That desperation and a similar threat were what made people living during the 1918 flu pandemic — which killed 50 million to 100 million people worldwide — flock to dangerous quack treatments like moths to flames. That included doctors.
Since they thought the 1918 flu was a bacterial disease instead of a virus, their knowledge and treatment efforts fell short, she said.
“Through the course of the pandemic, you see people gradually turning away from conventional medicine as they realize it can’t help and turning to the alternatives, folk medicines, quack cures and so on,” Spinney said. “Which, of course, until very recently (in the early 20th century), had been equally respectable and equally accessible.”
Doctors also “really had no concept of when a medicine becomes a poison — how medicines interact with human tissues and what the right dosing is,” Spinney added. Those questions are what “we ask in our clinical trials these days that cost so much, take so long and try to measure safety and efficacy.”
Additionally, during the Covid-19 pandemic, “we’ve talked a lot … about the importance of trust between people and doctors and public health experts,” Spinney said. “But trust also mediates the kind of intimate relationship between a patient and their physician. And it shapes, in a strong way, that placebo effect and hence the effectiveness of any treatment.
“One of the interesting things you see in 1918 is that trust broken down because people saw that their doctors were hopeless. And so they, seeking to control the symptoms, turned to alternative systems which they felt could offer more hope, more effective treatments at that point,” she added.
Devastation, desperation and an inexperienced, unregulated medical field constituted a petri dish for numerous unproven — and sometimes barbaric — treatments.
Aspirin out of control
The problem was misunderstanding that aspirin has a “narrow therapeutic window, meaning if you give too little it doesn’t work (but if) you give too much, it can cause some very, very dangerous conditions.” They include “sweating, ringing in the ears, rapid breathing and then brain swelling and coma, convulsions and death,” Brown said.
Antimalarial drugs: Quinine vs. hydroxychloroquine
“If you have malaria, you give somebody quinine, you attack the parasite,” Brown said. “If you don’t understand that the fever goes away because the parasite is killed by the quinine, you miss out that little step and say the fever went away because the quinine, so quinine must be good for all fevers.”
Quinine wasn’t toxic to the flu virus since the infective agent that caused flu — a virus — differed from the infective agent that induces malaria — a parasite. That modern medicine will test therapies for similar symptoms is reasonable and common, Brown said. “The problem is if you just take a drug used for one condition and you’re not testing it to see if it improves a second condition, but you’re just simply giving it on the belief that it must, should or will,” he added.
“At the beginning, the question was perfectly reasonable: Does this drug help in this condition?” Brown said. “You don’t start with the statement ‘it will help’ without undergoing … all the slow and methodical ways in which we test drugs. There are a lot of drugs that we thought would help and had horrible side effects or unknown effects that we haven’t bothered to test them.”
Drain their blood, rid their disease
“Some people were hooked on to the belief that even if you were well, having some blood removed was sort of a good preventative measure, like, perhaps today, we might take some vitamins or go on a jog,” Brown said.
The trust in and respect for this historical method meant that many practitioners, including top-tier military doctors, swore by bloodletting after others considered it useless.
Gas fumes for symptoms
Some British parents took their sick children to the local gasworks to sit and inhale fumes to reduce their flu symptoms.
Though chlorine is an effective disinfectant that, in high doses, can kill bacteria and viruses, it is also poisonous. Why parents started taking their kids to gasworks before their ideas were substantiated might have started with growing rumors, Brown said.
Laxatives, enemas and castor oil
“There was this belief that an enema would be good for you regardless, really, of what your specific disease was,” he added. “We have medical textbooks that were published as late as 1913 (or) 1914, in which laxatives were recommended as a treatment for the fevers that accompanied influenza.”
Expelling evil spirits and elements
Since Western medicine hadn’t yet fully spread through Eastern countries such as China and India, some relied on their ancient, traditional forms of healing.
Generations of local cultures and traditions shaped the remedies people sought to alleviate their symptoms. “Human beings, in general, need to feel a sense of control over whatever is afflicting them. That’s just a perennial truth,” Spinney said.
Lessons from 1918
Back in 1918, there was no widely available flu vaccine (1940s), no US Centers for Disease Control and Prevention (1946), no World Health Organization (1948) and no polio vaccine (1954).
Doctors and the general public know a lot more than they did in 1918 — so while doctors in 1918 didn’t know any better, “we can’t claim ignorance” about this pandemic, Brown said.
“We don’t need to be ignorant about the side effects and the fact that some of these drugs are completely useless.”