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TIME-CROWDING AS A FACTOR IN INFLUENZA
Boston Medical and Surgical Journal, 1918, 179, 581-582.
Portsmouth, N. H.,
October 17, 1918.
I read in the Boston papers the statement made by Dr. William A. Brooks about the influenza epidemic. If I understand Dr. Brooks aright, he seems to ascribe the epidemic to the crowded condition of ships,―vitiated air and lack of sunshine. Permit me to ask, through the columns of your JOURNAL, a few questions which may possibly prove of some practical interest:
Are we to regard the present epidemic as being mainly the result of crowded ships? Should lack of fresh air and absence of sunshine be alone considered as the principal factors of the influenza and pneumonia plague which ravages the country from shore to shore? Are not there other factors equally important? Is it not biologically true that where organisms are suddenly exposed to intense exertion, overstrain, exhaustion, fatigue, cold. etc., that they become reduced in vitality, that the general resistance to infection is lowered, and that they are apt to fall easy victims to invasions by pathogenic micro-organisms? May we not in our present plight take such factors into consideration? May it not be quite possible that we have also to count with fundamentally predisposing conditions such as overstrain, exhaustion, fatigue. exposure to cold, etc., due to the sudden, quick hardening process of severe training and drilling of millions of young men unused to hardships and exposures, unable to react and be adapted suddenly to the conditions of intensive training fit for hardened constitutions of veterans who are sifted by the natural process of the survival of the fittest? Is it not quite probable that we may have to count here with the results of such a fundamental factor as the intensive process of raising armies of young adults in the briefest possible time, in a few months, in a few weeks? May we not expect that nature exacts its full reckoning for the feverish activity of obtaining quick results.
Have not Spencer, Clouston, James and others warned this nation against its "breathless hurry," "painful tension," convulsive eagerness, and, more especially against its intense "solicitude for quick results"? Have we ever paid heed to the warnings of those great men?
In this supreme moment of national life may it not be the sacred duty of the medical men to sound a warning note of danger against any intensive process of work and training, against sudden hardening and exposure of millions of our young generation? May it not be well and practical to take critical account of our methods of work, methods which may possibly defeat the ultimate purpose of a vigorous and healthy national life? May it not be quite probable that in the hurry of getting quick results, by intensive training and hardening, we really exhaust and waste the energies of our young people, drain the valuable sources of our national man-power, and, expose the nation to serious dangers of wide-spread epidemics and virulent plagues?
If Dr. Brooks finds it necessary to point out the dangers of crowding in space, may not the medical profession find it requisite to warn the nation against the still greater dangers of crowding in time? Is it not probable that the medical profession may perform a great and lasting service to the country in this present hour of need, if, with the greatest thinker of all ages, Aristotle, special stress is laid on the principle of moderation?