http://influenza.sph.unimelb.edu.au/MOH_TOC.php
In this chapter, a case for *influenzal periods* surrounding pandemic years is made.
The author states: "We are not indeed called upon to prove that obscure nervous outbreaks were always followed by explosive influenza, but we should be able to show that such influenza does always cast a shadow before or behind."
Towards the end of the chapter he says this: "But when the pendulum swings always close to the danger limit, we shall not receive the warning, we shall always live in the shadow of a possible disaster. Our position in face of influenza will be that of the 17th century physician in regard to plague, and our remedy will not be specific but general, not found in the exclusion of infection from our shores, not even in specific immunisation, but in the more laborious and less dramatic task of attending to the general principles of hygiene."
There are some good charts beginning on page 12. In one, he details the special outbursts of diseases surounding pandemic years. Since I can't cut and paste from this .pdf, here is part of it:
1890: 15 weeks from Jan. 4, 1890
1891: 17 weeks from April 18, 1891
1891-92: 18 weeks from Dec 19, 1891
1893-94: 27 weeks from Nov 4, 1893
1895: 16 weeks from Feb. 16, 1895
1899-1900: 28 weeks from Dec 2, 1899
1908: 22 weeks from Jan. 4, 1908
Here's my simplified example of his review of pandemic years:
"Let us now inquire whether the epidemiological events
grouped around the explosions of influenza exhibit any objective
contrast to those of other sequences of years. We will begin
with the epoch centered in April-May 1743, under the former
of which months Huxham describes the epidemic influenza in
words frequently quoted and well known to all."
Passing backwards from the end of April, when the explosion occurred,
in April intermittent fevers were common, especially tertians;
in March " Variolae frequentes, Febres intermittentes
plures et quotidianae et tertianae."
In February there were some tertians and a catarrhal fever;
nothing of importance appears until
September 1742, when measles were epidemic;
in August intermittents are recorded and " perpauci aliter morbi."
In April, one year before the explosion, gaol typhus was epidemic at Launceston.
Passing forward in time from April, for each succeeding month until
September, stress is put upon the intermittents.
In May, "Febres quotidianae et tertianae creberrimae longe lateque."
In June, "intermittentes vero, tertianae potissimum epidemicae."
In July hardly anything but intermittents ;
in August, " multae adhuc Febres intermittentes ruri."
In the following year there were some intermittents in March ;
they were epidemic in May, scattered in June,
and are mentioned in August and November.
(In December we find reference to a malignant catarrhal fever
affecting French and Spanish prisoners of war,
very fatal, attended often by petechiae and sometimes by
parotid abscess, which, with its extension to the civilian population,
is the chief matter dealt with until June, when a change to
frank typhus is recorded and a few intermittents are noted.
Waiving the discussion of this malignant catarrhal fever, which
can hardly have been other than typhus,)
The most striking thing in the chronology is the record of epidemic intermittents
in temporal proximity to the influenza ;
they were very common both before and after the explosive outburst.
This might perhaps be thought either a normal course of events or an
idiosyncracy of the writer in his choice of material to record.
But, as a matter of fact, from July 1745 to December 1752, when
the record ends, during which period no explosion of influenza
occurred in England, intermittent fevers are only twice again
recorded, viz., under April 1748 (" nec non intermittentes sed Rure potissimum ") and under April 1751, when we read of "Febres intermittentes aliquae."
In this chapter, a case for *influenzal periods* surrounding pandemic years is made.
The author states: "We are not indeed called upon to prove that obscure nervous outbreaks were always followed by explosive influenza, but we should be able to show that such influenza does always cast a shadow before or behind."
Towards the end of the chapter he says this: "But when the pendulum swings always close to the danger limit, we shall not receive the warning, we shall always live in the shadow of a possible disaster. Our position in face of influenza will be that of the 17th century physician in regard to plague, and our remedy will not be specific but general, not found in the exclusion of infection from our shores, not even in specific immunisation, but in the more laborious and less dramatic task of attending to the general principles of hygiene."
There are some good charts beginning on page 12. In one, he details the special outbursts of diseases surounding pandemic years. Since I can't cut and paste from this .pdf, here is part of it:
1890: 15 weeks from Jan. 4, 1890
1891: 17 weeks from April 18, 1891
1891-92: 18 weeks from Dec 19, 1891
1893-94: 27 weeks from Nov 4, 1893
1895: 16 weeks from Feb. 16, 1895
1899-1900: 28 weeks from Dec 2, 1899
1908: 22 weeks from Jan. 4, 1908
Here's my simplified example of his review of pandemic years:
"Let us now inquire whether the epidemiological events
grouped around the explosions of influenza exhibit any objective
contrast to those of other sequences of years. We will begin
with the epoch centered in April-May 1743, under the former
of which months Huxham describes the epidemic influenza in
words frequently quoted and well known to all."
Passing backwards from the end of April, when the explosion occurred,
in April intermittent fevers were common, especially tertians;
in March " Variolae frequentes, Febres intermittentes
plures et quotidianae et tertianae."
In February there were some tertians and a catarrhal fever;
nothing of importance appears until
September 1742, when measles were epidemic;
in August intermittents are recorded and " perpauci aliter morbi."
In April, one year before the explosion, gaol typhus was epidemic at Launceston.
Passing forward in time from April, for each succeeding month until
September, stress is put upon the intermittents.
In May, "Febres quotidianae et tertianae creberrimae longe lateque."
In June, "intermittentes vero, tertianae potissimum epidemicae."
In July hardly anything but intermittents ;
in August, " multae adhuc Febres intermittentes ruri."
In the following year there were some intermittents in March ;
they were epidemic in May, scattered in June,
and are mentioned in August and November.
(In December we find reference to a malignant catarrhal fever
affecting French and Spanish prisoners of war,
very fatal, attended often by petechiae and sometimes by
parotid abscess, which, with its extension to the civilian population,
is the chief matter dealt with until June, when a change to
frank typhus is recorded and a few intermittents are noted.
Waiving the discussion of this malignant catarrhal fever, which
can hardly have been other than typhus,)
The most striking thing in the chronology is the record of epidemic intermittents
in temporal proximity to the influenza ;
they were very common both before and after the explosive outburst.
This might perhaps be thought either a normal course of events or an
idiosyncracy of the writer in his choice of material to record.
But, as a matter of fact, from July 1745 to December 1752, when
the record ends, during which period no explosion of influenza
occurred in England, intermittent fevers are only twice again
recorded, viz., under April 1748 (" nec non intermittentes sed Rure potissimum ") and under April 1751, when we read of "Febres intermittentes aliquae."
