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en:misc:talk-saine-novella-question01-part02 [2013/07/29 15:45]
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 **Part II of Dr. Saine’s Answer:** **Part II of Dr. Saine’s Answer:**
  
-**Pneumonia during the 1918-1920 Influenza Pandemic**+===== Pneumonia during the 1918-1920 Influenza Pandemic ​=====
  
 These statistical records about the survival from pneumonia take on a very particular significance when they are considered within the perspective of recurrent influenza pandemics, which can be associated with an extremely high mortality. Today, the USCDC regroups the mortality from influenza with the one from pneumonia, as the great majority of deaths from influenza are related to pneumonia. The USCDC reported that 50,097 persons died in the USA in 2010 from pneumonia and influenza, of which only 500 or 1% were from influenza and 49,597 were from pneumonia. [(http://​www.cdc.gov/​nchs/​data/​dvs/​deaths_2010_release.pdf)] These statistical records about the survival from pneumonia take on a very particular significance when they are considered within the perspective of recurrent influenza pandemics, which can be associated with an extremely high mortality. Today, the USCDC regroups the mortality from influenza with the one from pneumonia, as the great majority of deaths from influenza are related to pneumonia. The USCDC reported that 50,097 persons died in the USA in 2010 from pneumonia and influenza, of which only 500 or 1% were from influenza and 49,597 were from pneumonia. [(http://​www.cdc.gov/​nchs/​data/​dvs/​deaths_2010_release.pdf)]
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 In some “highly pathogenic” influenza epidemics, the mortality rate can be very high, particularly at their onset, which is usually characterized by fulminant pneumonia.[(http://​www.who.int/​mediacentre/​factsheets/​avian_influenza/​en/​)] For instance, from 2003 to 2012, nearly 600 human infections with highly pathogenic H5N1 viruses, which first appeared in Hong Kong in 1997, have been reported to the WHO, and about 60% of these people have died from their illness.[(http://​www.flu.gov/​about_the_flu/​h5n1/​)] In some “highly pathogenic” influenza epidemics, the mortality rate can be very high, particularly at their onset, which is usually characterized by fulminant pneumonia.[(http://​www.who.int/​mediacentre/​factsheets/​avian_influenza/​en/​)] For instance, from 2003 to 2012, nearly 600 human infections with highly pathogenic H5N1 viruses, which first appeared in Hong Kong in 1997, have been reported to the WHO, and about 60% of these people have died from their illness.[(http://​www.flu.gov/​about_the_flu/​h5n1/​)]
  
- The 1918-1920 influenza pandemic (NIP) had the highest mortality worldwide ever reported for any epidemic, and ranks as the single greatest recorded mortality event in human history.[(J. H. Walters. Influenza 1918: The contemporary perspective. //Bulletin of the New York Academy of Medicine// 1978; 54: 855-864. It is considered that up to 100 million people may have also died from the Justinian plague (6th century). (B. Lee Ligon. Plague: A Review of its History and Potential as a Biological Weapon. Seminars in Pediatrics Infectious Diseases 2006; 17: 161-170.)] Revised calculations of this influenza pandemic estimate that at least 40-50 million and possibly as many as 100 million persons died worldwide.[(J. S. Oxford. Influenza A pandemics of the 20th century with special reference to 1918: virology, pathology and epidemiology. //Reviews in Medical Virology// 2000; 10: 119-133.)]<​sup>,</​sup> ​[(“The recorded statistics of influenza morbidity and mortality are likely to be a significant understatement. … A recurring feature of the work on the pandemic in the last couple of decades has been the consistent upward revision of mortality figures. … In almost every instance where a researcher has reexamined the pandemic with a view to determining the true level of mortality, this has led to a significant upward revision. … Global mortality from the influenza pandemic appears to have been of the order of 50 million. However, even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated.” (Niall Johnson and Juergen Mueller. Updating the accounts: global mortality of the 1918-1920 “Spanish” influenza pandemic. //Bulletin of the History of Medicin//e 2002; 76: 105-115.))] In only 24 weeks, between 2-5% (50 to 100 million people) of humanity died. More people died of influenza in a single year than in four-years of the black-death bubonic plague that swept Europe from 1347 to 1351. [(One third or about 23 million people died when the black death (plague) swept through Europe in the fourteen century.)] As an illustration of the great mortality associated with the NIP, 1.9% of the soldiers in Camp Sherman died of the combined effects of influenza and pneumonia (CIP) per month during the fall of 1918. [(Warren T. Vaughan. //​Influenza:​ An epidemiologic study.// //American Journal of Hygiene//. Monographic Series No. 1. Baltimore, 1921.)]+ The 1918-1920 influenza pandemic (NIP) had the highest mortality worldwide ever reported for any epidemic, and ranks as the single greatest recorded mortality event in human history.[(J. H. Walters. Influenza 1918: The contemporary perspective. //Bulletin of the New York Academy of Medicine// 1978; 54: 855-864. It is considered that up to 100 million people may have also died from the Justinian plague (6th century). (B. Lee Ligon. Plague: A Review of its History and Potential as a Biological Weapon. Seminars in Pediatrics Infectious Diseases 2006; 17: 161-170.)] Revised calculations of this influenza pandemic estimate that at least 40-50 million and possibly as many as 100 million persons died worldwide.[(J. S. Oxford. Influenza A pandemics of the 20th century with special reference to 1918: virology, pathology and epidemiology. //Reviews in Medical Virology// 2000; 10: 119-133.)] [(“The recorded statistics of influenza morbidity and mortality are likely to be a significant understatement. … A recurring feature of the work on the pandemic in the last couple of decades has been the consistent upward revision of mortality figures. … In almost every instance where a researcher has reexamined the pandemic with a view to determining the true level of mortality, this has led to a significant upward revision. … Global mortality from the influenza pandemic appears to have been of the order of 50 million. However, even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated.” (Niall Johnson and Juergen Mueller. Updating the accounts: global mortality of the 1918-1920 “Spanish” influenza pandemic. //Bulletin of the History of Medicin//e 2002; 76: 105-115.))] In only 24 weeks, between 2-5% (50 to 100 million people) of humanity died. More people died of influenza in a single year than in four-years of the black-death bubonic plague that swept Europe from 1347 to 1351. [(One third or about 23 million people died when the black death (plague) swept through Europe in the fourteen century.)] As an illustration of the great mortality associated with the NIP, 1.9% of the soldiers in Camp Sherman died of the combined effects of influenza and pneumonia (CIP) per month during the fall of 1918. [(Warren T. Vaughan. //​Influenza:​ An epidemiologic study.// //American Journal of Hygiene//. Monographic Series No. 1. Baltimore, 1921.)]
  
 An estimated 675,000 Americans or 0.7 percent of the U.S. population (103 million [(Population Estimates Program, Population Division, U.S. Census Bureau Internet Release Date: April 11, 2000. Available at: http://​www.census.gov/​population/​estimates/​nation/​popclockest.txt Wade Hampton Frost. The epidemiology of influenza. //Public Health Reports// 1919; 34 (33): 1823-1836.)]) died of influenza during this pandemic, ten times as many as in WWI. When compared to the number of Americans killed in combat in World War I, World War II, Korea, and Vietnam combined—423,​000—it becomes apparent that the NIP was far more deadly than all four wars. Of the U.S. soldiers who died in Europe during WWI, half of them fell to the influenza virus rather than to the enemy. An estimated 43,000 servicemen mobilized for WWI died from influenza.[(http://​virus.stanford.edu/​uda/​)] An estimated 675,000 Americans or 0.7 percent of the U.S. population (103 million [(Population Estimates Program, Population Division, U.S. Census Bureau Internet Release Date: April 11, 2000. Available at: http://​www.census.gov/​population/​estimates/​nation/​popclockest.txt Wade Hampton Frost. The epidemiology of influenza. //Public Health Reports// 1919; 34 (33): 1823-1836.)]) died of influenza during this pandemic, ten times as many as in WWI. When compared to the number of Americans killed in combat in World War I, World War II, Korea, and Vietnam combined—423,​000—it becomes apparent that the NIP was far more deadly than all four wars. Of the U.S. soldiers who died in Europe during WWI, half of them fell to the influenza virus rather than to the enemy. An estimated 43,000 servicemen mobilized for WWI died from influenza.[(http://​virus.stanford.edu/​uda/​)]
  
-Some countries lost significant proportions of their population from influenza during the NIP, such as 2.6% for Portugal, 2.8% for the Philippines,​ 3% for Indonesia, 3.7% for Japan, 4% for Guatemala, 4.5% for India (or 13.9 million people), Ghana and the Maori population of New Zealand, 5.5% for Fiji, 6% for Kenya, 24% for Western Samoa, and 45% for Cameroon. [(Siddharth Chandra, Goran Kuljanin, Jennifer Wray. Mortality From the Influenza Pandemic of 1918--1919: The Case of India. //​Demography//​ 2012; 49: 857-864.)]</​sup>,</​sup>​[(Niall P. A. S. Johnson, Juergen Mueller. Updating the accounts: global mortality of the 1918-1920 “Spanish” influenza pandemic. //Bulletin of the History of Medicine// 2002; 76 (1): 105-115.)]<​sup>,</​sup>​[(Siddharth Chandra. Deaths associated with influenza pandemic of 1918--19, Japan. //Emerging Infectious Diseases// 2013; 19: 616-622.)]<​sup>,</​sup> ​[(Christopher J. L. Murray, et al. Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918--20 pandemic: a quantitative analysis. //Lancet// 2006; 368 (9554): 2211-2218.)] Among the Inuit, the death toll was terrible, as some villages lost their entire adult population.[(Warren T. Vaughan. //​Influenza:​ An epidemiologic study.// //American Journal of Hygiene//. Monographic Series No. 1. Baltimore, 1921.)]+Some countries lost significant proportions of their population from influenza during the NIP, such as 2.6% for Portugal, 2.8% for the Philippines,​ 3% for Indonesia, 3.7% for Japan, 4% for Guatemala, 4.5% for India (or 13.9 million people), Ghana and the Maori population of New Zealand, 5.5% for Fiji, 6% for Kenya, 24% for Western Samoa, and 45% for Cameroon. [(Siddharth Chandra, Goran Kuljanin, Jennifer Wray. Mortality From the Influenza Pandemic of 1918--1919: The Case of India. //​Demography//​ 2012; 49: 857-864.)] [(Niall P. A. S. Johnson, Juergen Mueller. Updating the accounts: global mortality of the 1918-1920 “Spanish” influenza pandemic. //Bulletin of the History of Medicine// 2002; 76 (1): 105-115.)] [(Siddharth Chandra. Deaths associated with influenza pandemic of 1918--19, Japan. //Emerging Infectious Diseases// 2013; 19: 616-622.)] [(Christopher J. L. Murray, et al. Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918--20 pandemic: a quantitative analysis. //Lancet// 2006; 368 (9554): 2211-2218.)] Among the Inuit, the death toll was terrible, as some villages lost their entire adult population.[(Warren T. Vaughan. //​Influenza:​ An epidemiologic study.// //American Journal of Hygiene//. Monographic Series No. 1. Baltimore, 1921.)]
  
 Could such a high mortality rate have been prevented from both a prophylactic and a therapeutic aspects? Dr. Eldridge C. Price of Baltimore wrote in December 1919, “Efficiency is ‘the power that accomplishes a desired or
 designed work.’ Therapeutic efficiency, therefore, is the restoration of the patient to health by the application of some 
means designed for that purpose. Could such a high mortality rate have been prevented from both a prophylactic and a therapeutic aspects? Dr. Eldridge C. Price of Baltimore wrote in December 1919, “Efficiency is ‘the power that accomplishes a desired or
 designed work.’ Therapeutic efficiency, therefore, is the restoration of the patient to health by the application of some 
means designed for that purpose.
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 What Dr. Price suggested is not an easy and simple task, namely reviewing the comparative results obtained by homeopathy and allopathy during the NIP, first, because such compilation has never been done and the documentation on this subject is quite voluminous, and would require much work; second, homeopaths published their results obtained through a number of surveys conducted among members of different homeopathic associations,​ while no similar surveys can be found in the allopathic literature. However, many outcome results have been published by public health services and the armed forces that could be used for outcome comparison. What Dr. Price suggested is not an easy and simple task, namely reviewing the comparative results obtained by homeopathy and allopathy during the NIP, first, because such compilation has never been done and the documentation on this subject is quite voluminous, and would require much work; second, homeopaths published their results obtained through a number of surveys conducted among members of different homeopathic associations,​ while no similar surveys can be found in the allopathic literature. However, many outcome results have been published by public health services and the armed forces that could be used for outcome comparison.
  
