Show Hit 0 Influenza t at at Its Is Source i Dr Simon Flexner Proposes Combating Dread Disease at Its Origin EASTERN EUROPE PLAGUE SPOT Many Recorded Epidemics Shown to Have Emanated From That Area Disease Claims More Victims Than European War New York According to Dr Simon Flexner Director of Laboratories of the Ro Rockefeller Institute for Medical Research further recurrences of the influenza epidemic can cnn be prevented pre d donly only by byi wIping out the disease at Its source In a recent address before the Congress of American Physicians and Surgeons later published by the American Ameri Amen can Medical Association he outlined the path of the the disease through Its different stages There are excellent reasons for regarding regarding regarding re re- garding the endemic home of Influenza to be Eastern Europe he said and andIn In particular the border regions between between between be be- tween Russia and Turkestan Many rec recorded epidemics have been shown show more or less clearly to emanate from that area while the epidemics of recent recent recent re re- cent history have been traced therewith there with witha a a high degree of conclusiveness collusiveness From this Eastern home at Intervals of two or three decades n a a migrating epidemic Influenza begins moving eastward eastward eastward east east- ward and westward with the greater velocity in IIi the latter direction Uncanny In Action To the casual observer there Is something uncanny In the way Influenza Influenza enza strikes down Its victims Vl While le leother other epidemics proceed from bad to worse with at least progressive Increases Increases increases In In- creases In Intensity Influenza seems to overwhelm communities over even wider wid- wid er I stretches of ot territory as by a n single stupendous blow While In the one case the gradually accelerating rate of speed of extension may be taken to Indicate personal conveyance of the provoking organism micro In the theother other ther the sudden wide vide onset appears the very negation of personal thou tion Hence Bence the Invoking of ot mysterious Influences the revival of ot the notion of ot and similar agencies to account for tor tills this phenomenon Indeed the public public public pub pub- lic mind In general lends ends Itself readily to such formless J Concepts for the reason reason rea rea- son fion that there still resides In the mass massof massof massof of the people even In the more enlightened en en- lightened countries a large r residue of ot superstition regarding regard regard- ing tug disease One does not need to look far tar or dig deep In order to to uncover PIe Uie e source of this superstition Weve We have ve only recently emerged from a past In which knowledge of the origin of ot disease was scant and finch views as were commonly held field and exploited were mostly osty fallacious It Is indeed very V Decently If It the transformation can be 00 said 1 to be perfect eVen even now that the medical profession as a whole has rum been completely emancipated All this Is very far from being beluga a matter of remote Importance only since In I the end the successful Imposition of ot sanitary regulations Involves wide cooperation cooperation cooperation co co- operation and until the majority of of ot in individuals In- In l composing a n community Is brought to to a fair level of understanding understand understand- ing of or and and belief bellet In the measures propose pro pro- posed pose serious aD and sustained endeavor to enforce them Is scarcely to be expected ex ex- Routing a Bugaboo And AmI yet no better Instance of a communicable disease could perhaps be Invoked than Influenza to exercise the th false Idea of the mysterious origin of epidemics p TO dwell solely on tho the sudden sud sud- den and overwhelming o stroke of the disease L to Ls J wholly to overlook the significant Incidents that Rasa Rasa- precede the Infection because SET Huh orich they are of nature and Iak laak all aU d dry matic quality Accurate observers noted long ago that Influenza In n Its epidemic epidemic- form did no not constitute an exception to 10 the common rule governIng governing govern govern- i ing ng epidemic epidemic diseases which were iou ob obviously ly associated with p persons and their migrations What Vhal the early arly students students students stu stu- dents infidel madej out by tracing the ept- ept epi ept epidemic demic ba backward to Its point of departure depar depar- i t ture ure more more modern observers have confirmed confirmed con con- firmed by care carefully ull l kept ept records often con I graphically compiled as I In the excellent excellent excellent excel excel- lent Instance of the Munich records record i covering c the epidemic of 92 1889 92 which can now be supplemented by u a n number of similarly constructed d records of the e epidemic just passed These detailed records show convincingly a period of invasion during which there Is s a gradual gradual gradual grad grad- ual rise In the number of cases to culminate within a period variously estimated at from one to three weeks in a n widespread pread so called so-called explosive outbreak of the disease It lilt happens that the early earls cases of f i e epidemic influenza a tend not not- notto to be seere severe severe se se- se v vere ere chiefly because they then rarely are rire attended by pneumonia end and hence are I frequently mistaken and the confusion In diagnosis Is s resolved only when the I full Intensity of the epidemic Is real real- In the meantime rich opportunity opportunity opportunity has been afforded for the free and unrestricted commingling of the s sick ick and the well of or doubtless healthy carriers of the Inciting age agent t and ond others