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
Following the 1890 epidemic cases complaining of blindness or partial
loss of vision, with optic œdema or neuritis and a glycosuria, were
occasionally observed. We have seen one of this type, and several
transient glycosurias without eye signs or symptoms. The glycosuria may
be of nervous origin. Our method of treatment was one of elimination and
rest. The gastro-intestinal tract was emptied with calomel, and
afterward a morning saline was given for a few days. Hot packs were
administered, one a day for about two weeks. The patient was instructed
to drink as much water as possible, and we eliminated sugar, bread and
the 20 per cent. vegetables from the diet. The glycosuria lasted for
three days, while the vision, although beginning to improve at once
after treatment, took five weeks to return to normal. The patient was
kept in bed for three weeks. How long the glycosuria had been present
before admission to the hospital we do not know. The transient
glycosuria group without the eye manifestations required very little
treatment. They also showed a transient hyperglycemia. A carbohydrate
free diet very rapidly cleared up these cases. After a time we decided
to watch the course of this group on a non-restricted diet, even with
sugar, and we found that they all returned to normal (blood and urine),
in a few days clearly indicating their transient nature. We do not
regard this process as a diabetes mellitus. We do not give the hot
packs, although free elimination by bowel was attained in all. These
cases were recognized only through routine urine examination.
Furunculosis with a high blood sugar, in one case 0.41, without
glycosuria was a very interesting complication. We saw a great deal of
furunculosis, always with the increased blood sugar from 0.2 to 0.3, but
never with glycosuria. Reducing the carbohydrates, or even a fast day
with good intestinal elimination, had excellent results.
Neuritis and general debility have often been associated with nasal or
tonsilar infection, which when surgically corrected led to the
disappearance of symptoms and improvement of health.
Finally, we wish to refer to an isolated case of acute osteomyelitis
which was incised, and from the purulent fluid present in the bone B.
influenzæ was grown in pure culture. This is a very unusual
complication, and is of particular interest on account of the positive
bacteriological finding. The patient made an uneventful recovery.
McGuire and Redden Jour. A. M. A., 1918; lxxi, p. 1311.
McGuire and Redden Jour. A. M. A., 1919; lxxii, p. 709.
Brown and Sweet Jour. A. M. A., 1918; lxxi, p. 1565.
Ross and Hund Jour. A. M. A., 1919; lxxii, p. 640.
Spooner, Scott and Jour. A. M. A., 1919; lxxii, p. 155.
Heath
Maclachlan and Fetter Jour. A. M. A., 1918; lxxi, p. 2053.
Heist and Cohen Jour. Immunol., 1918; iii, p. 261.
Kyes Jour. Med. Res., 1918; xxxviii, p. 495.
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