-Physicians like other scientists have been reporting their observations,​ successes and failures for centuries, particularly in times of epidemics. Homeopaths reported all around better results and felt a greater responsibility to publish them, as it would normally be expected, and as Dr. John Hutchinson of New York correctly pointed out in 1920, “The fact is established that homeopathic remedies cure pneumonia, each and every one when clearly indicated. And that is why the mortality rate in our school is so low—lower,​ much lower than any other statistics. Witness the extraordinary success of homeopathy in epidemic influenza, //the only success that has made a record//​.” [(John Hutchinson. Prescrition factors. Discussion: Influenza: a favoable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 807-813.)] Homeopaths have thus made some efforts to assemble and publish their records following the NIP.+Physicians like other scientists have been reporting their observations,​ successes and failures for centuries, particularly in times of epidemics. Homeopaths reported all around better results and felt a greater responsibility to publish them, as it would normally be expected, and as Dr. John Hutchinson of New York correctly pointed out in 1920, “The fact is established that homeopathic remedies cure pneumonia, each and every one when clearly indicated. And that is why the mortality rate in our school is so low—lower,​ much lower than any other statistics. Witness the extraordinary success of homeopathy in epidemic influenza, //the only success that has made a record//​.” [(John Hutchinson. Prescrition factors. Discussion: Influenza: a favorable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 807-813.)] Homeopaths have thus made some efforts to assemble and publish their records following the NIP.
  
 Dr. Lewis P. Crutcher of Long Beach, California pointed out in July 1919 in an editorial that it was in fact a great social responsibility for homeopaths to publicized their results, “The uniformity of results obtained from homeopathic 
practice in all parts of the country leaves nothing to be desired, for in practically all of the experiences of practitioners of the 
homeopathic school the mortality was almost nil, while the
 sequelae were inconsiderable. But what doth it profit a 
school of medicine if it cures all of its patrons and do not make 
it known to those who likewise would prefer to be cured, if 
they but knew? 
Publish and preach these facts, broadcast and do not be
 ashamed or afraid, and homeopathy will live again.” [(Lewis P. Crutcher. Now is the time. //Pacific Coast Journal of Homoeopathy//​ 1919; 30: 274- 275.)] Dr. Lewis P. Crutcher of Long Beach, California pointed out in July 1919 in an editorial that it was in fact a great social responsibility for homeopaths to publicized their results, “The uniformity of results obtained from homeopathic 
practice in all parts of the country leaves nothing to be desired, for in practically all of the experiences of practitioners of the 
homeopathic school the mortality was almost nil, while the
 sequelae were inconsiderable. But what doth it profit a 
school of medicine if it cures all of its patrons and do not make 
it known to those who likewise would prefer to be cured, if 
they but knew? 
Publish and preach these facts, broadcast and do not be
 ashamed or afraid, and homeopathy will live again.” [(Lewis P. Crutcher. Now is the time. //Pacific Coast Journal of Homoeopathy//​ 1919; 30: 274- 275.)]
  
-Aside from having less desirable results, there were other reasons that could explain the paucity of outcome reports from allopathic physicians. First, as influenza was then not a reportable disease in most localities, it became incumbent on physicians to keep good records. Second, most physicians were too busy to keep good records. As an illustration of this point, Dr. W. F. Edmunson of Pittsburgh, who followed his private patients as well as hospitalized patients during the NIP, reported, “I do not know the number of 
cases I treated. I would start out at eight thirty or nine, work until
 dinnertime, get dinner, tend the office until ten and then go out and
 work until one. It was a continuous strain which lasted all season, running far into the spring. [(W. F. Edmunson. Discussion: Influenza: a favoable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 598.)] Dr. Eli G. Jones of Buffalo reported there were so many cases to treat that he “could hardly find time to eat his meals.”[(Eli G. Jones. Some interesting facts. //​Homoeopathic Recorder// 1919; 34: 11-15.)] Dr. John C. Calhoun of Pittsburgh wrote, “When calls were accumulating at such a rate that there were not hours enough in the day to make them, something had to be done to get a short route to prescribing. For a time I was seeing from 75 to 100 persons a day. We had a scarcity of doctors due to war conditions and sickness of those at home.”[(John C. Calhoun. A “flu” experience. //​Hahnemannian Monthly// 1919; 54: 738-739.)]+Aside from having less desirable results, there were other reasons that could explain the paucity of outcome reports from allopathic physicians. First, as influenza was then not a reportable disease in most localities, it became incumbent on physicians to keep good records. Second, most physicians were too busy to keep good records. As an illustration of this point, Dr. W. F. Edmunson of Pittsburgh, who followed his private patients as well as hospitalized patients during the NIP, reported, “I do not know the number of 
cases I treated. I would start out at eight thirty or nine, work until
 dinnertime, get dinner, tend the office until ten and then go out and
 work until one. It was a continuous strain which lasted all season, running far into the spring. [(W. F. Edmunson. Discussion: Influenza: a favorable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 598.)] Dr. Eli G. Jones of Buffalo reported there were so many cases to treat that he “could hardly find time to eat his meals.”[(Eli G. Jones. Some interesting facts. //​Homoeopathic Recorder// 1919; 34: 11-15.)] Dr. John C. Calhoun of Pittsburgh wrote, “When calls were accumulating at such a rate that there were not hours enough in the day to make them, something had to be done to get a short route to prescribing. For a time I was seeing from 75 to 100 persons a day. We had a scarcity of doctors due to war conditions and sickness of those at home.”[(John C. Calhoun. A “flu” experience. //​Hahnemannian Monthly// 1919; 54: 738-739.)]
  
 Dr. Crawford Green, a pediatrician from Troy, N.Y., reported that, despite the heavy work over several months, the results remained consistent, “Unfortunately,​ I am unable to present accurate statistics from my own practice. I do not know how many hundreds of cases of influenza passed through my hands. Like many of my colleagues I never had time to count my cases. From September
 20, 1918, to May 12, 1919, there was not a single day that I
 did not have influenza under my care. I have had as many as 17 cases of influenza pneumonia at one time, but I do not 
know how many I treated altogether. In fact, I have not even 
separated my cases among children from my cases among adults. 
But among them all, there were two deaths in children. One, at eight months, was undernourished and had been a bad feeding case. It survived six days. The other, at twenty-two
 months, died after a very brief pneumonia. I saw this child 
only twice. The surroundings were bad and the child had no nursing care.” [(Crawford R. Green. The treatment of Influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1102-1112.)] Dr. Crawford Green, a pediatrician from Troy, N.Y., reported that, despite the heavy work over several months, the results remained consistent, “Unfortunately,​ I am unable to present accurate statistics from my own practice. I do not know how many hundreds of cases of influenza passed through my hands. Like many of my colleagues I never had time to count my cases. From September
 20, 1918, to May 12, 1919, there was not a single day that I
 did not have influenza under my care. I have had as many as 17 cases of influenza pneumonia at one time, but I do not 
know how many I treated altogether. In fact, I have not even 
separated my cases among children from my cases among adults. 
But among them all, there were two deaths in children. One, at eight months, was undernourished and had been a bad feeding case. It survived six days. The other, at twenty-two
 months, died after a very brief pneumonia. I saw this child 
only twice. The surroundings were bad and the child had no nursing care.” [(Crawford R. Green. The treatment of Influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1102-1112.)]
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 In another survey, Dr. Herbert Roberts of Derby reported that thirty physicians in Connecticut had lost 55 out of 6,602 patients treated, a mortality of 0.83 percent. He said, “There were 21 cases of meningeal form of influenza, and 496 cases of pneumonia.” [(H. A. Roberts. Discussion: Influenza: a favorable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 591.)] In another survey, Dr. Herbert Roberts of Derby reported that thirty physicians in Connecticut had lost 55 out of 6,602 patients treated, a mortality of 0.83 percent. He said, “There were 21 cases of meningeal form of influenza, and 496 cases of pneumonia.” [(H. A. Roberts. Discussion: Influenza: a favorable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 591.)]
  
-Professor Guy Beckley Stearns of the New York Homoeopathic Medical College reviewed reports of 16,913 cases treated by the members of the International Hahnemannian Association (IHA)[(Members of the IHA were known to practice genuine homeopathy.)] with 67 deaths, a mortality of 0.4 percent.[(Guy Beckley Stearns. //Treatment of influenza//​. New York: New York Homœopathic College, 1919, 3.)]<​sup>,</​sup> ​[(D. C. MacLaren. President’s address. //​Proceedings of the International Hahnemannian Association//​ 1919: 16.)] These last numbers must be fairly representative of the results obtained by genuine homeopathy, as they received 79 responses out of about 130 active American members of the IHA. Dr. Stearns reported that it was notably difficult to obtain replies from many physicians, especially in such busy times, and the tallying sent in probably represents the usual average outcome of the members of the IHA. In fact, subsequent conversations held by Dr. Stearns with many who had not answered showed about the same mortality average as given in the compilation.[(Donald Macfarlan. Materia medica meeting. //​Homoeopathic Recorder// 1920; 35; 262-265.)]+Professor Guy Beckley Stearns of the New York Homoeopathic Medical College reviewed reports of 16,913 cases treated by the members of the International Hahnemannian Association (IHA)[(Members of the IHA were known to practice genuine homeopathy.)] with 67 deaths, a mortality of 0.4 percent.[(Guy Beckley Stearns. //Treatment of influenza//​. New York: New York Homœopathic College, 1919, 3.)] [(D. C. MacLaren. President’s address. //​Proceedings of the International Hahnemannian Association//​ 1919: 16.)] These last numbers must be fairly representative of the results obtained by genuine homeopathy, as they received 79 responses out of about 130 active American members of the IHA. Dr. Stearns reported that it was notably difficult to obtain replies from many physicians, especially in such busy times, and the tallying sent in probably represents the usual average outcome of the members of the IHA. In fact, subsequent conversations held by Dr. Stearns with many who had not answered showed about the same mortality average as given in the compilation.[(Donald Macfarlan. Materia medica meeting. //​Homoeopathic Recorder// 1920; 35; 262-265.)]
  
 Professor Willis A. Dewey of the University of Michigan reported in a survey of 30 homeopathic physicians a loss of 17 among 9,250 patients, a mortality of 0.18 percent.[(W. A. Dewey. Homeopathy in influenza—A chorus of fity in harmony. //Journal of the American Institute of Homeopathy//​ 1920-21; 13: 1038-1043.)] Professor Willis A. Dewey of the University of Michigan reported in a survey of 30 homeopathic physicians a loss of 17 among 9,250 patients, a mortality of 0.18 percent.[(W. A. Dewey. Homeopathy in influenza—A chorus of fity in harmony. //Journal of the American Institute of Homeopathy//​ 1920-21; 13: 1038-1043.)]
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   - The odds ratios of surviving CIP with homeopathy were 9.0 (95% CI 8.2 to 9.9) as compared to PAA (//P// < 0.0001). ​   - The odds ratios of surviving CIP with homeopathy were 9.0 (95% CI 8.2 to 9.9) as compared to PAA (//P// < 0.0001). ​
  
-**The Prophylactic Role of Homeopathic Intervention**+===== The Prophylactic Role of Homeopathic Intervention ​=====
  
 The importance of the role of homeopathy during epidemics must also be viewed within the perspective of its omnipresent prophylactic role that it plays through three different ways. The first way of the prophylactic power of homeopathy during epidemics relates to the fact that homeopathic remedies can be given to large segments of populations as protective agents prior or in the midst of an epidemic. For instance, in 1974-75, there was a major epidemic of meningococcal meningitis that devastated Brazil. Around 250,000 became ill, more than 11,000 died and over 75,000 people were left with permanent brain damage. Many victims fell desperately ill in minutes with a stiff neck and fever leading to hemorrhages,​ coma and death within a day. The importance of the role of homeopathy during epidemics must also be viewed within the perspective of its omnipresent prophylactic role that it plays through three different ways. The first way of the prophylactic power of homeopathy during epidemics relates to the fact that homeopathic remedies can be given to large segments of populations as protective agents prior or in the midst of an epidemic. For instance, in 1974-75, there was a major epidemic of meningococcal meningitis that devastated Brazil. Around 250,000 became ill, more than 11,000 died and over 75,000 people were left with permanent brain damage. Many victims fell desperately ill in minutes with a stiff neck and fever leading to hemorrhages,​ coma and death within a day.
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 In the same editorial pages, Dr. Rabe added, “Homeopathy,​ being [based on] a law of nature and working in harmony with her, raises resistance by gradually restoring the physiological balance, in other words, by bringing about a state of health. //Real// homeopathy does not suppress, change or distort disease manifestations. The cure is never worse than the disease! … The homeopathic treatment of such bacterial diseases as influenza, pneumonia, typhoid fever, erysipelas, etc., amply proves that bacteria need have no terrors for him who understands the art of homoeopathic prescribing. Such a prescriber raises the resistance of his patient to bacterial attacks, increases the phagocytic power of the leucocytes; or, in plain language, enables the sufferers to //throw off// the disease.”[(R. F. Rabe. The power of resistance. //​Homoeopathic Recorder// 1919; 34: 427-429.)] In the same editorial pages, Dr. Rabe added, “Homeopathy,​ being [based on] a law of nature and working in harmony with her, raises resistance by gradually restoring the physiological balance, in other words, by bringing about a state of health. //Real// homeopathy does not suppress, change or distort disease manifestations. The cure is never worse than the disease! … The homeopathic treatment of such bacterial diseases as influenza, pneumonia, typhoid fever, erysipelas, etc., amply proves that bacteria need have no terrors for him who understands the art of homoeopathic prescribing. Such a prescriber raises the resistance of his patient to bacterial attacks, increases the phagocytic power of the leucocytes; or, in plain language, enables the sufferers to //throw off// the disease.”[(R. F. Rabe. The power of resistance. //​Homoeopathic Recorder// 1919; 34: 427-429.)]
  
