Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 9 (7).djvu/8

 New York, in the year 1905, had no fewer than 2,755 cases. Two years later, an ahnost equally severe outbreak occurred at Glasgow, at Edinburgh', and at Belfast.

The New York epidemic gave Flexner full scope for trial of the serum manufactured according to his method and tested on monkeys.

This period in the history of the disease produced important bacteriological researches, establishing beyond reasonable doubt the causative nature of Weichselbaum's coccus, and completing our knowledge of its cultural and l)io- chemical, characters.

The same period also saw the evolution of the doctrine of the carrier, a doctrine which affords the most satisfactory solution of the problem of the dissemination of the disease.

The most recent experiences of the disease are that of the present epidemics in England and in France. At various barracks and camps the disease has appeared, and, as usual, the armies in the field have almost entirely escaped.

Civilians have also suffered, a good deal of evidence going to shew that some of the soldiers have acted as carriers whilst in billets, and when on leave.

The coincidence of severe outbreaks of influenza have contributed an additional catarrhal factor in connection with the epidemiology of the present outbreak of cerebro-spinal fever.

It is principally a disease of towns. Surgeon-Colonel Reece in his notes on the prevalence of cerebro-spinal fever during the last four months of 1914, and the first six months of 1915 (Journal of the Boyal Army Medical Corps for June, 1915), gives the percentages as follows: —

Urban Districts ... ... ... ... 66*8. Rural Districts ... ... ... ... 10'3. London ... ... ... ... ... 23'3.

It is protean in nature. The period of incidence decreases with advancing age.

From the same paper I find that the first military case in 1914 was that of a Somerset Yeoman at Great Bentley, in Essex. The first symptoms of illness occurred on 19th September, 1914, he went home to Taunton on 28rd September, and died there on October 14th.

The next, of 18th October, 1914, was a soldier of the Canadian contingent in the Bustard Camp on Salisbury Plain. There had been