426 Colonel George Adami [Feb. 7, 



malaria — so giibly that it is difficult to realise that the sure differ- 

 entiation and recognition of these distinct diseases • has occurred 

 during the lifetime of some here present. Well-marked cases of 

 malaria had, it is true, been distinguished clinically for some genera- 

 tions by the shivering and hot stages of the ague and the swollen 

 spleen or " ague cake." But until our generation there was no 

 means of making a sure diagnosis, and in the war between the North 

 and the South in the States in the " sixties," and in the Boer War 

 only a score of years ago, it was impossible to determine whether au 

 important group of cases was either typhoid or malaria, or both, 

 and they were described in the returns as typho- malaria. It has 

 been through medical research in our generation that a sure diagnosis 

 has been made possible. 



When, on the one hand, Laveran, the great French pharmacist 

 and parasitologist, discovered the organism of malaria in the blood, 

 and, on the other, E berth and Gaffky showed how to isolate and 

 recognise the organism of typhoid fever, and Durham, Gruber and 

 Widal showed how the blood of a typhoid fever patient agglutinated 

 the Eberth-Gaffky bacillus — then, when these observations were 

 elevated into routine clinical methods with which every medical 

 officer must be acquainted — then, at last, diagnosis of these diseases 

 became easy. It has been by this routine observation that the 

 paratyphoid fevers have been differentiated from ordinary typhoid, 

 by the routine use of the microscope in the clinical laboratory that 

 cases of relapsing fever can be made out, and by clinical study and 

 negative laboratory findings that cases of typhus are differentiated 

 from the other fevers. 



It is these so-called continued fevers that have been the great 

 bane of armies of the past. Let us see what has happened in 

 this war. 



Typhoid. — Let us first take enteric or typhoid fever. In South 

 Africa, but twenty years ago, with a total force of something over 

 half-a-million men, 129*9 out of every thousand men were admitted 

 to hospital with the diagnosis of enteric, as compared with 47 • 95 

 admitted with wounds. In other words, of our British troops one 

 man out of every eight went down with typhoid. One quarter of all 

 admissious was from this one disease, and of them 18*6 out of every 

 1000 died, as compared with 2 '9 who died of their wounds and 

 9*59 killed in action. Or, twice as many men died of typhoid as 

 were killed in action, and six times as many as died as the result 

 of wounds. 



With these figures let me compare those of the present war. I 

 select those for the Canadian overseas forces, and that because in the 

 first place they are the more easily available to me. These are, I 

 gather, better than those for the British forces as a whole, and that 

 because Canada showed a greater sympathy for the well-being of her 

 troops as a whole, and no misplaced sympathy for the stupid con- 



