THE HAGUE, June 20.--The mysterious sickness now prevalent in Spain "comes from Germany and will doubtless soon reach other countries," said a Dutch tailor who recently returned from Germany.  "Conditions among the civil population of Germany are terrible.  Workmen die at their work from lack of nourishment...."

LONDON, June 26.--Influenza is now epidemic all along the German front, according to advices received from the Dutch frontier, and the prevalence of this ailment is aid to be hampering the preparations for offensive operations.

The proportion of men sent to hospitals on account of influenza has risen rapidly in all the German units in the last few days, and special hospitals are being established in the rear areas dealing solely with this disease.

Thus far only the more serious cases have been sent to the hospitals, but the German army doctors say that, unless even the light cases are removed from the units, it will be difficult to prevent further spread of the epidemic.

The disease prevalent in the German Army is reported to be of the new Spanish type, which recently broke out in Berlin and other German cities, and is presumed to have been brought to the trenches by men returning from leave.

In the German cities the disease has been very hard to deal with owing to the shortage of doctors and the conditions of undernutrition among the city populations.

WITH THE BRITISH ARMY IN FRANCE, June 26, (Associated Press.)--German troops on the western front are suffering from an epidemic of grip, which incapacitates them for a week or ten days.  There are also many cases of typhus and dysentery within the German lines southwest of Lille.

There is no evidence, however, that these illnesses are responsible for the delay of the new offensive.  It is believed that the German High Command has nearly completed its preparations for the next great attack against the allied front.

[The prevalence of influenza and dysentery among the German troops on the western front was reported by Philip Gibbs in THE TIMES of Tuesday last.]

What degree of importance should be ascribed to the report that an epidemic of "Spanish influenza" is sweeping through the German armies on the western front depends on the degree of virulence marking the particular strain of bacilli that is now at work.  Sometimes the effects they produce are little more than annoying, but not infrequently they are completely disabling for long periods -- several months -- and many of the victims die or become invalids for life.  It is possible, therefore, that the appearance of this malady may influence the conduct of the war, or even play a part in deciding its conclusion.

If one were allowed to be human rather than humane, there would be a general yielding throughout the allied world to the temptation to express the hope that the Germans may have the disease in a severe form.  That would be no more than they deserve.  Indeed, but for at least one reason -- the reason that wishes, in such matters, do not count either way -- it is better not to put in definite form a desire which, after all, is worthier of Germans than of civilized people.

Moreover, if the influenza is raging on one side of No Man's Land, it is sure soon to appear on our side of the lines.  But that it would be equally disastrous when thus transferred by prisoners or otherwise is by no means certain.  On the contrary, there is ground for hoping and even for believing that the soldiers of the Allies, not having been through a long course of undernourishment would be better able than the Germans to resist the attack of the bacilli, and that their sufferings from such a cause would be comparatively light.

The fact that this influenza is called Spanish by no means proves it of that origin.  Dubious, too, is the recently suggested theory that the malady in its present form was started by the conditions produced among men making long cruises in submarines.  Yet that theory may be true.  Bacilli are as much affected by environment as are any other animals, and the submarine strain of the influenza bacillus might well be measurably unlike its relatives and more injurious to human hosts.

AN ATLANTIC PORT, July 2.--Passengers arriving today from Spain were fumigated before the health officers would let them land.  In addition their clothing was passed through a steamer lest the passengers bring ashore germs of the influenza which has been prevalent in Spain for five months.

Passengers in the first cabin say it was supposed in Spain that the germs of influenza had been brought by the strong Winter winds from the battlefields of France and that they would have been more deadly if they had not encountered the snow-clad Pyrennees.

Mrs. Andrea De Onis of Salamanca said the disease had spread over Spain and brought business to a standstill in many cities....

WITH THE BRITISH ARMY IN FRANCE, July 8.--Captured documents and statements by prisoners indicate that the Germans are having a bad time in numerous zones with the new influenza which is running through Europe.  An unposted letter found in the pocket of a man captured on July 4 throws some light on the subject.  It read:

"I feel so ill that I should like to report sick.  Fever is rampant among us and already a whole lot of men are in the hospital.  Every day more go in.  As I have not yet had leave and am expecting to go any day, I shall not report sick yet anyway."

This letter, of course, refers to the prisoner's own sector and not to the whole German front, of which he would know little.

The new fever is said to strike down the men so quickly that they drop in their tracks while on duty.  They have high fever for two or three days and are usually laid up for at least six days in the hospital.

ROME, July 10.--Emperor William himself has fallen victim to the influenza that has been so prevalent in the German army, according to advices from a Swiss source that have reached the Epoca.

These say that the Emperor has gone home from the French front because of the attack of the "Spanish grip," as it is called, and that several members of the Emperor's family also are suffering from the same malady.

War correspondents' headquarters, JULY 12.--...The "Flanders grip," as they call the sickness which is now rife among them, is not the only form of sickness which is weakening their manpower for the time.  Typhus is said to have occurred in at least one resting division.  It would be interesting to know how the wet weather will tend to increase or diminish the chance of infection....

BERNE, July 22.--Owing to the prevalence of "Spanish grippe" the municipality has forbidden under penalty of 5000 francs or three months of imprisonment, performances in theatres, picture houses, music halls, concerts, or meetings of any kind, including religious ceremonies, until further orders.

There were cases of influenza, Spanish or some other kind, aboard a Norwegian steamer when she arrived at Quarantine on Tuesday and when she tied up at her pier.  This statement was made yesterday by Dr. Leland E. Cofer, Health Officer of the Port, and was confirmed by Health Commissioner Copeland.  However, all the patients transferred from the ship to the Norwegian Hospital in Brooklyn now have pneumonia.

Both Dr. Copeland and Dr. Cofer were emphatic that there was not the slightest danger of an epidemic of Spanish influenza in New York.  While, according to Dr. Cofer, the Spanish variety is more virulent than any other known influenza, it seldom attacks any but persons who are badly nourished.  Dr. Copeland said the same thing, and added:  "You haven't heard of our doughboys getting it, have you?  You bet you haven't, and you won't.  But you have heard of cases in the German Army, because prisoners taken by the English have had it.  No need for our people to worry over the matter."

When the steamer arrived at Quarantine her surgeon reported that there were nine cases of influenza on board.  (Dr. Cofer says the surgeon did not use the world "Spanish,") and that there had been three deaths at sea from pneumonia, which had been preceded by influenza.  Dr. Cofer permitted the steamer to proceed to her pier.  He had no opinion to express as to whether it might be well to establish such a quarantine, but Dr. Copeland said there would be a meeting of the New York Board of Health today, at which Dr. Cofer would be present, and that the subject would be discussed.

On the other hand, Dr. Rora Tole of the Norwegian Hospital, who has charge of the patients transferred from the ship said that while they were now suffering from pneumonia, the pneumonia was "probably brought on by Spanish influenza."

"At the time these patients entered the hospital," the doctor said, "their histories corresponded with the histories of cases of Spanish influenza in that, soon after they became ill, they developed severe headaches and high fevers.  It was caused, probably, by the close quarters and food that was not as nourishing as it might have been.  The patients are now suffering from pneumonia, and are doing as well as might be expected."

The following bulletin was issued by the Department of Health last evening:

"Many thousands of cases resembling influenza have occurred in Spain and Germany, and some in England.  In Spain and Germany it has been reported that one-third of the population of the sections in which the disease appeared was attacked.  On this side of the Atlantic the disease visited certain parts of Cuba last June and one-quarter of the population of Havana was said to have been affected, but not a single death resulted.  In Spain, however, it has been reported that something like 700 deaths from the disease have occurred.

"The symptoms reported are fever, general aching of joints and head, catarrh of the conjunctivil nasal and bronchial mucous membranes.  Cases usually run their courses in about three days, without serious results.  Reports from Spain state that in the majority examined, a streptococcus and a gram-negative diplococcus of what is known as the catarrhalis type were found.  It is evident that, before we know what the disease is, or even if all the cases reported can be ascribed to the same organism, we must await reports of further investigations.  From the reports of the physicians attending the cases in the Norwegian Hospital, we have no reason to believe that the illnesses are the same as those which caused the European epidemic.  The hospital physicians say the patients have pneumonia.

"The public has no reason for alarm, since, through the protection afforded by our most efficient Quarantine station and the constant vigilance of the city's health authorities, all the protection that sanitary science can give is assured.  The very mildness of the disease, as reported in Europe, is in itself assurance against anxiety on this side of the water.  Our troops in France, so far, have escaped attack from this influenza, although some of those of Germany and a few perhaps, of those of Britain and France, have suffered.   This has been ascribed to the great resistance which well-fed, healthy individuals offer to the disease."

Whether for informative or defensive purposes was not explained, but late last evening the statement was made at Quarantine that the reason the Norwegian was passed was because the ship's surgeon reported that all his sick folk had recovered.  This is altogether a different reason from that given by Dr. Cofer earlier in the day, when he said the ship had been passed because there was no quarantine at this port against influenza.

