is selected as the commonest and one of the most easily detected of the venereal diseases.

An inspection of this table shows that for each Army there was a period of rapid increase followed by a reduction in the monthly increase. This reduction is usually due to the fact that regiments or divisions were withdrawn from the United States, but in part is due to a reduction in recruiting, as in September and October, 1917 (Chart 9). If now we select those months when each Army was most

rapidly increasing we shall have the desired increments to compare with the admission from venereal disease and Table 97 has been constructed in accordance with these principles. Using the ratios thus deduced we are in a position to answer various inquiries about the relative prevalence of venereal disease in the Army and in civil life.

4. IS VENEREAL DISEASE MORE OR LESS FREQUENT IN THE ARMY THAN IN CIVIL LIFE?

This is a frequent inquiry, but for reasons stated above it is impossible to give a precise answer. It appears from Table 109 that the most probable proportion of gonococcus infection in the males of draft age is between 2 and 3 per cent.

We may perhaps get a more precise estimate by dealing with the figures for the National Army alone. Up to the 31st of December about 465,000 enlisted men had been inducted into that Army, and there had been 12,351 admissions for gonorrhea in this Army. Assuming 11,000 of these cases have been detected at time of mobilization we have 2.37 per cent infected. Since gonorrhea was not a cause of rejection by local boards or elsewhere, this would appear to give a fairly close estimate of the proportion of persons, age 21 to 31, in civil life who at a given time have obvious symptoms of gonorrhea. In camp the initial cases of gonorrhea have been cured. In consequence of Army ideals and restraint, and in consequence of Army medical prophylaxis, relatively few new infections are gained each week, and since cases of gonorrhea that do come to sick report are mostly cured in a few weeks, the number of current venereal diseases in the Army camps is remarkably small; and much less than the present components of the Army had before they were inducted into military service, and before they had undergone the medical cleaning up that accompanied that induction.

5. COMPARISON OF FREQUENCY OF GONORRHEA IN WHITE AND IN

COLORED TROOPS.

It has already been shown that, using the total admission to sick report, there is about 2.5 times as much gonorrhea among colored as white recruits. This result may be tested by the method of ratio of admission for gonorrhea to, increments of white and colored respectively.

Of the 465,000 National Army men who have been examined up to December, 1917, probably about 3.3 per cent were colored. Of the 12,351 admissions for gonorrhea in this Army 6.55 per cent were for colored troops-almost exactly twice the rate for whites.

As

Again the mean strength of the American troops in the United States Army, December, 1917, is given as 1,450,462, and that of January, 1917, as 200,224. Consequently, there were admitted to the Army during 1917 at least 1,250,000 men, and, indeed, some thousands more-let us assume, for the sake of calculation, 1,300,000. suming that no man was admitted twice to sick report for venereal diseases of all sorts we would have 71,955 men admitted, or 55 persons out of every 1,000 troops so admitted (including old infections in recruits and new infections). Making similar assumptions for white troops we have, for 1,250,000 white men entering and remaining in the Army, 66,903 admissions to sick report for venereal diseases, or 53 white enlisted men admitted out of every 1,000 in the Army. Of colored troops we have 45,000 enlisted men 5,052 admissions to sick report for venereal disease, or 112 colored persons so admitted out of every 1,000 strength. Here, again, there are relatively twice as many colored as white recruits (and troops) admitted to sick report for venereal disease.

At the time of physical examinations at camps, 2.23 per cent of the recruits were found to have gonorrhea, according to later statistics.

The average enlisted strength of selected camps in the United States in December was 857,563, of whom 29,3 5 were colored, or 3.4 per cent. The Adjutant General gives for the whole Army in the United States a mean strength of 1,248,172 in December, of which 38,555 are colored, or 3.1 per cent.

6. RELATIVE AMOUNT OF VENEREAL DISEASE IN THE THREE ARMIES. IS THERE A DIFFERENCE IN THE INCIDENCE OF VENEREAL DISEASE IN THE REGULAR ARMY, THE NATIONAL GUARD, AND THE NATIONAL ARMY?

Considering the mean annual rate of venereal disease per 1,000 as given in Table 102, it appears that the rate for white troops is 114 for Regulars, 120 for the National Guard, and 90 for the National Army. and, among colored troops, 352 for the Regulars, 590 for the National Guard, and 213 for the National Army. In general, the annual admission rate is least in the National Army, greater in the Regulars, and greatest in the National Guard, in the ratio of 95:120:124.

