On the Fringe of the Great Fight

by George Gallie Nasmith

By getting rid of cases of intestinal disease, and "carriers" of intestinal disease, destruction of excreta and garbage, screening of food, destruction of breeding places of flies, sterilization of drinking water, boiling of milk and vegetables, and in the case of typhoid and paratyphoid fevers, inoculation, the chances of intestinal disease germs getting through from one person to another are comparatively small, as the results would indicate.

To show that these results are not due to accident an example will demonstrate: Early in the war when the British took over from the French a section of the line in the Ypres salient, the Belgian population in the little village of Vlamertinge and neighborhood was being devastated with typhoid fever, and the French troops also had a great many cases. When the British troops took over the line they not only escaped getting typhoid fever themselves, but they succeeded in absolutely stamping it out among the civilian population, and in getting rid of any "carriers" of the disease.

The cases were discovered by a house-to-house investigation by "The Friends' Search Party"—a group of Quakers who had conscientious scruples against bloodshed. This search party notified the medical authorities, particularly the laboratory in the area, of any doubtful cases, and the diagnosis was then made by laboratory methods. In the last six months of my stay in France, near the Belgian border, I do not think that the Friends' search party unearthed a single case of typhoid, and as a matter of fact few cases of the ordinary epidemic diseases such as measles or diphtheria were discovered, although they continued to make house to house investigations and report to us regularly.

The insect-borne diseases in the Western Europe war zone are, as far as we know, carried by flies, lice and mosquitoes. Flies carry disease germs more or less mechanically, and are controlled by the methods outlined above.

Mosquitoes are responsible for transmitting malaria and yellow fever, though the latter never occurs in Europe. Malaria in France is also comparatively unknown, though we found the Anopheles mosquito which is responsible for transmitting the disease elsewhere.

There were also numerous cases of malaria recurring in soldiers from India, Egypt, and other hot countries, so that we had both the infected individual with the malaria parasites in his blood, and the mosquito which was capable of carrying the organisms. Yet in 1915 we had only a dozen cases of malaria develop in men who had never been out of England, and were therefore, presumably, infected in France.

Possibly the chief reason for this was due to the fact that after the mosquito has sucked the blood of an individual infected with malaria, and been infected with the malaria parasite, the weather was not warm enough for the parasite to undergo its necessary transformation in the blood of the mosquito. A continuous warm period of several days' duration is necessary for this purpose, and in France these time periods never occurred of sufficient duration. Here was a climatic feature which proved to be of very great importance in preventing the spread of a disease most inimical to the health of any army.

Here again, any cases of malaria developing were removed as rapidly as diagnosed, so that mosquitoes did not have much opportunity of becoming infected.

Typhus fever is one of the most dreaded diseases in the army, for it is highly fatal, and both in former wars and in the recent Serbian campaign has proved a terrible scourge. It is quite a different disease from typhoid fever, and is conveyed from man to man solely through lice. In other words, the phrase "No lice, no typhus" is scientifically true.

Every army in the field is a lousy army, and every soldier in a fighting unit is more or less lousy. The louse commonly present is the body louse, and it lays its eggs in the seams of the uniforms and on the underclothes. The eggs hatch out quickly so that when a man once becomes infected the lice multiply with great rapidity.