Q1. to Dr. André Saine from Dr. Steven Novella
What do you consider to be the best clinical evidence supporting the efficacy of homeopathy for any indication?
ASKED. 2013-03-28 | ANSWERED. 2013-05-20 / PART III. 2014-04-09
» Back to Debate's page | Q1. Response from Dr. Saine | Q1.Part II. | Q1.Part III. | Q1. Response from Dr. Novella
Part III of Dr. Saine’s Answer:
Comparative Mortality in Hospitalized Patients
During the NIP, mortality among patients with CIP was, as a rule, higher in hospitalized patients than in private practice. That was because the more severe cases were usually referred to hospitals and were often in a later stage of the disease and even in a moribund condition. For example, the Hahnemann Hospital in Chicago reported that out of 245 patients admitted during the height of the NIP, 108, or 44%, were in the late stage of the disease or had one or more of its complications.(1) The Boston City Hospital reported a mortality of 38% among 993 influenza patients, and the Cook County Hospital in Chicago had a mortality of 39.3% among 1,735 influenza patients.(2)
There are many reports that the great majority of the patients hospitalized for influenza during the NIP had pneumonia. Such was the case in the San Francisco Hospital: “At the San Francisco Hospital, Ward G, under homeopathic care, has had its full share of the patients of the epidemic. Since the ward was opened for the influenza patients there have been between eighty and one hundred patients admitted, most of which were suffering with pneumonia, and there has been much work for the attending physicians and interns.”(3)
Dr. Clarence Bartlett said that 94% of the influenza patients admitted to the Hahnemann Hospital in Philadelphia had bronchopneumonia: “In private practice, the illnesses were always typical, the bronchopneumonias being fewer and less severe than in hospital. All of the patients, with but three exceptions, came under care during the first 24 hours, and these three were physicians. All of my personal private cases recovered. Not one has since had any sequelae. … The ward cases were quite different. Of the 166 cases, there were only ten in which the physical signs of pulmonary consolidation were more or less were absent. In other words, we noted that bronchopneumonia was so generally present that it might well be accepted as a part of the disease, and not as a complication.”(4)
However, severe and complicated cases were certainly not limited to hospitals. In the discussion following Dr. Bartlett’s presentation to the Homoeopathic Medical Society of the State of Pennsylvania, Dr. E. A. Krusen pointed out that serious and complicated cases of influenza were met with in private practice as well, particularly among the less affluent population: “We observed different types of cases according to environment or conditions. The physician who has a regular or established clientele is, as a rule, consulted early in the course of the illness, and is, therefore, enabled to secure excellent results. On the other hand, patients who enter the hospitals, generally defer treatment until their condition is so serious as to make attention imperative. In the poorer districts of our large towns and cities many people did not send for a physician until the illness had advanced to such a stage as to make the prognosis practically hopeless. When the patient sent for his physician early, it was nearly always possible to avert an oncoming pneumonia. I have treated 692 cases with but five deaths. Of the latter three could have been saved in all probability had they had proper care in the beginning.”(5)
As a rule, homeopaths did not indicate in their outcome returns the percentage of patients treated in hospital versus private practice. A great opportunity for more detailed statistics was thus lost, for in the U.S. during the time of the NIP, there were 101 accredited homeopathic hospitals and inpatient institutions, and 151 other similar institutions with which homeopathic physicians had affiliation.(6)
In 1916, Dr. W. A. Dewey of the University of Michigan had been charged with compiling a list of the institutions that the homeopathic school of medicine possessed in the U.S. In this work, he reported their capacity to receive patients and some of their statistics, such as their consistently low mortality rates, “All the properties of our school, which we have thus far determined are strictly homeopathic properties. To date we have in the accredited class, 101 institutions. By that we mean that these institutions are homeopathic in management, homeopathic in staff, and the work is all done by homeopathic physicians. These 101 institutions represent 20,092 beds. There were treated in these institutions during the last fiscal year 110,000 inpatients. The average death rate in these institutions is the very small percentage of 4.1 percent for the 110,000 patients. I do not believe you can beat that in any aggregation of 101 hospitals anywhere else in the world other than in the homeopathic school. When we think that some of these hospitals are children's hospitals where the mortality is very high; that others are emergency institutions where perhaps 7,000 ambulance cases are attended to annually, and that in some there are from 1 to 50 accident cases per day, I think it is a remarkably low mortality rate.”(7)
The number of patients seen by homeopathic physicians in those institutions was significant, since many of them also had outpatient dispensaries. In fact, Dr. Dewey reported, “We have estimated that at least 750,000 of the sick and injured in this country are receiving in institutions homeopathic treatment and aid.”(8)
However, the capacity of those institutions was small in comparison to the population interested in receiving homeopathic care in the United States. According to the Council on Medical Education of the American Institute of Homeopathy, the number of homeopathic patrons in 1916 represented quite a significant segment of the population: “In states wherein a survey has been made indicating the medical faith of the population it was found that actually 35.5% employs homeopathic treatment and 48.5% are kindly disposed toward homeopathy.” That was at a time when the U.S. population was 102 million.(9)
It is most unfortunate that the homeopathic community didn’t do a better job of recording and making public all the results they obtained during the NIP. Previous generations of homeopaths had had to work and fight hard to obtain recognition, privileges and institutions in order to practice their art, as it should be practiced, despite the fact that they were already treating a large segment of the tax-paying population. To give an example, Dr. W. S. Mills recounted how the Metropolitan Hospital in New York City came under homeopathic management. Early in 1875, during a regular monthly meeting at the Union League Club,(10) “One of the gentlemen suggested that the homeopaths were entitled to a city hospital. Under the existing conditions, all of the public hospitals, supported as they were from the public funds, excluded homeopathic practitioners. Because of the large proportion of taxes paid by the patrons of homeopathy, he believed that the homeopaths were entitled to recognition. A petition was drawn up on the spot requesting a Charity Hospital under city patronage to be placed in homeopathic care. … Six hundred and fifty-five signatures, representing over half the estimated wealth of the City of New York, were obtained.” It was said during the presentation of the petition to the city commissioners, “We feel that an opportunity is thus offered to the commissioners to give to those who pay the majority of the taxes of the city a voice in the way in which said taxes shall be dispensed, without increasing by one dime the total amount [of expenses]. It would be an anomaly in a democratic government that the large taxpayers of this city are debarred from any voice in the care of the city’s poor, and we respectfully ask as a right that this injustice shall cease.” (11)
This failure to report outcomes from hospital services during the NIP was not limited to homeopathic institutions, but was common among all hospitals throughout the United States. However, despite this lack of reporting, descriptions of the consistently favorable outcomes from the practice of genuine homeopathy can again be found in countless references to this subject in the literature.
Dr. Wallace McGeorge of Camden, New Jersey, pointed out that many moribund patients who had been hospitalized during the NIP owed their lives to homeopathy: “In the terrible epidemic of influenza that visited us last month and is now passing over the Western States, homeopathy has come out with honor. Many people are alive today because of the curative action of homeopathic remedies, carefully prescribed and conscientiously given. Some of our physicians who have been called to attend the sick and dying in emergency cases in our hospitals have been sorely tried, yet even these have had cause to rejoice in the curative action of homeopathic medicines.”(12)
Dr. Ernest F. Sappington of Washington, D.C., reported that during the NIP, “Recoveries in the National Homeopathic Hospital in Washington were 100 percent.”(13) Unfortunately, records form this hospital are not available at this moment.
Lieutenant Foster J. Curtis, who was one of the homeopathic physicians commissioned to the Letterman Army Hospital in San Francisco, the largest army hospital in the United States, also had no mortality on his ward during the NIP.(14) No records from the Letterman Hospital have so far been found with the exception of this short note, which showed that they had an average number of complicated cases with pneumonia: “There has been no epidemic affecting this hospital except the one of influenza which started in October 1918, and continued with unabated virulence until the last part of January 1919. The disease was characterized by an onset with chill, chilliness, marked prostration, slight coryza and general soreness and pain, the latter most marked in the lumbar region. The incidence of pneumonia as a complication was the same as that experienced throughout the country generally.”(15)
If we then examine the records of another large army hospital, the one located at Camp Grant in Illinois, we find that from September 21 to November 3, 1918, 10,739 soldiers had been admitted to its base hospital and infirmaries. Of these, 2,332, or 22%, developed pneumonia, and 1,060, or 46%, of the pneumonia patients died.
If we then examine the records of another large army hospital, the one located at Camp Grant in Illinois, we find that from September 21 to November 3, 1918, 10,739 soldiers had been admitted to its base hospital and infirmaries. Of these, 2,332, or 22%, developed pneumonia, and 1,060, or 46%, of the pneumonia patients died. (16)
It was not unusual for professed homeopaths to offer “mixed treatments,” particularly when they were practicing in hospitals, but those who did ended up, as a rule, with mixed results. Before the American Institute of Homeopathy, Dr. Samuel Clement, Clinical Instructor in Contagious Diseases at the Boston University School of Medicine and resident physician at the Haynes Memorial Hospital for Contagious Diseases of the Massachusetts Homeopathic Hospital in Boston, described the kinds of patients that were often admitted to his hospital during the NIP: “I have enjoyed hearing during the session these reports of influenza treated with homeopathic remedies. These, however, were mostly from private practice, where the physician was called early to see the patient, and gave instructions on what to do—put to bed, given proper diet, liquid diet, etc. I had a low mortality rate, but can speak only from the institutional standpoint.
“Those of you who were engaged in this work will know that for a long time, along the latter part of September and October, the hospitals were the dumping ground to which all kinds of people were sent who had had all kinds of treatment. I was glad to hear what one physician had to say about the use of aspirin. Many of the patients, especially ladies, had been advised to take aspirin as a prophylactic against influenza or influenza-pneumonia. One lady had taken 240 grains in less than 48 hours. She was sent to the hospital—not as a case of influenza, but as scarlet fever because of the red spots on her body. If the doctor who had examined her had done it more carefully, he never would have made the diagnosis of scarlet fever.”(17)
Dr. Clement then pointed out that their treatment was handicapped in a great number of patients whohad previously been treated with allopathy, “So, many of the cases that came to the hospital were neglected cases, patients filled up with aspirin, codeine, morphine and digitalis. Therefore, it is a poor thing to try to report to you these cases and have a very low mortality rate in 632 cases. The largest number I admitted to the hospital in one day was 45. Out of these 632 cases, 264 were pneumonia cases. I am glad to say out of the 264 pneumonia cases, only 15 developed pneumonia after admission to the hospital.”(18)
Despite the fact that the patients at the Haynes Memorial were treated with homeopathy, as well as with (non-homeopathic) vaccines and beef and human serums, the result were reasonably good in view of the fact that 42% of all the ones admitted had pneumonia, 48% were severe cases and a great number had been weakened by allopathic drugs, but were by greatly inferior to the ones found under genuine homeopathy: “Out of the 632 cases, 175 were mild cases, temperature not
higher than 101°F; 158 were average cases, temperature about 102°F; 306 were very severe cases, temperature about 103°F. Out of 109 cases reported above, the highest temperature was 107°F. Of our pneumonia cases, the diagnosis was made on actual physical findings; 222 were bilateral bronchopneumonia, septic, resembling pulmonary edema and started inside of 24 hours.“
Some died a few hours after admittance to this hospital, and we did not have time to work out the records. Of the 128 that died, some lived two days, other only two hours. Our mortality rate was 20 percent. This isn't camouflage. The mortality rate in septic pneumonias was 44 percent; our mortality rate in pregnant women was about 46 percent.
“Many of our cases were drawn from the United States Navy enlisted men, about 109. One of the men at the Naval Hospital, having heard of the wonderful results of homeopathic treatment at the Massachusetts Hospital, said to me, ‘Our men are dying like flies.’ I went over there with the commanding officer and reviewed their treatment. The patients were given codeine, morphine and aspirin as a routine affair, also digitalis. They didn't like to send the officers to us, thinking they had better care at the Naval Hospital. However, they saw and admitted that our treatment was better than theirs and some of the officers and men were sent to our hospital. After only a short time in our hospital, they were pretty sure they were not going to die.
“I want to say that out of these 109 cases there were only 3 deaths, and these were moribund when admitted into the hospital. I want to emphasize this. These men in Government work praised our hospital for homeopathic treatment in influenza. They do not all agree, however, but they have a feeling in Boston that we have a wonderful treatment for influenza.
“Just a word with regard to allopathic prescribing. Of the five cases that had developed pneumonia under allopathic treatment, all died.”(19)
This mixing of homeopathy with allopathy by professed homeopaths practicing in hospitals was quite common, as was seen in the Haines Memorial. Often, the allopathy was termed “physiological medication.” Such an approach of giving drugs for their effects is not part of homeopathy and should simply be considered a failure to apply homeopathy properly.
Like all other large U.S. cities, New York City had its share of deaths from influenza-pneumonia during the NIP. On a single day in mid-October, more than 850 New Yorkers died from the flu.(20) From September 1, 1918, to February 15, 1919, there were 145,976 cases of influenza and 27,388 of pneumonia hospitalized in New York City, for a total of 173,304 cases of CIP. There were 14,873 deaths among the influenza patients, a 10.2% mortality rate, and 15,471 deaths among the pneumonia patients, a 56.5% mortality rate, resulting in a total of 30,344 deaths, or 17% for CIP. This figure was six times as great as in the same period the year before.(21) By the end of the NIP, the total number of deaths from CIP exceeded 35,000 for New York City.(22)
During WWI, a great number of the New York City Metropolitan Hospital homeopathic staff had gone overseas with Base Hospital No. 48. Nevertheless, the hospital continued to operate at full capacity during the NIP. The Metropolitan Hospital was quite large and had, before the war, a capacity of 1,897 beds. It was not only the largest general hospital in the world under homeopathic management, but was also a very busy one, and it accepted only charity cases. Frequently, the actual number of patients exceeded the normal bed capacity. For instance, it was reported that on January 26, 1915 there were 2,238 patients on the wards, which meant 20% above full capacity.(23)
In his oral autobiography, Dr. John Renner, who was the former editor of Midwest Homeopathic News Journal and who was known to be an accurate reporter of events, talked about the results obtained by the Metropolitan Hospital with influenza patients during the NIP: “Another statistic along that line is what happened at the Metropolitan Hospital in New York City. As a city hospital, they had to take every case brought to them, so it was a difficult place to build up a favorable record. Senator Royal Copeland was a [homeopathic] doctor before he became a senator, and he was in charge of the city hospital as Health Commissioner of the City of New York. He had such a good record [in the Metropolitan Hospital] in New York—the lowest death rate of any hospital in the city—that they awarded him a banner to signify their appreciation. He was able to do this because of his homeopathic medicine.”(23b)
The favorable results obtained by homeopaths with hospitalized patients during the NIP were also met with in a non-American population. Dr. Marguerite Everham, a missionary homeopathic physician, reported that she was busy treating influenza patients in a hospital accommodating 75 inpatients and an average of 100 outpatients a day in the dispensary in Swatow, China where “this influenza epidemic is like the plague.” She wrote that when influenza broke out in her region, “I had ever so much medical work, and so far as I know all the people I saw recovered.” (24)
Comparative Mortality in Hospitalized War Casualties
There were probably no more challenging conditions under which to obtain favorable results with CIP patients than among the soldiers wounded at the front in Europe.
In 1917, American homeopathic physicians and surgeons were asked by the U.S. Surgeon General, W. C. Gorgas, to organize two base hospitals and one hospital unit, namely Base Hospitals No. 44 and No. 48 and the Flower Hospital Unit. The first two served near the front at the Mars Hospital Center in the center of France, where they received the sick and wounded soldiers directly from the frontline casualty clearing stations.
Dr. H. M. Stevenson, president of the Southern Homoeopathic Medical Association, noted the close ties that existed for a short time between the U.S. Government and the homeopathic officials: “During the recent war, our school stood staunchly by the Government. Officials of the American Institute of Homeopathy remained permanently at Washington throughout the war, where they worked with the War Department and with the Navy Office to organize our homeopathic forces for the Government.”(25) Homeopaths actually offered to form more base hospitals but their offer wasn’t accepted, as Dr. Frederick Dearborn, the organizer of Base Hospital No. 48, deplored: “We likewise will never cease to regret the non-acceptance of the base hospital offered by the Hahnemann Hospital of Philadelphia, Hahnemann Hospital of Chicago and by the homeopathic women of the Institute. It is a great temptation to dilate upon these matters but this is not the time nor place.”(26)
The staff of Base Hospital No. 44 was made up of 38 physicians and surgeons and 100 nurses recruited mostly from Boston homeopathic hospitals; it was one of a dozen hospital units attached to the Mars Hospital Center.
