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were much less in proportion and the quantity of albumen
also.
Delirium. The delirium in the autumn epidemic was very
well marked, often of a rather violent nature and very persistent;
only a few cases in the summer epidemic were thus
affected.
Tremors. Well marked tremors of face, lips, hands and
arms occurred in the autumn epidemic in much higher proportion
than in the summer.
Epistaxis. The male eases in the autumn epidemic frequently
showed epistaxis (bleeding of the nose) and the
epistaxis was very often recurrent. Uterine haemorrhage
and abortion were of frequent occurrence.
Sore Throat. This was a common symptom; usually an
ordinary catarrhal condition of the fauces though some had
well marked follicular tonsillitis.
Diarrhoea. Some cases showed this, but it was not a
common feature.
Empyema and Ordinary Pleural Effusia. This was common
throughout the whole of the summer epidemic, but
such complications only arose towards the end of the
epidemic in the autumn. All these cases invariably recovered
after aspiration or operation.
A large number of cases who had been in the wards for
various periods prior to each epidemic, and were still inpatients,
developed the disease. The incidence was greatest
amongst the younger patients, and the death rate was
higher. The old patients, who developed the disease, had
it less severely, and showed a high percentage of recoveries.
Incubation Period. This was short as far as I could judge
about 2—3 days, or even less in some cases.
Duration of the Infectivity. Unknown.
Secondary Attacks. Only two nurses who had influenza in
the summer developed it again in the autumn. In the
autumn epidemic 54 nurses were attacked, of which 18
developed pneumonia, and one died. None of the cases that
were treated in the summer epidemic developed the disease
in the autumn, with the exception of the two nurses.