New-York tribune., 1918-10-22
Pneumonia on1'Fatigus
, the Editor o. The Tribune.

10 the Editor o. he tribune.
Sir: Groton School is boys boarding
school, at Groton, Mass. Plain living
strict discipline and great attention to
athletic development and competition dis
tinguish the school. was the school
physician during the years 19O6'12 The
health Of the school population was good,
with the single exception of an unusual
number CT cases of pneumonia amone tie
boys both before and during the earlier
years of my connection with the schoo.
In the school year 19o6-'7 there were
seven cases of pneumonia; in 19o7-'s and
l90S'9 about the same number each year
twenty cases in the three years.
Why should these boys, admitted to the
school only in good health, at an age
twelve to twenty years when serious
sickness is rare, favored by excellent iiv-
ing conditions and regular at letic trin-
ing in gymnasium work and outdoor sports,
have pneumonia year after year, while the
masters and their families, under no bet"
ter conditions. and the employees, appsf
emily less favored, were free from it?
During these years this question re-
ceived much frutless attention until the
A boy who had been in the infrmary with
fever, coryza and a cough went out convaes-
cent, took a long 'cross-country run, came
IN tired and quickly developed pneumonia.
This suggested fatigue in this and other
cases. 1t a so suggests the possibility oi
inspiration of infectious material in addi'
ton to fatigue, as, of course, boys exer:
cising violently and long breathe violently
and deeply.
Examination of the infrmary records
showed that in several instances boys had
been discharged from the infrmary after
respiratory infections and returned soon
after with pneumonia. This happened
among boys taught to disdain weakness
and trivial ailments and to admire athletic
excellence, suggesting that athletic zeal
throughout the school, by inducing exces'
sive fatigue among the boys wheE out OF
condition, had been the cause Of pneu'
monia.
Beginning in 1909, boys were kept Longer
in the lnfirmary, severe exercise vas for
bdden whi they were soft from even
slight sickness, and athletic work was re-
sumed gradually. In that year there was
one case of pneumonia; in I9lo-l ano
1911 there were none.
The kind OF fat que observed as CAUSE
o. pneumonia at Groton is an acute fatigue
due 10 vo'en exercise like rowing or sah-
ming in competitive sports, and not more
WEAKNESS from everyday activities. Inc
observed instances in which acute iatigue
was followed by pneumonia were in boys
already subject to or conva escent from
mild respiratory infections and presumably
easily tired.
Descrrt ons Of pneumonia at army camps
last winter suggest q strong resemblance
between the conditions in the camps ano
at Groton School. Great numbers o. young
men were assembled AMI probably as well
clot' ed housed and fed in essentials IS
the boys at Groton. E denies Of measles
and a variety o. NOR ess mid resplr'
a'orv irfees o~s areee6 e,-.e-44 a. - '"-
uous mi 'iterv srainin1 provided tie cendi'
tions for inducing acute fatigue smons
cents from measles etc May cases o.
pneumonia foi'owod '~t a.. n
proportion to the camp population 10
higher than at Groaon ~
WILLIAM N. COWLES, II. D.
Boston, Mass, Oetobsr 20, 1918.