APPENDIX I 469 



so that they could be placed under medical care and in suitable 

 institutions (see page 41). 



In comparison with the armies of our allies, the number of 

 soldiers who developed or contracted tuberculosis during the 

 war and had to be returned at once, was exceedingly small. Be- 

 cause of a too hasty examination or incorrect interpretation of 

 Roentgen pictures, some men were returned, who upon subse- 

 quent examination here, were found simply to be suffering from 

 chronic bronchitis or residual fraction of pneumonia. To avoid 

 as far as possible a repetition of such errors, Dr. Gerald B. Webb 

 was appointed Colonel and chief consultant in tuberculosis in 

 the American Expeditionary Forces and sent to France in March, 

 1918. On his arrival Colonel Webb established centers for the 

 correct sifting out of all chest cases, one at Savenay with the 

 New York Post-Graduate Unit, under Colonel Samuel Lloyd; 

 one at Vauclaire with the Mount Sinai Unit, under Colonel 

 Lilienthal; and another center at Guyon with the Pennsylvania 

 Unit. Colonel Webb visited almost every hospital of the 

 American Expeditionary Force, hoping that through his instruc- 

 tion and standardization of diagnostic methods, mistakes might 

 be reduced to a minimum and only positive sputum and hemor- 

 rhage cases sent home. 



In spite of the admirable work of Dr. Webb, the errors in 

 diagnosis increased because of unforeseen complications which 

 arose in handling the problem of the tuberculous, those afflicted 

 with other chest diseases, and the suspected tuberculous cases. 

 One must draw this conclusion from an article in the Annual 

 Report of 1920 by Colonel Brooke in which he says: 



"The seemingly large number of cases in the above category was unex- 

 pected and was apparently brought about by two conditions not anticipated at 

 the beginning of the war. First, the acute respiratory infections in 1918, 

 largely influenza and pneumonia, resulted in a residual chronic pulmonary 

 infection usually caused by the hemolytic streptococcus that clinically, even to 

 the physical signs, simulated pulmonary tuberculosis; second, shortly after the 

 signing of the armistice the tuberculosis-hospital centers in France were broken 

 up and a large number of cases were sent home with a tentative diagnosis of 

 tuberculosis that otherwise would have been sifted out overseas." 



With a foresight that cannot be too highly commended, the 



