

NATURE 



[October jr. i « » i s 



:ii (us article in last week's Nati re, thai in 



mi outbreak we are concerned with the 



disease which was widel} pandemii in 



<i-'. and prior to that had been almost 



unknown for forty-three years. Since 1892 influ- 



1 lias lifted up its head at intervals of :i lew 



-. anil since war began it lias been lli. I nise- 

 ol a fairly heavy mortality in this country, as well 

 as among other belligerent nations, and Farther 

 afield in South Africa, in India, and in various 

 parts of America. A cleat general conspectus ol 

 our present knowledge, and, it ma) be added, our 

 lack of knowledge, ol the disease is given in a 



memorandum 1 recent!} issued l>\ the Medical 



Officer of the Local Government Hoard. 



The chief peculiarity of the epidemic prevalence 



of influenza during [918 is that it has occurred 

 at short intervals, scarcely three months having 

 intervened between the epidemic which culminated 

 in Julv and the even more severe epidemic which 

 now prevails throughout the United Kingdom, 

 and is almost world-wide. It has recently 

 been stated that the epidemic occurrence of in- 

 llucn/a in July should have furnished warning of 

 the present autumnal epidemic. Those who put 

 forward this statement have not made themselves 

 acquainted with our national experience of influ- 

 enza. In actual fact no previous known epidemic 

 of influenza in this country has had a summer 

 maximum, and no previous epidemic has recurred 

 within three months of a previous epidemic. In 

 the light of events this rapid recurrence is not 

 difficult to explain; for the exigencies of warfare, 

 the rapid transport of many tens and hundreds of 

 thousands of troops across the seas in circum- 

 stances which necessitated dense aggregation of 

 persons, have intensified infection, multiplied the 

 opportunities for severe secondary infections, and 

 have exposed the civil population to exceptionally 

 virulent complex infection. 



The memorandum referred to above states that 

 I Ik bacillus of influenza (Pfeiffer bacillus), which 

 commonly is present in these cases — whether caus- 

 ally or as an aggravating cause ol pneumonia — 

 his associated with it pneumococci and hemolytic 

 Streptococci* which produce septic pneumonia and 

 empyema in a considerable proportion of the total 

 cases. The question of vaccine treatment and of 

 prophylaxis by vaccine is considered, and there is 

 some hope <>l success in this direction, though 

 reliance must be placed chiefly on the hygienic pre- 

 cautions ■■ ■ ch are detailed in the official docu- 

 ment. <>1 these, probably chief importance should 

 be attached to the avoidance, so far as practicable, 

 of overcrowded conditions; and in this connection 

 speciaj strj laid on the importance of avoiding 



large units ol aggregation, which great!) intensify 

 the risk of infee 1 Cl f ,]„ s ,.,,,,'_ 



sideration is too often ignored in civilian life: 

 under military conditions s, h large units ,,f 

 aggregation cannot alv ided. 



I lie main object of this article however, is to 



1 Memorandum on EpVemic Catarrh %. Sir \ 



Newsbolme, K.C.B. CH.M. Station, 



-557, vol. 102] 



emphasise the need for further research on this 

 disease Some ol the lines on which such 1 i-scan h 

 is called I01 are indicated in Sir Arthur News- 

 holme's memorandum. "Influenza is to be re- 

 garded .is a member of a group ol catarrhal in- 

 fectious diseases which in the aggregate are per- 

 haps the chief enemies of human health," and it 

 is significant that even in the years when the 

 ravages of influenza arc- greatest bronchitis and 

 pneumonia are each responsible lor twice as main 

 deaths as influenza. Thus the general problem 

 is that of the prevention ol catarrhs. How can 

 immunity be secured and maintained? Will im- 

 munity against one catarrh-causing organism 

 assist in securing immunit\ against others? If 

 immunity cannot be secured against influenza, can 

 one rob the disease of its terrors by a vaccint 

 against purulent bronchitis or pneumonia? 



These are among the problems urgently needing 

 investigation. When the National Insurance Act 

 was passed, one of its most valuable provisions 

 was the- id. per insured person which enabled the 

 work of the Medical Research Committee to be 

 initiated. During the war the energies of this 

 Committee, and, it mav be added, of most patho- 

 logists who could have been utilised for a national 

 investigation on influenza, have been diverted to 

 war-work. This work has been of great value ; 

 but it may be hoped that ere long staff and time- 

 will be available for a steady and continuous In- 

 vestigation of the numerous problems of immunity 

 in relation to catarrhal infections. The public 

 must be prepared to spend money on such invesli- 

 gations on a much larger scale than in the past 

 if success is to be achieved; and for this purpose 

 it will In- necessary to train a generation of patho- 

 logists who can be certain of a fair livelihood 

 while undertaking such work. Unless careers as 

 pathologists are open to a much larger number of 

 specially qualified workers than are at present 

 available, the work of research will continue to 

 be hampered as in the past. Tin- harvest truly 

 is great, but the labourers are few. 



Meanwhile we must depend in the main on 

 avoidance of crowds and on tin practice of 

 elementary personal hygiene in the prevention of 

 influenza. The public can minimise this disease- 

 only by the active co-operation ol every member. 

 This involves a self-abnegation on the part of 

 persons suffering from catarrh which is too often 

 absent ; they consider their work as more import- 

 ant than the welfare of their co-workers; and it is 

 evident that so long as this continues influenza 

 will at intervals continue to plague humanity. 



DYESTUFFS IND rill: TEXTILE 



1X1)1 STRY. 



TVTOTHING could be more convincing of the 



•L ^ neglect ol this niuntn lo provide the means 



whetriiv the applications ol scientific discover) 



should be- made available in the conduel of im- 

 portant industries than tin speech of Mr. Lennox 

 R. Lee on the occasion of the annual meeting- of 



