Evening public ledger. [volume] (Philadelphia [Pa.]) 1914-1942, 1918-10-25
Oliver CrOrnWeH Died of the Grip
The Disease Has Become Epidemic Periodically for Several Cen
tuies-Members OF the First Congress Brought 1t
to PhiladeLpha in 1889

ness and fever of from 101 degrees to 104
degrees Fahrenheit The pulse does not
become very rapid and the patient often is
drowsy. Vomiting may occur Sometimes
there may be darrhea, but usually there
is constipation. After the disease has become
established the mucous membranes of the
nose and throat become reddened and there
is sneezing and redness of the conjunctiva.
Involvement of the larynX. causing hoarse-
ness, and of the bronchi. causing cough, are
common There is an associated ieukopenia
or a normal leukocyte count. A leukocytosis
points to some complication. The fever gradu-
ally falls to normal after few days and
more or less prcstration is present during
convalescence. y transient albuminuria is
frequent. Many of the cases have hemor-
rhages of the mucous membranes of the
nose. some of the urethra or bowel.
MoI rlfre'luently lobuar pneumonia de-
~ veiops after "a few days, and This is re-
sponsible for most of the fatalities. The
pneumonia differs from the usual picture of
pneumonia, in that the temperature may he
very slight and the pulse rate may give
little indication of the gravity of the condi-
ton These cases, instead of subsidng may
come down to practically normal tempera-
ture for twelve hours; then there may he "A
sharp rise In temperature, not followed by a
chill. backache, boneache, headache. or nau-
sea.
About this time there may also be expec-
torati9n containing bright red blood. AS a
rule, twelve or twenty-four hours after the
second rise Of temperature OH physical ex-
animation In the lower lung, in a preponder-
ance of cases on the left side, as seen at
Great Lakes, small areas about the size of
a silver dollar of typical pneumonia con-
soiidation are found by auscultation. These
areas may become marked so that by the
second day Of the second rise scattered
through the lung, probably both lungs. ten or
fifteen of these small areas may have ap-
naura In ha amid at Inl.
the patient did well these would gradually
disappear They did not resolve as pneu-
monia would resolve The clearing up Of
the lung after this IN the recovered patients
was remarkable as to its rapidity. Other
cases went on to a typical lobar, massive
consolidation, as far as the physical signs
were concerned with dulness increase in
fremitus, typical tubular voice and breath
ing, and all the signs. except that there was
not very marked increase In the pulse
rate. and the resprations were not up to this
time markedly increased. Cases with al
most complete consolidation of the lung. as
to to- the Lower lobe, ioSes WITH tempsrature oo Of
with resprations "a or .6. There may be
RAPIDLY developing toxemia and vasomotor
depression, with death of the patient result
ing in many cases.
TIME incubation period in these infiuenzas
i is probably very short but 1t is difficult
to obtain accurate figures on this point. The
disease is probably spread entirely by con-
tact infection. the virus of the disease being
disseminated for short distances through
droplels driven into the air In coughing and
sneezlng. Circumstances which favor this
means of spread, such as crowding in cars,
favor the spread of the disease.
The measures to be taken to prevent the
spread of the disease comprise all those
which interfere with the transfer of the in
fectiOus materials from the sick to the un-
infected. This includes isolation of the pa
| tient, and the intelligent use of proper gauge
masks by the attendant In the time of an
| epidemic. prompt and efficient isolation OF
the first cases In company could accom-
plish much. II this has. been neglected and
the infection has spread among the popula-
| tion. measures which prevent the coming to.
| gether of numbers of persons In close quar-.
| ters are to be employed. The desirability oi
| closing schools in large city In the. pres
| 'ence of an epidemic Is a measure of doubtful
| value In. smaller places this Ia more rea.
sonable. and the danger of infection wher
| children are outdoors should be less thar
when they are brought together In a school
room.--Journal Of the American Medical A.
ISOLATION s, N, ~ .<s.ss