HYGIENE AND 
SAN! NATION 
COMPILED AND 
published at 
EH LISTED lECHIIICinnS SCHOOL 
LETTEHITmn GEITERflL H05PITRL 
FOR USE OF STUDENTS 
P U BLI SHED SEPTEMBER. I 941 
REVISED 6REPUBLISHED AUG. 1942 
REPUBLISHED MARCH 1943 
RE PUBLISHE D JULY 1943 
REPUBLISHED MARCH 1944 SPECIAL SERVICE SCHOOL 
LETTSRMAN GENERAL HOSPITAL 
MEDICAL SECTION 
HYGIEDE AND SANITATION 
DOR 
MEDICAL TECHNICIANS 
REVISED 
AND 
COi'flPLSTSLY REWRITTEN 
AUGUST 
REPRODUCED 
FEBRUARY 19UU PREFACE 
Hygiene and Sanitation. What is it all about? Why study? 
You say,rlWhat good is it to me?,: The answer is: , your health* 
Over a long period of time man has learned a good many things 
about sickness. If he does certain things, he might get sick. To 
c’tudy hygiene is to study a way of living — a way to stay healthy. 
Such a study is based on those facts that have proven themselves 
of undoubted value. 
But, a knowledge of facts is of no value mless we make use 
of them in a practical way. Military Sanitation is the study of 
how the facts of hygiene can he applied to our every day living, 
especially living in the field. TABLE OF CONTENTS 
PART I 
1. Pestilence 
2. The Dawn of Technique 
3. Bacteria 
A. Infection and Immunity 
5. Communicable Diseases and Their Classification 
6* Principles of Defending the Body Against Bacterial Invasion 
7# Venereal Diseases 
8. Respiratory Diseases 
9# Intestinal Diseases 
10, Insect-Bone Diseases 
11-, Miscellaneous Diseases 
PART II 
THE SOURCES OF INFECTION AND THEIR CONTROL 
12, The Sources of Infection and Their Control 
PART III 
TRANSMITTING AGENTS - DETAIL AND APPLICAT 
13, General Renarks 
lUo Control of Venereal Diseases 
15o Air and Its Control 
16. Water and Its Control 
17. Food and Its Control 
18. Insects and Rodentst Their Control 
PART IV 
SUSCEPTIDLES; THEIR PROTECTION 
19• Measures to Maintain Health 
GLOSSARY PART I 
2 Chapter 1 
PESTILENCES 
It is sometimes said that the men of long ago had no troubles. 
I suppose it is a comfort for us to believe that this was the case. 
From the point of view of sickness alone, however, our ancestors had 
pretty difficult realities to face. They feared Pestilence, Famine 
and ¥ars. Interestingly enough war was the least of their worries. 
The reason was perfectly simple. Pestilence at times caused the 
death of millions of people; whereas war resulted in the death of 
mere hundreds of men. 
But what is pestilence? It is serious sickness. It spreads 
often from one end of a continent to another. At first not many 
people are sick. In time more and more become ill, perhaps one out 
cf every two people. Thousands, hundreds of thousands, even million 
may die, A pestilence is thought to be at its worst, when in the 
brief space of a day or two healthy people are suddenly struck dead. 
Today we use such words as epidemics and pandemics in place 
of the word pestilences. 
Epidemics are as old as man himself. It is to our advantage 
to mention some of the great epidemics of the past. 
What is plague? Fany of you, I suppose, have some vague ideas 
and no particular knowledge about this disease. Few realize that 
Greece suffered terribly from plague in the time of Pericles, 430 
B.C. Thousands upon thousands died. Confusion, fear, and panic 
developed. Even the war against Sparta was temporarily halted. 
During Caesar’s lifetime, plague came to Rome, At first 
only a few citizens fell sick. Later, each new day came to be  - as the number oi sack and U; ing ever Increased. 'When the 
pestilence reached its greatest intensity, 10,000 people were dying 
every day, *nd Rome’s population, was. only a_ little over a million 
peonle at this time, ... 
Smaller epidemics continued to appear and disappear. In 
542 A.D, Egypt was visited by a severe epidemic. At the height 
or the-' pestilence, there were 10,000 deaths a day in the city of 
Constantinople. 
Then the plague once more developed into epidemic proportions 
in Italy, In 565, as a result of widespread deaths, panic, disorgan- 
isation, and terror men became passive - so passive, in fact, that 
they became the easy prey of the invading Lombard troops from the 
North. 
Without a doubt the years 1342-1349 wore some of the blackest 
that man has ever endured. By 1341 plague was occurring at various 
places in Europe. By the next year epidemic proportions were reached, 
and by 1343 plague was striking terror and death into the peoples 
of Europe, Egypt, North Africa, and England, Of every 10 people 
who became ill, 9 died, "In their terror and ignorance, men 
did the very things which increased death rates and aggravated calamity 
They fled from towns and villages, but death traveled along with them,. 
