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
The protean manifestations of the 1890 epidemic, with its unusual
nervous sequelæ, have not been seen to any extent, as far as we yet
know. In fact, the present epidemic appears to be relatively free from
complications other than those occurring in the lung during the acute
course of the disease. Hence, in all likelihood, there will be less of
the nervous after effects to be treated. It is, however, too early to
hope that the nervous system is going to escape.
In another part of this volume the vaccine therapy is discussed in
detail, so that we shall not repeat what has been brought out in that
article. We would, however, emphasize the value of honest and accurate
clinical reports of the use of vaccines, in order to establish their
present status in epidemic influenza. Overestimation and commercialism
are very likely to ruin a method of treatment, even when it may be of
value in a certain phase of the disease. If we do not carefully weigh
the pros and cons of the vaccine treatment in this epidemic from a
purely scientific and coldly neutral attitude, we are simply doing the
public and ourselves an injustice.
The treatment of influenza as the disease presented itself to us in this
community will be considered under three divisions—acute influenza,
pneumonia, and other complications.
_Acute Influenza_
There is one important thing to be done in the treatment of influenza,
whether the infection be mild or severe. Have the patient go to bed as
soon as possible. In most of the acute attacks the individual went to
bed of his own accord; but there were, unfortunately, too many instances
where the patient refused to surrender, trying, as we say, to fight the
attack. Some appeared to be able to accomplish this feat. But how many
of our cases of fatal pneumonia can be clearly linked up with this group
of the mild or subacute preliminary course? No matter how light the
attack may appear to be, the patient should be told of the necessity of
remaining in bed until the pulse, respiration and temperature have
returned to the normal and remained normal for at least five days. At
the onset a hot bath, with care to avoid chilling, followed by a drink
of hot lemonade and a Dover’s powder, gave considerable relief to the
patient.
The value of good nursing cannot be overestimated. The nurse must see
that the patient is always well covered and kept warm, not even
permitting him to rise in bed to reach for a drink; also the regulation
of the temperature of the room should be carefully watched. The main
point is to have plenty of fresh air. We have noticed that the patient
appeared more comfortable if the air was slightly warmed. Water should
be given at regular intervals. Under no consideration should an acute
influenza case be allowed to get up to go to the toilet.
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