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
At the onset, and while the febrile attack is still present, there is
little desire for food—but one does not need to worry about the question
of nourishment in such an acute illness. Milk, cream, cocoa, gruels and
fruit juices may be given at first, and as the fever subsides the diet
increased. We have found that the appetite returned to normal very
readily. In view of the urinary findings indicating a slight transient
nephritis, meat broths are to be avoided until the convalescent stage is
reached. We have been very guarded in recommending cold sponging in
acute influenza. As a rule, it was not necessary. The icebag to the head
is often of great value in the intense headache, which is so frequent.
It is our opinion that in the treatment of uncomplicated influenza what
has just been mentioned constitutes the important part. Most physicians
would agree with this. However, when we advance to drug therapy, we come
into the personal realm of likes and dislikes of drugs and methods of
usage.
We do not intend in any way to give our views in a dogmatic manner, nor
to touch upon all of the remedies that have been advanced. At the onset
of the disease a moderate calomel purge, followed by a saline, was given
in all cases. We were practically free from the so-called intestinal
type of influenza which was seen in some other communities, consequently
we did not hesitate to use calomel. Castor oil or magnesium sulphate was
given afterward, as was found necessary. Abdominal distention was rarely
seen, and when it occurred a plain soapsuds enema with turpentine was
administered.
Quinine sulphate (gr. iii-v, three times a day) combined with
phenyl-salicylate (gr. v) was a routine measure. We often noticed
deafness after a very few doses of quinine. It was then discontinued.
Acetyl-salicylic acid (gr. v, three to six times a day) seemed to have a
palliative effect on the severe headaches, although during the height of
the disease the general muscular aching did not appear to be relieved by
its use. It was not used routinely. These drugs possibly made the
patients more comfortable, but we were very skeptical as to their
influence on the general infection. The raising of the leucocyte count
by quinine in influenza appears very unlikely. The use of alkaline salts
has been a general procedure, particularly as we are now on the alkaline
wave of therapeutics. Sodium bicarbonate was added to the drinking water
of all patients (two drams to the quart). We gave this salt for its
diuretic effect. In a few cases more active diuresis by the alkalines
was readily and easily produced by the use of “imperial drink” three or
four times a day. We felt that good kidney elimination was of
considerable importance.
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