180 THE BRITISH HOM(EOPATHIC JOURNAL

OBSERVATIONS ON I N F L U E N Z A L COMPLICATIONS AND T H E I R ;

TREATMENT

By C. O. KENNEDY, B.Sc., M.B., Ch.B., M.F.Hom

LAST month Dr. Hamilton covered a very wide clinical field in his survey of
Influenza, and this evening, I would like to present a few examples of the
complications seen i n the hospital. In all, I propose to present 18 cases;
9 were proved to have had recent infection with Influenza A Virus (by estimation
of their anti-bodies)--in this group there were no deaths. Two presented a
similar clinical appearance and are included. The remaining 7 cases died
before the tests could be carried out. They are examples of the difficult
problem with which the clinician was faced, and by examining them in detail,
I hope to suggest lines for future treatment.
Before proceeding, there are a few general points of note : I n comparison
with the 1918 epidemic, when 88 per cent. cases were under 55, only 12 per
cent. were under 55. Of our 9 proved eases, 2 were under 55 ; 4 in their
sixties, and 1 each in the seventies, eighties and nineties.
A previous history of respiratory disease was elicited in only 4 cases.
I t is the combination of chronic respiratory disease, and the older age group,
which has made the satisfactory treatment difficult. According to Anderson,
" i f chemotherapy depended solely, or even mainly, upon the bacteriostasis
induced b y the presence in the body of a certain active substance then such
an association (of age and effective chemotherapy--the results under the age
of 40 years are more impressive than they are over t h a t age) is difficult t o
understand. Does it not rather suggest that successful sulphonamide therapy
demands the active participation of the host, and that, as age advances, the
ability to supply this assistance appears to wane, irrespective of the type o f
infecting organism ?a ,, Homceopathic remedies presumably encourage the
active participation of the host.
At the Epidemiological Section of the Royal Society of Medicine the
unexplained explosive nature of the epidemic in Liverpool was noted. Rarely
did 2 cases occur in one household ; there appeared to be a rather indefinite
spread of the epidemic from North to South in an East and West stream.
The characteristic symptoms of Influenza were notably absent in the
hospital cases--viz, sudden onset ; constitutional upset ; headache ; muscular
pains; shivering; dry short cough and huskiness of voice. Instead, the
onset was gradual (3-35 days) and the presenting symptoms were dyspncea
on exertion--7 (4), physical weakness and exhaustion--5 (2), dry cough--4 (2),
with a poor m e m o r y - - 3 (2) and a peculiar euphoria--1 (3).*
I n view of this unusual clinical presentation, such possibilities as
glandular fever, Q-fever and psittacosis, normally considered, are unlikely.
Instead the conditions which h a v e to be excluded are :
Atypical pneumonias, aspiration pneumonias, Friedlander's pneumonia
(of which you saw an example last month), staphylococcal pneumonia and
tuberculosis. H e a r t failure due to bacterial or rheumatic endocarditis, or
cor-pulmonale.
In the stuporosed patient, ursemia, meningitis due to tubercle or
meningococcus, benign lymphocytic meningitis, poliomyelitis or encephalo-
myelitis.
I recently saw a case of a girl of 11 years, who had been off colour for
7 days and developed an increasingly severe headache with vomiting, restless-
ness and delirium in the last 3 days. On examination, the temperature was
103 ~ She was flushed and fretful and slightly confused, slight nuchal rigidity
* Figures represent number of cases in which the symptoms occurred : those in paren-
thesis are the fatal cases.
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 18!

with some crepitations at the right apex. She was thought to be a case of
atypical pneumonia, but she failed to respond to penicillin and X - r a y of her
chest was normal. A lumbar puncture was performed--pressure 200 rams., 280
lymph, protein 90 mgm., globulin slight excess, reflexes absent, flexor plantar
response, streptomycin 0.5 gm. t.i.d, with P.A.S. 3 gm. q.i.d, was commenced
on the possibility of tuberculous meningitis ; the temperature fell by lysis.
A transient facial paresis was noted, with a recurring palatal weakness. The
reflexes slowly returned, but a sensory aphasia remained, associated with a
peculiar childish behaviour and grimacing. By 3 weeks the C.S.F. protein
had fallen to 75 mgm. per cent. with 18 lymphocytes. When last seen, the
aphasia had improved slightly. Agglutinations to Influenza Virus A and B,
to lympho-choriomeningitis, Q fever, and mumps were negative.
Proceeding to our own series of cases, I have a t t e m p t e d to correlate
the clinical appearance with the underlying pathology, as shown in the
following Table and it is obvious t h a t the radiological picture bears no
relationship to the severity of the illness.

Clinical ! Chronic Broncho - Congestion Nil

Appearance i Pneumonia Pneumonia pneumonia
Influenza .. 2
Weakness - -i
Lethargy ~i (1) 1 2(2) 2(D
Exhaustion
Coma . . 1
Stupor . . . . 1

Numbers in Parenthesis are those who died.

CASE 1. (Chart 1. Plates I and II.)

