Washington sentinel., 1898-03-05
HAS INFLUENZA BECOME ENDEMIC TO
THIS CoUNTRYf
London Lancet.

That is a question which is forced on
the mind by the seasonal exacerbation
OF the disease which has really never left
us since the land was swept by the great
psndemic waves Of 1880 ga. Ever since
those memorable years when the char
acters Of this remarkable affection and
its pr0tean sequelR were made familiar
to hosts of victims and TO the lard
worked members of our profession it
cannot be said that influenza has been
wholly absent. To be sure during the
summer months cases are few and far
between, but almost invariably with the
approach Of winter they multiply in
number and serve to swell the death rate.
Nor is it possible to afforc. satisfactory
explanation OF this recrudescence of an
Infective disorder that seems to obey no
law, but 10 arise with a capriciousness
that defies generalization. Does it recur
because ofceTtain favorable conditions
OF soil or atmospheric II so, why does
it prevail in times aud places in which
these conditions are so diverse1 The
mild yet comparatively dry season
through which we have been passing
this winter has been characterized by
recurrence Oi the disease in certain
localities; yet when we recall the con-
comiiants OF the more widely spread
outbreaks we are unable to connect the
type ofseason with the prevalence Of the
malady. Nor is it easy, in the lack Of
any system OF notification, to determine
to what extent influenza prevails at the
present time. That it does prevail and
that to a considerable extent is apparent
from the death returns and the state
ments OF practitioners in certain dis
tricts where the "green Yule" seems to
have been accompanied by much sick
ness. Yet--except, perhaps, in few
instances OF outbreaks in Institutions
there has been happily nothing ap-
preaching to the epidS mics with which
we we're familiar a few years ago. .
Influenza has its own typical charac-
ters and they still appear with each
Tecrudescence, although from their vari-
ETY. and number they may still pass un-
recognized. The pYrexia and prostra.
tion, anorexia and insomnia, neuralgia
and myalgia, and the sequels on the side
Of the nervous, circulatoTy, respiratory
and digestive apparatus are familiar
enough now, so that their very diversity
makes il all the more difficult to be GER
tain OF their one and only origin. II is
not known why in some outbreaks there
should be greater liability to one form
OF inhammatory complication {, nd IN
other outbr reaks to another, but so it is,
and unless we are to admit multiplicity
OF poisons we can only conjecture that
there must be some subtle variations oil
operation, The most reasonable view
Is that the toxin is one that acts mainly
upon the nervous system and that it may
lessen the resistance to other morbid
influences. Certainly pneumonia follow.
ing Influenza is generally more serious
and more prostrating than pneumonia
not so associated; cardiac depression
and failure are readily referable to dis
ordered nerve action and the CASTRO
intestinal affections that seem to have
been especially prominent OF late may
be mainly induced through nervous dis
turbances. Il might we'll be asked
whether anafiection which is apparently
linked with such varied disorders Of the
economy has not always prevailed, anC
whether we are only now beginning tC
appreciate the presence Of the underly
ing factor in the causation of what are
wont to be regarded as local diseases
II so, then influenza is, and always ha.
been, an endemic disease, but with eacl
succeeding generation it sweeps owe
the world in epidemic form II in tn,
past we have not been alive to the influ
entail factor in etiology we must bewar,
lest IN the present and the future ou
minds are so dominated by the concep
tion OF ITS ubiquity and variety as L
relegate to its sphere conditions tina
relationship with II whatever.