TYPHOID FEVER 71 



but until the discovery of the causal agent this truth was difficult of 

 demonstration. 



It follows from what has been said that the prevalence of typhoid 

 in any community is largely determined by the personal cleanliness 

 of the inhabitants and largely by the method of disposing of human 

 excreta. In the past typhoid has been the most destructive disease in 

 armies, miners' camps, exploring parties and wherever the disposal 

 of fecal matter has been primitive and imperfect. The dissemination 

 of this disease among our soldiers in 1898 was thoroughly investigated, 

 and some of the conclusions may be not only of interest but of value to 

 civilians. 



During the Spanish war of 1898 every regiment constituting the 

 first, second, third, fourth, fifth and seventh army corps developed 

 typhoid. This includes all the soldiers assembled in that war except 

 those who went to the Philippines and consequently were not investi- 

 gated by the board. More than 90 per cent, of the volunteer regiments 

 developed typhoid within eight weeks after going into camp. The 

 disease developed in certain of the regular regiments within from 

 three to five weeks after going into camp. These facts negative an old 

 claim that sudden change from civilian to military life favors the 

 development of this disease. The disease became epidemic in small and 

 large camps, in those in the north as well as in those in the south. 

 It had been held that simply bringing large numbers of men together 

 was enough in and of itself to cause a typhoid epidemic. Some had 

 argued that change of climate alone caused the disease. 



At that time typhoid was so widely and abundantly distributed in 

 this country, the chances were that whenever and wherever one thou- 

 sand or more men should be brought together, an average of four in 

 this number would reach the camp already infected. Those who came 

 with the infection would scatter the seeds before the disease in them 

 would be recognized. The number of cases in the different camps 

 varied directly with the methods of disposing of the excretions. The 

 disease was disseminated by contact, by flies and by water. Contact 

 infection was the most important factor. The grounds were covered 

 in some places with feces. The men tracked this infected matter into 

 their tents, soiled the floors, blankets, clothing, and tents. Men were 

 detailed to act as orderlies at the hospitals where they handled bed 