9 Mrs. P., act 33. Pnuemonia. Influenza A anti-bodies 1/32.
Five-day history of generalized aching with headache. Shivering and
sweating. Pleuritic chest pain referred to left shoulder. Dry unproductive
cough. No previous history. T. 101% P. 144. R. 40. Consolidation left
base. Absent air entry hyperaesthesia chest wall, left. W.B.C. 15,400.
B.P. 125/75. Urine nil. Sputum, nil obtainable.
Pain Chest: < l y i n g painful side p. 843 Bell., (Bry.), Nux v., Ran. b., (Rumex).
< l y i n g left side p. 843 Agar m., (Am. c.), (Cahin.), (Calc.),
(Kalm.), Naja, Phos., Spig.
< touching p. 844 Dros., Phos., Ran. b.
< Inspiration p. 843 Bell., Calc., Naja, Phos., Ran. b.,
Rumex, Sang., Spig.
Pain Shoulder < c o u g h p. 1052 Bry., Phos.
Inflammation left lung p. 836 Calc. (Phos.).
Thirst and large drinks p. 529 Bry., Phos.
Desire cold drinks p. 528 Bry., Cale., Phos. (Spig.).
Perspiration palms p. 1182 Calc. phos.
Heat palms p. 1011 Calc. phos.
N o t e : 1. Ran. b. more useful in fibrositis. 2. Bry. outstanding
modalities absent, i.e. > press < movement.
Phos. indicated, why not t r y Senega---" Generalized aching chest wall.
Violent cough with strange sort of hypermsthesia of chest wails in affected area,
feels too hot and wants to push off blankets -.1
5th day Senega 1 cm 2-hourly given with > of chest pain; but still pyrexia
from 99-100.
7th day Senega 1 cm. 4-hourly.
14th day Phos. 200 12-hourly and temperature settled ; X - r a y ; consolida-
tion left base cleared by 25th day.
182 THE BRITISH HOM(EOPATHIC JOURNAL

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CASE 2
Miss D., aet 62. Apical Pneumonia; Influenza anti-bo~lies not done.
No previous history. Chill 12 days before admission, with onset 4 days ago
of severe aching pleuritic chest pain ; harsh cough ; slightly delirious.
T. 101 ~ P. 84. R. 24. Dullness right apex. X - r a y consolidation
right apex, cleared b y 19th day. W.B.C. 7,500. Blood urea 38 mgm. per cent.
Urine hyaline casts. Sputum N.-H. Streptococci.
(Anac., Bell., Bry., Calc. (Carb. v.), (Chel.), (China),
Pain head, <cough p.138 ~Coloc. (Con.), Lac d., Lath., Lyc., Nat. m., Nuxv.,
and ~ P r e s s u r e p.146 ((Phos.), Puls., Gang., Sep., Spig., Stann., Sulph.
> C o l d application p.138 Bell., Bry., Cale., Lac d., Lach., Nat. m., Phos.,
Puls., Spig., Sulph.
Stitching pain sternum < cough, p. 871. (Bell.), Bry.
Cough cold air < . p. 781. (Bry.), Calc., Lath., Phos. (Gang.), Sep. (Sulph.).
Cough must sit up. p. 803. Bry. (Lach.), Phos., Puls., Sang., Sep.
As soon as cough begins must sit up, Bry.
Fever, perspiration absent, p. 1289. Bell., Bry. (Lach.), (~at. m.),
(Nux v.), Phos., Puls. (Gang.), Sulph.
Dryness mouth with thirst, p. 403 Bry., China, Laeh., Nat. m., Phos.
(Sulph.).
 I N F L U E N Z A L C O M P L I C A T I O N S A N D T H E I R T R E A T M E N T 183

Discoloration tongue brown, p. 401. Bell., Bry., China, Lach., Phos.,

Sep., Sulph.
Restless tossing about, p. 73. Bell., Bry., Calc., Lach. (Phos.), Sep.,
Sulph.
Bry. 24/10. Lach. 14/8. Phos. 16/7. Sulph. 12/7.
4th day. Bry. 200 given with ~ ~ but temperature remains at 100~ F.
8th day. Sulph. 200 6 4-hourly, and temperature settled forthwith, and
respiratory rate fell to 20.

CASE 3. (Chart 2. Plates III, IV and V.)

Mrs. M., aet 91. Chronic Pneumonia. Influenza A anti-bodies 1/64. No
previous history. Ill 14 days with noisy dry cough, extreme exhaustion and
diarrhoea. T. 100~ P. 88. R. 32. Widespread rgles. Consolidation right
base. W.B.C. 12,000. B.P. 120/70. Sputum, staph, aureus et albus. Non-
h~em. streptococci. Little change till patient deteriorated on 24th day.

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CHART 2.

Extensive consolidation left chest. T. 96~. P. 118. R. 32. W.B.C. 42,000.

B.P. 100/50.
Touching < . p. 89. A ~ n . , Agar., Ant. c., Ant. t., A m . , Bell., Bry.,
Chain., China, Cina, Coffea, Kali c., Kali iod., Lath., Med., Sil., Tarent.,
Thuja.
Answers, stupor returns, p.4. A m . (Bapt.), Hyos. (Plumb.).
184 TI-IE BI~ITISI=I I-IOM(EOPAT]tIC JOUI~NAL

Falling asleep while answering, p.1245. A m . , Bapt., Hyos.

Yellow tongue, p. 402. Ant. c., Arn., Bapt. (Hyos).
Weakness. Ant. c., A m . , Bapt., Hyos. (Plumb.). Arn. cm. i-hourly
with > and later Penicillin 250,000 units 3-hourly.
26th day. Improved. T. 97 ~ 1).96. R. 26. B.P. 120/70. W.B.C. 27,000.
Irritable when spoken to. p. 59. Cham., Graph., Kali phos., Nit. ac.,
Sep., Sulph.
Capricious. p. 10. Chain. (Nit. ac.), Sulph.
Thirstless. p. 530. Nit. ac., Sep., Sulph.
Weakness from exertion. Sep., Sulph.
Sulph. lm. 3 doses (hourly). Sulph. lm. 6 doses (2 hourly).
X-rays. 18th day consolidation right base. 63rd day: Consolidation
clearing left base.

CAs~, 4. (Chart 3.)

Mrs. S,, aet 65. Peribronchial consolidation. Influenza A anti-bodies
1/32. Previous history : no chest trouble. Haematemesis.
Six-day history of dyspn0ea on exertion, loose cough, huskiness of voice.
T. 97-4 ~ P. 120. R. 40. Hectic flush. Sordes. Inspiratory rs right
base, coarse ereps., > lying. Left base very poor air entry, liver edge
palpable.

