Influenza

Introduction

"FLU" - That dreaded three syllabic word carries with it the import of suffering and impending sickness whenever the Newspapers carry the news that it is once again within our doors. This year of grace 1972 has it again. Previously the epidemics of influenza used to visit humanity at very long intervals. But with the progress of civilisation and all round progress this disease is showing its ugly face more frequently as we shall presently see from the history of the disease so discerningly collected by our medical men.

Much has been said and dealt with by almost all schools of medicine in this field but one does not find the available knowledge about it in one place. It seems expedient, therefore, to put together all that can reasonably be collected at one place, subject to the exigencies of space and precision. Therefore, these pages shall make known for the advantage of the public and the progressive-medical men how to protect, abort, treat and manage influenza and post influenzal sequelae from the angle of vision of the Allopathic and Homoeopathic systems of medicine.

The Allopath might object to his learning the method the Homoeopath applies in such cases. But it would be advantageous to him, for, after all, he too is in need of something which can really benefit his patients and more so when it is not on shifting moving grounds but is of a permanent value. If we are not dealing with such a serious subject as medicine, which means health and happiness and often hazard of life itself to the patient, it would be amusing to notice the shifts that the old school are put to, to explain and justify their appropriation of homoeopathic ideas. They should leave the art of "conjecture" in medicine for the good of humanity whose health they swear by. It would be nice legal question to consider, whether a physician is not criminally liable, when he refuses to learn how the health of those entrusted to his care may be benefited ?

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Allopathic view

In order to do honor to our elder brother the Allopath let us first of all consider what his system of medicine (Allopathy) has to say about the subject "Influenza".

"Influenza", "La Grippe" or, in common parlance, simply "Flu" is an acute infectious disease spread by a filterable virus. "Virus" is a Latin word meaning poison but is used specifically as a term for a group of pathogens which are barely visible or invisible under the ordinary microscope; they are generally believed to be living organisms or chemical entities on the borderline between the living and the non-living, causing disease in plants, bacteria, insects, animals and man. With few exceptions, they are capable of passing through fine filters that can retain bacteria. They are incapable of growth or reproduction apart from living cells. They are composed of a protein structure units. RNA (Ribo-nucleic-acid) and DNA (De-exyribo-nucleic-acid) are the two main groups with many sub-groups which are classified according to their origin, mode of transmission and manifestations produced in the host. Many are named for the geographic locations where they were first isolated. Among the groups one such sub-group is known as "myxovirus" which has special affinity for certain mucins and have ability to sense influenza or influenza-like infections in man, other primates, and domestic mammals and even poultry. They are transmitted by means of respiratory secretions of infected hosts.

Types of influenza

Types A, B, C and D of influenza virus are recognised. They differ in antigen structure and do not have cross - immunity. They have low resistance to environmental influences and perish in a few hours at room temperature. When acted upon by disinfectants, or exposed to direct light of the sun or heated at 60°C, perish in 5 to 10 minutes.

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Influenza A viruses are the most important pathogens among the influenza viruses, infecting man and many domestic animals and birds. This type causes influenza and sometimes pneumonia and also naturally infects ferrets and pigs. Considerable changes in the antigen structure have taken place since 1933. A (1933-46), A-1 (1947-56) A-2 (1957 - to date).

Influenza B virus causes influenza and sometimes pneumonia in man, the disease being more endemic than that caused by influenza A virus.

Influenza C virus is thought to cause sporadic, mild influenza-like infections in man.

Para - influenza viruses D, HA 1, HA 2, C A are other varieties.

History

Influenza must be having a very remote antiquity, since humanity has been suffering from diseases of respiratory system and fever called catarrhal fever but it was recorded clearly for the first time in the fourteenth century and since the early decades of that century, it has been occurring in epidemics and pandemic with varying intervals and duration as also severity. Some notable years are 1837, 1847, 1890, 1916, 1918-19, 1957, 1960, 1964, 1968. Endemic and sporadic cases are not to be accounted for.

The 1918-19 pandemic was the severest.

Occurrence

Sporadically, epidemically and pandemically, influenza has now been visiting the world. It usually occurs in epidemic form many people in the community being struck at the same time. The epidemic generally reaches its peak in 2 or 3 weeks, then sub-sides in another month or two. A devastating world-wide epidemic (pandemic) occurred in the fall of 1918 and early winter of 1919, killing somewhere between 6 and 10 million people, including a half million in the U.S. A. Such widely fatal epidemic has, fortunately, not since occurred.

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However, in the year 1957 (summer), a world wide influenza originated in China but it produced a much milder disease than the 1918-19 pandemic. This was named Asian Influenza.

In India this year (1972) the Asian Influenza has again been declared to be "in the air", both literally and figuratively. Even in New York there were reported in first fortnight of December '68, 5,00,000 cases of Flu with 107 deaths and 40% absenteeism in factories.

In America it is now a warning from the United States Public Health Service that Type A Influenza tends to flare up every two or three years. Type B may also come. We would rather say that Influenza might become an annual feature in future because of the vast areas sprayed with insecticides all over the world and air being charged with poisonous matter inimical to human health. Those poisons are absorbed by the vegetables and fruit that reach us. Body reacts to this poisonous matter and attempts to expel it via the respiratory tract and excretions. Efforts results in fever, also.

Endemic Influenza or Influenza Nostras or the Acute Catarrhal Fever or "Winter Grippe" is a disease resembling in its general features pandemic influenza but is usually of less severe type, occurring with more or less regularity during the cold season especially in larger cities of the world.

One thing is sure. Once it starts in any country, it takes a global tour.

Probably, however, no diagnosis is made so frequently and often with so little justification as that of influenza. The layman, indeed, is very apt to term any severe nasal catarrh or infection of the upper respiratory tract an influenzal attack, irrespective of fever and bodyache.

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Age ? Any. But is more often found affecting persons between the age of 20 and 40. It has been found that in pandemics the disease is usually more severe in young and otherwise healthy adults than in infants and the aged.

It attacks both the sex.

Its incubation period is 1 to 3 days only.

Mode of infection

It is a droplet infection.

(All those suffering from influenza are its carriers.)

Clinical features

After a short incubation say of one or two days, at the most three, there is felt a sudden malaise, headache, pain in the back and limbs, anorexia and may be there is nausea and vomiting. Fever is usually 103°F (39°C) - remits for two or three days, with chills and shivering but there is seldom any rigor. Face is flushed, conjunctivae is suffused and hyperaemic fauces - with very prominent lymphoid follicles.

Pulse is rapid.

Leucopenia (2,000-4,000) per c. mm.

Cough - Harsh unproductive (dry) - No signs over the lungs.

Note : at this stage, clinically the case would be difficult to be distinguished from a severe respiratory infection due to respiratory viruses, which are : -

(a) Non-specific toxaemia : malaise, fever, headache, muscular pain, shivering, prostration.

(b) Upper respiratory Infection :

Pharyngitis, rhinorrhoea, laryngitis, croup (children).

(c) Lower respiratory Infection :

Bronchitis, pneumonia, Bronchiolitis.

(d) Specific features :

In adenovirus infection keratoconjunctivitis; Herpangina.

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Symptoms and signs

1. Onset :

Sudden fever. With symptoms similar to those of common cold or an acute bronchitis; aching in limbs and back.

The symptoms tend to vary with different epidemics.

Temperature 103°F. It is almost classical.

2. The general constitutional upset is more severe than one would expect with an ordinary cold : -

Headache, chill, lethargy are common.

3. A cough, sneezing, running eyes and nose, and laryngitis.
4. Nausea, vomiting and abdominal pains are also found in some outbreaks. Not in all.
5. Tongue is furred.
6. Appetite is lost.
7. Great prostration.

Complication

Bronchopneumonia is the most important complication and is responsible for most of the deaths.

The Pneumonia is usually caused by secondary infection with such organisms as the influenza bacilli, streptococci and staphylococci.

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Note :

1. Elderly people are more prone to develop Pneumonia. Caution the family.
2. Pleurisy.
3. Otitis media.
4. Meningitis Influenzal.
5. Oedema laryngis.
6. Raynaud's disease.

Prognosis

In ordinary cases which are uncomplicated the Temperature drops after 4 or 5 days but the prostration lasts a pretty long period (and is felt very early in disease).

If complications develop, the prognosis would be grave.

Imp. Note :

If the case lasts longer than a week, it is probably not a case of influenza or else some complication has developed, which must be looked for very carefully.

Differential diagnosis

From Common Cold and Fever :

1. By abrupt onset of fever and other symptoms.
2. By catarrhal symptoms occurring after onset of fever.
3. By intolerable aching all over the body particularly the back and limbs and the severe sudden headache.

Note :

In many influenza cases recovery is not always complete within a few days; many patients exhibit a rather marked "post-infection asthenia", characterised by weakness, dizziness, easy fatigue, palpitation and anorexia.

Allopathic treatment

There is no specific treatment of influenza in Allopathic system. Simple influenza is self-limiting disease, and signs of recovery are usually evident in four or five days.  *Aspirin or Codeine is usual for headache. After the complications have developed antibiotics like Penicillin are administered. It is said that by following this rule the unnecessary and possibly dangerous toxic and sensitizing reactions can be avoided. Some rely on COSOWIL or PHENICINE - all unreliable.

