328 CHAMBERLAIN. 



heart blood. The third case died of general peritonitis folloN\ing perforation of 

 the ileum. Autopsy showed enlarged and ulcerated Peyer's patches. 



Forty-one cases, constituting 50.6 per cent of the whole, show on the chart 

 a continued feter ranging from sixteen to forty days and averaging 26.4 days. 

 The temperature charts of 33 were classed as typical of typhoid, showing a well 

 marked fastigium which averaged 38"' .8 C. in three cases 39°.4 C. in seventeen, 

 40° C. in twelve, and 40°. 5 C. in one. 



Diarrhoea was noted in 11, constipation in 21 and regularity qf the bowels in 

 9. Eose spots were recorded in 7 cases and dicrotic pulse in 6. Complications 

 occurred in the shape of multiple peripheral neuritis in one and post-typhoid 

 psychosis, requiring transfer to the United States, in another. 



In this group of 41, Bacillus typhosus was recovered from the blood of two, 

 the stools of two and the urine of one. > , 



The records of 27 of the cases t constituting 33.3 per cent of the whole) 

 showed temperature curves which resembled the last week or ten days of a 

 typical typhoid chart. In one of these 27 eases Bacillus typhosus was isolated 

 from the stool, in another from the urine. It is believed that these patients had 

 been suffering from a mild attack of typhoid fever for periods ranging from 

 five to fifteen days before adinission to hospital. 



A third group consisting of 10 cases (12.3 per cent of the whole) presented 

 trivial rises of temperature lasting for a few days and bearing no resemblance to 

 the classical typhoid fever chart. All showed clear-cut serum reactions and from 

 the stools of 3 the Bacillus typhosus was recovered. There is no reasonable doubt 

 that all were sufl'ering from extremely mild and atypical typhoid fever, or else 

 were just at the end of an attack which had never caused them to be excused from 

 duty. Their actual appearance on sick report was not due to their own volition 

 but was the result of the general taking of temperatures and admission to hospital 

 of all who showed any degree of fever. 



Of the 81 eases considered above 3 were natives and the remainder Americans. 

 The total number considered (81) does not include the 5 cases in the adjacent 

 town of Parang and referred to in Table XIX* 



Taken as a whole, the epidemic was characterized by constipation, absence of 

 haemorrhage, very slow pulse, rarely over 100 and often normal, by a large 

 ratio of very mild or ambulatory cases, and by a low mortality, 3.7 per cent, 

 Ail analysis of the October epidemic was made by Lieutenant Charles T. Dulin 

 and of the whole period of the epidemic by Lieutenant Clarence E. Fronk. 



CAilP ELDKIDGE (LOS BANOS) EPIDEMIC. 



Eleven cases of typhoid fever occurred at this post during July and August, 

 1909, the garrison consisting of 4 companies of the 7th Infantry. The cases 

 were quite evenly distributed. One patient was a commissioned officer and of the 

 10 enlisted patients 4 came from "C" company, 3 from "A" company, 2 from "B" 

 company and 1 from "D" company. : . 



The post of Los Banos is -situated on an elevated, well-drained site. The 

 Garth closet system was in use at the time of the epidemic. The water for 

 drinking purposes was boiled. That for bathing is derived from a stream, the 

 intake being a considerable distance up on Mount Makiling. The possibility of 

 its having been infected can not be excluded. An effort made at this laboratory 

 to find carriers among the company cooks or elsewhere in the command was 

 unsuccessful. The garrison left .Fort. Wayne, near Detroit, (where typhoid is 

 said to have been common) on April 30, 1909, and arrived at Camp Eldridge on 

 June G, 1909. The first case oi typhoid fever entered hospital July 3, 1909. A 

 study of his chart and of the charts of the next two cases, ' admitted July 9 and 