u until tIl so high high high-a a degree of dissemination of the provoking microorganism microorganism microorganism micro micro- organism has been secured as to expose expose expose ex ex- pose th the entire susceptible element of the population which happens to be belarge belarge belarge large to an almost simultaneous response response response re re- re- re to the effects of the tho I Infecting microbe Deductions of like Import can an be drawn from the geographic movements of influenza epidemics In Eastern Russia and Turkestan Influenza spreads with the pace of a n caravan In Europe and America with the speed of an nn express train and In the world orld at large with the rapidity of an ocean l liner iner and If one project forward the ties outcome of the means menns of Intercom Intercom- of the near future we may maj predict that the pandemic next next pandemic should one arise will ext extend em with the swift swift- swiftness e swiftness swiftness swift swift- ness of an airship l Moreover not only Is this rate of spread determined by the nature of the h transportation facilities of the region region re re- region re- re gion or the era but to towns ns and villages mainland and island are invaded early or late or preserved entirely from attack according a as they lie He within in inor or without the avenues of approach orare orare or orare are are protected by Inaccessibility as In Instances of remote mo mountain settlements settlements settlements settle settle- ments and of Islands distant from ocean ocean lanes or frozen In during winter periods To Avert Recurrences It uIt Is desirable able In the inter Interest st of ot clear thinking to carry this consideration tion of the characteristics of epidemic influenza a step further A feature of the epidemic disease of particular significance Is the tendency to recur that Is to return to a stricken region a after fer an Interval usually of months mouths of relative quiescence Thus the beginning of the last pandemic pandemic pan pan- d demic mic In Europe Europe and and the United States States' has been traced to sporadic cases appearing appearing ap ap- appearing ap- ap in April May and June possibly possibly possibly pos pos- sibly even earlier In certain certain- places s while the destructive epidemic raged during September October mid arid November November November Novem Novem- ber of 1918 There are very good reasons rea rear rea reasons sons for for or believing that in Itself Influenza In- In Influenza In Is not a serious disease but that Its sinister character Is given by bythe bythe bythe the remarkable frequency with which It Is followed under particular circumstances circumstances circum circum- stances by a n concomitant or secondary pneumonic Infection to which h the severe se severe se severe vere effects and high mortality are aro traceable The manner In which to fight diseases diseases diseases dis dis- dis- dis eases of this nature Is according to Dr Flexner one of central rather than peripheral control that is fighting th the disease nt at its source rather than waging a n series of campaigns s against It after It has spread to distant cen cen- To quote According to this proposal an ef effort fort at control amounting g even to eventual eventual eventual even even- eradication of the diseases In the regions of their endemic survival would be he undertaken an effort Indeed not occasional and Intensively spasmodic as during luring the pandemic excursions but hut continuous over relatively IO long 1 periods In the hope that the seedbeds seed seedbeds beds as it were of the disease might be d destroyed ed That such an effort at the eradication eradication tion of ot a a serious epidemic disease may may maybe be carried through successfully th the experience experience ex ex- with yellow fever abundantly proves In attacking that disease the combat was not put off until Its epidemic epidemic epidemic epi epi- demic spread had begun and until new territory such as New Orleans Jacksonville Jack Jack- Jacksonville sonY sonville and Memphis had been invaded Invaded In in- varied but the attack was made on n Its sources nt at Havana Panama and now Guayaquil to which endemic points the extensions Into new w and neutral terri tern ory had been traced More Victims Than WarIn WarIn WarIn War In proposing to strive for the high achievement nt not merely of ot partying parrying the blows blow struck by destructive epidemics epidemIcs epidemics epi epi- but of rendering them Impotent Impotent Im Im- impotent im- im potent to s strike rike In the future we may pause for a moment to reflect on the different ways In which peoples peoples' react to great grent calamities su such b as those brought by war and b by disease As the results of ot a cruel and war revolutions In governments supposed the most stable may occur no such result follows fonow on still more d devastating ing lag epidemics The recent of ot Influenza claimed possibly more victims victims vic vic- tims than did the great war and the losses to the world In 10 emotion sp spent nt treasure consumed i and nd progress s' s sIm Impeded impeded impeded im Im- are fire Incalculable yet through l ln a n fortuitous circumstance of psychology ogy from the tho on the world may emerge chastened perhaps won v bettered while from the theother other because of f a depth of ig Ignorance amounting often often often oft oft- en to fatalism mankind may largely miss the deep meaning of ot the lesson Mules Show Horse Sense Owensboro I Ky G GW W. W Potts farmer owes his life Ufe to his mule mules Uprooted by the wind a giant maple crushed across the seat of Potts' Potts wagon wagon The mules es saw what was coming bolted anti and U joi Potts out of seat cent In I 4 Em a I |