4?)2 Colonel George Adam! [Feb. 7, 



We had not expected it, and we were unprepared. But the remedy 

 was obvious, and was apphed as soon as ever it could be secured in 

 sufficient amounts. Naturally it takes some little time to prepare, or 

 otherwise, it needs several weeks to render horses highly immune, but 

 once available, instructions were given that every wounded man 

 should be inoculated against tetanus. Here are the results which I 

 have abstracted from a paper by General Sir David Bruce, Chairman 

 of the Committee appointed to investigate this matter of tetanus and 

 its treatment. At first, I should explain, the amount of the serum at 

 our disposal being by no means excessive, too small a number of 

 units were injected into each man, and occasionally cases occurred in 

 which, despite inoculation, the disease showed itself. Eventually an 

 increased dose was made official, and from that time onwards tetanus 

 was practically obliterated from among our troops.* 



I should mention that the members of Sir David Biuce's 

 Committee found another very possible cause of failure in a certain 

 number of cases. They discovered that just as there are typhoid 

 and paratyphoid organisms, so there exist in nature at least four 

 distinct strains of the tetanus bacillus, so that the serum obtained 

 from horses inoculated against one strain only of the bacillus would 

 not be as effective in the cases of those infected with another strain 

 as it is in those infected with the homologous strain. 



Spotted Fever {Cerebrospinal Meningitis). — Epidemics of spotted 

 fever have developed at irregular intervals in Europe and North 

 America all through the last century, epidemics that have struck 

 terror, so few of those attacked surviving. Mostly it is young 

 children that have been the victims, but with this it is not a little 

 remarkable that numerous barrack epidemics have been recorded. 

 Since the century opened there have been serious epidemics in New 

 York and the great cities of the United States, spreading into 

 Canada. In the British Isles there was in 1900 to 1908 a similar 

 epidemic, with heavy death roll in Belfast, spreading to Glasgow ; 

 another in Nottingham in 1910 ; while ever since then scattered cases 

 and groups of cases have been recorded in Great Britain, until in 

 1912 cerebrospinal meningitis was made a compulsorily notifiable 

 disease. 



Then through the rain-swept winter of 1914-15 the disease 

 made itself felt in the Expeditionary Force. There had been some 

 dozen cases recorded among the civil population of England and 

 Wales in the first three weeks of October 1914. The first military 

 case was reported in the fourth week of that month. Here, as a 

 Canadian, let me say that there is no evidence that the Canadian 

 troops are responsible for the subsequent epidemic, as, again, 



* From the first No. 3 Canadian General Hospital employed double the 

 official dose, with the result that not a single case occurred in the thousands 

 of surgical cases treated there. 



