Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
One may frankly say there is no specific treatment for influenza.
Possibly we are in error in introducing the discussion, particularly on
treatment with such a definite and unsatisfactory conclusion. The same
statement has been made after all the previous pandemics, and one
wonders whether a like remark is going to apply to the next similar
scourge. The past two or three months should bring to the medical
profession a certain humility which should stimulate a keener sense of
research, especially as we now have at our disposal highly organized
laboratories where unsolved problems can be viewed from almost any
angle. Yet we are really, save here and there, putting our forces
together in the study of the disease. It is obvious that a fleeting
epidemic makes a most difficult subject for study, especially during a
time when there is a paucity of physicians. May we not hope, however,
that some researches on the disease may be forthcoming, so that we may
safely feel that at least preventive or protective measures will be
possible?
There is no one who is able to say that this or that drug has not been
thoroughly tried. The alkalies, salicylates, antipyretics, quinine and
the sedatives have all been freely used in the last as well as the
present epidemic. Each group of drugs has its following, although it
appears to be a general rule in this epidemic to use the antipyretics
(coal tar products) as little as possible. From the distant past we have
numerous records of treatment. Willis (1658) emphasized the value of
sweating and the use of diaphoretics, but at the same time he states
that in mild cases the cure is left to nature; Sydenham (1675) claimed
considerable value in fresh air. He also paid more attention to
restricting the diet, and was not favorable to the use of anodynes. One
certainly obtains the impression from the records of past epidemics that
many of the general principles in treatment were similar to what are now
in vogue. Medicinal remedies, of course, varied greatly, but to
enumerate them would be merely giving a résumé of the progress of
therapeutics. Sufficient is it to say that influenza has certainly,
since the earliest days, given therapeutists an ample opportunity to
test their wares.
The outstanding respiratory complication, pneumonia, has added a very
undesirable phase to the disease. In fact, the greater part of the
mortality was due to this serious sequela. Some interesting points have
been brought out in serum and blood therapy for this type of pneumonia.
The use of whole blood or serum from convalescent patients in cases of
pneumonia opens up a new and not unlikely fruitful means of treatment.
The method of treatment possibly may be applicable as an emergency
measure in other diseases, as has been shown in the case of scarlet
fever and poliomyelitis. We also have the anti-pneumococcic sera
available for therapeutic use. The drugs and the general treatment of
the pneumonia are virtually the same for the last two epidemics.
Public-domain text, read in full here on John Shaqi.
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