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A great deal of attention has been directed toward the prevention influenza, (an Italian word referring to the influence of heavenly bodies previously thought to cause disease). The disastrous epidemic of 1918 caused an estimated 20 to 40 million deaths from this viral disease. Vaccinations are available annually, especially recommended for the elderly and others with a chronic debilitating illness.

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By far, the majority of mild illnesses affecting people in their homes are caused by viruses. These conditions are usually self—limited, that is, our bodies overcome the infection and get well spontaneously. Recent advances inthe science of microbiology, including the use of the electron microscope, have helped to identify most of these germs. Viruses are nonliving organisms, different from bacteria or protozoa (one-celled animals). The virus particle is a combination of proteins and nucleic acid. They enter the cell of the host, take over its specific enzyme systems, and rapidly multiply to produce disease. Some of the more common viral infections will be discussed in next few blog posts.

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The majority of human illnesses with known causes are produced by infectious agents. In fact, some of the greatest medical discoveries in the twentieth century have resulted in the controlling of many contagious diseases through public health measures, sanitary engineering, immunization, etc. Although there remain some exceptions to this rule, infectious diseases as a
class are more easily prevented and cured than any other major group of disorders. Yet, despite the elimination of certain infectious diseases and a profound reduction in the death statistics of others, man is by no means free
of infection. Only a modest decrease in the total effect of disease has been produced through these control measures. I am thinking primarily of smallpox vaccinations and malaria control.

Additionally, numerous new infections have resulted from the widespread use of broad spectrum antibiotics, immune suppressive agents used in transplant procedures, the progressive longevity of people with chronic degenerative disease, and high-risk lifestyles such as drug abuse and homosexuality. Life threatening diseases that were never seen before this decade are now invading the immune deficient. These infections are termed opportunistic.

There is a very complex interaction between the microorganism and man when an infectious disease occurs. Much has been learned about the way
microbes enter the body, the ways they produce injury to the tissues, and the resistance of a person (the host), as well as the mechanism of recovery. Unfortunately, though, it is often difficult to transfer much of this scientific information to help the individual patient with his infection. It is well known that microorganisms of different species or different strains of the same
species, vary widely in their capacity to produce disease. Furthermore, we know that human beings are not equally susceptible to disease caused by a given bacterium or virus. Fortunately for us, the mere presence of an
organism in the body does not always lead to clinical illness. Often there is a carrier state (like the story of Typhoid Mary) or a hidden (subclinical) infection. Several factors are involved in the mechanism of getting an
infectious disease.

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Pain involving the ligaments and muscles is often seen in athletic injuries. When the ligament is torn, the injury is called a sprain. This often occurs in the ankle, the knee, the low back, or shoulder. Muscles that are bruised often
become painful and when the injury is considerable, that is called a strain. These small ligaments and muscle fibers may actually be torn, but heal without any residual weakness, after a short period of rest.

Inflammation of the bursa (bursitis) may occur as the result of trauma, arthritis, infection or other disorders. Common locations include the shoulder, hip, knee, elbow and heel. Severe local pain and tenderness is often present. Sometimes calcium deposits are seen on x-ray. Immediate application of cold in the form of snow or an ice bag is one of the most helpful remedies, followed by mild exercise and gentle hot and cold compresses, after the acute inflammation subsides.
The tendon sheath of the hand or wrist may become inflamed, Some of these are due to constriction of tendons or nerves, and may require surgery. In the wrist this is called carpal tunnel syndrome. Others are seen in
conjunction with rheumatoid arthritis, discussed in chapter five.

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Pain in the lower back, as well as the neck is very common in America. Many related, but distinct conditions can produce discomfort here. Disease of the spine, although less common than other problems, is often related to injury. An auto accident or sudden fall, causing acute flexion of the back, may compress and fracture one of the vertebral bodies. It may be an early sign of osteoporosis, thinning of the bones due to calcium deficiency. X-ray is often necessary to diagnose this condition accurately. Immobilization on a straight board, with the avoidance of any flexion, standing, or walking is extremely important First Aid in dealing with these acute injuries. Braces, which keep the back in extension, are often worn for several months in the treatment of a fractured spine.

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