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CIc[ART 3.
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 185

W.B.C. ll,000. B.P. 140/75. Blood urea 39 mgm. per cent. Urine nil.
Sputum nil.
Brown dry tongue. Ant. t., Ars., Bry., Pyrogen (Index to Borland's
Pneumonias--Stonham). Of these Ant. t. and Bry. were not indicated, and
Pyrogen chosen on the marked discrepancy between pulse and temperature.
Pyrogen 1 cm. hourly. Pyrogen 1 em. 3-hourly.
13th day. Improved. T. 98-100 ~ R. 28/44. At times too breathless
to drink. Sulph. 200 6-hourly. Dirty appearance; poor resolution of
pneumonia. > > temperature settled and respiration fell to 20-22.
17th day. Relapse. Sulph. repeated 20th day with good effect.
X-ray peribronchial consolidation right base cleared 27th day.

CASE 5
Mrs. V., aet 74. Bronehopneumonia. Influenza Virus A anti-bodies 1/64.
Twenty-one days increasingly profound weakness and dyspncea on
exertion. Tightness and soreness in chest. Previous history a similar
incident 2 years ago. Pneumonia 5 years ago.
T. 97.8 ~ P. 88. R. 48. Crepitation and dullness right base, with
late extension t o left. Cyanosis. W.B.C. 16,000. Urine, granular casts.
Sputum no T.B.
23rd day. Nat. sulph. 30 2-hourly. " When patient coughs he springs
up in bed and holds the painful side in his hand to ease the hurt." Nash's
Leaders in Homoeopathic Therapeutics and clinically left basal involvement.
28th day. Kali bic. 12 6 4-hourly. Relapse with cough < nocte and
going on to vomit must sit up.

CASE 6. (Chart 4.)

Mr. T., aet 65. ?Bronehopneumonia. ?Heart f a i l u r e . Influenza Virus
A anti-bodies 1/256.
Ten days' weakness, dyspncea on exertion, loose productive cough with
greenish sputum. Rawness of throat, poor memory. No previous chest
trouble.
T. 97.8 ~ P. 98. R. 40. Poor air entry, widespread r~les. Enlarged
liver. No venous congestion. > lying.
W.B.C. 15,000. Blood urea 40 mgm. per cent. Urine nil. B.P. 180/80.
Sputum, pneumococci and staphylococci.
10th day. Pyrogen 1 cm. Dry brown tongue. Mental dullness, flushes
of heat. Pulse and temperature deficit. 1
l l t h day. Psorinum 200. LS.Q. Greasy forehead, p. 375. Bar. c., Bry.,
China, Mag., Merc., Nat. m., Plumb., Psor., Rhus t., Sec., Tub.
Difficult respiration > lying, p. 770. (Bry.), Psor.
12th day. Not improving. Aureomycin 10 gin. 6-hourly. Sulph. 200,
slightly > . Busy delirium.
16thday. Condition deteriorated. Very drowsy. B.P. 100/60. Blood urea
33 mgm. per cent. Liver enlarged and tender. Raised jugular venous pressure.
A few seconds seem ages. p. 88. Cannabis ind. prescribed : - - > > .
X-ray. Large left ventricle, marked hilar shadows, with multiple small
opacities. ?Heart failure. ?Bronchopneumonia.

CASE 7
Mrs. H., aet 65. Influenza Virus A anti-bodies 1/128.
A chronic bronchitic, ill for 14 days.
T. 101.8 ~. P. 100~ R. 32. Very drowsy. Cyanosed. Widespread
rs in all areas. W.B.C. 26,000. Blood urea 89 mgm. per cent. Urine, fine
granular casts. Sputum, thick green. Staph. aureus.
X-ray : Congestive changes.
 186 TI-IE BI~ITISH H O M ( E O P A T H I C JOUI~NAL
9 \

15th d a y . A n s w e r i n g , s t u p o r r e t u r n s , p. 4. Arn. (Bapt.), Hyos. (Plumb.).

F a l l i n g a s l e e p w h i l e a n s w e r i n g , p. 1245. Arn., Bapt., Hyos.
Sleep p o s i t i o n c u r l e d like a dog. p. 1~46. (Ars.), (Bapt.), (Bry.). Baptisia
l m . 6 - h o u r l y . A u r e o m y c i n 1 gin. 4 - h o u r l y .

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10Zo +++,+,o-;:++
-~.--" +, ...........................
L+.~:-+,~ + +++ + ++i
--+--~,--~++r-+.,--T-~ -- -+-- -r- -+,,.... i-- -+,-+ -~,-- -+ .... --:--+--.....(
~..... ~ ~+ .... +.... +

:D

~ . I01 ~
--!-- --?-~-4--~-J--~-++, ...... l...... !...... i..... !-- --~. . . . i-- -i. . . . !.- --+:. . . . i. . . . ;-- ---~..... i--I--+: :: --!--., -.!--
--~-----:+: ..... i--.-~--.-.~ ...... i--. ' ' ' ' : : : : '
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r-.F-~.+--~--! I ' ~ --':---
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iiiii!!ii;
+,iiii!i :2ii ill
......,,-~,~+++-k::~:: i;il :+ ?,!: ~:::i::~oio~::i,+k
LY-.

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~ ~'~ t? - ~- '-?--
-+-0~:=-+=I:+:::+:::++-:~ + ~ :~::+::+::++:::+. +--+
u

+~++~+,+. I0 II 12 13 14- IS 16 17 18 19 2 0 21 22 23 24- 25 26 27 2 8 29 3 0

..... "':~9~-+..~ k&. ~o-+.
..... "-..~+:.+.+.~ ~ ++.~. .. . +,~.. ~;,.-,-.o ~+'..+ +~+.. +.,:+. ~+++.,.+,~+..,.++++,-,~
o~E 5 6 7 B 9 I 0 II 12 13 14- 15 16 17 18 19 2 0 2 1 22 23 2 4 25
FEBRUARY
C~ART 4.

16th d a y . S1. > . T. 9 8 . 4 ~. P. 68. R . 32.