This comparison of ratios is not altogether satisfactory in view of the fact that the armies grew at so very diverse rates; so that the diseases brought in by increments played a very diverse part. So a new table (Table 97) was made giving for the various armies the relation of admission to sick report for gonorrhea to increments of the armies, as shown (in part) in figures 10 to 39.

1 See (in part) Report of the Adjutant General of the Army to the Secretary of War, Washington, 1917, Table B.

A study of Table 97 shows plainly that only certain selected portions of it can be used for our purpose. Thus, of the Regular Army, we can make use of only the months of April, May, June, and July. Later than that the increment is not significant, since troops were going overseas and the apparent increment in the United States is merely the difference between the additions by recruiting and the subtraction of the overseas troops. To divide the total number of admissions from gonorrhea by this difference tends to give an absurdly high figure. For similar reasons we take the National Guard figures for April to August inclusive only. For the National Army we take the period September to December, inclusive. On these assumptions we find in the Regular Army 3,483 admissions at a time when 157,000 recruits are being received, or 22 per 1,000 recruits. In the National Guard 5,010 admissions occurred at a time when 265,000 men were being enlisted, or 19 per 1,000. In the National Army 12,227 admissions at a time when 452,000 were being inducted

E

nto service, or 27 per 1,000 men. On this basis the relation of infecion in increments of the National Guard, Regular Army, and Naional Army, is as 19:22:27.

Here again we reach the conclusion that the amount of active gonorrhea in our white civil population among men of age 20 to 35 is at one time only about 2 per cent.

We can reach a comparison of the proportion of venereal disease between volunteers (National Guard) and drafted men by comparing the ratio of admissions for gonorrhea to increments in the National Guard camps and in the National Army camps. This comparison is made in Table 98. In this comparison the drafted men show a higher incidence of venereal disease than volunteers in the ratio of 167 to 126 or as 4 to 3. Since the other comparison gives the relation of National Guard to National Army as about 5 to 3, it is probable that the facts lie between the two results or as 4.5 to 3 or 1.5 to 1. That is, the drafted men showed about one and one-half times more venereal disease than the volunteers. But it is to be recalled that a large part of the increments to the National Guard had previously seen service, had been cured of venereal disease and had the benefit of knowledge as to prevention and prophylaxis acquired in the Army.

TABLE NO. 98.-Gonorrhea, by increments, by camps.

7. RELATIVE FREQUENCY OF VENEREAL DISEASES IN RURAL VS. URBAN RECRUITS. ARE RECRUITS FROM THE CITIES MORE LARGELY INFECTED WITH VENEREAL DISEASE THAN THOSE FROM RURAL DISTRICTS?

Using method of admission to sick report in relation to increments, camps are first separated into two groups (a) the urban group, including camps that received troops from a population of high density (as shown in Chart 47) and (b) the rural group, of which the tributary population came from regions of low density. Further

more, the National Army and National Guard camps are treated separately. Then the total admissions to sick report for gonorrhea from any group are divided by the total increments in that group. The ratio is expressed per 1,000. The results are that in National Army urban camps the rate of admission for gonorrhea is 10.2, in National Guard urban camps 8.5, all urban camps 9.7 per 1,000, of increment. On the other hand in National Army rural camps the rate is 21.5; in National Guard rural camps 14.4; in all rural camps, 18.3. That is, there is almost exactly twice the amount of gonorrhea among rural recruits that there is among urban recruits. The difference in racial constitution (white and colored) of urban and rural communities does not significantly influence this result.

Incidentally, this table reveals the excess of venereal disease in the increments to National Army over those to the National Guard camps that we have seen before. The ratio is about the same as before (124:159) although not all camps are included in both tables.

TABLE NO. 99.-Gonorrhea by increments by camps by months.

8. HOW DOES THE RATE FOR GONOCOCCUS INFECTION IN THE ARMY IN EUROPE COMPARE WITH THAT IN AMERICA?

Rumors have been spread of the great amount of venereal infection among our soldiers in France. Is there any justification for these rumors? The statistics give a mean annual admission rate for gonorrhea of 36.24 per 1,000 in Europe and 82.47 in the United States. Also among colored troops of 66.4 per 1,000 in Europe as compared with 203.04 per 1,000 in the United States. The figures are thus larger for troops in the United States than for troops in Europe. Conclusions may be drawn from this statistical result only with caution.