On Tuesday a Norwegian steamer arrived at quarantine and her doctor recorded nine cases of influenza on board.  There had been three deaths from pneumonia, following influenza at sea.  Certain cases transferred from the boat to the hospital were classified as pneumonia, "probably brought on by Spanish influenza," says the physician in charge.  According to Dr. Cofer, the Health Officer of the Port, the surgeon of the steamer did not use the adjective "Spanish" in reference to the cases reported on the boat.  How ingenuous!  At Quarantine Wednesday morning it was said that the ship had been passed because there was no quarantine on influenza at this port.  On Wednesday night Quarantine said that the ship had been passed because her surgeon reported that the sick people on her had recovered.

Apparently the health officers soon became doubtful of the wisdom of letting the ship come up.  Yesterday Health Department Inspectors and Port Inspectors went to Quarantine to examine members of the crew and passengers who had not already passed quarantine.  To some extent this was locking the stable door after the horse had been stolen.  It may be true, as Dr. Copeland says, that "the public has no reason for alarm, since, through the protection afforded by our most efficient Quarantine Station and the constant vigilance of the city's health authorities, all the protection that sanitary science can give is assured."  There may be doubts as to the protection accorded by our most efficient Quarantine Station and vigilant city health authorities if, after so many thousands of cases of Spanish influenza in Spain, in Germany, in France, in England, in Cuba, it was only yesterday that the question of laying a quarantine against Spanish influenza was taken up by the protectors.  "You haven't heard of our doughboys getting it, have you?" said Dr. Copeland.  "You bet you haven't, and you won't."  The theory is that few but persons badly nourished, of low vitality, are attacked by this virulent form of influenza.  Naturally, the weakest are the best customers of disease.  But the British and French soldiers in France, some or many of whom are said to have had this influenza, are well fed.  The people of England, where it has raged considerably, are well fed.  The people of both Spain and Cuba are enjoying remarkable prosperity, and presumably their diet is in proportion, if always soberer and more frugal than ours.

There is no necessity for alarm and nobody is going to be alarmed; but perhaps the health authorities of the port and the city have been a little too eager to reassure the public, which prefers the truth to official demulcents.  And, possibly, those authorities have been too easy or incredulous in regard to our Spanish visitor.

Eleven more cases of Spanish influenza, or whatever it is, were reported at quarantine yesterday from a ship arriving from one of the Scandinavian countries.  The ship's surgeon reported that all his patients were in the convalescent stage and none had developed pneumonia.  The ship was passed.

The New York Board of Health, at its meeting yesterday, took official notice of the fact that there is influenza, germinated in Europe, in the city.  The board ordered that cultures be taken from each one of the patients now in the Norwegian Hospital in Brooklyn and that these cultures be sent to the board's bacteriological laboratory for observation and analysis.  This was done as a precautionary measure and not, so Health Commissioner Copeland reiterated, because he or any member of the board believes there is the slightest danger of an influenza epidemic breaking out in New York.

Dr. Cofer, Health Officer of the Port of New York, was asked yesterday if he intended to establish at this port a quarantine against foreign-bred influenza.

"I am glad you asked that question since it gives me an opportunity to clear up an evident confusion in the minds of many of the people of this city," he said.  "To give you first a direct answer to your question, I do not intend to establish a quarantine against influenza, Spanish or any other kind.  And right here let me digress long enough to say that Spanish influenza is altogether a misnomer.  We have had epidemics of influenza in this country with symptoms very like those of the cases developed in Spain.  Yet the world didn't rise up and call it American or United States influenza.  Nobody knows definitely whether this European variety that we have heard of recently is Spanish or Norwegian or Swedish or what.

"Now, you see, and you'd better make careful notation of these, there are just six diseases which are recognized the world over by health authorities, as proper diseases against which to declare a marine quarantine.  They are Smallpox, leprosy, yellow fever, plague -- that's the correct term, rather than a specific kind of plague -- typhus fever and cholera.  Just let a ship stick her nose into this harbor with a case of any one of these diseases on board and she will find herself tied up in the stiffest kind of quarantine.

"But there are other diseases, like diphtheria, scarlet fever, tuberculosis and typhoid fever, against which there is no need of establishing a marine quarantine.  There is need of exercising common sense in quarantine as in everything else.  To hold up and examine every ship reporting cases on board of diseases like the last I mentioned would require, first, an immense quarantine station, and second, an immense staff.  And what is much more, it would entail an interminable tie-up of shipping and a clogging of the port.

"This country is at war and, besides having on our hands the winning of the war, we have also the job of supplying our Allies with much that they need with which to enable them to fight on successfully.  This port cannot be clogged for a minute longer than necessity requires.  Therefore, when we find what may be called minor communicable diseases on ships entering the port, such as the ones I have spoken of, and to which must be added influenza, we simply report them to the city Board of Health, which is splendidly able and enthusiastically willing to take care of each case when or before it leaves the ship at its pier.

"There is not the slightest danger of an influenza epidemic breaking out in New York, and this Port will not be quarantined against that disease."

Another death among the influenza patients at the Norwegian Hospital in Brooklyn occurred last evening.  It was that of a boy 17 years old named Avid Sondstrom.  The cause of death was given as pneumonia.

A big passenger liner which arrived in this port on Friday reported that on her voyage twenty-one cases of Spanish influenza developed among the passengers and crew.  There were eight cases in the third cabin, all among a company of East Indians.  Of these five died, and tree were removed to St. Vincent's Hospital.  Dr. Cofer, Health Officer of the Port, found all the rest of the cases convalescent.  The majority of the patients were Hollanders, the doctor said, who were well nourished.  Persons from neutral countries who could afford to travel first cabin these days can usually find a way to get fairly nourishing food, he added.

When the ship arrived these patients were all getting well, and had not had pneumonia.  This was not the case with the East Indians, however.  The five died soon after pneumonia attacked them, and those at St. Vincent's Hospital are still in a serious condition.  These facts, Dr. Cofer asserted, simply tended to confirm the general theory that the disease attacked most seriously those who were physically run down and debilitated from lack of good food....

Colonel J. M. Kennedy, Medical Corps, U. S. A., Chief Surgeon at the New York port of embarkation, said yesterday ... "the present publicity given to incoming influenza is publicity given to an old story.  Ships having influenza aboard began arriving at this port six weeks or two months ago....  I am quite familiar with the procedure at Quarantine and that taken by the New York Health Department.

"It has my hearty approval.  Furthermore, I agree with Dr. Cofer ... that it would be utterly impracticable to establish a quarantine at this port against this disease.  We can't stop this war on account of Spanish or any other kind of influenza.  To quarantine against it would mean to isolate the patients somewhere and fumigate every ship.  That would clog the harbor and produce interminable delays in the sending of troops and supplies overseas, and that cannot be permitted.  'Over there' they don't quarantine a regiment in which influenza has broken out and withdraw it from the fighting line.  They take care of the sick and the rest go right on fighting....

"Influenza, and the kind that is coming here is just like ours or that of any other country, is not at all dangerous, except when pneumonia develops.  Pneumonia develops in a comparatively few cases, and few of those cases have fatal results, except where the patient has become debilitated through lack of proper food.  The less this whole subject is agitated the better it will be for New York and the whole country and for our army overseas."

By order of the post commander, Colonel John S. Mallory, Camp Upton was closed last night for an indefinite period on account of the accumulation there of so-called Spanish influenza cases.  At 10 o'clock last evening 170 cases were reported from the base hospital at the camp.  The muster at Upton yesterday was between 40,000 and 45,000 officers and men.  There are sufficient physicians and nurses, and the situation is under control, but, to avoid the spread of the disease beyond the camp confines, Colonel Mallory decided that, until further orders, no visitors would be allowed to enter the camp and no one stationed there would be allowed to leave it, except on the most urgent business.

The source of the disease has not been traced.  There have been no deaths.  In fact, there are not even any very serious cases.  The usual symptoms have manifested themselves -- severe headache, jointache, a rapid rise in temperature and violent sneezing.  The disease runs its course in three or four days, as a rule, and then a period of convalescence sets in.  In the days of convalescence, the Spanish influenza patients must be kept extremely quiet to prevent a sudden weakening of the heart.  To avoid this is the chief care of the doctors and nurses.

Camp Upton has, by comparison with other camps, been fortunate in its experience with this disease.  Some of the other camps not having as large muster roll as Upton, have reported from 4,500 to 5,000 cases.

BOSTON, Sept. 16--Influenza claimed sixteen deaths in six hours in Greater Boston today.  Several hundred new cases were reported.  Medical officers said they believed they had the situation well in hand, but the disease not being a reportable one in civil life, the health authorities were unable to state with accuracy to what extent it was spreading.

Ten of the deaths today were of naval men.  In the fourteen stations in the First Naval District 2,331 cases have been reported, with 47 deaths, out of a total personnel of 20,500.  The disease has spread to the naval prison at Portsmouth, N.H., where 59 cases have been reported.

Ways of instructing the public how to prevent the spread of influenza from cases that might come to the city were discussed at a conference yesterday by Health Commissioner Copeland, Dr. Louis I. Harris, Director of the Bureau of Preventable Diseases in the Health Department, and other officials of the department and the United States Public Health Service.  The conference was held after the Health Department had received reports that there were 8,000 cases of influenza among the soldiers at Camp Devens, at Ayer, Mass., with about 100 cases in the naval hospital at the submarine base in New London and others in Camp Lee, Va.

