Instructions for Diagnosis and Treatment of Flu Cases

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Instructions for Diagnosis and Treatment of Flu Cases


Carney Hospital




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"Boston, MA - Carney Hospital", RG 11-2-1, Administration, Influenza Epidemic, Box 1, Folder 7

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cohol and one the history of being a total abstainer. The delirium of the total abstainer was as bad if not worse than that of the alcoholics. They all recovered and are now about at their business. Three died of acute mania, one at the Psychopathic Hospital and two here. One patient developed hemiphlegia and died.
One case of otitis media, one peritonsillar abscess with a history of many previous attacks and one one localized emphysema which went as low as the second rib. This case died.
It might be interesting to note that at the height of the epidemic one case of malaria, one of typhoid, and one of scarlet fever were admitted to the wards as Influenza.
Sputum of the first 24 sailors admitted, four contained Group 4 pneumo-coccus only one had Group 2 pneumo-coccus. This case received 200 C.C. of serum and recovered.
Casts and albumin were found in the urine during the height of the attack but no true nephritis followed the disease.
Onset--Sudden, with chills and fever, pains in the back and legs lasting for three or four days, headache in no particular region, epistaxis, either early or fairly late, burning sensation of the eyes, injected conjunctive, the throat was raw and sore and the voice was hoarse or lacking. No coryza and rare herpes. The cough was dry and paroxysmal and tracheal in character. The fever in the uncomplicated disease lasted from four to six days, and with a high fever there was usually a slow pulse and respiration. Some of the patients were delirious and some were typhoidal in character, or in stupor. There was erythema of the face, back and chest. The white count was invariably low. The symptom which indicated a grave prognosis was the cyanosis of the lips, lobules of the ears and finger nails and tongue. This was present when the pulse was good, and when there was no evidence of dilation of the heart. It si-
mulated very closely one case which I have had under observation for some time which is the result of acetanilide poisoning in a patient who is addicted to the constant use of Orangeine Powders used for headache.
Salts, rest in bed, good nursing, baths for temperature over 102 5/10, no gargles, no throat sprays, for pain Sodium Salicylate and Sodium Bicarbonate equal parts grains 10: for cough Ammonium Chloride, Syrup of Tolu, Heroin, Paragoric, and Morphia, for stimulation in pneumonia Digitalis, plain tincture, if nauseated digalen hypodermically Barium Chloride, 1/4 grain every four hours, Caffeine Citrate, Cocaine Hydrochloride grains 1/5, and Camphor in Oil.
Recently we have been using blood serum:------When patient enters a white count is done, and if the history given shows a possible temperature over 4 days or physical signs show a pneumonia count below 10000--100 C.C. of serum is given and blood for Wassermann is taken at the same time. The serum is repeated in 24 hours if necessary. It is injected into the vein at a temperature of 42 degrees C. slowly by a 100 C.C. syringe. No ill effects seen, no remarkable drop in temperature, patients got well. No patient received more than a 200 C.C. On one case the temperature went from 104 to 106 a few hours after. After injection all stimulation is omitted for 24 to 48 hours and a 2 hour chart is kept. We have used it on four patients but failed to see the wonderful results tabulated by Redden and Maguire of the Naval Hospital. However we feel that it is of great value and shall continue to use it. The serum we use is prepared to expert Serologists and our technique for administration is good.
We never waited till the 10th day of convalescence to take the blood, taking it as early as the 4th day, repeating it in from 48 to 74 hours. We have never taken more than 500 C.C. at one time and never drew blood more than twice from the same patient. They feel by that time that they have given enough. One who received 200 C.C. gave up 500 in return but refused to give
any more, figuring that we had taken more than he had seen given to him. Even in the hospital it is difficult to get blood after serum is given. One patient who received 200 C.C. promised to give when stronger. She can not be persuaded to return. In the Naval Hospitals they take blood four times. Other places they conceal the bottles and pretend to do Wassermanns. Here we work in the open, if they refuse to give we have to be satisfied. We try to give the serum early, never late or in moribund cases, never in cases with a white count of over 10000; but we do give it in cases of a fixed type of pneumo-coccus grouping if the count is low. It is never given to any straight influenzas
We know by the time the patient is ready to give what his Wassermann is. If the case is positive specific we have used the serum in one case and rendered it harmless by adding 3/10 of 1 C.C. Tricresol to each 100 C.C.
I shall show you apparatus for collecting blood and demonstrate its use. Also apparatus for administering the serum. We do not prepare the serum ourselves as we find we can get better and more serum out of the blood from the hands of those who are proficient in its preparation. 500 C.C. of Blood yields in their hands a little more than 200 C.C. of serum.

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Carney Hospital, “Instructions for Diagnosis and Treatment of Flu Cases,” Daughters of Charity, Province of St. Louise Archives, accessed March 4, 2024,