 Preface and Bibliography of the Flu. This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. Recording by Grace Buchanan. The Flu by A. Moritz, Ph.D., physician. Honolulu, Hawaii, U.S. America. Preface. This booklet has been written and compiled for the use of any student or layman who seeks concise and clear information on the history of influenza. Brief and salient facts are set forth relating to flu epidemics and pandemics. Other collateral features have also been discussed, connected with or bearing upon this subject. A.M., author and compiler. Honolulu, Hawaii, U.S.A., 1921. Bibliography. Finkler Ditmar, influenza. Bonn, 1898. Fonseca, influenza. Salamanca, 1625. Hubbard, influenza. London, 1667. Lavineau, influenza. Paris, 1650. Besky, influenza. Paris, 1665. Perkins, influenza. Paris, 1776. Pfeiffer, Richard. Influenza. Presslau, 1892. Short, Thomas. Influenza. London, 1587. Thompson, Theodore. Influenza. London, 1852. Webster, NOAA. Epidemics, pestilences. London, 1800. American Dictionary of Medicine. A.M., author. 1914. Report of London College of Physicians. London, 1783. Madhava, Indian physician. Pathology. Rugvineshaya, B.C., 582. Deodorus Siculus, historian. Agirum, Sicily. 1978. End of Preface and Bibliography. Recording by Grace Buchanan. Chapter 1 of the Flu. A Brief History of Influenza in U.S. America, Europe, Hawaii. By A. Moritz. This LibriVox recording is in the public domain. Recording by Grace Buchanan. Chapter 1. What is influenza? The discovery of the bacillus. Alleged causes. Names given to the disease and their translation. Explanation of medical words. Influenza. An infectious and contagious disease. Most startling in its methods of sudden appearance and disappearance. Its widely diffused and rapid spread is seen in no other disease. It has excited universal and general attention. Physicians and scientists have been stimulated and fascinated whilst pursuing their investigations and studying the disease in its various phases to wit, spread, incubation, differences of type, and the exact microorganism which invades the system of man. And if there is more than one that enters together or separately. Discovery of the bacillus. In the year 1892, Dr. Richard Pfeiffer of the University of Breslau-Silesia Prussia discovered the specific microbe of influenza. A bacillus which is generally accepted as being the cause of the disease. However, there are some physicians who dissent. It was found to be present in the lungs, bronchial mucous membrane, sputum, and nasal discharge. It is one of the smallest of the known bacilli. Measures about one micron long and a one half micron in breadth. A micron is equal to one twenty-five thousandth of an inch. The bacillus is found singly and in pairs, is non-motile. Domestic animals are not subject to the flu, but monkeys and rabbits can be infected. Alleged causes of the flu. It has been attributed to numerous and varied agencies in the past. Philosophers, physicians, and the people believed the disease to be due to supernatural phenomena. Some of the causes given were in the main, fanciful, freakish, and imaginary. The delusions of minds filled with wonder or fear. And illusions of the senses such as comets, earthquakes, volcanoes. And cosmic dust caused by the rising and setting of the sun. AD 1411. Diabolical pollution of the air with pestilential vapors arising from the air and ground. These caused bleeding from the mouth, nose, and bowels, and in women caused abortions. AD 1580. Bad conduct of Sirius the Dog Star caused by anger. AD 1658. Blast from the stars. AD 1742. Malign influence, influenza of the stars, etc., etc. Names given to influenza. Translated. Date of epidemic, AD 827. Name? Zawulf. Language? Saxon. 827. Houghed flower on. Anglo-Saxon. 876. Italier-Februs. Latin. 1411. LaTac. French. 1414. L'Orient, French. 1427. Ladendo, Italian. 1510. Sifal, Catarao. French. 1510. Cacolouche, French. 1510. Cacolouche, Anglo-French. 1742. Influente, Italian. 1742. LaGriep. French. 1781. Catarao Russo, Italian. 1792. Zawulf. 1793. Probably so named from the cough of the flu victim, resembling the growl of the wolf, or from the sudden seizure by the outlaw wolf of its victim. 1793. Houghed flower on. 1793. Houghed head, flower on, to flow, hence head-catar. 1793. Italier-Februs. 1793. Fever of Italy. 1793. LaTac. The rot, slow recovery, persistent cough like TB. 1793. L'Orient. The thump or blow, suddenness of the attack of the flu. 1793. Ladendo. This word is puzzling. It is slang Latin or Italian or is misspelled. If latendo, it means the hidden one, the flu. If it is ludendo, then it may mean the tickler or laffer. The tickling cough spasms resembling a person laughing. In the epidemic of 1427, the manner of greeting was astu au ladendo? Have you had ladendo? Sefal Catarao, head-catar. Cock-a-loosh, from cock, the male bird, hence crested like the comb of a cock. Loosh means a cap or hood. The wearing of a cap, cocked or crest-shaped by the victim of the flu gave the name to the disease, hence cock-a-loosh. Cock-a-loosh is the above word cock-a-loosh, anglicized. Cock or cock is Anglo-Saxon for the French word cock. La gripe. La the and the verb agripe to grip or to cling to or choke. Influenza, the worldwide designation by which the disease is known today, is of Italian origin from the word influente, a malign influence or influenza from the stars being the cause. Latin in, into or upon, and fluo to flow, hence a flowing in, into or upon, caused by an unseen power or influence or influenza, like the profuse nasal discharge flowing from an invisible source. The perfect language. Sanskrit literally means the perfect language from san or sam, with and krita, perfected or done. It is a mother language, the ancient language of the Hindus, and called the infallible language because it is based on infallible rules and also the language of the gods. The language contains the root, plu, to flow, to rain, to swim. Now whether it is the Anglo-Saxon word, flowon, to flow, or the Latin words, pluo, to rain, and fluo, to flow, or the German Flesen, to flow, or the Greek word flio, to flow, and the Italian word influente, influo, and hence influenza. Every one of these words is drafted from this Sanskrit root, plu. From 1800 BC downwards is the time that the Sanskrit was in use. Plu or flu is an ancient disease, so the author of this booklet believes, and in confirmation thereof cites the views of native Indian Sanskrit scholars who have found the records of a pestilence resembling the flu a way back in the mists of antiquity, 1200 BC. This disease repeatedly ravaged the then centers of dense population, Central Asia, Mesopotamia, and Southern Asia, in