PREVENTIVE MEDICINE AND THE WAR 341 



among civilians. No part of the world has escaped this great 

 scourge. In the past, there have been pandemics, but none, 

 so far as we have statistical evidence, has wrought such heavy 

 destruction as this over so wide an area. Hitherto the pan- 

 demic of 1889-90 has been looked upon as the most widespread 

 and probably the most fatal. At that time more than 40 per 

 cent, of the population of Massachusetts was affected but the 

 death rate was not so high. The pandemic of 1918, when com- 

 pared with that of 1889-90 is estimated to have caused six 

 times as many deaths. 



During the four autumn months of 1918, 338,343 cases of in- 

 fluenza were reported to the Surgeon General. This means 

 that in the camps of this country one out of every jour men 

 had influenza. 



The combination -between influenza and pneumonia during 

 the fall of 1918 seems to have been closer and more destructive 

 than in any previous pandemic. During the autumn season 

 there were reported to the Surgeon General 61,691 cases of 

 pneumonia. This means that one out of every twenty-four 

 men encamped in this country had pneumonia. 



During the same period 22,186 men were reported to have 

 died from the combined effects of influenza and pneumonia. 

 This means that among the troops in this country one out of 

 every sixty-seven died. 



This fatality has been unparalleled in recent times. The in- 

 fluenza epidemic of 1918 ranks well up with the epidemics 

 famous in history. Epidemiologists have regarded the dis- 

 semination of cholera from the Broad Street Well in London 

 as a catastrophe. The typhoid epidemic of Plymouth, Pa., 

 of 1885, is another illustration of the damage that can be done 

 by epidemic disease once let loose. Yet the accompanying 

 table shows that the fatality from influenza and pneumonia at 

 Camp Sherman was greater than either of these. Compared 

 with epidemics for which we have fairly accurate statistics, the 

 death rate at Camp Sherman in the fall of 1918 is surpassed 