The medical work they performed was, as a rule, done in the most unfavorable conditions. A great number of the wounded soldiers developed influenza during transport in overcrowded trains. Dr. J. Arnold Rockwell of Cambridge, Massachusetts, wrote about his experience as staff physician of Base Hospital No. 44: “In the rush and confusion of war and the great desire to get patients back, the trains were often poorly manned, and it sometimes took a rescue train from one to three days from the expected time to arrive, so the patients seldom arrived in anything like a fair condition. During that epidemic of influenza which raged at the time it did in this country, the trains were filled regardless of medical or surgical cases, with mixed cases, so when the trains came to us forty percent of the cases had influenza which had spread through car after car, so those who at first needed surgical attention only had been infected with influenza as well as others. That condition ought to have been averted. As a result, there were many deaths, much time was lost, and many patients came down with influenza which possibly otherwise would have been free.”(27)
Mortality from CIP among wounded soldiers would be expected to be higher than in hospitalized soldiers in army camps or in hospitalized civilians, as Dr. Rockwell reported: “They were in such a critical condition that they died in a short time after arriving in the hospital.”(28) Only one base hospital located near the battlefront in France reported the mortality rate in its CIP patients during the NIP, namely Base Hospital No. 46 that reported, “We had 1,040 cases of influenza [23% of all the casualties of its medical department] in the same period [from July to December 1918], with 135 cases of bronchopneumonia and 38 lobar pneumonia, and 6 complicating empyema. Our pneumonia mortality, including complications, was 50 percent. Many of the cases of influenza developed a later bronchopneumonia.”(29) For the months of September through November 1918, the American Expeditionary Forces based in England and France during WWI reported 75,960 cases of influenza, of which 11,113, or 15%, developed pneumonia and 5,486, or 49.4%, of these died.(30)
Within four days in early October, in the midst of the most deadly wave of influenza, Base Hospital No. 44 received two trains of more than 1,700 sick and wounded soldiers, of whom about one third had influenza. “Many of these patients were in a serious condition, and several of these died within a few days. … A vast number of dressings were done, and all the departments of the hospital were taxed to their capacity. The pneumonias were of a virulent type, and a large proportion of the deaths occurring in the hospital were from this cause.”(31)
Moreover, the “pitiable condition” of the soldiers was compounded by the fact that they were in crowded spaces with no opportunity for isolation. And yet homeopaths at Base Hospital No. 44 were able to turn the unfavorable odds around. Dr. Rockwell and his team lost only 33 cases out of some three thousand patients that were put under their care from July to December 1918. If we assume the worse case scenario, namely, that all 33 deaths were due solely to pneumonia, the odds of surviving CIP at Base Hospital No. 44 during the NIP were at the very least 100% greater as in the rest of the American Expeditionary Forces, where the average death rate from CIP was 6%.(32)
Those very good results were obtained despite the fact that the medical staff did not have an adequate supply of homeopathic remedies, as Dr. Rockwell recalled: “One-third [of the remedies received from overseas] were broken. Because of the great need, it presented a sad picture to find bottle after bottle absolutely useless. And it so happened that several of our unquestionably most valuable remedies were among those lost, for instance, Phosphorus; when we needed it more than anything else, we had none to dispense.”(33)
Those results were even more remarkable when we consider the fact that a group of officer patients had written to the American Expeditionary Forces’ Adjutant General complaining about the poor food served at Base Hospital No. 44. An Services Of Supply inspector eventually looked into the matter and concluded that the hospital was doing the best it could under the circumstances.(34)
Another hospital under homeopathic management was Base Hospital No. 48, which was organized out of the Metropolitan Hospital of New York City, the charity hospital on Blackwell’s Island. It was the senior and first base hospital in operation at the Mars Hospital Center in France during WWI. Colonel Geo A. Skinner of the U.S. Medical Corps, who was in charge of the Mars Hospital Center, wrote to the Board of the Metropolitan Hospital on February 7, 1919, three weeks after the medical staff of Base Hospital No. 48 had been released from of their duties (since the war was over): “It gives me great pleasure to report on the splendid work done here at Mars Hospital Center by Base Hospital No. 48, organized from the Metropolitan Hospital of New York. … Base Hospital No. 48 reported at Mars Hospital Center on July 25th, 1918, and, with Base Hospital No. 68, cared for the first train of patients, which arrived here on August 2nd. From that time on until sometime after the armistice was signed this hospital has been constantly busy, having handled a large number of cases and always with great professional credit. The work at times has been exceedingly hard for the professional
personnel as many of the doctors were called to the front, leaving us very shorthanded at the rear. … In spite of being so shorthanded, the work of all the specialties
has been carried on in a very satisfactory manner. I have only praise and commendation for the splendid, unselfish work of every member of this organization, officers,
nurses and enlisted men. The character of the enlisted men was especially high and the discipline of the command has been most satisfactory. It was a great help to me as Commanding Officer of the Center to be able to call on Base Hospital No. 48 for so many men, and I availed myself freely of their ability.”(35)
The deplorable working conditions at these base hospitals during the second part of 1918 were described in graphic detail by an officer of Base Hospital No. 48: “August 2nd, the arrival of the first hospital train at 8:45 A.M., with nearly three hundred wounded … serious stretcher cases … everybody out to carry stretchers. The first awful sight of the interior of a hospital train … three cots high either side … the sickening stench of blood, gangrene and foul air. The tender but inept handling of the wounded … the moans and curses of the very bad cases … the journey from the train through the rain and mud, stumbling over the bad roads … the traffic jam of stretchers in the Receiving Ward … the assignment to the various wards, according to the nature of the wounds—gas cases, head wounds, fractures, walking cases.
“Another train load at noon … still another at three the next morning … mostly victims of the Chateau-Thierry drive. Stories of danger, heroism, pain and death—from those able to talk … some joking … others lying in a half stupor. One young boy, head encased in bandages, mumbling deliriously … so many young boys. The jargon of foreign voices in American uniforms, … several German wounded, also very young.
“Many desperate cases … the need for immediate operations. Operation hour after hour … head wounds … the terrible sound of clipping the bone of the scalp … gruesome abdominal wounds. … Wards loaded. Men desperately sick … all types of wounds—head, chest, abdominal, arm, leg, fracture cases … amputations … helpless, fed and bathed like babies. … For days we did nothing but work, eat and sleep. The wounded came in by the hundreds. At times we had to stop the admission of new cases because of the congestion.”(36)
These base hospitals were often overcrowded and their staffs were overworked. For instance, in August 1918 during the height of battle at the nearby front, 1,828 cases, mostly with battle wounds, were admitted to Base Hospital No. 48, and 1,744 cases were received in October during the height of the most deadly wave of the NIP.(37) The normal capacity of Base Hospital No. 48 was 1,240 beds,(38) but from July 25, 1918 until January 15, 1919 it constantly had from a thousand to fifteen hundred patients, including a large proportion of the most seriously wounded. Not only was this hospital over-occupied but it was also understaffed because eighteen out of their thirty-six commissioned physicians and surgeons were either at the front or directing other activities. A number of those had been part of operating teams in the front line trenches from July to November, and no fewer than three officers suffered injuries at the front.(39)
The total number of sick and wounded soldiers treated during the active service of Base Hospital No. 48 was 4,822, most of whom were seriously wounded; 2,960 were surgical cases and 1,862 were medical cases.
Despite those most unfavorable conditions, the total number of deaths from all causes, from battle wounds to pneumonia, reported by Base Hospital No. 48 was 85.(40) Such “splendid results” were similar to the ones mentioned earlier for Base Hospital No. 44, which was the other American base hospital with a homeopathically trained staff that had actually been supplied with homeopathic remedies.(41) These results are remarkable if we consider the fact that 6% of the wounded in battle in the American Expeditionary Forces in France died.(42)
On the other hand, mortality from pneumonia was quite high in other similarly located base hospitals. For instance, Base Hospital No. 68, which was under allopathic management and which was also located in the Mars Hospital Center, began its activity at the same time as Base Hospital No. 48 and reported a pneumonia case fatality rate of 32% for the period from August to November 1918.(43)
Base Hospital No. 18, which also served in France, reported, “The bronchopneumonia have been particularly fatal infections, and proportionally killed more soldiers than any other disease,” being the cause of 38.5% of all their deaths.(44)
Base Hospital No. 38, which also served in France, reported: “In general, the respiratory infections nowise differed from the classical types observed in civil practice. There are a few exceptions to this statement; hemolytic streptococcal infections were often insidious, of undefined symptoms and signs, and almost constantly hopelessly fatal. Bronchopneumonia showed, in fatal cases, a particular tendency to coalescent massive types simulating lobar. Any pneumonia superimposed upon lesions due to gassing, was extremely fatal, the secondary infection probably being the determining factor. In acute pulmonary affections complications were not unusual; empyema was of ordinary incidence.” Pneumonia was the cause of 26% of all the deaths occurring in this hospital.(45)
Base Hospital No. 31, which was also serving in France reported, “The combination of bronchopneumonia with typhoid fever seemed particularly fatal, three out of four cases dying.”(46)
The first American physician at the front during the WWI was Dr. E. Petrie Hoyle of Kittery, Maine, who volunteered in August 1914 in the British Royal Army Medical Corps. He reported that some of the wounded soldiers, ill with influenza, had broken “out with large patches of blackened flesh and buboes galore …,” “killing tens of thousands” in the armed forces. “Here is a personal report which I will vouch for as being God’s truth. My old British friend, the late Dr. Byres Moir [a staff physician of the London Homoeopathic Hospital], Scotch to the backbone, told me this in London after the last war [WWI]. He, though much over age limit [61 years old], was placed in charge of a large British transport full of American troops. It is so happened that he worked through that worst epidemic of flu when men rotted and were covered with those black patches, buboes, etc. Whilst all other transports were burying their scores of dead daily, Dr. Moir never lost a case.
“Dr. Moir did not lose a case on his ship, and the proof is in the British records. I asked Dr. Moir, whom I had known nearly all my life, why he did not publish this history in some of our medical journals, to which he replied that being an officer on government employ his hands were tied. I challenge and beg the British government to publish Dr. Moir’s record for the good of humanity, lest another such epidemic should occur, arranging that in future all their medicos travel with a set of homeopathic remedies and so save some lives.”(47)
Advantages of Homeopathy with the Sick, Wounded and War-Weary Soldiers
It is important to understand that, when the principles and practice of homeopathy are fully applied, the overall health of the patient is expected to improve. By taking care of the whole person, on the mental, emotional and physical levels, all at once, homeopaths were able not only to obtain remarkably low death rates in the CIP stricken soldiers, but also to diminish the risk of complications and increase the speed of recovery by effectively addressing all other sufferings and disabilities encountered in the sick, wounded and war-weary soldiers. In fact, the lower death rates achieved by homeopathy in soldiers with CIP was extraordinary, given the concomitant conditions suffered by the soldiers, such as battle wounds, gas inhalation, stress, emotional trauma, mental and physical exhaustion, trench fever, poliomyelitis, dysentery, etc.
In June 1942, soon after the United States entered World War II, Dr. E. Petrie Hoyle shared his own experience as a physician at the front in WWI in a paper entitled “Medical and Surgical Experiences in the First World War and Some Statistics and Medical Measures of Greatest Value to All Army Medical Corps.” He wrote, “I have some right to speak as I was actually ‘over there’ in Belgium and France for four-full years, and fully employed every single day, much of the time being at or near the front. Our unit crossed to Ostend on September 4, 1914. I was the first American doctor actually at the front, at Antwerp, Malines and Furnes, dating from September 5.
“What I am recounting now is a slight gift, humbly offered and suggested to every M.D. of any school of medicine as a faithful and actual record of war life, time and pain-saving. As a tribute of thankfulness, I offer my old school friends our way of treating wounds and illnesses. … Nota bene—Every surgical case is, nolens volens, a medical case, at one and the same time!
“I beg all to make a test, and don’t worry too much about ‘lack of control cases.’ In wartime, especially, one cannot command ‘controls’ nor even get laboratory findings, to help one’s clinical work. One has to work, at top speed, on clinical knowledge, plus using the medicaments on hand.” (48)
“We were so often under shell fire there that one hardly realized whether one was in this world or not. Anyway there was a feeling that the next bomb or shell might not leave a trace of you, but as a matter of fact work was done on the heartfelt supposition that the next bomb would fall in the next street or anywhere but just where you were working. The shriek of those shells is something very weird and fascinating, but we never worried as long as there were wounded to attend to, and we got so tired at night when we got to bed that there was nothing further but oblivion.”(49)
During WWI, Dr. Hoyle made extensive use of Calendula solutions to clean wounds and in wet dressings. The results were uniformly good even though these solutions were quite diluted from lack of adequate supplies, as he reported: “My war experience brings to mind ex-President Coolidge’s dictum, ‘Make it do; do without,’ for requisitions get side-tracked or pigeon-holed, and that is one benefit of a homeopathic medicine case, which supply goes so far when we use drop doses, or with some drugs a teaspoonful of drug also goes far, making a pint of wet-dressing solution.”(50)
He served the French, British and American troops during the four years of the war in seven different hospitals in Belgium and France,(51) and, in 1915-1916, one year into his services, Dr. Hoyle was put in charge of the Hôpital Auxilliaire No. 50 in Rubelles, France. He witnessed there the gruesome state the wounded were in when they arrived from the front: “It has been one service of work like handling the debris of train wreck, only rather worse!”(52)
The kind of injuries that war surgeons commonly dealt with near the front in WWI were described in even more graphic detail by Miss E. Wilkinson, a nurse who had graduated from the Montreal Homoeopathic Hospital and had joined the St. John’s Ambulance Corps. While serving in Gallipoli during the fierce Dardanelles campaign, she wrote, “Most of the men are absolutely riddled by bomb explosions, shell and shrapnel. Bullets are quite common protruding from all parts of their anatomy from brain to toe. Legs broken, lungs crushed, brain and skull all smashed, bullets in the intestines, others going through about every place in their body.”(53)
It is a remarkable fact that in those four years Dr. Hoyle did not see a single new case of tetanus or gangrene develop under homeopathic care despite the direst conditions of the soldiers with septic wounds: “I have used this [Calendula] on all sorts of wounds here, pouring it into compound fractures and using it on black wounds, as many men arrived here from the front with their wounds not dressed for four days, hence the torn flesh was in some instances black and offensive. … but to Calendula alone I attribute the quick sweetening of all these wounds.”(54)
“In the rush of war work, it is well to remember one piece of negative testimony. I came across in Belgium and France. TIME: The first few months of the First World War. PLACE: Various hospitals in Belgium and later France. DEMAND: Serum, to prevent tetanus following wounds, the soil of well-manured fields being supposedly full of tetanus germs. WHAT ACTUALLY HAPPENED: Not a shot of the serum was allowed to go to many non-army hospitals, including our units. RESULT: I never saw a case of tetanus in any hospital in my four years at or near the front. This fact rather spoiled the claim that such serum was an absolute necessity. We could never obtain, buy, beg, or steal, a single shot. I do not claim that the internal medicines given by me, or the Calendula used for wet-dressings, prevented the tetanus, so we leave this fact in the lap of the gods, and thank God for what did eventuate—NO TETANUS! … Even if wounds are known to be infected, which every war wound surely is. If the wound is deep, syringe with this dilution and very lightly pack with medicated gauze [with Calendula] to prevent sudden closing. Dress twice daily, if possible, though once daily dressings have carried thousands through to perfect cure. I never saw gangrene in a Calendula dressed wound.”(55)
These results are remarkable if we consider the fact that 1.8% of the ones who received wounds to soft parts and had bone fractures in the American Expeditionary Forces in France developed gangrene, and of these 47% died. Also 10% of the cases of gangrene developed after surgical operation.(56)
Such a record, which is commonplace for homeopathic surgeons who have learned to make full use of the homeopathic armamentarium, is extraordinary in view of the seriousness of the wounds in weakened and battle-weary soldiers and all the difficulties caused by a war.
The quality of care that homeopathic physicians provided and the favorable results they obtained with these cases and which were clearly not commonplace in the armed forces, greatly reduced the loss of soldiers from secondary infections, as Dr. Hoyle recounted: “Whilst still at Chateau Rubelles, as Medical Chief, the French Administrator told me to please spruce up all the wards as a very important army surgeon was arriving after lunch for an inspection. He tried to impress me by saying, ‘You understand that if this general were to find any fault, he could close the hospital overnight.’