the rains of Tegeloth Pelaezer, 1120 to 00, and Nebad Kednezer, 605 to 562. The sickness affected the citizens of ancient Babylon, and the described features of the epidemics were such as we have today in those of influenza. Cough, headache, fever, pain in the eyeballs and copious tears, and water gushing from the nose stained with blood, or all blood. The Sanskrit historians gave the name plu to the disease, probably from the flowing nasal discharge. It is an uncanny coincidence that our Hawaiian people who are descended from the Indian branch of the Indo-European family of nations used the softer letter p in pronouncing the shortened form of the word influenza, plu for flu. Unknowingly, the Hawaiians are using probably the word that their ancestors used 2500 years ago in India on the banks of the river Sindhu or Indus, explanation of medical words. Before entering upon a description of the epidemics of influenza which have ravaged the various countries of the world, it is essential to explain the meanings of certain medical words used in connection with epidemic, contagious, and infectious diseases. The definitions which are given if not exactly orthodox are fairly in accord with modern views and are clear, simple, and should be easily understood by any ordinary reader. Infectious. A disease acquired without any direct contact with a sick person. The infection may be carried by a person in apparently good health or by any intermediary substance or by the entrance of a non-immune person into a room, house, or any place of human residence or occupied as such where there has been recently any infectious disease such as flu, scarlet fever, measles or smallpox, etc., etc. Infection. The entrance into the system or body of living disease producing germs such as by A. droplet infection. Bacteria infected minute particles or droplets ejected by sneezing, coughing, spitting, and talking. B. aerial dust particles coated with bacteria. C. mixed. More than one bacterium or organism present in the system they may enter together or one precede the other. Contagious. A disease acquired from a direct contact with the sick. Contagion. The spreading of a disease by direct or indirect contact. A. direct contagion. B. indirect contagion or immediate as by a carrier who is apparently in good health but nevertheless carries disease and can convey it to other non-immune persons. C. by means of fomites, hereafter defined. Contagion. The virus or poison which transmits disease such as the vaccine used in anti-smallpox vaccination which in former years was obtained from the vacca or cow. Now the calf is the source of supply. Fomites. Any non-animate agents or substances that transmit contagion such as blankets, towels, handkerchiefs, or any articles which have been contaminated by the secretions or excretions of the sick. Endemic. A disease which is permanently present in a people or district. It may become epidemic. Epidemic. A rapidly and widely spreading disease attacking many people. Pandemic. A widely and rapidly spreading epidemic affecting many people and all countries. Sporadic. A disease occurring here and there not attacking many people, not widely spread nor epidemic. Incubation. The period between the implanting or acquiring of a communicable disease and its development and visible by external signs or other recognizable manifestations. End of Chapter 1. Recording by Grace Buchanan. Chapter 2 of the Flu. A brief history of influenza in U.S. America, Europe, Hawaii by A. Moritz. This LibriVox recording is in the public domain. Recording by Grace Buchanan. Chapter 2. Influenza Epidemics in U.S. America. A.D. 1557 appeared in America spread from Constantinople. Very fatal. 1580. Pandemic 2 spread to America. 1647. For the first time mentioned in the history of America swept the plantations in the south. 1732-33. Pandemic 3. October 1732 appeared in Connecticut. Following day in Massachusetts, Annapolis two days later attacked 50% of the garrison. 1761 appeared in the spring. Northern parts of the U.S.A. Philadelphia, Massachusetts and Weymouth. 1767 appeared in the month of May. 1775-76. Epidemic in the U.S.A. 1781-82. Pandemic 4. Very severe. Widespread. Appearing in the spring. Began in the east. China. Dense to India. Russia. Western Europe. Named the Russian Qatar. Appeared in U.S.A. in April 1782. 1788-89. Prevealed extensively in U.S.A. from the 15th to the 45th degree of latitude. Spread over this area in six to eight weeks. 1807. Generally disseminated throughout the U.S.A. 1815 Ditto, 1824 Ditto, 1825 Ditto, 1826 Ditto, 1830 Pandemic 6. November 1831 reached America. Seat of the outbreak. Manila P.I. in September 1830. 1843. Very prevalent in New England in the month of June. 1850-51. Epidemic in the U.S.A. 1873. Prevalent in the states of Pennsylvania, Ohio, Virginia, Illinois, Iowa, Michigan, Wisconsin, Minnesota, Missouri, Alabama, Louisiana, Texas. 1874-75. Reoccurred in all the above states. 1879. Epidemic in the U.S.A. 1889-90. Pandemic 9. Began in May 1889 at Bukhara, Russian Turkestan. One of the worst pandemics ever known. Ran over the whole globe in a few months. America infected from both Siberia and Europe. Appeared in New York end of October 1889. San Francisco infected from Japan. December 1889. 1918-19. Pandemic 10. Began in southwestern Spain in April 1918. Spread to the U.S.A. in May 1918. Wide morbidity. Prevalent all over the states. Pneumonia very severe and fatal. Especially in the training camps where it swept off numbers of the flower of the American youth. To date, number of epidemics in the U.S.A., 17. To date, number of pandemics in the U.S.A., 5. Influenza epidemics in Europe and Asia. B.C. 1103. Epidemic in Babylon or Bhaborus of the Persians. 722. Epidemic in Nineveh during the reign of Sargon, King of Assyria. 591. Deodorus mentions a pestilence as having occurred at this date. Accompanied with headache, coma, and death. Meningitis, AM. 412. The Roman historian and writer Livy refers to a pestilence resembling the flu in Book 4, page 52. 395. A pestilence claimed to be flu destroyed by thousands the soldiers in the Greek army at the Siege of Syracuse. Plague or Cholera, AM. AD 827. A cough disease with fever spread rapidly and widely, known as half or half a deflown. Also as seawolf. Epidemic in Britain. 876. A disease attended with cough and fever. Pain in the eyes. Italiae febras. Italian fever. Ravaged Germany and Italy. 888. A disease with cough and fever spread through Germany. 927. A disease with cough and fever. Epidemic in France and Germany. 996-7. A disease with cough and fever. Epidemic in England. 1173. First epidemic, or claimed to be the first, prevailed in Italy, Germany, and England. 