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Symptomatic measures may afford relief.

Dover's Powder (10 gr.) and steam inhalation give relief.

Cough syrups with or without codeine or morphine are often given.

Management of the case

1. Bed Rest is of primary importance, the sooner, the better. Continue even after recovery.
2. In order to avoid complications like pneumonia the patient should under all circumstances be protected from a draught of air. However, the room should be well ventilated.
3. Isolation is necessary to avoid its spread. It may not be possible as the disease is fast spreading.
4. Diet should be liquid - hot and sweetened. Hot milk. Fruit juice, nourishing soup.
5. The patient should not be given bath (cold or warm) since it causes further chilling, particularly the chest and head.
6. To avoid droplet infection, all the expectorations should be received in a pot and the excretions should be incinerated.
7. As the patient is left a physical wreck, he should be instructed to clothe himself properly and avoid chilling and fatigue at all costs.

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Note :

It is again stressed that convalescence being very slow, even after mild cases, several days of rest should be insisted upon before the patient is allowed to return to work.

8. The worst way to treat influenza is to ask the patient to walk about. It may bring about perspiration but an exposure would result in complications or prostration.

Prevention

It is said that controlled studies have revealed that influenza virus vaccines, given in two or three doses for the first year and then annually, protect about 80% inoculates. Therefore, it is being urged that the inoculation of whole populations, especially in the urgent conditions of epidemics should be done but this would present formidable problems. As such, at present at start of epidemics, immunisation can be restricted to workers in medical, nursing, transport and essential public services.

Immunity

Type specific immunity follows an attack which unfortunately lasts only a few months.

There is no cross-immunity between the different types and the sub-types.

The best immunity is improvement of general health of the people of the world or at least of a country so that there is no susceptibility to this disease. The correct physical training in schools and the wide development of sports are also important in increasing resistance. Correct nutrition should be a matter of constant care.

Natural immunity must exist, since large number of individuals escape the infection during serious epidemics even. Antibodies against the virus can be demonstrated in the blood of the patients who have recovered from the infection, and similar studies upon the blood of contacts seem to indicate that many sub-clinical cases occur during the epidemics.

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Acquired immunity can apparently be induced in some individuals by the use of a complex vaccine mentioned already, but unfortunately influenza cannot be prevented in all cases by its use. The vaccine is prepared from the various viruses of influenza which have been inoculated into various growing chicks embryos or tissue cultures. When type-specific vaccines are used a relatively high degree of immunity is conferred and this may last for 6 to 8 months. In some cases, prostrating reactions, with (a) fever (b) aching, (c) nausea and (d) vomiting occur following such vaccination. Moreover, local reactions at the site of injection are common.

How to avoid influenza

To avoid influenza in an epidemic persons should endeavour to live in open air as much as possible, well clad - and should keep away from crowded rooms, theatres, etc. The diet should be generous, containing plenty of raw fruit, green vegetables and dairy produce; every effort should be made to prevent any tendency to constipation. Nothing should be taken which might produce sore throat. A morning gargle with fresh or luke warm water is useful.

Price's Text book of Medicine gives five clinical types of Influenza :

1. Febrile type.
2. Respiratory type.
3. Nervous type.
4. Fulminant type.
5. Gastro-intestinal type.

This classification is perhaps more nearer reality and some prominent Homoeopaths agree with these types. Price has also given detailed description of these and of the complications and sequelae. (This classification is being mentioned here for we shall be grouping our Homoeopathic Remedies along with these types for the benefit of those who are converts to Homoeopathy or are institutionally so trained as to use Allopathic Text Books for their guidance).

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Homoeopathic point of view

Now let us try to know what the younger brother the Homoeopath (whom once Dr. Burnett used to call "the peculiar people") has to say and profess about Influenza. Since our aim is to aid the Homoeopath in his practice, we shall be dwelling on the subject rather in reasonable details. In what follows, therefore, we shall state the Homoeopathic view and allude to comparison where required of the prophylactics or remedies used by the two systems of medicine.

That there are no diseases but sick people is what homoeopathy declares from top of its structure. The concept of diseases in the two (the Allopathic and Homoeopathic schools of medicine is quite different. Hahnemann once said to one of his patients, "The disease from which you are suffering is no business of mine and the drug that I administer to you is no business of yours." In the therapeutics, etiology or nosology has classified diseases and since the Homoeopathic physician is found using books on Therapeutics, he too is apt to use the terminology as is found in medical books and dictionaries. That the word "influenza" brings before his eyes a certain group of patients or symptoms constituting a sick person cannot be denied. As Dr. Kent has said the Homoeopathic physician should learn the pathological conditions and use their terms for classifying the cases in order to report them to the State Boards, etc. But in each case the method is individualisation and individualisation alone, which should be his guide. And it is a widely known fact which generations of experience has demonstrated that constitutional homoeopathic prescribing tends to raise the general level of health and in so doing almost invariably raises the resistance of the individual being treated to colds and influenza. Dr. Tyler once said that the "influenza" word is perhaps the best which more aptly justifies the Homoeopath's contention that the diseases are due to miasms, because the word "influenza" means "influence". The miasms influence the health of individuals and have a sway over them when there is susceptibility to a particular influence.

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Influenza then is an acute miasmatic disease - self limiting having a prodrome, progress and a decline. Psora is the main cause and it is Psoric constitutions which are influenced most by it.

In Art. 31 of the Organon, Dr. S. Hahnemann says :

"The inimical forces, partly physical, partly psychical, to which our terrestrial existence is exposed, which are termed morbific noxious agents, do not possess the power of deranging the health of men unconditionally; but we are made ill by them only when our organism is sufficiently disposed and susceptible to the attack of the morbific cause that may be present and to be altered in its health, deranged and made to undergo abnormal sensations and functions; hence they do not produce disease in everyone, nor at all times."

Virus - is it the cause of influenza

Now the question arises, "Does homoeopathy regard filterable virus to be the cause of influenza ?" The reply is an emphatic 'No'. Let us see what Dr. J. T. Kent has to say about it. In his Lectures on Homoeopathic Philosophy he says, "Everything that can be seen, that can be observed with aid of the finest instrument, is but the result. Nothing in the world of immaterial substance can be seen with any faculty that is capable of seeing things in the world of material substance. The employment of instruments of precision will enable us to see the finest disease results, which are the outcome of or result of things immaterial, the very finest form of vegetable life; but the cause of disease is a million time more subtle than these and cannot be seen by the human eye. The finest visible objects are but results of things still finer, so that the cause rests within. The morbific agents that Hahnemann refers to are simply the extremely fine forms of simple substance or to bring them down to human thought we might call them "Viruses" but viruses are often gross because they can sometimes be observea by the vision of man, and, therefore, we must remember that within the virus is its innermost and that its innermost is in itself capable of giving form to the outermost, which is the visible virus aggregated and concentrated. The coarser forms would be comparatively harmless were it not for their interiors. Disease products are comparatively harmless were it not for the fact that they contain an innermost and it is the innermost itself that is causative. Every virus is capable of assuming forms and shapes in ultimates. The causes of ultimates are not from without but the immaterial invisible centre. There is something prior to the virus which gives it form. Therefore, virus is also crude enough to produce disease".

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What then is the cause of disease, if not virus or bacteria ? What ? If not virus ? We shall refer to Art. 16 of the Organon.

"Our vital force, as a spirit-like dynamics cannot be attacked and infected by injurious influences on the healthy organism caused by the external inimical forces that disturb the harmonious play of life otherwise than in a spirit-like (dynamic) way, and in like manner all such morbid derangements (diseases) cannot be removed from it by the physician in any other way than by the spirit-like (dynamic, spiritual) alternative powers of the serviceable medicines acting upon our spirit-like vital force."

Aura

The cause of disease is therefore, not the virus but the causes are finer than the virus. They are dynamic. All such dynamic influences have an aura of their own. Take for example a case of small-pox - another virus produced disease. Now, if one swallows small-pox crust, "it will be digested and very little trouble come from it, but the inhalation of the atmosphere that contains the aura of smallpox upon a plane corresponding to the susceptibility of the individual, will bring him down with the disease having a definite prodrome, a period of progress and a period of decline, showing that the very foundation of man's nature has been struck. Such an operation is upon the internals of man; upon his invisible, immaterial substance and it operates from within out, producing ultimates in his tissues, establishing result upon the skin."

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Aura what it is

Everything in the universe has its aura or atmosphere. Every star and planet has an atmosphere. The sun's atmosphere is its light and heat. Every human being has his atmosphere or aura; every animal has its atmosphere or aura. This aura is present in all entities. What may be said to be the aura of musk ? That is a strong physical aura which almost everyone can perceive. A grain of musk has been kept for experiment's sake, in a bottle for seventeen years, giving off a perceptible aura yet without loss of weight. As a further evidence of aura, take, for instance, the animals which prey upon their food and you know that they can discover by an extremely intense aura states and things that man cannot discover. This is not an ordinary nose, but it is really the very instinct of the animal, whereby he perceived what is prey. His instinct is analogous to man's perception, and by this instinct he discovers his prey, when man would not be able to discover it. Man can discover musk in a bottle but it is doubtful if man could discover the finest aura by its odor. This aura becomes useful and introduces a prominent sphere in the study of homoeopathics.

