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11
MEMORANDUM ON EPIDEMIC INFLUENZA.
"Influenza became epidemic in England in the winter of 1889-90; it
"recurred in epidemic form in the spring of 1891, and was maintained up to
"June of that year; a third epidemic took place in the winter of 1891-92, and,
"after a minor recrudescence in the spring of 1893, a fifth prevalence on a wide
"scale took place in the winter of 1893-94. England is now passing through a
"sixth epidemic period. Two detailed reports have been issued by the Board
"on the subject. The first was by Dr. Parsons, 'On the Influenza Epidemic
"of 1889-90,' with an Introduction by Sir George Buchanan, M.D., F.R.S.,
"the Board's Medical Officer at that date. The second was a 'Further Report
"on Epidemic Influenza, 1889-92,' by Dr. Parsons, with papers on the clinical
"and pathological aspects of the disease, by Dr. Klein, F.R.S., and an Intro"duction
by myself.
"A 'Provisional Memorandum upon Precautions Advisable at time when
"Epidemic Influenza threatens, or is prevalent,' was also drawn up by me in
"January, 1892, and was issued by the Board to Local Sanitary Authorities.
"The further study made by the Medical Department as to the natural
"history of influenza, and as to its clinical and bacteriological characteristics,
"goes to show that it is a disease against which it is most difficult to apply
"measures of prevention with any substantial prospect of success.
"Influenza is highly infective from person to person, its infectious quality
"is often manifested before the disease is fully recognized, its incubation period
"is one of the shortest of all infectious diseases, it varies so much in intensity
"that many cases are never diagnosed at all, one attack confers no marked
"immunity against another, and the infection is largely eliminated by means of
"the lungs, the sputa of the sick being invariably charged, during the acute
"stage of the disease, with its pathognomonic micro-organism. The disease calls
"primarily for measures of isolation and of disinfection, but there are difficulties