is chlorinated by the city of Greenville. Lyster bags were put into operation at the camp and during the period of contamination the water for use of the entire camp was boiled.

The new Thirtieth (old Ninth) Division of the National Guard was assigned to Camp Sevier. This division consisted of seasoned troops from Tennessee, North Carolina, and South Carolina. To these were added, however, considerable increments of drafted men to complete the division. The strength was reported to be about 8,000 on September 7. This number increased consistently at the rate of about 4,000 fortnightly, until November 9, when the strength was 27,000. The camp remained at about this strength during the rest of the year (Chart 27).

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

30,000

-20.000

10,000

17 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28

The leading diseases and causes of death at Camp Sevier are shown in Table No. 35.

TABLE NO. 35.-Admissions and deaths, infectious diseases, Camp Sevier, 1917.

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

The principal epidemic was that of measles, which reached its maximum development in November. Pneumonia, although much less prevalent, reached its maximum frequency during this month. Measles with broncho-pneumonia was the cause of the greatest number of deaths. Broncho-pneumonia claimed 13 and lobar pneumonia 20 deaths. Cerebrospinal meningitis was responsible for 8 deaths.

Venereal diseases were very prevalent and showed the highest frequency in September, soon after the camp opened.

A large number of ear infections followed measles-18 cases of acute mastoiditis were operated upon; 241 salvarsans were given. The epidemic of measles and pneumonia is accounted for by the arrival of an increment of 9,000 drafted men at a time when there was a sudden drop in the temperature and adequate housing was not available. These men were described as poorly nourished and badly clothed.

The physical condition of all enlisted men of this command showed notable improvement after their arrival in camp. A hookworm survey of the troops was made and an attempt initiated to eradicate hookworm infection from the camp.

19. CAMP HANCOCK, GA.

Camp Hancock is located near Augusta, Ga. As elsewhere, the latter part of 1917 was rather cold, December being recorded as the coldest for 40 years. However, no very great extremes of temperature were reached, the maximum being 70° on the 7th of November and the minimum 11° on the 30th of December. The amount of precipitation was very small. A measureable amount of snow fell in December.

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

The new Twenty-eighth (old Seventh) Division was assigned to Camp Hancock. This division consisted of seasoned troops coming from the State of Pennsylvania.

The camp early in September reached a strength of 27,000. In October the number was increased to 29,000 and in December to 32,000 (Chart 28).

The leading diseases and causes of death are listed in Table No. 36.

TABLE NO. 36.-Admissions and deaths, infectious diseases, Camp Hancock, 1917.

The record of disease is unusually small in this camp. No epidemic of any kind occurred. Four deaths only were reported, three of these being due to meningitis and one to typhoid.

The most prevalent by far are the venereal diseases. All others are very infrequent with the exception of tuberculosis.

20. CAMP WHEELER, GA.

Camp Wheeler is located 5 miles southeast of Macon, Ga., a city of 40,000 inhabitants on the Ocmulgee River. The terrain of the camp consists of broad rolling hills of sandy loam top soil underlaid by clay which hardens readily. One creek flows through the middle of the camp, with two ponds in its course, and another runs south of it. Swamps abounded in and around the camp and these had to be drained. A civil settlement occupied the center of the camp. Altogether the site was not promising.

The water supply is that of Macon. It comes from the Ocmulgee River which is contaminated. The water is filtered and treated with hyperchlorate of lime. The sewage is now disposed of through the trunk sewer of Macon.

The temperature at Camp Wheeler was cool during November; December was the coldest known in Georgia for 40 years. Both months were dry and consequently there was much dust in camp. However, on the 11th to 13th of December sleet and snow fell and did not disappear for 10 days. This cold slush, though it laid the dust, brought another kind of discomfort.

To Camp Wheeler came the National Guard from Alabama Florida, Georgia, and part of Virginia, a sparsely settled territory Troops began to arrive in September and by the end of the month there were 10,000, by the end of October 20,000 and by the end November, 23,000 (Chart 29).

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

-30.000

-20.000

-10,000

7

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

The leading diseases at Camp Wheeler during 1917 are given in Table No. 37.

TABLE NO. 37.-Admissions and deaths, infectious diseases, Camp Wheeler, 1917.

The outstanding epidemiological fact in the early history of Camp Wheeler is the outbreak of measles, followed by pneumonia, with many deaths. On the occasion of a personal visit the Surgeon General reported (November 26, 1917):

There had been a sharp epidemic of measles, some 3,000 cases and, as always occurs with measles, a certain number of cases of pneumonia. At the time of my visit there were some 300 cases of pneumonia in the hospital. While the hospital was crowded.

the right of way was given the pneumonia cases and they were being well cared for. In the past month there have been about 60 deaths from pneumonia.

I think the reason for the measles affecting so severely this particular camp is the fact that men came from the surrounding Southern States which are sparsely settled and therefore the inhabitants do not, as a rule have measles in childhood. Whatever the original cause of the epidemic and the present conditions, all these evils are accentuated by the crowded condition of the camp. The tendency to pneumonia has no doubt been increased by the fact that the men have generally been exposed to the cold weather of the past month with no other protection than their summer clothing. Clothing is now rapidly coming to the camp and about two-thirds of the men are supplied with woolen garments.

It was recommended that all men in the camp should have 50 feet of floor space each; that no fresh men should be brought into the camp until the epidemic had subsided; that an observation camp should be established and that all men were to be kept under observation until the main camp was free from infection.

The division surgeon offers additional data (Dec. 1, 1917):

The epidemic of pneumonia in the Thirty-first Division had its true beginning on October 21, six days after the first selective-draft men arrived in camp. Previously. there had been a few sporadic cases, never more than 9 at one time. On October 14 there were 3 cases, on October 21, 13; the number gradually increasing until, on November 1, there were 29; on November 10, 68; on November 20, 137; and on November 30, 326 cases.

The etiology of the disease, and the factors favoring its progress are given as follows: physically defective men, 60 to 70 per cent affected by hookworm; inadequate clothing; exposure at drills and even at mess; dust from camp roads, company streets and tent floors; herding in stoveless tents by day and sleeping often two on a small cot in a vain effort to keep warm; an epidemic of measles, brought in chiefly by draft men; an epidemic of bronchitis and other respiratory diseases, with coughing, sneezing, and expectorating in tents, streets and mess halls; and too early return to duty after measles. Of 50 pneumonia cases 12 were returned to the base hospital after having been discharged as cured of measles-3 after 1 day, 1 in 3 days, 2 in 5 days, 4 in 7 days, 1 in two weeks, and 1 in 3 weeks. Of 294 cases returned from the base hospital to the One hundred and twenty-fourth Infantry as cured of measles during the month of November, 30.8 per cent were sent to the hospital with bronchitis or pneumonia.

The rise and decline of measles and pneumonia and the relation of the second to the first are brought out in the following table, which is offered with the warning that it cannot be compared closely with the monthly record in which the admissions are classified somewhat differently.

About 116 cases of pneumonia were preceded by measles, or about 15 per cent of all pneumonias, with a mortality of about 51 per cent. This incidence of lobar pneumonia, secondary to measles,