Reprinted from The Medical and Surgical Reporter, January 13, 1894. 
Influenza and its Treatment. 
CHARLES B. WILLIAHS, A. B., 1*1. D. 
PHILADELPHIA. INFLUENZA AND ITS TREATMENT. 
CHARLES B. WILLIAMS, A. B., M, D.,* Philadelphia. 
Influenza(syn.Epidemic Catarrhal Fever, 
Contagious Catarrh ; French, La Grippe) 
is essentially an epidemic disease, running 
a specific and definite course and charac- 
terized by a catarrhal inflammation of the 
respiratory organs and sometimes of the 
digestive. There is pyrexia and a great 
deal of constitutional disturbance, with 
marked debility and depression of spirits. 
Epidemics.-The first epidemic of influ- 
enza that has been recorded in any medical 
record, occurred in 1510. But there can 
be no doubt that Aristotle and Galen 
saw epidemics similar to those which oc- 
curred in 1510 and those which at irregu- 
lar intervals have occurred in our own 
times. Among the chief epidemics of 
influenza are those-of 1762, 1782, 1787, 
1803, 1833, 1837, 1847. 
Watson, in his "Annals of Philadel- 
phia," states that Noah Webster in his 
work on "Pestilence" says : " The city 
was again visited in 1747, by bilious 
plague" preceded by influenza. Watson 
further states that in August and Septem- 
ber, 1807, the influenza prevailed in Phila- 
delphia. Then we have the epidemics of 
the last few years, occurring since 1889, 
with which we are all more or less familiar. 
Causes.-The Italians, in the 17th 
century, ascribed it to the influence of the 
stars, hence the term "Influenza" (Ital., 
Influence), by which the disease is now 
known. The more probable and more 
generally accepted theory is that influenza 
is due to some minute organizm of a spe- 
cific nature, conveyed by the atmosphere 
and distributed over wide areas. This 
organism, when introduced into the bodies 
of those affected, increases and multiplies 
indefinitely, and hence we have another 
source of infection in the breath, etc. 
Anyone having carefully observed the 
course of the present epidemic would not 
venture to question the contagiousness of 
influenza. 
Symptoms:-The period of incubation 
may last from a few hours to as many 
days, or may extend to two or three weeks. 
The disease usually develops suddenly 
with rigor or chills followed by fever, the 
temperature ranging between 101° and 
103° F. The pulse, at first frequent and 
full, soon becomes soft, weak and slow. 
At the same time the patient complains 
of severe aching and shooting pains in the 
back, limbs, chest, neck and eyes. Sore 
throat is a marked early symptom of the 
disease. Then follow hoarseness, coryza, 
deafness, dizziness, and sometimes nausea 
and vomiting. 
The local symptoms vary in individual 
cases, but as a rule they begin in the nose 
and conjuntivae and extend downward. 
There is an abundant watery discharge 
from the mucous membrane, accom- 
panied by sneezing, with impairment of 
taste and" smell. The mouth, tongue and 
fauces are sore. The inflammation ex- 
tends further down, ending in either a 
laryngitis or a bronchitis, with possible 
complications of pulmonary congestion, 
capillary bronchitis or pneumonia. 
Some persons are much less susceptible 
to the disease than others, while on the 
other hand, some appear to be altogether 
insusceptible. Influenza can hardly be 
termed a dangerous disease unless it ends in 
pneumonia. It is occasionally fatal to in- 
fants and to aged people. Then, as so many 
persons in every large community are 
" tottering on the brink of the grave," 
the influenza proves the immediate cause 
of the increase in the death rate during 
the prevalence of an epidemic. 
The prognosis is especially grave in 
chronic pulmonary or cardiac disease. 
Haemoptysis may not unfrequently, occur 
in those predisposed to it. The writer 
has seen an example of this occurring in 
a patient residing in Montgomery County, 
Penna. The prognosis is also grave where 
there are evidences of weak circulation, or 
symptoms of adynamia, as in diabetes, 
Bright's disease, fatty heart, etc. 