-**Confounding factors**+===== Confounding factors ​=====
  
 Many confounding factors, aside from allopathic and homeopathic interventions,​ could possibly explain the great difference in mortality between the ones reported by homeopaths and the US army, such as differences in their respective population (a mix of ambulatory and hospitalized patients of all ages, races and socio-economic status, including infants, pregnant women, elderly people and persons with compromised respiratory,​ cardiac or renal functions for homeopaths while it was limited to mostly young men between 18-40 years for the army), differences in their respective environments (such as rural, urban, camps, ships, boarding schools for the homeopaths while it was limited to camps, troop ships and battlefields for the army), and differences in the waves of reported treatment (reports from the homeopaths included the waves of the fall of 1918 and the winter of 1919 while the army reports were limited to the four last months of 1918). Many confounding factors, aside from allopathic and homeopathic interventions,​ could possibly explain the great difference in mortality between the ones reported by homeopaths and the US army, such as differences in their respective population (a mix of ambulatory and hospitalized patients of all ages, races and socio-economic status, including infants, pregnant women, elderly people and persons with compromised respiratory,​ cardiac or renal functions for homeopaths while it was limited to mostly young men between 18-40 years for the army), differences in their respective environments (such as rural, urban, camps, ships, boarding schools for the homeopaths while it was limited to camps, troop ships and battlefields for the army), and differences in the waves of reported treatment (reports from the homeopaths included the waves of the fall of 1918 and the winter of 1919 while the army reports were limited to the four last months of 1918).
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 However, the more one examines the various existing therapeutic outcome reports on the NIP, no clear or significant confounding factor seems to emerge, and the more the //​consistency//​ of the results obtained by homeopathy and allopathy are confirmed regardless of the place, population, circumstance or wave of the epidemic. However, the more one examines the various existing therapeutic outcome reports on the NIP, no clear or significant confounding factor seems to emerge, and the more the //​consistency//​ of the results obtained by homeopathy and allopathy are confirmed regardless of the place, population, circumstance or wave of the epidemic.
  
-This consistency is very clear for anyone perusing the homeopathic literature as expressed in 1920 by Dr. Crawford Green, a pediatrician from Troy, N.Y., “From every corner of 
our great country, wherever homeopathy is practiced and wherever there is opportunity for the exact study of comparative
 statistics, there comes indisputable testimony of the wonderful
 efficacy of homeopathy. Parallel groups of cases everywhere
 show a homeopathic mortality almost negligible when compared
 with any other system of therapy.”[(61)]+This consistency is very clear for anyone perusing the homeopathic literature as expressed in 1920 by Dr. Crawford Green, a pediatrician from Troy, N.Y., “From every corner of 
our great country, wherever homeopathy is practiced and wherever there is opportunity for the exact study of comparative
 statistics, there comes indisputable testimony of the wonderful
 efficacy of homeopathy. Parallel groups of cases everywhere
 show a homeopathic mortality almost negligible when compared
 with any other system of therapy.”[(Crawford R. Green. The treatment of Influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1102-1112.)]
  
-Dr. H. O. Skinner, a pediatrician from St. Paul, Minnesota, similarly remarked, “The remarkable thing about the homeopathic record in
 this epidemic is not so much its low mortality, as the fact
 that it was made by physicians widely separated, even to different countries and without inter-communication,​ with the 
same line of treatment and the same drugs. When it is considered that this epidemic was unlike anything which had 
ever preceded it, that it came on so suddenly as to forbid any 
study (to say nothing of the fact that subsequent study has
 not yet revealed much) and that it had, therefore, to be met, not specifically,​ but on general principles, the uniformity of 
the homeopathic treatment the world over and the uniformly 
good results there from, demonstrating homeopathy'​s ability
 to cope with this protean emergency, when the other schools 
of medicine failed utterly, behooves us no more by apathy 
than by design to permit it to perish from the face of the earth.”[(62)]+Dr. H. O. Skinner, a pediatrician from St. Paul, Minnesota, similarly remarked, “The remarkable thing about the homeopathic record in
 this epidemic is not so much its low mortality, as the fact
 that it was made by physicians widely separated, even to different countries and without inter-communication,​ with the 
same line of treatment and the same drugs. When it is considered that this epidemic was unlike anything which had 
ever preceded it, that it came on so suddenly as to forbid any 
study (to say nothing of the fact that subsequent study has
 not yet revealed much) and that it had, therefore, to be met, not specifically,​ but on general principles, the uniformity of 
the homeopathic treatment the world over and the uniformly 
good results there from, demonstrating homeopathy'​s ability
 to cope with this protean emergency, when the other schools 
of medicine failed utterly, behooves us no more by apathy 
than by design to permit it to perish from the face of the earth.”[(H. O. Skinner. Influenza in children. //Journal of the American Institute of Homeopathy//​ 1920-1921; 13: 505-514.)]
  
-A clear illustration of the consistency of the results obtained by the two schools of medicine is found in the following report from Dr. E. B. Finney of Lincoln, Nebraska, “I know of a physician on the border line of Kansas and Nebraska
 who reported to Kansas and Nebraska 700 cases without a single death
 when he was taken sick and had to go to bed. The disease was very
 virulent. There were forty deaths in one week which speaks well for
 his treatment as he was the only homeopathic physician in that city.”[(63)]+A clear illustration of the consistency of the results obtained by the two schools of medicine is found in the following report from Dr. E. B. Finney of Lincoln, Nebraska, “I know of a physician on the border line of Kansas and Nebraska
 who reported to Kansas and Nebraska 700 cases without a single death
 when he was taken sick and had to go to bed. The disease was very
 virulent. There were forty deaths in one week which speaks well for
 his treatment as he was the only homeopathic physician in that city.”[(E. B. Finney. Discussion: Influenza: a favorable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 590.)]
  
-**Age**+===== Age =====
  
-The fact that the outcome of the entire army is related to a population of young men between 18-40 years old who were in relatively good health prior to the epidemic would tend to disfavor the homeopaths who treated an overall less healthy and more susceptible population, which included infants and the older segment of the population. Statistics support this hypothesis, as it can be seen in the District of Columbia where the Commissioners kept good records during the epidemic and reported that in 1918 the average case mortality rate for influenza and pneumonia was 8.6%, but was 20% for the ones under 1 year-old, 7.3% for the ones between 20-29 years, 14% for the ones between 60-69 years, and 33% for the ones with 70 years and over. [(64)] Similarly the average case mortality for the entire US civilian population was about twice as much for infants and the older segment of the population, as it was for the 20-39 year-old segment (1.9% for the ones between 20-24 years, 3% for the ones between 25-29 years, and just above 2% for the ones between 30-39 years, but was about 5% in infants, and about 4% for people over 65 years). [(65)]+The fact that the outcome of the entire army is related to a population of young men between 18-40 years old who were in relatively good health prior to the epidemic would tend to disfavor the homeopaths who treated an overall less healthy and more susceptible population, which included infants and the older segment of the population. Statistics support this hypothesis, as it can be seen in the District of Columbia where the Commissioners kept good records during the epidemic and reported that in 1918 the average case mortality rate for influenza and pneumonia was 8.6%, but was 20% for the ones under 1 year-old, 7.3% for the ones between 20-29 years, 14% for the ones between 60-69 years, and 33% for the ones with 70 years and over. [(Annual Report of the Commissioners of the District of Columbia Year Ended June 30, 1919. Volume 3. Washington, 42.)] Similarly the average case mortality for the entire US civilian population was about twice as much for infants and the older segment of the population, as it was for the 20-39 year-old segment (1.9% for the ones between 20-24 years, 3% for the ones between 25-29 years, and just above 2% for the ones between 30-39 years, but was about 5% in infants, and about 4% for people over 65 years). [(Wade Hampton Frost. The epidemiology of influenza. //Public Health Reports// 1919; 34 (33): 1823-1836.)]
  
-Also, regardless of the different conditions associated with the armed forces, such as inoculations and confined spaces, it appears that the same demographic group was similarly affected in the civilian population. The Metropolitan Life Insurance Company based in New York City found that the disease killed 3.26% of its insured US industrial workers aged 25--45, a population of young men most similar demographically to the one of the armed forces. [(66)] Given that 25--40% of the population contracted the disease, the case mortality can be estimated to have been between 8--13% in that population.[(67)]+Also, regardless of the different conditions associated with the armed forces, such as inoculations and confined spaces, it appears that the same demographic group was similarly affected in the civilian population. The Metropolitan Life Insurance Company based in New York City found that the disease killed 3.26% of its insured US industrial workers aged 25--45, a population of young men most similar demographically to the one of the armed forces. [(John M. Barry. Pandemics: avoiding the mistakes of 1918. //Nature// 2009; 459 (7245): 324-325.)] Given that 25--40% of the population contracted the disease, the case mortality can be estimated to have been between 8--13% in that population.[(Edwin O Jordan. //Epidemic Influenza. A Survey//. Chicago: American Medical Association,​ 1927.)]
  
 Age and being a civilian do not therefore appear to explain the higher case mortality of 5.8-7.21% for the different armies versus the much better results of 0.7% reported by the homeopaths. Age and being a civilian do not therefore appear to explain the higher case mortality of 5.8-7.21% for the different armies versus the much better results of 0.7% reported by the homeopaths.
  
-Dr. H. O. Skinner, a pediatrician from St. Paul, Minnesota, reported having loss not a single child out of several hundred cases. [(68)]Dr. Plumb Brown, a pediatrician from Springfield,​ Massachusetts,​ said, “My experience was entirely outside of the hospital. I was in general practice. Fortunately the Board of Health obliged us to report our cases. Afterwards by looking up the records we were able to differentiate and find what percentage of cases were children. I found that 44 per cent of my cases were in children below the age of 14, many in young infants. The mortality in all cases was 16 per cent [for Springfield]. Ten per cent of all the cases developed pneumonia. I did not lose a single child.”[(69)]+Dr. H. O. Skinner, a pediatrician from St. Paul, Minnesota, reported having loss not a single child out of several hundred cases. [(H. O. Skinner. Influenza in children. //Journal of the American Institute of Homeopathy//​ 1920-1921; 13: 505-514.)]Dr. Plumb Brown, a pediatrician from Springfield,​ Massachusetts,​ said, “My experience was entirely outside of the hospital. I was in general practice. Fortunately the Board of Health obliged us to report our cases. Afterwards by looking up the records we were able to differentiate and find what percentage of cases were children. I found that 44 per cent of my cases were in children below the age of 14, many in young infants. The mortality in all cases was 16 per cent [for Springfield]. Ten per cent of all the cases developed pneumonia. I did not lose a single child.”[(Plumb Brown. Discussion: The treatment of influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1107.)]
  
-Dr. Stella Q. Root, a homeopathic obstetrician from Stamford, Connecticut,​ reported, “I only had 91 cases of influenza altogether, and 20 per cent of these
 were among children; 25 per cent of the children had pneumonia. I
 had no deaths among the children, and but one death in the 91 cases.” [(70)]+Dr. Stella Q. Root, a homeopathic obstetrician from Stamford, Connecticut,​ reported, “I only had 91 cases of influenza altogether, and 20 per cent of these
 were among children; 25 per cent of the children had pneumonia. I
 had no deaths among the children, and but one death in the 91 cases.” [(Stella Q. Root. Discussion: The treatment of influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1108.)]
  
