In a normal, nonepidemic influenza season, Thompson et al estimated the average annual US death toll from influenza to be 36,000 of 281 million people.
6,7 To put this in perspective, the 1918-1919 pandemic killed approximately 675,000 of 103 million people in the United States and killed 50 million people worldwide (with the possibility of having killed as many as 100 million people worldwide).
8 During the pandemic, osteopaths had a substantial impact on patient care: according to Smith,
9 patients who received conventional (ie, allopathic) medical treatment had a death rate 40 times higher than those who received osteopathic care. Unfortunately, there is no way to tell if the osteopathic success rate can be attributed solely to osteopaths' manual medicine and care philosophy of the body's intrinsic healing abilities over statistical issues of reporting. Given that in 1918 the “standard of care” for allopathic medicine entailed many less sophisticated traditions from the late 19th and early 20th century—such as purgative (eg, calomel) treatments
8 and, in some (mostly rural) settings, bloodletting
8,10—it is hard to imagine that osteopaths were not more successful with a system of rational healing
11 than many of their contemporaries were in fighting this virus.
In 1918, in terms of influenza-related complications such as pneumonia, 3 times as many patients died receiving conventional medical treatment than those receiving osteopathic treatment.
8,12 Ward,
12 addressing the Eastern Osteopathic Association in 1937, suggested that OMT, particularly when applied to cervical and upper thoracic regions, can help the body recruit and optimize its own immune system to fight influenza. The lower death rate from influenza and related complications from the patient population treated by osteopaths may be attributable to the less scientifically rigorous reporting methods of morbidity and mortality.
8 The difference in death rates may also have been an effect of osteopaths having different “practice rights” than physicians in the allopathic medical community (ie, osteopaths were likely not on staff at allopathic hospitals where patients' deaths were recorded). One thing is certain, however: at the time of the Spanish influenza pandemic, there was a substantial difference in the mortality
13 of patients who were treated by osteopaths. Furthermore, what remains true today is that lymphatic drainage treatments are a safe and efficacious means of treating patients (
Figure 1 and
Figure 2).
14 Ward
12 emphasized how OMT applied to the chest cage optimized the function of the ventilatory (ie, respiratory) system and reduced complications, and thereby reduced mortality rates. Osteopathic physicians should pay particular attention to the gentleness of the OMT techniques that they choose to perform on patients.
15
A review article by Hruby and Hoffman
16 included a helpful, step-by-step pictorial lymphatic treatment sequence for avian influenza that can also be adapted for use with any influenza strain. McConnell
15 and D'Alonzo
17 have highlighted, 80 years apart from each other, the tremendous value of osteopathic manipulative medicine in managing influenza.