1323. The same countries invaded, spread to persons, towns, and villages. 1327. The same countries invaded, spread to persons, towns, and villages. 1387. Jacob von Koneckschofen states in the Strasburg Chronicle, A general pestilence invaded the whole country, attended with cough and fever. Hardly one among ten were unaffected. 1403-04. Epidemic over Europe. 1411. Epidemic. Name given to the disease, LaTac. 1412. The disease caused contagion in the air, extensively. Caused abortions. During convalescence there was profuse hemorrhages from the mouth, nose, and bowels. This account of the disease is given by Besky of Paris, 1665. 1414. Epidemic in France in February and March. 1416. Name given to the disease, LaTac. 1417. Le Horméon. 1418. And Coqueluche. 1419. Authority, Labineau. 1420. Epidemic. Widespread in France and the continent of Europe. Name given to the disease, LaDendo. Symptoms? Cough. Insomnia, renal pains, anorexia, rigors constantly. Name friends was, Have you had LaDendo? 1510. Pandemic I. All over Europe. First accurate description given of its prevalence in the British Isles. Mild in type. Names given in France. Sefal Catorral. And Coqueluche. In Britain, Coqueluche. Authority, T. Thompson. 1557. Came from Constantinople. Very fatal. Spread to the USA. Ravaged Paris in July and August. Spain in August. England in September. Holland in October. Distinctive symptoms. Quote. Tightness and dreadful oppression over the chest. As if bound with red hot chains. The same sensations over the abdomen and stomach. End quote. Authorities, Thompson. Herman. 1562. Mild epidemic. 1563. Mild epidemic. 1580. Pandemic II. Started on the north coast of Africa in Algiers and Morocco in May. Also in the island of Malta. Spread to the USA. Authority, Fonseca of Madrid. England ravaged August, September, October, November. Rome, 9,000 persons died. Barcelona, Cadiz, Cordova, Seville, Madrid, and other Spanish cities are said to have been depopulated. The Spanish physicians bled their patience. This Venice section, Venice section, is said to have been very fatal. Those who were not bled, most lived. Thomas Short, London, 1587. States on page 9. All had the Cajalooche. Few died except those who were bled or had unsound viscera. Anna, wife of Philip I of Spain, died of the disease. Pope Gregory XIII was given up for death, but recovered. Epidemics in 1591, 1593, 1597, 1626. 1647, Noah Webster states, For the first time influenza is mentioned in the history of U.S. America. But it must not be concluded in the absence of earlier records that the disease never occurred in the U.S.A. Webster also cites from Hubbard. The disease swept the southern states and the plantations. The West Indies were ravaged and had an extensive morbidity. On each of the islands of Barbados and St. Kitts, there were 5,000 to 6,000 cases. 1658. Epidemic in Europe. Started the end of April. Thomas Wills, M.D. of Oxford says, Quote, The cause of the disease was a blast from the stars. End quote. 1675. Epidemic ravaged Germany. 1688. Epidemic began in May. Europe swept great mortality in Britain. 1693. Epidemic Europe. 1709. Epidemic in Europe. France, Germany, and Italy chiefly affected. 1712. Europe. Epidemic began in Germany. Fever, cough, sense of dread and oppression. Painful eyes and great backache. Rapid spread, great and prolonged exhaustion. Morbidity, great. Nearly everyone attacked. Mortality, very light. 1729 to 30. Origin, Moscow, Russia, April 1729. Morbidity enormous, lightning like spread. In London, great mortality, barely 1% escaped. In the month of September 1729, over 1,000 persons died each week. Rome had some 60,000 cases. Authority, Han. 1732 to 3. Pandemic, 3. Raged over the entire Earth, spread to US America, October 1732. 1742 to 3. La grippe and influenza appear as names given to the disease for the first time. Epidemic, great morbidity. Few deaths. 1758, the flu prevailed as an epidemic in France, Scotland and the West Indies. 1761, present in the USA in the spring. 1762, epidemic in Europe. 1767, US America began in month of May. 1775 to 6, spread from Europe to USA. Authority, Gluge. 1780 to 1. January 1780, started in France. 1781 to 2. Pandemic, 4. Very severe, widespread. Began in the autumn of 1781 on the borders of China and India, then spread to Russia and USA. In 1782, appeared in Western Europe. The name given in this pandemic was Russian Qatar. The British fleet sailed from the Channel Ports Plymouth and Portsmouth on May 6, 1782. No further contact was had with the land, yet on the 27th of May, the flu broke out on the fleet. The presence of flu carriers on the ships or infected stores, clothes and other fomites and only opened after a week or two at sea. Also the flu being epidemic at the ports of departure will amply account for this alleged miracle. Author. 1788 to 9. Widespread epidemic in the USA. Statement of Webster, quote, influenza is not spread by infection. Sailors on board ships 100 miles from land and insulated as to infection were attacked, end quote. Influenza is spread by infection. The explanation and defense is the same as just made above. Author. 1799 to 1800. Northeastern Europe. Epidemic. 1802 to 3. Pandemic 5. 1807. Pandemic 6. 1830. Pandemic 7. The seat of the outbreak was Manila P.I. in September. It spread to the USA. 1833. Epidemic in Northern Asia, Europe, North Africa. In St. Petersburg, great morbidity. None escaped. 1836 to 7. Pandemic 8. Starting point obscure. But in the Eastern Hemisphere, morbidity and mortality large. Pulmonary influenza or influenza pneumonia cases very common. In London for the week ending January 24, 1837 there died 1,166 persons. And for the week ending January 31 the death rate reached a total of 1,169. These deaths were solely due to flu. 1847 to 8. Pandemic 9. Point of origin unknown. Center of the focus of the disease, the Eastern Hemisphere and Europe especially. More females than males were attacked. Great mortality. Of those affected with the disease there died 83% of children, babies and infants. 104% of those 15 to 60 years. 247% of those over 60 years. Authority Peacock. In Paris one quarter to one half of the population were attacked. In Geneva one third of the population were attacked. In London 250,000 were said to have been stricken. U.S. America escaped the disease. 1850 to 1. 1857 to 8. 1873 to 4. 1875. 1879. Influenza prevalent in both hemispheres. 1889 to 90. Pandemic 10. Started at Bukhara in Russian Turkestan. Large province situated to the east of the Caspian Sea. March 1889. Very vicious in its morbidity and spread. Acted as never before. Ran over the whole globe in a few months. Contagious, which hitherto in doubt was clearly demonstrated by this epidemic which spread from Asia to Russia. America was infected from both Siberia and Europe. Tropical and temperate countries. Mountain and plane were all swept over alike. 