There are two realms of worlds, the realm of causes and the realm of ultimates. In this outermost or physical world we can see only with the eye, touch with the finger and such is the realm of results. The world of cause is invisible, is not discoverable by five senses. All disease causes are in simple substance; there is no disease cause in concrete substance considered apart from simple substance. We therefore, study simple substance, in order that we may arrive at the nature of sick-making substances.

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It does not make much difference to the homoeopathic prescriber whatever strain of virus is present - "A" "B" "C" or "D" or Asian - Siberian as he takes the reaction of the patient for his guide to the remedy.

Sometimes widespread publicity is given of the approaching epidemics of influenza by Health authorities in order to warn the public of the impending evil. We know that it is done with the best of intentions; but fear is one of the most depressing factors and makes human beings susceptible to a great variety of diseases. "The human mind should be kept as placid and normal in its outlooks on life and the life-giving impulses as possible. When an epidemic actually does take place under such strain and apprehension the whole vital system is depressed and one is much more susceptible to disease and much more apt to contract the prevailing ailment than would otherwise be the case."

"On the other hand if the principle "Similia Similibus Curentur" were better understood and its very great value in the healing art could be spread among the laity as industriously as this poison of fear, health and vigor would be the common lot and epidemics influenced by fear would become things of the past. If we could teach and spread abroad the facts that in the 1918 epidemics the homoeopathic physicians had the record of over 16,000 cases treated by Hahnemannian homoeopaths with a mortality of only one-quarter of one per cent, the fear of epidemics would be removed."

1. A. Roberts.

We shall presently see that Dr. Kent holds similar views, namely fear being a great source of attracting disease.

Ds. Jahr of France in his 'Forty Years' Practice" while talking of Influenza says. "What distinguishes Influenza, which is really nothing more than a very violent catarrhal fever, from other fevers of this class, is the circumstances that Influenza attacks the whole nervous system at once, sometimes with rheumatic pains in all the limbs, more or less lameness, fever and inflammatory symptoms increased to a genuine acute Bronchitis or acute Pleuritis".

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Dr. Richard Hughes, one of the ablest exponents of Homoeopathy maintains, in his "Principles and Practice of Homoeopathy" : -

"In my 'Therapeutics' I discussed this malady among those of the respiratory organs, assuming that was present when a severe fluent coryza was accompanied by headache, pains in the limbs, and great prostration, and advised Ars., and Eup. Perf. in its treatment. I expressed my suspicion, however, that such a condition was to true epidemic Influenza what English is to Asiatic Cholera, and advised consultation of the older Homoeopathic writers for their experience in the visitations of the thirties and forties.

"My suspicion was well founded, and I do not now speak as one to whom epidemic Influenza is unknown. The wayes of it which since 1890 have passed over the world with almost un-varying annual persistency have made all practitioners familiar with its features, and have taught us much as to its nature and various manifestations. It is evidently an essential fever, as much so as Typhoid and Dengue, to which last it presents many points of resemblance, especially in its characteristics of pain of head and limbs. Catarrhal, nasal and bronchial, is (contrary to our former notions) a secondary and incidental occurrence only. When it does set in, however, it is very apt to run down the air tubes into the cells, and to set up a low diffuse Broncho-Pneumonia, which in aged persons and broken constitutions readily proves fatal."

It would be seen that while Jahr considers it a mere catarrhal fever, Dr. Hughes classifies it as an essential fever. Though its action is primarily limited to the respiratory organs and here it is not a dangerous disease, but as far as its complications appear it is rightly classified by Hughes as an essential disease which might terminate fatally in the aged and infants.

Dr. Kippax - R. John in his "Lectures on Fevers" states as follows : -

"Influenza is a miasmatic-contagious disease of from three to ten days' duration, due to an unknown morbific agent and occurring in wide spread epidemics. It is characterised by suddenness of onset, by great and early prostration and by the development of general catarrhal symptoms. Usually there is intense frontal headache, coryza, sore throat, a tickling cough, dyspnoea, pains in the back and limbs, fever of varying intensity and great nervous depression. At times there is more or less catarrh of gastro-enteric mucous membrane, with hepatic disturbance. Inflammatory affections of the lungs are not rare complications. The disease is very rarely fatal except in advanced life. When death takes place it is generally the result of complications. Relapses are not uncommon."

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Dr. C. G. Raue in 'Special Pathology and Diagnostics with Therapeutic Hints" has written : -

"Influenza is an acute infectious epidemic disease characterised by a series of catarrhal manifestations affecting the respiratory and frequently the digestive tract attended by prostration, pains in the bones and limbs, severe nervous symptoms and fever." It usually commences with a chill or chilliness followed by fever of a remittent character, anorexia, headache, apathy and prostration and may be divided into three forms i.e.  (i) Catarrhal, (ii) Gastric, (iii) Nervous; depending upon the organs which receive the brunt of the attack."

Homoeopathic treatment

In Homoeopathy there are no specifics for any ailment. There can be as many types of Influenza as the human beings, because each individual puts his own stamp on the disease and modifies it too to some extent in his own peculiar way. Almost any remedy in the Materia Medica could prove useful in any given case. But this disease being acute and coming in epidemics, we have for our guidance the incomparable Organon and Dr. Kent's Lectures on Homoeopathic Philosophy. (Articles 100 to 102 of the Organon refer.) This has been explained by Dr. Kent as under :

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Genius epidemicus

The First Step.

"If the epidemic is entirely different from anything that has hitherto appeared in the neighborhood, it is at first confusing. From the first few cases the physician has a very vague idea of this disease, for he sees only fragment of it, and gets only a portion of its symptoms. But the epidemic spreads and many patients are visited, and twenty individuals have perhaps been closely observed. Now, if the physician will write down all the symptoms that have been present in each case in a schematic form, arranging the mind symptoms of the different patients under "mind" and the head symptoms under "head" and so on, following Hahnemann's method, they - considered collectively - will present one image, as if one man had expressed all the symptoms, and in this way he will have that particular disease in schematic form. If he places opposite each symptom a number corresponding to the number of patients in which that symptom occurred, he will find out the essential features of the epidemic. For Example twenty patients had aching in the bones, and at once he sees that, that symptom is a part of this epidemic. All the patients had the catarrhal condition of the eyes and flushed face, and these must be recorded as pathognomonic symptoms. And so by taking the entire scheme and studying it as a whole, as if one patient had experienced all the symptoms, he is able to perceive how this new disease affects the human race, and each particular patient, and he is able to predicate of it what is general and what is particular. Every new patient has a few new symptoms; he has put his own stamp on that disease. Those symptoms that run through all are the pathognomonic symptoms; those which are rare are the peculiarities of the different people. This totality represents to the human mind, as nearly as possible, the nature of this sickness and it is this nature that the therapeutist must have in mind."

The Second Step.

"Now let us take the next step, which is to find in general the remedies that correspond to this epidemic. By the aid of a repertory he will write after each one of these symptoms all the remedies that have produced that symptom. Having in this way gone through the entire scheme, he can then begin to eliminate for practical purposes, and he will see that six or seven remedies run through the picture, and, therefore, are related to the epidemic, corresponding to its whole nature. This may be called the group of epidemic remedies for that particular epidemic, and with these he will manage to cure nearly all his cases.

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The Third Step.

The question now arises which one is the remedy for each individual case ? When he has worked out the half dozen remedies, he can go through the Materia Medica and get their individual pictures so fixed in his head that he can use them successfully. Thus he proceeds from generals to particular, and there is no other way to proceed in Homoeopathy."

"He is called to a family with half with half a dozen patients in bed from this epidemic, and he finds a little difference in each case so that one remedy is indicated in one patient and another remedy in another patient. THERE IS NO SUCH THING IN HOMOEOPATHY AS ADMINISTERING ONE OF THESE REMEDIES TO ALL IN THE FAMILY BECAUSE OF A DIAGNOSTIC NAME.

Now, while one of the remedies in the epidemic group will most likely be indicated in many cases, yet if none of these should fit the patient, the physician must return to his original anamnesis to see which one of the other remedies is suitable. Very rarely will a patient demand a remedy not in the anamnesis. Every remedy has in itself a certain state of peculiarities that identifies it as an individual remedy, and the patient has also a certain state of peculiarities that identifies him as an individual patient, and so the remedy is fitted to the patient. No remedy must be given because it is in the list, for the list has only been made as a means of facilitating the study of that epidemic."

Note :

(Things can only be made easy by an immense amount of hard work, and if the physician does the drudgery in the beginning of an epidemic, the prescribing for his cases will be rapid and the remedies would be found aborting cases of sickness, malignant cases made simple.)

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The alternative method

"If the physician does not work out this scheme on paper he must do it in the mind, but if he becomes very busy and sees a large number of cases, it will be too much to carry them in the mind. You will be astonished to find that if you put an epidemic on paper you will fore-over be able to carry that knowledge of it in mind."

