Page:The Armed Forces Institute of Pathology-ItsFirstCentury.djvu/155

TRIUMPH OVER TYPHOID surgeon "in recognizing nearly half the cases of typhoid fever * * * probably did better than the average physician throughout the country does in his private practice " 13

Typhoid fever, the report found, "is disseminated by the transference of the excretions of an infected individual to the alimentary canals of others." Infected individuals included those in the early and undiscovered stages of the disease, and also convalescents who had passed through the attack but continued to excrete typhoid bacteria. 14 The existence of "carriers" who were not themselves suffering from the disease was not known until 1907, when the report on the original "Typhoid Mary" was published. 15

Contrary to the general belief— and a belief held by the Board itself at the outset of its investigation — that typhoid was primarily a waterborne disease, it was found that "infected water was not an important factor in the spread of typhoid in the national encampments in 1898." Transmission through the air in the form of dried dust carrying the bacilli of typhoid was regarded as "probable * * to some extent" and it was looked upon as "more than likely that men transported infected material on their persons or in their clothing" — a likelihood rendered all the more likely by the fact that "camp pollution was the greatest sin committed by the troops in 1898" and by the prevailing practice of detailing men from the ranks on a day-by-day basis to act as orderlies in the hospitals. 16

A new villain in the transmission of the disease was fount! in the flies which served to convey the infected organisms from their source to a person. To the modern generation, living in a wire-screened and stableless environment, and trained from childhood to swat the fly, the idea of the fly as a carrier of disease is commonplace. In 1898, however, when schoolchildren were exhorted to emulate the fly in its supposed neatness, evidenced by constant rubbing of its wings with its legs— "washing" itself, it was thought to be— the idea that the common fly was a carrier of deadly disease was novel. General Sternberg, in his Circular No. 1, issued on 25 April 1898, had suggested the possibility of flies as a source of infection in typhoid, camp diarrheas, and perhaps yellow fever. The statistics gathered by the Typhoid Board showed that men who