View report page

Influenza, Bronchitis and Pneumonia.
Ever since the first institution of registration these causes of death have shown increase from
time to time, as though in response to the stimulus of an epidemic influence; in other words, the great
influenza outbreak of 1847–48; the succeeding minor prevalences of 1851, '55, '58, '62-63, '69 and '75;
the then following pandemic of 1890, with the subsequent epidemic waves of 1891, '92, '95 and 1900 ;
and the lesser waves of 1908-09 and of more recent years, have each and all been accompanied by noteworthy
increase in the number of deaths returned as due to "bronchitis" and "pneumonia."
Again, in addition to the well-known type with respiratory complications, influenza has been
found to present from time to time distinct gastro-intestinal and nervous types, and during recent years,
in London, the welling up in each first quarter of the year of deaths attributed to influenza and to
respiratory diseases has been accompanied by a corresponding increase in the number of deaths ascribed
to cerebro-spinal fever. It should further be noted that there has been apparent in London for some
years past an approximation or merging into one another of the prevalences of illness attributed in the
earlier months of each year to cerebro-spinal fever and later in the summer months diagnosed as
poliomyelitis.
The question was thus seen to arise, and has been discussed in the Annual Reports for 1914,
1915 and 1916, as to the need from an epidemiological point of view for associating the prevalence of
influenza not only with illnesses in which respiratory and gastro-intestinal complications are present,
but also with illnesses in which disturbances affecting the central nervous system predominate. It
has, in fact, become apparent that, it is now necessary to consider the desirability of enlarging the present
connotation of the term influenza.
The varieties
of influenza
Influenza, Cerebro-spinal Fever and Poliomyelitis.
Dr. Franklin Parsons, in his report on the influenza epidemic of 1889-90, wrote as follows :—
By many observers throe forms of influenza have been recognised, viz. :—
"(a) Nervous- The prevalent form in the epidemic of 1889-90, characterised by groat
depression and severe pains in the head, spinal region and muscles." (He adds, some distinguish
a rheumatic form characterised especially by pains in the muscles and joints.)
"(b) Catarrhal—Marked by coryza and tendency to congestion of the respiratory mucous
tract.
"(c) Gastric—Especially noticed in children and marked by vomiting, diarrhoea and
other symptoms of gastro-intestinal disturbance.
"These three forms have all been observed in cases occurring together under the same roof and
are evidently mere varieties of the same disease,"