Does Asprin Explain the Lethality of the Spanish Flu?

I ran across an article at The title intrigued me – I do wonder what makes one lie greater than another – so I clicked the link. I found out what they considered the greatest lie of covid – but I am more interested in their linking aspirin with the death rate of Spanish Flu a little over a hundred years back. The article included this abstract:

It intrigued me – as a demographer, I looked at a lot of data on the Spanish Flu epidemic – probably the location that was most memorable was Milk’s Camp – a church remained, but the town, village, however you term it was still empty nearly a century after being hit hard by Spanish Flu.

The unprecedented overall mortality and the mortality rate among young adults during the 1918–1919 influenza pandemic are incompletely understood. Deaths in the United States peaked with a sudden spike in October 1918. Later, Wade Hampton Frost [2] studied surveys of 8 US cities and found that, for every 1000 persons aged 25–29 years, ∼30% were infected with influenza virus, and 1% died of pneumonia or influenza. This 3% case-fatality rate has been called, “perhaps the most important unsolved mystery of the pandemic” [3, p 1022]”

“Official recommendations for aspirin were issued on 13 September 1918 by the US Surgeon General [64], who stated aspirin had been used in foreign countries “apparently with much success in the relief of symptoms” (p 13), on 26 September 1918 by the US Navy [29], and on 5 October 1918 by The Journal of the American Medical Association [31]. Recommendations often suggested dose regimens that predispose to toxicity as noted above. At the US Army camp with the highest mortality rate, doctors followed Osler’s treatment recommendations, which included aspirin [48], ordering 100,000 tablets [65]. Aspirin sales more than doubled between 1918 and 1920 [66].Again, anyone starting to pick up a bit of a rhyme in the history here?”

The next chunk of data was the following statement:

The Smithsonian points out the aspirin dosage in 1918  was higher than we regard as safe today:

“One hypothesis suggests that many flu deaths could actually be attributed to aspirin poisoning. Medical authorities at the time recommended large doses of aspirin of up to 30 grams per day. Today, about four grams would be considered the maximum safe daily dose. Large doses of aspirin can lead to many of the pandemic’s symptoms, including bleeding.”

As I looked into the possibility that aspirin increased the lethality of the 1918 flu epidemic, I realized that I missed many of the articles on the topic that were written during the H1N1 epidemic of 2009 – I think at the time I was focused on colon cancer.  While I can’t write conclusively about the effects of Aspirin, the articles have a level of face validity.

This 17th century poem, by Matthew Prior seems to cover the idea:

I sent for Ratcliffe, was so ill,
That other doctors gave me over
He felt my pulse, prescribed his pill
And I was likely to recover.
But when the wit began to wheeze,
And wine had warmed the politician, 
Cured yesterday of my disease,
I died last night of my physician.

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