Venereal diseases.-These were nearly all brought in by recruits. Of the infections got by men already in the service seven were contracted in October, seven in November, and five in December.

14. CAMP GORDON, GA.

Camp Gordon is located at Chamblee, Ga., within 10 miles of the capital city of Atlanta (154,839). The region is agricultural and is on the edge of the black belt of the State. The ground of the cantonment is naturally rolling, with some turfed and wooded areas. Prior to occupancy by the Government the site was dotted over with unsanitary farmhouses, barns, and outbuildings, from which wells and streams were contaminated and around which were numerous breeding places for flies. These unsatisfactory conditions were remedied during the construction of the camp by tearing down all old buildings, closing polluted wells, placarding streams, burning over and plowing under suspected places, and thoroughly policing the entire area.

The water supply is obtained from Atlanta, being delivered to the camp through an 18-inch main. The city supply is taken from the Chattahoochee River, sedimented in large impounding areas, and made fit for use by treatment. The sewage plant consists of the standard septic tank, sprinkling filters, and secondary sedimentation tanks. It worked unsatisfactorily. One menace to the health of the camp was the unsanitary condition of the cheap lunch and softdrink stands in the village of Chamblee.

November at Camp Gordon, though colder than is usual for the region, was a pleasant month, with 16 clear days. Temperature ranged from 73° on the 8th to 25° on the 25th. December had the lowest temperature rate for that month, recorded in Georgia for 40 years. Temperature ranged from 68° on the 2d to 8° on the 9th. Rainfall was greatly below normal; there was but a slight snowfall. There were 17 clear days.

To Camp Gordon were called from civil life the following contingents:

These men were from the States of Georgia, Tennessee, and the Southeastern counties of Alabama. The territory included Atlanta. (154.839), Memphis (131,105), Nashville (110,364), Savannah (65,064), Augusta (41,040), Chattanooga (44,604), Macon (40.665), Montgomey (38,136), and Knoxville (36,346). Taken as a whole the territory from which Camp Gordon drew its men is 18.5 per cent urban, ranking next to the last of the cantonment areas in order of urbanity.

The strength of the camp at different dates is shown in chart 23. The population was extremely irregular, falling off abruptly in October and then rapidly increasing by transfers to a maximum of 38,000 in the middle of December, after which it abruptly declined again. Approximately 1,700 colored recruits entered the camp in October; there were 700 remaining in December.

87894-186

Polygon of weekly strength of Camp Gordon measured by scale on the left.

[Increments are indicated by dotted rectangles of which the unit, 1,000 men, is represented by the smal rectangle above the polygon.]

7 14 21 28 5 12 19 26 29 16 23 30 7 14 21 28

The leading diseases at Camp Gordon are shown in the accompanying table:

TABLE NO. 31.-Admissions and deaths, infectious diseases, Camp Gordon, 1917.

1 Figures in parentheses indicate number of colored troops in venereal disease only.

Gonorrhea was responsible for the largest number of disease, admissions from September to December, with measles ranking next. Camp Gordon stood fifth in the rate of incidence of both these diseases. Out of 285 new cases of venereal disease (the camp sanitary inspector reports) 259 were contracted prior to entering the service. The measles epidemic reached 495 cases in December and did not begin to decrease until the middle of January. At first it was regarded as

of a mild type, little complicated by pneumonia, but at the end of December and still more in January pneumonia following measles increased in frequency and fatality. At the end of the year clothing was still insufficiently supplied. Meningitis never reached such an alarming frequency as at Camp Jackson and the mortality was low. The cases were widely scattered throughout the camp. Every effort was made to secure early recognition of the disease and inspection of contacts. German measles was troublesome, totaling 114 cases in December. Admission of tuberculosis in December exceeded those of any other National Army cantonment except Camp Dodge.

15. CAMP PIKE, ARK.

Camp Pike is situated about 3 miles from the city of Little Rock, Ark., on a plateau 500 feet above sea level, between the Arkansas River and Five Mile Creek.

The weather at Camp Pike was dry and mild during November, 1917. In December it was exceptionally dry and cold; a temperature of 5° was reached on the 9th of the month and there were 12 clear days. There were no snowfalls.

The water supply of Camp Pike comes from the city of Little Rock. It is a mixture of clarified water from the Arkansas River and wells, the latter being used when the Arkansas River supply needs to be diluted on account of excess of sodium salts. The sewage was discharged into a septic tank and effluent ran down the bed of a small creek.