Only twenty-three cases of influenza had been reported to the Health Department here, Commissioner Copeland said, and all had been isolated so that there was no danger of the disease spreading from them.  All the cases were sailors from the American Navy, who contracted the illness on ships as the result of heavy colds, Dr. Copeland said, and all were mild except two that had developed pneumonia.  The men were taken from ships by navy surgeons and physicians of the Public Health Service and sent to the Long Island College Hospital in Brooklyn.  Four of the cases were discovered yesterday on ships from Philadelphia, Newport, Charleston, and Panama.

"There is no danger of the affection spreading here from the cases we have under treatment now," said Commissioner Copeland, "and the Health Department, the Public Health Service and the navy surgeons are co-operating to see that no new cases are introduce.  A rigid examination of the crews of all ships is being made at Quarantine and the navy yard.

The Health Department took steps yesterday to prevent the spread here of the so-called Spanish influenza.  This latest effort was embodied in the action of the Board of Health at its regular meeting in placing pneumonia and influenza on the list of diseases that must be reported by all physicians.  Pneumonia occurs as the secondary stage in the disease, and is the cause of death....

Pneumonia and influenza were formerly exempted from the list [of communicable diseases to be reported], and this, the authorities held, left a way by which the disease might come into the city and its spread be attended by very little publicity until perhaps too late....

Health Commissioner Copeland decided that the old method would not do in the present crisis, and he decided that the best way to check the possible spread of Spanish influenza was to put it and pneumonia on the list of diseases that must be reported....

The campaign to keep Spanish influenza from entering the city is under charge of Dr. Harris, Chief of the Bureau of Communicable Diseases.  Dr. Copeland said that all precautions had been taken and that the grave danger was not that it should spread through cases arriving here on steamships, but that it might "execute a flank attack" and reach this city by the way of the railroads from Boston or elsewhere.

"In Boston," said the Commissioner, "a great many cases have been found, and naturally some of those affected will come to this city by railroad, bringing the germs with them.  It would be impossible under present conditions to check up these arrivals, and the result would be an epidemic here.  To prevent this we have changed the existing order."

Up to the present time, Dr. Copeland said, there have been no local cases of the new disease reported, all those found being among sailors in the service or on incoming vessels.  These cases have been placed under quarantine in the city hospitals.

Three cases of influenza at 42 Clifton Place, Jersey City, were quarantined by the Health Board of that city yesterday.  Dr. Joseph Craven, Superintendent of the board, said it was the old-fashioned influenza, an infectious germ disease requiring the quarantining of the patient, but, he did not know of any reason for calling it the Spanish influenza or any other special name.

Major C.H. Goddard, the camp surgeon, said that many of the first cases reported last Friday were now ready to leave hospital, but that 30 new cases developed yesterday.  The malady is being fought principally with sunshine and fresh air.

Every window in camp is up to stay indefinitely.  The men in barracks are sleeping alternately head to foot, beds remain out doors all day, and the floors are scrubbed continually.  Every man has also been provided with an extra blanket. 

It was not found necessary to close the camp theatres, and the Y.M.C.A. succeeded in arranging entrance for entertainers coming from the city.  The Long Island Railroad warned all persons who bought tickets in New York for Camp Upton of the quarantine, and the military police refused admission to visitors.

WASHINGTON, Sept. 18.--That the outbreaks of Spanish influenza, which have given army officials some concern, may have been started by German agents who were put ashore from a submarine, was the belief expressed today by Lieut. Col. Phillip S. Doane, head of the health and Sanitation Section of the Emergency Fleet Corporation.

"It is quite possible that the epidemic was started by Huns sent ashore by boche submarine commanders," he said.

"We know that men have been ashore from German submarine boats, for they have been in New York and other places.  It would be quite easy for one of these German agents to turn loose Spanish influenza germs in a theatre or some other place where large numbers of persons are assembled.

"The Germans have started epidemics in Europe, and there is no reason why they should be particularly gentle with America.  Of course, there is no way of proving that the disease was started here by German submarine agents, but it is well within the range of possibility."

A program of prevention was started today in all the Eastern Shipyards.  Colonel Doane sent his staff physician, Dr. W. F. Coon, to Boston to take charge of the situation and instructed C. E. Turner, his sanitary engineer, to ask the port authorities of that city to examine all passengers of incoming ships.  All shipyards on the East coast and in the Great Lakes region have received instructions as to methods of combating the disease.

Surgeon General Rupert Blue of the Public Health Service telegraphed today to health officers in different parts of the country to report all cases of Spanish influenza.  No report had been made, General Blue said tonight, on the three cases that developed in New York today.  These and other cases that may develop there are expected to be reported, however, under the request telegraphed today.

Brig. Gen. Robert F. Noble, U.S.A., who is Acting Surgeon General of the Army in the absence of Surgeon General Gorgas in Europe, also said tonight that no report had been made to him on the cases in New York.

Now that the disease had found entry into New York, Federal health officials fear it will spread rapidly there.  But unless it is more virulent than the outbreak now sweeping the army camps great fatality is not expected.  In Europe, there has been considerable fatality, but this is attributed to the fact that the population has been undernourished and less able to resist its attacks.

Both Surgeon General Blue and General Noble said tonight that it would not be possible to quarantine civilians against the disease.  To do that, it was asserted, would mean absolute, nonintercourse.

The cases that have developed so far in this country have been very mild.  There are something like 10,000 cases in the army, of which about 3,000 are at Camps Devens, Lee, and Upton.  But there have been only a few deaths so far in the army.  They occurred at Camp Devens.

While it has become the fashion, General Blue said, to call the present outbreak Spanish influenza, he said it was not a new disease, but identically the same as that which swept this country in 1889 under the name of influenza.  That epidemic, he explained, started at Constantinople and spread to San Francisco inside of six weeks.

The present epidemic had its origin in Spain.  It spread to Germany and all over Europe, has made its way to Central America and Mexico, the West Indies, and Hawaii.

Three cases of Spanish influenza were reported to the Board of Health yesterday.  They were not army or navy or incoming ship cases, but persons living on Manhattan Island, all in or near the middle section of Central Park West or in cross streets leading to it.  Health Commissioner Copeland lives in the territory where the germ has developed.  Two other cases, sailors from ships in the harbor, were also reported yesterday.  Speaking of these native cases yesterday Commissioner Copeland said:

"It looks very much as if we were in for our influenza siege.  Three of the five cases reported today were simon-pure New York bred.  They are not at all serious, and all have been quarantined.  Every precaution has been taken to prevent the spread of the disease, but we are going to have more cases.  The hospitals are ready for them.

"When cases develop in private houses or apartments they will be kept in strict quarantine there.  When they develop in boarding houses or tenements they will be promptly removed to city hospitals, and held under strict observation and treated there.  If we are going to have a visitation, and it looks as if we are, it is no more than many other communities have had and we must all keep our heads.  The citizens of New York may be sure that the Health Department is as ready to handle this situation as it is possible to make it."

NEWPORT, R.I., Sept. 18.--  Rear Admiral Joseph W. Oman, commandant of the Second Naval District, and naval medical officers say they feel that the situation relative to Spanish influenza shows some improvement daily.  There were 241 new cases reported today in and about the Newport naval area and four deaths.  By direction of the Navy Department the quarantine against enlisted men of the navy departing from Newport without a special pass was lifted today.

AYER, Mass., Sept. 18.--There were three deaths from pneumonia, resulting from influenza, at Camp Devens today....  About 3,500 cases of influenza were reported under treatment at the base hospital, new cases nearly equaling the number of patients discharged.

BOSTON, Sept. 18.--Influenza and pneumonia continued today to take victims in New England.  Within the twenty-four hours ending at 10 o'clock tonight forty-one deaths were recorded by the health authorities....  A warning against public hysteria was issued tonight by Dr. William C. Woodward, Health Commissioner of Boston.  He said that fear would lower the vitality of those exposed to influenza, and added that the rainstorm of today undoubtedly would result in a larger death list tomorrow, but that there was no cause for alarm, as the health authorities had the situation well in hand.  The second death of a prominent Boston physician engaged in fighting the epidemic was recorded today....

CAMP UPTON, L.I., Sept. 18.--Twenty new cases of Spanish influenza caused the camp authorities today to close the Liberty and Buffalo Theatres and forbid entertainments in the Y.M.C.A., Knights of Columbus, and Jewish Welfare Board Buildings.

Tonight seventy-four men who were the first to be stricken by the disease last week were discharged from the base hospital, but were segregated for additional observation.

CAMP DIX, WRIGHTSTOWN, N.J., Sept. 18.--In spite of previous reports to the contrary, there were only 150 cases of influenza in the base hospital at Camp Dix today.  The balance of the cases, including most of the 200 that were reported yesterday, are being treated in the regimental infirmaries.  Of the cases in the base hospital thirty-five have developed pneumonia.  Of five deaths from pneumonia at Camp Dix yesterday three were traceable to influenza.  The organizations that have been hit hardest are those made up of hardy Westerners from the 34th Division.

