Peking Dust Part 12

APPENDIX II

From the "New York Medical Record," October 12, 1918:

THE ORIGIN OF THE SO-CALLED "SPANISH INFLUENZA"

BY JAMES JOSEPH KING, A.B., M.D.

NEW YORK

CAPTAIN MEDICAL CORPS, U. S. ARMY

We desire to present in this preliminary note a consideration of the similarity of the present epidemic to the epidemic of pneumonic plague which broke out in Harbin, China, in October, 1910, and spread rapidly and continuously throughout Northern China at that time; and to suggest that this epidemic may be the same disease modified by racial and topographical differences. The origin of this epidemic was suggested to the writer soon after its outbreak in our camps by Mr. Guy M. Walker, an eminent American authority on Chinese affairs. This suggestion led to an investigation of the reports of the pneumonic plague in China and there is sufficient likeness of that epidemic to the present one prevailing in our cities and army camps to warrant a consideration of it.

In the latter part of 1910 the pneumonic plague first appeared in Harbin a town in Manchuria under Chinese control. Harbin is on the Trans-Siberian Railroad, and was the original hotbed of the disease. The plague had prevailed in Russia previous to November, 1910, but the Russians, alert to its danger, took immediate action and stamped it out. It was believed that the plague was carried into Harbin by the fur dealers and by the Chinese laborers returning to their homes to celebrate New Year's Day, a custom universally observed in China. From Harbin the plague rapidly spread in all directions, usually following the lines of traffic along the railroads. It spread as far south as Chefu, a seaport town, probably having been carried there by Chinese coolies returning from the north.

This plague has been very serious. The mortality has been fearfully high. It has spread throughout China. Wherever the Chinese coolies from the North have traveled they have carried this disease. From 1910 up to 1917 China has not been free from it. The writer has heard of several cases being present in Peking last year.

In the early part of 1917, about 200,000 Chinese coolies, collected from the northern part of China, where the pneumonic plague has raged at intervals since 1910, were sent to France as laborers. Part of them were sent around through the Mediterranean; some, perhaps the majority, were sent across the Pacific, and then through Canada and America, to be transported across the Atlantic to France.

Trainloads of these coolies were sent in solid trains across the United States to New York and thence to France.

They made splendid laborers in France, and were in back of the lines during the German drive of March, 1918. No doubt many of them were captured by the Germans at that time.

Hence the outbreak of it in the German army and its rapid spread in Spain.

So far as we know, this disease first broke out last spring, in the German army, where it is said to have been very serious. We next heard of it in Spain, hence the name Spanish influenza. The name is really a misnomer, but it has stuck probably because it is the first epidemic of influenza that Spain has ever had. Since our soldiers and sailors have been returning from the battlefields of France it has become very prevalent and serious in our camps and cities all over this country.

... It seems possible that the _Bacillus pestis_ may have been present in a non-virulent state in the Chinese coolies, and a.s.sumed new virulence, vigor, and a somewhat different form, when transplanted into virgin soil. The high mortality and infectivity of this epidemic strongly suggest it.

On this basis the epidemics which have followed all great wars may be explained. If a nation or tribe can survive any disease long enough it will acquire immunity to that disease. When, however, foreign people commingle freely and intimately, as in war, epidemics will break out. The inactive, non-virulent organisms in one race will become virulent in some other race which has not acquired immunity to that specific organism.