1918 to 9. To 1920. Pandemic 11. Origin in southeastern Spain, Barcelona, a seaport. April 1918 where a German submarine is said to have carried it. Originally acquired by this boat at the Baltic port or ports of Danzig or Stetten. Swept Europe and entered Asiatic Russia later Japan U.S. America was infected at its Pacific and Atlantic ports. The conditions of trade and commerce during the World War were unusually favorable for the carrying of influenza to the USA. America, the great sold as always acting most generously. Putting herself on short rations in order to feed the starving millions of the world and sending her ships with food and clothing to the flu infected ports carried back the disease to her own people. To date, number of epidemics in Europe, 47. To date, number of pandemics in Europe, 11. Names for influenza. Italian, Catarro Russo and Influente. Portuguese, Catarro Epidemico. Spanish, Catarro Epidemico. German Blitzkatar equals Lightning Katar. German, Influenz. End of chapter 2. Recording by Grace Buchanan. Chapter 3 of the Flu. A brief history of influenza in U.S. America, Europe, Hawaii by A. Moritz. This LibriVox recording is in the public domain. Recording by Grace Buchanan. Chapter 3. Influenza in Hawaii. Previous to the year 1889 Hawaii had been tolerably free from the flu. Such cases which had appeared in former years were of a mild character, as were also those which prevailed during the 1889-90 epidemic. Epidemic Katar has been known in the Hawaiian islands for many years. The annals of the early missionary fathers mention it. Dr. Alonzo Chapin, an early missionary physician, refers to it, age 39 of the author's monograph on leprosy, is the following quotation taken from the doctor's writings in the years 1836-37. In Hawaii, quote, diseases occur epidemically, as was the case with Katar, repeatedly, end quote. This epidemic Katar was probably influenza in a mild form. Or it may have been the epidemic Katar of the kind known to the physicians of today, as that caused by the micrococcus catarallus, a globular or spheroid shaped microorganism. South Wind Katar. In Hawaii during the season when the south wind prevails from November to March, epidemic and infectious colds are very common. They are attended with disagreeable frontal headache, nasal discharge, sore throat, fever, aching limbs and body. These are cases of mild flu. Elderly people middle-aged and old foreign residents and our Aboriginal population are those mostly affected. Hawaii today, due to great increase of travel, greater speed of ocean steamers and its cosmopolitan population, is probably infected, like all other ports of the USA, different species or strains of the influenza bacillus and also those of the micrococcus catarallus. Contagious nature of colds or guitars, so called. It is a well-known fact that when isolated peoples are visited by strangers, whether they arrive by sea or land, epidemic colds speedily appear amongst the residents of these localities. The Eskimo, Indian tribes, residents of South Sea Islands, Caroline, Marshall and Marquesas groups, Pitcairn Island, etc., isolated peoples and out of the track of travel when visited by strangers become affected with epidemic, Katar and cough, which may attack great numbers of them and cause high mortality. Those visitors who carry the germs of the Katar show no visible signs of disease themselves. Possible sources of disease During the past four centuries, there is clear evidence that Hawaii has been infected with diseases from certain sources. There is also evidence that is not so clear yet is worthy of consideration. From what countries could ships carry diseases to Hawaii before the opening up of the islands to foreign trade? Spain, China, Japan and Russia. Since the opening up of the islands to foreign commerce, the ships of all nations have carried to Hawaii a varied assortment of diseases, some nearly harmless, but others of the deadliest kind. In the past centuries there are credible records of Spanish visitors, also of Chinese and Japanese, and of a people coming in prowls and junks with tufts of hair on their faces, Formosans, whose speech has an alliance with the Malayo Polynesian, and hence Hawaiian. At the present time, numerous ships which visit Honolulu carry infectious and contagious diseases amongst their crews and passengers, especially those who travel in the steerage. What occurs today at known intervals on a very large scale most probably happened on a smaller scale at extended and unknown intervals in past centuries. Diseases were introduced to Hawaii and carried from here. Castaways and shipwrecked mariners and diseases to the shores they arrive at, the same as other voyagers, and probably did so to Hawaii. If there was no tuberculosis in Hawaii before the coming of the foreigner, then where do the ancient words ho'oki'i a'ke'pa'u come from? Ho'oki'i means in English to grow thin in flesh, to waste away. A'ke'pa'u means to consume, to finish, hence, to eat away. Even today, inspection of arrivals from overseas ports and even limited quarantine carefully carried out by competent officials is not always an effective protection against the introduction of infectious and contagious diseases into any country. The following list of contagious and infectious diseases eluded 18 officials at the port of Honolulu and infected the town. Some later infected other islands of the group. Year 1853. Month May 13th. Disease Smallpox. 1881. February 4th. Smallpox. 1895. August 22nd. Cholera. 1889. December. Plague. 1911. February 23rd. Cholera. 1911. October 27th. Yellow fever? 