Eighteen new cases of Spanish influenza were reported yesterday, five in Manhattan, eleven in Brooklyn, one in the Bronx, and one in Queens.  Six of the Brooklyn cases were British sailors from an Australian ship lying alongside a Brooklyn pier.  Among the Brooklyn cases one was the wife of a soldier and another a patient who came from Massachusetts and brought the disease with him.

In addition to the cases reported to the health Department it was said late yesterday that ten cases of influenza had developed on Staten Island.  They were all admitted to the United States Marine Hospital at Stapleton.  None of the cases was serious, and all originated on ships just arrived from foreign waters....

Health Commissioner Dr. Copeland reported the discovery of a new micro-organism by the Bacteriological Bureau of the Health Department in its search for the cause of Spanish influenza, but gave no details.

Beginning today the authorities will concentrate upon a campaign of health education.  Dr. Copeland said he has asked the clergy to advise their congregations on Sunday and to request all to assist the Health Department in combating the disease.

"It is the duty of everyone to be on his guard not only to avoid contracting the disease but also against spreading it among others," said Dr. Copeland.

"The symptoms are similar to cold in the head but more severe:  sneezing, headache, rise in temperature, a decided cough, and marked prostration.

"As soon as any of these symptoms are noted, particularly sneezing or coughing accompanied by a rise of temperature, consult the family physician.

"To avoid contracting the disease keep properly clothed so as to prevent all minor colds, live regularly, eat proper food and get sufficient sleep, so that the body will be able to resist the infection.

"Inasmuch as Spanish influenza is highly infectious and is communicated from one person to another, avoid as much as possible all crows and places where persons come into close contact."...

"It is well known," said ... Surgeon General [Rupert Blue], "that the influenza which swept a large part of Europe and this country in 1893 was caused by a very minute bacterium usually spoken of as Pfeiffer's bacillus.  On the other hand, fairly extensive outbreaks of an influenza-like disease have been found to be due to other bacteria, notably pneumococci, the germ of lobar pneumonia.

"It is important to know whether we are dealing with Pfeiffer bacillus, or with some other germ.  Moreover, we should know whether the outbreaks in various parts of the country, such as New Orleans, Mobile, Boston, and New York, are all due to the same germ.  I hope my request will soon furnish us with cultures from different places so that comparative studies can be made at the Hygienic Laboratory."...

"Cover up each cough and sneeze; If you don't you'll spread disease," was offered by the Surgeon General as the best slogan for everybody while influenza is raging.

WASHINGTON, Sept. 21.--The Surgeon General of the army today issues the following rules to the public to safeguard against the spread of respiratory diseases:

1.  Avoid needless crowding -- influenza is a crowd disease.

2.  Smother your coughs and sneezes -- others do not want the germs which you would throw away.

3.  Your nose, not your mouth, was made to breathe through -- get the habit.

4.  Remember the three Cs -- a clean mouth, clean skin, and clean clothes.

5.  Try to keep cool when you walk and warm when you ride and sleep.

6.  Open the windows -- always at home at night; at the office when practicable.

7.  Food will win the war if you give it a chance -- help by choosing and chewing your food well.

8.  Your fate may be in your own hands -- wash your hands before eating.

9.  Don't let the waste products of digestion accumulate -- drink a glass or two of water on getting up.

10.  Don't use a napkin, towel, spoon, fork, glass, or cup which has been used by another person and not washed.

11.  Avoid tight clothes, tight shoes, tight gloves -- seek to make nature your ally not your prisoner.

12.  When the air is pure breathe all of it you can -- breathe deeply.

Early last May dispatches from Madrid told a mysterious malady which was raging through Spain in the form and of the character of the grippe.  Not long after, a similar epidemic took hold in Switzerland and penetrated simultaneously in mild and isolated forms into France, England, and Norway.  Early in August this disease, carried from Europe in ocean liners and transports, began to make its appearances in this country, and within the past two weeks the occurrences of the malady in the civilian population and among the soldiers in the cantonments have increased so greatly in number that Government, State, and municipal health bureaus are now mobilizing all their forces to combat what they recognize to be an approaching epidemic of a so-called "Spanish influenza."

What is Spanish influenza, and what are its symptoms?  Although clinical and bacteriological investigations of the disease are still in their early stages, the medical profession believes it has already arrived at certain unshakable conclusions in the matter.  In the first place Spanish influenza, if not the grippe itself, is accompanied by all the symptoms of the grippe, and differs from this disease only in that it is more severe and is more likely to lead to pneumonia, if not checked in time, than the less virulent form of influenza which goes by the name of the grippe.  As with the grippe, the disease is characterized by excessive sneezing, reddening and running of the eyes, running of the nose, chills followed by fever of from 101 to 103 degrees, aching back and joints, loss of appetite, and a general feeling of debility.

If properly treated, the malady can be overcome without much difficulty.  Surgeon General Blue of the Public Health Service, in a report issued several days ago, advises that persons so attacked should go to their homes at once, get to bed without delay, and place themselves under the immediate care of a physician.  Treatment under the direction of a physician is simple, but important, consisting principally of rest in bed, fresh air, abundant food, with Dovers powder for the relief of pain.  Every case with fever should be regarded as serious, and such a patient should not leave the bed until a normal temperature is restored.  Convalescence requires careful treatment to avoid serious complications, such as bronchial pneumonia.  During the present outbreak, in foreign countries, quinine and aspirin have been most generally used during the acute attack.

The history and bacteriological character of Spanish influenza are still uncertain.  Few of the cases under observation have revealed the presence of the influenza bacillus which would be required to bear out the contention that Spanish influenza is nothing more than the classified influenza, or grippe, which had its origin in Russia in 1889.  The designation of the new malady as "Spanish influenza" is purely arbitrary.  The malady has not been definitely tracked to Spain, further than that it was in Spain early this year, that this particular form first obtained a hold.

Spain disclaimed the unwelcome guest.  The people leaped at the conclusion that this new evil, like other evils of the war, must be traced to German origins.  Hence two theories presented themselves.  One was that a new trench bacteria must have been born in the German lines, where the troops, poorly fed and clothed, were living in a reduced state of vitality, and that this bacteria must have been carried from Flanders into Spain by the strong winds to the Spanish coast last Winter.  While this theory would explain the subsequent appearance of the new influenza among the allied troops, it would hardly be as applicable to Spain, because Madrid, a city of the interior, was in the grip of the disease long before any of the coast towns were even touched.

The other theory was that the disease was carried into Spain by the crews of German submarine boats, just a the bacteria of yellow fever were believed to have been created out of the filthy and crowded conditions of the old slave ships.

This theory, in the opinion of medical scientists must be accepted as ingenious rather than probable.  It has not been definitely concluded that Spanish influenza is anything more than the familiar grippe.

It is fairly certain that the Spanish influenza, if different from the familiar grippe, originated in the German camps. In this connection it may be noted that through all the wars of history diseases generated by unsanitary herding of men in the camps of belligerents have always produced epidemics which before that time had been little or not at all known to many of the populations affected.  Going far back, we find that Athens was visited during the Peloponnesian war, 430-423 B.C., by a severe disease known as the Attic sickness, which cost many valuable lives, including that of Pericles.  Some historians even ascribe to this the fall of the Athenian hegemony.

During the Punic wars, the Carthaginian Army was said to have been reduced by smallpox, and Hamiloar was forced thereby to raise the siege of Syracuse.  In the year 165, the Roman legions before Seleucia were thinned by a similar scourge, the disease following the banners of the conqueror and conquered and spreading to Rome itself where it worked havoc under the name of "Antonin's Plague."  The Black Death which swept over Europe in the fourteenth century attacked the army of the Black Prince and forced him to abandon the siege of Calais.  Syphilis at the end of the fifteenth century spread through the army of Charles VIII, invader of Naples, decimating it after the battle of Fornuovo.

Since the seventeenth century the typhus scourge attached itself to the wake of armies, working its most notable piece of destruction with the Napoleonic hosts.  In more recent times typhus has appeared in terrible guise in the Crimean war.  According to reliable information typhus cost England 16,000 men, France 80,000, and Russia 800,000.  Typhoid fever, has repeatedly become a pandemic of wartime, particularly in America during the civil war and in Europe during the Franco-Prussian war.

In modern times dysentery has been a common affliction of warring armies and still remains a source of serious concern for medical staffs.

Far less dangerous than any of the scourges enumerated above, Spanish influenza has its serious aspect in its possible impairment of an army's offensive efficiency.  For this reason the medical staffs of all the allied armies are exerting every precaution to protect the allied front from infection.  The disease reduces a soldier's vitality, so that he cannot fight, and makes him a ready carrier of the disease to others, unless he is instantly removed from the ranks.

America was practically exempt from direct contact with the new disease, if it was new, until the arrival in this port on Aug. 12 of the Norwegian liner Bergensfjord; which had during the voyage more than 200 cases of sickness resembling influenza.

