to be the champions of peoples with whom they had no intimate relations, of whose existence almost they were unaware, simply to spread the gospel of altruism, stirred no great emotion.

Yet Mr. Wilson stirred emotion as no man has in our day, as few men have in the age-long struggle between liberty and absolutism, which is the road civilization has traveled. Men will fight with the gallantry of their blood in defense of country or to avenge a long and deep-seated wrong; they will fight with the cool courage of grim determination when urged by patriotism; but they will fight more desperately and die more gladly for a principle. And it is that extraordinary trait in human nature, it is, perhaps, because in every man there is implanted the divine spark, it is because, perhaps, in every man, even the most material, there is a touch of the mystic, that a great spiritual cause, the meaning of which is only dimly revealed, makes its most powerful appeal. Men of learning and illiterate, men from the great cities and little rural communities, were thrilled and uplifted at the thought they were to carry the banner of freedom three thousand miles across the seas.

Across those three thousand miles of sea there flowed not only the troops that were to be the undoing of Germany, but the invisible ether was crowded with the waves of new thoughts. They spread and spread until they engulfed the world. In places and lands where Democracy had no meaning men were asking what was this force that could make a great nation take up arms; what new religion it was that could inspire men to sacrifice and devotion. Democracy might not reform the world, but it could be the means to cure many of its ills. The example was infectious. A great spiritual force was unloosed. The little stone in the sling was to bring the giant low.

This war has ended as no war in history has been brought to an end. After every other war new states have been created, for the victors have sliced up the territory of the vanquished to gratify their selfish interests or to take from the weak what they long coveted. This war sees new states created, brought into being by the spirit of Democracy. It is wonderful when one looks at the map of 1914 and compares it with the new map. Republics rising on the thrones of kings. Races long oppressed, in whom the aspiration for freedom has never been crushed, liberated from their bonds, and

turning not to kings to be their masters but to presidents to guide them. Mighty empires that have been created by fraud and force and cunning, that have lived by oppression and thrived on deceit, that have stood the storm and stress of centuries, that have met craft with intrigue and chicanery with duplicity, have crumbled. Verily the old era is passing, and we stand at the dawn of a new age and a better world.

Mr. Wilson lit a flame that ran around the world. America has been the promise of hope to the down-trodden and the despairing. Mr. Wilson's idealism, scoffed at and laughed at when to men of stunted vision it was the dream of a visionary, is now recognized as the words of the prophet inspired.

It is the dreamers weaving their dreams in the spiritual exaltation of their own high ideals who have brought progress to the world. It is the dreamers, the poets, the prophets, the statesmen of large imagination, endowed with the power to see the future, who have led mankind to their own high plane. It is the visionary who makes things real. In belligerent as well as Allied and neutral countries, even in the United States itself, in those places and among those peoples to whom Democracy was either meaningless or a word of little meaning, it was given a meaning, a vital force and substance, which has made the world incomparably richer. It has quickened thought. Even while men. were fighting-forced against their will to fight because they were helpless in the grasp of an immoral and vicious system-the spiritual force of Democracy was sapping their morale. Men were reading and puzzled and in doubt. They were trying to find the truth. They were like little children in the fear of darkness groping for the light. Autocracy had brought its own condemnation. Might not Democracy be its own vindication?

The world is ennobled by its visions. Progress is measured by dreams transformed into actions. The dream and the vision are the parents of thought. At every supreme crisis, when the structure of civilization which men with bleeding hands have so painfully erected is in danger of destruction, there comes forward a man who gives a fresh impetus to thought and holds aloft the ideals which are to their fellow men their inspiration and their strength. The crisis broke upon the world, and the man was there.

In the last great epidemic, in 1890, 1891 and 1892, the greatest mortality occurred in 1891, the second year, although all three of these years showed a higher death rate from the acute respiratory diseases in New York City than had been experienced before for many years. It is not as yet possible to not as yet possible to assess even approximately the extent of the loss which influenza has brought and will bring to the country before the sickness and death rates are freed from its malign influence. The present indications, however, would seem to show quite clearly that the immediate deaths resulting from influenza and its complications in the United States during the present year will probably exceed 300,000.

In the epidemic of 1891, it was the opinion of the best observers that the deaths caused by the disease and its immediate complications did not represent more than one-half of those which were properly chargeable to this cause. The sequelæ in many instances were so serious that a large number of persons who recovered from the immediate effects of the disease subsequently died from the remote results. It was well said some years after this epidemic by one of the keenest clinical observers in this country, that we had come to recognize in grippe, or true influenza, a most potent influence in the development of every form of latent weakness or disease.

In 1890 it was reported by the RegistrarGeneral of England and Wales that the number of deaths directly ascribed to influenza was 45.2 per 10,000, but that an analysis of the vital statistics of the period showed that the number of deaths directly or indirectly attributed to it was 271 per 10,000, or more than six times the apparent

rate.