To Camp Pike were called from civil life the following contingents:

These men came from the States of Arkansas, Louisiana, Mississippi, and the western part of Alabama. This territory includes. Little Rock (50,000), Fort Smith (30,000), New Orleans (370,000), Shreveport (30,000), Meridian (25,000), Birmingham (150,000), and Mobile (60,000). Taken as a whole, the territory from which Camp Pike draws is 20.3 per cent urban, being near the last in rank of urbanity.

The strength of the camp at different dates is shown in Chart 24. The rise of strength was varied until October 12, when there were nearly 24,000 troops in camp. Most of the original command, consisting, as we have seen, of men drawn from a rural territory, was sent to southern militia camps as the epidemic of measles became severe, and it was gradually replaced at Camp Pike by drafts of men taken from cantonments farther north. Thus the strength slowly declined until November 25, after which it mounted by transfers from other camps to nearly 32,000 at the end of the

year.

Polygon of weekly strength of Camp Pike measured by scale on the left.

[Increments are indicated by dotted rectangles of which the unit, 1,000 men, is represented by the smal rectangle above the polygon.]

40.000

[] = 1000 Men

-30,000

-20,000

-10.000

E

7 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28

The leading diseases at Camp Pike are given in Table 32.

TABLE NO. 32.-Admissions and deaths, infectious diseases, Camp Pike, 1917.

1 Figures in parentheses indicate number of colored troops in venereal disease only.

The high admission rate of Camp Pike, especially of measles, of its complications, and of primary lobar pneumonia, resulted in a visit by the Surgeon General on December 5, 1917. After citing the alarming figures of admissions to sick report and of deaths, the Surgeon General continues:

The figures indicate a serious condition of affairs at this camp. The principa cause of measles, as has been pointed out in other camps, is that a large number the troops come from the sparsely settled States, and have not had measles befor:

*

*

*

Of the 16 cases of meningitis occurring within the month, 10 came from Fort Filey. This is an illustration of the way one camp can infect another by means of cases brought by incoming troops. Crowding in this camp I do not think exists to any appreciable extent. * Within the last 15 days 8,000 new men have been introduced into the camp. It is possible that when these 8,000 men begin to show infection, we will go through an epidemic similar to that which we have just passed. However, as most of these men come from the thickly populated State of Iowa, I do not think it probable that they will have measles, as several of the men have just been through the epidemic.

One great difficulty here is lack of segregation. In Camp Bowie, for instance, if we get a case of meningitis in a tent of 9 men, it is a very easy matter to segregate these 9 men and determine whether or not they have been infected here. With a squadroom containing 120 men this is much more difficult.

Measles. As the table shows, measles appeared in camp in September with 43 cases, rose to 980 in October, and to 1,943 in November; then diminished slightly to 1,288 in December. Practically the entire command was infected. The abatement of the epidemic resulted largely from the exhaustion of susceptible material. An attempt has been made to trace the origin of the measles to the First Arkansas Infantry, which guarded the camp during construction and which had suffered severely from measles. Measles were also prevalent in Little Rock and adjacent territory.

Pneumonia. As the table shows, primary lobar pneumonia was common and the case mortality high, probably not far from 20 per cent. For lobar pneumonia following measles, the case mortality was over 40 per cent. Primary broncho-pneumonia was fatal in 13 per cent of the cases and broncho-pneumonia following measles in 40 per cent. On account of the crowding of the base hospital by measles, many cases were discharged prematurely and consequently were specially susceptible to pneumonia.

In the pneumonia wards each bed was screened; paper handkerchiefs to be used only once were provided, and the ward was scrubbed daily with an antiseptic solution. There were 54 cases of empyema, complicating pneumonia, with 9 deaths. Many ear complications followed measles. At the base hospital 30 operations were performed for acute mastoiditis.

Scarlet fever. There was an epidemic of this disease, as many as 196 being in the hospital on December 15. In many cases this was complicated by pneumonia.

Mumps. An epidemic started in November, with 123 cases. This increased to 344 in December. With the new year the epidemic declined. No deaths occurred, but some cases of orchitis.

Venereal diseases.-The high venereal rate appearing in the statistics is due to old cases found in drafted men. The admission rate for new cases, acquired since connection with camp, is stated to average 3 per 1,000.

Meningitis.-There were 32 cases of this disease and 7 deaths. Of these cases approximately 11 came originally from Camp Funston, with a transfer of troops. The cases occurred spasmodically and there was no area which could be located as a focus of infection. A considerable number of the meningitis cases have followed suppuration of the middle ear, consequent upon infected tonsils. The camp surgeon states that many patients refuse tonsillectomy, some of whom subsequently die of a streptococcic meningitis. He lays stress on the seriousness of the psychological barrier.