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Fighting Influenza

How did physicians and scientists understand influenza in 1918?

During the mid to late nineteenth-century, physicians and scientists had begun to understand that diseases are caused by microorganisms. This was a radical departure from traditional medical theories which had held that diseases were caused by miasmas or an imbalance in the body’s humors.

Building on this new understanding of disease, scientists and physicians achieved incredible successes, identifying fifty causative agents of diseases ranging from typhoid, tuberculosis, cholera, plague and malaria between 1880 and 1920.

In 1918, most physicians and scientists mistakenly believed that influenza was caused by a bacteria. not a virus. Called Pfeiffer’s bacillus, this bacteria had been first identified as the cause of influenza by Robert Friedrich Pfeiffer, a leading German scientist. Although Pfeiffer had failed to provide definitive proof that this bacillus actually caused influenza, few scientists questioned his claims.

In the midst of the pandemic, however, this theory came under attack. Researchers performing autopsies on influenza victims reported, over and over again, that they had failed to locate the bacillus. Attempts to infect healthy patients with influenza by injecting them with Pfeiffer’s bacillus also failed to cause influenza.

Although they were unable to locate the cause of influenza, scientists and physicians did understand that influenza was spread through contact with droplets from the nose and throat of an infected person during coughing and sneezing.

What happened when patients contracted influenza in 1918?

Most early twentieth-century physicians were familiar with influenza and its symptoms. Diagnosis, however, was often difficult as physicians frequently confused the disease with another viral infection, the common cold. In 1918, diagnosing influenza became even more difficult because an especially virulent form of the disease had erupted.

Early symptoms of the disease now included a temperature in the range of 102 to 104 degrees. Along with this high temperature, patients also experienced a sore throat, exhaustion, headache, aching limbs, bloodshot eyes, a cough and occasionally a violent nosebleed. Some patients also suffered from digestive symptoms such as vomiting or diarrhea. Most patients who experienced these symptoms made a full recovery.

Many patients recovered only to suffer a relapse. Their temperatures, which had fallen, rose again and they now experienced serious respiratory problems. In some cases, these patients also experienced massive pulmonary hemorrhages. After death, pathologists found these victims to have swollen lungs and oversized spleens.

Because patients experienced symptoms not traditionally associated with influenza, physicians found the disease especially difficult to diagnose in 1918. In the early stages of the pandemic, many physicians and scientists even claimed that influenza patients were suffering from cholera or bubonic plague, not influenza.

Preventing Influenza:

Before the advent of antibiotics in the 1940s, practitioners had only a limited ability to treat diseases. Moreover, even if antibiotics had been available in 1918 (they were not), a viral disease such as influenza could not have been treated by these drugs.

As a viral infection, influenza can be prevented by a vaccine and during the early weeks of the pandemic, many people believed that a vaccine against influenza was forthcoming. Although vaccines have been developed before scientists have ascertained the exact cause of a disease, medical researchers’ failure to ascertain and isolate the influenza virus did not bode well for the development of an influenza vaccine at this time.

During the fall of 1918, researchers from the Public Health Service, including the renowned Joseph Goldberger, began looking for a vaccine. They were joined by researchers in many other countries. These researchers developed a range of vaccines which were then tested in communities all over the world. None of these vaccines proved effective.

While researchers placed their hope in vaccines, many politicians and physicians came to believe that the spread of the disease could be contained by quarantines and bans on public gatherings.

Across the United States, cities and counties also began to require or recommend that citizens wear gauze masks. Unfortunately, while masks are highly effective at preventing diseases which are caused by bacteria , they are less effective in providing protection against viral diseases. As a result, even in communities where the wearing of masks was made mandatory, influenza could not be contained.

Public officials also sought to limit influenza by banning spitting in public places and demanding that those who sneezed covered their mouths.

Treating Influenza:

Confronted with a widening pandemic, physicians and scientists now began thinking about ways to treat and cure influenza. Here again, limited understanding of the disease meant that many of the treatments advocated by both physicians and laypeople were ineffective.

Practitioners and patients used a variety of remedies, many of which could be found in their local drugstores. Patent medicines, that is medicines whose ingredients were secret and trademarked, were still very popular. Among these medicines, Vicks Vapo-Rub, atropine capsules (belladonna), and a host of other treatments were especially common. In terms of curing or even treating influenza symptoms, these remedies did little to nothing.

Although most physicians no longer believed that diseases were caused by miasmas or an imbalance in the humors, many practitioners did resort to treatments which were derived from these medical theories. These treatments included causing patients to sweat by wrapping them in blankets or cupping them to remove excess blood.

Home remedies were also popular and many people wrote to the Public Health Service recommending treatments which they had developed. A “sure cure” for influenza was proposed by a woman in Missouri who claimed that her secret remedy consisted of water, salt and coal oil. She offered the remedy to the government for a reward. No such reward had been offered but she was not the only person to believe that a reward would be forthcoming.

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