362 VITALITY AND EFFICIENCY WITH RESTRICTED DIET. 



about the inside of the Ups, which were much swollen. I have told you 

 of the bronchitis which accompanied the disease. I had the sputum examined 

 for tuberculosis on two occasions, with negative result. I had no report as 

 to any other organism. 



"The eruption was pretty generally distributed over the whole body, arms, 

 legs, back, and, I think, on the forehead. The spots were fairly far apart; 

 for example, perhaps a dozen spots on the abdomen and chest, half a dozen 

 on the arm, etc. These are, of course, only guesses, but the glans penis and 

 scrotum were peculiarly involved and were quite sore.' ' 



Simultaneously with the illness of Spe the younger brother and the 

 attending nurse became ill. The following sentence in Dr. Walker's 

 letter relates to this phase of the illness: 



"The brother's illness came after Wesley's. It began about ten days after 

 Wesley came home and was like a grippe bronchitis with persistent and 

 moderately high fever which lasted ten days to two weeks. No eruption or 

 sore mouth. The nurse who cared for these boys was also ill for a few days 

 with a bronchial attack with fever for a few days. Much milder than the 

 brother's." 



Of special note in connection with this case is the fact in the first 

 place that the subject obtained this infection which, it is reasonable 

 to argue, he might not have had if he had been on normal diet. On 

 the other hand, he made complete recovery and returned to college 

 on April 2, 1918. He has completed his college year and is in ex- 

 cellent health. It is extremely unfortunate that a clear, unques- 

 tioned diagnosis could not have been made of this case. Conference 

 with several of the best clinicians in Boston leaves the whole situation 

 very uncertain. It would be useless here to record the various conjec- 

 tures made from the clinical picture outlined, but there seems to be a 

 reasonable uniformity of opinion that Spe did not have typhoid fever. 



The whole history of this case is of special interest, in connection 

 with the statement made by Loewy and Zuntz in the article 

 reporting their experience on war diet, in which they espe- 

 cially emphasize the fact that the possibility of a lowered resistance 

 to infectious diseases can only be studied when there is extensive 

 clinical material at hand. 



The number of men under observation was approximately 25. 

 One {Fre) withdrew primarily on account of his inability to with- 

 stand the discomfort of hunger pains. Spe is the only case of a 

 serious illness occurring during the research. Since all the men were 

 given substantially the same treatment, ate at the same table, and 

 had the same food, it is highly probable that we deal in this case 

 with a sporadic infection that is without direct connection with the 

 dietetic conditions. It still remains a fact, however, that one man 

 out of the 25 men studied— ^. 6., 4 per cent of our men— contracted a 

 severe illness. This, in connection with the suggestion made by Dr. 

 Minot in his report on the blood examination, would certainly be taken 

 into account as an argument against the general use of restricted diets. 



