INFLUENZA 



1497 



From craw-craw (in the restricted sense of the word) by the absence of the 

 horny consistency, and by the smaller size of the vaccinal papules. 



From lichen convex by being non-follicular and by being an acute and not a 

 chronic eruption. 



From an ordinary generalized vaccinia by the main lesion being a papule 

 and by the usually small size of the vesicles . 



Prognosis. — This is invariably good, as all our cases and apparently most 

 of Crocker's cases recovered very quickly without any scarring or pigmentation. 

 Crocker has pointed out that it may go on to vesiculo-pustular formation, and 

 in some of these cases fresh crops may continue to appear for months, or the 

 vesicles may enlarge and become herpetiform or bullous; but it is possible 

 that these exceptional forms are due to secondary infections and not solely 

 to the lymph. 



Treatment. — The essential treatment is rest and quiet. On quinine by 

 the mouth and an antiseptic ointment — i.e., carbolic ointment — for the skin, 

 rapid recovery takes place. 



Prophylaxis. — There is no explanation why eleven out of sixty persons vac- 

 cinated by the same lymph and belonging to the same African tribes, living under 

 similar conditions, and about the same age and of the same sex, should develop 

 an eruption while others did not. Therefore it is not possible to suggest ar^y 

 prophylactic measures. 



INFLUENZA. 



Remarks. — An acute specific fever, until recently believed to be caused by 

 Hcsmophilia influenza (Pfeiffer, 1892) (usual term: Bacillus influenzcB), spread 

 from man to man aerially, and typically characterized by a sudden and 

 severe onset, pains in various parts of the body, some catarrh of the respira- 

 tory passages, which typically subside in some two or three days and are 

 apt to be followed by a prolonged convalescence. Recent researches by 

 Charles Nicolle and Charles Lebailly tend to show that the malady may 

 be due to a filter-passing virus. Bradford, Bashford, and Wilson state 

 that the virus isolated in cases of influenza consists of minute Gram-positive, 

 roundish, coccus-like bodies, varying from 0*15 fji to 0-5 /x, capable of passing 



ParofDis. 





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FiG. 632. — Temperature Chart of Influenza. 



through Berkefeld N and V filters. It is an anaerobe, and is not destroyed 

 by heating to 56'' C. for thirty minutes. They have isolated this organism 

 from the blood and sputum of a number of cases. 



It is not our intent to discuss the aetiology or to enter upon a full description 

 of influenza, which can be found in any textbook on medicine, but rather to 

 attempt to impress upon the tropical practitioner the necessity of recognizing 

 this complaint, which is very apt to be mistaken for pappataci and dengue 

 fever, and vice versa. 



Typical Attack. — Suddenly, without warning, the victim feels very ill; he 

 may shiver, feel sick, or be giddy, but in any case he feels acute pains in various 

 parts of the body, but especially in the lumbar region, behind the eyeballs, and 