"Of course, every now and then there will come up a rare and a singular case, which will compel you to go outside of the usual group. Never allow yourself to be so cramped that you cannot go outside of the medicines that you have settled upon as medicines of the disease."

Thus is described the method of finding the Genius Epidemicus.

In Homoeopathy, the physician first sees the disease in general as to its nature, and then when an individual has this disease, this individual will present in his own peculiarities the peculiar features of that disease, as he modifies the disease in his own peculiar nature. The homoeopath is in the habit of studying the Slightest shades of difference between patients, the little things that point to the remedy.

If we looked upon disease only as the old - school physician sees it, we would have no means of distinction, but it is because of the little peculiarities manifested by every individual patient, through his inner life, through everything he thinks, that the homoeopath is enabled to individualise. Make the patient your friend or ward.

Susceptibility is the cause of disease

Disease causes exist among attenuated things, the infinitesimal or immaterial substances. In contagion there is practically but one dose administered, or at least that which is sufficient to cause a suspension of influx. When cause ceases to flow only in the direction of least resistance and so when resistance appears influx ceases, the cause no longer flows in. In the beginning of disease, i.e.  in the stage of contagion, there is this limit to influx, for if man continued to receive the cause of disease (if there were no limits to its influx) he would receive enough to kill him, for it would run a continuous course until death. BUT WHEN SUSCEPTIBILITY IS SATISFIED, THERE IS A CESSATION OF CAUSE AND WHEN CAUSE CEASES TO FLOW INTO ULTIMATES, NOT ONLY DO THE ULTIMATES CEASE BUT CAUSE ITSELF HAS ALREADY CEASED.

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Disease causes, existing as they do as immaterial substances, flow into man in spite of him; he can neither control nor resist them, and they make him sick. But certain changes occur and man ceases to be susceptible, and there is no longer an in flowing of cause into his economy; a suspension has taken place, because susceptibility has ceased.

Why all do not fall sick during an epidemic

Because of varying degrees of susceptibility some are protected from disease cause and some are made sick; the one who is made sick is susceptible to the disease cause in accordance with the plane he is in and the degree of attenuation that happens to be present at the time of contagion. The degree of the disease cause fits his susceptibility at the moment he is made sick.

In the thirty first (31) paragraph of the Organon Dr. Hahnemann says that disease causes are limited in their ability to effect changes in health, to certain conditions and states i.e.  susceptibility. When a natural disease is taken it runs its period, and tends to decline, and the patient will not be susceptible until another change of state has arrived.

When a violent epidemic is ranging we all know that, although the number of victims is large, they are few compared to those who go through the epidemic unscathed, and the question always arises, why is it ? We suppose, and probably rightly so, that a large number of the immense have escaped because they were unusually strong and vigorous, or in a state of very good order. But we find among those who have escaped the epidemic a number of persons who are anything but strong, really invalids, one in consumption, another in the last degree of Bright's disease, another with diabetes. The reason for their having remained unaffected with the epidemic is that they have sickness that it is impossible for the epidemic to suppress. The epidemic is dissimilar to their diseases and cannot suppress their disease because of its virulency. These things go to prove that dissimilars are unable to cure; they can only suppress. If the chronic disease is stronger than the epidemic disease, it cannot be suppressed. As such, it will be seen why some vigorous and some chronically sick people can escape the epidemics.

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Homoeo prophylaxis

Dr. Kent says, "Man is protected from sickness in two ways, by Homoeopathy and by use. The physician and the nurse who go into the district of epidemics who keep busy, who have, in the highest sense of the word, the true love of the use, who have gone into the work as mediums of mercy, will be largely protected just simply from their love of the work, from their delight in it. They have no fear. Fear is an overwhelming cause of sickness; those who fall prey to fear are likely to become sick, but those who face disease with no fear are likely to remain well; they do sometime fall sick, it is true, but I believe it is because they begin to have fear in the work."

"The other and greater prophylactic is the homoeopathic remedy. After working in an epidemic for a few weeks, you will find perhaps that half-a-dozen remedies are daily indicated and one of these in a large number of cases than any other. This one remedy seems to be the best suited to the general nature of the sickness. Now one remedy seems to be the best suited to the general nature of the sickness. You will find that for prophylaxis, there is required a less degree of similitude than is necessary for curing. A remedy will not have to be so similar to prevent disease as to cure it, and these remedies in daily use will enable you to prevent a large number of people from becoming sick. We must look to Homoeopathy for our protection as well as for our cure."

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Dr. Clarke (J. H.) while speaking on the subject said sometimes, "The best prophylactic against an attack of influenza is Arsenicum. When a case of influenza occurs in a household, every person who has not already been infected should take Arsenicum Alb. 3 - a few globules, a drop of the tincture, a disc, or a capsule of pilules, for a dose - three times a day. In the case of persons who are very susceptible to influenza, and take it on every opportunity, I keep them constantly under the influence of Arsenicum, giving one dose daily whether there are cases in the house or not."

Non-medicinal protection

Dr. Clarke, says, further, "So much for medicinal protection. I need not here go into details about common-sense protection. It will be obvious to every one that anything that brings about a lowered state of vitality - over-exertion, long fasting, chill, wetting, and the like, must be carefully avoided when influenza is about. In many a case it only needs the impetus of one of these lowering causes to set the infection alight, when the normal resistance would be amply sufficient to protect a person against it."

During an attack. what to do

Dr. Clarke says, 'When an attack has definitely set in, it depends upon the severity of the attack and the degree of robustness of the patient, whether bed is to be enjoined. Thousands of the people have slight attacks which do not prevent their following their usual vocations, but only make then very uncomfortable. Those who are at all delicate should keep indoors, and if there is fever, should keep in bed. Whatever is the course adopted, it is very essential that the strength should be kept up with plenty of nourishment. It does not do to starve Influenza. If the digestion is in fair order, solid food may be taken, if it is relished. All food taken should have good food-value - co cold meats and no done-up meats. If there is distaste to food and difficulty of eating, concentrated liquid food should be given every hour or two. Warmth is also an essential. I do not advise "open air treatment" for influenza, though ventilation is necessary. But chill must be avoided in every case."

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Bath ? "Another point which is of importance. NO BATH SHOULD BE TAKEN WHILST AN ATTACK OF INFLUENZA IS ON. In a debilitated state a bath is a great vital expense, and though it may stimulate for a time, the reaction is sure to be injurious."

Walking ? The treatment of influenza "on foot" is perhaps the worst. Some people are of the view that if one walks about and gets perspired, influenza gets relieved. It is a wrong notion and injurious. Bed rest is the best. It is one of the donots of influenza state namely, 'to walk'. Let the patient be confined to bed. Otherwise greater exposures and complications, relentless suffering shall be the fate.

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Medicines (homoeopathic)

Hahnemann was the first to say something about the use of medicines in cases of influenza. Let us refer to introductory remarks about Camphor in the Materia Medica Pura (Vol. I). On page 305 (Bhattacharya's Edition) he remarks :

"When the influenza endemic in Siberia comes among us as it does occasionally, when the hot stage has already commenced, Camphor is of service, only as a palliative, seeing that the disease is one of short duration. It should be given in frequent but ever increasing doses, dissolved in water. It does not shorten the duration of the disease, but renders it much milder, and hence it conducts the disease innocuously to its termination.

(On the other hand, NUX VOMICA, in a single dose, and that the smallest possible), will often remove the disease homoeopathically in a few hours)."

Taking his cue from Hahnemann Dr. YOUNAN, the celebrated Homoeopath of Calcutta says, "On the strength of this recommendation, I was tempted to give Nux Vomica to my Influenza patients oftener perhaps than I should have done otherwise. Like every other drug it has its own sphere of action and will cure the cases, especially if administered at the commencement of the disease, and I have more than once succeeded in breaking up a threatened attack of Influenza. IF THERE IS ANY PROPHYLACTIC REMEDY AGAINST INFLUENZA, IT IS NUX VOMICA, EVEN IN THE SMALLEST DOSES. When it is simillimum to a case, nothing is prettier or prompter than its therapeutic action."

Dr. Clarke on the other hand says, "In regard to medicines, Baptisia is, as previously, the leading epidemic remedy. Many patients rapidly get through an attack with Baptisia 3x or 30 every hour or two hours. But Baptisia has a very serious rival in the nosode of Influenza Influenzinum. This I have used very extensively for the last year or more. I have always given it in the 30th, every two hours generally and found it very efficacious in cutting short an attack or modifying the symptoms. As might be expected, INFLUENZINUM and Baptisia antidote each other, so it does not do to alternate them." (Strange enough that Lilienthal makes no mention of Baptisia in his Therapeutics, while writing of Influenza).