Prior to the arrival of this vessel, however, and even prior to the epidemic in Spain, it is worth noting that on April 2, the officials of the Ford plants at Detroit reported that more than 2,000 employes had been suffering from a malady which was very much like the grippe and yet somewhat different from the grippe.  At that time "Spanish influenza" was unknown.  No observations were made of the Ford cases, and it is only possible to guess at their connection, if any, with what is now known as Spanish influenza.

As to the liner Bergensfjord, however, there was definite investigation.  Eleven passengers were transferred immediately to the Norwegian Hospital in Brooklyn.

On Aug. 16, eleven more cases of Spanish influenza were reported at quarantine from a ship arriving from one of the Scandinavian countries.  All of the patients were in a convalescent stage and none of them had developed pneumonia.  The ship was passed, but the question was then raised for the first time as to whether the Health Officer of the Port should not be required to quarantine against the disease.  At that time Dr. Leland E. Cofer, Health Officer of the Port, and Health Commissioner Copeland, were inclined to take the matter lightly and advanced the opinion that "Spanish influenza" was a misnomer and that the epidemic was not as new to this country as was generally supposed.  They regarded it as nothing more than the grippe or at the best a sort of "cousin" to the grippe.  At that time also they were firmly convinced that New York was not in danger of an epidemic, a conclusion which fails of justification in light of later developments.

On Aug. 18 a big passenger liner at this port reported that on her voyage twenty-one cases of Spanish influenza developed among the passengers and crews.

The theory that the strange epidemic of influenza attacked only those who were run down because of lack of proper food was exploded in late August when a dispatch from an Irish port told of the occurrence of symptoms of this disease among officers and men stationed at an American destroyer base.  Aside from American soldiers, the American sailors are probably the best fed persons in Europe, but the disease attacked several score of them there, and for a week or so disrupted crew assignments completely.  All of the cases recovered.  It was found in that instance that the disease was not dangerous if taken in hand quickly enough.

Within the last week the so-called Spanish influenza has reaped a harvest in the army cantonments of this country.  More than 6,000 cases were reported from Camp Devens alone.  Of this number only one case passed from influenza into pneumonia and proved fatal.  The cantonment was not placed under quarantine because it had been decided at Washington that such a step would not check the spread of influenza.

Outbreaks of Spanish influenza at five additional training camps were reported on Friday by Surgeon General Gorgas, making a total number of cases up to noon on Friday 9,313, with 11 deaths....

Reports received at Washington from European countries indicate that 20 per cent. of the population has been affected this Summer by Spanish influenza, for which reason General Rupert Blue warned the public on Friday against an apparent tendency to underrate the disease.  While the epidemic in some places has been mild, he stated that mortality becomes quit common when the Spanish influenza is neglected and allowed to pass into pneumonia.

In view of the fact that the disease is easily communicable from person to person as well as through carriers, precautions are urgent against carelessness in the matter of personal cleanliness.  Sneezing, spitting, and coughing should be done always into a handkerchief as secretions thus released act as carriers....  Smokers who experience the first symptom of influenza are advised to give up tobacco for a few days until the symptoms disappear, as smoking irritates the mucous membrane.

Inasmuch as the last pandemic of influenza occurred more than twenty-five years ago, physicians who began to practice medicine since 1892 have not had personal experience in handling such a disease as now seems to be spreading through the country.  For their benefit Surgeon General Blue has issued a special bulletin setting forth the facts concerning influenza....

One hundred and fourteen cases of Spanish influenza originated in New York City in the sixty hours ended at 6 o'clock last night, according to Health Commissioner Copeland.  This number equals but does not exceed the highest daily average of cases reported to the Health Department.  Commissioner Copeland is confident the illness is not spreading alarmingly, and says he hopes the public will heed the warnings against sneezing....

AYER, Mass., Sept. 23.--Although sixty-five deaths resulting from influenza and pneumonia occurred at Camp Devens during the last twenty-four hours, officials expressed confidence today that the height of the epidemic had passed.  Many organizations within the camp reported no new cases....

WASHINGTON, Sept. 26.--Because of epidemics of Spanish influenza in army camps, Provost Marshal General Crowder tonight canceled calls for the entrainment between Oct. 7 and 11 of 142,000 draft registrants.  During the twenty-four hours ending at noon today, 6,329 new cases of influenza in army camps had been reported to the office of the Surgeon General of the army.  One hundred and seventy deaths, resulting chiefly from pneumonia following influenza, and 723 new cases of pneumonia also were reported....

It is lamentably evident that the malady called Spanish influenza is fast assuming the pandemic form in this country, and lamentably evident, too, that it is a really serious affliction.  Of panic there is no need whatever, but it is to be regretted that the measures for its restriction and suppression which our civilian and military health authorities are now taking did not begin some weeks ago -- that is, immediately on the arrival of the first cases from abroad.

At that time we were assured that because we were adequately fed and had not suffered any such great and prolonged mental strains as have the populations of most European countries, there was no danger that the disease would spread here either as rapidly or as far as it did there.  All of these assurances have proved fallacious, and nowhere among us have the ravages of the influenza been as swift or as often fatal as in our training camps, among men as strong and well fed as any in the world.  They are all young, too, and the great majority of them are suffering from no mental strain except the one produced by an eager desire to get "over there" as quickly as possible.

As a matter of fact, the malady is practically indiscriminate in its attacks, and the weak and the strong alike contract it.  In other circumstances rigid measures of isolation would, or at least could, have been adopted, with the result of confining the infection within narrow limits.  Whether or not such measures, taken betimes, would have interfered more with "the conduct of the war" than will a widespread epidemic among our soldiers and workers--that is a question on which opinions can differ honestly, but it is a question of which the present discussion would not be much more useful than that of whether or not the stable door should be locked after the horse is stolen.

Almost as useless, too, is the advice to keep out of crowds.  Country folk will do that anyway, but city folk -- except the members of a leisure class never as small as right now -- can pay next to no attention to that counsel of perfection.  What we all can do, however, is to frown sternly on the unguarded cough and sneeze, and we can abandon the notion that there is something virtuous or heroic in refusing to give up and go to bed when the premonitory symptoms of the influenza make their appearance.

Dr. Copeland, Health Commissioner of New York City, tells us that his department has found, and will soon put into general use, a vaccine that will prevail over "Spanish Influenza."  According to Dr. Copeland, this new vaccine will be considered revolutionary.  And yet, according to him and other physicians, it is an application of old remedies to a new disease.

Whether the disease be new or old, the results and the prophylactics, the results sometimes asserting themselves in spite of the prophylactics, will always be justified essentially.  Some misunderstood germ must be at work to cause the wide prevalence of Spanish influenza.  If it differs from the grippe, in its austere frequent manifestations twenty-five years ago, the Galenists would have told us of it.  They do tell us that we must avoid crowds.  That is an injunction not so easily to be obeyed in the subway and on the elevated lines and in cities generally.  They tell us to wash our hands before eating, a command that might have occurred to several millions of us without this official direction.  They don't tell us why so many soldiers and sailors, young men of full vitality, with the best of habits, living much out of doors, seem to be the subject, and yield so easily, to this disease.

Without trusting or distrusting too much Dr. Copeland's vaccine against this prevalent complaint, the inoculated and the uninoculated should not worry too much about the Spanish influenza.  At the worst, it is no more, in many cases it is considerably less, than the old grippe, without the Iberian adjective, which we all endured, mostly had, say, in 1893.

In order to prevent the complete shut-down of industry and amusement in this city to check the spread of Spanish influenza, Health Commissioner Copeland, by proclamation, yesterday ordered a change to the hours for opening stores, theatres and other places of business.

The Department is of the opinion that the greatest sources of spread of the disease are crowded subway and elevated trains and cars on the surface lines and the purpose of the order is to diminish the "peak" load in the evenings and mornings on these lines by distributing the travelers over a greater space of time.  This will reduce crowding to a minimum.

Dr. Copeland's action was taken after a statement made by Surgeon General Blue, Chief of the Public Health Service in Washington, was called to his attention, in which Dr. Blue advocated the closing of churches, schools, theatres and public institutions in every community where the epidemic has developed.  Dr. Blue said:

"There is no way to put a nationwide closing order into effect, as this is a matter which is up to the individual communities.  In some States, the State Board of Health has this power, but in many others, it is a matter of municipal regulation.  I hope that those having the proper authority will close all public gathering places if their community is threatened with the epidemic.  This will do much toward checking the spread of the disease."

There were reported in the twenty-four hours ending at 10 o'clock yesterday morning, 1,695 new cases of influenza and 188 of pneumonia.  The influenza cases were thus distributed:  Manhattan, 615; Bronx, 367; Brooklyn, 421; Queens, 97; Richmond, 195.

In the same period the deaths were 42 from influenza and 184 from pneumonia.  The influenza deaths were thus distributed:  Manhattan, 11; Bronx, 5; Brooklyn, 24; Richmond, 2.

The decision to issue a proclamation changing the hours of work and the opening and closing of amusement places was arrived at after a series of conferences in the Department of Health offices in Centre Street that lasted nearly all day.  Dr. Copeland met first the heads of the various departments, and afterward he conferred with the department staff of nurses and the Medical Inspectors of every district.  Business interests were represented at the afternoon meeting....