Treatment:-There is no specific for 
influenza, but it is possible, and indeed it 
is often highly important, to arrest the 
disease, or diminish its violence at its 
onset. 
In the first place, all cases should be 
kept indoors, in a cool room, well venti- 
lated, but free from draughts. If the 
case is seen early, Pulv. ipecac et 
opii gr. x., either alone or in combination 
with Pilocarpinse hydrochlorat. gr. i-i, 
* Ex-Resident Physician Pennsylvania Hospital, 
Assistant Surgeon to Methodist Episcopal Hospital. 3 
taken at bedtime with a hot lemonade, 
will do a great deal towards diminishing 
the violence of the attack. 
The above treatment will be found to 
ameliorate considerably the pains and 
cough, and the patient will feel relieved 
by morning. Quinine is a remedy usually 
well borne, and in combination with 
Strychnia, gives good results, especially 
where there is marked debility. The 
following formula will be found to be of 
excellent service in this stage. 
TV QuininflB sulphatis vel Cinchonidinse sali- 
JLK cylatis gr. xviij. 
Strychnin® sulphatis gr. ss. 
M. et div. in pil no. xij. 
Dispense in capsul. 
Sig. One pill t. i. d. 
Should the patient still complain of 
pain or be restless at night, small doses of 
ext. Opii may be conveniently added to 
the above formula. 
A prominent symptom of this year's 
epidemic has been a severe supra-orbital 
neuralgia, attended sometimes with shoot- 
ing pains in the frontal sinuses. Indeed 
the neuralgia has shown a tendency to 
persist long after the active symptoms of 
the grippe have subsided. This pain may 
be due to pent-up nasal secretions or, on 
the other hand, it may be purely neuralgic. 
However, the following treatment will 
usually afford relief: Internally, large 
doses, of the salicylates, preferably, Am- 
monij salicylatis gr. xv. q. q. h., and the 
instillation of a drop or two of a 1 per 
cent, solution of Cocaine hydrochlorate 
into the nostril of the affected side. If 
there is occlusion of the nares from pent- 
up nasal secretions causing pain in the 
frontal sinuses, then the occasional use of 
Dobells solution with the atomizer,may be 
all that is necessary to relieve the patient. 
One can readily see that the treatment 
of influenza resolves itself almost entirely 
into symptomatic treatment. 
For the bronchitis that usually follows: 
In the early stages the following formula, 
advised by Dr. H. C. Wood, is valuable: 
TV Potassii citratis gss. 
-LV succus limonis fjiss 
Syrup, ipecac f5iij. 
Glycerinae f3ss. 
Aquae q. s. ad fsiij 
M. Sig. fSij.q. s. h. 
Should there be extensive bronchitis 
and the secretions accumulate, and there 
are evidences of pulmonary congestion, 
then Antimonii et potassii tart. gr. ss., 
may be conveniently added to the above 
formula. Eucalyptol vel Terebene, m v. 
in capsul. q. q. h. will also act well in 
this complication. 
Where expectoration has been estab- 
lished and is no longer tenacious, an ex- 
pectorant mixture containing Ammonium 
chloride maybe substituted for the above. 
Alcohol in the form of brandy or whis- 
key, and best administered in egg-nogg or 
milk punch, is required where there is 
much debility and in old persons who 
need stimulus, from the start of the dis- 
ease. 
The diet must depend on the individual 
case. Should the case be a severe one, 
large quantities of concentrated liquid 
nourishment are required. Usually most 
patients,in the first few days of the disease, 
refuse nourishment in any form whatso- 
ever. The writer has found that boiled 
milk seasoned with a little salt, will be 
taken and relished by these patients who 
could not be induced to take any other 
food. 
During convalescence, tonics together 
with nourishing food and some mildly- 
stimulating beverage, as wine or beer, are 
required. Change of air is beneficial, but 
the patient must guard against taking 
cold and sustaining a relapse.