EPIDEMIC INFLUENZA 101 



easy to distinguish it from other indefinite ailments of 

 the upper respiratory tract. In the midst of an epi- 

 demic, however, when many similar cases may be seen, 

 its manifestations are more obvious and uniform. The 

 attack is usually sudden with a chill, or chilly sensations* 

 and fever. Headache, frontal or general, develops, 

 with pains in the back, joints, and extremities. In the 

 severer cases the prostration that accompanies these 

 symptoms forces the patient to bed. The eyes become 

 inflamed and painfully sensitive to light. The face is. 

 flushed; the throat swollen and raw, a thin irritating 

 secretion flows from the nose, and the progress of the 

 infection is denoted by hoarseness and a dry and dis- 

 tressing bronchial cough. Examination of the chest,. 

 however, reveals no certain signs of lung involvement. 

 Other organs are not usually obviously affected. Pulse 

 and respiration are only slightly accelerated. The 

 temperature remains fairly constant, between 101.5 

 and 103 F. for two to four days and, then after a pro- 

 fuse perspiration, it falls rapidly to normal (about 

 98.5 F.) with the beginning of convalescence. 



The duration of uncomplicated influenza is usually 

 one to three days; in the severer cases four to six days. 

 When symptoms persist beyond this period a secondary 

 pneumonia or seme other sequel is to be suspected. 



Peculiar features of the disease are an early drop in 

 the circulating white blood cells, a lowering of the resis- 

 tance of the lungs to secondary infection by common 

 bacteria, resulting in a high incidence of severe and 

 ffctal secondary pneumonias, and the persistence of a 

 profound physical and mental depression during con- 