-Dr. J. G. Dillon of Fargo, North Dakota further remarked, “The children cases I saw were
 those in general practice, as well as the patients at the Institution 
known as the North Dakota Children’s Home. … Sixty-seven cases developed [influenza] at the Children'​s Home without any 
complicating pneumonia or death; most of these cases were on Bryonia and Gelsemium, which seemed to be successful in carrying them
 through to complete recovery.” [(71)]+Dr. J. G. Dillon of Fargo, North Dakota further remarked, “The children cases I saw were
 those in general practice, as well as the patients at the Institution 
known as the North Dakota Children’s Home. … Sixty-seven cases developed [influenza] at the Children'​s Home without any 
complicating pneumonia or death; most of these cases were on Bryonia and Gelsemium, which seemed to be successful in carrying them
 through to complete recovery.” [(J. G. Dillon. Discussion: The treatment of influenza in children. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 1110.)]
  
-Also some particular segments of the civilian population were greatly more affected than the members of the armed forces. For instance, it was known that the mortality of coal miners was much higher for the same age-male population. For instance, the death rate in coal miners from the 1918 flu epidemic was 36% higher than the same age-adjusted population.[(72)] Dr. Geo Krepreka of Stacyville, Iowa reported in a paper on pneumonia secondary to influenza, “During the months of October, November and December, as 
an assistant surgeon in the U. S. Public Health Service, approximately 2,000 cases of influenza were thrust into my hands, and as a result, received at least some form of homeopathic treatment. About one half the time was devoted to the coal mining
 camps in the vicinity of Albia and Ottumwa, while the other half 
was spent in towns where the residing physicians were either
 stricken with the disease themselves, or were in the army. During 
this time I had visited 15 different localities, so that I undoubtedly 
must have come in contact with the disease in all forms of its 
virulence. The death rate under homeopathic treatment, as we
 all know, has been exceedingly low, in fact I know of but four
 deaths out of the list wherein homeopathic treatment failed.” [(73)]+Also some particular segments of the civilian population were greatly more affected than the members of the armed forces. For instance, it was known that the mortality of coal miners was much higher for the same age-male population. For instance, the death rate in coal miners from the 1918 flu epidemic was 36% higher than the same age-adjusted population.[(E. B. Starr. Excessive mortality from influenza-pneumonia among bituminous coal miners of Ohio in 1918. //American Journal of Public Health// 1920; //10// (4): 348-351.)] Dr. Geo Krepreka of Stacyville, Iowa reported in a paper on pneumonia secondary to influenza, “During the months of October, November and December, as 
an assistant surgeon in the U. S. Public Health Service, approximately 2,000 cases of influenza were thrust into my hands, and as a result, received at least some form of homeopathic treatment. About one half the time was devoted to the coal mining
 camps in the vicinity of Albia and Ottumwa, while the other half 
was spent in towns where the residing physicians were either
 stricken with the disease themselves, or were in the army. During 
this time I had visited 15 different localities, so that I undoubtedly 
must have come in contact with the disease in all forms of its 
virulence. The death rate under homeopathic treatment, as we
 all know, has been exceedingly low, in fact I know of but four
 deaths out of the list wherein homeopathic treatment failed.” [(George Krepreka. Clinical varieties of pneumonia as secondary to influenza. //Iowa Homeopathic Journal// 1920; 13: 253-258.)]
  
-**Pregnancy**+===== Pregnancy ​=====
  
 The fact that it is widely recognized that the case mortality was highest in pregnant women enhanced the value of outcomes reported by homeopahts, as this population wasn’t present in the army. The fact that it is widely recognized that the case mortality was highest in pregnant women enhanced the value of outcomes reported by homeopahts, as this population wasn’t present in the army.
  
-According to a survey sent to all the physicians in Maryland, it was reported that the case mortality was 27% in 1,350 pregnant women with influenza. About 50% of the pregnant women with influenza eventually developed pneumonia, and 54% of these died. Miscarriages occurred in 26% of the ones without pneumonia and in 62% in the ones with pneumonia. 60% of the ones who developed pneumonia in the last three months of pregnancy died. [(74)]+According to a survey sent to all the physicians in Maryland, it was reported that the case mortality was 27% in 1,350 pregnant women with influenza. About 50% of the pregnant women with influenza eventually developed pneumonia, and 54% of these died. Miscarriages occurred in 26% of the ones without pneumonia and in 62% in the ones with pneumonia. 60% of the ones who developed pneumonia in the last three months of pregnancy died. [(John W. Harris. Influenza occurring in pregnant women. //Journal of the American Medical Association//​ 1919; 72; 978-980.)]
  
-Despite these outstanding and difficult odds, the consistency of results under homeopathic treatment was maintained in the population of pregnant women, as it was reported by many homeopathic obstetricians. Dr. Stella Q. Root, a homeopathic obstetrician from Stamford, Connecticut,​ said, “I did not complete my record
 in time to write Dr. Huntoon, and so I brought it with me. It is 
comparatively simple. 
I only practiced six weeks of the influenza period. During that 
time I had 91 cases of influenza, with 23 cases of pneumonia. I had
 42 pregnant women, varying from two months to term. Of these 42
 pregnant cases, a little less than 25% had influenza, and only three of
 these ten had pneumonia. I only lost one case out of the 91. I thought 
until I heard the statistics this morning in the Bureau of Homeopathy
 that my record was nothing but luck, but now I hope it was due to 
homeopathic therapeutics. The case I lost was a woman four months
 pregnant. She induced an abortion on herself, had been flowing for 
five days and was almost exsanguinated. Her home conditions were
 such, that although the hospital was well filled with pneumonia I had
 no alternative but to take her there. She stood the curettage well
 and was in fair condition when I sent her home in an ambulance at
 the end of a week. A week from the time she went home she developed influenza, and almost immediately pneumonia. We felt that a
 week was rather long for the exposure if she had contracted it from
 cases in the hospital. She died within four days. The fetus was 
stillborn. There were four others with influenza delivered during this period. 
One had pneumonia quite severely but did not have premature labor, 
but a few days after her temperature went to normal she was normally
 delivered. Two others had influenza but not pneumonia, and were
 delivered almost immediately after the subsidence of the temperature,​ with no bad symptoms afterwards. One was delivered who had influenza with mild pneumonia after her delivery. Of the other five cases 
three have since been delivered safely. Two were only about two
 months pregnant at the time of the influenza and are still not delivered. 
This was not the experience of Stamford Hospital generally. Of
 course a good many cases were sent in in rather extreme conditions, but the superintendent told me that the feeling at the hospital was
 that if a woman had influenza and was pregnant, or had a miscarriage,​ it was practically a fatal case. The cases I treated were all treated
 homeopathically,​ so I give all the credit to homeopathy.” [(75)]+Despite these outstanding and difficult odds, the consistency of results under homeopathic treatment was maintained in the population of pregnant women, as it was reported by many homeopathic obstetricians. Dr. Stella Q. Root, a homeopathic obstetrician from Stamford, Connecticut,​ said, “I did not complete my record
 in time to write Dr. Huntoon, and so I brought it with me. It is 
comparatively simple. 
I only practiced six weeks of the influenza period. During that 
time I had 91 cases of influenza, with 23 cases of pneumonia. I had
 42 pregnant women, varying from two months to term. Of these 42
 pregnant cases, a little less than 25% had influenza, and only three of
 these ten had pneumonia. I only lost one case out of the 91. I thought 
until I heard the statistics this morning in the Bureau of Homeopathy
 that my record was nothing but luck, but now I hope it was due to 
homeopathic therapeutics. The case I lost was a woman four months
 pregnant. She induced an abortion on herself, had been flowing for 
five days and was almost exsanguinated. Her home conditions were
 such, that although the hospital was well filled with pneumonia I had
 no alternative but to take her there. She stood the curettage well
 and was in fair condition when I sent her home in an ambulance at
 the end of a week. A week from the time she went home she developed influenza, and almost immediately pneumonia. We felt that a
 week was rather long for the exposure if she had contracted it from
 cases in the hospital. She died within four days. The fetus was 
stillborn. There were four others with influenza delivered during this period. 
One had pneumonia quite severely but did not have premature labor, 
but a few days after her temperature went to normal she was normally
 delivered. Two others had influenza but not pneumonia, and were
 delivered almost immediately after the subsidence of the temperature,​ with no bad symptoms afterwards. One was delivered who had influenza with mild pneumonia after her delivery. Of the other five cases 
three have since been delivered safely. Two were only about two
 months pregnant at the time of the influenza and are still not delivered. 
This was not the experience of Stamford Hospital generally. Of
 course a good many cases were sent in in rather extreme conditions, but the superintendent told me that the feeling at the hospital was
 that if a woman had influenza and was pregnant, or had a miscarriage,​ it was practically a fatal case. The cases I treated were all treated
 homeopathically,​ so I give all the credit to homeopathy.” [(Stella Q. Root. Discussion: Influenza and pregnancy. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 931-932.)]
  
-Similarly, Dr. Anna Johnston of Pittsburgh reported the same consistency of results in pregnant women, “Before I left home I was 
too busy to fill out the questionnaire. I had 266 patients and did not 
lose a single case. I had 12 cases of pneumonia, mostly among children. Part of those were in the hospital. We had some very sick
 children there who had come in from different families. They had
 originally had influenza but developed pneumonia. One child ran
 a temperature of 106.6, and the worst one had a temperature of 107, pulse 180, respirations 80. She got well. I had eight pregnant cases, two were seven months pregnant. The peculiarity of one case was
 that she was practically over the influenza when she developed pernicious vomiting. The vomiting was very severe and lasted for days. We had to resort to rectal feeding. We thought we would lose her, but she recovered. I did not lose any of those cases. All went through
 to term, were delivered, and everything was all right.”[(76)]+Similarly, Dr. Anna Johnston of Pittsburgh reported the same consistency of results in pregnant women, “Before I left home I was 
too busy to fill out the questionnaire. I had 266 patients and did not 
lose a single case. I had 12 cases of pneumonia, mostly among children. Part of those were in the hospital. We had some very sick
 children there who had come in from different families. They had
 originally had influenza but developed pneumonia. One child ran
 a temperature of 106.6, and the worst one had a temperature of 107, pulse 180, respirations 80. She got well. I had eight pregnant cases, two were seven months pregnant. The peculiarity of one case was
 that she was practically over the influenza when she developed pernicious vomiting. The vomiting was very severe and lasted for days. We had to resort to rectal feeding. We thought we would lose her, but she recovered. I did not lose any of those cases. All went through
 to term, were delivered, and everything was all right.”[(Anna Johnston. Discussion: Influenza and pregnancy. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 933.)]
  
-Dr. L. A. Royal of West Liberty, Iowa reported in the survey of homeopathic physicians from Central Iowa that was mentioned earlier, “Another complication or condition that complicated the ‘flu’ was pregnancy. I had a report of about fifty cases. Four of 
which miscarried. Two poorly developed blue babies were reported where the mother had the ‘flu’ late in her pregnancy. I 
had six cases with the combination of pregnancy, ‘flu’ and
 pneumonia at the same time with no mortality. In fact of the 
forty some cases reported of pregnancy complicated with ‘flu’ and pneumonia there was no mortality reported. This 
is a striking contrast between no deaths out of fifty and the reports by Harris in the A. M. A. journal, volume 72, page 978 where 
he recorded 1,350 cases of ‘flu’ and pregnancy of which 54 
per cent resulted fatally and 62 percent aborted.” [(77)] In the survey from Harris in JAMA, out of 678 pregnant women with pneumonia 365 died.[(78)]+Dr. L. A. Royal of West Liberty, Iowa reported in the survey of homeopathic physicians from Central Iowa that was mentioned earlier, “Another complication or condition that complicated the ‘flu’ was pregnancy. I had a report of about fifty cases. Four of 
which miscarried. Two poorly developed blue babies were reported where the mother had the ‘flu’ late in her pregnancy. I 
had six cases with the combination of pregnancy, ‘flu’ and
 pneumonia at the same time with no mortality. In fact of the 
forty some cases reported of pregnancy complicated with ‘flu’ and pneumonia there was no mortality reported. This 
is a striking contrast between no deaths out of fifty and the reports by Harris in the A. M. A. journal, volume 72, page 978 where 
he recorded 1,350 cases of ‘flu’ and pregnancy of which 54 
per cent resulted fatally and 62 percent aborted.” [(L. A. Royal. Influenza and its results under homeopathic care in Central Iowa. //Iowa Homeopathic Journal// 1919-1920; 13: 194-198.)] In the survey from Harris in JAMA, out of 678 pregnant women with pneumonia 365 died.[(John W. Harris. Influenza occurring in pregnant women. //Journal of the American Medical Association//​ 1919; 72; 978-980.)]
  
