ee eee 
THE PRESIDENTIAL ADDRESS. 21 
Although this fever has well-marked characteristics of its own, such 
as a peculiar type of temperature curve, and other symptoms, yet for a 
long time it was unrecognised as a separate entity, and remained mixed 
up with other diseases, such as typhoid fever, malaria, and rheumatism. 
In 1916 MacNee, Renshaw, and Brunt in France made the first definite 
advance by showing that the blood of trench-fever cases was infective. 
They succeeded in transferring the disease to healthy men by the injection 
of the blood. The most careful microscopic examination of the blood 
corpuscles and lymph failed, however, to reveal any living germ. 
Nothing more was done until the following year, when the British War 
Office took the matter up seriously and formed a Committee for the purpose 
of investigating the disease. 
The United States of America, on coming into the war, at once recog- 
nised the importance of trench fever, and without delay also undertook 
its investigation. 
In October 1917, at the first meeting of the Medical Research Com- 
mittee of the American Red Cross in Paris, Major R. P. Strong recom- 
mended that a research into trench fever should be undertaken. He stated 
that, after several months’ study of the problems relating to the prevention 
of infectious diseases occurring in the Allied Armies on the Western Front, 
it became evident that the subject of the method of transmission of trench 
fever was one of the most important for investigation in connection with 
the loss of man-power in the fighting forces. 
At the next meeting, in November 1917, this was agreed to, and a 
Trench Fever Committee, under the chairmanship of Major Strong, was 
formed. The research was organised, and experiments begun on Febru- 
ary 4, 1918. In less than six months the investigation was completed 
and the report in the hands of the printer. This is a striking example of 
research work which, if carried out at the beginning of the war instead of at 
the end, might have saved the Allied Armies hundreds of thousands of 
cases of disease, which, although never fatal, were often of long duration 
and led to much invaliding. 
The most important result of the work of these two Committees was that 
it was amply proved that the louse, and the louse alone, was responsible for 
the spreading of the disease. This discovery meant that in a short time 
trench fever would have disappeared from our armieson the Western Front: 
Just as the elimination of goat’s milk blotted out Malta fever, the 
elimination of the mosquito malaria and yellow fever, so would the 
elimination of the louse have completely blotted out trench fever. 
