PROTECTION AGAINST TYPHOID FEVER.

[To THE EDITOR or THE " SPECTATOP."1 SIR,—I think your readers may like to see the information contained in the following leaflet, which has been prepared and circulated by the Research Defence Society.—I am, Sir,

&c., Z.

"RzsmAncn Dere/fee Socrrrr.

President—Lord Lamington, G.C.I.E.

FORM D5. October, 1914. For supplies of this leaflet, free of charge, address the Hon. Secretary, 21 Ladbroke Square, London, W.

PROTECTION AGAINST TYPHOID FEVER.

We all know that there are certain fevers which we are not likely to have twice. The first attack protects us against a second attack. For instance, if we have once had scarlet fever it will be many years before we can have it again: we may be exposed to it, but it will not be able to do us any harm. Some change was worked in us, by the fever, which keeps us proof against the fever. To this protection we give the name of immunity. It is not every kind of fever which does this. Influenza does not do it: a man can have influenza again and again. But a man is not likely to have scarlet fever twice, nor typhoid fever (also called enteric fever) twice.

The object of the preventive treatment against typhoid fever is, that you shall not have typhoid fever once. Why is it, that one attack of typhoid fever protects us against a second attack? It is because the germs of typhoid fever produce a chemical substance, which we call toxin : and this toxin causes the blood to produce certain substances which fight the toxin. We give the name of antitoxin to these natural remedies which the blood makes in itself. The antitoxin produced by the blood opposes itself to the toxin produced by the germs. And, long after we have got well, this antitoxin still remains in our blood, guarding us against the risk of re-infection. Even if the germs of typhoid fever get into us, they will not injure us: for our blood is immune against them.

For the protective treatment, no living germs are used. Only

the toxin is used. The germs are destroyed by heating, till nothing is left but the toxin which they produced. Thus the treatment cannot give you typhoid fever : only living germs could do that. But the toxin can, and does, enable your blood to form antitoxin : and this antitoxin can, and does, protect you against typhoid fever. It is very important that the treatment should be given, not in one large dose, but in two, or even three, smaller doses, with an interval of some days between each dose, so that your general health may be disturbed as little as possible.

This protective treatment was discovered by Sir Almroth Wright, and was first used in 1896. At the time of the South African War, 1899-1902, it caused serious disturbance of the general health, in some cases, for several days. Still, the results proved, that typhoid fever, in the South African War, was twice as common in the non-protected as in the protected.

It is fifteen years since the outbreak of the South African War. Let us take some more recent results: the improvements made in the protective treatment have not been in vain.

(1) Mr. Taft, on May 4th, 1911, at the time when he was President of the United States, said : 'We have a division of

18,000 men in Texas and California. They have been there for two months, living under canvas, and in a country soaked with rain and deep with profanity-provoking mud. But so effective have been the regulative and preventive methods adopted to reduce sickness, that the percentage of sick men is less than it was in the posts from which these men were mobilized. I need not recall the dreadful record of sickness from typhoid fever in the camps at Chickamauga and other camps established during the Spanish-American War. The percentage of typhoid cases was so high that it is hard to believe. Of 120,000 men there were 20,000 cases, with a case-mortality of 7 per cent. Of the volunteer regiments mobilized during the Spanish-American War, 90 per cent. became infected with typhoid fever within eight weeks from the date of mobilization. To-day, two months after mobilization, with the modern health regulations, and by the use of vaccination against typhoid, not one case of typhoid fever has appeared in the entire force, except that of one teamster who was not vaccinated. It is hard to credit the accuracy of such a record. But, as I have it directly from the War Office, I can assert it as one more instance of the marvellous efficacy of recent medical discoveries and practice.' In the autumn of 1911, the pro- tective treatment was made compulsory throughout the United States Army, for all officers and men under 45 : except, of course, those who had already suffered from typhoid fever.

(2) Sir William Leishman, in a letter published during the present war, August 22nd, 1914, says: 'The benefits of inoculation are so well recognized in the regular forces that we find little difficulty, in foreign stations, in securing volunteers for inocula- tion; for instance, about 93 per cent. of the British garrison of India have been protected by inoculation, and typhoid fever, which used to coat us from 300 to 600 deaths annually, was last year responsible for less than 20 deaths. Inoculation was made com- pulsory in the American Army in 1911, and has practically abolished the disease; in 1913 there were only 8 cases and no deaths in the entire army of over 90,000 men.' (3) In Avignon, in the South of France, during the summer of 1912, typhoid fever broke out in the barracks. Of 2,053 men, 1,366 were protected, and 687 were not. The non-protected had 165 cases of typhoid fever, of whom 21 died : the protected had not one case. In the winter of 1913, the French Senate resolved that the protective treatment should be made compulsory throughout the French Army: and, in special circumstances, among the reservists.

(4) In Canada, among the 'camps' of the Canadian Pacific Railway, the protective treatment has given excellent results. In 1911, among 5,500 men protected, there were only 2 cases of typhoid fever ; while, among 4,500 non-protected men, there were 220 cases. In 1913, among 8,400 men protected, there was only one case; while, among 2,000 non-protected men, there were 76 cases.

These four instances are enough to show the great value of this treatment. Remember to avoid all excitement or exertion for 24 hours after you have been treated. Any serious discomfort from the treatment, now-a-days, is very rare : still, some people are more sensitive to it than others. But it is better to run the risk of discomfort than to rim the risk of typhoid fever. Besides, typhoid fever is dangerous not only to the patient, but to other men who may get the infection from him.

If desired, you can be treated with approved vaccine, free of charge, at the office of the Research Defence Society. Address : Hon. Secretary, 21 Ladbroke Square, W. TeL 975 Park."

[We most sincerely trust that not only all persons on active service, but all men and women who will be brought into con-

tact with the sick and wounded at our hospitals, will not wait to be inoculated till an epidemic of typhoid has actually broken out. They should be inoculated at once, while there is time, leisure, and opportunity, and while the doctors can .ttend to them.—En. Spectator.]