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Vol. II. JANUARY 15th, 1894. No. 7.
Editorial.
INFLUENZA AND ITS TREATMENT.
The manifestations of Influenza in this section of the country during the past two months have been numerous and varied, although the malady has been far less directly fatal than on its first appearance in the winter of 1889–90. The different types of the disease, the pulmonary, the nervous and the abdominal, have been less distinctly marked, but it has been especially severe in the case of elderly people when appearing as an intercurrent affection. Another noticeable feature is, that the disease has shown a greater disposition to attack children than in former years, although when children have been enjoying usually good health, fatal results have been rare. This, however, has not been the case with sickly or puny children, as the disease has manifested itself in various ways, such as throat, ear and other complications. In many cases nothing more than the peculiar pains characteristic of the disease have been noticed; in others, it has passed off with nothing more serious than would result from a bad cold, so that large numbers have fought it out on this line. The prevalence of the malady in the vicinity of Philadelphia, and we presume this observation holds good elsewhere, has been wide spread, showing conclusively that it is largely dependent upon atmospheric influences. Indeed, up to the present writing, the condition of the weather has been extremely favorable to the development of influenza, and we all hope that better weather during the remainder of the winter will tend to check its spread.
Judging from published reports, the treatment of influenza during the present epidemic has been mainly symptomatic, simple remedies being employed in place of the powerful antipyretics and analgesics that were so extensively used three years ago, and this may account in part for the reduced mortality. In this connection the writer ventures to suggest the use of a limited number of remedies that have proven of signal service within the past two months. In the pulmonary type, to relieve the distressing and frequent cough, nothing has given better results than morphine hydrochlorate and pilocarpine hydrochlorate, given hourly in doses of one-fiftieth of a grain each, together. This combination seems to allay sufficiently extraneous irritation, while it favors the re-establishment of the normal secretions, and has shown remarkably favorable effects when broncho-pneumonia threatened to supervene. Given in these small doses, it produces neither narcotism nor depression, and the patient is ready to take his regular meals, to which is added liquid nourishment during the intervals. Hot milk—not boiled—and the free use of beef-tea made from a good extract of beef, are helpful in assisting to maintain the strength. In the abdominal type, with much pain along with mucous discharges from the bowels, showing involvement of the liver, a combination of mercury biniodide with codeine sulphate appears to control and modify the progress of the disease. One one-hundredth grain of the former with one-tenth to one-fifth grain of the latter may be administered every two hours, and along with this, where we have to contend with the pains peculiar to influenza—rheumatic and neuralgic—it is well to administer conjointly small doses of bryonia. From two to five drops of the tincture can be given at intervals of two to four hours. Cases which do not respond readily to bryonia, will often quickly show amenability to the administration of rhus toxicodendron, given in one-drop doses of the green root tincture at intervals of two hours. It is remarkable what power these two simple remedies exercise over the fugitive neuralgic pains peculiar to influenza, doubtless because they modify the nutrition of the cells composing the fibrous structures, enabling them to throw off waste products and thus maintain a condition approaching that of health. The after-treatment will embrace the administration of the arseniates of iron and strychnine, and in debilitated subjects this should be supplemented by the exhibition of cod-liver oil or petroleum in the form of emulsion.
It will be noted that nothing has been said in regard to the advisability of antiseptics, and for this reason, viz.: That although the disease may apparently be associated with a micro-organism, this microbe plays no important part in the various manifestations of the disease. Whatever influence it may possess is, as we have seen from clinical experience, counteracted, discounted, by what the older physicians were pleased to term the vis medicatrix naturæ; and besides, we have absolutely nothing to warrant us in assuming that our present antiseptic measures and remedies exercise any perceptible influence when taken into the system, at least so far as regards this particular malady. Further investigations in this line may develop some new ideas in this respect, but for the present, we must rest content with the stern facts as we see them at the bedside. Special attention should be directed here to the theory of “Digestive Leucocytosis,” as elaborated by Professor Chittenden, published in another department of this number.