Treatment of Influenza in Italy

Kai Tiaki : the journal of the nurses of New Zealand, Volume XII, Issue 1, 1 January 1919, Page 20

Treatment of Influenza in Italy

A Sister on the Italian front writes : — " Since I have been back we have been fighting a most terrible outbreak of Spanish influenza, and our death roll has been ghastly. It seoms now as if the scourge wore abating slightly. I encloso a brief note of what was to mo quito a new treatment — the C.C.S. doctors hero rejected it as too brutal. " Abces de Fixation. " The influenza epidemic, generally taking the form of septic pneumonia, has boon raging with unexampled fury on tho Italian front. In various places the following heroic remedy has met with a certain amount of success : That a general inflammation sometimes cures itself by sudden local suppuration is well known; tho method of Fochier is founded upon this principle, and aims at artificially producing the necessary suppuration in the form of an abscess. " Tho irritant medium employed is spirit of turpentine, of which 1 cubic centimetre is injected into the cellular tissue of the loin, thigh or log. Should no painful reaction follow within twelve hours from the timo of the first injection, another must be made at a different spot, and this may be repeatod a third or even a fourth time, though tho ' prognostique ' is not very favourable if a second has boon made without result, the probability being that in this case tho patient's vitality is so much lowered by the course of tho disease that no further leucocytic reaction is capable of taking place. It is, therefore, important that recourse should be had to this remedy before it is too late, though naturally from the extreme painfulness- of the procoss, doctors are unwilling to employ it if o cure can be obtained or reasonably hoped for by ordinary means. (In the case of children pure turpentine must not bo employed, but diluted with GO per cent, of sterilised oil it can be tolerated fairly well.)

" Tho rosult expected and desired from the turpentine injection is that within a few hours, generally six or eight, redness, swelling and intense pain appear in the whole limb. These conditions tend to localise with more or loss rapidity (septic symptoms elsewhere at the same time subsiding), pus is formed and a large abscess results, which must be treated with hot fomentations, both to assist maturation and to control the pains. It must be opened, with tho usual aseptic precautions, at the critical moment, just

before it bursts, probably in from five to six days ; not too soon, or the full benefit will not be obtained. If, on the other hand, it appears to open prematurely of itself, and the pus begins to trickle away while the general inflammatory condition continues, a second abscess must be induced in another place.

" The pus in these abscesses smells strongly of turpentino, and is in itself aseptic, but the wound remaining after the abscess has been drained is highly suscoptible of infection, and the utmost. precautions must be taken to keep properly sterile dressings constantly in place ; often a most difficult matter with delirious patients for each of whom a special nurse cannot be detailed, and unavoidable secondary infection has sometimes taken place with fata] results. Jn favourable cases, the abscess having boon satisfactorily drained and kept aseptic, begins to heal, and the whole process is over in eight or ten days. If the patient's strength can bo maintained there is then a very good chance of recovery.

"As may be imagined, this method is not very favourably regarded by the patients, who groan over ' V abces du medicin. Comme si je n*avais pas assez de mal sans cela ! ' If indeed they are in a condition to speak.

" If, however, life is to bo saved, it is worth it."-— From "The British Journal of Nursing."

In connection with tho above, the- following extract from a nurse's account of her exporiencos in nursing influenza in Now Zealand is of great interest : — ■

'The first blister applied was kept on (by a V.A.D.) almost twelve hours : result, skin broken and open wound, but recovery of patient. Therefore in cases where the temperature kept persistently high this treatment was adoptod, and in every case proved successful. Of course, before applying the blistor (a little above the lumbar region, at bases of lungs), the patient was told what might happen, therefore was not alarmed. I could not get the cantharides blisters as the hospital cleared out the chemist's shop, but I have since thought that possibly the Maoris would nover havo stood this hnroic treatment ; certainly I found iodine practically useless, and mustard gave but tomporary rolief. Turpentine somotimes gavo relief, but as we all know in some cases nothing that we could do would save them."