1918. June. Influenza. The epidemic of 1889-90. The 10th epidemic, which had its origin in the month of March 1889 when the Ikara Russian Turkestan ultimately reached Hawaii both from Japan and San Francisco. From the former country in August of that year and from the latter city in December. Influenza became epidemic in the islands in the year 1890 in the months of January-February-March and practically ceased to exist in the latter part of April. In the early autumn of the year 1889 a disease started in Russia, which on that account took the name of the Russian disease. It spread rapidly over Europe and the British Isles. Very soon after that the epidemic of 1889 started in Russia and in the early autumn of the year 1889 and in the early autumn of the year 1889 in Europe and the British Isles. Very soon it crossed the Atlantic and with extreme rapidity spread over the whole continent of North America. Early in January 1890 Dr. Trousseau, the port physician reported many cases existing among passengers on the mail steamer en route to the colonies. In its journey westward from its initial starting point in Russia and the lines of California its march has been marked by great prevalence and fatality. In Hawaii with its mild and salubrious climate its intensity has greatly modified and although it caused great distress and physical suffering very few deaths have resulted from it. This disease has prevailed as an epidemic on several former occasions of influenza. Other extracts from the same report are as follows. Agent Reynolds, quote, influenza has visited most of the families in town since its arrival but deaths have been few, end quote. Dr. S. B. Swift, quote at Kalawapa females at the bishop home were most affected, end quote. Dr. Jared Smith, Kauai quote, extreme prevalence of influenza of mild type began the middle of January, end quote. Dr. D. Campbell, Waimea, Kauai quote, influenza widespread, end quote. Dr. Greenfield, Hamakua, Hawaii quote, no influenza epidemic Qatar and bronchitis wet and cold weather, end quote. Dr. G. Herbert, Wailuku Maui, quote one third of the population affected at least 3,000 cases. One pneumonia case fatal, symptoms, fever, frontal and occipital headache, spinal and limb pains, pulmonary congestion and occasionally pneumonia, end quote. Estimated number of cases of influenza? Island of Oahu, 6,500 population, 28,000 Island of Maui, 3,300 population, 19,000 deaths in Honolulu, February 3, March 5, total, 8. Earlier arrival of influenza Hawaii invaded from Japan. On or about the 20th of August, 1889 recently arrived Japanese laborers had influenza in a mild form. This shipment on arrival from Japan at Honolulu were transferred immediately from the ocean steamer to the deck of an inter-island one and were landed direct at Onimea and Hakalao plantations. The type of influenza was very mild, never infected other laborers, but those who had the disease were segregated for a week. At Onimea there were nine cases at Hakalao, 11, author. The epidemic of 1890 left the trail of its own somewhat different from the way it had acted as an epidemic. For almost a decade cases of the nervous type frequently kept cropping out. These were attended with insomnia, great prostration, severe neuritis and facial neuralgia. Frequent attacks and relapses in the intervals of this nervous form of influenza were responsible for the disease of Honolulu's most prominent physician in the year of 1894. The last and fatal attack the doctor believed he acquired from visitors to Honolulu from Siberia, that country and European Russia being a continuous source of endemic influenza. Dengi. Dengi in its initial stage or degree of progress in some respects resembles the flu and is often mistaken for it. Such was the case in the years 1900 to 1901 when imported laborers from Puerto Rico W.I. carried the Dengi or break bone fever with them. This disease has practically disappeared, a sporadic case of it comes to light now and then. Its transmission by the mosquito, Kuleks fatigans, is not yet definitely determined. The new and more virulent type or species of the influenza bacillus was carried overseas to the port of Honolulu in the third week of June 1918 and spread to the residents of the town. And it was this new imported type of influenza that was responsible for the high mortality in the epidemics of that disease in 1918 to 1920 due to influenza and complicating pneumonia, the so-called pulmonary or pneumonic form of the disease. All these matters have been fully described in the public press and in part in the reports of the Board of Health, which QV. End of Chapter 3 Recording by Grace Buchanan Chapter 4 of the Flu A brief history of influenza in U.S. America, Europe, Hawaii by A. Moritz. This LibriVox recording is in the public domain. Recording by Grace Buchanan Chapter 4 General Considerations Contents Effect of influenza on man Pulmonary influenza or influenza pneumonia Immunity Incubation Salient points Quarantine Cause of flu Why microbes created Flu preventatives Hours when flu attacks Salient points Effect of influenza on man When the influenza bacillus or microbe has gained access to the system of man, it speedily produces an acute infectious toxemia or blood poisoning due to the toxin or poison liberated in the blood by the bacillus. There are also other disease-producing microorganisms found in the sputum or spit of the influenza victim. These are spheroid or bead-shaped and called coxie, cocus, a berry, Greek, which apparently aid the bee influenza as allies of destruction to our systems. The effects of the flu poisoning on the human lung somewhat resembles the conditions seen in those who have died from inhaling strong chlorine gas, carbon monoxide or nitrogen gases in an atmosphere devoid of oxygen. The type or general character of the flu which has prevailed in Hawaii during the past two years, especially in Honolulu in the months of January, February, March and April 1920 is the highest development of destructiveness to man that the bee influenza is capable of. It was the true Russian Qatar or malignant flu and so-called by the Italians Qataro Russo and not Influente or Influenza. This type of the flu was reintroduced into the USA in the spring of 1918. Influenza pneumonia. Pulmonary influenza or Influenza pneumonia frequently complicates the flu in some epidemics but not in all of them. It is the main cause for the mortality due to that disease. A century and a half ago the French physicians first demonstrated its peculiarities and its difference from ordinary pneumonia which is as follows. A, it develops gradually and complicates the bronchitis of influenza. B, its peculiar physical signs are the respiratory murmur in the early stages of the flu is diminished and later completely disappears. Then bronchial breathing begins without dullness or crepitant rouse like true pneumonia. In Hawaii as elsewhere the complicating pneumonia seldom appears before the second or third day. Occasionally it comes to the fore after the fifth or sixth. It is not always easy of detection in a mild case. In our epidemic in Honolulu last winter 1920 some of the cases considered as pneumonia were in fact those of simple pulmonary congestion and edema attended with expectoration of frothy blood-tinged mucus resembling the swollen or drowned lung found in those who have been submerged and died from drowning. The true influenza pneumonia sputum or spit is greenish-yellow. This greenish color leads to the presence in the sputum of a green pigment excreted by the