5

H.— 31a.

or local authorities stand outside the scope of the present memorandum. The individual must be taught to realize and acquiesce in his duty to the community. ' Well-ventilated, airy rooms promote well-being, and to that extent, at any rate, are inimical to infection ; draughts are due to unskilful ventilation, and are harmful; chilling of the body-surface should be prevented by wearing warm clothing out-of-doors. Good nourishing food and enough of it is desirable. There is no virtue in more than this. Alcoholic excess invites disaster. Within the limits of moderation each person will be wise to maintain unaltered whatever habit experience has proved to be most agreeable to his own health. The throat should be gargled every four to six hours if possible, or at least morning and evening, with a disinfectant gargle, of which one of the most potent is a solution of twenty drops of liquid soda chlorinate in a tumbler of warm water. A solution of common salt, one teaspoonful to a pint of warm water, is suitable for the nasal passage ; a little may be poured into the palm of the hand and snuffed up the nostrils two or three times a day. " Since we are uncertain of the primary cause, of influenza, no form of inoculation can be guaranteed to protect against the disease itself. From what we know as to lack of enduring protection, after an attack, it might, in any case, be assumed that no vaccine could protect for more than a short period. But the chief dangers of influenza lie in its complications, and it is probable that much may be done to mitigate the severity of the affection and to diminish its mortality by raising the resistance of the body against the chief secondary infecting agents. No vaccine should be administered except under competent medical advice. No drug has as yet been proved to have any specific influence as a preventive of influenza. " At the first feeling of illness or rise of temperature the patient should go to bed at once and summon his medical attendant. The early stages of the attack are the most infectious, but infection may persist throughout the illness, and segregation should be maintained at least till the temperature is normal. ' Relapses and complications are much less likely to occur if the patient goes to bed at once, and. remains there till all fever has gone for two or three days ; much harm may be done by getting about too early. Chill and over-exertion during convalescence are fruitful of evil consequences. " Hie virus of influenza is very easily destroyed, and extensive measures of disinfection are not called for. Expectoration should be received, when possible, in a glazed receptacle, in which is a solution of chlorate of lime. Discarded handkerchiefs should be immediately placed in disinfectant or, if of paper, burnt. The liability of the immediate attendants to infection may be materially diminished by avoiding inhalation of the patient's breath, and particularly when he is coughing, sneezing, or talking. A handkerchief should be held before the mouth, and the head turned aside during coughing and sneezing. The risk of conveyance of infection by the fingers must be constantly remembered, and the hands should be washed at once after contact with the patient or with mucus from the nose or throat." All these suggestions have been dealt with by the medical men of the Dominion in their evidence before us. There is difference of opinion in minor points, but there is a general accordance on the main points. Inoculation. On the important question of inoculation there appears to be a definite tendency both at Home and in the Dominion to take a more favourable view of its value as a prophylactic, although its use as a therapeutic agency is still doubted. In a communication dated the Bth July, 1918, from the Secretary of State for the Colonies to Your Excellency, and forwarded to us by the Health Department, there is this paragraph : — " In spite of a good deal of research on the subject of epidemic influenza both. in this country,, and elsewhere there is not at present, the Board state, any completely d effective means of controlling the spread of the disease, but that amongst measures advocated a as likely to minimize its incidence and severity are careful hygiene of nose and throat, fresh air, free ventilation, avoidance of overcrowding,