-Also homeopaths had their share of difficult cases in pregnant women. Dr. Susan J. Fenton of Oakland reported several difficult cases with late stage pneumonia, as in this pregnant woman with double bronchial-pneumonia,​ “Mrs. H., mother of three, had been under another [allopathic] 
physician’s care for one week when I was called. I found a
 complication of seven-month pregnancy with double bronchial pneumonia, temperature,​ 102-103 degrees, pulse 110-120, respiration 50-60. The patient was unable to breathe except 
by having the head rose on three pillows, mild delirium was 
present, and great restlessness. She has no nurse except a 
sister who attended her by day while the husband was at work, and he took care of her at night. On the eighth day, her baby was delivered, weighing four
 pounds. A wet nurse was secured and the child is well and 
thriving. Fortunately the lungs began to clear after delivery,​
 and while she made a slow recovery, she is now well.” She concluded, “I had thought my record pretty good with only one
 death in 100 cases during the first epidemic, and none in the 
same number of cases for the second, until I read in some 
journal of one homeopath who reported 2,000 cases without 
a single death.”[(79)]+Also homeopaths had their share of difficult cases in pregnant women. Dr. Susan J. Fenton of Oakland reported several difficult cases with late stage pneumonia, as in this pregnant woman with double bronchial-pneumonia,​ “Mrs. H., mother of three, had been under another [allopathic] 
physician’s care for one week when I was called. I found a
 complication of seven-month pregnancy with double bronchial pneumonia, temperature,​ 102-103 degrees, pulse 110-120, respiration 50-60. The patient was unable to breathe except 
by having the head rose on three pillows, mild delirium was 
present, and great restlessness. She has no nurse except a 
sister who attended her by day while the husband was at work, and he took care of her at night. On the eighth day, her baby was delivered, weighing four
 pounds. A wet nurse was secured and the child is well and 
thriving. Fortunately the lungs began to clear after delivery,​
 and while she made a slow recovery, she is now well.” She concluded, “I had thought my record pretty good with only one
 death in 100 cases during the first epidemic, and none in the 
same number of cases for the second, until I read in some 
journal of one homeopath who reported 2,000 cases without 
a single death.”[(Susan J. Fenton. Experiences during influenza epidemic. //Pacific Coast Journal of Homoeopathy//​ 1919; 30: 142-144.)]
  
-**Complications and Mortality Rates in Military versus Civilian Populations**+===== Complications and Mortality Rates in Military versus Civilian Populations ​=====
  
-Whether the percentage of complicated cases and the ensuing death rate were higher in the military versus the civilian population is not obvious at first glance. However, there are more indications that the mortality rate was overall actually higher in the civilian population, of which about 90% received allopathic treatment and 10% received homeopathic treatment. For instance, following the NIP, the Health Commissioner of Buffalo conducted a very thorough survey with more than 2,000 public school teachers at 
his command for a house-to-house canvass. He was able to establish the fact that during the influenza epidemic practically all influenza cases in the city of Buffalo had been 
reported. He wrote regarding the verification of their statistics, “Much has been said and
 written about the inaccuracy of morbidity statistics 
relative to influenza. … With 2,000 teachers at my command I was enabled
 to accomplish much which otherwise would have 
remained impossibility. First, I was enabled to
 check up the reported cases. As a result of this comparison I found that fully 95 per cent of all the cases
 were reported, the remaining 5 per cent, being practically those in which the patients were only slightly ill,
 therefore deeming it unnecessary to call a physician, or 
those in which, for some reason or other, it had been 
impossible to obtain a physician.” Out of 31,842 cases of influenza and pneumonia there were 28,663 recoveries and 3,179 deaths, a mortality of 10%. [(80)]+Whether the percentage of complicated cases and the ensuing death rate were higher in the military versus the civilian population is not obvious at first glance. However, there are more indications that the mortality rate was overall actually higher in the civilian population, of which about 90% received allopathic treatment and 10% received homeopathic treatment. For instance, following the NIP, the Health Commissioner of Buffalo conducted a very thorough survey with more than 2,000 public school teachers at 
his command for a house-to-house canvass. He was able to establish the fact that during the influenza epidemic practically all influenza cases in the city of Buffalo had been 
reported. He wrote regarding the verification of their statistics, “Much has been said and
 written about the inaccuracy of morbidity statistics 
relative to influenza. … With 2,000 teachers at my command I was enabled
 to accomplish much which otherwise would have 
remained impossibility. First, I was enabled to
 check up the reported cases. As a result of this comparison I found that fully 95 per cent of all the cases
 were reported, the remaining 5 per cent, being practically those in which the patients were only slightly ill,
 therefore deeming it unnecessary to call a physician, or 
those in which, for some reason or other, it had been 
impossible to obtain a physician.” Out of 31,842 cases of influenza and pneumonia there were 28,663 recoveries and 3,179 deaths, a mortality of 10%. [(Franklin C. Gram. The influenza and its after-effects in the city of Buffalo. Journal of the American Medical Association 1919; 73: 886-891.)]
  
-These numbers are not dissimilar to the ones of another reliable larger scale report from the Public Health Service conducted in the District of Columbia: “The total number of cases of influenza reported to the Public Health Service from October 1, 1918 to February 1, 1919 was 33,719, and the total number of deaths from that disease was 2,215, a mortality of 6.6%. In addition to the number of deaths from influenza during this period, 680 deaths resulted from pneumonia, probably largely due also to influenza.”[(81)] Without including the pneumonia cases, the cases mortality rate is similar to the ones reported by the different armies. However, by including the pneumonia cases as it was done in the army, the mortality was significantly greater at 8.6%. Unfortunately,​ the statistics of the outcomes from both the homeopathic and allopathic health care are mixed together in this civilian population, and can’t be used for comparison. However, as the homeopaths had significantly less mortality throughout the country as well in the District of Columbia, as seen in the survey mentioned earlier, [(82)] the case mortality average for this civilian population would even be higher by subtracting the homeopathic outcome.+These numbers are not dissimilar to the ones of another reliable larger scale report from the Public Health Service conducted in the District of Columbia: “The total number of cases of influenza reported to the Public Health Service from October 1, 1918 to February 1, 1919 was 33,719, and the total number of deaths from that disease was 2,215, a mortality of 6.6%. In addition to the number of deaths from influenza during this period, 680 deaths resulted from pneumonia, probably largely due also to influenza.”[(Annual Report of the Commissioners of the District of Columbia Year Ended June 30, 1919. Volume 3. Washington, 17-18.)] Without including the pneumonia cases, the cases mortality rate is similar to the ones reported by the different armies. However, by including the pneumonia cases as it was done in the army, the mortality was significantly greater at 8.6%. Unfortunately,​ the statistics of the outcomes from both the homeopathic and allopathic health care are mixed together in this civilian population, and can’t be used for comparison. However, as the homeopaths had significantly less mortality throughout the country as well in the District of Columbia, as seen in the survey mentioned earlier, [(Ernest F. Sappington. Discussion: Influenza: a favortable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-20; 12: 588.)] the case mortality average for this civilian population would even be higher by subtracting the homeopathic outcome.
  
-**Percentages of Cases with Complications**+===== Percentages of Cases with Complications ​=====
  
 It is possible that homeopaths as a whole had less cases of influenza that developed complications (pneumonia, meningitis, etc.), as homeopathic treatment will prevent influenza from further progressing as soon it is implemented and will thus greatly prevent the incidence of complications. It is possible that homeopaths as a whole had less cases of influenza that developed complications (pneumonia, meningitis, etc.), as homeopathic treatment will prevent influenza from further progressing as soon it is implemented and will thus greatly prevent the incidence of complications.
  
-However, homeopaths did have their share of complicated cases as Dr. C. Martz of Fort Wayne, Indiana pointed out, “During the influenza epidemic I was busy day and night, treating the most serious and complicated conditions of this disease. However, throughout the entire run of the epidemic I had no serious developments of pneumonia, no bad ‘after effects’ of the disease, and not one death. This is sure proof of the efficiency of homeopathic treatment, as I treated all cases strictly homeopathically.”[(83)]+However, homeopaths did have their share of complicated cases as Dr. C. Martz of Fort Wayne, Indiana pointed out, “During the influenza epidemic I was busy day and night, treating the most serious and complicated conditions of this disease. However, throughout the entire run of the epidemic I had no serious developments of pneumonia, no bad ‘after effects’ of the disease, and not one death. This is sure proof of the efficiency of homeopathic treatment, as I treated all cases strictly homeopathically.”[(C. Martz. Discussion. A study of the comparative value of the homeopathic treatment and other methods of treatment in lobar pneumonia. //Journal of the American Institute of Homeopathy//​ 1922-1923; 15: 541-550.)]
  
-Similarly, the assumption that physicians didn’t see fulminant cases in the civil population is clearly contradicted by Dr. Royal H. S. Hayes’ experience, who wrote in the winter of 1919, “I would say that Waterbury [Connecticut] was one of the hardest-hit cities in the country and there were many cases of pneumonia here of that malignant type during October with occasional cases since. … Dr. George Royal furthermore says he studied but could not find a simillimum for these desperate cases.[(84)] If we turn to the Hahnemann’s provings of Cuprum metallicum, it will be seen that Cuprum metallicum is exactly the remedy. It has, in fact, checked many of the cases for me, and quickly, the cure being more rapid than the progress was downward, sometimes. If the condition is so far advanced that the rattling has become extensive in both lungs and the pulse above
 120, Cuprum metallicum can only palliate, and often with borderline cases careful observation and dexterity is necessary to bring reactions to the viable point. I have had no experience with potencies lower than the 200th, preferring after some observation to hit hard at once with the 40 M or 50 M.”[(85)]+Similarly, the assumption that physicians didn’t see fulminant cases in the civil population is clearly contradicted by Dr. Royal H. S. Hayes’ experience, who wrote in the winter of 1919, “I would say that Waterbury [Connecticut] was one of the hardest-hit cities in the country and there were many cases of pneumonia here of that malignant type during October with occasional cases since. … Dr. George Royal furthermore says he studied but could not find a simillimum for these desperate cases.[(Dr. Hayes was referring to Dr. George Royal who had previously reported that during the NIP he had difficulty finding the genius epidemicus, and recommended that homeopaths should never stop proving medicines in order to be able to face any upcoming contigencies (George Royal. Drug proving: why and how should homeopaths prove drugs. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 727-733).)] If we turn to the Hahnemann’s provings of Cuprum metallicum, it will be seen that Cuprum metallicum is exactly the remedy. It has, in fact, checked many of the cases for me, and quickly, the cure being more rapid than the progress was downward, sometimes. If the condition is so far advanced that the rattling has become extensive in both lungs and the pulse above
 120, Cuprum metallicum can only palliate, and often with borderline cases careful observation and dexterity is necessary to bring reactions to the viable point. I have had no experience with potencies lower than the 200th, preferring after some observation to hit hard at once with the 40 M or 50 M.”[(Royal H. S. Hayes. Influenza: brief comments. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 846.)]
  
 In an article written in 1921, Dr. Hayes described several such cases with fulminant pneumonia he treated during the NIP, “ ‘Black’ cases and swift ensuing deaths raged in certain neigh­borhoods as if struck by overwhelming fate. Cuprum metallicum was the genius of the ‘Spanish’ strain of influenza here and often, turned the vitality streaming back where the apparently indi­cated Bryonia had not availed. In an article written in 1921, Dr. Hayes described several such cases with fulminant pneumonia he treated during the NIP, “ ‘Black’ cases and swift ensuing deaths raged in certain neigh­borhoods as if struck by overwhelming fate. Cuprum metallicum was the genius of the ‘Spanish’ strain of influenza here and often, turned the vitality streaming back where the apparently indi­cated Bryonia had not availed.
Line 231: Line 231:
 “A striking cure: Boy, 6 years. October 25th. Projectile vomiting, bloody. Sweaty and flushed all over. Beating frontal headache ameliorated by holding it with the cold hand. Averse to touch or motion. Delirium about his play; appears wild. Dozing and starting, escaping from bed. P. 144, T. 103. Belladonna 1 M, one dose (was not then familiar with Cuprum metallicum) That evening: active delirium, great muscular strength, could hardly be held down by two strong women, constant attempts to escape, constant stream of talking and screaming, tears running down face, drenched with sweat; insatiable thirst but taking only small drinks, pain in epigastrium,​ rapid running of tongue out and in, gnashing teeth, right lung involved. T. 106, P. about 160. Cuprum metallicum CM, one dose at noon. Next day his tempera­ture was 100 and he was sitting at the table eating soup not­withstanding which he made a rapid recovery. His mother said that she could see him improve each hour until at night he fell asleep. “A striking cure: Boy, 6 years. October 25th. Projectile vomiting, bloody. Sweaty and flushed all over. Beating frontal headache ameliorated by holding it with the cold hand. Averse to touch or motion. Delirium about his play; appears wild. Dozing and starting, escaping from bed. P. 144, T. 103. Belladonna 1 M, one dose (was not then familiar with Cuprum metallicum) That evening: active delirium, great muscular strength, could hardly be held down by two strong women, constant attempts to escape, constant stream of talking and screaming, tears running down face, drenched with sweat; insatiable thirst but taking only small drinks, pain in epigastrium,​ rapid running of tongue out and in, gnashing teeth, right lung involved. T. 106, P. about 160. Cuprum metallicum CM, one dose at noon. Next day his tempera­ture was 100 and he was sitting at the table eating soup not­withstanding which he made a rapid recovery. His mother said that she could see him improve each hour until at night he fell asleep.
  