diplococcus or double-coccus like a necklace of beads or sometimes resembling rounded small rods. Legacies of the Flu to Man Attendancy to TB Softening of the heart muscle Nervous prostration Insomnia, restlessness and inability for brain work Passion of spirits And irritability of temper Neralges, middle-ear disease, eye troubles Vertigo or giddiness from the ear disease or eye or heart Stomach disease after intestinal influenza Vomiting spells, etc., etc. Emaciation, diarrhea The open-air life of the occupants of TB hospitals accounts for their freedom from the epidemic flu but they are not immune to every epidemic. Residents of asylums, hospitals and jails are not so fortunate numbers of the inmates being attacked. Daily rations of quinine should be given. Immunity, the king protector Paradoxical as the statement may appear the mild and balmy climate of the Hawaiian islands or any other place that protects nor prevents any person from being attacked by the influenza. A mild climate is not a factor of prevention against any infectious or contagious disease. The dominant agent and king of protectors is an immunity inherited or acquired. Climate cannot alter, change or prevent any person from being infected with smallpox, plague, cholera, scarlet fever, typhus or influenza. In the presence of king flu all men are not equal. Those who have had several attacks of the disease in former years or have recently had it are fairly immune not absolutely so but others who have not recently had flu are liable to become infected with it and may be stricken at any time. Good living, careful personal hygiene, fresh air and abundance, avoidance of overheated and poorly ventilated rooms together with a general high standard of living are excellent in their way to prevent ordinary disease but in so far as they can prevent anyone from being infected by the flu the absolute protection is entirely lacking in them. None of these very essential hygienic principles can produce immunity which is the sole protector from an attack or more than one attack of influenza and it is nature's standby and by means of which it braces up the system to convalescence and ultimate recovery. Successful vaccination against smallpox will prevent or render mild an attack of that disease in 95% of those who have been vaccinated and revaccinated. A baby in arms if successfully vaccinated is immune and protected whereas an unvaccinated giant living in a balmy climate should he contract smallpox will probably be a candidate for a coffin or the furnace of a crematory. A mild climate cannot alter nor render less harmful to the system of man the specific toxin or poison of influenza once it is liberated into his blood nor the toxin of any other microorganism of the infectious type. In the combat with disease many of the advantages of our Hawaiian climate are to a certain extent neutralized by a lack of stamina and disease resistance and also the neglecting to call in the services of a physician at an early stage of the illness of some of our inhabitants. Any person who is affected with symptoms of disease such as fever, headache, nasal discharge, cough sore and tickling throat and lassitude during the prevalence of flu, epidemic or sporadic should take to bed and by doing so it may mean and is in line with a quick recovery and a mild case of that disease whereas fighting off the disease and struggling to pursue one's daily avocation may change a mild type of illness to a very grave and hopeless one. In this respect influenza resembles typhoid fever of the ambulatory type. The victim does not realize how sick he is but when the hour comes that exhausted body and brain forces him to seek his bed it is often too late and death or prolonged sickness awaits him. Frequently the athlete and the physically strong when stricken with flu refrain from early rest struggle against the inroads of the disease exhaust their recuperative powers and when finally driven to bed collapse and die whereas a weaker individual being speedily overcome gives up and takes early to bed and recovers. The death rate amongst those who are attacked by the flu varies in each epidemic and pandemic as a fair average approximately most recover say 75 percent incomplete recovery 15 percent and in the late epidemic in Honolulu the winter of 1920 the death rate was 8 percent to 10 percent in the USA it was 4 percent to 6 percent and in Europe 4 and a half percent incubation great discrepancies occur in the statements of different observers but in as much as each epidemic varies in severity a severe type of the flu may have a shorter incubative period than a mild type and therefore taking the variations and type into consideration may reconcile the differences if influenza was accompanied with a facial eruption or exanthem this would materially assist in the determination of its incubative period in Hawaii two or three days is the most frequent period of incubation it may vary however from 24 hours to 72 hours even to 5 days in these long incubative cases headache aching eyeballs and great langer are the indicating signs and those persons so affected succumb slowly and offer great resistance to the overpowering toxins of the bacillus influenzae the immunity which a person may possess in one epidemic and not in another may be accounted for by assuming that each epidemic may have a difference in the strain or the species of the influenza bacillus salient points period of life most cases occur between 20 and 40 years in schools the older children are first attacked open-air schools are a positive but not an absolute defense against infection indoor schools the ratio of prevalence amongst children of all ages is 40% outdoor schools all ages the ratio of prevalence is 10% open-air occupations such as workers in the field 12% are attacked closed rooms factory operatives 49% are attacked main factor of spread not the weather but human intercourse especially commerce the greater the speed of commerce the greater and quicker is the spread of the flow it follows the path of human travel it is a contagion solely spread by human intercourse vis the influenza carrier or carriers positions in life which require contact with travelers necessarily influence and spread the disease flow is spread in the same ratio of speed as the carrier of it when the flu is a weakling his best nurses and foster mothers are overcrowding and lack of pure air where the crowd is there the flu is little crowding means little flu plenty of crowding plenty of flu quarantine and isolation period of isolation for ordinary flu patients 12 days period of isolation for influenza pneumonia cases until the end of convalescence quarantine and