Med Journal October 2020 - Page 8

tle Rock echoed his boss ’ s sentiments “ it is just simple , plain old la grippe .” 7 As late as October 4 , when the civilian cases of flu began to mushroom in the central Arkansas area , both Dr . Geiger and Dr . Charles Garrison of the Board of Health continued to attempt to prevent panic in the general population with calming statements .
Drift vs Shift
The flu virus has a heightened ability to change the face it shows to the human population . On the surface of this virus are two common type of proteins ( designated as N and H ) that provide a fingerprint that the human immune system can recognize and produce antibodies . Once infected with the virus , the human system produces immunologic memory , protecting against repeat infection or at least moderating the effect of the virus . The proteins on the surface of the virus have the ability to undergo change so that the human host can ’ t recognize it . The terms viral drift and shift are used to describe how this change occurs . In most cyclic epidemics of influenza , the virus undergoes a viral drift ; meaning , that it changes , but not much . In the event of a viral shift , the change is enough that most humans can ’ t recognize the virus and the epidemic is much worse . The Flu of 1918 , represented a dramatic viral shift and the result was a worldwide pandemic . There is speculation that there were similarities between the Russian Flu in 1889 and the Spanish Flu of 1918 . Most flu epidemics strike the very young and those over the age of 65 . In 1918 , the flu had a much larger impact on young adults than the older population . One explanation for this change would have been that those in the over 65 age group were exposed in 1889 and therefore had a degree of immunologic memory .
A second element that intensified the impact of this flu on the younger humans has to do with a vigorous immune system . Young adults have a stronger immune system , the virus attack is met with a strong overwhelming response ; this is now known as a “ cytokine ” storm . 8 It is thought that this response may have been responsible for the dramatic increase in pneumonia , central system infections , and death observed in otherwise healthy young people during the 1918 pandemic .
What tools did they have to fight the flu ?
The Chinese have a saying ; “ when hope is gone , the ultimate sanity is grasping at straws .” Often , families relied on folk medicine and family remedies . If home remedies failed , they called the doctor . The physician ’ s armamentarium was quite limited . Three medicines served as the most commonly used : calomel ( mercury ), quinine , and laudanum ( opium ). These medicines had a long history in
Advertisement for a cure for the Spanish Flu from Dr . Davie that appeared in a 1918 edition of the Malvern Metore .
treating fevers of other origins , especially calomel and quinine . In hindsight , the mercury made the influenza worse . Quinine , commonly used , for malaria and other fever illnesses , may have modulated the fever and opium had an impact on the muscle aches and headaches associated with the flu .
Even in normal times , patent medicine advertising provided a large part of the revenues for newspapers ; during epidemics this increased . Tanlac is a good example of a medicine that was advertised in obvious drug ads in local papers like the Benton Courier . In addition , articles were published that appeared to be legitimate articles , quoting U . S . Government authorities . Reading through the articles , it becomes clear that the purpose of the articles was to sell a drug like Tanlac . 9 An interesting aside , is the repetition of the same article in many small-town newspapers across the state .
After the epidemic in 1889-1890 , Dr . Richard Pfeiffer identified
80 • The Journal of the Arkansas Medical Society www . ArkMed . org