-“Cuprum metallicum made the most brilliant and sensational cures of severe or prolonged cases besides curing the mild ones at every turn. It is difficult to resist the temptation to report them but we will close by reporting one or two actions of the remedy in sequelae or imperfect recoveries. … There were many cases of debility persisting weeks or months after allopathic treatment presenting more or less clear symptoms for Cuprum metallicum and the remedy acted quite satis­factorily.”[(86)]+“Cuprum metallicum made the most brilliant and sensational cures of severe or prolonged cases besides curing the mild ones at every turn. It is difficult to resist the temptation to report them but we will close by reporting one or two actions of the remedy in sequelae or imperfect recoveries. … There were many cases of debility persisting weeks or months after allopathic treatment presenting more or less clear symptoms for Cuprum metallicum and the remedy acted quite satis­factorily.”[(Royal H. S. Hayes. Using Cuprum in “flu,” etc. //​Proceedings of the International Hahnemannian Association//​ 1921: 280-286.)]
  
-Mario DiCecco of Litchfield, Connecticut reported having discussed with his grand-father,​ Dr. Royal Hayes, the great influenza epidemic, and Dr. Hayes had told him that after losing a few cases at the beginning of the epidemic he discovered that Cuprum metallicum was the //genius epidemicus//​ for the area, and subsequently didn’t lose any more case in over 900 patients, of which 69 presented with the “malignant” type of pneumonia. [(87)]+Mario DiCecco of Litchfield, Connecticut reported having discussed with his grand-father,​ Dr. Royal Hayes, the great influenza epidemic, and Dr. Hayes had told him that after losing a few cases at the beginning of the epidemic he discovered that Cuprum metallicum was the //genius epidemicus//​ for the area, and subsequently didn’t lose any more case in over 900 patients, of which 69 presented with the “malignant” type of pneumonia. [(Personal communication,​ July 5, 2013.)]
  
-It is known that patients, even in the most advanced and desperate state of pneumonia, or any other acute infections, will recover under the simillimum if it is properly administered. Dr. C. A. Dixon of Akron, Ohio described such a desperate case of pneumonia he saw being treated by a more experienced colleague during the NIP, “The patient was in complete collapse, jaw dropped, tongue black, breathing irregular, unconscious defecation, etc. A desperate case I think you will all admit. The homeopath who had it in charge did not resort to morphine, nor to digitalis, nor anything but the indicated remedy, which in that case we thought was Lycopodium. That was given I think in a 50 M. The lady made a complete recovery from that deathbed scene, and is now well, very much to the surprise of even the nurse who was on the case.”[(88)]+It is known that patients, even in the most advanced and desperate state of pneumonia, or any other acute infections, will recover under the simillimum if it is properly administered. Dr. C. A. Dixon of Akron, Ohio described such a desperate case of pneumonia he saw being treated by a more experienced colleague during the NIP, “The patient was in complete collapse, jaw dropped, tongue black, breathing irregular, unconscious defecation, etc. A desperate case I think you will all admit. The homeopath who had it in charge did not resort to morphine, nor to digitalis, nor anything but the indicated remedy, which in that case we thought was Lycopodium. That was given I think in a 50 M. The lady made a complete recovery from that deathbed scene, and is now well, very much to the surprise of even the nurse who was on the case.”[(C. A. Dixon. Discussion. Some indicated remedies in pneumonia. //Central Journal of Homeopathy//​ 1921; 2 (7): 32-35.)]
  
-**Case Fatality in Pneumonia Cases**+===== Case Fatality in Pneumonia Cases =====
  
-As we are more interested in pneumonia cases, not all returns from homeopaths separated the cases of pneumonia from the ones of uncomplicated influenza. However, there are a sufficient number of reports from homeopaths indicating the total numbers of influenza and pneumonia cases and deaths //with the same consistency of outcome//, as the following one from Dr. T. O. Barnhill of Findlay, Ohio, “We had a whirlwind in Ohio, which lasted until the first of January. I treated four hundred and fifty-five cases of influenza and twenty-six of pneumonia. I lost not a case.” [(89)]+As we are more interested in pneumonia cases, not all returns from homeopaths separated the cases of pneumonia from the ones of uncomplicated influenza. However, there are a sufficient number of reports from homeopaths indicating the total numbers of influenza and pneumonia cases and deaths //with the same consistency of outcome//, as the following one from Dr. T. O. Barnhill of Findlay, Ohio, “We had a whirlwind in Ohio, which lasted until the first of January. I treated four hundred and fifty-five cases of influenza and twenty-six of pneumonia. I lost not a case.” [(T. O. Barnhill. Discussion: Influenza: a favorable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 595.)]
  
-**Comparative Records Between the Two Schools Within the Same Locality**+===== Comparative Records Between the Two Schools Within the Same Locality ​=====
  
-When physicians were practicing in the same town with the exact same population this consistency of results is again observed, as it was reported by Dr. H. H. Crum of Ithaca, New York, “I had three hundred cases with one death. One good homeopathic doctor had two hundred and seventy-
five cases and no deaths [0.17% mortality for the combined outcome from these two homeopathic physicians]. I am the health officer for the city of Ithaca and had all cases reported to me. In October and November 1918, twenty-four hundred cases of influenza were reported. Seventy-five died [3% mortality for the combined homeopathic and allopathic outcomes]. Of the twenty-four hundred cases, between nine and ten hundred were Cornell students, eight hundred of them belonging to the army. They were students of military tactics and all of them were cared for by army doctors. They were hospital cases. The dormitories were turned into hospitals. The treatment was entirely allopathic. Students of the army class were healthy but, even so, forty-five of the seventy-five deaths occurred among those nine hundred students [5% mortality]. Private patients fared much better. In going over the records of deaths, I found that I had but one death while the old school man next to me, who has patients of the same class as mine are, had fifteen deaths among the same number of cases. Think of it! Two hundred and ninety-four cases with fifteen deaths! [5% mortality] … 
There are other homeopaths in Ithaca and we feel that we have a right to be proud of losing so few patients.”[(90)]+When physicians were practicing in the same town with the exact same population this consistency of results is again observed, as it was reported by Dr. H. H. Crum of Ithaca, New York, “I had three hundred cases with one death. One good homeopathic doctor had two hundred and seventy-
five cases and no deaths [0.17% mortality for the combined outcome from these two homeopathic physicians]. I am the health officer for the city of Ithaca and had all cases reported to me. In October and November 1918, twenty-four hundred cases of influenza were reported. Seventy-five died [3% mortality for the combined homeopathic and allopathic outcomes]. Of the twenty-four hundred cases, between nine and ten hundred were Cornell students, eight hundred of them belonging to the army. They were students of military tactics and all of them were cared for by army doctors. They were hospital cases. The dormitories were turned into hospitals. The treatment was entirely allopathic. Students of the army class were healthy but, even so, forty-five of the seventy-five deaths occurred among those nine hundred students [5% mortality]. Private patients fared much better. In going over the records of deaths, I found that I had but one death while the old school man next to me, who has patients of the same class as mine are, had fifteen deaths among the same number of cases. Think of it! Two hundred and ninety-four cases with fifteen deaths! [5% mortality] … 
There are other homeopaths in Ithaca and we feel that we have a right to be proud of losing so few patients.”[(H. H. Crum. Discussion: Influenza: a favorable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 595.)]
  
-Dr. Martha I. Boger of Portsmouth, New Hampshire reported, “During the first
 epidemic, I treated 531 cases with two deaths. One patient 
committed suicide. The temperature had become normal, but 
there was insanity in the family. The other patient was mahogany colored, having been pronounced as dying by the 
regular physicians who preceded me. In spite of that, she 
lived five days longer. Had I been a better prescriber, I believe she would have recovered. 
In the second epidemic, I have not kept so close a record, but I have lost but one, also diagnosed by my predecessors as
 hopeless. However, two other cases with similar verdict recovered. Dr. Stone of the Kittery, Portsmouth U. S. Sanitary
 Zone, said that I had the lowest death record in the community. This sounds boastful, but I have openly declared 
that it was not my luck, but the therapeutics which I have
 practiced.” [(91)]+Dr. Martha I. Boger of Portsmouth, New Hampshire reported, “During the first
 epidemic, I treated 531 cases with two deaths. One patient 
committed suicide. The temperature had become normal, but 
there was insanity in the family. The other patient was mahogany colored, having been pronounced as dying by the 
regular physicians who preceded me. In spite of that, she 
lived five days longer. Had I been a better prescriber, I believe she would have recovered. 
In the second epidemic, I have not kept so close a record, but I have lost but one, also diagnosed by my predecessors as
 hopeless. However, two other cases with similar verdict recovered. Dr. Stone of the Kittery, Portsmouth U. S. Sanitary
 Zone, said that I had the lowest death record in the community. This sounds boastful, but I have openly declared 
that it was not my luck, but the therapeutics which I have
 practiced.” [(Martha I. Boger. Influenza—brief comments. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 1216.)]
  
-In some localities, homeopaths were reporting an almost nil mortality rate. Dr. Harry B. Baker of Richmond, Virginia wrote, “Our results have been much superior to those of the old school. Neither Dr. Tabor nor myself have lost a case. Gelsemium was the //genius 
epidemicus//​ and covered probably 95% of the cases. I used it as a prophylactic also with very satisfactory results.”[(92)] While Dr. B. E. Miller of Portland, Oregon wrote, “We have had our quota of influenza, but I have not heard of a death under homeopathic treatment. One of the severest cases I have had is that of Dr. A. L. Canfield, who developed pneumonia with influenza. He is now well and on the way to recovery. Our doctors are worked to the limit.”[(93)]+In some localities, homeopaths were reporting an almost nil mortality rate. Dr. Harry B. Baker of Richmond, Virginia wrote, “Our results have been much superior to those of the old school. Neither Dr. Tabor nor myself have lost a case. Gelsemium was the //genius 
epidemicus//​ and covered probably 95% of the cases. I used it as a prophylactic also with very satisfactory results.”[(Harry B. Baker. Clinical comments on influenza. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 682.)] While Dr. B. E. Miller of Portland, Oregon wrote, “We have had our quota of influenza, but I have not heard of a death under homeopathic treatment. One of the severest cases I have had is that of Dr. A. L. Canfield, who developed pneumonia with influenza. He is now well and on the way to recovery. Our doctors are worked to the limit.”[(B. E. Miller. Clinical comments on influenza. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 682.)]
  
-In December 1918, the editor of the //Iowa Homeopathic Journal// reported a similar experience, “In Iowa City for instance, our practitioners have had their full share of them to treat and thus far have had but a single fatality. What is true here is also true the state and country over. The death rate has been almost negligible.”[(94)]+In December 1918, the editor of the //Iowa Homeopathic Journal// reported a similar experience, “In Iowa City for instance, our practitioners have had their full share of them to treat and thus far have had but a single fatality. What is true here is also true the state and country over. The death rate has been almost negligible.”[(Narrow-mindedness in medicine. //Iowa Homeopathic Journal// 1918-1919; 12: 246-250.)]
  
-Dr. A. P. Stauffer of Hagerstown, Maryland further remarked that his results were consistent with his homeopathic colleagues in town, “It is with special delight that I have heard these statistics for I have had the same experience. I treated during the month of October five hundred and fifty-five cases. During the first three weeks I did not lose a case. In the last week of the month I lost three cases, due to pneumonia. My experience in Hagerstown is like that of other homeopaths of the city. It makes a man feel that his life is worthwhile when he realizes what he has accomplished in an epidemic of this kind, while the other school of medicine lost case after case. We may certainly be grateful for the fact that we belong to a school that can bring such results.”[(95)]+Dr. A. P. Stauffer of Hagerstown, Maryland further remarked that his results were consistent with his homeopathic colleagues in town, “It is with special delight that I have heard these statistics for I have had the same experience. I treated during the month of October five hundred and fifty-five cases. During the first three weeks I did not lose a case. In the last week of the month I lost three cases, due to pneumonia. My experience in Hagerstown is like that of other homeopaths of the city. It makes a man feel that his life is worthwhile when he realizes what he has accomplished in an epidemic of this kind, while the other school of medicine lost case after case. We may certainly be grateful for the fact that we belong to a school that can bring such results.”[(A. P. Stauffer. Discussion: Influenza: a favoable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 596.)]
  
