Characterized by Catarrh of the Respiratory Mucous Membrane.-Bronchial catarrh, snuffles, and conjunctivitis, are marked, with fever and prostration, while bronchitis and pneumonia are not infrequent.

3d. The Gastric Form, with Catarrh of the Digestive Tract.— This sets in with frequent vomiting, which may last from one to two days, when it gradually subsides, or it may terminate in a profuse diarrhea.

Convalescence may occur quickly, though this is rare. Ordinarily the patient will feel far from well for a week or ten days after he is able to be up, and some cases are still more prolonged, even without apparent complications.

Except that young children and the very aged quite generally escape, the disease is no respector of persons or place, or time or season, or station or occupation. It may attack one member or all of the household. While most are attacked but once, second, and even third, attacks are not very infrequent.

The prognosis is generally good, except in weakly persons and those at the extremes of life. Pneumonia is the great cause of death in these cases.

The treatment that has usually been adopted is essentially symptomatic. Quinine has been used by those who regarded the affection as in some sense malarial in character, though most observers have claimed that its administration was rather hurtful and retarded convalescence. Antipyrine, phenacetine, antifebrine, exalgine, etc., have been in large demand. Some have reported excellent results from the use of salicylic acid, aud salicylate of soda. Salol has had its advocates. The older physicians have some of them relied on aconite and Dover's powder. But no matter what their treatment, all have been able to report many cases and "excellent results."

But though the epidemic, as we write, has essentially disappeared, its victims are most of them still far from well. There is still great muscular weakness, and a sense of nervous exhaustion, of depression of spirits, that will undoubtedly manifest itself as a factor in our mortality reports for weeks to come.

THE original imported Hoff's Malt Extract, Tarrant's, is the only Malt that ever received an award of merit in Germany. It received the Bronze Medal at the Hamburg Exhibition last year, and was awarded the first order of merit (a Silver Medal) at Melbourne, Australia.

To prevent substitution, specify "Tarrant's" when prescribing Hoff's Malt.

ARRANGEMENTS have been completed to hold a Tri-State Sanitary Convention at Wheeling, W. Va., February 27th and 28th, 1890. Representatives will be present with papers and addresses from Pennsylvania, West Virginia, and Ohio.

The object of the convention is to consider the question of floods, and their results, from a sanitary standpoint, and the best methods of managing a given community after such a calamity.

Every person interested, directly or indirectly, in this important subject is earnestly requested to be present and assist in discussing the papers, and add whatever information he can to the solution of these practical and most important questions, affecting, as they do, the health and lives of thousands of citizens of these three great commonwealths, annually.

Reduced rates have been secured from the Central Traffic Asso

ciation.

"

WE would modestly suggest, for the benefit of specialism fanatics, that if they would recommend their uncured and disappointed patients to go at once and consult a general practitioner, they would frequently confer a blessing on suffering humanity. We have known instances of this kind which resulted in an entire cure, which utterly failed in the hands of the specialist. Try it! "It's a poor rule that will not work both ways."

New Concord, Ohio.

I. W. CHISHOLM, M. D.

19

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