Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
coughing the material is carried about ten feet. They demonstrated that
masks of medium meshed gauze, two to ten layers thick, worn by the
person coughing did not prevent the passage of infectious material into
the air, but that a three-layer buttercloth mask was much more
efficient. Haller and Colwell (44) used three distinct sets of
experiments—one with the mask over the mouth of the patient, one with
the mask over the plate, and the third with masks over both—and
concluded that a five-layer mask made up of 24 × 20 mesh protected the
plate in the second series of experiments. They suggested marking one
side of the mask, so that it would always be worn with the same side
out. Leete (45), in England, by a similar series of experiments
concluded that a dry mask of six to eight layers of butter muslin worn
by a contact would protect him against droplet-carried infections.
Dannenberg (46) suggested making the gauze mask over a copper screen
wire frame to give it shape and keep it away from the mouth, thus
keeping it relatively dry. All observers agree that masks while dry are
more efficient than they are after they have become moist.
The efficiency of the mask has also been widely discussed from the
clinical standpoint. Mink (47) in discussing their use at the Great
Lakes Training Station said that he had no objection to the mask as it
is “intended to be worn,” but that as it “was worn” by the medical corps
men at the station 8 per cent. of those who used the mask developed
influenza, as compared to 7.75 per cent. of those who did not; 30 per
cent. of the dental officers at the station developed the disease in
spite of the fact that they were all accustomed to wear masks during
their work. In discussing the mask Vaughan (48) said: “With reference to
the mask, I am strongly of the opinion that we have overestimated its
value. * * * When I went to Camp Devens they were not using the mask. I
called the doctors together and told them its use was not compulsory,
but I said: ‘Every doctor who took care of cases of pneumonic plague and
did not wear a mask died from it, and every man who cared for pneumonic
plague cases and didn’t wear a mask did contract it.’” They were then
allowed to choose for themselves. It has been pointed out that the
epidemic dropped off at once in San Francisco with the universal
compulsory use of the mask on the street, but it is also said that the
epidemic in Los Angeles, which ran a course parallel to that in San
Francisco and in which masks were only indiscriminately used, began to
drop off simultaneously. While it is difficult to get at the facts, it
seems that, provided epidemic influenza is carried through the air or by
means of droplets, the universal use of masks should decrease the number
of exposures. The claim has been made that masks merely tend to prolong
the epidemic, and that susceptible persons develop the disease after the
epidemic proper has passed. If the mask will protect the susceptible
Public-domain text, read in full here on John Shaqi.
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