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Title: Preventive medicine and hygiene
Year: 1917 (1910s)
Authors: Rosenau, M. J. (Milton Joseph), 1869-1946 Whipple, George Chandler, 1866-1924 Trask, John W. (John William), b. 1877 Salmon, Thomas William
Subjects: Hygiene Public Health Sanitation Military Hygiene
Publisher: New York, London, D. Appleton
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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or one division during one year. Trench fever has been reported especially in Flanders, France, andEngland, but also from the troops in ]\Iesopotamia, the Balkans, Salonica, 1 Hunt, G. H., and Rankin, A. C.: Intermittent Fever of Obscure Origin. Oc-curring Among British Soldiers in France, The Lancet, Nov. 20, 1915, p. 1133. DISEASES OF THE SOLDIER 1245 on the Volhynian front, and among Austrian and German troops onthe eastern front, and in Austrian troops in the Tyrol, Definition.—Trench fever includes a great number of cases of con-tinued, intermittent, irregular, and relapsing types of febrile attacks.No fatal cases have occurred. One attack does not seem to give definiteprotection against subsequent attacks. The incubation in a few casesappears to be between 14 and 25 days. No important sequelae have beenobserved. Relapses have been noted in some instances. The diseasemay be said to occur in epidemic form. There is no seasonal prevalence,nor known relation to weather conditions.
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Fig. 182.—Trench Fever, Periodic Type. {British Medical Journal, July 29, 1916.) Symptoms.—The symptoms met with in practically all the cases areprecisely those classically grouped as a definition of pyrexia from anycause, and nothing more. There is the general feeling of lassitude,headache, pains in back and limbs, flushed face, coated tongue, and, later,free perspiration; there is loss of appetite with constipation, at timesvery obstinate; pains are commonly most severe behind the eyes and inthe back of the head and neck; the somewhat, characteristic shin painsgenerally occur later; there is usually slight congestion of the pharynx,but little or no discomfort from it. At one time—in August, 1915—aconsiderable number of cases developed severe urticaria, but this wasprobably an accidental coincidence. Absence of complications or se-quelae other than atonic muscle (heart and other) has been a strikingfeature throughout. The two principal features difEerentiating the cases from

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