Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
From the last great epidemic or pandemic of influenza, that of 1889 and
1890, have come clinical descriptions which should be reviewed before
speaking of the clinical manifestations which have characterized the
present epidemic as shown in the two groups studied.
One of the best descriptions of that epidemic was given by Dr. O.
Leichtenstern in Nothnagel’s Encyclopedia of Practical Medicine. This
contribution, among many others, describing the epidemic of 1889 and
1890 is one of the first to refer to the Pfeiffer bacillus as being
etiologically associated with the disease. It differs, therefore,
greatly from descriptions of previous epidemics. Leichtenstern says:
“The typical influenza consists of a sudden pyrexia of from one to
several days duration, commencing with a rigor, and accompanied by
severe headache, generally frontal, with the pains in the back and
limbs, by prostration quite out of proportion to other symptoms and
marked loss of appetite.” He continues by saying that to these
characteristic symptoms may be added the catarrhal phenomena arising
from the affection of the respiratory tract, particularly the upper
(coryza) and “occasionally” the lower, the trachea and bronchi. This
description is so in accord with the symptoms of uncomplicated influenza
as found in the present epidemic that very little need be added. Any
difference which may occur in the description of the disease is likely
to be accounted for by the peculiarity of onset, whether in the upper or
lower respiratory tract, and by the different ways of interpreting
complications which may have arisen. It is evident from this description
that the upper respiratory tract was affected more generally than the
lower in the epidemic of 1889 and 1890. In the present epidemic it can
safely be said that the reverse was the usual state of affairs. It was a
rather unusual occurrence when the affection was limited only to the
nose, pharynx, larynx, trachea and larger bronchi. A very large number,
no doubt, had a peculiar œdema, a so-called “wet lung,” which we shall
discuss later; others went on to a capillary bronchitis or a
bronchiolitis, and a large number had broncho-pneumonia. This sequence
we shall attempt to show in the statistics at hand. In some cases the
lesion in the lower respiratory tract seemed to be primary, there having
been no initial coryza. At least none was observed and no history was
obtained.
_Prodromal Stage and Communicability_
The length of the prodromal stage—the stage from the time of contact to
the earliest onset of symptoms—has always led to interesting
observations and discussion. In this epidemic we have rather definite
information bearing upon this subject.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account