-Dr. W. J. Grier of Independence,​ Kansas reported, “I have been about as busy as any and lost one case,” and after describing a difficult case in a pregnant woman who recovered and her baby was saved he said, “These cases have been nearly 
100 per cent fatal here in the hands of the regulars. … Dr. W. B. Kelley, who is 75 years young, has practiced here for thirty-three years and never lost a case of influenza going day and night. He is homeopathic. People are beginning to comment on the record of the homeopaths in this epidemic.”[(96)]+Dr. W. J. Grier of Independence,​ Kansas reported, “I have been about as busy as any and lost one case,” and after describing a difficult case in a pregnant woman who recovered and her baby was saved he said, “These cases have been nearly 
100 per cent fatal here in the hands of the regulars. … Dr. W. B. Kelley, who is 75 years young, has practiced here for thirty-three years and never lost a case of influenza going day and night. He is homeopathic. People are beginning to comment on the record of the homeopaths in this epidemic.”[(W. J. Gier. Influenza: a clinical report from Kansas. //Journal of the American Institute of Homeopathy//​ 1918-1919; 11: 1099-1100.)]
  
-Likely the most obvious of such examples occurred in Washington, D.C., as we earlier saw that a reliable large scale report from the Public Health Service conducted in the District of Columbia reported that from October 1, 1918 to February 1, 1919 there were a 8.6% mortality among 33,719 cases of influenza/​pneumonia among the civilian population treated by the different schools of medicine. [(97)]+Likely the most obvious of such examples occurred in Washington, D.C., as we earlier saw that a reliable large scale report from the Public Health Service conducted in the District of Columbia reported that from October 1, 1918 to February 1, 1919 there were a 8.6% mortality among 33,719 cases of influenza/​pneumonia among the civilian population treated by the different schools of medicine. [(Annual Report of the Commissioners of the District of Columbia Year Ended June 30, 1919. Volume 3. Washington, 17-18.)]
  
-Dr. Ernest F. Sappington of Washington, D.C. reported, “I escaped without any mortality in that attack. The experience could be multiplied many times in the District of Columbia.”[(98)] For instance, Dr. F. A. Swartwout of Washington, D.C. reported, “In Washington we were very active and I had a great opportunity to notice the effects of our treatment. Eleven of us got together about the middle of November [1918] and talked things over. The eleven men reported thirty-six hundred cases treated and six deaths among them. We had another whirlwind in January and it ran the number of cases up a great deal. The exact number is not known. Some of the men treated fifteen hundred to two thousand cases with only three or four deaths. I questioned one man just before coming here and he had had four hundred cases with one death. My record shows about seven hundred and fifty cases with one death. We kept no account of percentage. The National Homeopathic Hospital figured up the records of its cases. At one time no cases were in but influenza and there was not a single death from that disease. I can't give you anything further on statistics. These facts were noted by the health department in Washington. One of our leading physicians, Dr. Kingsman, said that a health officer had called him up to find out why he had sent in no death certificates. His only reason was that he had had no deaths. That was the way the record ran in Washington. An old school friend of mine said that he was ‘tickled to death’ to be able to keep his mortality rate down to fifty per cent.” [(99)]+Dr. Ernest F. Sappington of Washington, D.C. reported, “I escaped without any mortality in that attack. The experience could be multiplied many times in the District of Columbia.”[(Discussion: Influenza: a favortable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-20; 12: 588.)] For instance, Dr. F. A. Swartwout of Washington, D.C. reported, “In Washington we were very active and I had a great opportunity to notice the effects of our treatment. Eleven of us got together about the middle of November [1918] and talked things over. The eleven men reported thirty-six hundred cases treated and six deaths among them. We had another whirlwind in January and it ran the number of cases up a great deal. The exact number is not known. Some of the men treated fifteen hundred to two thousand cases with only three or four deaths. I questioned one man just before coming here and he had had four hundred cases with one death. My record shows about seven hundred and fifty cases with one death. We kept no account of percentage. The National Homeopathic Hospital figured up the records of its cases. At one time no cases were in but influenza and there was not a single death from that disease. I can't give you anything further on statistics. These facts were noted by the health department in Washington. One of our leading physicians, Dr. Kingsman, said that a health officer had called him up to find out why he had sent in no death certificates. His only reason was that he had had no deaths. That was the way the record ran in Washington. An old school friend of mine said that he was ‘tickled to death’ to be able to keep his mortality rate down to fifty per cent.” [(F. A. Swartwout. Discussion: Influenza: a favoable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 597.)]
  
-Unfortunately,​ no detailed records from the National Homeopathic Hospital have so far been found. However, from a rare allopathic hospital outcome that could be found in the literature the hospital mortality in Washington, D.C. was far from being negligible. A temporary influenza hospital with a capacity of 19 beds was opened by the USPHS in Washington, D.C. at the beginning of the second wave. From its opening on December 19, 1918 to its closing on March 15, 1919, the number of patients admitted was 223, of whom 30 died, or a case mortality of 13.4%. [(100)]+Unfortunately,​ no detailed records from the National Homeopathic Hospital have so far been found. However, from a rare allopathic hospital outcome that could be found in the literature the hospital mortality in Washington, D.C. was far from being negligible. A temporary influenza hospital with a capacity of 19 beds was opened by the USPHS in Washington, D.C. at the beginning of the second wave. From its opening on December 19, 1918 to its closing on March 15, 1919, the number of patients admitted was 223, of whom 30 died, or a case mortality of 13.4%. [(Annual Report of the Commissioners of the District of Columbia Year Ended June 30, 1919. Volume 3. Washington, 42-43.)]
  
-**Confined Spaces**+===== Confined Spaces ​=====
  
-The more detailed studies on the NIP reported that the incidence and mortality of influenza were higher in people living in confined spaces, such as crowded troop ships, camps or boarding schools with dormitories. Surgeon General William Gorgas told one training camp commander, “We know perfectly well that we can control pneumonia absolutely if we could avoid crowding the men, but it is not practicable in military life to avoid this crowding.” The Medical Department even asserted, “There is to be expected a definite relation between the degree of crowding and the amount of respiratory infection.” [(101)]+The more detailed studies on the NIP reported that the incidence and mortality of influenza were higher in people living in confined spaces, such as crowded troop ships, camps or boarding schools with dormitories. Surgeon General William Gorgas told one training camp commander, “We know perfectly well that we can control pneumonia absolutely if we could avoid crowding the men, but it is not practicable in military life to avoid this crowding.” The Medical Department even asserted, “There is to be expected a definite relation between the degree of crowding and the amount of respiratory infection.” [(Carol R. Byerly. The U.S. Military and the Influenza Pandemic of 1918--1919. //Public Health Reports// 2010; 125 (Supp. 3): 82-91.)]
  
-As an example of the high incidence of cases in more confined spaces, in the fall 1918 influenza developed in 90% of the 1,217 persons on board the New Zealand “crowded” troop ship Tahiti.[(102)] Also, about 75% of the crews of two destroyers of the Brazilian fleet developed influenza in the fall of 1918, of which nearly 10% of the crews died, a case mortality of 13--14%. [(103)]+As an example of the high incidence of cases in more confined spaces, in the fall 1918 influenza developed in 90% of the 1,217 persons on board the New Zealand “crowded” troop ship Tahiti.[(Jennifer A. Summers, et al. Mortality risk factors for pandemic influenza on New Zealand troop ship, 1918. //Emerging infectious diseases// 2010; 16 (12): 1931-1937.)] Also, about 75% of the crews of two destroyers of the Brazilian fleet developed influenza in the fall of 1918, of which nearly 10% of the crews died, a case mortality of 13--14%. [(Cynthia Schuck‐Paim,​ et al. Exceptionally high mortality rate of the 1918 influenza pandemic in the Brazilian naval fleet. //Influenza and Other Respiratory Viruses// 2013; 7 (1): 27-34.)]
  
-Aside from influenza, other infectious diseases were clearly more prevalent in the confined spaces of army camps, as Dr. Alexander Lambert, president of the American Medical Association,​ pointed out for meningitis, “The occurrence in the camps of meningitis, another
 disease of the respiratory group, as far as its portal of 
infection is concerned, has been forty-five times as frequent in the army as its occurrence in civil life among 
the same age group. This has been due to overcrowding and the diminution of air space allowed the individual soldier in badly ventilated barracks.” [(104)]+Aside from influenza, other infectious diseases were clearly more prevalent in the confined spaces of army camps, as Dr. Alexander Lambert, president of the American Medical Association,​ pointed out for meningitis, “The occurrence in the camps of meningitis, another
 disease of the respiratory group, as far as its portal of 
infection is concerned, has been forty-five times as frequent in the army as its occurrence in civil life among 
the same age group. This has been due to overcrowding and the diminution of air space allowed the individual soldier in badly ventilated barracks.” [(//Alexander Lambert. Medicine, a determining factor in war.// //Journal of the American Medical Association//​ 1919; 72: 1714-1721.)]
  
-However, homeopaths reported the same consistent favorable results whether they were practicing in rural or urban areas, hospitals, camps, troop ships or boarding schools. For instance, Dr. Herbert A. Roberts recalled some of his experience as the physician in charge on a US troop ship. “During the first
 voyage over to Brest I was Transport Surgeon. We had very little influenza during September. In the month of October, I was sent over
 with another load of 2,000 men, and we developed on the way over in
 the course of two weeks, over 81 cases of influenza. This is what we 
did. We put all these cases in the Hospital Bay of the ship, and from
 sunset to sunrise every porthole had to be closed tight on account of
 danger of submarines. These cases of influenza presented three meningeal and several of the pneumonic form. However, I landed every man 
in Brest in good condition. This ship was the only ship in our convoy
 of nine ships that had that record. I was the only homeopathic surgeon on these nine ships. One ship in that convoy which carried 4,000 
troops, lost 31 on the way over. Every man in our ship received 
homeopathic treatment, and careful individual treatment.” [(105)] Once another boat pulled alongside to get all the spare coffins from Dr. Roberts’ boat because it's mortality rate was so high. On his return to port, the commander said to Roberts, “Used all your coffins?” To which Roberts replied, “Yes, and lost not one man!”[(106)]+However, homeopaths reported the same consistent favorable results whether they were practicing in rural or urban areas, hospitals, camps, troop ships or boarding schools. For instance, Dr. Herbert A. Roberts recalled some of his experience as the physician in charge on a US troop ship. “During the first
 voyage over to Brest I was Transport Surgeon. We had very little influenza during September. In the month of October, I was sent over
 with another load of 2,000 men, and we developed on the way over in
 the course of two weeks, over 81 cases of influenza. This is what we 
did. We put all these cases in the Hospital Bay of the ship, and from
 sunset to sunrise every porthole had to be closed tight on account of
 danger of submarines. These cases of influenza presented three meningeal and several of the pneumonic form. However, I landed every man 
in Brest in good condition. This ship was the only ship in our convoy
 of nine ships that had that record. I was the only homeopathic surgeon on these nine ships. One ship in that convoy which carried 4,000 
troops, lost 31 on the way over. Every man in our ship received 
homeopathic treatment, and careful individual treatment.” [(H. A. Roberts. Discussion: Influenza: a favoable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 591.)] Once another boat pulled alongside to get all the spare coffins from Dr. Roberts’ boat because it's mortality rate was so high. On his return to port, the commander said to Roberts, “Used all your coffins?” To which Roberts replied, “Yes, and lost not one man!”[(Julian Winston. Influenza-1918:​ homeopathy to the rescue. //New England Journal of Homeopathy//​ 1998; 7 (1) : 1-3.)]
  
 Dr. Roberts explained that despite the fact that a great number of homeopathic physicians had joined the army their medicines were not included in the armed forces Medical Manual, “The remedies which are
 used largely by the homeopathic physician should be at our
 command. This would seem just, especially as we have had
 1,862 surgeons from our school of medicine in service in this war. There is a proviso that other remedies than those in the Medical Manual may be obtained and used when it is deemed necessary for the saving of life. It was by taking advantage of this proviso of the Manual
 that we were able to prescribe homeopathically while in service.” Dr. Roberts explained that despite the fact that a great number of homeopathic physicians had joined the army their medicines were not included in the armed forces Medical Manual, “The remedies which are
 used largely by the homeopathic physician should be at our
 command. This would seem just, especially as we have had
 1,862 surgeons from our school of medicine in service in this war. There is a proviso that other remedies than those in the Medical Manual may be obtained and used when it is deemed necessary for the saving of life. It was by taking advantage of this proviso of the Manual
 that we were able to prescribe homeopathically while in service.”
  