I n d i f f e r e n c e , does n o t c o m p l a i n , p. 54. Hyos., Op., Stram.
O v e r p o w e r i n g sleepiness, p. 1250. (Hyos.), Op., (Strata.).
Moaning respiration, p. 774. Op. Opium 200 3 - h o u r l y . Opium 1 cm.
3-hourly.
19th d a y . > ?. Tub. boy. 200 3 4 - h o u r l y o n . T h i c k e a s y e x p e c t o r a t i o n .
Shortness of breath. Sense o f suffocation. W i d e s p r e a d fine r&lcs o v e r chest.
Subsequent days > >.

CAs~ 8
Mrs. M., aet 65. B r o n c h o p n e u m o n i a . I n f l u e n z a V i r u s A a n t i - b o d i e s
1/64.
S l o w l y c o n v a l e s c i n g f r o m " g a s t r i c 'flu " a n d collapsed.
T. 98 ~ P. 104. R . 36. S t u p o r o s e d . C y a n o s e d lips a n d cheeks > l y i n g
fine creps r i g h t base. W . B . C . 21,900. B . P . 165/105.
1st d a y . Opium 200. R e g a i n e d consciousness. C o m a ; s m a l l p u p i l s ;
w a r m skin. T a c h y p n ~ a r e m a i n s 42.
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 187

4th day. Pyrogen 10m. Dry brown tongue. Pulse and temperature
discrepancy. T. 99.6 ~ P. 104. R. 40.
6th day. Puls. 10m 6 2-heurly. Mild disposition. > fresh air.
Tachypncea settled. T. 99, P. 80, R. 40.
X - r a y : Bronchopneumonia right mid and lower lobe.

CASE 9. (Chart 5.
Plates VI, VII and VIII.)
Mr. A., aet 53.
Comatosed. ?Toxic myocarditis.
Admitted comatosed; profound weakness; dyspncea on exertion and
delirious 2 nights.
T. 99 ~ P. 102. R. 44. Warm cyanosis. Resents eyes being opened.
Emphysematous chest. Poor air entry, widespread r~les, liver enlarged.
Increased venous pressure. W.B.C. 18,000. B.P. 156/190. Blood urea
14 mgm. per cent. Urine, granular casts. Sputum, Staph. aureus. Non-
Haem. Streptococci. M. catarrhalis only slightly sensitive to penicillin.

.,,,,....,:., ,,:., t:., .J~, , / y / i / J ~ " ~'~ ,"~" /iJ /!J / i / ,/,v Ir !~'!/, f / / z / / i / ~ ' ~ . -
; _;....... , ~ . . : ................... :. . . . . .,.. j_,-:-.. . . . . . . . . . . . . . . . . . .
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ii
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PENICILL.INI~ -~ -~ - ~ ~ ~:~5OO, OOO UNITS 3 HRLY. 'i" ! :: ~ i

DAT~ 5 6 7 8 9 IO II 12 13 14" 15 16 17 18 19 2 0 21 ~1~ ~4

JANUARY
CHART 5.

Carb. v. 200. Blueness. Pale extremities. Extreme exhaustion; > oxygen.

/~lo apparent improvement. Carb. v. cm. Patient regained consciousness after
189 hours. Kali sulph, as a follower2, and on green sputum--no effect.
Penicillin 500,000 units 3-hourly in view of little improvement and no
symptomatology.
1188 T H E B R I T I S t t t t O M E E O 1 ) A T t t I C J O U R N A L

On 5th d a y from admission ; patient relapsing into rambling delirium etc.

T. 9 8 : 4 ~ 1). 110. 1~.40.
Suspicious. p. 85. Acon., Am., Bar. c., Bry., Cannabis ind., Caust.,
Cenchris., Cic., Digit., Kali ar., Lach., Lyc., Puls., Rhus fox., Sec., Stram., Sulph.
Loquacity. p. 63. (Acon.), (Ars.), (Bar. c.), (Cannabis ind.), (Caust.),
Lach. (Rhus. tox.), Strata. (Sulph.), Lach. 200.
L o q u a c i t y changing from one subject to another, p. 6 3 . Lach.
Thinks he will be murdered, p. 29. Rhus tox., Stram.
Cyanosis. p. 1356. (Bar. c.), (Bry.), (Caust.), (Cic.), Digit., Lach. (Lyc.),
Rhus tox., Sec. (Stram.), (Sulph.).
Radiology. Tele-radiograms show reduction in heart size.

C~s~ 10. (Chart 6.)

P.J., aet 10 months.
Bronchiolitis Anti-bodies not tested.
Cough for 14 days+ Anorexia and vomiting 4 days treated with
Penicillin--improved and t h e n r e l a p s e d . T. 103 ~ P. 160. R. 64. Distressed
grunting respirations, widespread fine r~les in all areas.

9 i,I i:l : ~::$~i~ , : ..... :, il

"V/IJJ:,~ / JI ~ 'J J :' / J:/E ~ /: /, '' I I ~ I '' I
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" "

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::~-11,1-- 'i. _~_.~,..t.!..~..t.i__t.+_.t_.+

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DAT~ 18 19120 21 22 3 24. 25 26 27 28 I 2 3 4 5 6 7
FEBRUAR~ MARCH
CEA~ 6.

Thirst large drinks, p. 529. Acon., Ars., Bry., China, Cocc., Cupr., Eup. p.,
Ferr. phos., Lac d., Lyc., Merc. c., Nat. m., Phos., Stram., Sulph., Verat.
Cough drinking ~ . p. 786. Ars., Bry., China, (Cocc.), (Nat. m.), Phos.,
(Stram.), (Verat.).
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 189

Vomiting, drinking ~ . p. 532. Ars., Bry. (China), (Cocc.), (Ferr. phos.),

(Merc. c.), (Nat. m.), Phos. (Sulph.), Verat. v.
Vomiting cough ~ . p. 532. Ars., Bry., China, (Ferr. phos.), (Merc. c.),
Nat. m. (Phos.).
Embarrassed respiration : flapping alae nasae ; propped up, chin tilted
up and head thrown well back. 1
5th day. Phos. 200 given, no effect. ~ Oxygen
6th day. Phos. 10m. ~ ] tent.

