INFLUENZA AND PNEUMONIA.

Pukekohe & Waiuku Times, Volume 7, Issue 428, 22 November 1918, Page 1

INFLUENZA AND PNEUMONIA.

Tiw older generations of physicians regarded pneumonia, or inflammation of the lung, as due to chill. They argued that chilling of the surface produced an internal congestion, which went on to inflammation. According to " Medicus," the medical authority of the Melbourne " Argus," they were perfectly right so far as they went, but they were without the knowledge that the actual disease was determined by the presence of a minute specific germ. Many of them regarded the complaint as infectious; bnt it was not until after 1890 that the bacterial nature of the disease was fully established. Various organisms were for a time in dispute, but about 1886 a particular germ, discovered by Fraenkel, was definitely accepted as the true invader, and is nowadays everywhere recognised as the " pneumo-coccus." Consequently in modern text-books pneumonia has been removed from diseases of the lung and is now classed among the acute infections. It is still accepted that chill, and especially a chill contracted when the sufferer is fatigued, out of condition, or placed in unhygienic surroundings, is the factor which most frequently predisposes to an attack of pneumonia. While there is no question that pneumonia is an acute infection, " Medicus " says it is very rare in ordinary everyday surroundings to find that the disease is directly communicated from a sufferer to those in attendance. But whete many persons are crowded in ill-ventilated dwelling places or on board ships, the malady often spreads very rapidly. In the mining " compounds" in South Africa the mortality was so appalling that a special investigation was carried out some years ago by Sir Almroth Wright. Pneumonia is an extremely fatal disorder in any circumstances, but its fatality varies very considerably. In the South African compounds the mortality occasionally reached very high figures. In ordinary civil hospital practice it ranges from 20 to 30 per cent. John Bunyan referred to conbumption as " the captain of the men of death," but Sir William Osier suggests that at the present day this title belongs to pneumonia. The " pneumo-coccus " may be looked upon also as a rather cowardly germ, which frequently waits for some other organism to make an initial attack, and then takes advantage of the situation to get to work on its own account. In this way it is a frequent associate of the influenza bacillus, and begins its deadly thrust just where the less fatal germ would be content to accept defeat. So far as information is available, it is this association of pneumonia and influenza which is responsible for the grave features of the present pandemic outbreak, which goes by the name of Spanish influenza. The question put by the community is, "What shall we do to be saved?" and it must be confessed that it is only possible to set out certain general and special precautions which are advocated, and to bid the people be of good cheer, for there is no doubt that panic is the very worst attitude in which to face any threatening peril. In the first place, it is of the highest importance to avoid chill, and, as has been remarked, to avoid chill when the state of bodily resistance is lowered by anxiety, fatigue, or want of food. In the spring season many people are careless as to clothing. In the old world there is a proverb, " Don't cast a clout till May is out." The second general precaution is the maintenance of personal hygiene, and especially attention to good ventilation; always keeping in mind that ventilation does not mean sitting in a draught, nor yet sleeping on a verandah, or between open windows. As the bailiff in "The Silver King " remarks, " There is a pleasant way of doing things and an unpleasant way," and many wellmeaning individuals seem to choose the unpleasant methods of ventilation. It is an unfortunately common experience to see an ovei-heated woman wrapped in fms enter a tram car and insist on sit iug before an open window for a quarter of an hour, much to the general discomfort and her own certain undoing. That is not hygiene. The first special precaution is to avoid close contact with anyone who has unfortunately already contracted influenza. There is a superstition in Ireland that when in search of good luck it is wise to avoid''hoppers and blinkers," and it is a scientific truth that during an influenz.i epidemic it is courting disaster to associate closely with ■• sneezers " or " spitters." Otherwise, personal hygiene means careful living aud cleanliness in every acceptation of the term. There is a verg general modern belief that protective inoculation, or, as it as wrongly termed, " vaccination," is a reliable safeguard. "Mediae" considers it only necessary to say that 6uch a procedure has not yet passed beyond a stage that is purely experimental There are tome atuto infectious diseases which of themselves confer a lasting immunity. For example, it is extremely rare for anyone who has suffered from smallpox, typhoid fever, or scarlatina to contract the disease a second time.

But pneumonia and influenza are not included in such a category. The immunity conferred by an attack of either complaint is of very short duration. The late Sir James Paget is said to have suffered from ten definite attacks of pneumonia, and with some people influenza is almost an annual occurrence. And the difficulty of protective inoculation against these diseases does not end there. Kecent research in America has made it clear that there are different straios of '• pneumo-coccus," and that a "vaccine" prepared from one strain is without effect against its relatives, although the disease is to all appearances identical in course and systems Influenza, again, is closely imitated by some other catarrhal organisms, and '' Medicus " holds it to be extremely doubtful if the modern practice of using a " mixed vaccine," containing two or three or more organisms, is either highly scientific or in any degree effectual It bears a perilous resemblance to what is called the " blunderbuss prescription of pharmacy." All that can be said with conviction, at present, is that no body of evidence exists, based on experience, which justifies the assertion that such a method is reliable, and, as has been indicated, the probabilities are not in its favour. Hear also what Sir Almroth Wright, the founder of modern protective and curative inoculation, says:—"The body has the machinery for immunisation, and yon can play tunes upon it if you know the laws. If you do not happen to know the laws when playing upon it, it may be quite injurious."