56 INFLUENZA. 



comes more tense and defined, ultimately terminating in sup- 

 puration in the submaxillary or parotid gland and surround- 

 ing tissue. This condition, when it does occur, is usually pre- 

 ceded by return of the pyrexial symptoms, as elevation of tem- 

 perature and capricious appetite. 



One manifestation of this catarrhal type of influenza — occa- 

 sionally prevalent in certain seasons and in particular localities 

 — has been, during late years, so distinctly marked and pos- 

 sessed of leading features so striking, notably the colour of the 

 conjunctival membrane, that it has by many been regarded 

 and spoken of as a distinct and separate affection under the 

 name of iDink-eye, or epizootic cellulitis. This, however, is 

 probably better regarded as merely a modification of the 

 simplest form of the fever we are now examining, than as an 

 affection differing essentially from it. 



In this particular manifestation of influenza the force of the 

 poison seems directed to, and expended upon, those organs 

 and tissues, chiefly external, of the fibrous or fibro-serous 

 order ; while where fatal results occur, the structural changes, 

 when any are visible, are principally in connection with in- 

 ternal structures of the same fibrous or fibro-serous character. 

 Here the constitutional disturbance is sometimes a very marked 

 feature : the temperature is elevated, probably 105° F. ; there 

 is a cough, not marked by much involvement of the lower air- 

 passages ; and the pulse is generally possessed of more volume 

 and tonicity than where the mucous membrane of the respira- 

 tory tract is markedly affected. 



The conjunctiva is of a clear pink colour, hence the name 

 pink-eye; and, when looked at carefully, will show in many 

 cases infiltration of the subjacent connective tissue, giving the 

 appearance of conjunctival cedema. 



The invasion of the subcutaneous connective tissue is very 

 attractive in swelling of the limbs of an anasarcous nature and 

 consequent stiftiiess : this swelling and stiffness — the result 

 of infiltration into the cellular tissue, which is largely distri- 

 buted amongst muscles and tendons, and which occurs as the 

 basement structure of the serous membranes of the joints — is 

 not unfrequently critical in its appearance : seeing that where 

 much pain existed in early stages of the disturbance, it is 

 largely mitigated when such swellings are developed : the 