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Influenzinum is the nosode of Influenza. Dr. Clarke in his Dictionary of (Homoeopathic) Practical Materia Medica - (Appendix attached to VOL. III) at page 1624 (1962 Edition) gives its characteristics as under :

"The nosode of influenza has with many practitioners taken the place of Baptisia as the routine remedy in epidemics. It may be given in the 12th or 30th potency, either in the form of tincture, pilules or discs; or ten globules may be dissolved in six ounces of water, and of this a dessert spoonful may be given for a dose. It may be repeated every two hours. This will be found sufficient to control a large proportion of the cases. The general directions I give to my patients are these. When 'colds' appear in a family let all those who are unaffected take Arsenic 3 thrice daily, and let the patients take Influenzinum 30 every hour or two. This generally prevents the spread of the trouble and clears up the 'cold', whether they are of the influenza type or not. Influenza has the property of developing old troubles, and thus it takes an infinite variety of forms in different persons, so that Influenzinum need not be expected to cure all cases unaided, or indeed, to be appropriate to every case."

Dr. Clarke finds 'Influenzinum compatible with Act. R., Ars., Bell., Bry., Hep., Merc; (and many others)."

Dr. FRED B. MORGAN, M. D., (IOWA) published in the Homoeopathic Recorder, April 1950 issue two letters in this behalf which need be preserved and being appropriate to the subject are being re-produced herein below :

"The two letters herewith were rescued from an old letter file. They seem too valuable to be lost because of the intrinsic value of the material contained therein and because of the ability of the writer. Both letters were written by the late Guy Buckley STEARNS, M. D. President of the Foundation of Homoeopathic Research."

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Letters

March 7, 1940

Dear Dr. Morgan,

INFLUENZIN NEBEL came through Dr. S. Alexander Klein's suggestion.

It came from France. Probably it came from Lederle and it contains bacillus influenzae (Pfeiffer), pneumococcus, types 1, 2 and 3 and streptococcus haemolyticus. The potencies were run up for me by Ehrhart and Karl, Chicago. INFLUENZIN MENINGITIS is a potency made from a spinal puncture by Dr. Griggs of Philadelphia in a case of influenzal meningitis. He finds it specific in that type of case (I have had no experience with this influenzin) (I carry it in my armamentarium. - F. B. M.) The old Spanish Influenzin, which probably goes back to the epidemic of 1918, comes through occasionally in the chronic type of influenza. The ones that come through most frequently are Influenzin serum and Influenzin antitoxin. These came from Ehrhart and Karl and they, I suppose, obtained then from one of the biological laboratories in the Middle West. At any rate, they come oftener in our tests than any other Influenzins. The Influenzin antitoxin comes most frequently (my experience co-incides - F. B. M.)

Patients with chronic conditions have, as one of the main factors, a chronic type of influenza more frequently than any other infection; and often times Influenzin will clear up the whole complex. There is nothing typical about the chronic influenzal cases, although they may have respiratory symptoms. Unaccountable weakness is quite a common indication, but one should suspect influenza as a major factor in any chronic trouble.

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For instance, a patient, who had been a major in the Engineering Corps of the War of 1914, had for years what he called a chronic "rheumatic" condition that for several months had made it difficult for him to get about. He had diathermic treatments, and had been on strict dietetic regime without benefit. A single does of Influenzin serum brought a reaction that brought lyric praise, as he could go about more comfortably than he had been able to for two or three years.

Two cases of Raynaud's disease have responded permanently to Influenzinum Antitoxin. (Raynaud's Disease is the Gangrene found in females affecting their ears (lobes) and nose tip first and later hands). Another one was cured. In the second case the response was prompt, although gangrene of the hand had already commenced. In the latter case other remedies have had to follow Influenzin, but the first effect was gratifying. Although a patient may become immune for a period of a year or two, mild attacks are often not recognised.

Fraternally yours,

Guy Buckley Stearns.

Under date of August 6, 1940, Dr. Guy Buckley Stearns wrote me :

"I am always pleased to have a report on the action of any of the Influenzins. Influenzin Meningitis came from a nasal puncture made for diagnostic purposes by Dr. Griggs of Philadelphia. He first potentised it and the child's life was saved by it. I had Ehrhart and Karl run the potencies up to the CM. It really ought to be named Influenzinum Meningitis, Griggs.

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Encephalitis lethargica, I believe, is always an influenza infection and probably many other meningeal cases are the same. Frequently, we have intestinal influenzas. Some epidemics of diarrhoeas are intestinal influenza......

We have had three cases of Raynaud's disease - one in which gangrene had already been established. The tips of the fingers and thumb of the left hand were shriveled and black, and there were gangrenous areas in the palm of the hand. She was in the hospital at the time and the consultants had decided she must have her arm amputated. She refused and, being an old patient of mine, wanted me in consultation. I could not go, but my associate, deferral, saw her and diagnosed her trouble as Raynaud's. She made a remarkable response to Influenzin antitoxin. However, she had to have other remedies, Carbo Oxigenisatum being the one that appeared to be constitutional. However, intercurrently she had to have Influenzin Anti-toxin three times, and Streptococcus phage three times. All the gangrenous areas have cleared up and the gangrenous fingers are quite amazingly improved. The bones of the first phalanx apparently alive and the tips of the fingers seem to be proceeding with restoration underneath.

One of the other cases was acute and responded promptly to Influenzin antitoxin. The third case was chronic; for several years the woman had not been able to touch anything cold or put her hands in cold water. Her husband, because he had heard of our cases of Raynaud's, gave her a dose of Influenzin without result. I gave him the Influenzin serum and Influenzin antitoxin and told him to test them on her pupils. Influenzin antitoxin caused the pupils to dilate, and one dose of the 1M cured her.

There has been a great deal of streptococcin infection in the last three years, with an occasional case of septic endocarditis. Of the streptococcic pages, 701 is the one most often indicated. When the pages are needed they work quickly and thoroughly. You can take this as a valuable tip.

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"I have found much in these letters of Dr. Stearns that is thought-provoking and has proved of positive benefit in treating ill persons, that I am assuming that other physicians will value these letters as I have."

The New Asian FLU Nosode. Mr. A. L. Wagaland, Chairman of the B. H. A. presided at a Press Conference in London on September 17, 1957 at which he announced the new nosode against Asian 'Flu.' He was supported by two doctors and a pharmaceutical chemist, who helped to deal with technical questions. In this address Wagaland said :

"We are drawing attention to the new nosode "Asian 'A' Influenzinum, because we are convinced that it could be of great value in the event of the threatened epidemic becoming a reality in this country. IT HAS A VALUE AS A PROPHYLACTIC. It has value as a means of speeding up recovery. It has value as a means of making recovery complete and thus avoiding the debility that so often follows.

Although a hypodermic vaccine has been produced, as I understand it, the cost and the difficulty of production would make it impossible for it to be made available for general public use. The Ministry of Health has stated :

"On present evidence there is no medical necessity for general vaccination against so mild a disease. On past experience the protection given by vaccines of this type does not usually exceed 30 to 40 per cent."

Homoeopathic doctors have used nosodes generally for a very long time and there is a store of evidence of their effectiveness, both as prophylactic and in treatment. They are inexpensive and can be produced in large quantities.

Not always mild

Epidemics of the kind visualised, and indeed influenza generally, do not always have such mild effects as the Ministry of Health had forecast in this instance. Doctors frequently are told by their patients, "I have never been well since I had the 'FLU'". In these cases the nosodes prove invaluable.

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Dr. Guy Stearns, an American doctor, in his paper on influenza nosodes given to the International Hahnemannian Association said : "In the matter of influenza, the acute cases are quickly cured by the proper Influenzinum nosode and the chronic cases are so modified by the nosode as later to make easy the selection of the chronic simillimum. Infection originally occurs because of some constitutional tendency. The disease factor is best met by the nosode-the constitutional factor by the constitutional remedy."

It may be of interest to note that although their method of use is entirely different the hypodermic vaccine is based on a theory which is fundamental to homoeopathy - namely, "Like cures Like." Dr. John Henry Clarke, the eminent homoeopathic physician and author, says in his book while writing about "Whooping Cough".

"The method of treating cases of disease with a remedy derived from the infectious principle of the disease itself was discovered by Hahnemann and his contemporary disciple Pasteur, Koch, von Behring and Roux. The last two had the candour to admit : "There is truth in Hahnemann's method of curing 'like by like'". The Homoeopathic preparations are made in such a way that no danger to patient is run. Disease viruses are treated in the same way a serpent venoms, and the homoeopathic preparations of both retain all the therapeutic properties of the original source without any of their dangers."

A new Influenzinum is sold in the form of tablets - two a week are to be taken for four weeks. They should give immunity for 40 days and then a booster dose should be taken Children could take the tablets.

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This nosode is available from Nelson and Co., Homoeo Chemists, LONDON.

Yet another nosode which proves very effective in cases of Influenza with severe back-ache is the "Variolinum" in 200 potency. Those who often suffer from back-ache more so as Lumbago and fear Influenza would do better by taking. "The Variolinum 200" as the nosode prophylactica and even curative.

"Whenever influenza is about, in Calcutta, it cannot reach others without first visiting me" - Dr. Younan.

It is an interesting remark to show that there is constitutional susceptibility in some persons to catch in influenza.

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Therapeutics

Although the homoeopath should have nothing to do with the "therapeutic" part of medicine and always individualise his case (yes each and every case), and Doctor Southerland had once said that it should not be taught to the Homoeopathic students, yet it has been observed that books on Therapeutics are sometimes ready help for the busy physician. We given below Homoeo Therapeutics of Influenza from several angles and from several recognised authorities.