Having covered the successfully treated, and proved cases, we now come
to those whose clinical appearance bears some resemblance to the foregoing,
but did not respond to treatment.
I n the 7 cases, 2 have to be discarded because of insufficient d a t a - - o n e
was a foreigner, and the other moribund, with no history available. Three
did not appear to be seriously ill on admission, and remained stationary, or
even improved for several days, and then suddenly deteriorated and died.
The remaining 2 cases died within 24 hours of admission.
Mrs. R., act 74, is an example of the former group. She had suffered a
chill for the previous 5 weeks, with dyspncea on exertion, a husky voice, a
dry cough, and a localized phlebitis in the left leg. Her memory was poor.
On admission. T. 97.2 ~ P. 98. R. 26. Cyanosed and consolidation
right apex with bronchial R.M. Although her pulse and temperature
remained within normal limits, her tachypncea was persistent, ranging between
28 and 48. Terminally, she developed auricular fibrillation. In only one
case was a tachyeardia the presenting sign. In none, was a satisfactory drug
picture seen.
Mr. W., act 54, is an example of the latter group. He was a known
bronchitic subject, and had been unwell for 3 weeks. During the previous
3 days, he had a choking sensation with increasing headache. He collapsed
and revived with Carbo vet.
On admission his temperature was 101 ~ pulse 136, respiration 50. He
was very dyspnceic, restless and widespread r&les were heard. On the pro-
found prostration, warm skin, and restless head, Ars. alb. cm. was prescribed
with initial improvement, but the patient relapsed. Endotracheal aspiration
was successfully attempted and temporarily improved the oxygenation.
At post-mortem examination, thick green pus was found in the trachea
and bronchi; the left ventricle was enlarged, with a dilated right ventricle,
and venous congestion.
This last case demonstrates the apparent euphoria of these p a t i e n t s - -
on the morning of admission he insisted on getting up, dressing and shaving ;
even the day before, he had walked along to his favourite public house.
The impairment of memory was seen in Mrs. R. and in one other case,
who although apparently rational, failed to recognize me from one day to the
n e x t ! This made the assessment of the patient's condition difficult, and
homceopathic case taking Mmost impossible.
I n these groups of fatal cases, no clearly indicated remedy was seen,
and I decided to repertorize fhe characteristic symptoms, in the hope of
focusing one's attention on a limited section of the Materia Medica.
Weakness of~memory, p. 64. Art. nit., Am., Ars., Bar. c., (Carb. a.),
Carb. s., Carb. v., Cannabis ind., Digit., Kali p., Kali br., Lach., Laur., Lyc.,
Med., Merc., Nux m., Phos., Puls., Sep., Sil., Stann., Sulph., Tub., Verat.
Inclination to lie down. p. 1371. (Am.), Ars., Bar. c., Carb. s., Carb. v.,
(Digit.), Kali ars., Lach., Lyc., (Merc.), (Op.), Phos., Puls., Sep., Sil., Stann.,
Sulph. (Verat.).
Weariness. p. 1421. Art. n., Arn., Ars. (Bar. c.), Carb. ac., Carb. s., Carb. v.,
Cann. s. (Digit.), Kali p., Lach., Laur., Lyc., Merc., Nux m. (Op.), Phos., Puls.,
Sep., Sil., Stann., Sulph., Tub., Verat.
190 THE BRITISH HOM(EOPATHIC JOURNAL

Respiration accelerated, p. 762. Arg. n., Arn., Ars. (Bar. c.), (Cannabis
ind.), (Carb. ac.), (Carb. s.), Carb. v., Digit. (Kali ars.), (Laur.), Lyc., Merc.,
Nux m., Op., Phos., Puls., Sep., Sil., (Strann.), Sulph. (Tub.), Verat.
Respiration difficult after exertion, p. 769. Arg. n., Ars. (Carb. s.),
Carb. v., Digit., Kali ars., Lach., Laur., Lyc., Merc., Nux m., Phos., Puls., (Sep.),
Sil., Stann., Sulph. (Tub.), Verat.
Arg. n. 9/4, A m . 7/4, Ars. 14/5, Bar. c. 7/4, Carb. ac. 4/3, Carb. s. 11/5,
Carb. v. 11/5, Digit. 8/5, Lach. 11/4, Laur. 7/4, Lyc. 13/5, Merc. 11/5,
Nux m. 9/4, Op. 4/3, Phos. 13/5, Puls. 11/5, Sep. 12/5, Sil. 12/5, Stann. 9/5,
Snlph. 13/5, Tub. 7/4, Verat. 10/5.
Referring to •eatby and Stonham's Therapeutics, the following seem the
most likely, on pathological or therapeutic grounds.
Lycopodium (I3/5). Pathology. Depressant action in tissue; pressure
in sternum. Rattling cough; with thick purulent sputum, mucoid, salty.
Dry hot skin.
Therapeutics. Loose cough ; great dyspncea ~ expectoration.
Arsenicum (14/5). Weakness ; prostration ; restlessness ; but the mental
anxiety was notably absent.
Argentum nitricum (9/4). Provings : Bronchial catarrh and cedema of
lungs ; albuminuria ; cold clammy skin. Faintness ; stuporose ; shortness
of breath ; palpitation, weakness, induced early and profound ; ~ slightest
exertion, tiredness and weariness of limbs. White patches in throat ; rawness,
dry sore tongue. Burning heaviness in chest ; suffocative cough ; hoarseness.
Nux Moschata (9/4). Provings : Dual personality; as ff two heads;
poor memory for recent events. Minutes seem hours. Irresistible drowsiness,
easily roused, only to fall back into stupor.
Larynx dry and rough; hoarseness; oppression in chest; dyspncea.
Stannum (9/5). Provings : Great weakness ; must lie down ; feeble
voice. Cough shattering patient; depressed; irritable, peevish. Restless
but quickly exhausted ; husky voice ; hard dry cough ; or loose with profuse
expectoration; ~ talking and drinking; sweet spfftum.
Tub. boy. (7/4). Thick easy expectoration ; shortness of breath ; sense
of suffocation ; hacking cough ; widespread rs in chest.
Also note the euphoric mentality of the tuberculous patient.
Bacillinum. Bronchorrhcea and dyspncea; mucopurulent sputum, and
bubbling rs 5
The only example of this drug was in the Case No. 11 ; Miss R., aet 6 years ;
with a history of Influenza for 3 weeks before admission, persistent pyrexia
and dry cough. T. 100 ~ P. 102. R. 24. Widespread fine tales. X-ray
N.A.D. Influenzinum given on the history, without effect, but Bacillinum
cleared the condition.
A further possible clue to the treatment of these cases was encountered
while reading the accounts of the highly fatal epidemic of bronchiolitis at
Aldershot in 1917, where reference was made to the similarity of the clinical
appearance to the Mustard and chlorine gas casualties.4 Further study
showed that this similarity was true for our own particular cases, as shown
in Table I, and covered pathological as well as clinical features.
I t is therefore suggested that this may prove a profitable line for future
research in these cases which present no serious drug picture, but are within
this group.
I suppose it may be argued that these clinical pictures are similar only
by virtue of their being the end result of a " suppurative bronchiolitis " ;
the sites of action of the Virus, in the case of Influenza and poison gas are the
same, producing comparable necrosis of the bronchial mucous membrane,
permitting the prophylactic use of mustard or chlorine gas in potency on
" homceopathic grounds "
That this may well be so is strengthened by a further reference to the
I~LATE I.

