422 
Combating Lousiness 
Free Ventilation as a help. 
It lias long been held that fresh air is of benefit in checking the spread 
of typhus fever, good results having followed the free ventilation of 
wards by opening the doors and windows or by placing the patients in 
the open in a lean-to or tent. Thus Cheyne (1818, Dublin Ho.sp. Rep. n, 
53) 1 recorded very few cases of typhus extending in houses in which 
“proper attention was paid to cleanliness and ventilation'’ and sub¬ 
sequent authors have made similar observations. Jacquot (1858, Le 
typhus de VArmee d'Orient, p. 64) 1 wrote of the Crimean war: “Pas de 
typhus l’ete alors que le soldat vit en pleine air et laisse ouvertes les 
barraques ou les tentes.” Eecent experience has been similar, thus 
Hartmann (1915, p. 861) cites Curschmann as having laid stress on the 
open air treatment of typhus owing to the excellent results obtained in 
the epidemic of 1879 at Moabit Hospital, Berlin. 
Since all the evidence hitherto collected points to lice as the sole means 
whereby typhus is transmitted from man to man, it follows that free 
ventilation during the cool weather in which epidemics mostly occur 
must impede the conveyance of lice from man to man. The beneficial 
effect of fresh air is doubtless attributable to the cold checking the 
wandering of lice, the insects remaining near the warm bodies of the sick 
and becoming torpid when they become cooled. This view was also 
expressed in 1915 by Boral (p. 641), Frisch (p.^67) and von Wasielewski 
(p. 627). 
Frequent Inspection essential. 
Experience in the Army has convinced competent observers that 
frequent inspection of men and their clothes is necessary to diminish the 
prevalence of lice and to keep the men clean. Inspection is needed 
because men may be careless or desirous of concealing their condition 
from fear of being considered unclean, or the men may be infested with¬ 
out knowing it. A case in point is recorded by Busson (1915, p. 674) 
wherein a faithful hospital attendant, when inspected, to his own great 
astonishment was found to be a “ Massentrager ” (a heavily infested 
carrier). 
Inspection should be carried out once a week (Heymann, 1915, p. 
320; Peacock, 1916, p. 59), and should include the men's bodies and their 
clothing. The inspection should be carried out by a quick intelligent 
person; special attention should be paid to men who are prone to be 
habitually dirty, these being frequently a main source of lice in a group 
1 Quoted by Hirsch, 1881, jjp. 413. 414. 
