The Division of Internal Medicine, Tuber culosis and Cardio-Vascular Diseases selected expert examiners to eliminate the physically unfit and to guide defective men to treatment calculated to restore them to future efficiency in military and civil life. Hundreds of thousands of examinations for tuberculosis and diseases of the heart were made. This division provided hospitals for incipient cases of tuberculosis as well as for advanced cases. It also provided for examinations of gastro-intestinal diseases.
The Division of Infectious Diseases co operated with the Division of Sanitation by selecting bacteriologists, pathologists and other laboratory men, establishing and fitting out laboratories for army posts and mobile units for general, special and research work, a labor atory being attached to every army post, mobil ized division and army corps. Tests of blood specimens and analyses of stomach contents and water analyses were made in these laboratories. The medical officer is held responsible for the application of approved methods for preventing the spread of infectious diseases, the three infections most dangerous to armies being venereal, the pneumonias and cerebrospinal meningitis. Typhoid and paratyphoid are con trolled at the start by vaccines, the efficacy of which was first developed by Sir Almroth Wright. Quarantine guards against measles, diphtheria and influenza; diarrhoea and dysen tery are kept to the minimum by pure water, pure food and reduction of the fly nuisance. Modern medical science keeps away, the old plagues of army camps — cholera by Isolation, disinfection and vaccine; and spotted typhus by delousing and hot shower baths. Such cases of gout, rheumatism and Bright's disease as i occur were brought into the army when the patient enlisted.
In the early stages of the World War, tetanus was common in the European armies, but it has now been practically eliminated. Research into causes of trench fever and tests in which the famous 66 volunteers from among the Americal soldiers played an important part, have led to the discovery that its transmission was due to the bites of body lice. An appro priation of $100,000 and co-operation and re search with French and British surgeons are to be credited for this achievement. Trench fever had been incapacitating 8 to 10 per cent of the British troops during 1916-17 for periods of from two to three months. The importance of eliminating body-lice or "cooties" led to provision for delousing apparatus, with twin disinfecting chambers mounted on a five-ton lorry so that operation could be carried on near the trenches. Steam at five pounds pressure
was passed through the air-tight chamber con taining clothing to be treated, killing all living matter. Eggs remaining in seams after the disinfecting operation were removed by stiff wire brushes.
The Division of Urology (genito-urinary dis eases) looked after the prevention of venereal diseases by employing prophylactic, sociological and educational measures — through the en forcement of public health and vice laws, rec reation for the soldier, educational measures such as lectures, moving pictures, exhibits and literature, and also through thorough prophy lactic treatment and segregation. It published a manual on venereal disease, in co-operation with the Council of National Defense Com mittee for Civilian Co-operation in Combating Venereal Diseases, and with the War Depart ment and Navy Department Commissions on Training Camp Activities. There was strict en forcement of the provisions against alcohol in the five-mile zones surrounding camps, and can tonments and against prostitution within ten mile zones. This work in the civilian territory adjacent to the camps and cantonments was placed under the United States Public Health Service of the Treasury Department in the summer of 1918.
The Division of Psychology sought to elimi nate the mentally unfit and to make possible the placing of men according to ability. All company officers and enlisted men were ex amined and the mentally superior encouraged by assignment to duties for which they were evidently fitted. Of the 150,000 examined by this division, more than 1 per cent were rejected as mentally unfit for military service. The Division of Neurology and Psychiatry was or ganized because it was the experience in the Allied armies that a large number of neurotic, mental and other defectives were found, who soon became useless for field service. While physically sound, they were incapable of be coming soldiers because of insanity, mental de fect, epilepsy, drug habit or other nervous dis orders. This division took special charge of victims of the varieties of °shell shock," who are cared for in a base hospital specially set aside for such cases, and it also had charge of asylums for insane and of the men in the nervous and mental wards in the military hos pitals.