Foreword With the October 1943 issue, The Bulletin became a monthly periodical, instead of a quarterly, dedicated to keeping the personnel of the Medical Department informed on developments in war medicine. The new publication, known as The Bulletin of the U. S. Army Medical Department, absorbed the former quarterly dental and veterinary bulletins and will have material devoted to those fields in each issue. The Bulletin is intended to be educational rather than directive in nature. It will contain the best information obtainable concerning military medical experience, observations, and procedure that may help to improve further the quality of professional services. The Bulletin will be a medium whereby experience gained in one theater of combat may be shared with those serving in other combat areas and with those in this country who are preparing for overseas duty. News items concerning military and scientific developments as well as original articles will be emphasized. The Bulletin, however, should not serve as a basis for the forwarding of requisitions for equipment or supplies referred to therein. Obviously, some of the most interesting field experiences cannot be divulged in a periodical of this kind when our country is at war. The Bulletin will, however, publish that which can be safely told, drawing not only on current literature, but on many authoritative reports which reach The Surgeon General's Office from the field. Officers are invited to submit for publication reports of their field experiences that can profitably be shared with other officers. The Medical Department has been commended for its work in caring for the sick and wounded in theaters of operations in war. The Bulletin will endeavor to stimulate such progress and to advance further the high standard of medical service in the Army of the United States. LABORATORY METHODS USED FOR THE RECOGNITION OF DEATHS IN AMERICAN LAND FORCES DURING MAJOR WARS Lowell A. Rantz, M.D., Paul J. Boisvert, M.D., and Wesley W. 37 40 BALANCED SUSPENSION AND FRACTURES OF THE FEMUR Lieut. Colonel Vernon L. Hart, M.C., A.U.S. RELATION OF THE WEIL-FELIX REACTION TO THE CLINICAL COURSE OF TSUTSUGAMUSHI DISEASE Captain Edwin N. Irons, M.C., A.U.S., and Major Charles A. Arm- PROCESSING DEL-MAR-VA POULTRY FOR THE ARMED FORCES Major Donald C. Kelley, V.C., A.U.S., and Captain Robert J. Byrne, BACTERIAL FLORA IN CANTONMENT-TYPE SURGICAL WARD Captain Charles M. Furtherer, M.C., A.U.S., and Marian Hofmann.. 100 THE DETECTION OF METHANOL IN BLOOD-METHANOL MIXTURES Major Reuben Roseman, Sn.C., A.U.S., Technician Fifth Grade GREETINGS AND THANKS TO YOU After nearly four years of warfare in North Africa, Italy, Alaska, New Guinea, Guadalcanal, Saipan, Iwo Jima, Okinawa, France, and Germany, our armies, in the year just past, achieved their ultimate goal-victory over Germany and Japan. They had trained hard at home and in foreign lands. They had fought hard in the desert, in the jungle, and in torrid and frigid zones. They were superb! Their victories were complete. Always with them to protect them from disease and always near to aid their wounded were the skilled, merciful, and unsurpassed men and women of the Army Medical Department. The fighting is over. The sick and wounded have been brought home. This nation is deeply grateful and indebted to all of its brave sons and daughters who gave so much. While there is still much to do to complete the work of the Medical Department, each day sees a smaller number in our Army hospitals. It is my privilege again to say to all who, in any way, helped in the work of the Medical Department: Well done, and my heartfelt thanks! May the New Year bring to you who have returned to civilian life, and to your comrades who are still required in the service to finish the job, the happiness and peace which you so much deserve. Witut Major General, U. S. Army, News and Comment STATUS OF PENICILLIN TREATMENT OF EARLY SYPHILIS In the four years since our entry into the war, probably no serious disease has undergone a more revolutionary therapeutic revision than syphilis. In the beginning, treatment consisted of alternating courses of mapharsen and bismuth, administered in weekly injections for a period of one to two years. This prolonged schedule was compressed in 19422 to a regimen calling for semiweekly injections of mapharsen and bismuth for a period of only twenty-six weeks. While a decided improvement, the latter routine was also difficult to accomplish with the necessary regularity, particularly in theaters of operations and among combat troops. Soon after the demonstration3 that penicillin was effective against the Treponema pallidum, the Army embarked on a controlled series of clinical investigations carried out in cooperation. with the Subcommittee on Venereal Diseases of the National Research Council. As a result of experience gained, within and without the Army, it was directed in October 1944 that syphilis in the Army would be treated with a total dose of 2,400,000 units of penicillin. This bulletin was altered somewhat later, but the therapeutic scheme was not changed." During the past year, thousands of military personnel have been treated for early syphilis with penicillin by the method prescribed. While an exact statistical evaluation of the results in early syphilis is not available at this time, certain broad statements can be safely made, based on small, well-observed groups of patients and spot surveys of large numbers of syphilis registers reaching the Venereal Disease Control Branch of The Surgeon General's Office. The failure rate in primary syphilis, including both seronegative and seropositive cases, has been apparently less than 5 percent. On the other hand, the failure rate in secondary syphilis has been in the neighborhood of 20 to 25 percent. It has long been recognized by syphilologists that any given treatment schedule produces better results in primary than in secondary syphilis. Fortunately, in the Army, infectious syphilis is generally detected early in its course. Surveys show that between 75 and 80 percent of cases are diagnosed and treated in the primary From the Venereal Disease Control Branch, Preventive Medicine Service, Office of The Surgeon General. 1. Diagnosis and Treatment of the Venereal Diseases, S.G.O. Circular Letter No. 18, 10 March 1941. 2. The Diagnosis and Treatment of the Venereal Diseases, S.G.O. Circular Letter No. 74, 25 July 1942. 3. Mahoney, J. F., Arnold, R.C., and Harris, A.: Penicillin Treatment of Early Syphilis, Am. J. Pub. Health, 33:1387-1391, Dec. 1943. 4. Penicillin Treatment of Syphilis, War Department Technical Bulletin TB MED No. 106, 11 October 1944. 5. Management of Syphilis, War Department Technical Bulletin TB MED 198, 20 August 1945. |