PLATE II.
PLATE III.

PLATE IV.
PLATE V.

PLATE VI.
PLATE VII.

PLATE VIII.
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 191

T A B L E I.

MUSTARD GAS CHLORINE GAS PRESENT SERIES

MENTALS .. ! Dullness a n d stupidity. Loss of memory, drowsi*

ness, coma.

GENERALS .. Exhaustion. Exhaustion, asthenia W e a k n e s s a n d exhaus-

for weeks, lassitude, tion.

RESPIRATOI~Y Hoarseness, rawness Gasping suffocation. H u s k y voice, rawness.

behind s t e r n u m . Dyspncea ~ exertion. Dyspncea on exertion.
Dyspncea ~ exertion. Tightness.

CouG~ .. Dry, Barking. Choking. Dry. Loose.

SPUTUM .. Mucopurulent. F r o t h y yellow ~ 30. Purulent.

SIGNS .. Cyanosis, bronchitis. Bronchitis. Cyanosis.

Widespread vesicular Subcrepitant rhles. Widespread fine rhles.
rs Bubbling rales. Liver enlarged.

POST- E m p h y s e m a , atalecta- Voluminous lungs. E m p h y s e m a . L u n g s do

MORTEM . sis. Thick p u r u l e n t
exudate in trachea.
Slight dilatation Rt.
ventricle. Destruc-
tion m u c o u s m e m -
brane a n d round-
celled infiltration.
Acute dilatation of Rt.
ventricle a n d con-
gestion.
Necrotic m u c o u s m e m -
brane, fibrin and
peribronchial infil-
tration.
not collapse. P u s in
trachea a n d bronchi.
P a t c h y consolidation.
Dilatation R t . ventricle.
Venous congestion.

T A B L E II.
SUMMARY OF DRUGS USED SUCCESSFUllY AND T H E I R LEADING INDICATORS.

Drugs
Drug Patient Leading Indications which
followed

Sulphur . 2, 3, 4 Capricious. Irritable w h e n spoken to.

Dirty appearance. Poor resolution of
infection.
Pyrogen .. i 4, 8 Pulse a n d t e m p e r a t u r e discrepancy, Sulphur
D r y brown tongue. PulsatiUa
Arnica .. 3 Generally ~ touching. Relapsing coma. Sulphur
Bacillinum 1t Mucopurulent s p u t u m . Widespread rhles.
Dyspncea.
Bryonia . 2 B u s y delirium. Pains < Movement >
pressure. Sulphur
Cannabis indica 6 Seconds seem ages.
Carbo vegetabilis 9 Collapsed c y a n o s e d ; pale extremities >
oxygen. Lacbesi~

Lachcsis 8 Suspicious. L o q u a c i t y a n d delirium.

Opium . 9 Lack of complaints a n d chest infection in
association. T u b . boy,

Phosphorus 10 Reclining posture, with neck extended.

Thirst. Vomiting and coughing <
i drinking,
Putsatilla 8 Mildness ; < w a r m room > fresh air.
Tuberculinum 7 Shortness of breath ; thick easy expector-
Bovinum ation. Widespread fine rgles.
1
192 THE BRITISH HOM(EOPATHIC JOURNAL

relative immunity of workers in low concentrations of chlorine gas to Influenza

in the 1918 epidemic. Subsequent therapeutic trials were made into the
treatment of acute and chronic bronchitis with chlorine gas, and the results
:reported appear very favourable, but the treatment is not now employed.
(The optimum concentration is 0.013-0.015 mgm./litre for 1 hourd.)

CONCLUSIONS
All cases were serious and the majority looked as if they might die;
some failed to respond to all measures; some lived because of treatment
whether homceopathie, antibiotic or endotraeheal aspiration.
I t is considered that some would have died without both homceopathie and
antibiotic treatment--Cases 3, 6, 7 and 9. Of these, Case 9 might not have
regained consciousness without Carb. v. cm. Case 6 and 9 relapsed, although
on adequate dosage of Penicillin and Aureomycin, and improved dramatically
with Homceopathy. Can our remedies enable the required concentration
o f anti-hiotics to reach the affected areas ?
A s u m m a r y of the leading indications for the remedies used with a good
result is given in Table II.

