An indisposition to do anything, or to be anything; a total deadness and distaste, a suspension of vitality; … an ossification all over; an oyster-like insensibility to the passing events; a mind-stupor; a brawny defiance to the needles of a thrusting-in conscience. — Charles Lamb

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The victims of influenza are less articulate than Charles Lamb, but at this moment there are thousands of them, the world over, who have recently experienced the hang-over which is so characteristic of this infection, and thousands more will do so before this strange disease again retires to its normal level of incidence.

In discussing the health of our army, General James S. Simmons stated that respiratory diseases were the most troublesome in the last war and that influenza must still be considered one of the most formidable “disease enemies” of the soldier. Many of us this winter were reminded of the world outbreak of flu in the winter of 1918–1919: in this country alone there were then more than 20,000,000 cases resulting in about 430,000 deaths in less than six months.

During the present war England had to cope with the urgent problems of acute respiratory infection in overcrowded air-raid shelters and in factories; now these dangers are our concern wherever they are met in camps, schools, industrial concentrations, transports, or public carriers. The possibility of recurrent epidemics, perhaps of increasing virulence, even of another pandemic, must be faced.

Although influenza is still far below its 1918–1919 level, we must not be complacent. Some signals are flying. The number of influenza cases, 82,951, reported by our State Department Health for the week ending December 18, 1943, was more than three times greater than the previous week and more than twenty-seven times that of the corresponding week in 1942. While the fight goes on, let us consider what advances have been made since 1918–1919 in the prevention and treatment of influenza and its ally, pneumonia.

A comparison of what was known then with our present knowledge reveals that we have made amazing progress. It was generally believed in 1918 that influenza and all of the pneumonias were of bacterial origin. The viral nature of epidemic influenza was first established in England in 1933, but it was not until 1938 that “virus pneumonia” was clearly recognized. Thus we are across the frontier of explorations that promise to push the range of medical knowledge at least as far as did the pioneer bacteriologic investigations of the last century.

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