THE CONTROL OF HUMAN LICE 313 



by mixing the prisoners, and the exchange among them of souvenirs, espe- 

 cially shoulder straps under which the lice clung in masses, the lice 

 became generally distributed. It was not long before the German armies 

 found the louse a very live problem and their scientific journals are full 

 of papers on the control of the vermin 



In Serbia a few cases of typhus fever occurred in October, 1914, 

 and in January, 1915, the disease was epidemic among Austrian prisoners 

 who were greatly crowded and necessarily compelled to live under very 

 unsanitary conditions. The disease quickly spread from them to other 

 individuals, and as there was no quarantine, and the Austrian prisoners 

 and the infected individuals were sent or allowed to go to various parts 

 of the country, Serbia was soon afflicted with a terrible and widespread 

 epidemic. Weakened by the ravages of war, the country was nat pre- 

 pared for an epidemic and for a time typhus raged almost at will. The 

 majority of the Serbian doctors, who were few in number, became afflicted. 

 The epidemic was at its height in April when the number of cases was 

 at least 9000 a day, but it was impossible to gauge the number of cases 

 in the rural districts. At least 100,000 men, or a quarter of the army, 

 were destroyed in this epidemic which was checked by the energetic efforts 

 of the medical officers, assisted by Dr. R. P. Strong and his American 

 colleagues. The work of the Serbian Sanitary Commission is briefly de- 

 tailed by Doctor Strong in various reports. 



In Roumania typhus fever and relapsing fever became epidemic in 

 the winter of 1916-17 and the conditions wliich occurred there are very 

 vividly portra3'ed by Wells and Perkins (1918). Rulison (1918) gives 

 the history and statistics of the epidemic from its beginning through the 

 greater part of 1918, estimating 26,000 deaths from typhus fever up to 

 February 13, 1919. 



It was inevitable that the louse should reach the western trenches 

 and contaminate them with disease, and we find that trench fever was 

 soon considered the most disabling disease of this front. Reports show 

 that a very high percentage of the men in the trenches became verminous. 



RESERVOIRS OF LOUSE BREEDING 



Before discussing the control measures, we must also know whence 

 arise these infestations of lice which can infect whole nations, because 

 prophylaxis must take into account the reservoirs of the pest. In the 

 United States, where cleanliness and bathing arc more or less the gen- 

 eral rule, there have never been great outbreaks of these vermin except 

 in time of war. In certain parts of the world, however, the louse is an 

 ever-present associate of man. This is especially true of the ignorant and 

 the densely populated portions of the world, the Mexican and South 