ACKNOWLEDGEMENTS
I should like to express m y thanks to m y Chiefs for permission to present
their cases, and to :Dr. Templeton for his encouragement and very helpful
criticisms, to the House Physicians, who were responsible for some of the
clinical details, and to Dr. Jackson of Hillingdon Hospital for permission to
record the case of a girl of 11 years quoted on p. 180.

REFERENCES
1 BORLAND, DOUGLAS, Pneumonia&
2 Mr/~LER, GIBSON, Relationship of Remedies.
a ANDERSON, et al. (1938-42), Pneumococcal Pneumonia and its Treatment. I n Glasgow.
4 VEDDER (1925), Medical Aspects of Chemical Warfare.
5 BOERICKE, O., Pocket Manual of Homveopathic Materia Medica. N i n t h Edition.
P a g e references---refer to K e n t ' s Repertory of the Homeopathic Materia Medica. Fifth
Edition. 1945.

:DIscUSSION
:Dr. F. H. BODMAN congratulated :Dr. Kennedy very much on the admirable
way in which he had presented these interesting cases. He admired both the
point s that he had made about the significance of the respiratory rate in
dealing with these patients and the X-ray pictures which he had shown.
Dr. Kennedy had pointed out in one case that the size of the heart got smaller
under treatment and the speaker thought he could make that observation in
two of the other cases in which serial X-rays were shown. This did suggest
that perhaps part of the picture was that they were dealing not only with an
influenzal infection but also with a degree of heart failure and perhaps the
picture of clouded consciousness with a stuporous condition of mild delirium
was to be attributed rather to the heart failure than to the toxmmia associated
with the virus infection. That might alter their views as to the kind of treat-
ment they were going to give these elderly patients. They did not get ~nueh of
a reaction in the temperature or the pulse and the only indication was the high
respiratory rate.
Besides the interesting suggestions about mustard gas or chlorine in these
cases he was wondering whether it would be possible to consider other nosodes
besides Pyrogen. The condition seen in most of these patients might be a
typhoidal or typhus state and it might be worth while using a nosode from a
typhus or typhoid case. He noted that they kept an infant patient in an
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 193

oxygen tent. Was it not worth while considering treating some of these
patientsl although in a comatose condition, in an oxygen tent ?
Dr. TEMPLETON said as one who was partly responsible for some of the
cases described, most of them were very ill and likely to die, and that is why
many received various forms of treatment, homceopathic and otherwise. He
had no excuse to make for this if excuse were necessary for he would be a very
foolish m a n w h o debarred himself from the use of any form of therapy.
Dr. Bodman's remark as to the resemblance of some of the cases during
this epidemic to typhoid was interesting for in more than one of them Baptisia
was quite in the picture though, once again, he would repeat one of Dr. Rorke's
dicta that " When a chest ease looked hke Baptisia give Opium ". Here the
drug which seemed to act has a not dissimilar picture and that was Pyrogen.
The discrepancy between pulse and temperature and the dry red tongue were
the guides usually present in addition to the toxic state. Several suggested
Arnica because, in spite of the seriousness of their condition, they complained
of nothing but, here it was more the negative condition of " complaining of
nothing " rather than the positive state of Arnica where " he says he is well "
This may be a help in such cases for Arnica, where given, did not seem to work.
I t was felt, as Dr. Kennedy has indicated, that even where there was a
positive improvement from the homceopathic remedy, that this alone would not
be sufficient and so an antibiotic was given to shut off further tox~emia. He
was quite sure this was justified. Aureomycin seemed the only antibiotic
which did any good. Even then, the indicated remedy (that is, indicated by
positive symptoms) was of the utmost value. This is shown by the case which
received aureomycin where, after Pyrogen had done something, still the heart
was giving out. The antibiotic seemed to stem the infection but the condition
of the patient was most distressing. " Minutes were like ages " and " the
nights like eternity ". Cannabis indica worked like magic and the progress of
the patient was a joy to observe. He (Dr. Templeton) could not quite see why
Dr. Kennedy craved for Nux ~nvschata but that probably was because he never
considered Nux moschata of sufficient depth for such a case, but then, of course,
neither did he Cannabis indica.
He would confirm Dr. Borland's advice that in cases which seemed
improved for the administration of oxygen, Carbo veg. was often indicated.
This was a useful tip.
The clinical findings in most of the cases mentioned were typical for this
epidemic and indeed one did not need the proof of the antibody reaction to say
that these were influenzal in origin. The lungs were full of a very special type
of crepitation usually widespread and obscuring any signs of consolidation if
there was any. A case in point treated at home would seem to show that there
was a widespread broncho-pneumonia. An X-ray taken after she was ambulant
had been demonstrated and it seemed impossible that such a condition was still
present and the patient up and about. She says she feels quite well though the
crepitations are still present. Arnica has done nothing here and one is now
trying Influenzinum.
This patient has since cleared remarkably on her constitutional remedy
Sulphur.
One thing he had noted and that was that many of the worst cases had had
previous chest troubles, chiefly asthmatic. This was not in agreement with
what had been stated at the Royal Society of Medicine where one speaker held
that this epidemic seemed to miss very young children and those susceptible to
respiratory infection.
Another case which Dr. Kennedy had mentioned amongst the fatal cases
was remarkable in demonstrating the amazing powers of patients within 24 or
48 hours of dying. This man, an old asthmatic and hypertensive, aged about
50, was seen the first day sitting at a table with his head in his arms (the
typical Kali carb. position) with a chest full of the typical crepitations, T. 100~
194 THE BRITISH HOM(EOPATHIC JOURNAL,

