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
In some of these there was a disturbance of carbohydrate metabolism, as
shown by an occasional glycosuria and an increase in the blood sugar, or
by a possible disturbance of the suprarenals, as brought out by the
administration of adrenalin hypodermatically (Goetsch test). In the
application of this test in post-influenzal patients it appeared that
the whole endocrin system was in a state of imbalance.
It appears to us not at all improbable that the so-called psychoneuroses
of which fatigue, nervousness, irritability and tachycardia play such an
important part might also be explained in the same way. These constitute
a group of sequelæ which were frequently recognized after previous
epidemics, and which are again coming to the foreground.
We are of the opinion, on account of the apparent absence of any
specific pathology of the gastro-intestinal tract and its appendages
during the attack of influenza, that the sequelæ referred to the
digestive system are largely due to exacerbations of previous
physiological disturbances or pathological processes. The patient with a
previous peptic ulcer has a recurrence of his ulcer. The patient with an
infection of the biliary tract has an acute exacerbation, or may have an
attack of biliary colic. In fact, there seem to have been many more
cases of this kind since the epidemic than before, and most of the
patients date the time of the onset from a period soon after recovering
from influenza.
Very few, if any, patients in our experience have exhibited sequelæ due
to disease of the cardio-vascular or genito-urinary systems. It may be
that these will appear later when the more remote effects of an acute
infection are recorded.
A very commonplace sequel, but of more or less interest, is the tendency
to furunculosis. Our attention was particularly called to the associated
hyperglycæmia. The blood sugar readings varied from 0.2 to 0.41. There
was no glycosuria, acetone or diacetic acid. We have no explanation to
offer for this, although one might dilate readily on many attractive
theories. The hyperglycæmia, one may add, was readily reduced by a
lowered carbohydrate intake, which also had a curative action on the
furunculosis.
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