Armstrong – Table of Contents

cases and around 500,000 deaths. The very young, old and infirm patients were the most
vulnerable to a fatal outcome, but, surprisingly, many apparently healthy young adults
succumbed to the disease. The usual clinical manifestations were fever, chills, aching,
weakness followed by dry cough, sore throat, nasal stuffiness and burning of the eyes.
The excessive mortality was due to the super-imposition of severe influenza with viral or
virulent bacterial pneumonias (often caused by the streptococcus or staphylococcus).
According to Dr. Thomas L. Rivers, then a young medical officer stationed in September
1918 with the Army’s Permanent Pneumonia Board at Camp Pike outside Little Rock,
Arkansas (2): “The soldiers who suffered most of all were the big, white farmer boys
from the Mid-West and Negro troops from rural Louisiana and Mississippi. While they
were healthy enough, they just had no immunity. The scrawny fellows from the big city
slums, by and large, escaped because they had acquired immunity before they got to
camp.”
In 1918, the virus of influenza had not been identified (1933), and vaccines and
antibiotics were still 20-25 years in the future. The only treatment available, beside divine
intervention, was rest, fluids, adequate nutrition, temperature and cough control and good
nursing care. In a later “flu” epidemic in 1968, a local medical-science newspaper
reporter, during a telephone interview, asked the author about the nature of illness caused
by influenza. After a lengthy technical explanation, the reporter asked the author, “What
is influenza really like”? The author’s reply was, “Well, with influenza you think that you
are going to die and afraid that you wont”. This was the statement printed and
emphasized in the newspaper report (3).