Of the first class we had 351 cases, the second class we had 153, the third class we had 71; total, 575.

Of the first class 323 were cured and 27 developed into glandular inflammation. All cured.

Of the second class 147 cases were stopped at the outset, and 13 cases developed pneumonia. All cured.

In the third class there were cured 69 cases, and in two inflammatory fever developed. All cured.

In those cases affecting the sensory nervous systems and not developing into glandular inflammation, 2 had irido choroiditis and 2 had idiopathic herpes. The other 320 had neuralgia of the trifacial and its branches, experiencing great pain unaccompanied by swelling.

The glandular swelling was confined in all cases to the lymphatics of the neck and throat except in two cases, one of which affected the glands of the groin, and the other suffered from orchitis, making a total of 351 cases.

Those of the second class, 140 were of a typical nature experiencing profuse mucous discharges, many of which were of a purulent nature.

Those of this class developing into pneumonia, 1 was double pneumonia, 12 single, 8 on left side, and 4 on right side.

The kidneys were complicated in 18 cases. One of these had pneumonia. None bad diarrhoea.

Of the third class, consisting of 71 cases, 68 were to all appearances incipient inflammatory fever, of which 3 developed into typical forms. All recovered.

No age was exempt from the malady, the younger men suffering the most from pyrexia and pain; and it was to this class that pneumonia was confined, except in one case, and the severity of this case was due to intemperance and exposure previous to coming to the hospital.

PATHOLOGY

The pathological phenomena presenting themselves were of a complex nature, and so much so that our attention can to a better advantage be directed to the cause, symptoms, and complication of the disease during its various stages.

The characteristic feature of the disease as it appeared here, was its beginning with a general soreness of the muscles of the body followed by darting neuralgic pains along the courses of the larger nerves, listlessness, mental depression with anorexia, and an extraordinary weakness.

These symptoms were followed by a tightness of the throat and chest which came on periodically, followed by dyspnoea. Then followed the fever, when all of the above symptoms were increased and lasted from three to ten days.

Subsequent to the premonitory symptoms, the features which followed were characteristic of one of the three forms of disease.

The patient did not necessarily enter the first class first, but was liable to be taken with symptoms peculiar to the second or third class and vice versa.

A case unrestricted or checked by treatment would almost invariably pass through the three stages sooner or later.

The primary symptoms of la grippe appeared January 6 and disappeared March 20, 1890; the secondary symptoms disappeared May 28, 1890.

A careful record of a number of typical cases were kept during their progress and presented the following average facts:

First day: Respiration normal, pulse regular, bowels regular, feel well, urea deficient.

Second day: Condition same, except urea decreasing.

Third day: Feels languid, dumpy headache; evening headache intense; urates and uric acid in urine; urates in abundance.

Fourth day Pulse 130, temperature 103; intense pain in head and back; urine scanty, specific gravity, 1024; urates, uric acid, and oxalate of lime, chlorides abnormal. At 2.30 p. m. broncho pneumonia appeared.

Fifth day, 5 a. m. : Pneumonia decided; expectoration; urine same except chlo rides disappear from urine.

As the fever increases the specific gravity of the urine increases, and as the urea decreases the urates increase, until finally the urine is acid and crystals of uric acid, urates, and oxalates appear.

In a case presenting all of these features, inflammatory fever usually sets in, especially if the patient was prone to a rheumatic diathesis.

Local climatic peculiarities modify grippe fever, as is illustrated by one coming down with a fever, and in a week or two after promised recovery may be afflicted with a cough or sore throat, and possibly pneumonia or even nephretis or inflammation of some other organ.

While gathering data from these cases for physio-chemical facts, a climatometrical record was kept, the variations of which compared identically with the variation of the number of cases of la grippe that appeared.

The details of these observations are too lengthy to insert here, but I found that the condition of the system produced by these climatic changes resulted from an absence of electricity, or rather an electro-negative condition of the air, a great decrease in atmospheric ozone, an increased amount of moisture, a higher temperature, and a higher barometric condition, all acting or existing in an uncommon and unusual relation with each other.

In other words, la grippe is a disease of deoxidation from causes external to the body per se, and is variable with the oxyogalvanometric and barometric condition of the air we breathe. Expressed mathematically, its prevalence is proportional to the increase in weight and humidity and inversely to the amount of ozone and elec trical condition of the atmosphere.

As far as microscopical examinations of excretions were carried, I was unable to detect any germ or microbe which I thought was peculiar to Russian influenza.

TREATMENT.

From the pathological condition most liable to arise under the intense nerve depression resulting from the uneliminated organic excrement which we find existing in the blood in abundance, the result of nerve depression, and which the reserve energy strives to throw off, eliminate, and burn up, I regard the popular antipyretic sedative treatment unwarrantable and unscientific.

There is no physiological nor therapeutic indication for it, and I believe that more cases of prostration and heart failure have resulted fatally from the effect of the antipyretic drugs administered than from the disease influenza.

In every case recorded here in this hospital more benefit was derived from tonic eliminative remedies than all else.

Hot air and hot water, externally and internally, being the most effective, followed by antiperiodic alkaloids.

I am, general, very respectfully, your obedient servant,

WM. W. AVERELL,

U. S. Army, Assistant Inspector-General, National Home for Disabled Volunteer Soldiers.

Descriptive list of members admitted to the Pennsylvania Home for Disabled Volunteer

F, 8th N. Y; E, 2d Pvt.
Pa. H. Art.
Keystone Bat...
E, 7th Pa. Cav
A, 99th Pa. Vols
K, 20th Ohio Vols
K, 175th Pa. Vols..
A, 2d Pa. H. Art

Soldiers and Sailors from the 29th of December, 1888, to the 'st of June, 1890.

Descriptive list of members admitted to the Pennsylvania Home for Disabled Volunteer

69 8.00

8 5885588588722855862588 8995 8848 85758888 E O XX**** 88788878 28 87

49 30.00

67 8.00

United States. 62 17.00 general debility