370 THE TREATMENT OF DISEASES. 



and taste are completely lost ; nausea and vomiting are not uncommon, and there 

 may be diarrhoea. The skin, at first hot and dry, soon becomes moist, and sometimes 

 exhales a peculiar musty odour. In some epidemics, profuse perspiration has been 

 a prominent symptom. The patient complains also of pains in the limbs and back, 

 and of much soreness and tenderness in various parts of the body. In a simple, 

 uncomplicated case, the disease runs its course in three or four days, and the patient 

 is convalescent before the end . of the week. Cough and much debility are apt to 

 last longer than the other symptoms, and till the patient gets rid of these the 

 complaint is easily renewed. The most frequent complications are bronchitis, 

 inflammation of the lungs, and rheumatism. Respecting the course of the tempera- 

 ture, we know little or nothing : it is a subject for observation in future epidemics. 

 In some cases delirium is a prominent symptom, and is to be regarded as an un- 

 favourable sign. The cough is usually very severe, and has been known to produce 

 rupture, and to give rise to abortion in pregnant women. The cough, at first dry, 

 is soon attended with thick, stringy expectoration, often tinged with blood. 



Influenza cannot be regarded as a very serious disease, although the mortality 

 varies greatly in different epidemics. In 1837 the death-rate was only about two 

 per cent., and this was universally acknowledged to be an unusually severe outbreak. 

 Although the relative number of deaths to those attacked was so small, the absolute 

 mortality was enormous ; and it was calculated that in that year more people died 

 of influenza than died of the cholera which had raged a few years previously. In 

 fact, funerals were for a time so numerous, that the resources of the undertakers 

 were stretched to their utmost. One firm alone had seventy-five bodies waiting for 

 interment, and mourning coaches and black horses could not be procured in sufficient 

 numbers to meet the demand. It will be seen that the danger of influenza to the 

 community is great, whilst to the individual attacked it is comparatively small. 

 Death claims a certain number, but has, so to speak, a very large choice of victims. 

 In cholera it sometimes happens that half the patients die, but then the number 

 attacked is comparatively small. 



True influenza is met with solely as an epidemic attacking large numbers of 

 people, and spreading rapidly over the whole of the globe. If we bear this in mind 

 there will be no danger of our confounding it with those local catarrhal affections 

 that occur in all temperate climates almost annually. One thing is certain with 

 respect to influenza, and that is that it does not arise from exposure to cold, or, as we 

 say, from "catching cold." This has been observed in many epidemics. 



The very young and the very old bear influenza badly, especially the latter. A 

 writer during the prevalence of the epidemic of 1837 says : " The daily newspaper 

 obituaries have been unusually long, and the ages of the persons whose deaths they 

 announce are in almost all cases great." Frequent delirium, convulsions, and 

 fainting are bad symptoms ; whilst as favourable signs may be mentioned copious 

 warm sweats, free expectoration, spontaneous diarrhoaa, and a copious red deposit 

 from the urine. People with pre-existing lung disease often bear influenza very badly. 

 Curiously enough, it seldom attacks those labouring under acute diseases until the 

 period of convalescence arrives, when their immunity apparently ceases, and they 

 become just as liable to its invasion as others. Thus it has often happened that a 