The present epidemic has differed from the last in several respects and, so far as we are now able to judge, has been attended with a higher immediate mortality, but has apparently left less serious results on the health and vitality of those who have recovered. It seems likely, therefore, that we shall not be compelled to pay proportionately so heavy a penalty in subsequent years as we did in the last outbreak. In any event, however, so far as life and health are concerned, it is apparent that the toll of the epidemic measured in deaths and disabilities will be for the United States four or five times as great as that of the war.

These deaths, too, and the invalidism. which will follow, like those of the war, have fallen for the most part upon the age groups of the population which are at the period of greatest usefulness, that is, in the age groups between fifteen and forty-five, and especially between the ages of twenty and thirty. The casualties of the war are in many respects far less serious than the disabilities which will be left from influ

enza.

How the Disease is Transmitted

The question naturally arises as to how such a pandemic of disease should be possible at the present time. It is a matter of common knowledge that extensive advances have been made in the last thirty years in our knowledge of bacteriology and the relation of microorganisms to the infective

diseases, and that the application of this knowledge in respect to so many other diseases has brought about an enormous reduction in the sickness and death rate caused by them and has placed in the hands. of public-health officials adequate measures for their control. How then should it be possible that in spite of this knowledge every country in Europe and North America should experience an epidemic, which has been attended with the greatest loss of life that has occurred in a century?

The files of the daily papers during the month of October and early November, 1918, give full indication of the almost hopeless, helpless attitude of the authorities. toward the outbreak. Still we know quite definitely that the disease is transmitted solely through the infective organisms contained in the discharges from the nose and mouth, and therefore, theoretically at least, should be preventable.

There may be, and undoubtedly there is, some question as to whether the cause of the disease is the influenza bacillus-the socalled "Pfeiffer Bacillus"-or is some as yet unrecognized organism; but there is no doubt whatever of the fact that the organisms causing the disease are contained solely in the discharges from the nose and mouth. Moreover, whatever their nature may be, it is quite certain that they do not undergo any multiplication outside of the living body and are quickly destroyed when the secretions are exposed to drying or to direct sunlight or even diffuse daylight.

Like measles, the period of the greatest infectivity in influenza comprises the early days of the disease, and the agency and the importance of "disease carriers" in its transmission are uncertain and somewhat doubtful. In sparsely settled rural districts, in several instances, it has been possible to trace every case to direct exposure to some previous case and the period of incubation was rarely longer than two days.

Vaccines of various kinds for the prevention and for the treatment of the disease have been extensively used. Small groups of workers have been engaged in the study of its pathology and bacteriology and have been endeavoring to definitely determine what the relation of the influenza bacillus is to it, but no definite conclusions have thus far been reached. This seems the more unfortunate because the most favorable opportunities for the study of the disease have already passed, and probably will not recur again until another epidemic appears. Very

little has as yet been added to our actual knowledge, although the disease has been prevailing almost continuously either in Spain or France or Great Britain or the United States for nearly a year.

No Organized Study of the Disease

Most unfortunate, too, it must seem to everyone who thoughtfully considers this question, that there has been during this time no systematic, concerted effort on an adequate scale by a highly qualified group of scientific men to solve this problem, although influenza presents a world health problem of stupendous importance and magnitude. But the reason for this is evident enough even on casual consideration. There does not exist in any country an institution or an organization which has the resources, the personnel, or the facilities for immediately taking up the study of such a problem, when it presents itself, or which contemplates within its program of work the investigation of such problems. It is manifestly not for our local or State authorities to undertake such a work and the Federal Government has no facilities for it. Neither the United States Public Health Service, nor the Medical Service of the Army or the Navy is equipped for such a study-and there is no scientific institution prepared for such work.

Its

The Rockefeller Institute for Medical Research might be thought of in this connection, but this institution is primarily designed for special scientific investigations dealing with medicine and carried on for the most part in the Institute itself. resources, while large, are already heavily taxed by the great demands of the work which it is undertaking, and it could not now well add the heavy burden which the investigation of world health problems, such as this one is, would involve.

There are many public-health problems of other kinds which ought to be dealt with as research problems. Unfortunately, there has been very little real research devoted to the questions of public health, administration and policy. Public-health administrators have generally had neither the training, the facilities, nor the resources to undertake work of this kind, and they have been compelled to confine their activities solely to the practical aspects of their work. The methods employed and the results obtained in public-health work should be subjected to critical study.

There is, then, the greatest urgency for

providing in some way for an institution cr an organization which can undertake the study of such world health problems as influenza presents, and which shall be prepared to take up the investigation at once. and anywhere and at any time, of health subjects which are of the first importance. In the present instance, if the real cause of this disease and the final solution of its prevention could not have been at once found (for we must all believe that eventually the explanation of every infectious disease will be discovered), yet the nature, the manner of spread of the infection, the best methods to be adopted for the prevention, the value of vaccines and the influence of various conditions on the development and the extension of the disease-these are questions to which most important contributions could have been made, and which would have been of incalculable value in all countries, when the health authorities were actually called upon to formulate administrative measures to deal with epidemics.