To begin with let us refer to Dr. Martha Boger-Shattuck's grouping of cases and remedies suggested in 1932 and published in the Homoeopathic Recorder, May, of that year.

Influenza with sudden onset

Acon. - Ars. - Bell. - Camphor. - China. - Ferr Phos. - Ipecac. - Phos.

Influenza with insidious onset

Gel. - Bryonia. - Arnica. - Bapt. - Caps. - Caust. - Echin. - Lach. - Rhus Tox - Ant. tart.

Influenza with complications

Tub. - Graphites - Sulphur - Phos. ac. - Pyrogen - Psorinum - Sul. iod.

William Boericke, M. D. and O. E. Boericke's 'Pocket Manual Homoeopathic Materia Medica'' contains the following list of remedies under 'Influenza' in the "Therapeutic Index' : (P. 1004).

Eryng., Bap., Eucalp., Lobel cerul., GELS., RHUS., Eup. perf., Bryonia; Arsenic.

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In the Repertory part of the Pocket Manual of Materia Medica, Dr. Boericke gives under "Fever" the following medicines : - (P. 927, 928).

INFLUENZA (grippe). ACO., Aesc., Ant. iod., Ant. t., Arn., ARS., ARS. IOD., Ars. s. r., Asclep., BAPT., BELL., BROM., BRY., Calc. c., Camph. Canchal., CARB. AC., Card. m., DULC., Eryng., EUCAL., EUP. Per., Euphorbia, Euphras., GELS., Glon., Glycerin., Influenzin., Iod., Ipec., Kali. Bi., Kali. c., Kali iod., Kali. s., Lach., Lob. cer., Lob. purp., Lyc., Merc. s., NAT. SAL., NUX. V., PHOS., Phyt., Pod., Psor, Puls., PYROG. RHUS. T., Rumex., SABAD., Sal. ac., Sang., SANG. N., Sarcol. Ac., Senega, Sylph., Spig., Spong., STICTA., Sul., SUL RUB., Triost., Ver. a.

INFLUENZA, Debility of : -

Abrot., Adon. v., ARS. IOD., AVENA, Carb. ac., CHIN. ARS., Chin. s., CINCH., Con., Eup. perf., Gels., IBERIS., Lac. ac., Lathyr., Phos., Psor., Sal. ac., Sarcol ac.

Influenza, pain remaining : - Lycopers.

For their detail kindly consult the parts of the Materia Medica (Boericke's) "Respiratory" "Fever", "Head" and the introductory remarks as also "Extremities" to make a complete picture of the individual case. We have however, added a Materia Medica at the end.

Dr. Boenninghausen's 'Characteristics and Repertory, translated, Compiled and Augmented by Dr. C. M. Boger, M. D. mentions the following drugs at pp. 904 Col 2nd. (Roy and Company) under "Sensations and Complaints in General".

Aco., (4), Arn (2)., Ars. (4), Bap. (2)., Bell (3)., Bry (3)., Cam (3)., Caust (4)., Chel (2)., China (2), Cimic (3)., Eup. perf (5)., Gels (3)., Ip. (2)., Merc (5), Nux v. (5), Phos (3)., Phyt (3)., Puls (2)., Rhus-t (4)., Sabad (3)., Sang (2)., Scil (2)., Sil (2)., Spig (3)., Stic. (2)., Ver. v (3). [Figures refer type]

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Kindly note that Boger has classed Influenza as Sensations and Complaints in General and not under Fevers Simple or Compound.

Boger has also attached the Materia Medica to the "Boenninghausen's Repertory" and any remedy selected by the use of that Repertory should be verified from the said Materia Medica of Characteristics under various heads of the remedy so as to make a positive picture.

Dr. Boger in his "Synoptic Key of the Materia Medica has mentioned under "generalities" the following medicines supplemented by a few in the "Supplemental Reference Table" of the same Book.

Ars. iod., Bap., Bry., Camp., Caust., Cup., Eucalp., EUP. P., Fer. P., GEL., Merc., NUX-V; Rhus-T; Sabad.

The remedy may be verified from the Synoptic Key-Materia Medica (II part) itself.

Note :

It is wrong and inadvisable to select a remedy from one Repertory and verify it from some other author's Materia Medica unless the author has not written any Materia Medica.

Note :

Boger's Synoptic Key is for quick bedside reference and not for office work where it should be possible to refer to fuller works. It involves labour and hard work. But then Homoeopathy is not for the indolent. While we play with the lives of people any lethargy or love of ease is criminal.

Remedies description

Now to revert to the Grouping by Dr. Martha Boger-Shattuck we may reproduce the description of the remedies mentioned by the author in author's own language.

Group i

Aconitum napellus

Although this is recommended strongly in the List from Boger (Boenninghausen), it has not proved useful or indicated so often in my practice. It is likely to be of help in the patient who has a very strong FEAR.

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Arsenicum album

This remedy has also got FEAR, thirst for small quantity, restless to a marked degree (mental), gastric irritability. It is a good remedy to bring the RESTLESSNESS under control; but, I should draw your attention to the warning given by Kent in his Lectures on Materia Medica wherein he states that Arsenic is not pathologically indicated for more serious states like pneumonia and no sooner the restlessness is controlled, Lyco., Phos., or Sulph (according to the prevailing indications) must be administered if the life of the patient is to be saved. In my early years of practice, I remember to have lost a case of bronchopneumonia as I was not aware of this.

Belladonna

This remedy will be indicated for the flushed face with a throbbing headache, fear of dark; although there is photophobia, the child will insist on light at night and this is a peculiar feature.

Camphora officinalis

This is another remedy which I have not seen indicated often. There is coldness but the patient does not like covers. It is likely to be indicated for cases with collapse.

China officinalis

The main indications for this remedy will be weakness following loss of vital fluids : gastro-enteritis, perspiration. Chilly patient.

Eupatorium perfoliatum

This is the classical remedy indicated for 'Break-bone Fever'. The bones feel as if they are pounded.

Ferrum phosphoricum

One characteristic of this remedy is fever with 'peaks' - more than one diurnal variation. (Comp. Pyrogen and Veratrum viride - indicated for hyper-pyrexia).

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Ipecacuanha

A thirstless patient with nausea, vomiting, and diarrhoea (at times) and with a clean tongue - this peculiar combination will call for this remedy. In addition, there might be bronchial catarrh with coarse rales.

Phosphorus

Is indicated for the Respiratory Type; bronchopneumonia more often than Lobar. There is thirst and cold water is retained only for a short time; it is thrown out no sooner it gets warm in the stomach.

Group ii

Gelsemium sempervirens

Insidious onset, temperature not very high; drowsy, headache. The remedy is very similar to Puls. The differentiating point I have found most useful is that Puls., is associated with digestive upset (nausea, vomiting, anorexia, pain in abdomen, loose motions) whereas, Gels., has no gastric concomitants with fever. Both remedies are thirstless during fever and are drowsy. (In the 1932 epidemic this remedy was used with great success-Puls).

Bryonia alba

Pains, worse Motion and Better Pressure are the leading indications. The headache will be worse by even a motion of the limbs. Thirst for large quantities and dry lips; generally constipated but, in a few cases, diarrhoea is observed.

Arnica montana

Soreness, Ecchymosis, Sensorium affected (typhoidal type) : drowsy - does not complete the answer, apathetic. This remedy stands comparison with Bapt. (foul discharges).

Capsicum annuum

This will be indicated in those cases complicated by otitis media better by warmth and warm applications (Comp : Hep.; Opp : of Puls). The patient is thirsty and feels chill when he drinks water.

Capsicum annuum

Affections of the Larynx with hoarseness (Comp : Phos - incontinence while coughing; Phos. and Caust, are indicated for painless hoarseness. In Phos. only is painful hoarseness).

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Note :

Both are inimical. Do not give one after the other.

Lachesis mutus

This will be indicated in the serious type of cases with throat involvement which is worse by Hot drinks; Left to Right affection of the throat; Agg. sleep, after; there might be involvement of the heart.

Rhus toxicodendron

Early typhoidal state. Thirst for small quantity of water, no gastric irritability (Comp. Ars.), restlessness of the physical type. (Comp. Ars) Pains are better by motion (Comp : Bry).

Antimonium tartaricum

This will be indicated for the respiratory cases with capillary bronchitis (fine rales) with cyanosis and working of the alae nasi.

(See Kent's Repertory pp. 340 - Fan-like motion of Wings of Nose in pneumonia-Amm. c., Ant. t., Kreos LYCO, Phos, Sul.)

Group iii

Tuberculinum bovinum kent

Aviare was used successfully in the last Influenza epidemic in a case of Bronchopneumonia which would not progress further and a stalemate was reached. The case responded to 30 potency initially but, failed to respond even when the 200 potency was administered later. With the background of mixed infection in mind, Bacillinum 200 was administered and the case made good recovery. One dose administered every week. Tuberculinum (Kent's Bovinum) would be indicated in chronic broncho-pneumonia with Influenza onset. In some cases, a lurking tubercular infection is flared up after an attack of Influenza; these cases call for the remedy.