“The British nursing staff and I thought that as we always kept things clean and tidy we need not miss our lunch or break our backs about anything. The general and his staff came on time,” and after a careful inspection, “he turned to us and said, ‘My compliments! I have never inspected wards which were so clean-smelling as these are, and where unhealed compound fractures were doing so well.’ I emphasize that every surgical case is at one and the same time a medical case. We always saw to that, and what is another record for that hospital, where a good percentage of the cases were compound fractures, is that during my charge there, of one week short of one year, we never had a death. … Of course all such cases will be having internal medication such as I am about to outline. …
“I am trying to impress on my readers, some of whom I trust will be ‘old school’ students, that every surgical case requires some constitutional or primary medical stimulation internally, at one and the same time. If there is much tissue loss, which is often the case in major war wounds, then to give a well known cell-proliferant is common sense, especially if bed space is a consideration, and bed costs are to be counted. If a bone is shattered, plate that bone and splint that limb to the best at your command, but I still assert that there are remedies which are long-known as able to hasten flesh growth and bone repair and to harden callus deposits. …
“The main point I wish to make here is that any homeopathic doctor who can should go to work, well equipped with necessary remedies for a certain range of diseases sure to be met with, to wit, pneumonias, bronchitis, sore throats, bowel complaints especially of various types, and most emphatically drugs for malaria, considering many battle areas, and of course such remedies needed in wound treatment at one and the same time … compound, and also for gaping wounds requiring much new tissue to fill up … to sooth pains due to nerve injuries, whether by surgery or war, hence its [Hypericum] field of usefulness after operations. In case of nerve shock from near-by explosions without any wounds, it often puts soldiers to sleep so quickly that they think they have had a narcotic dose.”(57)
One particular type of difficult cases that were often encountered near the front were the shelled-shock cases, which added even more burden to the overworked physicians of these base hospitals. Dr. Theodore Bacmeister of Chicago, assigned to Hospital No. 28 at Fort Sheridan, Illinois, for the disabled or wounded ex-service men and women, explained the burden created by “the soldier of the shattered or broken nervous system—universally called the shell-shock case—is a tremendous problem. His name is legion, his condition is pitiable, his cure tedious and precarious and in the past he has been a much neglected patient. The thorough study, painstaking analysis and careful classification of these psychopathic cases—most of whom prove to be types of dementia praecox—is a huge problem.”(58)
However, Dr. Hoyle described how the burden of these cases for a base hospital was quickly dealt with under homeopathic care: “For traumatic shock: in war many a man has been blown up and thrown twenty to thirty yards by a near-by shell explosion yet never with a skin wound to show. He may have turned black, blue and green in a few hours, and be or have been but partially conscious. Give such a case a few doses of Arnica internally and he will show remarkable improvement in some hours or by next day, with very little soreness considering all things. Such cases recover mentally and physically and you have emptied another bed quickly. Without such treatment, some of these men will linger on the verge of being absolutely unfit for weeks or months, as I have seen. In a French mental hospital at Lyon I have seen squads of such a nerve wrecks being exercised by scrambling round a yard on their hands and knees. They could not even stand erect. They should all have been medicated, and not whipped into crawling; they needed some medicine. … One other class of wounds, always highly septic, was those of hands and feet which had not been washed for many weeks (no blame to such owners).”(59)
The mortality from CIP had been reported to be greater when it was compounded with typhoid fever or dysentery, which was quite common among soldiers at the front during WWI, as Dr. Hoyle reported: “Another cause of bowel troubles will be from cold or chill tropic nights striking a sweaty body and garments when men have to sleep out when enveloped in sweat-damp or rain-soaked clothes, so a consideration of this trouble is in order. Diarrheas not caused by bad food or sleeping out whilst wet are of two classes, amebic and bacillary. … Some or many of you following the troops are bound bang for hot countries where tropical waters are not safe to drink and heavily charged chlorinated waters are not very healthy in the long run. You may be ordered to boil drinking waters, but what happens when you are also ordered not to light fires lest you draw artillery fire? The boys will then drink almost anything wet. … But that water was fouled with German and Belgium dead, besides dead horses and cattle and much city sewage of strong character, so you can guess what it was like. … hence we were not surprised when some thirty-odd nurses did not come on duty one morning. … Those nurses were all in bed with their knees drawn up to their chins, which position relieved some of their agonies. They all had the same type of diarrhea, much flatulence, stools forcibly ejected, watery, frothy, bright saffron-colored stools, all having a strong musty odor.”(60)
“The head surgeon (British) Mr. S, said to me, ‘Hoyle, they tell me that you have a case of medicines. We surgeons don’t know a damned thing about medicines. Please take charge of the nurses.’ I was delighted, because my medicines were homeopathic. I found every nurse bent double, knees drawn to the chest with atrocious abdominal pains. They instinctively assumed this position, because the pressure on their abdomen gave partial relief; they all had forceful, gushing, foul, with musty odor, jelly-like stools, with terrible belly pains, which made them groan. Now those nurses were all separated, in different houses, near the hospital, the rooms having been commandeered for our staff. There was no chance of their comparing symptoms, so as to tell the same tale of suffering. Their symptoms were all clear cut and all pointed but to one medicine, that is to a homeopath.
“There was no time to examine the stools for any particular bacteria, nor, in the light of symptom-prescribing was it absolutely necessary, in order to choose the correct medical stimulus to cure, however pretty it might have looked on a fully filled chart.
“Homeopathy was, and is, able to rise superior to any bacteriological finding. Our medical stimuli are probably not to be classed as bactericidal in action. It is enough if we consider that they inhibit, or overcome, germ action, by stimulating the vital forces towards repair.
“Happy to relate, and perhaps almost incredible to you, all those nurses reported for duty within four or five hours, though still very weak. War is war and they were brave and very willing. Every nurse, thank God for similia, felt the beneficial action of that Colocynthis after the second or third dose.(61)
“This is ‘exact’ medicine, and may save a whole regiment for prompt action when needed most.”(62)
“Now the very next day a British Tommy [a private] of the Royal Marine Reserves was brought into our hospital from the adjacent British lines, with a diarrhea practically every ten minutes. He had been ill three days. Here is where I made a great mistake. I failed, and not homeopathy. Being rushed with work, I took the same bottle of Colocynthis out of my pocket, where it still reposed, and said to that man, without asking questions as I should have done, ‘Hold out your hand, back uppermost,’ on which I dropped one minim (drop) of that medicine. ‘Lick it off, and find me again in fifteen minutes.’ A second time was repeated, but when he presented himself a third time, as he was not better, I began to be wise, homeopathically speaking.
“As he was in his shirt sleeves, rolled up above the elbows, it being oppressively hot, I observed that he was shivering and his skin covered with gooseflesh, so I asked him the questions I should have done on seeing him first. I learned that he shivered and trembled all the time; that his skin was rough (gooseflesh) all over his body; that he could hardly control his stools; great headache; that he was dull, drowsy, and very dizzy (the three classical D's which decided his prescription. The drug was ‘chosen’ on the spot.)
“Now, I'll bet every homeopathic M.D. knows off-hand the one remedy required to cure this case, and that a million or two of lay patrons of homeopathy will name the right drug, at first shot. That's the certainty of homeopathy.
“You may at once say that this man’s disease was undoubtedly self-limiting, the more so, that he had left the trenches, to which I reply, ‘If you can rapidly reproduce like cures, on people exhibiting just these symptoms, often enough, nay always, and under varying circumstances of time, place, and conditions, and ‘do it in order’ so to speak, will this not teach you anything?
“This Tommy received a ONE drop dose of Gelsemium on the back of his hand, which certainly could not have reached his stomach, licked same off, and was told to find me again in fifteen minutes. After two such doses, fifteen minutes apart, and at the time for the third dose, he came to me and whispered, ‘Honest I am cured; my guts are warm! I have stopped shivering; my diarrhea has stopped; please don’t send me back to the trenches. Have you any work to do in the hospital?’ As we were all overworked, I replied, ‘Find the Sister in charge of any of the wards, and ask her how you can help, but don't work for one Sister all the time. Scatter your help.’ He remained cured after two doses only, working everywhere, doing the heavy and dirty work, until he was evacuated with us, during the great bombardment.”(63)
Sadly, prejudice and ignorance prevented the great majority of homeopaths, who had been commissioned in the U.S. Armed Forces during WWI, from practicing their art and science, as Dr. E. A. Moulton of Chicago, who had been assigned to a hospital train, reported: “You as homeopaths no doubt are interested to know how I fared, being limited to the drugs listed in the Manual of the Medical Department. Was it practical or possible to practice pure homeopathy? It was not.”(64)
In 1919, Dr. William Boericke, professor of Materia Medica and Therapeutics at the University of California in San Francisco and editor of the Pacific Coast Journal of Homoeopathy, wrote, “The homeopaths of the United States feel that an injustice has been committed by the restrictions placed upon their methods of treatment in the army and cantonments during the war. We realized that when things had to be done quickly and on a vast scale, that a certain standardization and unity of action was essential in the army and navy medical department as in many other departments. But we feel that some workable arrangement might have been arrived at whereby the unquestioned strong points of our treatment might have been used to combat the casualty lists. American mothers were interested in having their sons returned to them irrespective of the mere convenience which results from other treatment.”(65)
Comparative Records of the Two Schools of Medicine in the Same Hospital
When physicians of the two schools of medicine were practicing side by side in the same hospital, the consistently brilliant results continued to be observed under homeopathy, as Dr. Frieda Weiss of Cleveland, Ohio, wrote: “It was my privilege to be acting surgeon under the U.S. Public Health Service in New Jersey during the flu epidemic. The 83 beds in the hospital were occupied continuously. The old school physician in charge and I compared notes. The patients who were admitted during the day were to be under his care; and the patients admitted during the night were to be under my care. I attended the deathbeds of one or two every day of those who were under the care of the old school physician. Not one of my patients died.”(66) It was reported that the difference in the death rates was so marked that Dr. Weiss was soon afterward put in full charge of the entire hospital.(67)
Dr. J. Arnold of Braidwood, Illinois, who practiced for three months in a base hospital, said of the more serious empyema or septic cases he treated: “My cases were taken routinely with cases taken by my associates who were allopaths. I had no deaths of empyemas among my patients. Those treated with the tincture of digitalis and Brown's mixture(68) by the old school developed empyema in 16 percent and a death rate of 10 percent. No microscopic examination was made in my cases to determine the type, but it is reasonable to suppose that I had the various types and same percentage as the allopaths.”(69)
Dr. C. H. Murphy of Lansing, Michigan, was a regimental surgeon at the base hospital of Camp Custer. In the autumn of 1918, the mortality was 6.3% and 28.4% for influenza and pneumonia, respectively.(70) “The immense superiority of homeopathic treatment of influenza has been incontestably proven. The influenza has been a great boost for homeopathy. Murphy of Lansing, Michigan treated 325 cases of influenza in a camp where the mortality had been 20 percent [for CIP], while the mortality under his homeopathic treatment was less than 3 percent.”(71)
Comparative Records of the Two Schools of Medicine in a Small, Circumscribed Community
Comparative records of the two schools of medicine within a small, circumscribed community would be expected to be similar to those of two wards using different methods of treatment in a community hospital that is serving a homogenous population. In December 1918, Dr. W. R. Andrews of Mannington, West Virginia, described his experience in his small community: “In the recent influenza epidemic my experience was unique, from a local standpoint, though common to homeopathy since the days of Samuel Hahnemann. Mannington has a local population of five thousand and a rural population of perhaps as many more, all dependent on town physicians since the war thinned out the rural doctors. Locally, the disease was epidemic throughout the month of October, though many cases have continued to appear all through November and, no doubt, will keep on doing so all winter.
“In the month of October I treated, in round numbers, two-hundred cases without a death. Some of our physicians estimated their number of cases considerably higher. Our local undertaker held forty flu funerals, though perhaps ten were shipped in from camps and elsewhere. So many pregnant women aborted and died of pneumonia in this section that it is commonly stated that no pregnant woman lived through the flu. My cases probably were average cases in every respect save one. …
“My two hundred cases included six pregnant women. Three of these recovered without delivery of any kind. One was normally delivered in twenty-four hours after first symptoms, with prompt subsidence of all flu symptoms under Bryonia. Another aborted, twin boys, at six and a half months, after two weeks of flu, with final recovery. The sixth aborted at five months, twenty-four hours after beginning of attack, with normal recovery from both conditions.
“I had four cases of pneumonia. Three were protracted, one of which became desperately low, being anointed for death by a priest, and life hung in the balance for several days and nights. None of these were under my control early.
“I believe aspirin to have been the cause of so much pneumonia and so many deaths hereabouts. Some of my colleagues used it almost indiscriminately, if not entirely so. In one country home where I was called and where there had been very serious heart symptoms in two or more cases, a physician had supplied the mother, in advance, with fifty-two tablets of aspirin to use in case she could not get a physician. There were cases and she used aspirin. Aspirin is very generally regarded by old school men as a ‘harmless heart depressant.’ There is no such a remedy in the presence of a toxemia such as epidemic influenza produces. I was a medical student in 1889 when this disease first made its epidemic appearance in America and I recall that it was generally conceded by eminent old school men then that antipyrin was the prolific cause of much pneumonia and death in that epidemic.
“December 16. Since the above was written, the disease has continued to be rather prevalent among the adjacent rural population, and I have treated seventy-five more cases without a death. My [allopathic] colleagues have had fewer deaths, proportionately, than in October, though some very sad ones.”(72)
It can therefore be appreciated why skilled homeopaths become such valuable assets in their community. On October 28, 1918, towards the end of the most severe wave of the NIP, Dr. John B. Garrison of New York City wrote to the city Health Commissioner Dr. Royal Copeland: “The number of lives which might be saved is beyond estimation if homeopathy could be generally used. In the little borough of Hopewell, New Jersey, there are three physicians, two allopaths and one homeopath. Each one has been equally busy making on an average of 80 calls per day covering an area of a five-mile radius. The allopaths have had many deaths while the homeopath has only had two, and both of them were foreigners who would not obey any restraint and would get out of bed and roam around at will. That has been the record of homeopaths all over so far as I am able to learn.”(73)
Montgomery Ward and Company Health Service
In the early part of the twentieth century, many large U.S. corporations offered welfare and unrestricted medical services to their employees and their families, similar to the ones offered by a community hospital. By 1915, some of these medical services were under homeopathic management, including the National Cash Register Company in Dayton, Ohio, which treated 25,024 employees and family members during that year. Some other notable large companies that were under homeopathic direction during that time were General Electric Company in Fort Wayne, Indiana, and three car companies in Detroit, namely, the Continental Motor Company, the Chalmers
Motor Company and the Studebaker Corporation.
The Medical and Welfare Department of Montgomery Ward Company of Chicago, one of the largest industrial plants in the world, was also under homeopathic medical management during the NIP, and its story during the NIP is pertinent to our current discussion because it illustrates the wide influence homeopathy can have on a nation.
In 1912, Montgomery Ward had asked Dr. Frank Wieland, a homeopathic physician who was a graduate of the Hering Medical College, to take charge of its Health Service. The company had great expectations: “In a crowded part of Chicago, over along the river, where traffic isheavy and constant, and no tree or blade of grass is ever seen, where always there is the smoke of trains, and their noise; the creaking of bridges, and steamboat whistles, and the infinite clanging of street cars, there stands one of the great industrial plants of the city. There was a time, when the doors closed behind the nine thousand employees each morning, nine thousand personalities were submerged. I don’t mean that the workers were ever sweated or overworked. They did their work, quite impersonally, and when they were through at night, the doors swung out, the workers left, and resumed their personalities. It happened that the president of this great organization was a dreamer of dreams, a seer of visions. He stood, one evening, as the workers passed out. A few of them he knew. The great mass he had never before seen, and scarcely one knew him. The firm had been wonderfully successful, and success in business comes only from the solidarity of the employees. He decided that he wished to do for these people some great thing that would be of benefit to them, but would have no taint of charity. It was thus that the Medical and Welfare Department of Montgomery Ward and Company had their inception. Into my hands, by the merest chance, the evolution of it all was entrusted. Of me only one thing was required; that the Medical Department must be the best in the world.”(74)
Dr. Wieland pointed out that Montgomery Ward had set the bar high for their medical service: “We have been able to accomplish some rather unusual results. I wish I could make you understand the joy with which I took up this work. Think of the inspiration of having a firm say to you, ‘Here are eight thousand men and women. They are giving us good service. We wish to show our appreciation by making them, and keeping them, the healthiest community in Chicago. Norestriction is put on you, except one. This must be the best Medical Department, as far as Big Business is concerned, in the country. Now go to it.”(75)
The organization of the services was described as follows: “There is no actual hospital connected with the establishment, but there are 13 beds in the rest room for women, and two for men for emergency use only.” The seriously ill and injured were sent by ambulance to the Hahnemann Hospital, where all major operations were done. “The amount of work done is enormous, thus, there were treated in the medical offices during 1915, 49,034 employees, which averages over 160 cases a day. There were a total of 1,095 accident cases, and the physicians of the staff made 1,767 calls. This does not include the work done by the matron or the nurses, house and visiting. The medical staff comprises the director and three assistants, all graduates in homeopathic medicine and four nurses. The specialists, including the radiologist, are also homeopaths. The saving to the firm in the matter of drugs alone has been enormous, to say nothing of the great lessening of days of illness that always obtains when homeopathic treatment is followed.”(76)
“The field we had to work in was quite virgin. We were missionaries all right. The first month had scarcely passed before the insurance company called up the management and said, ‘You’ve got to fire that Medical Director; he's a homeopath.’ I happened to be present when the conversation took place. The manager turned to me and asked, ‘Are you a homeopath?’ I confessed the truth. He put a troubled hand upon a more troubled brow, and exclaimed, ‘Oh, my God.’ Thanks to having had a Christian bringing up I know when ‘my God’ indicates despair and when thanksgiving. He didn't look grateful. A month later he called me to his office again. I was spiritually fortified for more criticism. His face was wreathed in smiles. During the first month our department had cost $300 less than the month before, and even then that expense had included the outfitting of the Medical Department. Few realize the economy of homeopathy. The first day of my incumbency a girl, getting $7 a week—we have no $7 a week girls now—brought in prescriptions for my O.K., aggregating $3.75. These were for one day only. Multiply that figure by 8,000, andthen by the number of working days in the year, and you have an idea of what the expense might be under other than homeopathic control. In any large concern, money talks. We save thousands of dollars a year; but best of all, the health standards have so risen that the Benefit Society, an organization existing among the employees themselves and quite independent of the firm, has remitted its dues for the last three months because there was so little demand upon its funds.”(77)
During the NIP, the care and attention offered by Dr. Wieland and his staff led to outstanding results. “In the great influenza epidemics oflast winter our city suffered severely indeed. Here was a wonderful opportunity to prove what homeopathy could do. Of our several hundred cases in the first epidemic not one was lost. In the second, equally deadly, one man died of pneumonia. He was alone, and no physician was called until he was quite moribund. … This epidemic came at the holiday season, when literally hundreds of thousands of customers passed through the store each day. And yet we won out.”(78) He later told the American Institute of Homeopathy, “We had only one death. The patients were not drugged to death. Gelsemium was practically the only remedy used. We used no aspirin and no vaccines.”(79)
It is legitimate to ask whether those results were obtained simply because allopathy was not used, or whether they were also due to a positive effect of homeopathic treatment, “Our doctors and nurses worked night and day. No expense was saved to save our employees’ lives. One doubting Thomas, a professor in a great university, said to me, ‘Your homeopathy had nothing to do with it; it was your care of your patients that gave you your phenomenal results.’ Homeopathy requires of us that we observe every hygienic regulation, and that we add to it that medication that covers the picture the disease presents. Other physicians had the advantage of hospitals and nurses; they also had a working knowledge of aspirin and digitalis, and strychnine; and yet their patients died by the hundreds and ours lived. To the everlasting credit of one large hospital in this city be it said that one of its heads came to us and said, ‘We have losttwo of our interns and three of our nurses and our patients are dying like flies. If you know of anything that will save our patients share that knowledge with us.’ And it is absolutely true that, finally, the heaviest buyers of homeopathic remedies were old-school physicians.
