56
THE INDIAN MEDICAL GAZETTE.
NOTE ON/A RECENT OUTBREAK OF
INFLUENZA.
/
By H. R. DUTTON, MAJOR, I-M-S-,
Civil Surgeon and Central Jail,
Superintendent, Bhagalpur.
A small
epidemic of influenza broke out in Bhagalpur Central Jail recently. The first case occurred on 16th October, 1920, but was not definitely diagnosed until several clays later. Cases were mostly of a mild type at first, and It was not until chest symptoms, developing in these cases about eight days later, became noticeable, and the numbers reporting sick the
became
that the definite of influenza was arrived at. It was then decided to inoculate the entire jail population with influenza vaccine, and, on receipt of a supply, inoculation was started on 4th November, 1920, and the first dose was completed on 6th November, 1920. The second dose was completed seven days later, inoculation being complete 12th on November, The total number of cases was 82, 1920. whom of 16 only had received a first inoculation of vaccine, the remainder being uninoculated; and, of the total number, 16 developed broncho-pneumonia and two lobar pneumonia. There were two deaths, both due to lobar pneumonia, both in men over 60 years, and both occurred on the third day after the temperature had dropped to normal. These cases, on post-mortem examination, showed massive consolidation in each case of the whole of one lung and part of the other, and large antemortem clots in the left side of the heart. No of case broncho-pneumonia ended fatally, although several cases were very serious, with well-marked physical signs. Of these 16 cases of broncho-pneumonia, one only had received a The remainder first inoculation of vaccine. were uninoculated, as were also both the lobar pneumonia cases. The average stay in hospital of all cases was 8.69 days. The last case occurred on 12th November, 1920. The routine
considerably increased,
diagnosis
treatment
adopted was a purge immediately on a three-hourly mixture containing
admission, and
sodii bicarb, gr. 30 and ess. cinnamon m. xv. All cases were treated in the open air as much as possible, beds being in the open air in the shade, the entire day. A case showing any signs of chest trouble was segregated at once from the remainder and given daily injections follows:?1st day, of influenza vaccine as 1 c.c., 2nd day, 2 c.c., 3rd day, 3 c.c., etc., up to and including the 6th day. Symptoms of cough, cardiac asthenia, etc., were treated as they arose with appropriate remedies, such as
digitalis, brandy, etc. The points worthy (1) The first cases cases not developing disease first appeared
of note are:? all mild, severe chest until eight days after the in the jail. were
[Feb.,
1921.
(2) The apparent great value of curative injections in small, but gradually increasing in strength, daily doses, in' all cases developing symptoms of
broncho-pneumonia.
The great value of prophylactic inoculation, no case having occurred after the second dose had been given and only one after the first dose, in spite of there being about 150 men over 50 years old in the jail at the time. (4) The only two deaths that occurred were uninoculated debilitated old men whose health was bad on admission to the jail, and who had very severe lobar pneumonia, which may or may not have been actually part of the disease, but an additional complication. (5) The sodium bicarbonate and cinnamon mixture, combined with open-air treatment, proved a rapid cure for the ordinary uncomplicated cases.
(3)
THE INDIAN MEDICAL GAZETTE.
NOTE ON/A RECENT OUTBREAK OF
INFLUENZA.
/
By H. R. DUTTON, MAJOR, I-M-S-,
Civil Surgeon and Central Jail,
Superintendent, Bhagalpur.
A small
epidemic of influenza broke out in Bhagalpur Central Jail recently. The first case occurred on 16th October, 1920, but was not definitely diagnosed until several clays later. Cases were mostly of a mild type at first, and It was not until chest symptoms, developing in these cases about eight days later, became noticeable, and the numbers reporting sick the
became
that the definite of influenza was arrived at. It was then decided to inoculate the entire jail population with influenza vaccine, and, on receipt of a supply, inoculation was started on 4th November, 1920, and the first dose was completed on 6th November, 1920. The second dose was completed seven days later, inoculation being complete 12th on November, The total number of cases was 82, 1920. whom of 16 only had received a first inoculation of vaccine, the remainder being uninoculated; and, of the total number, 16 developed broncho-pneumonia and two lobar pneumonia. There were two deaths, both due to lobar pneumonia, both in men over 60 years, and both occurred on the third day after the temperature had dropped to normal. These cases, on post-mortem examination, showed massive consolidation in each case of the whole of one lung and part of the other, and large antemortem clots in the left side of the heart. No of case broncho-pneumonia ended fatally, although several cases were very serious, with well-marked physical signs. Of these 16 cases of broncho-pneumonia, one only had received a The remainder first inoculation of vaccine. were uninoculated, as were also both the lobar pneumonia cases. The average stay in hospital of all cases was 8.69 days. The last case occurred on 12th November, 1920. The routine
considerably increased,
diagnosis
treatment
adopted was a purge immediately on a three-hourly mixture containing
admission, and
sodii bicarb, gr. 30 and ess. cinnamon m. xv. All cases were treated in the open air as much as possible, beds being in the open air in the shade, the entire day. A case showing any signs of chest trouble was segregated at once from the remainder and given daily injections follows:?1st day, of influenza vaccine as 1 c.c., 2nd day, 2 c.c., 3rd day, 3 c.c., etc., up to and including the 6th day. Symptoms of cough, cardiac asthenia, etc., were treated as they arose with appropriate remedies, such as
digitalis, brandy, etc. The points worthy (1) The first cases cases not developing disease first appeared
of note are:? all mild, severe chest until eight days after the in the jail. were
[Feb.,
1921.
(2) The apparent great value of curative injections in small, but gradually increasing in strength, daily doses, in' all cases developing symptoms of
broncho-pneumonia.
The great value of prophylactic inoculation, no case having occurred after the second dose had been given and only one after the first dose, in spite of there being about 150 men over 50 years old in the jail at the time. (4) The only two deaths that occurred were uninoculated debilitated old men whose health was bad on admission to the jail, and who had very severe lobar pneumonia, which may or may not have been actually part of the disease, but an additional complication. (5) The sodium bicarbonate and cinnamon mixture, combined with open-air treatment, proved a rapid cure for the ordinary uncomplicated cases.
(3)