-When called to service he was first assigned at the base hospital in Newport News and was put in charge on the mumps ward for five weeks. His results were here complimented and he was moved to the measles ward. He wrote, “I had charge of the measles ward for six weeks and homeopathic remedies were used entirely. This gave a very good
 opportunity to demonstrate the value of our school of medicine, for measles in the army is a serious disease and up to the 
time I took it over the ward had a mortality of 4%. This disease ranks next to pneumonia in importance. When a disease 
of childhood is contracted by an adult many complications are 
sure to develop. … These six weeks were well spent and brought a deal of satisfaction,​ for I closed the service with no deaths under my care during this busy period.” Then he became Ship Surgeon for troop transport. In his first trip he reported having to deal with his “old friends, mumps and measles, and some influenza.” He wrote, “We were laboring in the hold of the ship with port holes all closed from sunset to sunrise during rough weather and no attendants but enlisted men of the medical corps. No trained nurses were aboard either trip and we landed each time all of the men we started with and in good condition, thereby gaining a deal of satisfaction in the use of, and confirming our faith in the homeopathically applied remedy.”[(107)]+When called to service he was first assigned at the base hospital in Newport News and was put in charge on the mumps ward for five weeks. His results were here complimented and he was moved to the measles ward. He wrote, “I had charge of the measles ward for six weeks and homeopathic remedies were used entirely. This gave a very good
 opportunity to demonstrate the value of our school of medicine, for measles in the army is a serious disease and up to the 
time I took it over the ward had a mortality of 4%. This disease ranks next to pneumonia in importance. When a disease 
of childhood is contracted by an adult many complications are 
sure to develop. … These six weeks were well spent and brought a deal of satisfaction,​ for I closed the service with no deaths under my care during this busy period.” Then he became Ship Surgeon for troop transport. In his first trip he reported having to deal with his “old friends, mumps and measles, and some influenza.” He wrote, “We were laboring in the hold of the ship with port holes all closed from sunset to sunrise during rough weather and no attendants but enlisted men of the medical corps. No trained nurses were aboard either trip and we landed each time all of the men we started with and in good condition, thereby gaining a deal of satisfaction in the use of, and confirming our faith in the homeopathically applied remedy.”[(H. A. Roberts. The homeopathic therapy of an army medical officer. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 793-795.)]
  
-It is not clear how many homeopathic physicians and surgeons had access to homeopathic remedies during the war, but it seems to be a very small minority. Base Hospital No. 48 was one of the rare units having access to a complete homeopathic pharmacy. This Base Hospital had been organized by the Metropolitan (originally homeopathic) Hospital of New York City, which was at that time the largest hospital in the United States with 2,200 beds. Dr. Frederick M. Dearborn, who was in charge of the organization of this hospital pointed out, “We were the only Unit in the Center possessing a complete line of homeopathic remedies.” There were 21 homeopathic physicians in this Unit.[(108)]+It is not clear how many homeopathic physicians and surgeons had access to homeopathic remedies during the war, but it seems to be a very small minority. Base Hospital No. 48 was one of the rare units having access to a complete homeopathic pharmacy. This Base Hospital had been organized by the Metropolitan (originally homeopathic) Hospital of New York City, which was at that time the largest hospital in the United States with 2,200 beds. Dr. Frederick M. Dearborn, who was in charge of the organization of this hospital pointed out, “We were the only Unit in the Center possessing a complete line of homeopathic remedies.” There were 21 homeopathic physicians in this Unit.[(//American Homeopathy in the World War// . Edited by Frederick M. Dearborn. (Chicago: American Institute of Homeopathy, 1923), 169.)]
  
 Dr. J. Arnold Rockwell related his experience as a physician who had access to homeopathic remedies in a base hospital near the battlefront in France, and how extreme was the crowded spaces he was working in, “The staff of Base Hospital No. 44 was made up mostly from the homeopathic hospitals in Boston and consisted of thirty-eight officers, one hundred nurses and two hundred enlisted men. … During that epidemic of influenza which raged at the time
 it did in this country, the trains were filled regardless of medical
 or surgical cases, with mixed cases, so when the trains came to 
us forty per cent of the cases had influenza which had spread
 through car after car, so those who at first needed surgical attention only had been infected with influenza as well as others. That
 condition ought to have been averted. As a result, there were
 many deaths, much time was lost, and many patients came down
 with influenza which possibly otherwise would have been free.” Dr. J. Arnold Rockwell related his experience as a physician who had access to homeopathic remedies in a base hospital near the battlefront in France, and how extreme was the crowded spaces he was working in, “The staff of Base Hospital No. 44 was made up mostly from the homeopathic hospitals in Boston and consisted of thirty-eight officers, one hundred nurses and two hundred enlisted men. … During that epidemic of influenza which raged at the time
 it did in this country, the trains were filled regardless of medical
 or surgical cases, with mixed cases, so when the trains came to 
us forty per cent of the cases had influenza which had spread
 through car after car, so those who at first needed surgical attention only had been infected with influenza as well as others. That
 condition ought to have been averted. As a result, there were
 many deaths, much time was lost, and many patients came down
 with influenza which possibly otherwise would have been free.”
  
-He further explained that despite the most dire therapeutic conditions they came out with an unusually low mortality rate, “When these cases arrived, and especially those complicated 
with influenza, they were in a pitiable condition because of the
 two days on the road in excess of the time expected that they 
would put in. There were thirty-eight fresh pneumonias taken
 off the train. These pneumonias were lobar, apparently, and
 were very fatal. We had no time to give much medical care. The small rooms into which these patients were crowded gave 
no opportunity for any method of isolation. The fresh pneumonias were put in a room by themselves, and the uncomplicated influenzas by themselves. We did the best we could, but
 had no opportunity of making a study of them, or giving the 
proper care. When I tell you that the surgical teams of our unit
 were at the front, that fifty-seven of the nurses had been requisitioned and taken from us before the flu epidemic came on, and ten of our men down with influenza, and had from one thousand to seventeen hundred patients—that in this critical condition 
the work piled up in proportions which we were not able to cope
 with. We found that Gelsemium, Eupatorium perfoliatum,​ Arsenicum album and Bryonia made up our group of remedies, which did excellent work
 as far as we could give it. Some only lasted two or three days. We lost thirty-three cases out of the three thousand patients
 under our care [a mortality rate of 1.1%]. Many of the three thousand were convalescent 
patients. It seemed to us as if they were dying by thousands—
they were in such a critical condition that they died in a short 
time after arriving in the hospital. 
I do feel that if they had received proper care on the train, 
with proper allotment of air space, and with little more than
 army regulation consideration of the value of human life, we would have made a better record on the pneumonia cases. It was brought out in the Bureau of Homeopathy that we
 did better in pneumonia than any other school, and I am glad we can make these assertions. However, we could not get this in the army because we did not have the essentials to work with to secure good results. We had many cases of poliomyelitis,​ diarrhea, gangrene, aggravated by exhaustion, poor food and drinking water. These cases will probably present intestinal difficulties for many years, and will have a long and tedious recovery.”[(109)]+He further explained that despite the most dire therapeutic conditions they came out with an unusually low mortality rate, “When these cases arrived, and especially those complicated 
with influenza, they were in a pitiable condition because of the
 two days on the road in excess of the time expected that they 
would put in. There were thirty-eight fresh pneumonias taken
 off the train. These pneumonias were lobar, apparently, and
 were very fatal. We had no time to give much medical care. The small rooms into which these patients were crowded gave 
no opportunity for any method of isolation. The fresh pneumonias were put in a room by themselves, and the uncomplicated influenzas by themselves. We did the best we could, but
 had no opportunity of making a study of them, or giving the 
proper care. When I tell you that the surgical teams of our unit
 were at the front, that fifty-seven of the nurses had been requisitioned and taken from us before the flu epidemic came on, and ten of our men down with influenza, and had from one thousand to seventeen hundred patients—that in this critical condition 
the work piled up in proportions which we were not able to cope
 with. We found that Gelsemium, Eupatorium perfoliatum,​ Arsenicum album and Bryonia made up our group of remedies, which did excellent work
 as far as we could give it. Some only lasted two or three days. We lost thirty-three cases out of the three thousand patients
 under our care [a mortality rate of 1.1%]. Many of the three thousand were convalescent 
patients. It seemed to us as if they were dying by thousands—
they were in such a critical condition that they died in a short 
time after arriving in the hospital. 
I do feel that if they had received proper care on the train, 
with proper allotment of air space, and with little more than
 army regulation consideration of the value of human life, we would have made a better record on the pneumonia cases. It was brought out in the Bureau of Homeopathy that we
 did better in pneumonia than any other school, and I am glad we can make these assertions. However, we could not get this in the army because we did not have the essentials to work with to secure good results. We had many cases of poliomyelitis,​ diarrhea, gangrene, aggravated by exhaustion, poor food and drinking water. These cases will probably present intestinal difficulties for many years, and will have a long and tedious recovery.”[(J. Arnold Rockwell. Report of Base Hospital No. 44. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 795-798.)]
  
-Dr. W. Y. Mackenzie, physician of the Knights of Pythias Widows and Orphans Home in Weatherford,​ Texas, reported that, despite the confined space common to an orphan home, no deaths in 103 
cases of influenza, of which four had pneumonia. He had as many as sixty patients in bed simultaneously. [(110)]+Dr. W. Y. Mackenzie, physician of the Knights of Pythias Widows and Orphans Home in Weatherford,​ Texas, reported that, despite the confined space common to an orphan home, no deaths in 103 
cases of influenza, of which four had pneumonia. He had as many as sixty patients in bed simultaneously. [(Profession at large. //Pacific Coast Journal of Homoeopathy//​ 1919; 30: 157.)]
  
-Dr. George H. Wright of Forest Olen, Maryland reported a similar experience in a boarding school for girls, “I had charge of a
 young ladies'​ academy of about 360 girls. I attended over 100 cases
 there without any fatalities.”[(111)]+Dr. George H. Wright of Forest Olen, Maryland reported a similar experience in a boarding school for girls, “I had charge of a
 young ladies'​ academy of about 360 girls. I attended over 100 cases
 there without any fatalities.”[(George H. Wright. Discussion: Influenza: a favoable mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 589.)]
  
-Similarly, Dr. W. H. Hanchette of Sioux City reported the same consistency of good results when homeopathy was introduced in a boarding trade school in the midst of the epidemic, “There was a school nearby my office, a tractor and automobile school, where young farmers came in large numbers. These young men had come from twelve states, and brought the influenza with them. They were dying at the rate of two a day at that time. The school was
 turned into a hospital. After they became ill they lived, on an average, only two or three days. One of the teachers had been a patient of mine. He had been sick with pneumonia, and had recovered. This man went to the manager of the school, and said, ‘Why don't you try homeopathic treatment?​’ The manager said, ‘I will try anything. We will have to close the school if this keeps up.’ He was panic-stricken. He came to me in the midst of a very busy office hour, and said it was important that he see me at once. He said, ‘I want you to take charge of the school, and give talks on how the students shall take care of themselves, regarding ventilation,​ proper clothing, etc.’ I treated 40 
cases at this school, and every one recovered. The principal of this school will bear me out in my statement. Any of you with your homeopathic medicines could have done the same.” [(W. H. Hanchette. Discussion: Influenza: a favoable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 593.)]+Similarly, Dr. W. H. Hanchette of Sioux City reported the same consistency of good results when homeopathy was introduced in a boarding trade school in the midst of the epidemic, “There was a school nearby my office, a tractor and automobile school, where young farmers came in large numbers. These young men had come from twelve states, and brought the influenza with them. They were dying at the rate of two a day at that time. The school was
 turned into a hospital. After they became ill they lived, on an average, only two or three days. One of the teachers had been a patient of mine. He had been sick with pneumonia, and had recovered. This man went to the manager of the school, and said, ‘Why don't you try homeopathic treatment?​’ The manager said, ‘I will try anything. We will have to close the school if this keeps up.’ He was panic-stricken. He came to me in the midst of a very busy office hour, and said it was important that he see me at once. He said, ‘I want you to take charge of the school, and give talks on how the students shall take care of themselves, regarding ventilation,​ proper clothing, etc.’ I treated 40 
cases at this school, and every one recovered. The principal of this school will bear me out in my statement. Any of you with your homeopathic medicines could have done the same.” [(W. H. Hanchette. Discussion: Influenza: a favorable ​mortality and publicity. //Journal of the American Institute of Homeopathy//​ 1919-1920; 12: 593.)]
  
 **Part III of Dr. Saine’s answer will follow in October.** **Part III of Dr. Saine’s answer will follow in October.**
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