One of the decisions reached is to close all stores other than those dealing exclusively in food or drugs at 4 o'clock in the afternoon.  To prevent evasions of this rule Dr. Copeland made it plain that department stores which carry either food or drugs as a department would have to close and not keep open on the ground that they were dealers in either food or drugs.

All moving picture houses and theatres outside of a certain district are considered community houses and are held to draw their patronage from within walking distance.  There was debate on the proposition to close the schools and churches and other places of assemblage, but it was decided against at this time.

As to the legal right of the Health Department to put the order into effect, the Commissioner said that it was a question of obeying the order now or having the city closed up.  The department has the power to do the latter, but it does not want to do it.  Those at the conference understand the position taken by the department and Dr. Copeland looks for the heartiest support of all....

"We have not closed up New York City largely because this community is not stricken with the epidemic," said Dr. Copeland.  "The increase reported today has, however, caused us some serious hours.  I had a conference this morning with the department nurses and the medical inspectors.  These nurses and inspectors go into the schools and their testimony is that there are few sick school children in this city.

"I had a conference with the Superintendent of Schools, Mr. Ettinger, and he has had a survey of the schools made and he found there were few sick there.  He agrees with the department that the schools should be left open.  We feel this way because New York is a great cosmopolitan city and in some homes there is careless disregard of modern sanitation.  From these homes, however, thousands of children are carefully washed up and their teeth scrubbed before they are sent to school.  In the schools the children are under the constant guardianship of the medical inspectors.

"This work is part of our system of disease control.  If the schools were closed at least 1,000,000 children would be sent to their homes and become 1,000,000 possibilities for the disease.  Furthermore, there would be nobody to take special notice of their condition.

"I don't want to be in the position of giving an interview that would appear antagonistic to what Surgeon General Blue has said.  He is dealing with the nation.  He finds a variety of conditions while we face only one here.  For instance, in Oswego, with 23,000 persons, there were found 3,500 cases today.  Now, if we had one-sixth of the population here affected with Spanish influenza we would have 1,000,000 cases.  We would have to close everything up.  We have had about 6,000 cases here, while Philadelphia has had 20,000 and Boston 100,000.  One half of the 6,000 cases here are in 600 homes.

"It has been the position of the Department of Health from the first that no individual is in danger if he or she escapes the mouth or nasal secretion of some other person who has it.  We believe it is proper to keep the theatres and churches open if we can eliminate the sneezers, coughers, and spitters.  We pointed out to the theatre managers the importance of making the public who go to their places know that these things are prohibited.  Today we ordered these managers to instruct their ushers and attendants to escort from their theatres those who violate the Department rules and to use force if necessary.  We will back them up.

"In this city the chief danger of spread of the disease lies in the subways--and the other lines to a lesser extent.  The crowds carried at the morning and evening peak of the load must be diminished.  For years there has been talk of establishing a relay system of travel or a zone system so that persons would go to and from work at different hours.  This plan we have established.

"The plan means general inconvenience.  That is granted, but the purpose is to prevent the spread of disease, and we expect our big public to take to it as patriotically as they have obeyed the mandates of the Federal Government in measures affecting the war.

"The Department of Health was faced with the problem of either doing this or closing the subways, and we have worked out this plan with as little hindrance to business and amusement as possible.  We have given orders to the public utilities companies to keep the rear windows open and the fans going in the subway.  This means warm clothing and so it is again put up to the public to do its part."

Dr. Copeland said also that State Fuel Administrator Cooke has promised that he will issue a statement permitting fires in the homes and the heating twice a day of places in which persons are engaged in sedentary occupations.

It was reported that a quarantine had been established on Blackwell's Island, but no order was issued by the Health Department.  There have been several cases among the prisoners, but no deaths, and the prison authorities decided yesterday to revoke all pass privileges of visitors.

Twenty persons were summoned to Yorkville Court yesterday for violation of the Sanitary Code in not providing properly cleansed glasses for the serving of drinks.  Some were fined and some released on their promise to use more care.  One hundred and twenty-five men were summoned to Jefferson Market Court for spitting in the public thoroughfares.  Each was fined $1 and warned.

Ten spitters were arraigned in Yorkville Court and nine in the Tombs Court.  In Yorkville Court most of the prisoners were fined $3 each, but those arraigned in the Tombs Court were held in $200 bail for trial in Special Sessions.  Twenty-two spitters paid small fines in Harlem Court, and three in the West Side Court.

A call for the mobilization of all nurses and women with elementary training in the care of the sick was sent out yesterday from the headquarters of the Atlantic Division of the Red Cross to the 225 nursing committees in New York, New Jersey, and Connecticut.  They are wanted to help combat the Spanish influenza epidemic.  The call, Ethan Allen, manager of the division, explained, was a preparatory measure.

A large number of nurses from the Atlantic Division, in response to a special call last week, are now serving in Massachusetts, but in the future the work will be organized so that the resources of the Red Cross will be distributed systematically.  Miss Clara D. Noyes, Director of the Bureau of Field Nursing at national headquarters in Washington, is making arrangements to coordinate the work.  It is planned that groups of ten and fifteen nurses in each community will form the nucleus for a complete mobilization of all nursing personnel.

As fast as nurses are enrolled by the various nursing committees, the records will be forwarded to the division headquarters.

Demands for nurses are being received hourly at division headquarters, Mr. Allen said, and the present supply is far below the demand.  He urges every woman who is capable and can spare the time to communicate at once with the local headquarters of the nearest chapter....

WASHINGTON, Oct. 4.--With reports from all quarters indicating that the Spanish influenza epidemic is spreading, the Federal health authorities are intensifying their plans for co-operation with the health authorities of the various States in an effort to check the disease.

In Washington, where there are thousands of war workers living in congested quarters, drastic steps have been taken by the Federal and municipal authorities.  Not only have the theatres, movie houses, and dance halls been closed, but steps were taken today to close all churches and public playgrounds until further notice.  All indoor mass meetings for the Liberty Loan campaign have been canceled, but outdoor meetings will be continued.

Telegraphic reports from medical officers in military camps, depots, and forts in this country show an increase in the number of new cases of influenza and pneumonia and deaths from the same.  All but three camps which have been sending daily reports gave figures of new cases.  The new cases up to noon today, as compared with the preceding twenty-four-hour period, are as follows:

Today. Yesterday. Influenza 12,975 12,004 Pneumonia 1,854 930 Deaths 390 331

The total number of cases of influenza to date is 127,413, pneumonia 10,429, and deaths 2,869.  In connection with these figures it must be borne in mind that the deaths reported daily are for all causes.  Under normal conditions the daily death rate at the present strength of troops in the country is from fifteen to twenty a day.  The normal pneumonia rate -- that is to say, previous to the present epidemic -- is about thirty-five to forty new cases a day.

The greatest number of cases, as well as the greatest increase in new cases, is reported from Camp Funston, Fort Riley, Kan., with 1,276.  Yesterday this camp reported 861 cases.  Camp Jackson, Columbia, S.C., and Camp Sherman, Chillicothe, Ohio, each reported more than a thousand new cases, but neither of these camps reported yesterday, and it is believed that many of yesterday's cases are included in today's report.

Camp Grant, Rockford, Ill., reported 389 new cases of pneumonia and 43 deaths.  Camp Dix, Wrightstown, N.J., reported 172 new cases of pneumonia and 59 deaths. The number of new cases of influenza is falling at both Dix and Grant.  Camp Greene, Charlotte, N.C., shows a heavy increase in the number of new cases of influenza, jumping from 54 to 174.  Camp Hancock, Augusta, Ga., shows a decrease of 50 per cent.

Camp Devens, Ayer, Mass., and Syracuse, N.Y., which have suffered from severe epidemics, seemed to be clearing up.  Syracuse reported 36, while Devens reported 53.  Camp Humphreys reported 771 new cases of influenza, as against 353 for the preceding twenty-four hour period.

____________

$50,000 to Fight Disease in State.

Special to The New York Times.

ALBANY, Oct. 4.--After a conference with Governor Whitman, State Health Commissioner Hermann M. Biggs announced today that $50,000 had been made immediately available for use in fighting influenza in the State.  The money will be used to obtain the services of nurses and hpysicians [sic], who will work under the direction of the State Health Department and in co-operation with local health authorities.  In the care of influenza patients who otherwise would be uncared for, every effort will be made to obtain nurses from such localities as are still comparatively free from the disease

CAMP GRANT, ROCKFORD, Ill., Oct. 4.--There seems to be a bit of self-respect in even the Spanish influenza microbe.  It has attacked all ranks of the 40,000 men in this camp, but has declined to enter the barbed wire inclosure where the German prisoners are herded.  The death toll since the epidemic began here had reached a total of 234 at 1 o'clock this afternoon.  There were 76 deaths from pneumonia following influenza for the twenty-four-hour period ending last midnight.

To the Editor of The New York Times:

I am told that in one hospital in New York more than twenty nurses were down with Spanish influenza two or three days ago, since which time more cases have undoubtedly developed in the hospital staff.

