For Convalescents Taking for granted, of course, We might explain why H-O is the But no! We ask you to try H-O HO THE ONLY STEAM-COOKED Oatmeal The H-O Company, Buffalo. NY Members U. S. Food Administration License No. G-12996 See For Nervous and Mental Diseases and Selected Habit Cases. Seven New Buildings, four of which are residential. Grounds comprise 75 acres of woods and lawns. Recreation: In Summer-Golf, Tennis, Lawn Bowling, Croquet and Quoits. In Winter-Gymnasiums, Bowling Alleys, Billiards, Skating, Skiing, Snowshoeing, and Tobogganing Diversions-Occupational Rooms, Music Rooms and Library. Treatment-Daily Medical Attention, Hydrotherapy, Electricity and Massage. Accommodation-Single Rooms, Rooms with Bath, or Complete Suites. A Good Cuisine. GUELPH is situated on the Grand Trunk and Canadian Pacific Railways, seventy miles from Niagara Falls. Rates are reasonable. For information apply to A. T. HOBBS, Medical Supt. ᄆᄆᄆ Typhus Fever. By Dr. A. L. Lincecum, Captain M. R. C., El Campo, Texas.. 39 45 Crime and the Human Family. By Henry J. Girvin, Chief Buffalo Police 48 75 Abstracts, at end of original articles, on advertising pages and.. Price of Single Copies of this Magazine, 20 Cents. Alf. E. Tovey, Printer BUFFALO MEDICAL JOURNAL Yearly Volume 74 SEPTEMBER, 1918 ORIGINAL ARTICLES Number 2 The right is reserved to decline papers not dealing with practical medical and surgical subjects, and such as might offend or fail to interest readers. Contributors are solely responsible for opinions, methods of expression and revision of proof. Typhus Fever. DR. A. L. LINCECUM, El Campo, Texas; Captain M. R. C. Typhus, ship, prison or spotted fever, exists in practically all the civilized countries of the world open to our commerce and from which soldiers are likely to be drawn to the western front. It is an acute infectious fever, unquestionably due to a specific germ but the exact organism has not been demonstrated and it would be idle to speculate as to its nature, whether bacterial or protozoic. However, as with yellow fever, while we do not know the exact organism we do know the method of transmission, namely by the bite of the body louse, apparently not by other species. The bed bug has also been incriminated with some degree of probability and it is possible that other insects may serve as carriers but the disease is no more contagious than yellow fever. In fact, after thorough delousing, I have had patients cared for in houses occupied by persons free from the disease, without their developing it. Typhus is endemic in Mexico where frequent epidemics occur in winter. It is from this source that the disease is mainly introduced into the southern and southwestern states. At times it is traced or probably due to individual Mexicans or returning Americans who have crossed the border surreptitiously without inspection and delousing. For example, a Mexican was found by a police officer reeling along the streets of a Texas town, was arrested and put into the jail. He died within a few days and was buried without having any special attention directed to his case but, whether he was actually suffering from typhus and whether his arrest for drunkenness was warranted or due to the weakness of disease, or whether he merely served to convey infected lice to the jail, seven other prisoners shortly after his death, developed the disease. The incubation period of the disease is about 12 days but the danger may persist almost indefinitely in premises in which lice have not been destroyed. Two special sources of menace to the U. S. may be mentioned. Mail bags loaded at, say, Mexico City are shipped under guard of Indians who are practically universally lousy and who sleep on the bags. During the disturbances which have existed in Mexico for several years, various leaders have held back freight cars from the U. S. to transport troops, and lice have been found in these cars even after they had been sealed up for three or four weeks. Paradoxically, the persistence of lice under such circumstances, is due to their habit of destroying one another. They are markedly cannibalistic and it is literally a case of the survival of the fittest. For example, in one experiment, three species of lice and several other insects were placed in a bottle. In the course of a few days, only the most vigorous of one species of lice remained. It is obvious, from the almost universal reports of infestment with lice in the trenches, that it is largely a matter of accident that typhus has not been prominent on the western front as it was in the Balkans and an appreciation of the means of conveyance and of prevention, as well as the ability to recognize the disease early, are matters of military preparedness. A typic, severe case of typhus begins almost without prodromes; with sudden chill, agonizing pains in the back, head and extremities so that it might well be mistaken for meningitis. Indeed, the differential diagnosis must depend upon the results of examination of spinal fluid withdrawn by lumbar puncture. Muttering delirium or maniacal symptoms may also occur. Or, there may be bronchitis with cough. Again, the disease may be marked by obstinate vomiting and alimentary disturbances. Haemorrhages may occur, either assuming the form of haemoptysis or haematemesis. As in various other general infections, haemorrhagic cases are likely to be malignant. Superimposed typic temperature charts of typhoid and typhus resemble each other greatly at first, though the rise in typhus is usually more rapid and a temperature of 105° is quite uniformly reached on the second or third day, while the morning remissions are less than in typhoid, being very close to one degree below the evening temperature. However, the tongue also resembles that of typhoid in the general initial redness and subsequent light coat and the early differential diagnosis may be extremely difficult; indeed, if typhus is not known to exist, an error in the early stages of the first case encountered is almost |