Pulmonary Influenza or Influenza-Pneumonia frequently complicates the “Flu” in some epidemics, but not in all of them; it is the main cause for the mortality due to that disease.
A century and a half ago the French physicians first demonstrated its peculiarities, and its difference from ordinary Pneumonia, which is as follows:
(a) It develops gradually and complicates the Bronchitis of Influenza.
(b) Its peculiar physical signs are: the respiratory murmur in the early stages of the “Flu” is diminished, and later completely disappears; then bronchial breathing begins without dullness or crepitant rales, like true Pneumonia.
In Hawaii as elsewhere, the complicating Pneumonia seldom appears before the second or third day; occasionally it comes to the fore after the fifth or sixth; it is not always easy of detection in a mild case. In our epidemic in Honolulu last winter, 1920, some of cases considered as Pneumonia were in fact those of simple Pulmonary congestion and oedema, attended with expectoration of frothy blood-tinged mucus, resembling the swollen or drowned lung found in those who have been submerged and died from drowning.
The true Influenza-Pneumonia sputum or spit is “greenish-yellow,” this greenish color being due to the presence in the sputum of a green pigment excreted by the diplo-coccus or double coccus, like a necklace of beads, or sometimes resembling rounded small rods.
LEGACIES OF THE “FLU” TO MAN.
A tendency to T. B., softening of the heart muscle, nervous prostration, insomnia, restlessness and inability for brain work, depression of spirits and irritability of temper, neuralgias, middle ear disease, eye troubles, vertigo or giddiness from the ear disease or eye or heart; stomach disease after intestinal influenza, vomiting spells, etc., etc., emaciation, diarrhoea.
The open air life of the occupants of T. B. hospitals accounts for their freedom from epidemic “Flu”; but they are not immune to every epidemic. Residents of asylums, hospitals, and jails are not so fortunate, numbers of the inmates being attacked; daily rations of quinine should be given.