Graphites

The patient will be having associated skin complaints (cracks) which are aggravated in the winter. Nose sore on blowing. Abnormally acute smell.

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Phosphoricum acidum

Profound weakness of the nervous type and depression; self abuse. Bores fingers in nose.

Pyrogenium

This remedy along with Veratrum Viride would be indicated for hyper-pyrexia; pulse and temperature ratio is disturbed and there may be two peaks in 24 hours.

Psorinum

This would come in for cases complicated by asthma better Lying with head low - a very peculiar symptom also arms stretched on sides, wide apart.

Sulphur

Chronic cases with the following indications : Rectum : urging, morning Agg; Unrefreshed morning; Hunger 11 A.M.  Unwell : Burning palms and soles, better uncovering or cold applications.

Sulphur iodatum

I remember that one Homoeopath while writing in the Homoeopathic Recorder, said that if Sul., does not help the patient go to Sul. Iodide. This is a combination of two deep acting remedies : Sul., and Iodide. Lingering consolidation is one of the indications.

Miscellaneous

Chelidonium majus

Influenza with Jaundice.

Cimicifuga racemosa

Influenza with joint pains.

Mercurius solubilis

Salivation with thirst, intestinal and throat type.

Nux vomica

Gastric type of Influenza; ineffectual calls for stools. Extreme chilliness.

Pulsatilla pratensis

In 1932 epidemic showed good effect; Thirstless patient with digestive concomitants.

Sabadilla

Throat Pain; better warm drinks; Left to Right affection of the throat.

Sanguinaria canadensis

Symptomatology very similar to that of Sulph; employed in case where Sulphur would prove too deep acting.

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Squilla maritima

Dry, troublesome cough.

Spigelia anthelmia

Influenza with trigeminal neuralgia or pain in the region of the heart.

Silicea terra

Septic focus.

Sticta pulmonaria

Constant cough, can't stop it.

Chininum arsenicosum

Profuse sweating of the debilitating type 6 X Trit. 3 hourly to start with and then increase the interval between the doses. This is also very useful in Malaria with severe burning in the epigastrium.

Influenzinum

For troublesome sequelae like persistent cough or malaise.

Strychninum phosphoricum

6X - Trit. is used as a heart tonic.

Lycopodium clavatum

This was indicated in one case of Influenzal Pneumonia treated in the recent epidemic. Alae nasi working, thirstless patient. Cough; Agg. Lying on the Left side, Agg. Lying on back. Lyco and Sulph. come up for consideration : Sulph. follows Lyco and not the reverse. This decided in favour of Lyco (the patient had pneumonia of the left base). Lyco. 200, one dose brought the temperature from 104°F to 99.6°F, the next morning (the 3rd day of onset) normal. Watch for fall of temperature by crisis.

Phytolacca decandra

Pain, throat, better from Cold drinks for this remedy in Influenza.

Dulcamara

Drenching aggravates.

Arsenicum iodatum

A good heart tonic. Not chilly. (Comp : Ars.). Other symptomatology similar to Arsenicum album.

(Note : Here full symptomatology is not given. Consult Materia Medica).

(Natrum Mur is recommended by some Biochemic minded, persons. Lilienthal, Boger-Boenninghausen or any other book on Homoeopathic Therapeutics does not mention Natrum Mur for acute Influenza, neither does the symptomatology correspond with the cases in epidemics. Some persons who give Natrum Mur bungle their cases. Clarke in his Dictionary also warns against the use of Nat. Mur during fever.

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Dr. Dhawle of Bombay stated in one of his articles on Influenza that in the 1957 epidemic Pulsatilla, Bry. alb; and Gelsemium proved very useful.

(Note : Pulsatilla is prominently indicated for Fevers due to Sun's Heat).

He also affirms the master's declaration that "Epidemic Remedy" is the best prophylactic. In one case of influenza pneumonia of the left base, Lycopodium 200 reacted marvelously. China Ars. 6X helped to remove the weakness caused by profuse sweating which was seen even when the fever was controlled by the homoeopathy remedy.

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Some clinical tips on influenza from various masters

Bacillus sycoccus (Paterson)

(A nosode) is a remedy of great value in all catarrhal conditions and violent coughs. Dr. T. D. Ross.

Tuberculinum avis

Recurrent influenza with long teasing cough : Dr. Boericke.

Natrium sulphuricum

'I firmly believe that Influenza which was been of such dread to Physicians in general has at last met a remedial agent which will render it as susceptible to treatment as any slight catarrhal trouble. I have found that Nat. Sulph., will serve the great number of cases and have received wonderful results from its use, both at the beginning and when followed by sequelae' Dr. Charles Qaunght.

Magnesium phosphoricum

Dr. Qaunght must have added that if the pain becomes unbearable, Magnesia Phos., should be exhibited. Dr. Heselton.

Bacillinum burnett

I have often used Bacillinum in grippy colds or in Bronchitis where a cough has persisted despite the usual treatment. It is quite astonishing sometimes to note how promptly a dose of Bacillinum will stop such a cough. Dr. Walter Sands Mill.

Sarcolacticum acidum

For Influenza with Nausea and uncontrollable vomiting of water with extreme weakness and prostration when Arsenicum and Ipecac have failed. Dr. Beta.

Eupatorium aromaticum

3X is the drug in cases of Influenza complicated by aphthous inflammation of the mouth. Dr. W. Karo.

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Tuberculinum koch

I was struck with the similarity of the pathogenesis of Tuber. Kochii to the late effects of influenza as I had observed them in my practice. I had also noted the effect of an attack of influenza on phthisical patients and have seen them rapidly broken up by such an attack. I, therefore, concluded that Tuberculinum Kochii might form the pathologic similimum of late Influenza effects. Experience proved that the law of similars in this was true as elsewhere and I have confirmed the observation many times. Dr. Clarke.

Conium maculatum

Is especially useful in profound and long continued weakness following exhaustive diseases. Cowperthwaite.

Kalium iodatum

6X is recommended as a prophylactic against colds and Influenza. Dr. Heselton.

Natrium sulphuricum

Is Schuessler's specific for epidemic influenza where it has given good account of itself; witness Plumb Brown's case records. T. K. Moore.

Baptisia tinctoria

In the delirium of severe influenza with a sense that a part of the body is separated from another, I ordinarily think of Baptisia. The symptoms are also clearly delineated with COTYLEDON. Dr. Robert L. Redfield.

One has seen startling examples of the prompt curative action of Baptisia in Influenza - in slight cases and in serious ones. Dr. Tyler.

In gastric influenza, Baptisia has seemed to me to be practically specific; sudden attack of violent diarrhoea and vomiting, frightfully and suddenly ill. Dr. Tyler.

Bryonia alba

Is an efficient medicine when the bronchial mucus membrane is attacked and the general pains are tormenting. Dr. Goodnough.

Pyrogenium

Those cases that simulate typhoid fever and the positive diagnosis is only established after the Widalreaction has decided one way or the other, respond well to Pyrogen. Dr. F. Aquilar.

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Eryngium aquaticum

Boericke recommends in cases having urinary disorders in influenza or sweat of urinous odour in evening. Thick yellow mucous discharge with smarting in throat and larynx.

Eucalyptus globulus

Accelerated but not strong pulse with high temperature. All discharges show a tendency to foulness. Constant sensation of phlegm in throat; relaxed aphthous condition of mouth and throat. Stuffed up sensation; though nose does not stop running. Pricking sensation in extremities.

Lobelia syphilitica

Gives a perfect picture of sneezing influenza, involving the posterior nares, palate and fauces. Very depressed. Pain in knees. Great oppression in lower part of chest, as if air could not reach there. Pain in chest under short ribs of left side.

Podophyllum peltatum

Great loquacity during fever. Profuse sweat. Paralytic weakness of left side. Tongue, broad, large moist, burning; putrid taste, Chills 7 A.M.

Triosteum perfoliatum

Heat and Numbness of lower limbs after stool and increased flow of urine; loathing of food with occipital pain. Aching all over.

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After influenza badly recovered from (tyler)

Gelsemium sempervirens

Patients sometimes come saying "cannot get well after 'flue' a few weeks ago'. They are found to have a temperature of some where 99°. Not ill : Not well !

If they are chilly, with heats and chills; if they feel a weakness and heaviness of limbs and eyelids, Gels., quickly puts them right.

China officinalis

Continued debility, with chilliness.

Anaemic : pallid : weak.

Sensitive to touch : to motion : to cold air.

Worse alternate days.

Weariness of limbs, with desire to stretch move or change position.

Kalium phosphoricum

General weakness and gloom.

Arsenicum album

Chilliness : restlessness : anxiety : fear : fear death (Acon) : prostration.

Burnings, relieved by heat.

Oversensitive : fastidious.

Queer symptoms : - red-hot needle pains. Sensation of ice-water running through veins.

Or boiling water going through blood vessels.

Thirst, sips of cold water.

Pulsatilla pratensis

Flitting chilliness : chills in spots. Cold creeps in back. Chilly in warm room. Profuse morning sweat.

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Heat as if hot water thrown over him.

One-sided chilliness - heat - sweat.

External warmth intolerable. Worse in a close room.

Palpitation with anxiety : must throw off clothes.