Is it not a fact that by wearing a sort of disinfecting mask, covering the mouth and nose, any one can come in contact with this disease without danger of contagion?  And, if that is so, why do not all doctors and nurses who come in contact with it wear such masks?  Is it any more ridiculous for those exposed to this communicable disease to protect themselves from deadly gases by the same means?  I think not.

This suggests the whole question of preventive measures.  Take the offices and waiting rooms of nose and throat specialists.  Such places are presumably filled every day with people whose noses and throats are in turn filled with the germs of contagious diseases.  Yet does any one know of a nose and throat specialist whose office and waiting room are so constructed that they can be sterilized with steam daily?  And has any one seen a nose and throat specialist wear a mask when treating persons having colds or worse?

I should like to hear what some of our leading physicians have to say on this entire subject.

JULIAN STREET.
Norfolk, Conn., Oct. 2, 1918.

Dr. Royal S. Copeland, the Health Commissioner, and Dr. S. S. Goldwater, Director of Mt. Sinai Hospital and former Health Commissioner, disagreed sharply yesterday concerning conditions in this city in the matter of hospital facilities for caring for Spanish influenza and pneumonia patients.

Dr. Goldwater is of the opinion that conditions are far worse than the public is aware and that unless help comes from the Government, should the epidemic spread, there will be danger that many will suffer for lack of care.  Dr. Copeland, taking the contrary view, called Dr. Goldwater's statement his "weekly letter to the public," and said the former Health Commissioner was taking the provincial view "bounded by the walls of Mt. Sinai Hospital."

Dr. Goldwater suggested to Dr. Copeland, in view of what he had found out regarding hospital conditions, that the Commissioner telegraph to Surgeon General Blue, Director of the Public Health Service at Washington, asking for the use of some of the buildings the army has acquired for hospital use here; that nurses waiting to go overseas be placed in service in the emergency, and that doctors be assigned to help the Department of Health.

Dr. Copeland told Dr. Goldwater that he would "take care" of the matter, and this he did, not by telegraphing to the Surgeon General, but by getting in communication with the military authorities here.  He disagreed entirely with Dr. Goldwater as to hospital conditions, and said frankly that he had called upon the military authorities, not because help was needed now, but to be prepared to meet possible future conditions.

Conditions are much worse than the public has any idea," said Dr. Goldwater, "and something must be done to relieve the situation.  In the first place, I believe that there are far more cases of influenza in this city than the reports of the Health Department show.  This is not because those reports are not entirely accurate, but it is because the doctors are too busy to make out reports and because there is a great deal of unreported sickness.

"In Mt. Sinai we have seventy patients, and within the last twenty-four hours we had to turn away seventeen persons.  We had absolutely no place to put them.  In the case of a four-year-old girl, I telephoned to Harlem Hospital and learned that they had thirty patients on the floor.  In Gouverneur Hospital the same condition exists.  We have not heard from Bellevue, being unable to get them on the telephone.  We have had calls for help from the Willard Parker Hospital.  Facing the present conditions, I feel that unless something is done we will be in a serious condition.

"Now, the Government has acquired buildings here for hospital purposes, and these could be used to meet the present emergency.  Army nurses are assembled here constantly for overseas duty.  There are usually about 1,000 here, and these could be placed in temporary service here.

"We are facing a serious epidemic and we have got to be prepared to meet the emergency.  If things grow worse we will be in a serious state.  Reports are all that bacteriologically it is not the same as the old-fashioned influenza.  How serious it is at present can be gathered from the fact that we were unable to care for 100 patients in the children's dispensary because of lack of space and nurses."

Much more optimistic was Dr. Copeland, who pointed to the fact that the new cases of influenza reported for the twenty-four hours ended at 10 o'clock yesterday morning were 2,073, an increase of only 3 cases over the preceding twenty-four hours.

He explained that the full machinery for gathering the report was working yesterday, although it was a holiday.  He saw also reason for hope in that a tour of several hospitals had convinced him the new patients were afflicted in a less virulent way, as though the epidemic was burning itself out.

"I do not see any reason for haste, and to ask Washington for help is unnecessary," he said.  "I am taking the matter up with the United States authorities here, but that is a matter of future preparedness.  Dr. Goldwater takes the provincial view of the doctor in charge of one hospital--a view bounded by the walls of Mount Sinai.  He talks about conditions as they are in Mount Sinai.

"I have taken pains to find out where there are vacant beds.  At the Metropolitan Hospital there are 150 beds to which influenza patients can be sent.  Dr. Goldwater might transfer some of his patients to this hospital.  The Willard Parker has 50 beds vacant; the New York Hospital 'some vacancies'; Presbyterian, 20 to 25 beds; St. Luke's Hospital, 3; Post-Graduate, 15; the Knickerbocker, well filled but with room for 3 or 4, and the Flower Hospital, 8 to 10 beds.  There are unlimited beds in the Kingston Avenue Hospital, Brooklyn, that can be used when bedding is transferred from Riverdale.

"It is true that there is a scarcity of nurses, but we are combing the city for them and the Red Cross is helping.  There are doctors enough.  With the present number of cases under treatment, there is one patient for every four doctors in the city.  When we get 8,000 cases there will be one for each doctor."

A reassuring statement on the effect of influenza was made last night by Dr. Alvan H. Doty, former Health Officer of the Port.  In the present outbreak which, he said, is quite likely to visit every section of the United States, we have the disease which periodically appears in an epidemic form in every part of the civilized world.  Dr. Doty said it was unfortunate that the name "Spanish influenza" was given this old visitor, for it is misleading and disturbing to the public.

The means for preventing the disease relate chiefly to cleanliness, he said, and he points out the method of communication.  He warned of the importance of covering the mouth and nose while sneezing or coughing, and said the handkerchief should be placed in boiling water as soon as possible after use.  Other methods of prevention are the frequent washing of the hands, the individual drinking cup and towel and the avoidance of all crowds.

After pointing out the importance of early diagnosis, Dr. Doty said that the mortality, which is chiefly due to pneumonia, does not as a rule exceed 3 or 4 per cent. of the cases.  Therefore it is not a very dangerous disease.

"Under ordinary conditions the disease does not usually affect more than 25 to 35 per cent. of the inhabitants.  However, under adverse circumstances it may go beyond this," he said.  "During an official visit to Russia some years ago I found in the overcrowding, poverty, and dirt a very satisfactory explanation why the epidemic of influenza in certain sections of that country involved over 75 per cent. of the population, therefore the importance of good sanitary conditions as a preventive measure is evident.

"From various sections of the country reports are made that a vaccine has been discovered for the prevention of influenza.  Until the value of such an agent has been fully determined by careful and exhaustive investigation, which will not be completed during the present epidemic, it would for various reasons seem unwise and improper to recommend it for general use."...

Commissioner Copeland of the Health Department issued yesterday these rules to be observed in connection with the epidemic of influenza:

Keep away from the cougher, sneezer, or spitter who does not use a handkerchief.

Keep out of crowds whenever possible.

Don't use dishes nor towels which have been used by others until they have been washed in boiling water.

Don't put your lips against the telephone mouthpiece and don't put into your mouth pencil or any other article that has been used by another.

Keep in the fresh air and sunlight as much as possible, but wear sufficient clothing to keep warm.

Sleep in well-ventilated room under plenty of bed clothes.

Walk instead of using the street car or subway whenever your journey is a short one.

Be temperate in eating and observe the ordinary rules of hygiene.

Wash your hands and face immediately upon reaching your home and change your clothes if possible before mingling with the rest of the family.

Go to bed upon the first indication of illness and call a doctor.

The sick person should have a room by himself.

Care should be taken to have the sick person cough, sneeze or expectorate in gauze, which should be burned at once.  Persons handling this gauze should wash their hands after each attention.

Patent medicines should be avoided.

The patient's room should be kept well ventilated; care should be taken that no draft strikes him.

Visitors should be kept from the sickroom.

The patient should remain in bed long enough after the fever in influenza has subsided so that he will be in no danger of an attack of pneumonia.

There was an increase of 303 cases of Spanish influenza reported in the city yesterday.  As an additional agency for combatting the disease Health Commissioner Copeland announced an Emergency Advisory Committee to assist the Health Department.  The new committee will serve in more than a merely advisory capacity, for it is the Commissioner's intention to ask its assistance in handling actual problems, especially as experts in special lines....

"We have," [Copeland] said, "the advice of really prominent men, experts in public health, and with the indorsement of [these] national experts ... and the approval of our own Academy of Medicine, through its able committee on public health, we can get on very well.

"Whatever any other citizen proposes, provided it appeals to the staff of the Department of Health and our advisers, will be adopted.  I have no time at present to discuss personal criticisms, especially when they are founded upon such glaringly inaccurate premises.  Constructive criticism is welcomed....

"[W]e cannot agree that the profession has been lax in its vigilance and its duty to the community to the extent alleged.

"Undoubtedly the number of sick persons in New York is greater than the cold figures indicate, but we stand by our statement that up to date 2 per cent. of the population is the extent of the present serious epidemic.  If there were no other reason for calmness, patriotism, and the cause of the Liberty Loan would lead us to advise coolness on the part of our people.