isolation are beset with difficulties owing to the extraordinary contagious nature of the flu due to the multiplicity of contacts, carriers and mild undetected cases it should be borne in mind that influenza is a most refractory disease and not at any time or season is it under our control and to bring about this condition is as yet an unsolved problem it may attack us at any time although its favorite period of appearance is the autumn and winter months influenza is mainly a respiratory disease hence isolation and quarantine cannot be relied upon to prevent the spread of the flu and both of these restraints of personal liberty and hindrances of commerce must fail besides being also unpractical and impossible people must meet to transact business in public places must eat and drink in public use telephones in public places use public lavatories and many other acts of public nature all of these acts cannot be quarantined nor can talking amongst crowds even if rigid quarantine rules were enforced the flu has hitherto eluded them and spread outside of the quarantine limits cause of the flu in the absence of any alleged cause or theory which can account for the erratic prevalence of the flu the author advances the following A. the bacillus of influenza normally cannot exist or thrive in our everyday ordinary atmosphere constituted of 20% of oxygen and 80% of nitrogen B. under certain atmospheric conditions such as any fractional excess above 4 or 5 nitrogen the normal amount present in the air the bacillus of flu can become acclimated and acquires new sources of vitality vis the means to exist in the presence of oxygen and to thrive and multiply in it and propagate in this temporarily changed atmosphere it speedily becomes imbued with virulent disease producing properties multiplies on a vast scale and proceeds to attack and scourge man hence an epidemic of flu is brought into our lives C. later when the normal atmospheric balance is restored the bacillus ceases to be pathogenic or disease producing loses its power facultative or potential to multiply and live on a large scale but certain of the most vigorous members of the colony survive and remain dormant and latent and years or months later under the same favorable atmospheric conditions nitrogen excess in the atmosphere become active and produce a new epidemic of flu each epidemic may be considered as a sprouting of the seed of the previous or past ones such seed or microbe is not permanently nursed by any host such as man or animal as a carrier but the bacillus lies hidden in the dust of rooms addicts books packed away clothes towels non-sterilized fomites in general especially blankets and handkerchiefs wall paper etc on premises which had been occupied by flu victims or victim or convalescence from the disease weeks months or years before no disease producing microbe can develop itself anew it must come from the seed of the old stock whether it be flu typhoid plague TB or smallpox like produces and only can produce like is an infallible law and applies to every living microbe malignant or harmless anything with life when the entire species is eradicated or destroyed with no live members or parents surviving is absolutely gone forever save and accept the supreme deity sees fit to regenerate it in Honolulu how uncomfortable we all feel when the south wind prevails with its excessive humid atmosphere headaches sweats sneezing lassitude and loss of appetite etc affects many of us and coughs and sore throats this is the sick wind or atmosphere so called by the Hawaiian a condition of mild flu producing weather akin to the nitrogen plus air and oxygen minus which the author has suggested as an explanation of the cause of dormant influenza developing into an epidemic why were microbes created we have an abundance of non disease producing microbes dwelling in our bodies and also many other harmless micro organisms pervade the lower strata of our atmosphere the upper strata of the air or devoid of microbes say five miles from the surface of the earth but in as much as human beings cannot breathe in comfort at such a high elevation we cannot escape germs of disease by residing at great heights the harmless microbes inhabiting our bodies are good friends and protectors disease producing microbes may have been created for the purpose of maintaining a bacterial balance but not too much of one kind nor too little of the other if Providence intended to decimate mankind and destroy him by microbic diseases one species of a deadly and virulent micro would suffice micro organisms in order to live and exist must find suitable surroundings and pabulum if these are lacking they must perish man and animals in the main furnish the homes and food which enables a microbe to exist and when death destroys the host the parasitic microbes still lives in the body of its victim when buried in the ground hence the necessity for cremation which is the ideal and most efficient method of disposing of the corpses of those who have died of infectious diseases spores have great vitality the creator by introducing microbic life to our globe must have intended it to live and propagate bacteria are provided with a wonderful defense against eradication this is evident in the protection designed for the spore or reproductive element of bacteria whose coat or outer cell envelope is one of the most resisting substances to destruction in the organic world agents that cause other forms of life to succumb fail to destroy it the average spore when subjected to a dry heat temperature of 300 degrees Fahrenheit for one hour is apparently still alive it requires this same temperature to be maintained for several hours in order to destroy it it is an unalterable law of life that every living species grows old and ultimately perishes even one day's existence to a microbe may combine birth infancy maturity and old age it is impossible to believe or to think that our creator is always creating new or fresh supplies of flu microbes or any kind of the disease producing ones whether microbes survive the deluge or were post-pluvial creations is a moot point if Noah took microbes into the ark and preserved them by divine order for future liberation amongst mankind he certainly did his work efficiently insofar as the species of the influenza bacillus is concerned it has lost none of its virulency or vigorousness in the year 1920 after living 6,000 years preventives of influenza? are there any influenza preventives? serums of late years have been the chief agents used for preventing and treating the flu as a preventive remedy the immunity or protection afforded is very brief and it ceases to be of value in a few