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volunteers and kept there thirty days till the fever developed. After forty-eight hours lice were re- moved from half of the volunteers, and put on other . volunteers, to exclude possibility of mechanical transmission, directly from patient to individual. It was proved that the virus carried the infection. The lice were put on the arm in a piece of old undershirt, so that eggs and larvae were repro- duced normally, and these were strapped on and the men were allowed to scratch so that normal skin irritation was produced. The inoculation pe- riod after biting was nineteen to twenty-five days as compared with five to six days with the plasma in- fection. The conclusions from these experiments were that first, direct transmission was not essential ; secondly, if lice carried the disease, measures should be taken to eradicate the lice, a not imprac- ticable procedure. In connection with this paper, Dr. Thomas B. Futcher, of Baltimore, told how he had had an opportunity of seeing cases of trench fever in an English base hospital. Distressing noc- turnal pain was a symptom of the disease. Sir David Bruce had conducted some experiments in 484 PROCEEDINGS OF NATIONAL AND LOCAL SOCIETIES. [New York Medical Journal, the Hampstead hospital. He found that if lice that had bitten trench fever patients were allowed to hite volunteers, the results were negative as far as transmission of the disease was concerned. It was not stated how long the lice had fed on trench fever patients. In discussing these experiments it was asked if the patients had been allowed to scratch and it was found that the)' were prevented from scratching. Another series of experiments were then started. The arms of the volunteers were scarified. The lice were allowed to bite and the bodies of the lice were rubbed into the abraded surface. In seven days the volunteers developed trench fever. Dr. E. L. Opie, in conclusion, said that he had not tried scarification experiments. It seemed to add little to the knowledge obtained by injecting whole blood, but there was obviously possibihty of introducing the virus directly through the skin.__ The incubation period of seven days corresponded" to that when whole blood was injected into the circulation. Pneumonia in the Army Buy Sildalis Camps. — Dr. Rufus Cole, of New York, gave his experience in one army camp where Doctor MacCallum had charge of the pathological work. Pneumonia among soldiers was a most serious disease. Previous ex- perience on the Mexican border had convinced the authorities of the seriousness of the condition. The past winter had shown alarming increase of* pneu- monia and a high incidence of measles. In study- ing types of pneumococci, many abnormal types were encountered. At Camps Wheeler and • Bowie Doctor Zinsser and Doctor Dochez found that many cases were due to streptococci. Under the direction of Colonel Russell, a study was then made of all types of pneumonia. Two definite types were discovered. The first type occurred in the measles ward, where there were many cases of severe pulmonary infection. These were similar to cases seen by the pediatrician and not usually seen in adults. The patients were mentally alert and extremely anxious. There was intense respiratory disturbance and deep cyanosis. The physical signs differed greatly from lobar pneumonia, there being few signs of consolidation. In cases which came to autopsy Doctor MacCallum found small hemor- rhagic spots on the lungs. The alveoli were con- gested and contained blood. The later lesions showed small punctate areas with opaque forms resembling miliary tubercles. Purulent exudate was found in the bronchioles. This pneumonia following measles was often mistaken for miliary tuberculosis. Streptococci were found in the sputum of these patients, and shortly before death in the blood stream. The second type of the dis- ease, in the pneumonia wards, resembled the cases seen in civil life. These cases had pneumococcus infection and the mortality was lower. There was increased prevalence of empyema. Often there was double infection. At autopsy both streptococci and pneumococci were found. Three types were distinguished at autopsy: Acute pneu- monia, of the ordinary type ; bronchial interstitial pneumonia, due to streptococci, and interstitial bronchopneumonia. In other camps there had been cases of streptococcic empyema without pre-

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