FIGHTING DISEASE IN WAR

Nelson Evening Mail, 18 July 1916, Page 6

FIGHTING DISEASE IN WAR

ELIMINATING EPIDEMICS. FORMS OF -SHELL-SHOCK." Nothing has been more remarkable in the experience of the war titan the absence of epidemic disease in the British expeditionary force in France since it settled down to the occupancy of the trendies many months ago, writes a war correspondent. The scourge of armies, typhoid, which caused 8000 deaths in the South African war, has been reduced to an ineffectiveness which would have been, thought impossible beforehand. Dysentery has claimed very few men, and the other epidemic disease, cerebro-spinal meningitis, was more of a curiosity than anvthing else. This excellent state of affairs is very largely due to the preventive and sanitary measures that have been taken, and Hiis is specially the case with regard to typhoid. Setting aside the preventive efficacy of inoculation, the immunity from epidemics can bo chiefly attributed to the steps taken to remove from the military zone at once any person who might originate a typhoid epidemic by conveying the germ of the disea.se to others. No soldier who contracts typhoid is allowed to mix with others till he has satisfied the bacteriologists that he is free from the germ. The precaution would by itself be unavailing if the civilians of villages in the war zone who were potential carriers of infection were allowed to remain there. They. too. have been examined by the bacteriologists, and anyone who proves to he a carrier is removed. The time for the setting up of an epidemic is when the men are hungry, harassed, toil-worn, their vitality lowered. Such an occasion arose immediately after the retreat from Mons. but the typhoid outbreak was at once suppressed and held in hand -

CLOCKWORK SYSTEM. Another outbreak, in the civilian population, occurred when the battered train of desolate Belgian refugees swept through Flanders across the lines. That, too. a much more serious outbreak, was also subdued. But at the present time, with men well fed. well clothed, and a system organised like clockwork, epidemic disease cannot easily find a foothold and cannot assume a general offensive.

The far more disabling disease has been that of trench-foot, which ought not to attack men when proner precautions are taken, but is very damaging when they are not. Other rather mysterious affections are a form of nephritis and a condition of the heart which may arise from over-strain. In this conditio:) the blood pressure appears to be out of gear, and it has been suggested that some sort of neurasthenic condition may be at the bottom l of the trouble. Probablv the effect of war conditions on the nerves may be responsible for manv nhvsical states that are otherwise myi terious.

WORK OF THE NEUROLOGISTS That is a medical problem, in which however, a new organisation of inquiry promises- a good deal of amelioration, both now and in the future. The Medi cal Research Committee has united all the neurologists who attend the bast* hospitals in Franco or at- home to examine and report on all nervous case> on a common plan. As the ablest and most distinguished neurologists are included in this scheme, and as they exchange results and meet to discuss cases, the best kind of treatment is secured, and a mass of invaluable information is being obtained.

But the cases as tliev show no *rreat divergence from those which neurologists of wide experience meet with m civil life. "'Shell-shock" covers a great many conditions. All, however can be classified under headings already known.

EFFECTS OF CONCUSSION. The simplest form is that of concussion caused by- the wind of a bursting high explosive. The symptoms are those of other kinds of concussion; the patient has no memory of the arrival of the shell, .because all consciotisness was obliterated by what took jjlace for some time before. The same unconsciousness the same complications, follow ; the same treatment of rest in bed is prescribed.

But another form of actual injury from shell-shock produces a, more mysterious effect. The soldier's memory is •'•ontinuous; he remembers everything-, but he becomes dazed, like a much-pun-ished boxer at the end of a. heavy fight. His conduct becomes "curious:" "his actions indeterminate. For this man, too, there is nothing but rest.