178 



SCIENCE 



[N. S. Vol. XLVII. No. 1208 



Army did in 1898 there would have been 

 1,000,000 cases ! In fact there have been 

 less than 4,600 ! Besides that, the percent- 

 age of fatal eases in the inoculated men was 

 4.7 per cent., in the uninoeulated 23.5 per 

 cent. ; and perforation of the bowel, the 

 most dangeroiTS complication, occurred six 

 times more frequently among the unvacci- 

 nated than among those who had been pro- 

 tected. In the British armies the anti- 

 tj^phoid vaccination is still voluntary but 

 over 90 per cent, are thus protected. If 

 it had been compulsory, hundreds of the 

 4,571 ivho died ivould have been saved! 



In our own army in over four months 

 (September 21, 1917, to January 25, 1918) 

 a period one month longer than our war 

 with Spain (the Surgeon General's Office 

 gives me the official figures), we have had 

 an average (i. e., every daj'' of these four 

 months), of 742,626 men in our canton- 

 ments and camps. These men have come 

 from all over the country, in many cases 

 from where auttimnal typhoid was reaping 

 its annual harvest, in practically all cases 

 unprotected by the vaccination. Between 

 these two dates there have been 114 cases 

 of typhoid and 5 of paxatjTphoid. Had the 

 conditions of 1898 prevailed there would 

 have been 144,506 cases instead of 119 in 

 all! The reason is clear. The men were all 

 immediately vaccinated against typhoid, 

 paratyphoid and smallpox.^ 



Besides this as soon as the antityphoid 

 inoculation was completed the number of 

 cases rapidly fell and from December 14 to 

 January 25 — 6 weeks! — ^there have been 

 only 6 eases of typhoid and one of para- 

 typhoid among probably now nearly 1,000,- 

 000 men ! Truly marvellous ! 



Now all this is the direct result of bac- 

 teriological laboratory work. Was it not 



s Of the latter disease there have been only 4 

 cases, all unvaeeinated. 



worth while? Has it not "benefited the 

 human race"? Are you not glad that 

 your son is thus protected? 



I may add that the German armies show 

 a similar absence of typhoid. I have seen 

 no figures but only general statements. 



Tetanus or "Lock-jaw." — Pew people 

 realize what terrible suffering this disease 

 causes. The mind of the patient is per- 

 fectly clear, usually to the very end, so that 

 his sufferings are felt in their full inten- 

 sity. All of my readers have had severe 

 cramps in the sole of the foot or calf of the 

 leg. The pain is sometimes almost "un- 

 bearable." In tetanus not the muscles of 

 the jaw alone are thus gripped, but the 

 muscles all over the body are in cramps ten 

 or twenty fold more severe, cramps so hor- 

 rible that in the worst cases the muscles of 

 the trunk arch the body Kke a bridge and 

 only the heels and the head touch the bed ! 



Never shall I forget a fine young soldier during 

 the Civil War who soon after Gettysburg mani- 

 fested the disease in all its dreadful horror. His 

 body was arched as I have described it. When at 

 intervals he lay relaxed, a heavy footstep in the 

 ward, or the bang of a door, would instantly cause 

 the most frightful spasms all over his now bowed 

 body and he hissed his pitiful groans between 

 tightly clenched teeth. The ward was emptied, a 

 half-moon pad was hung between the two door- 

 knobs to prevent any banging; even the sentry, 

 pacing his monotonous steps just outside the 

 ward, had to be removed beyond earshot. . . . The 

 spasms became more and more severe, the intervals 

 shorter and shorter; it did not need even a footfall 

 now to produce the spontaneous cramps, until 

 finally a cruelly merciful attack seized upon the 

 muscles of his throat and then his body was re- 

 laxed once more and forever. He had been 

 choked to death. 



Do you wonder at the joy unspeakable 

 which we surgeons have felt of late years 

 as we have conquered this fearful dragon ? 

 In 1884 the peculiar germ, shaped like a 

 miniature drum-stick, was discovered. Its 

 home is in the intestines of animals, espe- 

 cially of horses. The soil of France and 



