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1918
11
summer suffered again in the autumn. Five doctors had had
no cases in the autumn amongst, the patients who suffered in
July, and all the other doctors stated that an attack in July in
the vast majority of instances conferred an immunity and the
patient did not suffer again in the autumn. When a second
attack occurred the patients had always shewn a special
tendency to suffer from Influenzal attacks.
Contrary also to the usual experience in Influenza, relapses
were rare; when a relapse did occur the initial attack was mild,
but the relapse was of a more severe character.
In the opinion of most of the doctors, the incubation period
was a short one. In the majority of cases the incubation
period was about two days, but undoubted instances of a period
of only 36 hours were recorded and in other cases the incubation
period was lengthened to five or six days. No opinion
was expressed as to the effect of a shortened or lengthened
incubation period upon the severity or otherwise of an attack.
Most of the doctors also were cf opinion that the infectious
period was a short one; probably less than a week from the
onset of the initial symptoms. Evidently the most infectious
period was during the early stages of the disease, and the
disease was spread by coughing and sneezing, but these acts
were not essential to its spread; even the act of speaking when
in close contact was sufficient.
Apart from lung complicatious the disease was not of long
duiation, but where lung complications supervened, the duration
of the disease, of course, depended on the nature of the
complication. The lung complications varied considerably ;
most of them were lobar pneumonia, or lobular pneumonia. A
large number had congestion of the bases, but no consolidation.
The most dreaded complication was a type of toxic pneumonia,
where the patient died with all the symptoms of septicaemia
aud the consolidation was slight.
The lung complications occurred early and late and
usually the most fatal cases were those where the lung
symptoms appeared early.
All the doctors complained of the lack of nursing facilities
in the home. Private nurses were almost unobtainable, but