With death peering over the head of every bed these physicians were too fine to allow prejudice to stand between them and their patients’ welfare. During three epidemics of scarlet fever we have never lost a case. Possibly our Belladonna and Hepar sulphur did not do everything, but each did its share. We have never lost a diphtheria case. We have not had a typhoid case in four years. When we assumed charge of the work there was an average of nine patients in the hospital all the time. Several weeks frequently pass now with no hospital cases except operative ones. … Does it mean nothing that under homeopathic administration the useless drugging of our employees has ceased, and that from the catalogue, reaching a million homes, advertisements of patent medicine, of drugs of unknown qualities, of tonics and cures, of all the elixirs that delight the soul of the medicine-taker and never do any good, have been ruthlessly cut out? This cost the firm hundreds of thousands of dollars a year. Was there a moment’s hesitation on their part? Not one. It was only necessary to show the department heads that no good could ever come out of these patent drugs and that their responsibility to their customers was a sacred one.”(80)
The philosophy of homeopathy went beyond the welfare of the employees and their families and extended into the sale and catalogue departments of Montgomery Ward. “To an unscrupulous house, the temptation to advertise and sell patent medicines that claim to cure everything might be very great. One of the first procedures of our Medical Department was to point out to our managers, that it was undignified to offer to the country, or to any trade, drugs and patent medicines that were of doubtful worth. There was not even an hour of hesitation. The catalogue was sent down to our office for criticism. At this time no medicine of questionable value is advertised. All rubber goods that might be used for questionable purposes, all emmenagogues, all tonics and bracers, have been cut out of the catalogue. That seems to me indeed a very great moral victory. … In the doctor’s office, during 1915, over fifty thousand were cared for. Eighty-four patients were operated in the hospital, and there were 175 who were ill, in the hospital, from various non-surgical causes. Over 70,000 were cared for by the nurses and matrons [for a total of 120,000 patient visits in 1915]. Of course you understand that each repeater is regarded as an individual, in making up our records. Our visiting nurses made 1,800 calls. From all causes there were 13 deaths, largely from tuberculosis, among those who were already ill, when we assumed the plan of health insurance. In nearly four years there has been no death, as a postoperative result, and during three years, there was no death from any acute inflammatory illness, such as diphtheria, scarlet fever, or typhoid, among those patients under the care of our staff. … Eight thousand people, many of them too poor ever to have had capable attention, except as charity, are taught the hygiene of proper living, and are given the inspiration of courteous treatment, in clean environments.”(81)
The institutional adoption of homeopathy in this company and the care dispensed by Dr. Wieland and his staff had many invaluable short- and long-term benefits: “Can we say that a Medical Department has been of doubtful value, if sickness has been practically eliminated among several thousand people; if the useless drugging of employees has ceased, its place being taken by a better knowledge of how to keep the body well? Does it mean nothing to the world at large that our drug catalogue, originally of several hundred pages, has shrunken until it seems to have taken an obesity cure. It reaches over a million homes. It carries a message to many who are in isolated communities, to many whose faith in the mail order house is absolute. It was only necessary to point out to the department heads that the carrying and advertising of drugs of questionable value, of tonics and cures and elixirs that delight the soul of the confirmed medicine taker and never do any good, was of questionable business ethics, and undignified for a commercial house that depended for its existence upon the respect and goodwill of the community at large. The elimination of one certain patent medicine cost the house $100,000 a year. Did the firm hesitate one moment, when it came to know that the preparation was valueless as a therapeutic agent? It did not. Does it mean nothing to the local community that in our group of many hundreds we have never lost a case of typhoid, in many years, have had no such case? That we have never lost a case of scarlet fever or of diphtheria? That tuberculosis has been eliminated quite, although our regulations do not allow a sick employee to be dismissed from our employ.”
“Does it mean nothing to the city of Chicago that throughout two epidemics of influenza, when many hundreds were ill, that we lost only one case each year, thanks to early recognition of the disease, to required rest in bed, and efficient nursing by a paid crew of visiting nurses? Does it mean nothing to any commercial house, if day after day, the same employees sit at their desks, with practically no absences on account of sickness? I think it means much.”(82)
“If our enterprise had failed under homeopathic administration, surely the blame would have fallen on homeopathy. Why may not its success accrue to it? We do not advertise the fact that we are homeopaths. We let our results do that. But we have thrown into the garbage gallons of elixirs and tonics, and pounds and pounds of tablets and pills of unknown value.”(83)
“Tell me—could this immense department have grown to what it is if homeopathy had not been successful? Could we have secured the thousands of dollars we have spent if our venture had been a failure? From all over the United States, and from foreign countries have come presidents of corporations, and men and women interested in the ever threatening problems of labor, to study our system and our results. A business agent of one union came to our plant and spoke long and weepingly of the woes of the down-trodden working man. He reported later, ‘Phew, you can’t start trouble there; they're all satisfied.’ Homeopathy puts upon us particular obligations. It isn't enough that we practice it and prescribe it. We've got to prove that we have the goods on all other systems of medicine; and we've got to go out and fight to prove it, if the fighting is necessary.”(84)
Dr. John Renner, while recounting some outstanding results obtained by homeopathy, mentioned the ones obtained by Dr. Wieland and his staff: “One striking example: Montgomery Ward & Co., during the influenza epidemic, and the two years following, lost but two patients through influenza, the plant having been under homeopathic care. This report created such a stir in the industrial circles that numerous firms sent investigators.”(85) “During the same epidemic [of 1918], Marshall Field, the large department store, lost several hundred employees, and Sears Roebuck, too, about the same size as Montgomery Ward, lost several hundred. … This information was publicized in the newspapers and industrial journals of the time and reached many different countries. In fact one organization in Holland sent over a commission to find out from Montgomery Ward what they had done for influenza treatment to come up with such statistics. It was a phenomenal record. The United Cigar Company, I recall, placed homeopathic physicians in charge of all the medical stations they had for employees in Chicago and they had many at the time.”(86)
Dr. Benjamin Woodbury, professor of Materia Medica at Boston University, said in regard to the results obtained by homeopathy at Montgomery Ward, “It might briefly be mentioned that by this method thousands of dollars are saved by the dispensing of homeopathic medicines, and it is needless to emphasize the economy of working energy conserved, and the lessened disability of workers.” After mentioning statistics from other institutions, he commented, “These reports were carefully compiled and represent a very fair estimate of the work that is being accomplished in the various institutions enumerated. The question has been raised among some statisticians that the majority of patients who are very ill do not apply to homeopathic physicians for relief; this argument, however, does not avail to any extent at the present time, as nearly every hospital mentioned in these reports supports one or more ambulances, which are constantly on call within their respective districts, and answer all emergencies that come to them.”
Comparative Mortality from CIP in Major U.S. Cities
It is interesting to note that, among the large U.S. cities on the East Coast, New York had the lowest mortality during the NIP. Its health commissioner had imposed particular measures, such as “distancing healthy New Yorkers from those infected, increasing disease surveillance capacities, and mounting a large-scale health education campaign while regulating public spaces such as schools and theaters.”(88) However, the commissioner later pointed to the superior results obtained by homeopathy that he found by examining the records.
On April 29, 1918, just before the first wave of the NIP, the homeopathic physician Royal Copeland was appointed Health Commissioner of New York City. When he was suddenly called by the New York City mayor to assume this office, he wrote, “When His Honor asked me to take this office, I said to him at once, ‘I cannot accept it. I cannot afford to take it. I don’t want it, because I am not a sanitarian, I know nothing about public health, I am not interested in it, and it does not appeal to me in the least.’ He put aside all of these objections, and finally I said to him, ‘As a well-wisher of yours, I could not consent to your appointing me, because I am a homeopathic physician.’ He said, ‘That argument does not go with me, because I have had a homeopathic doctor in my family for thirty years, and I notice that he is just as scientific and just as able as any other man in the community.”(89)
Dr. Copeland further commented, “I did not seek and do not want the office; its acceptance was urged upon me as a patriotic duty. In the spirit of service and with the help of my friends, I will ‘carry on,’ ‘doing my bit,’ by trying to keep the City free from contagious, infectious and pestilential disease.(90)
Dr. Copeland boasted that New York City’s death rate during the NIP was lower than that of other large cities. After the pandemic, it was reported that New York City had had an excess death rate of 452 per 100,000 during the NIP, compared to 559 for Baltimore, 608 for Washington, D.C., 710 for Boston and 748 for Philadelphia.(91) In fact, Dr. Copeland said, “[New York City] fared better than did the rest of the world.”(92)
In December 1921, Dr. Copeland testified at a hearing before the Regents of the University of Michigan to protest against the amalgamation of the homeopathic and regular medical departments of the university: “I often say I have the largest practice of any doctor in the world, 6,000,000 people in the City of New York, and, during the daytime, 2,000,000 more. We had in 1918 an epidemic of influenza. I sat in my office, Mr. President, for six weeks. I had only one meal in my house during that time. I watched the death rate go up and up. I went to the Calvary Cemetery and saw a new grave in every lot and 400 bodies in a building at the rear of the cemetery waiting to be buried. I went out and got a steam shovel and men off the street. We dug trenches in which to bury the dead.
“Two million citizens had the disease and 35,000 died. I had some curiosity about the results and when the thing was over immediately put forward a private inquiry to see how the homeopaths got along. The contrast between the two schools of medicine was startling. There can be no doubt that the superiority of homeopathy in a purely medical condition is just as great as it was fifty years ago. Gentlemen, if you had no personal interest whatever in this matter, the knowledge you could gain of what homeopathy did during the influenza epidemic would make clear to you that no university was doing its duty unless it perpetuated the teaching of homeopathy. I am here to say that there was a difference as between night and day, and if you had nothing else except this evidence you would say that homeopathy deserves to live and be perpetuated on this campus. It is the one therapeutic school. It continues to have faith in medicines and is filling a place that no other school of practice cares to enter. The properly trained homeopathic doctor was never more needed than at present. We have gone through a war to preserve the rights of small nations, the right of self-determination and against forcible annexation. We have in the State of Michigan a very decent minority of the people who employ homeopathic doctors. It was said that almost fifty percent of the state taxes are paid by patrons of homeopathy. Don't you think they are entitled to some consideration?”(93)
Iatrogenesis Associated with Allopathic Drugs
One of the great advantages that homeopathy has always had over allopathy is the absence of iatrogenesis associated with its practice, since homeopathy adheres faithfully to one of the most fundamental principles of medicine, namely Primum non nocere, “physician, above all, do no harm.” How is then, that allopathy has received the full support of governments and health authorities, and has been permitted to monopolize the health care system despite its confessed inefficacy and its pervasive and massive iatrogenesis? That remains a mystery that calls into question the dynamics and values of our societies on such fundamental subjects as health, well-being and life itself. It is as if the myth of the magnificence of medicine is too comforting to be questioned.Shortly after the most deadly wave of the NIP in October 1918, Dr. John Dill Robertson, the Health Commissioner of Chicago, had the prescriptions in a thousand drug stores of Chicago inspected and tabulated. The accumulated statistics showed: “Between October 1st and November 1st, 1918, there were 441,641 prescriptions made for pneumonia and influenza, and of these 104,010 were found to contain narcotics:”(94) 50,081 of the prescriptions contained codeine; 17,812, heroin; 17,504, opium; 10,003, morphine; 3,866, chloral; and 1,383, cocaine.(95)
An editorial in the American Physician entitled “Use of Opium in Influenza and Tuberculosis” stated: “Such use of narcotics, it was contended by able sanitarians is dangerous, some of them going so far as to say that to give opium in influenza was to invite pneumonia. Clinicians do not go that far, but very able clinical authorities are very conservative in recommending opiates in this disease. That all sanitarians did not view the matter in the same light was testified to by the fact that the Government relaxed the narcotic regulations during the influenza epidemic of 1918-19.”(96)
It is not surprising that Arthur Brisbane, one of the most read and sought after American newspaper editors of the twentieth century, wrote in one of his editorials in early 1919, after the major wave of the NIP had passed, “In New York City six doctors were arrested in one day for supplying habit-forming drugs to thousands of miserable victims. Not a pleasant outlook.” Subsequently, Dr. Royal Copeland, Health Commissioner of New York, confirmed that there were two hundred thousand drug victims in New York City, and that he was preparing for a great increase in the number” immediately after the NIP.(97)
At the same time, Dr. Eldridge Price of Baltimore examined the allopathic approach to the influenza patient a little more closely: “At thisjuncture it is quite in point to call attention to the means used by orthodox medicine in the endeavor to cure influenza patients. The treatment suggested by Osler in 1894 has been continued with little modification up to the present day. This treatment consists in the use of purgatives, somnifacients, diaphoretics, antipyretics, and finally stimulants. These are theagencies advised ex cathedra and used secundum artem, and the agents are citrate of magnesia, castor oil, and compound cathartic pills; Dover's powder—which combines the effect of an anodyne and also a diaphoretic—acetanilide, aspirin, quinine and codeine, in large amounts; and finally, should there be suggestion of cardiac weakness following this treatment stimulants ‘should be given freely,’ and in the convalescent stage ‘strychnine in full doses.’ So far as may be judged, this is the ne plus ultra in treating epidemic influenza, and fairly demonstrates the degree of therapeutic efficiency of orthodox medicine in this field, from whichthe 30 percent mortality record was obtained in the epidemic of 1918.”(98)
Every medical generation is easily criticized by the succeeding ones, but few medical authorities have been able to see through the confusion and dangers of the therapeutics and use of the crude drugs that were used in their own time. It is as if the delusion of caring and of being cared for with new “promising” drugs blinds the mind to the dangers inherent in medical intervention. However some very prominent physicians have been able to see through this confusion, but their observations were not very influential.
Oscar Comettant, a well-known nineteenth-century writer, social critic and investigative journalist, described in the Moniteur scientifique, a journal of pure and applied sciences, how skeptical some of the “princes” of medicine have historically been of their own drugs: “Once there was a convalescent patient who asked her physician, ‘Tell me doctor, how is it that you doctors never get sick? What is your secret?’ In a philosophical manner, the doctor answered, ‘We doctors actually dine comfortably on the profit of our prescriptions but without ever taking any of the drugs we prescribe.’
“We should not be surprised by that answer, for the most famous physicians of all eras and traditions have been the greatest skeptics of medicine. Hippocrates, the father of medicine, said sadly, ‘Practitioners differ so much among themselves, that the things which one of them administers, thinking it the best that can be given, another holds to be bad; and, in this respect, one might say that the art of medicine resembles augury.’ Plato considered physicians to be equally harmful to individuals and societies. Broussais squarely asks on page 826 of his treatise Examen des doctrines médicales, ‘Is medicine more harmful or beneficial to a society?’
“Sydenham, the English Hippocrates, said, ‘What is known as the art of medicine is much more the art of conversation and chattering than a healing art.’
“Chomel in his Pathologie générale said about therapeutics, ‘Darkness still enwraps the most important branch of medicine.’
“Magendie said before the College of France on February 16, 1846, ‘If I were to say all I thought, I should add that it is especially in those hospital services in which the most active medication is employed that the mortality is the greatest.’
“Finally, Bichat wrote in his masterpiece of science, observations and logics entitled Anatomie générale: ‘Materia medica is an incoherent assemblage of incoherent opinions. It is perhaps, of all the physiological sciences, the one that best shows the capriciousness of the human mind. What do I mean? It is not a science for a methodical mind, it is a shapeless assemblage of inaccurate ideas, of often puerile observations, of deceptive remedies, and of formulae as fantastically conceived as they are tediously arranged.’