"There is no present occasion for panic.  As Colonel William H. Welch said in his telegram today, the situation in New York is less serious than in other affected parts of the country.  Certainly, comparison with the experience in the army, where is collected the flower of the nation under ideal supervision, makes us take courage."

Former Health Commissioner S. S. Goldwater, now Superintendent of Mount Sinai Hospital, said last night he believed that, although the "paper program" of the Health Department for preventing the spread of influenza through the schools was all right, the enforcement was weak.  He gave it as his opinion after personal investigation that there was "almost criminal laxity" in carrying out the program of the Health Department in the schools.

Under the program, every pupil was to be subjected to careful scrutiny upon entrance at the schoolhouse, and all those who had suspicious symptoms were to be excluded from the classrooms and the assembly halls.  The former Health Commissioner said he had found the carrying out of these measures was "lamentably weak."

Dr. Goldwater said he did not think it was so necessary to close the churches.  As to suggestions that theatres be closed, he pointed out that the United States Public Health Service had warned the public that the epidemic would spread more slowly if persons remained away from gatherings, because of the theory that the disease spreads more rapidly in crowds.

Unless all the preventive measures possible were taken in the schools and other public places, Dr. Goldwater said he agreed with the warning of the Public Health Service that the illness would "almost inevitably reach every susceptible person."  He added that "if the situations continues there will be such large masses of persons ill that the hospitals and medical facilities will be exhausted."...

...Colonel Victor C. Vaughan, Chief Epidemiologist of the United States Army ... declared the regulations here "most excellent," and while he would advise against persons congregating in crowds, he would not, he said, advise at present that schools, theatres, churches, and factories should be closed.  The Colonel said it would be a good thing if people would stop the habit of hand-shaking during the epidemic.  He also warned that there must be special care in the disinfection of glasses and dishes.

...[P]olicemen of the Sanitary Squad have undertaken to see that dry sweeping is discontinued.  They are also inspecting the small moving picture places, and yesterday they ordered closed, because of the lack of proper ventilation, the Favorite Amusement Company at 523 Eighth Avenue and the Superior Amusement Company at 405 East Thirty-first Street.

Recent restrictions forbidding children under 12 years to go to moving picture places had been withdrawn, Dr. Copeland said, because it was shown that a majority of the managers were heartily co-operation with the department, and also because only 7 per cent. of the grip cases were among children of between 5 and 15 years.

Superintendent of Schools Ettinger reported that there was no unusual amount of sickness among school children, and that most of the absentees in schools at present were among the teachers.

The Health Department is closely watching conditions in the schools, and at the first sign of danger, it was said, they will be closed; but until that time they will remain open, and this is the view of many who have studied the situation, according to Dr. Copeland....

While there is an increase in new cases of influenza, there is a slight decrease in the number of pneumonia cases over the previous day's report.  This holds also of the deaths....

Dr. Copeland is hopeful that New York is approaching the "peak" of the present epidemic, and he bases his belief on the following comparative figures of weekly deaths from influenza and pneumonia, corrected to correspond with increase in population, as compared with the grip epidemic years ago:
 

"I was particularly struck with a statement made by Dr. Morris Menges in his talk before the Academy of Medicine on Friday night, when he said that the present epidemic remarkably resembles that of 1889," said Dr. Copeland.  "This morning Dr. William H. Guilfoy, Director of the Bureau of Vital Statistics, submitted figures showing a statistical resemblance between this outbreak and that of 1889.  These figures and Dr. Menges's observations make it appear that we are nearing the peak now."

Shortage of nurses is one of the most serious phases of the epidemic.... 

Lillian D. Wald, Chairman of the Nurses' Emergency Council, said there was no limit to the number of women needed for emergency work.

"We want women, whether or not they have had any training in the care of the sick," said Miss Wald.  "The only qualifications are willingness and courage...."

American Red Cross agents ... will meet any women prepared to render patriotic assistance by working as domestics in the hospitals for reasonable wages....

Dr. Charles E. North of the New York Milk Committee has suggested that everybody wear a mask, which should be changed frequently.  The sanitary police are seeing to it that street car windows are kept open, and that there are is no dry sweeping on the subway and elevated steps and platforms.

Dr. Copeland says that he is opposed to the continuance of dancing in public halls at this time, as he believes that this form of amusement is a means of spreading the disease.

WASHINGTON, Oct. 12.--Surgeon General Blue of the United States Public Health Service in a statement tonight urged the public to "learn something about the home care of patients ill with influenza," in order, he said to reduce unnecessary calls on physicians, who have been greatly overworked.

With reports today showing the epidemic to be spreading in many parts of the country, he found an acute shortage of doctors and nurses everywhere to meet the urgent needs of the patients who are seriously ill.

"The present generation," said the Surgeon General, "has been spoiled by having had expert medical and nursing care readily available.  While I cheerfully recognize all the good that has been done by our splendidly trained graduate nurses, I believe that the public generally has come to rely too much on their services and has not interested itself sufficiently in studying the home care of the sick."

Every person who feels ill and appears to be developing an attack of influenza should at once be put to bed in a well-ventilated room, Surgeon General Blue said.  If the patient has a fever, a physician should be called, and this should be done in any case if the symptoms appear serious or the breathing painful.  The diet should be light, and both quiet and cleanliness are essential.

Attendants of persons having influenza, the Surgeon General said, should wear a gauze mask and take all precautions to prevent contagion.

The epidemic today appeared to be subsiding in cities along the coast, in Massachusetts and Virginia, but in the Middle West and on the Pacific Coast it was reported as spreading.  Many new cases were reported in Kansas, Missouri, Ohio, South Dakota, Minnesota, and New Mexico.

Through the South the number of new cases was reported stationary in some localities, while in others an increase was noted....

Surgeon General Blue and Commissioners of the District of Columbia united in a recommendation that the Civil Service Commission should not call any more war workers to Washington until after the epidemic subsides.

It was said the matter will be taken up with President Wilson tomorrow upon his return from New York, with a view to the issuance of an Executive order.

PITTSBURGH, Oct. 12.--In response to telegrams from medical men throughout the country, Dr. George F. Baer of the Homeopathic Hospital, this afternoon made public the formula of his recently reported cure or preventive for Spanish influenza.  The treatment, he said, is a hypodermic injection of a sterile solution representing 1.54 grams of iodine in chemical combination with creosote and guaiacol.

In experiments conducted here, Dr. Baer said, patients in acute stages of the disease have been made well in a few days, while in one case the employes of a bank were inoculated with the solution and, though exposed to influenza, failed to contract the disease.

The injection, he said, is not a serum, but a solution.  It is put into the veins of the arm, and the patients feel but little ill effect.

The number of new cases of Spanish influenza increased yesterday, and there were numerous indications of the quickening of activities at the Department of Health....

To better organize the city in its fight against the spread of the epidemic it was decided by the Advisory Committee to divide the city into districts....

"The city is to be divided into districts," [Dr. Lee K. Frankel] said.  "We shall use for that purpose the district subdivision recently gotten up by the Community Council of National Defense, which has prepared maps for all the boroughs.  We shall put into each district a representative to be in charge of all the agencies in that district.  We shall try to find districts with a physical plant where cooking can be done, so as to supply families where there is illness, and the people are unable to care for themselves in connection with supplying food.

The office of the Nurses' Emergency Council in the headquarters of the New York County Chapter of the Red Cross ... was crowded yesterday with women who had answered the appeal for volunteers with nursing experience.  During the day about seventy-five signed to work, some as aids to visiting nurses, and the Salvation Army sent twenty-five men to the council for service as orderlies.  All were distributed among hospitals where the need was greatest.

Because of the epidemic State Superintendent of Prisons Carter sent word yesterday to Sheriff Knott of New York County to send no prisoners to Sing Sing Prison for the present.  Those destined for Sing Sing will be kept in the Tombs until further orders.

WASHINGTON, Oct. 14.--The Public Health Service announced tonight that it now is mobilized for a national campaign against the Spanish influenza epidemic.  Additional headquarters for State-wide efforts to control the disease will be established in co-operation with State and local health authorities at Baltimore, Md.; Columbus, Ohio; Richmond, Va., and Columbia, S.C....

Dr. Admont Halsey Clark, Associate Professor of Pathology of Johns Hopkins University, who died of pneumonia developed from influenza today in Johns Hopkins Hospital, Baltimore, where he was resident pathologist.  He was stricken while engaged in experimental work on a cure for the disease, which had been suggested by the officers of the Federal Public Health Service.  His friend and associate, Dr. Ernest George Gray of the Johns Hopkins Hospital surgical staff, died of pneumonia on Sunday.

• History 135F Home Page

• "The Influenza Epidemic and How We Tried to Control It" by Elizabeth J. Davies, R.N., from Public Health Nurse (1919) 11(1):  45-47

• "Influenza Vignettes" by Mary E. Westphal, Assistant Superintendent, Visiting Nurse Association of Chicago, from Public Health Nurse (1919) 11(2):  129-32

• "A Retrospect of the Influenza Epidemic" by Permelia Murnan Doty, Executive Secretary Nurses Emergency Council, from Public Health Nurse (1919) 11(12):  949-57