TRENCH FEVER 205 



kissing. Mild antiseptics are sufficient: 1 to 1000 carbolic 

 acid or 1 to 3000 corrosive sublimate. A salve of mercury is 

 usually prescribed. Its importance is greatest in surgical 

 and children's wards and clinics and in schools. 



Noma or Cancrum Oris. This is a perforating ulceration, 

 usually of the cheek, on weak and debilitated children. It is 

 said to be due to a host of different organisms, cocci, pseudo- 

 diphtheria bacilli, and many others. The one most frequently 

 found is an anaerobic germ of double appearance, as a rod 

 and as a spirochete. The treatment is of a radical surgical 

 character, as ordinary external applications are unavailing. 

 It is not very contagious, but discharges and sloughs are best 

 burned. 



Trench Fever. Trench fever is an infectious disease of 

 primarily acute nature, but occasionally assuming a subacute 

 or chronic form. It is characterized by irregular fever, 

 vertigo, severe headache and bone pains and sweating and 

 evidences of blood infection. It is transmitted by the body 

 louse and possibly by other parasites. The lice bite infected 

 persons, the virus being in the blood, and act as hosts for it 

 because it requires seven days for the development within 

 the body of the parasite. The lice do not then transmit the 

 virus by biting or at least not only in that manner, as it seems 

 that the deposition of excreta of the louse upon the skin is 

 sufficient for the non-immune to be infected. The lice 

 remain infective for at least three weeks but do not pass the 

 virus to their young. Disinfection takes the form of destroy- 

 ing lice and nits, for which kerosene, cresol, and hot soap 

 water are used. The clothing must be rendered innocuous 

 by steam or soaking in a proper solution. 