“Despite all those above opinions from the princes of medicine, people of all times have continued to rush to their physician when indisposed. Oh! How sweet is the delusion that is being pursued!”(99)
Is it possible that the dangers of “regular” or “scientific” medicine were the main culprit in the high mortality encountered around the world during the NIP? Could the difference in outcomes between allopathy and homeopathy be explained simply by the iatrogenesis associated with allopathic treatment rather than by the positive effects of homeopathic treatment?
The eminent surgeon Dr. William J. Mayo thought so when he suggested that homeopaths obtained better results because they didn’t use “nasty” medicines: “We must remember the fact that most diseases are self limited [he was surely not referring to pneumonia with its average mortality rate of 25%] and that nature tends to cure rather than to destroy. High dilutions, in two glasses, a teaspoonful each hour taken alternately, pleasantly suggest betterment. The opposition of the regular medical profession lengthened the days of homeopathy but shortened the days of so-called ‘allopathy,’ whose nasty medicines induced the patient in self-defense to get well. Today homeopathy is a part of regular medicine, its follies have been dropped and the good added, and the sons of homeopathic practitioners, like the sons of the ‘allopathic’ and eclectic practitioners are studying regular medicine which is broad enough to contain all honest searchers for the truth in medicine.”(100)
That opinion, which, incidentally, is unsubstantiated, is worth examining, because many skeptics still think the same way: “In homeopathy, mental suggestion appeared in its simplest form and was often effective in the treatment of functional disorders.” It is peculiar that a man of science like Mayo could reach a conclusion so contrary to all experience and huge amounts of data. It is not known to what extent Mayo examined the evidence for the efficacy of homeopathy during the NIP or for any one of the other non-“functional disorders” having a high mortality rates, such as yellow fever, diphtheria, smallpox, cholera, typhoid fever, tetanus, poliomyelitis, tuberculosis, or simply pneumonia. However, Mayo conceded that the era of “nasty medicines” was self-defeating. Should the authorities and medical leaders like him have then apologized to the families of the extra deaths associated with the practice of “nasty medicines”? “We are so sorry for your family that we weren’t wise enough to direct you to physicians who, at the very least, practice a much safer medicine, and with whom you would have had without doubt much higher odds of surviving CIP, especially if you were pregnant”?(101)
One of the editors of the Journal of the American Institute of Homeopathy added the following comments about Mayo’s address: “The homeopathic library is at every investigator’s command—how much better would it be that it be consulted than that such error—
it can hardly be intentional misrepresentation—should be voiced by so exalted an authority!”
Dr. L. A. Royal of West Liberty, Iowa, quoted the following extract from an editorial about the illogical use of drugs in allopathy during the NIP: “In the September Therapeutic Digest published by the Wm. S. Merrell Company is an article by its editor on The Treatment of Influenza, in which he wrote, ‘In the epidemic which occurred twenty years ago, phenacetin, antipyrine and quinine were the principal reliance of the medical profession. Since that time aspirin has won its way to the front as a popular medicament and in the routine treatment adopted by many physicians aspirin plays the leading role notwithstanding the fact that this drug is a heart depressant. The routine treatment laid down in the army hospitals embraced the use of coal tar derivatives and in case of pneumonia, large doses of digitalis were ordered at frequent intervals. The rationale of this method of treatment is difficult to understand. We have here a disease, which throws a heavy strain on the heart and are ordered to give coal tar derivatives which are heart depressants. When pneumonia sets in we are instructed to give huge doses of digitalis at frequent intervals, which would cause the heart to drive more blood into the lungs already overcrowded. The action of digitalis in this case would undoubtedly add to the congestion and increase the area of the lungs involved. This routine treatment has undoubtedly been responsible for a considerable portion of the excessive mortality.’ ”(102)
It was very obvious to homeopathic clinicians during the NIP that patients who had previously been treated with allopathic medications were often in worse condition than other patients and were slower to respond to homeopathy, as Dr. James W. Ward, the former Health Commissioner of San Francisco and Dean of the Hahnemann Medical College of the Pacific, observed: “My case book covers a total of 182
reported patients. They were from every walk of life and presented the average line of a physician’s practice without selection. In this list are to be found 24 cases of pneumonia, 14 of which were of potential type. The remainders were true pneumonias. The recoveries were 100 percent in all the influenza cases. … It was noteworthy that where no medication had been employed before the homeopathic treatment was begun, the response to care was prompt. The more aspirin, codeine, Dobell’s solution and other extra-homeopathic medicines were used, the slower was the recovery.”(103)
Iatrogenesis with Aspirin
Of all the crude drugs used during the NIP, aspirin was blamed most often for hastening and increasing morbidity and mortality. Dr. W. H. Hinsdale, dean of the Homeopathic Department of the University of Michigan Medical School, said of the cult of aspirin, “If we wished to make an apology for the last epidemic for its mortality, we would call attention to one complication that was artificially enforced upon it and for which it should not be blamed. The general use of aspirin increased its complications and hence its mischief. Aspirin poisoning is a handicap that the cult of modern medicine feels obliged to enforce upon the Vis medicatrix naturae in case of nearly all diseases, nowadays. Influenza’s natural statistical record was tampered with to her embarrassment in the making. Why, may I ask, is not preventive medicine made to include the prevention of dangerous medicines being used to the detriment of mankind as well as to the stamping out of the breeding places of diseases and the restraint of distributors?”(104)
Dr. Benjamin Woodbury of Boston University wrote about some of the then better known mischief caused by aspirin: “Numerous cases were encountered during the influenza epidemic of severe stomach disturbances with hematemesis, melena sometimes being the first indication of the gastric hemorrhage. Some of the cases were very severe with syncope, the symptoms returning in one case after but three or four tablets had been taken.”(105)
Dr. W. A. Dewey of the University of Michigan went further in indicting aspirin: “Much of the mortality in the recent epidemic of influenza was due to its indiscriminate use.” He said that in overdose it causes “violent palpitation of the heart, deficient respiration, and weakness approaching unconsciousness, and disturbances in the sensory centers, vision and hearing—in fact, the sensitive nerve tissue is paralyzed.”(106)
He went on to quote contemporary authors about the use of aspirin and other antipyretics during the NIP: “Dr. Simon Baruch [professor at the Columbia College of Physicians and Surgeons in New York City] says in the Therapeutic Gazette of June 1919, ‘It was a painful disillusion to learn that these powerful agents (coal tar derivatives) only enabled the patient to die with a lower temperature while the mortality continued and even increased under their excessive use. … They especially handicapped the heart just as the influenza poison does.’ Dr. Albert Doerschuk [a noted Kansas City pharmacologist and historian] writes as follows, ‘These drugs in remedies, preventives andcures for the grippe were swallowed by tons last winter by hysterical people who went beyond all advice in self-medication. Women numb in every limb, with barely enough intelligence to find the way home, from the effects of the preventive medicine, were suffering from the flu. Men with intense pains on top of their heads and eyes bulging out from the salicylates (aspirin) had the flu. Many persons were in bed from the prostration of the drugs taken instead of from the flu.’ We can corroborate the above remarks from personal observation.
“Dr. C. T. Hood in the Clinique of January 1919 says that the public is told that ‘if ten grains of aspirin two or three times in 24 hours would be of service, ten grains six to eight times a day was better. People have been and are buying aspirin in 100 and 500 packages and taking it by the dozen, by so doing they are driving the tack in their own door post upon which to hang the crepe.’
“We have seen that it is a depressing drug, that it poisons the heart and circulation, that it also poisons the blood itself, and that it stupefies the mind. Add these effects to the general depressing effect of the influenza toxemia and death is sure to follow.
“Another physician practicing in a small country town in central Illinois told the writer that out of a large number of cases treated from the start without aspirin there was no mortality, while in those who had taken aspirin themselves or had it given to them by friends or physicians the mortality was very great.”(107)
A case with aspirin overdose presenting with massive intestinal hemorrhage in a “powerfully built” American soldier was actually reported in the Lancet as a novelty in 1919: “In view of the promiscuous way in which aspirin, often self-prescribed, is taken by the general public the following case is of considerable interest to the profession, ‘Patient, sergeant, U.S.A., aged 24, was admitted to the Thetford Military Hospital, on October 25th, 1918, with the history of having been taken ill two days previously with influenza. He was a powerfully built man and gave no history of previous gastric or intestinal trouble. He stated that he had been taking aspirin capsules of his own in addition to 18 5 grains tablets given to him by the medical orderly. Instead of keeping to the prescribed dose, he had taken them all, together with a number of capsules in the course of six hours. He did this in order to get fit quickly, as he was under instructions for France.
“On admission patient was markedly anemic, temperature 101.4°F, pulse 120. During the day he vomited undigested milk, with no trace of blood. On October 26th, the anemia was more profound. Pulse 150, weak and irregular. An enema was administered with little result. The vomiting continued at intervals. On the following morning, at 5 a.m., a large quantity of blood was passed by the bowel and he rapidly became unconscious. No thought of an exploratory laparotomy could be entertained. He died a few hours later.
“Post Mortem: There was no peritonitis, and no free fluid in the abdominal cavity. The last five feet of the ileum was acutely congested, and the cecum and colon were loaded with blood clots. The line of demarcation between healthy and congested bowel was very definite. On opening the small intestine it was found to be uniformly inflamed. The mucous coat had apparently disappeared, leaving the submucous coat and blood vessels exposed and eroded. Bleeding from this large area had evidently been the cause of death. The other organs were in a healthy condition.
“Remarks: Aceto-salicylic acid is known to pass unchanged through the stomach and upper portion of the small intestine, and is then converted into free salicylic acid. It is probable that this man took nearly 200 grains of the drug into an empty alimentary canal, and that the salicylic acid formed was responsible for the removal of the whole lining membrane of the bowel in the area described. The mucous membrane of the cecum and colon appeared to be unaffected. An inquest was held and a verdict of ‘Death by misadventure through an overdose of aspirin’ was returned. It would be interesting to know if this possible action of large quantities of salicylic acid on the bowel is recognized, or if this case may have been due to some impurity in the aspirin.”(108)
Dr. W. B. Hinsdale, dean of the Homeopathic Department of the University of Michigan Medical School, pointed out that homeopaths had some major advantages over the allopaths at the onset of the pandemic: “Homeopaths started in the campaign with two advantages, and it could have been foretold they would come out with better statistical showing. First, they did not have the aspirin and other coal tar complications in their cases to increase the life risk, and second, they had a few remedies upon which they could place reasonable reliance and were not obliged altogether to experiment their way from day to day and from patient to patient. … To non-homeopathic physicians we say, for God's sake, throw aspirin where Macbeth threw the laxative.”(109)
During a meeting of the American Institute of Homeopathy held in June 1919, members described cases where patients had taken aspirin before coming under their care. They then realized that they had all had more or less the same experience throughout the country. Dr. Dudley A. Williams of Providence said, “I did not lose a single case of influenza; my death rate in the pneumonias was 2.1%. The salycilates were almost the sole standbys of the old school and it was a common thing to hear them speaking of losing 60% of their pneumonias.”(110)
Dr. C. P. Bryant of Seattle said, “I treated over 100 cases of influenza and pneumonia, lost two cases, one who had taken aspirin for a week when pneumonia developed before I was called; the other a very malignant case with very high temperature from the onset.”(111)
Dr. Cora Smith King of Washington, D.C., said, “Three hundred and fifty cases and lost one, a neglected pneumonia that came to me after she had taken one hundred grains of aspirin in twenty-four hours.”(112)
Dr. C. B. Stouffer of Ann Arbor said, “We treated over 300 cases of influenza among the members of the Student Army Training Corps with no deaths. … Only in those cases having had aspirin was convalescence delayed and pneumonia produced.”(113)
Dr. A. F. Stevens of St. Louis said, “During the flu period almost every victim got his aspirin. Almost everybody believed in it because it relieved his distress and ‘couldn't do him any harm.’ The result was that thousands died who might have lived had they been willing to bear discomfort for a little while. They died like flies around a plate of poison although ‘science’ did all that could be done to ‘save’ them.”(114)
Dr. G. H. Wright of Forest Glen, Maryland, said, “I attended over one hundred cases without any fatalities. I never deviated from the homeopathic remedy. I never gave aspirin. One case that was loaded with aspirin before I saw him, referred to me from an old school physician, died. This epidemic should encourage us to renewed faith in homeopathy.”(115)
Dr. Edward Cobb, professor at the Hahnemann Medical College of Chicago, wrote, “Of seven pregnant women, five were desperately sick. One died; she had taken aspirin freely before calling a doctor.”(116)
In the address quoted earlier, Mayo admitted that one of the great weaknesses of allopathic medicine, namely that it is based on empiricism: “[Sir James] MacKenzie points out that medical treatment has always been in advance of knowledge, that treatment has been empiric, even experimental, and that knowledge has come later from the results of these unorganized attempts to palliate or cure the diseases of man. … We can hope that eventually knowledge will precede treatment and that treatment will be based on knowledge, and not, as heretofore, largely on empiricism.”(117)
Perhaps there is no more poignant illustration of this weakness of empirically-based practice of allopathy, namely that knowledge comes after the results, is found in the use of aspirin during the NIP. Since the early 1980’s, the use of aspirin in febrile children under 12 has been banned in many countries, and in 2002 the U.K. Committee on Safety of Medicines went even further when it warn that aspirin should also be avoided by anyone younger than 16 with a fever.(118) In 2005 the United States Department of Health and Human Services recommended, “Children aged less than 18 years with suspected or continued pandemic influenza should not be treated with aspirin or other salicylate-containing products.”(119)
Homeopathy, on the other hand, is based on the inductive method, in which all observations and experiments lead to a general principle, which is then applied with certainty to every sick person. Knowledge precedes results. Homeopathy has nothing to do with the “hit and miss” of empirical medicine. It boils down to the application of a law, which requires the matching of two sets of facts, the symptoms of the medicine with those of the patient. Aside from certainty, it makes the practice of medicine gentle and safe, since only the smallest dose of medicine is required to stimulate a general healing response. Even better, homeopathy, instead of being palliative, is curative because it stimulates the living organism to regulate itself.
The use of high doses of aspirin in influenza patients during the NIP is now known to cause, in some cases, toxicity and a dangerous build up of fluid in the lungs, which may have contributed to the severity of symptoms and a greater incidence of pneumonia, secondary bacterial infections and mortality. “Additionally, autopsy reports from 1918 are consistent with what we know today about the dangers of aspirin toxicity, as well as the expected viral causes of death.”(120)
Recently Dr. Karen Starko pointed out, “Because physicians of the day [at the time of the NIP] were unaware that the regimens (8.0–31.2 g per day) [of aspirin] produce levels associated with hyperventilation and pulmonary edema in 33% and 3% of recipients, respectively. Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance.
“In 1918, the U.S. Surgeon General, the U.S. Navy, and the Journal of the American Medical Association recommended the use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.”(121)
Dr. H. L. Maps of Passiac, New Jersey, said that death from an unusual type of pulmonary edema was in fact a common phenomenon during the NIP: “The doctor on my right asked a question about patients dying of edema of the lungs. The autopsies in cases of influenza were very interesting. Ordinary cases of the flu secondarily developed bronchopneumonia or rather what resembled bronchopneumonia, and later, edema of the lungs. There was, primarily, bronchitis, followed by a pathological condition which simulated bronchopneumonia. The spots would undergo necrosis and grow larger until they involved the whole lung. In one case which I examined, the blood would not clot. The condition was simply an extravasation of the blood from the necrotic area and a filling up of the bronchial tubes with a modified blood. The condition is hard to describe. Every man ought to see an autopsy on influenza. It is not like anything else we know. The condition is a hemorrhagic inflammation of the lung with secondary necrosis and almost continuous oozing of a blood which does not coagulate. This causes the bubbling which has in many instances been called edema of the lungs.”(122)
Other physicians who performed autopsies also described influenza pathology as being unique and characterized by “the intense congestion and hemorrhage” of the lungs, which could only have been worse with the use of aspirin. It was reported that Dr. William Henry Welch, the famous pathologist and bacteriologist from Johns Hopkins University, turned away during one of these autopsies surprised at seeing the blue, swollen lungs with wet, foamy, and shapeless surfaces, and said, “This must be some new kind of infection or plague.”(123)
It was also reported that one of the most horrific features of the NIP was bleeding, not just from the nose and mouth but also from the ears and eyes.(124) Dr. Frank Newton of Somerville, Massachusetts, summarized well the cumulative experience of homeopaths of the dangers associated with the use of aspirin during the NIP: “There is one drug which directly or indirectly was the cause of the loss of more lives than was influenza itself. You all know that drug. It claims to be salicylic acid. Aspirin’s history has been printed. Today you don't know what the sedative action of salicylicacid is. It did harm in two ways. Its indirect action came through the fact that aspirin was taken until prostration resulted and the patient developed pneumonia.”(125)
Iatrogenesis from Digitalis, Narcotics and Inoculations
Aside from aspirin, allopaths were also using large doses of other drugs that have been suspected of being harmful to people with influenza, such as digitalis and narcotics. Multiple inoculations given in a short time may also have played a role in the higher morbidity and mortality of CIP in the armed forces during the NIP. inoculations.