weeks in Hawaii the author has not been greatly impressed with the value of serums in the treatment of influenza the alleged great benefits and cures set forth in medical papers and publications of laboratory statistics by manufacturers of the serums are not obtained here serums after injection are supposed to aggravate all the symptoms of flu followed by a great improvement in the patient's condition but this prophecy is not always borne out hence the increase of the headache fever and pains in the limbs and aching bones alarms and frightens the patient of the Asiatic Hawaiian races and many of the Caucasians amongst cases of influenza lying side by side those treated by simple remedies recovered just as speedily and safely as those who had undergone the serum treatment and were attended with much less discomfort quinine the bisulfate of quinine is one of the best hemo or blood microbesides that we have and its daily use in times of epidemics of influenza may prevent the user of it from being attacked it is more preventive in some of the epidemics than in others the ratio of prevention is 40-60 sometimes more sometimes less the remedy is easily taken and in small doses has no drawbacks it is best so administered it is cheap and in the coated tablet form palatable convenient any person can take it and pursue his usual avocation after 40 years of practice as a physician the author feels convinced of the value of quinine he learned its value in western Europe even if the headache of flu is very severe small trial doses may be given as the author knows from personal experience it is helpful in a later stage of the disease with excessive sweats, cold clammy skin and aching bones should you to cadaveric bacilli circulating in the blood give quinine and your patient or patients will soon respond to its beneficial effects their condition will improve and they will thank you and ask for the medicine should small doses upset the stomach in very susceptible persons then it may be given in hypodermic injection using the more soluble salts of quinine a white powder soluble in one to five of water or the acid hydrochloride of the British pharmacopeia in the USA pharmacopeia it is the dichloride which is soluble in less than its own weight of water if small doses of quinine cause headache and ringing in the ears in a well person then the remedy is unsuitable and should not be taken or it will not prevent an attack of the flu in that person Professor Dittmar Finkler, MD of the University of Bonn, Renish Prussia in his work on influenza cites the experiments carried out by Dr. Grazer Medical Army Corps on duty at the Cavalry Barracks at Bonn where five squadrons of German cavalry were quartered during an epidemic of flu one of the squadrons, complement of men was given daily rations of quinine for several weeks during the prevalence of the epidemic the other four squadrons received no quinine the results are set forth first squadron, complement 135 flu cases, 22 quinine, none second squadron, complement 135 flu cases, 4 quinine, 0.5 grams daily third squadron, complement 135 flu cases, 19 quinine, none fourth squadron, complement 135 flu cases, 42 quinine, none fifth squadron, complement 135 flu cases, 32 quinine, none it is reasonable to assume that the food or pabulum of the bacillus of influenza is poisoned by quinine entering the blood hence the micro will avoid by instinct any person whose blood contains quinine in solution if the bacillus has gained access to the system it is speedily destroyed and becomes cadaveric as soon as it enters the zone of the quinine barrage are there hours of the day when the system is more susceptible to invasion by the bacillus influenzae? to determine this question requires careful study time, a great deal of patient and tedious work and perseverance yet it is possible to gain some information on this phase of the flu at intervals during the past 21 years from more than 1000 cases of influenza in adults the author has managed to collect 132 cases wherein it was possible to check and verify with some degree of accuracy the time of contact with a known source of flu no subsequent contact being had with any other known source of that disease material evidence was collected from isolated plantation camps sparsely inhabited villages and the suburbs of Honolulu at such times as there was no epidemic of flu a record of cases collected mostly in the autumn and winter months from October to March is here under set fourth hours of contact 5 a.m. to 8 a.m. 30 cases incubation 2 to 3 days pneumonia none hours of contact 8 a.m. to 6 p.m. 22 cases incubation 2 to 3 days pneumonia none hours of contact 6 p.m. to 10 p.m. 80 cases incubation 1 to 5 days pneumonia 9 amounts in attendance at social gatherings public meetings, restaurants, places of amusement together with lack of pure air in overheated and unventilated rooms and halls plus lowered vitality after the day's work easily and clearly account for the great excess of cases in the above table between the hours from 6 to 10 p.m. influenza has neither cosmic nor heliacal connections salient points care of the flu patient ventilation of the sick room should be carried out with due regard to the wishes of the patient what is a cooling agreeable breeze to the average Caucasian may be felt as an arctic blast by the Hawaiians and Asiatic races this causes them to fret and worry there is a happy medium in ventilation of sick rooms as in all things if the patient has pneumonia encourage resting on the right or left side changing from time to time discourage any patient from lying on the back the health of the nurse the nurse must protect her own health by regular hours for work, rest, sleep, meals and exercise an overworked nurse is a non-efficient nurse and it sends her along the road to a breakdown and makes her or him more subject to acquiring flu from the patients practice nose breathing use sign language in the sick room keep the mouth closed tightly closed lips are a better safeguard than a flu mask mouth breathing is an inviter of infection anoint the lips and nostrils frequently with campfer vaseline or spirits of campfer use no sprays for the nose or throat containing alleged germ destroyers gargle the throat with a little listerine water by doing so you do not kill your protective friends the non-pathogenic bacteria these will get the best of Mr. Flu in due time leave the nose alone germ killing sprays so called are useless and are a delusion remember the flu bacillus is enclosed in a spray-proof coat almost as tough as shark skin end of the flu a brief history of influenza in US America, Europe, Hawaii by A. Moritz Recording by Grace Buchanan