July 4, 1919] 



SCIENCE 



9 



Department of tlie United States Army after 

 the Civil War which stands as a lasting monu- 

 ment to the industry and genius of the sur- 

 geons of that time; it is the "Medical and 

 Surgical History of the War of the Eebel- 

 lion." This was the first great medical his- 

 tory ever published of any war, and remains 

 still the standard to be attained. 



As a result of the scientific medical work 

 during and after the Spanish- American War, 

 the investigations of three American army 

 surgeons, Jesse Lazear, James Carroll and 

 Walter Reed, gave to the world the solution 

 of the problem of the transmission of yellow 

 fever by mosquitoes. With this knowledge, 

 came simultaneously the power to control this 

 dread disease, which for centuries had been 

 the scourge of the West Indies, and had time 

 and again spread in devastating epidemics to 

 this country and even to southern Europe. 

 Lazear and Carroll laid down their lives to 

 gain this knowledge, and paid the ultimate 

 sacrifice in order that thousands, through 

 their work, might be protected and live. The 

 sanitary control of mosquitoes, and thus of 

 tropical malaria and yellow fever, and the 

 wise administration of this knowledge, made 

 possible the building of the Panama Canal. 

 It was an American army surgeon, William C. 

 Gorgas, who seized this great opportunity and 

 transformed a pesthole of tropical diseases 

 into a healthy and safe terrain, that the engi- 

 neering genius of the United States Army 

 might be free to construct the canal. The 

 Frenah under De Lesseps had failed because 

 of the epidemic and tropical diseases which 

 were at that time imcontrollable. Disease had 

 defied and overcome engineering skill and 

 genius. Preventive medicine controlled and 

 conquered. 



Ten years ago the practical application of 

 the knowledge gained from the study of the 

 epidemic of typhoid fever of the Spanish- 

 American War brought about the compulsory 

 inoculation against typhoid in the United 

 States Army. It had been shown by the 

 Vaughan and Shakespeare Board that nearly 

 65 per cent, of the typhoid fever of that war 

 was transmitted by contact of man with man. 



and was not water borne. Hence sanitation 

 could only reduce typhoid to a certain level 

 and not eradicate it. The introduction of 

 compulsoi'y typhoid inoculation in the army 

 has practically eradicated the disease. Fol- 

 lowing the work of the English medical corps 

 in the Boer War, a United States Army sur- 

 geon, F. F. Eussell, made possible the prac- 

 tical application of this method in the U. S. 

 Army and proved conclusively that ts^phoid 

 fever could be completely controlled. The 

 American Ai'my Medical Corps has, in the 

 recent war, discovered the transmissibility of 

 trench fever by body lice, and thus has shown 

 the means of prevention of this new disease 

 which, while killing no one, rendered thou- 

 sands of men useless for weeks and ineffective 

 for fighting. This discovery came to save 

 thousands of men for the fighting lines at a 

 time when they were urgently needed. 



Medical science has to-day, therefore, within 

 its grasp the power to control the diseases 

 which, in former times, decimated warring 

 armies and spread out from these armies 

 among the non-combatant populations. For- 

 merly, when war broke out, it was almost in- 

 evitably followed by some dread pestilence 

 among the civil populations of the countries 

 in which the war was waged. By proper sani- 

 tation and preventive inoculation, dysentery 

 and cholera can be abolished; by vaccination 

 armies can be protected against smallpox. 

 Body lice dissem^inate typhus, recurrent fever, 

 and trench fever, and by projier disinfection 

 of these vermin these diseases cease to occur. 

 Through sanitation and preventive inocula- 

 tion, typhoid fever, the scourge of the two 

 previous wars, is absolutely controlled, and 

 this inekides also paratyphoid, which has been 

 recognized as a separate entity only since the 

 Spanish-American War. In the Spanish- 

 American War, 60.5 per cent, of all deaths 

 were caused by typhoid, and in the present 

 war 85 per cent, were caused by pneumonia. 

 The typhoid of the Spanish-American War 

 was due to local causes and local epidemics. 

 The pneumonia of this war was beyond con- 

 trol, and was part of a world-wide epidemic 

 that swept over both hemispheres, and the 

 morbidity and mortality of some of the cities 