In fact, Dr. H. C. Whitaker of Dublin, Ohio, wrote, “Along early in the year 1919 the Chief Surgeon of the American Expeditionary Forces issued an order to the effect that all cases of pneumonia should have enough digitalis to render the heart susceptible to it so a quick action could be obtained if needed, and enough morphine to control the cough.”(126)
In 1918, Dr. Carleton A. Harkness of Chicago, who had been assigned to the base hospital of Camp Lee, reported that the soldiers were receiving typhoid, paratyphoid, colon bacillus and small-pox vaccines all at once.(127)
Dr. Daniel Coleman, visiting physician to the Metropolitan and Community Hospitals in New York City, reported: “The only cases that the author lost during the terrible epidemic of 1918 were two who had received vaccine inoculations and a third, a pregnant woman, to whom he was the nineteenth consecutive consultant. Even then she might have had a chance under homeopathic treatment, if a relative, a young old school doctor who lived in the house, had not frequently administered large doses of all kinds of drugs.”(128)
Dr. George Royal, professor in the University of Iowa Homeopathic Medical Department, related a conversation he had with a ranking officer of an army base hospital on the subject of pneumonia in the cantonments of the country during the 1918-1919 winter: “The officer was discussing the frightful mortality rate, the violence of the onset, the rapid formation and vicious character of the serum which poured into the thorax during the first 48 to 72 hours of the disease, the changing of this serum to pus, the profound prostration not only of the nervous system but of every vital force of the body. This officer, who was formerly a neighbor of mine in Des Moines, closed his remarks as follows, ‘Royal, you don't have any such pneumonia in private practice; it is simply fearful. And what is true out in my camp is true in every camp in the country.’ I put to him the suggestive question, ‘Do you believe the inoculation of the soldiers had anything to do with the difference in the death rate between the soldiers and the civilians who had not been inoculated?’ His reply was, ‘I wish the blood of the soldiers could be tested after the seven vaccinations, so as to determine what changes had been wrought in it.’ ”(129)
However, it cannot be assumed that fulminant cases were always the result of inoculations, as Dr. R. Hayes had observed with reference to the population of Waterbury, Connecticut: “Dr. George Royal reports the officer as saying, ‘You don’t have any such pneumonia in private practice,’ referring to that type which presents rapid degeneration of blood elements and fulminating edema soon after the onset or appearing suddenly after a few days of ordinary progress. I would say that Waterbury was one of the hardest-hit cities in the country and there were many cases of pneumonia here of that malignant type during October with occasional cases since. These occurred in my practice in people who had not had influenza inoculation or other recent vaccinations.”(130)
In his presidential address before the American Medical Association, which was entitled “Medicine, a Determining Factor in War,” Dr. Alexander Lambert referred to the unexplained and extraordinarily high incidence of meningitis in the army as compared to the civilian population: “The occurrence in the camps of meningitis, another disease of the respiratory group, as far as its portal of infection is concerned, has been forty-five times as frequent in the army as its occurrence in the civil life among the same age group.”(131)
Dr. William Henry Welch, one of the four founders of Johns Hopkins Hospital, said during a discussion before the Association of American Physicians in May 1918, five months before the fatal wave of the pandemic hit the world, “What reasons have played a part in enhancing the virulence of the streptococcus? This is the most important problem today in dealing with infections in soldiers.”(132)
In January 1941, as the U.S. was preparing to enter WWII, Dr. Arthur H. Grimmer of Chicago, asked “Will History Repeat?” in the editorial pages of the Homoeopathic Recorder, where he summarized the cumulative experience of homeopaths with the dangers of using crude drugs and inoculations in American soldiers during WWI: “In the world war of 1917, the war that was fought, to make ‘the world safe for democracy,’ the defenders of that glorious crusade were the victims of an unjust and bigoted medical system. They were permitted to choose and practice their own political and religious freedom but were ruthlessly denied the right of medical choice. When some of those heroic defenders in the service of our nation objected to having their blood stream poisoned by injections of the products of disease, serums and vaccines, they were sentenced to twenty years of imprisonment.
“This despotic procedure, engineered by a political medical clique, stands out the blackest blot on the pages of United States history. The Surgeon General of the Army (Wilson’s administration) reported that of the two million selects who did not go across or experience any of the rigors of war, they were well fed and clothed, had regular hours of sleep and exercise, all designed to bring them up to a high state of health and physical fitness; yet out of those two million men, six hundred thousand of them went back into civil life invalids. The question is, what caused so many of these young men tested and selected by the medical brains of the army for their fitness, to become sick? The food, clothes and general routine were all acknowledged to be excellent, then what made them sick?
“The answer is obvious: the pollution of the blood stream of those heroic young men with laboratory filth called serums and vaccines.
“It is safe to say that a large majority of those soldier boys opposed this unsanitary procedure but were compelled to submit to it or go to prison for a period of time not inflicted on the worst of the murderers and felons of the current time.
“What gratitude a great nation showed its brave defenders, simply because they had more discernment and courage than the average select! And still more shame on the men in high places, who raised no voice or made no effort in their behalf, but remained mute and weak, before a tribunal whose acts of infamy have left an indelible deformity on our country’s history!
“With resistance broken and health undermined by the products of disease forced directly into the blood, is it any wonder that the epidemics of flu and pneumonia took a toll far greater than the casualties of battle?
“The appalling death rate of the boys in the training camps still remains an unforgettable calamity in millions of American homes. And saddest of all that most of those victims would have been saved under homeopathic treatment.
“If in place of the routine use and abuse of aspirin and cathartics, those gallant young men could have had a few of our simple homeopathic remedies like Aconite, Arsenicum album, Bryonia, Rhus tox, Gelsemium, Ferrum phosphoricum and a few others that any tyro in homeopathy can apply, many a sad mother’s tears would not have gushed forth in rivers of woe through the long heartsick lonely years to say nothing of the countless thousands of physical wrecks that need not have been.
“And what have we to offer in the place of prophylactics against small-pox, typhoid and other intestinal epidemic diseases, as well as flu, pneumonia, diphtheria and all other acute epidemic diseases? Our epidemic remedies give us the most certain and effective protection with absolutely no consequential sequelae as a result of their use.
“And lastly the economical aspect of the manufacture and application of homeopathic procedure is from ten to twenty-five percent cheaper. Perhaps it is this commercial angle that has prevented the universal acceptance and use of homeopathy. Millions of money invested by manufacturing chemists and pharmaceutical houses taking a toll annually of billions from the American public will not be surrendered without a bitter fight. Too many of our doctors are dominated by the commercial aspect rather than the humanitarian side of medicine.
“Only the born doctor places the passion of cure above the glitter of wealth.”(133)
How did the multiple inoculations received within a very short time by the soldiers affect their immunity to the influenza or other viruses, and any subsequent secondary bacterial infection? That will remain unknown since no research was ever conducted on this subject.
From the perspective of these cumulative observations by homeopaths about the iatrogenesis that occurred with allopathy during the NIP, Dr. Clifford Mitchell wrote in a May 1919 editorial in the Clinique, entitled “What Scientific (?) Medicine Has Cost Uncle Sam,” “According to Dr. W. Henry Wilson, about 400,000 persons died of influenza in the United States last autumn. Now if the contention of Dr. John Dill Robertson, [the Health Commissioner of Chicago], is correct that one-half of the deaths were due to drugging as with morphine, codeine, aspirin, and quinine, it is reasonable to suppose that 200,000 lives would have been saved had there been recognition, adoption and general use of homeopathic principles of therapeutics in the country. It has been a favorite contention of ours in the
Clinique for many years that no physician should be licensed until he can present evidence of having had a course in homeopathic materia medica and therapeutics. Whether he practices homeopathy or not is his own business, but he should be obliged to give the law of similars attention. Uncle Sam instead of ignoring homeopathy should subsidize it. Has not Dr. Frank Wieland demonstrated the pecuniary value of the system as well as its therapeutic merit? We invite attention on part of Uncle Sam to the influenza figures of Montgomery Ward & Co., and we also suggest to the labor people that they investigate the same.”(134)
Treatment Effect of Homeopathy
As already mentioned, when I refer to homeopathy, I am referring specifically to certain principles and precise rules of practice, which are logical and scientific in every aspect of their development and practical application, and which are the hallmark of genuine homeopathy.
But even though homeopathy is based on a set of fixed principles, its art and science are always evolving, because its materia medica is based on cumulative clinical and experimental facts, which can never become outdated and therefore are always relevant. However, clinical results can vary greatly from one professed homeopath to another, because they will depend greatly on how skillfully the practical rules of homeopathy are applied. To illustrate this point, I mentioned earlier a difficult case that died under the care of Dr. Martha I. Boger of Portsmouth, New Hampshire, of which Dr. Boger said, “Had I been a better prescriber, I believe she would have recovered.”(135)
As a rule, however, the most skilled homeopaths are able to treat difficult cases—such as ones that are on the brink of death, as in the later stage of an infectious disease—with great therapeutic ease and simplicity. An example can be seen in this case, which was treated by Dr. Edwin Berridge of London, of a very sick child with pneumonia during an influenza epidemic: “March 8th, 1899, I visited a child 7 years old, at 3 p.m. The day before had been slightly languid, not so lively as usual, and did not care for her morning bath; also slight cough. At 11 p.m. was seized with burning fever, rapid breathing, thirst, and occasional delirium. I found her lying on left side, breathing with mouth open. Pulse was 150; respiration, 80; temperature, 104.4°F. No pain, though there had been headache. Thirsty for cold water often, drinking a moderate amount each time. No movement of nostrils, though her mother had noticed it once. Upper lobe of left lung consolidated, no air enters, no vocal resonance, and dullness on percussion. Pneumonic crepitation in lower lobe of left lung, Right lung normal.—Phosphorus CM (Fincke) in water, a spoonful every 4 hours till relieved.
“March 9th, at 6 p.m., yesterday she could breathe with mouth closed, and temperature had fallen to 104°F. No return of delirium, and had a good night. Today at 3 p.m. pulse was 110; temperature, 100.6°F; respirations less frequent, but I could not count them satisfactorily. Air entering the whole of left lung freely. Cheerful and lively. Bowels have acted naturally. No thirst. Cough increased. Last dose was taken at 7 a.m.
“March 10th, 5 p.m., she has had two more doses at 7 p.m. and again at 4 a.m. as the cough was troublesome. Now pulse is 104; temperature, 98.2°F. Air enters still more freely, though there is still a little crepitation. Lively and wants more food. Stopped the Phosphorus, and she soon recovered.”(136)
The homeopathic literature contains literally hundreds of such dramatic cases, which illustrate therapeutic ease and simplicity, and which, incidentally, are rarely found in any of the pre-antibiotic allopathic literature.
Now let us compare that case with a typical example of a similar, severe case of pneumonia but this time treated with a mix of many allopathic drugs and homeopathic remedies. Dr. H. V. Halbert, professor of Clinical Medicine at the Hahnemann Hospital in Chicago reported the following case after the NIP: “The unsatisfactory treatment of many cases in the recent epidemic may properly be blamed to the damnable use of coal-tar derivatives and the stereotyped employment of opiates to relieve the cough. Another cause was our failure to recognize the leucopenia and to increase the resisting power of the patient and the physician who did not put his patient to bed and administer mild, indicated remedies while consistently seeking to support the patient's strength made a great mistake. The trend toward a disseminated pneumonia with lung necrosis, following an early pulmonary edema, was evidence of a cardiac impairment which too frequently was ignored. Patients died without reason and we have learned a serious lesson at great cost in human lives.
“Let me illustrate by one patient. A strong and well built woman of middle age was sent to our hospital with the initial attack of influenza; soon her temperature ran very high, both lower lobes of the lungs were rapidly involved and she developed a marked pneumonia with a delirium demanding complete restraint. The leukocyte count was under four thousand and her blood pressure was only 100; involuntaries were constant, bloody sputum was excessive and in every way she seemed doomed.
“The usual remedies were used for the lung condition and for the temperature; in addition, nuclein solution—10 to 30 drops—were given hypodermatically three times daily and strychnia sulphate—1/30 gr—was likewise administered with equal or greater frequency. It was necessary to give rather large doses of bromides and hydrobromate of hyoscine to quiet the nervous system and to induce sleep but in a few days the white count increased, the blood pressure improved and the heart attained a better force. Then, with the aid of our indicated remedies, the delirium passed and the patient made a slow recovery, being able to leave the hospital at the end of a month.
“I quote this case briefly to demonstrate three points: first, the use of strychnia and nuclein to increase the blood pressure and the leukocyte count, which method I found advantageous in many severe cases during the epidemic; second, the absolute necessity of overcoming a pneumonia delirium by any remedy or measure which will induce sleep and rest; third, the beneficent effect of our homeopathic remedies compared to the danger in using aspirin and opiates; fourth, it is my belief that many of our cases were fatal because we did not recognize early the inevitable hypostasis due to a weak heart.”(137)
Many cases like Halbert’s can be found in the homeopathic literature; what they show is the great difference between that way of prescribing and the strict method of Hahnemann illustrated by Berridge’s case, where the most characteristic aspects of the case were sought until a clear image of the curative remedy appeared; the remedy was given singly, and a rapid, unmistakable and uninterrupted recovery followed.
In Halbert’s case, the recovery was difficult and prolonged under a mixture of many allopathic drugs and homeopathic remedies. Admittedly, every case is different, and that makes comparison difficult; nevertheless, those two cases are typical of countless examples of the two ways of practicing homeopathy.
Even the most skilled and experienced homeopaths will face difficult cases in which the curative remedy in not obvious at first sight. However, by continued observation and close application of the principles of homeopathy, such therapeutic challenges will, with very rare exceptions, be eventually solved, as Dr. Dorothy Shepherd of London demonstrated with the following case: “During the serious influenza epidemic in 1918-19, one’s clinical acumen was greatly tried, but again and again one was thankful for the very efficient aid that homoeopathic medicines provided, and over and over again an apparently serious case quickly turned the corner.
“Patients used to say, ‘I only had a very mild case of flu.’ They never gave the credit of the rapid cure to the almost tasteless watery medicines they used to imbibe. There were no complications, no heart trouble, no bronchopneumonia, no septic pneumonias and therefore no fatal incidents in several hundred cases. A triumph for homeopathy indeed. Very few cases gave one much anxiety.”
However, she presented a difficult case, in which several remedies had been prescribed before the homeopathic and curative one was eventually found leading to a beneficial response. “There was another case that caused me some anxiety, as it would not respond to the usual remedies: He was a young man invalided out of the army on account of shrapnel wounds in his ankle. The rest of his family, both parents, several brothers and sisters, responded quickly to the treatment given, temperatures came down within twelve to twenty-four hours. They were kept in bed for seven days, after the first day of normal temperature for two to three days only a faint diet, which was gradually augmented. His mother could not understand why her eldest son did not get well as quickly as the rest and put it down to the effects of the war wounds. She was not so far wrong either, as it turned out in the end.
“After nearly a week of pyrexia I had visited him at all hours of the day and night to get all the symptoms collected together, nurses were at a premium just at that time; one depended on the relatives provided there was anybody left to do the nursing, and one carried several door keys on one's pockets to let oneself into the various houses. Well, eventually one got the following disease picture: very high, steadily rising temperature, going up to 105°F at night, the pulse remaining somewhere about 100-110, therefore the pulse and temperature were quite out of proportion.
“He was extremely restless, never staying long in one position, very confused as regards the number of extremities he owned, there seemed to be so many arms and legs in the bed; he complained of the extreme hardness of the bed, his back was so painful and the bed was as hard as a board. He had received Rhus tox for his restlessness, also Arnica for the hardness of the bed and remote effects of war injuries, also Baptisia, which seemed to correspond to the confusion of the mind and the sensation of there being more than one person in the bed: nothing would touch the illness, however; the weakness went from bad to worse. There were drenching sweats, an offensive, penetrating odor from his perspiration; he had to change his shirts several times in the twenty-four hours; his mouth and tongue were foul and yet Mercury did not touch him.
“One did not give up hope; but continued to study the case. In the back of one’s mind one knew there was something that would act as the key to open the door to this maze, this complicated septic fever. Suddenly it came to one, there was a certain remedy which had this arrhythmia of pulse and temperature; a high temperature with a low pulse or vice versa. This was Pyrogenium, and in reading up Pyrogenium in the materia medica there was the simillimum: The extreme restlessness, the bruised feeling of the parts lain on, the relief by movement of feet, by change of position, offensive, disgusting perspiration, great weakness and lassitude: the imaginary crowding of supernumerary limbs in the bed: it was all there.