Better out of doors.

Better for slow motion (opp : Bry., Eup. per., etc.)

Dry cough at night, goes on sitting up : returns only on lying down again. (Hyos.) Thirstless : no hunger. Tearful; peevish.

Sulphur

Partially recovers and then relapses. Frequent flushes of heat. Uneasiness in blood.

Very sensitive to open air : to draughts (opp : to Puls); worse for washing and bath. Takes cold.

Oppression, burning, stitches, congestion, in chest.

Heat, crown of head with cold feet.

Soles burn at night, must be put out of bed.

Hungry - starving at 11 a.m.

Drowsy by day : restless at night. Starts from frightful dreams.

Burnett recommends : Cypripedium pubescent, Scutellaria, Cyprepedin as his sheet anchors in Post-Influenzal Neurosis

Case :

A case to justify Burnett : - "J.M.  ill and away from work for a year after an attack of influenza which lasted six weeks, till he "Collapsed".

Said his heart was weak. He couldn't walk. Was suicidal. "Couldn't restrain himself". He complained of depression : despondency : felt his brain would burst. Given - SCUTELLARIA 30.

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A week later : "Different : livelier : stronger": Went back to work - absolutely himself again.

Dr. S. K. Ghosh mentious the efficacy of Radium Bromide in high potency, for treatment of neuralgia persisting as a sequelae of influenza.

FOR POST-INFLUENZAL PARALYSIS :

1. Causticum.
2. Gelsemium.

For post influenzal mental retardation remember : our old friend BARYTA CARB. Here do not use below 200th.

For cases spoiled by Anti-biotics : SULPHUR arsenicum, NUX VOM.

For cases spoiled by the use of Aspirin : ARNICA; CAPSICUM.

For cases 'Never-well-since' influenza : -

1. CARBO VEG.
2. INFLUENZINUM.
3. TYPHOIDINUM.
4. KALI CARB.
5. LATHYRUS.

"Our Doctors tell of great cures with LYCOPODIUM of literary persons unable, after an attack of "FLU" to get to work again. The intellectual sequelae of 'flu' often call for LYCO; while the neurotic ones (to almost insanity) need SCUTELLARIA, and those with long-lasting weakness and chilliness find their rapid help in CHINA."

"Lyco calls by wrong names, says "Cluent Foryza" when he intends saying "Fluent Coryza". Tyler 'Drug Pictures' (515).

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When BRY. AL; did not relieve the bronchial cough in Influenza, Sulphur did.

For the Dry persistent, worrying cough that remains after Bry. Al., STICTA is curative.

For the Great Weakness and exhaustion with loss of appetite, NUX VOM low worked charmingly and in many cases completed the cure and enabled the patient to return to work." Dr. Wallace Mc. George. M.D.

"I have found TUBERCULINUM 30, 200, 1M the best general antidote to Influenza poisoning." Clarke.

"I have found MEDORRHINUM high a good antidote to the effects of Influenza". Dr. Swan.

"I prescribe PYROGEN very often especially for Influenza. It works wonderfully. It cures but nevertheless the constitution remains the same. AFTERWARDS I must prescribe something else." Dr. Bellokossy.

Conium maculatum

Is especially useful in profound and long continued weakness following exhaustive diseases. (Think of it particularly in cases of widowers/bachelors.) - Dr. Cowperthwaite.

Phosphorus

Is very useful for the debility following la grippe; it is a great post-influenzal tonic. - Dr. Dewey.

In regard to the debility of CHINA, one has again and again proved the value of the drug in patients, who, after an attack of Influenza remained chilly and weak and went crawling about, feeling that they would never be able to wear summer clothing or go back to normal, and where potentised China promptly restored normality and the trouble was forgotten. - Dr. Tyler.

Sometimes after acute or violent diseases, we find the patient greatly prostrated. He is depressed in mind, weak in body, low spirited, hopeless of recovery and yet you know that there is no absolute certainty that the patient cannot get well; there are no organic lesions remaining. He has weakening night sweats. Perhaps Sulphur has been given without result. In such cases, PSORINUM is the remedy. - Farrington.

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Acute pain in limbs after Influenza : This medicine is indicated because the atmosphere is getting charged with atomic effects of one of the contents of which is STRONTIA CARB : RADIUM BROMIDE. (Decide which one is better indicated). - Anon.

The cardiac irritability following Influenza finds a remedy in - Dr. Joseph S. Hepburn.

If the palpitation results from the patient having taken too strong tea or Anacin (containing quinine see the pathogenesis of CHINA. - Anon.

Chronic Influenza characterised by obstinate, rheumatic, neuralgic pains, coupled with low temperature : there is one drug I should like to mention. It is not very well known, but it should be considered in such desperate cases, although it is quite a dangerous drug, viz. THALLIUM. It belongs to the lead group of metals (and it has been recommended for cases of baldness and ataxy). It is especially suitable to cases of chronic influenza with violent lancinating pains and trembling in the lower limbs. It should be given in occasional doses, alternating with Influenzinum. - Dr. W. Karo, M.D.

For the persisting infections of the accessory and naso-pharynx, the remedies which I have found most frequently indicated are :

Kali Bichromicum.

Silicea.

In those cases calling for Kali bi., there has been a persistence of glairy discharge, associated with pain or a sense of fullness or pressure over the frontal sinuses or antra and usually a sense of obstruction at the root of the nose. These post-influenzal Kali Bi patients are always very much below par; classical examples of post-influenzal debility and their symptoms are acutely aggravated in cold, damp weather, and better in warm bed. If by any chance, as they not frequently do, they complain of sharp, pressing pain over the affected sinus, that is always a confirmatory symptom of great value for use of Kali Bi.

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In Silicia, there is damming up of the discharge and a steadily increasing tension in the affected sinus. - Dr. Borland.

There was one remedy which I found useful in my own personal experience if Influenza, if Gelsemium did not completely meet the case, 2 doses of Nux Vom., would meet it. Mc Donaugh said, 'All true influenza was due to some intestinal infection, - Nux Vom was very good intestinal remedy and often covered the post-influenzal effects in so called 'gastric flu.' - John Paterson.

In the acute digestive complications of Influenza, the drug which I have found most frequently indicated is Bryonia. Here we have a classical picture of acute gastritis, with extreme abdominal sensitiveness, intense nausea, agg. by any movement; better eructations and relief from hot drinks. This is not infrequently a complication which yields to Bry. - Dr. F.M.  Borland

For post-influenzal nervous asthenias, there are three remedies which I have found of the greatest value :

1. PICRIC ACID.
2. PHOSPHORIC ACID.
3. COCCULUS INDICUS.

In all the three, there is the same feeling of weariness and inability to sustain any mental effort. - Borland

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Dry cough following influenza : 'Sudden, spasmodic burst of violent cough, hurting the lower ribs greatly MEPHITIS. O.S.  Haines.

After Influenza, one has always used INFLUENZINUM 200 and has seen it clear up such little legacies as FURIOUS, UNBEARABLE TEMPERS, hitherto unknown in the patient and EPILEPTIC FITS even. - Tyler

Post-influenzal asthenia :

1. CHININUM ARS.
2. CHINA.
3. CARBO. VEG. - Charles Boericke

A remedy which comes near to a specific in chronic post-influenzal states, if indicated by the exhaustion of mind and body, apathy, depression and hopelessness : CADMIUM METAL. PURUM 30. Journal of American Inst. of Homoeopathy.

Inula helenium

For post-grippe coughs, dry spasmodic ones worst at night, in rapid succession, with pains over chest, call for it especially. - Dr. William Boericke.

Curare

Takes hold of grippe or its after effects right away when the patient has these symptoms : - weakness with shaky lower extremities especially : the patient is surprised at his weakness and says, "Why I am all gone"; thirst for large quantities of cold water; sensation of heat and sensitive to heat; it is a remedy for the rapid pulse of post-influenzal myocarditis of which we see so many some years, persisting for weeks or months after grippe when some degree of the above symptoms are present. - Dr. R. E. S. Hayes, M. D.

When after any infection of upper respiratory tract (Pertussis, Influenza, etc.) attacks of irritating nervous cough at regular intervals persist for weeks, this terminates it - the medicine is CORALLIUM -

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Lathyrus sativus

After influenza where there is much weakness and heaviness, slow recovery of nerve power. Sleepy, constant yawning. - Boericke

Lycopersicon esculentum

Pains left after influenza.

Avena sativa

Inability to keep mind on one subject. Strength of hand diminished. Numbness of limbs as if paralyzed.

Abrotanum

Great weakness and emaciation of lower extremities after influenza.

Adonis vernalis

A heart medicine after influenza, increased urinary secretion, slow weak pulse. Fatty degeneration of heart.

Carbolicum acidum

Debility after influenza. Smell very acute.

Iberis amara

Cardiac Debility after Influenza.

Antimonium iodatum

Loss of strength and appetite, croupy cough with inability to raise the the sputum.

Salicylicum acidum

Prostration after influenza, also tinnitus aurium and deafness.

Arnica montana

If fear of approach and hardness of bed remain Arnica might be needed. Deathly coldness of forearm. So weak, must lie down after each stool. agoraphobia.