34« 



NATURE 



! rv 2, [919 



nature, so that there is always the possibility of 

 furthei attacks overwhelming the enfeebled com- 

 monwealth oi cells, il 1 rposed to reinfection. It 

 is possible thai in eai lier epidi tnii s the 1 ausal 

 relationship between influenza and Fatal lung and 

 failure was less clear than ii is in the recenl 

 1 i. , and might tiavi b< n overlooked, alth 

 the coincidence between outbreal pneu- 



monia and influenza has long been known. In 

 some respects circumstances are now very favour- 

 able to the. spread of such infectious disorders: 

 overwork is a common condition; our national 

 dietary, cleverly controlled though it be, cannot 

 be regarded as a normal one, since freedom of 

 .In, ire is limited; overclouding is in many areas 

 inevitable, and doi tors are few. 



As is the case with other contagious 1 

 which have shown a tendency to increase of late 

 years (diphtheria, for example), the fundamental 

 causes of the epidemic are unknown, and are to 

 be discovered only by widelj organised co-opera- 

 tive investigation. It is not even certain that 

 we arc- dealing with the same organism as is 

 responsible for the causation of so-called 

 "influenza" during non-epidemic times: if it is 

 the same, then the causation of the sudden in- 

 crease in virulence remains to be explained ; if 

 not, then we are confronted with the problem as 

 to the origin of the germ, or as to its lurking- 

 place in the interim between epidemics, or as to 

 the causes of the subsidence of the prevalence 

 of its effects. It is known that passage through 

 hosts belonging to a different species may either 

 augment or diminish the virulence of bacteria to 

 man, and the relation of influenza to the some- 

 what similar affection ol cats and dogs and to 

 tin conditio') known as "pink-eve" in horses is 

 perhaps worth definitelv clearing up. The ten- 

 dency to recurrence, and especially to the re- 

 currence of a particular variety of this polymor- 

 phic disease in the same locality, has led to the 

 view that the germ possibly lurks in the soil, or, 

 as suggested by a correspondent to the Times En- 

 gineering Supplement of December iq, in drains. 



The mode of spread of influenza along lines of 

 Be suggests that the disease is communicated 

 by personal contact, and the success which has 

 attended the wearing' of gauze masks as a means 

 of protection not only indicates the usual method 

 by which infection is incurred, but also shows 

 whal 1 an be accomplished by the adoption of 

 simple measures of safeguard. The condition is 

 known to be extraordinarily infectious, even in 

 the early stages, and there can be 10 doubt that 

 il is often widely, though unwittingly, spread by 

 those with slight attacks determined to "carry 

 on"; anyone- so doing not only lays himself open 

 to I In- possibility of fatal complications, but may 

 also infect a large number of others in the mean- 

 time, and the la, i tha hi own attack was a mild 

 one is no security that tin disease transmitted 

 to others will be. of a similar degree of severity. 

 We an- not even certain that the disease may not 

 be spread by "carriers" themselves in apparent 

 health, although this does not seem likely. 

 NO. 2566, VOL. I02] 



helical Research Committee has ahead} 



Collected a good deal ot information with regard 

 to this epidemic, and it is sincerely to be hoped 

 that a means will be found by some such organ- 

 ised body oi workers lor preventing its further 

 ■ repetition. Researches into ibis sub- 

 ject will 1" valuable, not merely as 1 

 to bai t( ' iology, but also as useful nia 

 study oi epidemiology in general. 



What applies to influenza applies with equal 



force to oilier infectious diseases; in all cases 

 a pronounced liability to le-.o. c- ■ 

 diseases as after-effects. Although 

 medical attention is necessarily attracted t< 

 chronic states, it seems obvious that proper at- 

 tention to their fundamental causation would not 

 only be- more worthy e;l the name of 1. 

 but also lead to results of permanent value in 

 connection with public health. For example, 

 regular and systematic examination of the 

 by means of the elect ro-cardiograph and other 

 applianci s lor the- exact investigation of the heart 

 in all cases of infectious disease would probably 

 throw light on one- of the underlying cau 

 disablement by chronic heart disease, 'flu- same 

 is true of the investigation of the activity of the 

 j kidney on the lines of experimental physiology 

 and experimental clinical medicine. The me 

 correspondent to the Times of December J4 has 

 rightly directed attention to the fact that the 

 influenza epidemic, "with its (1,000,000 deaths 

 and its incalculable disablement, is the pric 1 

 public indifference to health affairs"; research 

 into epidemics, he states, must begin in the fever 

 hospitals and in general practice, where the cases 

 an- to be met. Such research must necessarily 

 be organised, and its results integrated after 

 careful sifting by some centralised bodv of ex- 

 perts. The records of properly conducted investi- 

 gation into malaria, kala azar, syphilis, diphtheria, 

 tetanus, trench fever, typhoid, and sleeping sick- 

 ness have led to valuable results, although much 

 more remains to be done. 'Who has heard of 

 extensive research work on measles, scarlet fever, 

 or whooping cough in recent years; vet \vho 

 doubts that these diseases may leave many and 

 serious after-effects which often need very pro- 

 longed treatment in after-life, and incontestablj 

 produce extensive disablement? The most stul- 

 tifying of all attitudes is that which lends medical 

 practitioners to "treat symptoms as they arise." 

 More attention should certainly be focussed on 

 flu- causation of these symptoms, and in the in- 

 fectious eliseases we have very prolific sources of 

 disease. 



II '/.YD CIRCJJ1 [TION OF THE GLOBE. 



UNTIL some twenty years ago meteo 

 was regarded as an elementary si ic n. c 

 founded on theories so simple that they might 

 be- taken as self-evident. Thus the cyclone was 

 looked upon as a warm column of rising- air with 

 spirally inflowing winds at its base; the- anti- 

 eye lone-, conversely, contained a cold core of de- 



