Recipes Project - Nursing and Nutrition: Treating the Influenza in 1918-9

06/02/2018 Lisa Smith https://recipes.hypotheses.org/ By Ida Milne Monster representing the influenza virus. E. Noble, c. 1918. Credit: Wellcome Library, London. This season’s higher than normal influenza cases has inevitably drawn comparisons with the 1918-19 influenza pandemic, the worst in modern history. It killed more than 40 million people, according to the World Health Organisation. It punctured medical doctors’ newfound confidence in the power of bacteriology to fight infectious disease. In Ireland, it killed at least 23,000 people (the number of certified deaths from influenza and excess pneumonia) and infected about 800,000 people, one fifth of the population. Entire communities fell silent as it passed through. Laboratories churned out vaccines, but the general consensus was these vaccines, made from bacteria suspected to cause influenza like illness such as Pfeiffer’s bacillus (haemophilus influenza), were ineffective. Physicians threw everything in their medical bag at it, trying desperately, and in vain, to find a cure for a disease they found baffling. Ultimately, doctors came to realise that the most effective treatment was good nursing – which included nutritious food – and strong liquor. From a school journal The Clongownian, 1919. By kind permission of the editor, Declan O’Keeffe. There was little consensus amongst the medical profession on what medicine worked best. Some suggested quinine and grains of aspirin to reduce fever and grains of opium for sleeplessness. Calomel (mercurous chloride) was liberally prescribed, as doctors then were very keen on keeping the bowels open. Strychnine, which we tend to view now as the villain’s poison of choice in James Bond movies, was injected as a stimulant. D.W. McNamara, a young house doctor in Dublin’s Mater Hospital during the crisis, later wrote that one of the popular treatments in the hospital was an injection of camphor in olive oil, which he described as ‘the very nadir of therapeutic bolony’. Instructed by his seniors to use it, he felt guilty that he had inflicted further pain and suffering on the very ill. Some doctors, especially his older colleagues, favoured brandy or whiskey ‘in heroic doses’. Alcohol had, he considered, a good deal to recommend it, as it was ‘probably no less worthless than any of the other nostrums, and at least its customers had a merry spin to Paradise’. The demand for whiskey was so strong that some flu-stricken communities wrote to the Chief Secretary’s office to see what could be done to improve supplies. Non-prescription medicines were in high demand. As well as compounding regular medicines, pharmacists worked long hours to prepare huge quantities of tonics, cough medicines and poultices. The poultices were usually a mixture of boiling water and ground linseed, reputed to aid decongestion, enclosed in cloth and placed on the chest or throat.[1] Journalists passed on tips on cures to their readership. The Irish Independent related that Major R. T. Herron, Medical Officer, Armagh Union infirmary, had suggested gargling with a solution of permanganate of potash as a useful preventive measure. Sir R. Winfrey, MP, a qualified chemist, recommended a prescription of thirty drops pure creosote, half-ounce rectified spirit, three-quarter ounce liquid extract of liquorice, two drachms salicylate of soda and twelve ounces of water, with the recommended adult dosage of two tablespoonfuls three times daily.[2] While good nursing with bed rest, plenty of liquids and nourishing food offered a better chance of survival than medication, this was not always possible when every member of the family was sick. In some areas, the Women’s National Health Association, the St Vincent de Paul and neighbours set up community nursing schemes and community kitchens to cook and deliver nourishing soups and stews to those too weak to care for themselves. Local farmers often donated vegetables and meat. Sinn Féin’s Dr Kathleen Lynn, who opened a hospital to treat influenza sufferers and vaccinate people, suggested that sufferers should be given milk, barley water and egg flip, while those in good health ought to fortify themselves with butter, eggs, fresh meat, vegetables and porridge. Many newspapers reported that people were carrying handkerchiefs doused in eucalyptus oil in front of their mouths as a preventive measure. Macnamara considered this practice about as effective against influenza as ‘a black beetle would be to halt a steamroller.’ Advertisement in Abel Heywood and Son’s Influenza: Its cause, cure and prevention, 1902. Credit: Wellcome Library, London. Beef extracts Bovril and Oxo were in heavy demand, and production was sometimes halted when they ran out of bottles when sales went up. Beef extract or tea was understood to strengthen the body as a defence against infection. Goodbody’s Flour Mills in Clara, Co Offaly supplied Bovril to their 300-strong workforce during the pandemic. Manufacturers changed their regular advertising to offer their product as a useful treatment. Readers of the Enniscorthy Guardian were urged to ‘pour a little Cousin’s lemonade into a saucepan and warm it, to provide the perfect drink for influenza sufferers.’ A pharmacist in Gorey, Co Wexford, advertised his cod liver oil emulsion as offering protection from influenza. Purveyors of snake oils – the cure-all nostrums – swiftly added curing influenza to their list. Such claims preyed on the general fears created by an untreatable mass disease. The use of whiskey as a treatment crops up frequently in written records and oral histories I captured from survivors or families of sufferers. Raphael Sieve, whose family lived in south Dublin at the time, told me that his father kept his teenage brother constantly mildly drunk with whiskey at the time, until he pulled through. When I presented this idea in a paper, a medical doctor suggested that there might be good science behind it. He said that the reason that young healthy adults may have suffered more than normally in this flu was because of cytokine storms, where the immune system overreacts. He thought that small regular doses of whiskey might help prevent this. One survivor I interviewed, Tommy Christian, from Boston, Co Kildare, was administered gruel, a type of watery porridge, which he said ‘had an awful lot of responsibilities’, a hint perhaps that it was intended to open his bowels. His family put a poultice made of linseeds and hot water wrapped in cotton on his chest, another common treatment. Tommy had his first taste of whiskey, in a hot toddy – made from sugar, whiskey and hot water – as that five-year old flu sufferer, a taste he said he continued to enjoy for the rest of his life. Despite being extremely ill in 1919, he lived to his 99th year. Proof that the old remedies can sometimes be best? Editor’s Note: Ida Milne’s book on the influenza epidemic in Ireland comes out in May 2018 and can be ordered through Manchester University Press. [1] Telephone communication with a family member of Phillip Brady, who worked as a pharmacist at Kelly’s Corner, Dublin, during the epidemic; further details with author. [2] Irish Independent, 4 March 1919.