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
We have previously considered pneumonia, which is the principal
complication with simple influenza, and the two are closely allied. As
an end result of the pneumonia, non-resolution and fibrosis of the lung
are of first importance. We cannot say very much on the treatment of
this condition. The duration varied from a few to several weeks, and
recovery was infrequent. Our treatment aimed at supplying as much
nourishment as was possible to give, with, in addition, good nursing.
The treatment otherwise was purely of a general hygienic type. Tepid
sponging appeared to give considerable relief from the profuse sweating
these patients so often had. Drugs were of value only for some local
effect. We wonder if carefully handled vaccine therapy at the onset of
such a complication might not prove of some value. The autogenous would
be the one of choice.
Empyema was not found to be as prevalent as one would imagine. With so
much non-resolution of lung following the pneumonia we were surprised to
see so little empyema. All delayed resolutions we explored with the
needle, so we feel that the condition, if present, would have been
recognized. The treatment of empyema need not be given any special
emphasis. It is, as of old, a surgical affair. One or two new points in
the technique have been brought out in the way of drainage, but possibly
they have not been sufficiently tried to lay any stress upon them at
present. Dakin’s solution in certain chronic cases appeared of value.
Our empyema cases did well.
Pleurisy with effusion was observed a number of times, although it has
been our experience to find a very few large effusions. Pleural puncture
often gave negative results, even when the signs did appear to indicate
the condition. We aspirated the fluid when present. The end results were
always good. In only one case did we have to repeat the aspiration for
reaccumulation of fluid.
Chronic bronchitis, accompanied at times with considerable dyspnœa, has
been seen on several occasions. There is very likely associated with
this condition some fibrosis of lung, and probably some organization of
small bronchioles themselves. Expectoration has been variable, profuse
or scanty, mucoid or purulent. We consider rest in bed, with as full a
diet as possible to build up the general condition of the patient, the
best form of treatment. These cases had little or no temperature, and
consequently at first absolute rest was not considered necessary, but we
now regard it as the essential part of the treatment. Atropine and
heroin are of value at certain times. We confess to have seen very
little benefit from the expectorants. We are rather surprised that this
sequela is not of more frequent occurrence.
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