Transmission from Place to Place The rapidity of the spread of influenza throughout a country is only limited by the rapidity of the means of transportation. The disease is carried from place to place by persons, not things. Its rapid extension is due to its great infectivity, the short period. of incubation, usually two days or less, the mild or missed cases, and the absence of proper precautionary measures. There is no mystery about its spread, and it is perfectly possible by proper isolation, although it is not usually practicable, to protect a group or a community from the infection.

The epidemics in different regions bear an extraordinary similarity to each other, and finally check themselves. The whole period, from the appearance of the first cases in an outbreak to the subsidence, is rarely in excess of six weeks, and often not more than four or five weeks. There is first the appearance of a few cases, than a rapid rise, covering a period of ten days or two weeks, a short period of only three or four days in which the epidemic remains at a maximum, then a rapid decline for eight or ten days, which is followed by a further slow decline, and often by a subsequent recrudescence.

Vaccination is now practicable for several varieties of pneumonia, but as to the value of such preventive treatment in influenza,

we have even now no definite information. This is one of the problems which is being most earnestly studied by the New York State Commission appointed by Governor Whitman for the investigation of influenza. This commission numbers among its members many of the most distinguished bacteriologists, sanitarians and clinicians of the country.

The total number of deaths resulting from the present pandemic of influenza will never be known, even approximately. The disease has been more fatal through its complications apparently in this country than anywhere else, but recent reports show that it is reappearing in France and Great Britain in a more virulent form than was the case last year.

Conditions of Army Life

The experience during this epidemic in the camps and barracks, and among members of the student army training corps, and in institutions, has shown clearly the great infectivity at this time of the acute respiratory diseases, and the relatively high morbidity and mortality from these diseases where barrack living conditions exist; in other words, where comparatively large groups of persons live and sleep in single

rooms.

It is estimated that in the army, in this country, the total death rate per thousand in the age group between twenty and thirty, was over twelve. This is at least twice the average mortality at this age group under ordinary civilian conditions, and is probably four times the mortality at this age group throughout the county. If it were maintained for the whole country it would mean that the mortality from the epidemic would be over 1,250,000.

Tremendous Economic Loss

It must be remembered, in addition to all humanitarian considerations, how great is the economic loss which has been encountered. The deaths have occurred at the period of life at which the greatest outlay has been made, and when scarcely any return has been received by the community for the investment. Human life is a great financial asset, and its value is rapidly increasing, for while the death rates have fallen steadily in these recent years, they have been constantly outstripped by the rapidity of the fall in birth rates.

ALEAGUE to Enforce Peace presupposes

a peace worth guaranteeing and preserving. It must be a peace which represents "a new international order based upon the broad and universal principles of right and justice." Peace in itself has no inherent merit; it can always be obtained by submission to force, tyranny, and injustice.

The present war was begun for conquest and dominion; it developed into a titanic contest between forces representing antagonistic political systems; it became simply a struggle between right and wrong. The Allies were fighting for the simple, elementary principles of common justice, and to bring about conditions under which another great war will be impossible. They will dictate a peace of victory, but unless it is a peace of justice the war will have been lost. Germany is an international criminal, and justice for a criminal implies punishment. Generosity must follow, not precede, punishment; otherwise it is mere maudlin sentimentalism-sending flowers to jails for efficient murderers and chivalric burglars.

The Holy Alliance of the Last Century

There is nothing novel in the idea of a federation of the world nor in an alliance of certain nations for worthy and unselfish ends. The idea of a League of Nations, such as has been approved by the Governments of the United States and France, and by statesmen and publicists the world over, had its theoretical counterpart in that Holy Alliance of evil memory, which for years after Napoleon had been sent to St. Helena maintained the

peace of Europe. Much of present value may be learned from the history of that League of Monarchs.

The Congress of Vienna remade the map of Europe arbitrarily as dynastic and princely interests required, without the slightest regard for the wishes or welfare of the people. Absolutism, which had been so rudely shaken by the French Revolution, was to be made secure; and for almost half a century the Alliance enforced peace throughout Europe. But it was a peace based on wrong and injustice, a curse instead of a blessing.

Among the extremely practical statesmen assembled at Vienna there was one war-weary monarch, who dreamed of a Europe in which kings and their subjects should live in peace and amity, according to the principles of the Christian religion. Metternich regarded the Emperor Alexander as an "eccentric" and "a madman," but, as he was "a madman to be humored," he gave verbal adherence to the proposal that the rulers of Russia, Austria, and Prussia should agree to conduct the domestic and foreign affairs of their kingdoms according to the principles of the Christian religion, and support each other in maintaining peace and justice on earth. So on the occasion of a review on the plains of Vertus the Holy Alliance was solemnly proclaimed. The Prince Regent of England approved the principles upon which it was based, and most of the states of Europe subsequently adhered to the treaty.

That the Czar was sincere is no longer questioned. But the King of Prussia was under the influence of the Emperor Francis