P. 140, R. 32. He was given Kali carb. lm 2 - h o u r l y . Seen next day he was
very much better. Next day he walked 400 yards uphill to his favourite
public house for his lunch all against the doctor's orders and indeed without.
his knowledge. Next morning he dressed and shaved, and when sitting in his
chair collapsed. When seen, he looked as if he were dying, and he was, for
though he lived for 12 hours he was unconscious for the last 8 hours.
This case suggested as did most of the other fatal cases, that where all the
systems were diseased, heart, lungs, kidneys (he had casts in his urine), the
chances of survival are very much decreased. The infection seems to be the
last straw and that is another argument for killing the infection in addition to
stimulating the resistance of the patient.
Two recent deaths in oldish people confirm this :
1. A case of chronic bronchitis and asthma with cot pulmonale and
chronic nephritis (casts and raised blood urea). After making a remarkable
recovery from one attack caught a fresh infection and died.
2. An old diabetic, aet 79, having recovered from gangrene of the toes was
admitted with a mixed ?basal infection, ?hypostatic congestion (and these are
not easy to distinguish), showed casts in the urine and a raised urea and died in
spite of all one could do.
I n this epidemic, and this was confirmed by Dr. Hamilton's paper, there,
seemed to be no remedy epidemicus such as he had suggested was frequently
present in epidemics of Virus B. He had heard of no Eupatorium cases such as
they had in France and that made him suggest the heresy that we had still t(>
find the true virus of this epidemic.
Dr. JOHN PATERSON wished to endorse the thanks to Dr. Kennedy for hia
paper. He had only one or two points to make. The first arose from his.
opening remarks about antibiotics. He thought he was right in saying that,
he gave the opinion that those who were using antibiotics, where they en-
countered failure, attributed that failure to a poor response of the tissues.
That was an important point to keep in mind in dealing with any remedy.
Unless there was a certain power in the tissues no response with any remedy
would be forthcoming. I n the influenza epidemic of 1918 he had very vivid
recollections of the type of case which gave very little indication of the patient
being ill, and yet sudden death occurred.
Where they got a proving of potassium they would find from the literature
that it was characterized by a paucity of symptoms--practically no symptoms
--until this sudden collapse of the heart muscle occurred. I n experimental
work on animals, probably the first evidence was this sudden collapse of the
myocardium. Dr. Bodman had made reference to the using of other nosodes
and particularly to the typhoid vaccine, T.A.B. His students would bear him
out in this, that he had suggested to them that where they got lung conditions,,
particularly broncho-pneumonia, which were not responding to a remedy, t h e y
should think of a nosode, and probably the nosode most likely was Morgan.
Sulphur was the outstanding associate remedy of Morgan, and if Sulphur h a d
not been working there, probably Morgan would.
Dr. MITCHELL expressed his appreciation of Dr. Kennedy's paper. H e
described how he had come across a report of the successful use in Ireland o f
chlorine gas inhalation for the treatment of the common cold. Reference to
Clarke's Dictionary revealed many nasal and bronchial catarrhal symptoms.
Developing a cold himself he had taken Chlorine 6c 2-hourly and succeeded in
completely aborting the cold in one day. In the past he had been decidedly
unsuccessful in treating himself for colds. He had often managed to ameliorate
the symptoms with Nux vom., Ars. alb., and other remedies, but had never
before managed to stop one so thoroughly. Before he took Chlorine, in
addition to common cold symptoms such as sneezing, running nose with some
obstruction and general malaise, he had a curious sensation under the sternum.
This sensation was a difficult one to describe. The nearest he could get to
 INFLUENZAL COMPLICATIONS AND THEIR TREATMENT 195

doing so was to say that it was like a mild irritation as of smoke in the trachea.
Dr. ALVA BENJAMIN said that he seemed to remember that Dr. Borland
suggested some time ago that Natrum carb. was a useful remedy in these eases
which displayed very little reaction. He had used it on many occasions when
in general practice and found it very useful.
Dr. BOYD said that the cases they got into hospital were mostly pulmonary.
There was a point which it was very useful for them as homceopathic people to
remember, and that was that in hospital if they had to think of penicillin at all,
they should always combine it with a remedy, not leave it to act alone. He was
quite convinced that these antibiotics had a selective action and that one lost
the antibiotic action between the bacteria themselves, with the result-that the
bacteria which remained after the action of the penicillin got very much more
active. That was why so often a case seemed to respond to penicillin and then
went off again. In examining the bacteriology of the sputum one often found
there was a change. I n hospital they made a habit of combining the penicillin
with a carefully chosen remedy and he thought that gave much more satisfactory
results.
Dr. KENNEDY, in reply, said that he had found it rather difficult in going
through the notes because he had not always seen the patients when the
remedies were prescribed for them. I t was sometimes difficult therefore for
him to say why a particular remedy was chosen.
He disagreed with Dr. Bodman in his reference to heart size : the heart
size had not changed in other X-rays apart from the two he mentioned. The
first X-ray pictures were usually with a portable apparatus and the heart size
in such cases was not comparable with the later radiograms. That might
account for the misinterpretation. I n many of their cases there did not seem
to be any signs of heart failure at all. The blood-pressure was maintained
until near the end. There was very tittle rise in venous pressure. The liver,
he agreed, was enlarged--why, he did not know.
He was interested in Dr. Paterson's and Dr. Boyd's remarks about
penicillin and tissue response. He had not found that patients improved
initially on penicillin and then relapsed. His experience was that the patient
either got better or did not get better. That, however, was only his personal
experience and was confirmed by general impression from the literature.
Concerning penicillin and tissue response, he was always under the impression
t h a t the response to penicillin allowed the patient to build up his own response
to allow the homoeopathieally-indicated remedy to act.
I n very few patients was Bacillus Morgan found in the stool. There were
only three with B. coli which were not of Type 1. He wondered where Mustard
gas and Chlorine Came into the Emanometer classification.*
With regard to high and low potencies, he could assure Dr. Seymour that
when one came to the hospital initially one was not advisedCto give high
potencies but there was ample opportunity to see the use of both by the
consultant.
He thanked the Faculty very much for the reception of his paper.
The meeting concluded with a vote of thanks to Dr. Kennedy.
* Chlorine is in G r o u p 1 of E m a n o m e t e r classification a n d its association w i t h the
o t h e r acute remedies of this Group, Aconite a n d the Veratrums a n d Bromine, is signific~ut
and interesting.--Editor.