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 use of tartrates and citrates, as in “imperial drink” in a condition
where we know some kidney impairment is present, is possibly flying in
the face of danger—especially in view of the fact that these salts are
so available in the production of experimental nephritis. But we have
only to see their application in the human in mercury bichloride
poisoning, where an intense nephrosis usually develops, to fully realize
that these salts may be given without danger to the kidney. We do not
suggest that the kidney lesions of influenza and mercury bichloride
poisoning are the same. We are merely bringing out this point of analogy
in support of their use in certain desirable cases.
The respiratory symptoms gave us more concern than any other phase of
the uncomplicated case. The irritating, distressing, non-productive
cough suggested both a sedative and expectorant. Ammonium chloride (gr.
iii-v, t. i. d.) was the usual expectorant. It seemed to increase in
value with the more chronic type of case. It is our impression with
those acute hacking coughs that the sedatives produced more gratifying
results. Elixir terpin hydrate with heroin, codeine and occasionally
morphine were preferred. When good results were noted sedatives were
given liberally. Steam inhalations combined with tr. benzoin co.,
followed by spraying the throat with medicated liquid petroleum, gave
some relief. The tendency to œdema, however, as we saw it in the cases
complicated by pneumonia made us hesitate to use inhalations. Possibly
the fear was groundless. Morphine (grs. ⅙) was given for sleeplessness,
and it was repeated if necessary.
Cardiac stimulants were rarely needed. The tincture of digitalis was the
choice, but in the uncomplicated cases was very seldom used.
At the beginning of the epidemic we prescribed whisky in almost every
case. Our idea was that it would have a sedative action. At the present
time we are very doubtful of its value. Toward the end of the epidemic
we used it very moderately. The results obtained possibly depended for
the most part upon the type of patient. Some of the soldiers asked to
have it discontinued, not from any moral point of view, while others
wished more frequent doses. The elderly patients seemed to appreciate
this remedial agent to a fuller extent.
_Pneumonia_
The pneumonia following the original infection was, from the standpoint
of physical diagnosis, often difficult of diagnosis in its early stages.
The infection commencing as an influenza would at times pass
imperceptibly into pneumonia, and obviously the points brought out in
the previous paragraphs on treatment were applied until the diagnosis of
pneumonia had been established. Some new factors were peculiar to the
pneumonia and demanded further changes in the handling of the cases.
Public-domain text, read in full here on John Shaqi.
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