“So Pyrogenium CM—the only potency one had except the MM, both Heath Potencies(138) from America—was given two hourly in a watery solution, and by the morning, a few hours after the late night visit—one found the patient had slept more restfully and the temperature was down to 100°F, that night within twenty-four hours of starting this new medicine the temperature was normal, and it kept normal after that. One continued the remedy for a couple of days and then finished off with one dose of Pyrogenium MM dry on tongue. One does not remember now, whether he had a constitutional remedy at the end of ‘seven days bed’ after the temperature reached the normal level. Anyway, the patient was kept under observation for several years afterwards, and he had no after effects from his serious attack of wartime flu, and on the whole he came off quite lightly, compared with many other victims; he was only in bed for a little over two weeks: eight days’ temperature and seven days’ recuperative rest. In this case the normal influenza, if one may be allowed to call any influenza normal, was complicated by previous inoculations of the various typhoid, paratyphoid and cholera bacilli; he had had anti-malarial inoculation, he had been vaccinated, he had had anti-streptococci injections and inoculation against tetanus, and he could not remember what other inoculations he had had to submit to. I came to the conclusion that he was full of septic matter; and his blood stream was a battlefield of all sorts of serums and bacteria, and hence the drenching sweats, the high temperature, the offensive odor and the extreme prostration.
“In my own mind I am absolutely convinced that this young man would have been another of the numerous victims of the fatal influenza epidemic if it had not been for our Pyrogenium. … Thus it proves again the great truth of the homeopathic law: Like cures like.”(139) She thus illustrated what every experienced homeopath knows—namely, the response to a homeopathic remedy is very easily differentiated from the classic placebo response.
Dr. R. F. Rabe, professor of Materia Medica at the New York Homeopathic Medical College, discussed in his September 1919 editorial in the Homoeopathic Recorder the great precision that is required in prescribing when one is trying to comply with the law of similars: “Homeopathy may often appear to fail; but if the apparent failure be investigated it will be found that the law of similars has been wrongly applied or that its tools, the materia medica, have not been understood. A poor workman may bungle a job with even the very best of tools, and usually excuses his failure by cursing the tools. So with homeopathy, its tools are often cursed and cast aside when the blame should fall upon the ignorance of the physician who essays to use them. Failures should teach us more than our successes; but let us be fair and place the blame where it properly belongs.”(140)
Dr. Shepherd also emphasized, that in order to obtain the greatest success, each case of influenza must be individualized down to its smallest details: “As always, it is necessary to study each case clinically at the bedside and carefully collect the symptoms presented by the individual. This takes time; it is so much easier to walk into a room, diagnose the case, and write out the prescription of the prevalent fashionable drug. The homeopathic doctor has to know his materia medica with all its drugs exceedingly well before he can match up with the correct remedy the symptoms shown by the sick person. He has to take so many factors into consideration. There are quite thirty to forty remedies for influenza, and to find the right one which will cut short the feverish attack and permit the patient to feel well without complications following within a few days, is extraordinarily difficult.”(141)
Another advantage homeopaths had over allopaths during the NIP was the cumulative and relevant knowledge and experience that they had obtained in previous influenza epidemics. At the beginning of the NIP the more experienced homeopaths said they were using more or less the same remedies in this epidemic as in previous similar influenza epidemics. On this point, Dr. J. H. S. Johnson of Chicago remarked that clinical successes were unambiguous during the NIP as they had been in the previous influenza pandemic: “Recalling the epidemic of influenza which gripped the country in 1889 and 1890, my books show that from December 25, 1889 to February 1, 1890 I made one thousand prescriptions to 285 persons, 185 of these I prescribed for in their homes, 180 were clearly defined as la grippe cases. There were a number of clearly defined pneumonia cases that I did not classify nor include as la grippe, while in fact every case of pneumonia began with marked symptoms of influenza or la grippe. I had no death certificates to sign from any cause during this period, and no sequelae followed my treatment.”(142)
Dr. T. A. McCann, the personal physician of Charles F. Kettering, pointed out that the more experienced and skilled practitioners of genuine homeopathy had no deaths to report during the NIP and had only rare cases if any that developed the late stage of the disease, once patients came under their care: “I have treated one thousand cases of influenza. I have the records to show my work. I have had no losses. I want no credit given me for these results. It is only another undeniable testimony of the efficacy of homeopathic drugs carefully administered. Given an individual in a fair degree of health when stricken with this malady, there is no reasonable excuse for a homeopathic physician losing a single case. The symptoms of the disease are too well known to any intelligent physician to be repeated here. … With careful attention to detail, has given me one hundred percent cure. … If you have any occasion to use any part of this telegram, please give all credit to homeopathy, and none to the Scotch-Irish American.”(143)
Dr. G. G. Balcom of Lake Wilson, Minnesota further pointed out that results were in fact predictable under genuine homeopathic care during the NIP: “I want to join my testimony with Dr. McCann, that given a patient with a fair physical condition when he contracts the flu-pneumonia he should be restored to health by the properly selected homeopathic remedy. … I have had over three hundred cases and no deaths. I do not find that I need vaccines or serums. The fellows that have used them about here have been used to having deaths. The use of the coal tar derivatives is to be condemned. Aspirin has much to answer for.”(144)
The better the principle of similarity is applied, the greater and the more predictable will be the results. However, valuable results can still be obtained from less accurate and individualized homeopathic prescriptions. For instance, even homeopathic surgeons, who tended to be less skilled prescribers but had to treat the general population during the NIP, obtained the same constancy of positive results: “Dr. Samuel H. Starbuck of Seattle, Washington, one of the most eminent surgeons on the Pacific Coast, is what very few surgeons are, a good prescriber. During the epidemic of influenza in that city he treated six hundred cases and no deaths. That is a splendid record.”(145)
Even beginners in homeopathy had reasonably good results, as Dr. A. B. Hawes of Bridgewater, South Dakota reported: “About a month before the Spanish influenza reached Bridgewater, I commenced studying up on the subject. I heard time after time of the heavy death rate in Chicago, New York, Boston, and all over the country, and was scared stiff. When the flu struck Bridgewater I commenced with two homeopathic remedies, and have found no occasion to deviate there from, except that in certain conditions it has been necessary to use some of the other homeopathic remedies, and with pride I will say that so far I have treated 267 cases beginning with the commencement of the fever and have not had a case of pneumonia or a single death. Of the other 19 cases, that is, cases who did not take my medicine during the fever stage, but called me when they had a relapse, two cases had pleuro-pneumonia. Both recovered. Two cases, pneumonia, with one recovery and one death. One case with endocarditis proved fatal. Recently I had one case of pleurisy (acute plastic) with recovery. Ask me again if I believe in homeopathy.”(146)
Even some “mixers,” that is, physicians who were using homeopathy in combination with allopathy, reported good results. Dr. O. N. Hoyt of Pierre, South Dakota, who was dispensing triturations of a mixture of acetanilide, codeine and strychnine with the homeopathic remedies in cases presenting with violent and high fever, wrote,“I have ever stuck close to the homeopathic remedy and during this siege of influenza, when we have all been worked to death out here, I have handled over two hundred and fifty cases with no deaths.”(147)
Even some eclectic physicians, who were practicing halfway between homeopathy and allopathy, had excellent results during the NIP. For instance, Dr. A. S. Tuchler of San Francisco wrote, “The writer has made use of the same remedies that were used at the time of the influenza epidemic some twenty years ago. In three weeks, while this epidemic was at its height, we treated on an average of thirty patients daily, at their homes, with temperatures ranging up to 105°F, without having to sign a death certificate. The following remedies were found to be mostly indicated: Eupatorium perfoliatum, Bryonia and Gelsemium, with Aconite and Veratrum viride, as indicated by the pulse and temperature.”(148)
Similarly, Dr. Joseph N. Gardner, a former allopath in Washington, D.C., treated homeopathically three hundred cases of influenza during the NIP without having a single death.(149)
Mortality was not always low among professed homeopaths. Many “mixed” allopathy and homeopathy at the same patient, and their records showed mixed results. For instance, the record of the Hahnemann Hospital in Chicago showed a 10% mortality rate in pneumonia cases, even though it claimed the lowest mortality of all hospitals in Chicago: “The records of the hospital for the year 1918 state that the number of patients cared for in the hospital was 3,243; the number discharged cured was 2,627; the number discharged improved was 196; the number discharged unimproved was 45; the number who died was 136; this includes those who died within 24 hours, viz. 41; giving a mortality rate of 3.09 percent; (the lowest mortality rate claimed by any general public hospital in Chicago). The Out-Patient Department records a total of 14,175; the X-ray Department had a total of 513. During the influenza epidemic, from September 23rd to December 31st, there were admitted 245 cases of influenza and its complications. Of the uncomplicated influenza none died. Of the pneumonias developing after admittance none died. The doors of the hospital were closed to none, however, and 108 cases entered the hospital in late stages of the disease and its complications, principally pneumonia: of the 39 who died, 16 were moribund on admission and lived less than 24 hours. If we deduct these moribund cases it leaves but twenty-three deaths in a total of 229 cases.”(150)
Such a high mortality rate in pneumonia patients was partly due to the fact that a great proportion of the pneumonia cases had been transferred to hospitals in a moribund state, but was also due to the poor quality of the homeopathic treatment provided—a problem not encountered among Hahnemannians. In another similar institutional instance, patients were also treated with a mixture of homeopathy and allopathy at the Haynes Memorial Hospital for Contagious Diseases of the Massachusetts Homeopathic Hospital in Boston. Dr. Samuel Clement, resident physician at this institution and Clinical Instructor in Contagious Diseases at the Boston University School of Medicine, described the pitiful condition of arriving patients: “Out of the 632 cases, 175 were mild cases, temperature not higher than 101°F; 158 were average cases, temperature about 102°; 306 were very severe cases, temperature about 103°F. Out of 109 cases reported above, the highest temperature was 107°F. Of our pneumonia cases, the diagnosis was made on actual physical findings; 222 were bilateral bronchopneumonia, septic, resembling pulmonary edema and started inside of 24 hours. … Some died a few hours after admittance to this hospital, and we did not have time to work out the records. Of the 128 that died, some lived two days, other only two hours. Our mortality rate was 20 percent. This isn't camouflage. The mortality rate in septic pneumonias was 44 percent; our mortality rate in pregnant women was about 46 percent. … Just a word with regard to allopathic prescribing. Of the five cases which had developed pneumonia under allopathic treatment, all died.”(151)
The mortality in patients with pneumonia treated with a halfway application of homeopathy can be in general practice 1-2% versus 0% with genuine homeopathy, and up to 20% versus 0-1% in hospital services. To illustrate one of the differences between the practices of these two groups, the less qualified homeopaths were found to be promoting the false idea that a knowledge of only two to six remedies was all that was necessary to deal with any influenza epidemic.
In truth, to obtain the greatest success with homeopathy, physicians must apply the practical rules with meticulous exactness, and should therefore be able to prescribe any of the more than 500 remedies at their disposition. So, for example, Dr. R. F. Rabe wrote in a 1918 editorial in the Homoeopathic Recorder: “Bryonia should not therefore be given when Phosphorus is required, and vice versa. The physician who boasts of seeing sixty to eighty cases a day is not able to prescribe correctly or successfully. The thing can’t be done! It may be good business, but it is very poor science. To prescribe successfully for the pneumonia patient requires that the physician sit down quietly at the bedside and calmly contemplate the case from every side and angle. We homeopaths are compelled to treat patients, not diseases and the recognition of the symptom image is by no means always easy. He who is not dominated in his actions by law and principle is likely to be easily stampeded, so that his therapeutics become a jumble of unrelated and antagonistic remedial measures.”(152)
Dr. Rabe further described an example of excellence in prescribing: “The most frequently required remedies, both for the influenza and pneumonia, have been Bryonia, Eupatorium perfoliatum, Gelsemium, Phosphorus, Rhus tox, Ferrum phosphoricum, and Iodium. The indications for these are well known to us all. Of course, other remedies have also been indicated. Among others we saw a bronchopneumonia which had begun upon and rapidly spread from the right side. The ten-year old patient was doing nicely on Phosphorus when, without discoverable cause, a sudden extension of the disease to uninvolved lung tissue took place with a sharp rise of temperature. Ferrum phosphoricum took the sharp edge off the violence, but did not check the process. A mahogany-red right cheek (upon which the child had not been lying, thank you) was sufficient to arouse our Sherlock Holmesian sense of the mysterious. Judicious diplomatic sparring revealed the fact that our little patient objected to having her feet warmly covered. This trinity of symptoms, flushed right cheek, wants feet cool, right-sided pulmonary complaints, was quite sufficient to serve as the foundation for ourtherapeutic tool. Of course, Sanguinaria canadensis was given every 3 hours, and in the ridiculous 200th. Within twelve hours the temperature dropped to normal and remained there. Gentle reader, we defy any old school man to perform the same stunt! It can't be done. Neither can it be done by the routine prescriber, to whom pneumonia spells Aconite, Bryonia, Phosphorus and Antimonium tartaricum. Successful prescribing is an art and to master the art means more than a superficial knowledge of a few headliner keynotes in large type. Treat the patient, not the disease!”(153)
Across the board, homeopaths reported a smaller percentage of pneumonia cases among all their populations, because prompt homeopathic treatment cut short the course of influenza and prevented it from going into any of its later stages and complications. Out of 28 homeopathic physicians from Central Iowa, 18 answered a survey, in which it was tabulated that out of 5,032 cases of influenza only 137 developed pneumonia, “We should be proud of the small percentage that developed pneumonia less than 3 percent against an estimated 30 percent of the Old School. The majority of these cases were reported as coming on the fifth or sixth day. With about the following history, the attack of influenza would be practically well in three days, the patient then against orders would over expose themselves with a result that on the fifth or sixth day they would develop this so called pneumonia, and you would immediately have a very sick individual on your hands. … I challenge any other school of medicine to show as good percentage in as many cases.”(154)
The same question can be asked again: could this unfailingly lower mortality rate reported by homeopaths during the NIP be due solely to the fact that they didn’t use any crude drugs?
There is very little doubt that the crude drugs of allopathy that have been mentioned, particularly when given in high and frequent doses and combined with the numerous inoculations, weakened the individual’s natural defenses and contributed to the higher morbidity and mortality rates seen in soldiers during the NIP. But the question is, by how much, which no one can know precisely.
Dr. Carleton A. Harkness of Chicago reported that when salicylates were dropped from the treatment regime, the mortality also dropped, “My low death rate at Camp Lee was due entirely to the fact that I avoided the use of aspirin absolutely. I was complimented by the chief medical officer as having the lowest death rate in the hospital. After the medical chief had noted the effect of aspirin on the blood and the results which I was having in using homeopathy he discouraged the use of aspirin and the death rate came down very rapidly after that ruling.”(155)
The evidence suggests that the mortality due to the heavy prescription of allopathic drugs may in some cases have been as high as 10% of the total mortality in CIP patients. Dr. R. F. Rabe wrote in another editorial in the Homoeopathic Recorder entitled “What Impression Will It Make?”, “Facts and circumstances are now coming to light which prove beyond any question the marvelous superiority of homeopathic therapy in influenza. The difference in the mortality rates of the old school and of our own is so startling and so strikingly in favor of homeopathy that one is compelled to believe that revolutionary changes in the therapy of the dominant school must take place as a result. We make bold to say that if this difference were reversed, the homeopathic school would speedily be legislated out of existence. … Quinine, aspirin and digitalis have undoubtedly killed their thousands, as will be shown by one little circumstance alone. An old school army medical officer in one of the numerous large encampments in this country had charge of two wards of sixty-five beds each, all filled with influenza patients. The death rate in the hospital was twenty-five percent, a fact which evidently appalled this young medical officer, who, at the risk of court martial, refused to continue to give to his patients the deadly triad of drugs above enumerated. His superior officer permitted him, however, to withhold all medication and to rely upon good nursing, nourishment and fresh air alone. Promptly the death rate fell to fifteen percent, while in the rest of the hospital it remained at twenty-five. Drugs were now discontinued in the remaining wards and the death rate dropped to fifteen percent in these also.
“It is quite fair to assume, therefore, that aspirin, quinine and digitalis accounted for ten percent of the deaths. Compare, however, this rate of fifteen percent, with that of the homeopathic physicians, who, in over forty-two thousand cases, had a mortality rate of approximately one and five-tenths percent. It is truly a remarkable showing.
“All honor to the medical officer who refused to go on with his death dealing drugs, and to his superior officer who was big enough to coincide. But what about the thousands of other Old School physicians?”(156)
Treatment Effect of Allopathy
Many, like Dr. William J. Mayo, suggested that the excellent results reported by homeopathic physicians during the NIP were simply due to the fact that homeopaths didn’t use toxic doses of drugs, and aspirin in particular.
However, some contemporary researchers pointed out that the salicylates hypothesis is clearly not applicable in places where salicylates and the other commonly prescribed drugs in the U.S. during the NIP were not available: “The overwhelming majority of the millions of Indian peasants [in India] who were killed by the flu certainly had no access to salicylates whatsoever. If the salicylate hypothesis only works in the United States and in similar settings, then we question its validity given the worldwide scope of severe mortality in 1918–1919.”(157)
As previously stated, it is possible that aspirin and the other drugs contributed to a higher morbidity and mortality in influenza patients but it can’t explain the virulence of the NIP throughout the world, particularly in isolated communities were aspirin and the other common allopathic drugs of the time were not available.
