ettled States. Second, there was a huddling together of men on ccount of inadequate clothing and heating facilities and on account f cold weather. The next most affected camp was Pike, Ark., which drew from a outhern territory that is only 20 per cent urban. The mean annual ate for measles here was 511 per 1,000 men. There was no crowd g here as at Camp Wheeler, but the men lived in barracks and egregation was difficult. The next highest admission rate, 509, is ound at Beauregard, La. Here were National Guard troops from early the same territory as supplied Camp Pike; the measles was Admission Roirs per 1000 Mew Strength BEAUREGARD, La. TRAVIS, Tex. TAYLOR, Ky. DON!PHAN, Okin. CUSTER, Mich. FUMSTOM, Kans. LOGAN, Tex DEVENS, Mass. SHERMAN, Ohio GRANT, III. UPTON, M.Y. DIX, M.J. WADSWORTH, S.C. CHART NO. 52. most frequent among the drafted men. Next came Camp Bowie, ex., with a rate of 499. It is probable that this included some cases f German measles. The soldiers came from Texas and Oklahoma nd they were overcrowded in the tents. The soldiers at Camp Travis came also from Oklahoma and Texas; the rate of measles at this camp was 469. Camps Lewis and Cody, both drawing from n extremely rural territory, had each a low morbidity rate (13 and 7, respectively); but this seems to have been compensated for by he highest rates of any camp for German measles (115 and 176, espectively). In Camp Wadsworth, S. C., and other camps occuied by city troops, measles was almost absent. In the worst afflicted camps, measles paved the way for certain omplications that were much more serious than the primary disease. Thus in Camps Bowie, Beauregard, and Sevier measles was followed in many cases by pneumonia of a very fatal type. On the other hand, at Camp MacArthur, Tex., where the morbidity rate for measles was about 24 per cent that of Camp Bowie, Tex., the morbidity from the complicating pneumonia was only 2.1 per cent that of Bowie. But then the troops at Camp MacArthur were from Michigan and Wisconsin, populous States, and at Custer there was only 1 case of pneumonia following 318 cases of measles; there were, however, a number of cases of streptococcus pleurisy following measles. CAMPS Death Rafts per 1000 Mean Strength The variations in the frequency with which pneumonia follows measles was partly dependent upon crowding at the hospitals. For where the pressure on hospitals to receive new patients was great, patients convalescing from measles were discharged before fully recovered. Thus a high rate of measles in a camp caused a disproportionally high morbidity rate of pneumonia. Measles proved to be the most important of all diseases in the Army of the United States during 1917 because of the complications that accompanied or followed it. There are on our records 3,421 cases of measles with complications. The most important of these in order of frequency are: This table gives a sufficiently vivid picture of the grave menace to ffectiveness and life that an epidemic of measles brings to the Army and warrants all possible preventive and epidemilogicalrophylactic measures. Measles offers favorable conditions for the evelopment, of the pneumococcus and opens the doors, as it were, o the streptococcus. The latter, lodging in inaccessible points, tarts centers of proliferation especially in the middle ear and in he communicating mastoid sinus, from which more rarely the meninges become infected. Also the streptococcus may develop n the lungs and pleura, inducing conditions under which a large ercentage of the patients die. 5. EPIDEMILOGICAL METHODS. In some camps a rapid examination of incoming men was made t the railroad station and those with suspicious symptoms of the asopharynx or with skin erythemas were not permitted to go to he barracks. At the physical examination a more complete invesigation was made for acute cases. Quarantine became operative n some camps. Where a command was known to be infected (as t Camp Kearney, Cal.) daily examinations of the entire command. were made by medical officers, throats sprayed and precautions aken to provide the best of ventilation and greatest feasible sepaation of men at night. The cubicle system was installed in some arracks to prevent droplet infection. Special regulations were nforced against emitting discharges of nose and throat upon the round. Dust aggravated symptoms and dust storms were folowed by an increased number of men coming to sick report for neumonia, so that the practice of spraying roads with oil was introuced in some camps of the Southwest, and with apparently good esults. TABLE No. 89.—Measles, complications, enlisted men in United States, 1917. TABLE NO. 90.-Complications with fatal cases of measles, enlisted men in United States, NOTE.-Total deaths from measles, 947. Of this number 20 deaths caused by measles uncomplicated. Total admissions for measles, 47,573. II. THE PNEUMONIAS. It has been well said that, as typhoid fever was the preeminent medical problem of the Spanish-American War, so pneumonia was of the present war in the winter of 1917-18. Pneumonia has, indeed, always played an important part in war. In our Civil War, there were 61,202 cases of "inflammation of the lungs" out of 5,417,360 admissions of white soldiers for disease, or 1.13 per cent of admissions. The 61,202 cases occurred during four years when the mean strength of the white troops of the Army was 468,275, giving a mean annual rate of 32.7 per 1,000 men. Moreover, there were 14,738 deaths from pneumonia among a total of 128,930 deaths from disease, or 11.42 per cent of deaths. Our advances in the knowledge of the pneumonias have been so great that it will not be easy to compare the data of 1917 with those of 1861-1865. Nevertheless the attempt will not be without interest. As is well known, the pneumonias may be classified in various ways. By the microorganisms involved they may be classified as pneumococcic and streptococcic pneumonias. Of the former, four different types have been isolated. Again, pneumonias may be classified anatomically into the lobar and broncho-pneumonias. in 1917 it was not practicable in camps to differentiate the types of pneumococcic pneumonia to study the other microorganisms involved, cases were reported as of the two anatomical types, lobar and broncho-pneumonia. Since |