Ambulances in Wellington during the 1918 flu epidemic. Ref: PAColl-7489-69. Alexander Turnbull Library, Wellington, New Zealand. /records/22511121

February 1919

The influenza bacillus was described by Pfeiffier and others in 1892, not long after the severe European epidemic in 1889–90, and for some considerable time this germ was thought to be the sole originating cause of the disease, producing conditions in the respiratory tract favourable to the development of the micro-organisms of pneumonia. With the development of bacteriological research it later became evident that symptoms usually described as those of influenza could proceed from organisms other than Pfeiffer’s bacillus. In the last edition of the Manual of Medicine in the University series it is stated that “this organism appears to have become much less common in Britain in recent years than it was in the nineties, and to have been in great measure replaced by the micrococcus catarrhalis and other organisms even in cases where clinical features would suggest influenza.” The disease is said to be endemic in Northern Central Asia. There is no doubt that the infection spreads with the quickest means of transit at the speed of an express train. The germs found in cases of influenza include Pfeiffer’s bacillus, Grampositive diplo-streptococci, Gram-negative diplococci, pneumococci, Friedlander’s bacilli, and micrococcus catarrhalis. Nicolle and Lebailly on 14th October, 1918, showed that the disease could be produced in monkeys by the filtrate of the influenza expectoration when injected by the subconjunctival and nasal routes, and they also reported that the inoculation of the filtered bronchial secretion of influenza patients produced the disease in two men inoculated by the subcutaneous route. A week later, Dujarrie de la Rivière successfully inoculated himself with influenza from a filtrate made from the blood of cases infected with influenza, showing that the filtrable virus is present in the blood as well as in the bronchial secretion. In December, 1918, Gibson, Bowman, and Connor confirmed these results. It appears certain, therefore, that the virus of influenza can pass through a Chamberland filter, and the weight of evidence favours the conclusion that there is a yet undiscovered filtrable organism which is the cause of the disease. This is the opinion of the majority of the members of the War Office Conference. There has lately been issued an unconfirmed cablegram announcing that a definite organism of this kind has been discovered. On the other hand, it may be that Pfeiffer’s bacillus may be able to pass through a filter in one phase of the cycle of its development, and Hort’s recent investigations lend some colour to this view.

As regards the vexed question of treatment, all are agreed that at present we know of no drug which has any specific action in influenza. In the epidemic in the nineties quinine was vaunted, but it was found of little use recently, when salicylate of soda received general favour. The supplies of this drug in New Zealand are of inferior therapeutic quality, and salicin is preferable, and is highly recommended by Mr. E. B. Turner, who has had much experience in its use. The Royal College of Physicians states in a memorandum: “In the uncertainty of our present knowledge considerable hesitation must be felt in advising vaccine treatment as a curative measure.” We have read many reports from all over the world of the results of vaccine treatment as a prophylactic and curative agency in influenza, and they are very conflicting, and the only verdict at present is “not proven.” At the same time the prospect is very bright that in the near future, in view of the recent advances in the investigation of the etiology of the disease, a vaccine will be available which will revolutionise the treatment of a scourge that causes little less devastation than war.

A Royal Commission has been established in New Zealand to investigate the recent epidemic of influenza which caused great death and disablement in this eountry. It may be that the masses still hope for some great result from Royal Commissions, but most medical men, being well-informed, will cherish no delusions of that kind. A body composed entirely of laymen is as competent to investigate a serious and baffling disease and its consequences as a committee of doctors would be to report upon the Confession of Faith or hydro-electric power. We think it was Palmerston who said that he prayed fervently that the people would never realise with how little wisdom they are governed.

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