Actually, the characteristics of the NIP around the world doesn’t suggest that aspirin played a great role outside of the U.S., for other populations without access to these drugs were struck more severely with an overall mortality five times as great. Among others, indigenous populations experienced a much greater mortality, namely 4 times as high in Fiji, 4.5 times as high in Guam, and 7 times as high among the Maori of New Zealand. In various indigenous communities of Canada, Sweden, Norway and the United States, mortality rates were estimated to be 3 to 70 times as high as for non-indigenous populations. In some Inuit communities, where there was “a failing level of basic care,” up to 90% of the people died from influenza.(158) Across the British colonial countries of the Caribbean, the difference in mortality rates was greater than 45-fold between the least affected and the most affected.(159)
It is very likely that the incidence and severity of pneumonia were increased by the use of large doses of aspirin. However, there is evidence that despite the discontinuation of aspirin “on the diagnosis of pulmonary involvement,” the mortality remained high, as it did at Camp Cody, New Mexico. During the fall of 1918, the base hospital of Camp Cody admitted 3,265 cases with influenza. Of those, 624, or 19%, were diagnosed with pneumonia with an overall mortality of 7.3% and 38.4% for the ones with pneumonia.(160) Its mortality from CIP was more than the average for the other army camps located on U.S. soil (6.6%), or for the entire U.S. army (5.8%).(161)
Moreover, in many reports, particularly from army camps, aspirin is not mentioned at all in their treatment lists. Nevertheless, their morbidity and mortality remained high. For instance, earlier in 1918 it had been reported that Camp Sevier in South Carolina had a 27% mortality rate among 567 soldiers diagnosed with pneumonia. No mention of aspirin is made in their treatment list.(162)
Fort Riley in Kansas had a population of 63,374 soldiers in the fall of 1918. Of those 15,170 were hospitalized with influenza, a 24% incidence, of which 2,524 were diagnosed with pneumonia. It was reported that all deaths in this camp that were associated with influenza were due to pneumonia and its complications: “The total number of deaths from the epidemic was 941, a pneumonia mortality of 35.8%.” Aspirin or any other salicylate was mentioned in the treatments said to have been used with the soldiers at Fort Riley.
The authors concluded, “It is believed that not much may be expected in the specific treatment of pneumonia.” Regarding digitalis, they reported, “Tincture of digitalis, standardized to definite dosage and administered to full estimated requirements during the first twenty-four to thirty hours in pneumonia, has lessened the deaths that might be attributed to circulatory failure.” They also used antipyrin nasal spray to relieve sinus pain, pneumococcus antiserums and other serums.(163)
Similar reports can be found in the civilian population. For instance, of 1,735 patients with influenza admitted to the Cook County Hospital in Chicago during the fall of 1918, 1,072 or 62%, were diagnosed with pneumonia, and 681, or 64% of the pneumonia patients, died; the overall influenza mortality was 39%. Aspirin was not mentioned on the list of treatments used.(164)
It is likely that when higher doses of aspirin were used, mortality was highest, but the use of aspirin by itself can’t explain the high mortality reported throughout the many army camps and allopathic hospitals.
Most attempts to evaluate the efficacy of allopathic treatment used during the NIP came to the same conclusion—namely, the mortality was, with very few exceptions, high regardless of the treatment used.
For instance, the San Francisco Board of Health tried to determine the effect of treatment in the different wards of the San Francisco Hospital. It tabulated 977 deaths among 3,422 patients with influenza who had been admitted from October 5, 1918 to February 5, 1919, a 28.6% mortality rate from influenza. The exact number of cases diagnosed with pneumonia was not precisely determined, but it was reported that the great majority of these 3,422 patients had “lung signs.” As each ward provided its own treatment, “An opportunity was thus had of judging the comparative merits of the different forms of treatments.”
It was found that cough was best controlled with heroin and codeine; aspirin was given for relief of initial pains and headache; mustard pastes gave great relief and were of benefit; atropine seemed to have appreciable effect in lessening the fluid in the bronchi; vaccines and leucocytic extract had no appreciable effect; venesection alone or with intravenous bicarbonate was associated with temporary improvement but no permanent effect; convalescent serum had to be discontinued. The report concluded, “That any form of treatment had a definite specific effect in influencing or aborting the disease was not determined. … The most important single measure was rest in bed. Early in bed and late to rise.”(165)
Since the San Francisco Hospital served as the clinical facility for the medical schools of the University of California in San Francisco (UCSF) and Stanford University, and since homeopathy was taught at UCSF, it is strange that the San Francisco Board of Health didn’t make any mention of homeopathy in its review, as if Ward G of the hospital, which was under homeopathic management during the NIP, did not exist. It was reported, that soon after the ward had opened to receive influenza patients, most of the first ninety patients admitted had pneumonia.(166)
All investigators agree that the mortality from influenza during the NIP was as a rule related to pneumonia. After the NIP, 12 localities in different parts of the United States were canvassed by the United Stated Public Health Service, whose senior statistician, Dr. Selwyn Collins, concluded, “These relations indicate that the mortality is determined primarily by the incidence of pneumonia. The cause of the high mortality in young adult life evidently lies in the complicating pneumonia. All of the relations ... bear this out.”(167)
The Medical Department of the U.S. Army wrote in the section on communicable diseases of their monograph on the history of WWI, “The mortality from respiratory diseases during the World War was due almost entirely to pneumonia, primary or secondary. … Of all the deaths charged to influenza, 99.4 per cent were recorded as due secondarily to pneumonia.(168)”
It was also found during the NIP that the highest mortality was in soldiers newly arrived in army camps or transport boats, and most investigators agree with Dr. Edwin O. Jordan’s original conclusion: “One of the chief reasons for the great variation in case-fatality in different groups is undoubtedly the nature and relative abundance of secondary invaders ... The excessively high mortality in certain army camps, on certain transports and in particular hospitals or barracks seems most readily explicable in this way.”(169)
Present-day researchers also agree with Jordan’s conclusion that secondary infection was the main cause of death in pneumonia patients: “During the pandemic, medical journals contained hundreds of detailed reports of local influenza epidemics. In addition, during and after the pandemic, remarkably detailed reviews of relevant epidemiologic and clinical records and population-based surveys were conducted by government and academic institutions worldwide. Care providers and experts of the day in epidemiology, pathology, bacteriology, and infectious diseases clearly concurred that pneumonias from secondary bacterial infections caused most deaths during the pandemic.”(170) The same conclusion—that death was mostly due to secondary bacterial infections—has been reached in regard to military populations.(171)
Mortality attributed to influenza during the NIP can be viewed simply as mortality from pneumonia, which is very similar to what it was before and after the NIP. Dr. William Osler had already reported in 1912 that at the Johns Hopkins Hospital he had lost 30% of his pneumonia cases, and remarked that since 1854 there had been an extraordinary uniformity in mortality from pneumonia.(172) In its major study on the NIP, the U.S. Public Health Service wrote, “The death rate was by no means parallel to the influenza attack rate, but was correlated closely with the pneumonia rate. In other words, the case fatality of pneumonia tended to be fairly constant, around 30 percent.”(173)
In the pandemic of Russian influenza of 1889-1892, the last influenza pandemic that preceded the NIP, there is no indication that the mortality from pneumonia was lower than during the NIP. In fact, researchers found a 33.3% mortality rate in pneumonia patients admitted to the Boston City Hospital and Massachusetts Hospital during the 1889-1892 influenza pandemic.(174) Incidentally, since aspirin or pure acetylsalicylic acid was first manufactured and marketed in 1899, it can’t account for the uniformity in mortality.
This uniformity in mortality from pneumonia in influenza epidemics can also be observed in other, later epidemics. Even though the mortality from influenza would wax and wane depending on the epidemic, type of secondary infections, or group affected, the mortality from pneumonia remained high in influenza epidemics.(175) Dr. Selwyn Collins pointed out in his review of influenza epidemics that the mortality from pneumonia during the 1928-1929 influenza epidemic was “not greatly different from the 25% in the 1918-1919 epidemic.”(176)
At the time of the NIP, medicinal nihilism was in full swing in “scientific” medicine, and it is particularly interesting to note that therapeutic considerations are not mentioned at all in a large proportion of the clinical reports on the NIP. Much is written about the characteristic, spread, onset, severity, control, course, outcome and management of the epidemic; susceptibility and immunity by age, race, length of service in the army, state of birth, climate, weather and housing conditions; means of transmission; laboratory and necropsy findings; infective agent; quarantine; the use of masks, sprays, serums and vaccines for prophylaxis; and complications and sequelae. But there is no mention in many of the large reviews of treatment or treatment effect.
Even in a major study by the Surgeon General’s Office that surveyed the situation in the midst of the epidemic, no mention of therapeutics is made. Instead the author says, “It should be stated that the policy of the Surgeon General’s Office has been to leave many of the details of camp management, so far as relates to sanitary and medical matters, to the camp authorities.”(177)
The mortality in the army camps located on U.S. soil during the NIP was on average 6.5% for the influenza cases and 28% for the pneumonia cases. A 1921 review of the treatment provided during the NIP in these camps was summarized thus: “In general it seems evident that there has been no distinct advance in special methods of therapy, and that so far the most effective treatment is that afforded by rest in bed, good nursing care, a light, easily digested diet, careful observations to detect complications, the treatment of special symptoms such as cardiac weakness by digitalis, as they arise, the avoidance of unnecessary moving of the patient, and continued care with daily watchful supervision and graduated exercise during convalescence.”(178)
After WWI, the Medical Department of the U.S. Army made an extensive and detailed study of the “factors tending to modify the incidence and mortality of the respiratory diseases.” At the end of the section on influenza and pneumonia, the monographs ended with a very meager segment on treatment, which first addressed the uncomplicated influenza cases: “In the absence of definite knowledge of the etiology of influenza, no specific remedies are available for its cure. … The important elements of treatment, once the patient comes under medical care, were found to be rest in bed, warmth, and a light, hot diet. … Aspirin was largely used for the pains of onset, though it was criticized by some as being depressant.” As for the pneumonia cases, the study reported, “The general principles applicable to the uncomplicated influenza cases in regard to rest, warmth, and ventilation apply equally here. The usual drug medication was generally used without striking success.”(179)
The medicinal nihilism that existed at the time of the NIP seems to have influenced present-day researchers who have examined the determinants of mortality during the NIP, for they rarely mention any treatment effect, including iatrogenesis and of course homeopathy. For instance in 2011, Shanks et al. examined the determinants of mortality in the naval units during the NIP but made no mention of any treatment effect, positive or negative from the treatment provided.(180)
In a long 1919 review of all the various aspects and manifestations of the influenza epidemic in the American Expeditionary Forces in England and France, only two paragraphs were devoted to therapeutics, where it was mentioned, “For the treatment of the individual patient, the most important and essential feature is to put him to bed promptly.” As regards drugs, the author concluded: “Various drugs have been employed, such as quinine to the physiologic limit, whisky, three ounces every four hours, tincture of digitalis in full doses. Opinion as to the value of these drugs varies considerably, and the death rates in those series, in which they have been employed, do not furnish convincing argument in their favor. One series of cases treated systematically with full doses of atropine showed a very high death rate.” For the months of September through November 1918, it was reported in this review that 75,960 cases had influenza, of which 11,113, or 15%, developed pneumonia and 5,486, or 49.4%, of these died.(181)
The Louisiana Board of Health, which conducted its own review of the efficacy of the various treatments used during the NIP and of course without paying any attention to the results obtained by homeopaths wrote, “The fact that no special line of treatment for influenza was of any avail, or was even known, was speedily impressed on the medical profession soon after the outbreak of the influenza pandemic. The results, of course, naturally was, that each practitioner devised expedients which he applied on the spur of the moment, and under stress of necessity, and judged of the efficacy of his method of treatment according to results obtained by him. … With medication there is something of a variety which approaches the ‘hit and miss’ therapy of the prepharmacological era.”(182)
After the NIP, Dr. Louis T. de M. Sajous, Professor of Medicine at the University of Pennsylvania, conducted an extensive review of the treatments used during the NIP, and again without paying any attention to the results reported by homeopaths. In stating that very few treatments had any positive effects, he mentioned, “Many physicians have utilized in early cases, with asserted good results, what might be termed an old fashioned type of treatment consisting, e.g., in giving small doses of tincture of Aconite and tincture of Veratrum viride at short intervals for a few hours.”(183)
During a meeting of the American Public Health Association held in Chicago in December 1918, Dr. Bernard S. Maloy of Chicago reported having treated 225 cases of pneumonia with small doses of tinctures of Aconite and Veratrum viride without losing a single case during the NIP.(184) It is superfluous to mention that these two medicines are part of the homeopathic armamentarium and had been used, before the NIP, by generations of homeopaths particularly in the first stage of pneumonia.
Only one series of control therapeutic trials conducted during the NIP was found in the literature. After having experienced “complete failure” in the first wave of the NIP, Dr. William Small of the British Royal Army Medical Corps and Dr. W. O. Blanchard of the U.S. Army, both allopaths, began conducting very clever and forward-thinking control trials of different medical treatments. “Early in October, however, the disease reappeared in a more virulent form, and in certain districts the mortality from it was very high. Nearly every case presented pulmonary symptoms in some degree, and at the commencement of the wave was serious in about one out of every four. In many there was a profound degree of toxemia and a tendency to cardiac failure. The pulmonary complications included bronchitis, pleurisy, bronchopneumonia, and lobar pneumonia, and edema of the lungs. Other complications were rare, but there were a few instances of nephritis, and one of purulent meningitis. Delirium, unconsciousness, and extreme tremor were frequently present in the severer types. It will therefore be apparent that the series of cases with which we are dealing included a large proportion of the most virulent infectious.”
In regard to medical treatment, they reported, “We had had ample opportunity in the first stage of the influenza epidemic of testing the action of various medicinal agents, and were not satisfied that any of them exercised much influence of the course of the disease. At the commencement of the second wave we determined to test systematically certain likely remedies with the view of determining, if possible, their relative value, and of enabling us to adopt as routine treatment that which appeared to give the best results. Accordingly, groups of patients—fifteen in each—were put upon different drugs, and the progress of the various groups noted and compared. Aconite, aspirin, sodium salicylate, belladonna, arsenic, quinine, Dover's powder, and gelsemium were tested in this way.(185)
“The results were most striking. The patients treated by gelsemium improved in a manner far exceeding those given any other treatment. They stated that after a few doses their headache and backache had been much relieved, and that they felt greatly better in every way. In most the temperature speedily commenced to fall, and the improvement in the general condition was obvious. So great was the contrast that it is no exaggeration to say that it was usually possible, without previous knowledge, to pick out the cases treated with this remedy.
“Of the other drugs tested, belladonna showed evidence of beneficial action in a number of cases, but none of the other drugs appeared to have the slightest influence. The patients were not selected in any way, but were taken consecutively as they were admitted; moreover, we were working separately at the time, and came to the same conclusions independently. The same observation was also made by the sisters in charge of the wards, who enthusiastically supported gelsemium against the other remedies.
“We are well aware of the fallacies attending judgment of the action of remedies, and have therefore endeavored to examine very critically our original observation. For this reason we have delayed drawing attention to the beneficial action which we believe gelsemium to exert. The test was repeated with the same result—again so striking that thereafter we did not feel justified in using any other remedy. Seeing, however, that belladonna appeared also to be of value, we considered it advisable to use it in combination.
“Gelsemium has previously been recommended as a remedy for influenza (Ellingwood, Prescriber, 1913, p. 175).(186) Our observations lead us to believe that it exerts a marked beneficial action on the course of the disease, that it tends to shorten the illness, and it undoubtedly relieves—and rapidly—the discomfort of the patient. Beyond slight ocular disturbances in a very small number of cases, we have not seen any disadvantages in its use.
“During the second phase of the epidemic—in the two months from October 10th to December 9th, 1918—there were admitted to a general hospital of the British Expeditionary Forces in France, 937 cases of influenza. The mortality was 26 (2.77 percent) [which is at the very least only one-quarter the mortality reported during the same time by rest of the American Expeditionary Forces for the entire epidemic(187)]. We have reason to believe that this figure compares very favorably with that obtained in other places, and it may therefore be of interest to outline the treatment employed.”(188)
It is unfortunate that health authorities didn’t take the opportunity to research and adopt the most effective treatments from all the schools of medicine. Consider how many more lives would have been saved. To illustrate this point, out of more than 2,000 patients admitted to the Cook County Hospital during a five-week period in September and October 1918, there were 642 deaths, a mortality of 31% from influenza.(189) When influenza returned to Chicago in January 1920, “out of the 326 patients admitted [to the Cook County Hospital] with pneumonia, 205 died, a mortality rate of 62.5 percent.” In neither case was there any mention of what treatments were used.(190)
If, on the other hand, health authorities had taken the opportunity to pursue and invest in the most effective and scientific treatment, Dr. Lewis Thomas, who eventually became Dean of Yale Medical School, would likely not have been able to make his famous observation during his internship at the Boston City Hospital in 1937, “If being in a hospital bed made a difference, it was mostly the difference produced by warmth, shelter, and food, and attentive, friendly care, and the matchless skill of the nurses in providing these things. Whether you survived or not depended on the natural history of the disease itself. Medicine made little or no difference.”(191) Unfortunately, he hadn’t investigated the tract record of homeopathy.
Attention: The section on Comparative Mortality in Pregnant Women in Part II has been rewritten and contains new data and statistics.
The fourth and last part of this answer with Discussion, Conclusion and Summary will follow soon.