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SCIENCE 



[N. S. Vol. L. No. 1292 



poliomyelitis has been established in north- 

 western Europe from which the recent epi- 

 demic waves have emanated. 



Similarly, there are excellent reasons for 

 regarding the endemic home of influenza to be 

 eastern Europe and in particular the border 

 region between Eussia and Turkestan. Many 

 recorded epidemics have been shown more or 

 less clearly to emanate from that area, while 

 the epidemics of recent history have been 

 traced there with a high degree of conclusive- 

 ness. From this eastern home, at intervals 

 usually of two or three decades, a migrating 

 epidemic influenza begins, moving eastward 

 and westward, with the greater velocity in the 

 latter direction. 



Now since the combating of these two epi- 

 demic diseases, when they become widely and 

 severely pandemical, is attended with such 

 very great difficulty and is of such dubious 

 success, and this notwithstanding the prodig- 

 ious public contests which are waged against 

 them in which the advantages are all in favor 

 of the invading microorganismal hosts, it 

 would seem as if an effort of central rather 

 than peripheral control might be worth dis- 

 cussing. According to this proposal, an effort 

 at control amounting even to eventual eradica- 

 tion of the diseases in the regions of their 

 endemic survival would be undertaken, an 

 effort indeed not occasional and intensively 

 spasmodic, as during the pandemical excur- 

 sions, but continuous over relatively long 

 periods, in the hope that the seed beds, as it 

 were, of the diseases might be destroyed. 



That such an effort at the eradication of a 

 serious epidemic disease may be carried 

 through successfully the experience with 

 yellow fever abundantly proves. In attacking 

 that disease the combat was not put off until 

 its epidemic spread had begun and until new 

 territory such as New Orleans, Jacksonville, 

 Memphis, etc., had been invaded, but the at- 

 tack was made on its sources at Havana, 

 Panama and now Guayaquil, to which en- 

 demic points the extension into new and 

 neutral territoi-y has been traced. 



I do not disregard the essential fact in 

 bringing this suggestion forward, that the 



control at its sources of yellow fever is quite 

 another and probably far simpler problem 

 than the control in their endemic foci of 

 poliomyelitis and influenza. It is perhaps un- 

 necessary to go far into the reasons why the 

 latter would doubtless prove to be far more 

 difficult of accomplishment than has been the 

 former. I am not now engaged in presenting 

 a plan of operation or proposing that the at- 

 tempt at eradication be made immediately. 

 Our knowledge of all the facts involved in the 

 epidemiology of i)oliomyelitis and especially of 

 influenza may still be too imiDerfect for imme- 

 diately effective action. But the very magni- 

 tude of the problem of these otherwise un- 

 controllable epidemic diseases invites to an 

 imaginative outlook which, while i)erhaps non- 

 realizable to-day, may not, in view of the 

 rapidly advancing knowledge of the infectious 

 diseases, be hopelessly out of reach to-morrow. 



ISTor am I insensible to the labor and cost in 

 money and talent which the setting out on 

 such an ambitions enterprise would entail. 

 But here at least is a world problem of such 

 proportions and nature as to invite the partici- 

 pation of all the scientifically advanced coun- 

 tries in a common effort to suppress . one of 

 the most menacing enemies of civilized man 

 and of human progress. 



In proposing to strive for the high achieve- 

 ment, not merely of parrying the blows struck 

 by destructive epidemics, but of rendering 

 them impotent to strike in the future, we 

 may pause for a moment to reflect on the 

 different ways in which peoples react to great 

 calamities, such as those brought by war and 

 by disease. As the results of a cruel and 

 devastating war, revolutions in governments 

 supposed the most stable may occur; no such 

 result follows upon still more devastating 

 epidemics. The recent epidemic of influenza 

 claimed, possibly, more victims than did the 

 great war, and the losses to the world in 

 emotion spent, treasure consumed and prog- 

 ress impeded are incalculable; yet, through a 

 fortuitous circumstance of psychology, from 

 the one calamity the world may emerge chast- 

 ened, perhaps even bettered, while from the 

 other, because of a depth of ignorance amount- 



