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Von Unruh wrote: "Therefore my conclusion is that the —_ 1,000,000 deaths, 242,842 males and 302,046 females influenza bacillus is merely a weaker or dwarfed form of _ died of tuberculosis. This was for all nationalities and the real tubercle bacillus, a strain that in this case failed colours. Specific subsets within these statistics revealed of better development because of a higher degree of | that among African Americans, every million deaths resistance in the host. In both tuberculosis and represented 248,179 males and 326,973 females having influenza we deal with the self-same organism that in died of tuberculosis. Among people of Irish parentage, tuberculosis is fully developed, while in influenza it lacks 309,507 males and 375,636 females died of TB for every development. In other words, we are dealing with a million deaths. And among people of German difference in degree only, but not in kind."” parentage, its victims numbered 249,498 males and Von Unruh's distinction is suggestive of a similar, well- 254,958 females for every one million deaths.” acknowledged comparison between the damaging effects Although Park had seen these statistics before, their that Mycobacterium tuberculosis has inflicted on man for _ effect was not lost on him: "Consumptives [people with centuries and the better resistance that humans with a uberculosis] frequently carry influenza bacilli [Pfeiffer's healthy immune system have had against bird or fowl _ bacilli] for years and are particularly susceptible to tuberculosis (Mycobacterium avium), found in swine as well. —_ attacks of influenza."”! Did types of fowl tuberculosis in the form of Mycobacterium In 1918, with "flu" victims dropping all around them, (Haemophilus) influenzae suis from pigs combine additively ohn B. Hawes, MD, of the Massachusetts General with latent human tuberculosis to cause the deadly Hospital, and Richard Cabot, MD, of Harvard, wrote: galloping consumption — of "One of the diseases most 1918-19? frequently mistaken for Victor von Unruh's findings . pulmonary tuberculosis is could have been taken lightly, Did types of fowl influenza, chronic or acute.” were it not for similar thoughts tuberculosis...from pigs According to Hawes and Cabot, published in the more prestigious 9 png Q the symptoms of both diseases medical journals of his time. combine additively with were often identical.” ; latent human tuberculosis to Tufts pulmonologist Edward Bureau of Laboratories, 1918 O. Otis also caught Park's Something was eating at cause the deadly galloping attention. Otis not only physician/researcher/editor consumption of 1918-19? mirrored Hawes and Cabot's William Park during the carnage view, he went a step further: of 1918. Park, heading the state- "Often a patient gives the history of-the-art Bureau of Laboratories of a previous attack of influenza in New York City, was relied upon by both the US which may have been an active outbreak of a latent Government Health Corps and other major research — tuberculous focus, which later again became inactive."” centres across the country. Along with collaborators, Back in 1901, an editorial in the Journal of the American including bacteriologist Anna Williams, Park co-authored — Medical Association specifically cited Liverpool physician R. the important teaching text, Pathogenic Microorganisms. Buchanan: "Dr R. J. M. Buchanan makes the not At first, Park blamed Pfeiffer's bacillus for the 1918 improbable suggestion that many of the so-called pandemic and reported it to the US Army Health Corps. sporadic cases of influenza are really symptomatic of the But flustered by the secondary infections and lack of — initial infection of tuberculosis, or possibly an consistency in other labs in isolating Pfeiffer's, Park flip- | exacerbation of a latent tuberculosis previously flopped, cautioning against attributing the pandemic unsuspected or undetected."* solely to Pfeiffer's. In saying this, Buchanan had fired the shot heard By the same token, Park felt uncomfortable with the — around the world, and physician Walter Lindley, editor of muzzling of the media and medical corps by the Wilson the Southern California Practitioner, was quick to respond. administration regarding the ferocity of the 1918 Lindley on Buchanan: "The author, impressed by the American epidemic in general—that is, until it was too large number of instances in which patients have late to deny its viciousness. referred the commencement of their ill-health to an So although Pfeiffer's influenza bacillus, also known as __ attack of so-called influenza, conceives that many of the Mycobacterium influenzae, was no longer at the top of his so-called sporadic cases of influenza are really choices for the causal agent of the 1918 pandemic, it was | symptomatic of the initial infection of tuberculosis or its association with another mycobacterium, tuberculosis, possibly an exacerbation of a latent tuberculosis."” which bothered Park the most. He had just re-read Flick’s A complaint by Wakley and Wakley in the Lancet in 1899 account of what preceded both Great Pandemics. regarding an epidemic of infectious fever raging in New In 1888, physician Lawrence Flick, citing US census York is also appropriate: "The name ‘influenza’ seems to reports leading into the two greatest world "influenza" _ have a strong attraction for some people. Every ache pandemics in history, reported that out of every and pain, no matter where located and whether Did types of fowl tuberculosis...from pigs combine additively with latent human tuberculosis to cause the deadly galloping consumption of 1918-19? Otis NEXUS ¢ 21 OCTOBER - NOVEMBER 2011 www.nexusmagazine.com