1502 



WAR ZONE FEVERS 



History. — ^As Strong has pointed out, there is insufficient data 

 to permit any of the diseases described by the ancients, or in 

 mediaeval or modern times, being connected with the disease; 

 while McNee believes that it is unlie any disease reported in other 

 wars, and that it may have been introduced into the British Army 

 by Colonials. Early in 19 15 Graham drew attention to the disease 

 as seen in the British Army, in which thousands of cases occurred 

 between April and October. In January, 1916, it was observed in 

 Salonica by McGavin, Wylie, and Acland, of No. i New Zealand 

 Stationary Hospital. In May, 1916, it was observed in Mesopotamia, 

 and in the same month was reported by Beauchant and Boidin as 

 being present in the French Army in France, and about this time 

 Werner in Warsaw drew attention to its existence in the German 

 armies, and Hurst gave a good general account of the disease. In 

 the same year McNee, Renshaw, and Brunt showed that the disease 

 could be transmitted to healthy men by intramuscular and intra- 

 venous injections of the blood of patients, and the Germans also were 

 similarly successful. In the same year it was observed at Salonica 

 that the clothes or body louse, Pediculus corporis, was the only 

 possible source of infection in a certain hospital orderly who had 

 never been in contact with patients, and in whom the incubation 

 was eighteen days from the first time he became infected with lice 

 from some clothing. In 1918, Strong, Swift, Opie, McNeal, Baelzer, 

 Pappenheimer, and Peacock, in France, showed that the virus was 

 present in the blood plasma and would not pass through a filter. 

 They also proved that the louse was the infective agent, and that 

 the virus was naturally conveyed by its bite. This virus is present 

 in the plasma, sometimes in the urine, and occasionally in the 

 sputum. Artificially the disease may be transmitted by rubbing, 

 lice faeces, human infected urine or sputum, into excoriated skin, but 

 the incubation resembles that of the inoculation of infected plasma. 



A little later, in the same year, the British Committee in London 

 showed that lice bites did not produce the disease, which, however, 

 could be produced in healthy men by rubbing infected louse faeces 

 into excoriated cutaneous areas. Further, they demonstrated 

 that the incubation period was six to eight days, and that blood 

 taken from the infected men and injected into healthy men could 

 reproduce the disease after an incubation of five days. Also, in 

 19 18, Couvy and Dujarric de la Riviere claimed that a spiro- 

 chaete, S. gallica Couvy and de la Riviere, 1918, could be found in 

 the blood of man and infected guinea-pigs, and in the liver and 

 kidneys of these guinea-pigs. The infected guinea-pigs were shown 

 to suffer from a fever resembling that in man. They, however, 

 did not retransfer the disease from the guinea-pig to man, and 

 the general opinion at present is that the organism is not the cause 

 of the disease. Other organisms such as a piroplasma and a 

 haemogregarina have been described as causal. 



In 19 16 Toepfer found Rickettsia bodies similar to those described 

 in 1909 by Ricketts in Rocky Mountain spotted fever, and by 