Panic bred social and moral disorganization5 farms were abandoned, 
and there was shortage of food; famine led to displacement of pop- 
ulations. Of the hundred million people, 25 million died as a result 
of the dreaded plague - the Black Death as it was called," 
During the 15th Century there were at least six epidemics 
in Europe, In the 16th Century there were ten. By the middle of 
the 17th Century there had already, boon eleven. Then plague descended upon England, In London the disease caused some forty deaths in 
May and each month witnessed more and more, fatalities. 
May... 43 deaths 
June590 H 
July 6,137 " 
August. 17,036 
Sep tember 31.159 
Each month, the number of deaths increased up to the peak, which 
was reached in September. This rapid increase is one of the char- 
acteristic features of epidemics. As a result of this particular 
epidemic, some 60,000 deaths occurred in London alone. This 
amounted to about one fourth of the population, . . > 
By 1769 the disease was spreading over the continent of 
3 
Europe, as it had done so frequently in the past. In 1770 one fourth 
of the population of Moscow died (50,000). In the. Ukraine there 
were 300,000 deaths. 
Between 1896 and 1936 there have been 40 million plague 
deaths in India. Since 1936, man has gained considerable control 
over the once dreaded disease. In the last few years in India, 
there have been less than 30,000 people to suffer sickness from 
plague, deaths have been much fewer. The Control, man has ob- 
tained, has been a great achievement. 
Another disease that has cuased epidemics in the past is 
smallpox. In 1520, three and a half million died in Mexico, and 
Central America, 
Cholera is another disease that has caused much misery and 
death in the past. It is interesting to trace the path, which choj/ra 
followed in the 19th Century, An epidemic occurred in India in 
Id?. Travelers and traders carried the disease to Japan, whore an 
epidermic appear in 1823, From Japan to Russia cholera was carried by tnose sick wno traveled. -Russia1s epidemic came in I830, Cholera 
spread toward JJurqpo , which suffered from this pestilence from I83I 
to 1832. An Irish ship carrying choleric passenger from Europe brought 
tho disease to Canada in I832. There ’-'as an epidemic in Europe in 1SU6, 
and another one in the United States in In the severe epi- 
demics, three or four out of every five who became ill, died. 
Typhus fever, like other diseases, caused widespread disaster when it 
reached epidemic proportions. Suffice it bo say that Napoleon’s failure to 
conquer Russia was to a great extent due to the ravages of typhus fever. 
Furthermore, it has been estimated that between 1917 and 1923 there were 
30,000,000 cases of typhus with 3*000,000 deaths in European Russia alone ! 
Since 1900, ’’Russia has suffered from two wars, one revolution, two 
cholera epidemics, from a fcanine unequalled since the Thirty Years’ War 
from typhus, malaria, typhoid, dysentery, tuberculosis, and syphilis, to an 
extent unimaginable except to those who were spectators.” 
In thinking of the diseases that have caused havoc in the past wc 
can list the big six of all times. Tirey are plague, typhus, smallpox, 
cholera, dysentery, typhoid fever and paratyphoid fever. Man has learned 
enough about these particular diseases to control them pretty well. That 
is to say, epidemics are very unlikely to occur again. 
Today we face new problems, In our day, there have been epidemics 
of influenza, meningitis, and infantile paralysis. 
There r.was one epidemic of .influenza in the l6th Century and one in, 
the 17th Century. Five occurred in the 12th and throe in the 19th. ■ The 
pandemic of 1890 in Europe attacked one out of every two people. In 191S-19 there occurred a world wide pandemic. It is estimated 
that there were 700,000,000 cases and 200,000,000 deaths. Of. every 
100 to fall sick, only one or two died. This is mild compared to the 
severity of plague and cholera in the past. In the United States 
one out of every four fell sick from influenza. 
What was the cause of such sicknesses? we know the cau 
of many of these diseases, hut it is recently acquired knowledge. 
Until man discovered the actual causes there was much guessing— 
guessing so fantastic that it seems unbelievable. Influenza was 
thought to .be due to the influence of the stars. Frequently evil 
spirits were blamed. The,Romans believed that their Gods were 
unhappy. As a result they put the statues of their Gods into bed 
and honored them with feasts. 
What did our ancestors do to prevent sickness? If they 
suspected evil spirits, they locked themselves indoors, scaled doors 
and windows to keep thorn,out, and just in case any evil spirits had 
sneaked in while doors were being.closed, they burned roots, onions, 
f:lgs or whatever they believed would drive the spirits away. At 
times people tore out all their hair. At one time tiny dropped 
vinegar into the eyes of the sick, in an effort to keep them awake. 
To go to sleep was considered the worst thing that could happen. 
Others danced wildly in the streets, in a sort of hysteria. Such 
an act probably allowed disease to spread from person to person more 
rapidly, . Chapter 2. 
TSF- DAW Of TBCHLUQpS 
We are today relatively safe from epidemics of plague, cholera, 
smallpox, typhoid, dysentery and typhus fever. , This is no idle dream. 
We have gained an advantage over cor old enemies. 
In 1837 it was discovered that fermentation and putrefaction were 
closely connected with the presence of “bacteria (germs) derived from 
the air. 
By 1857, Pasteur, the great french scientist, showed that al- 
cohol was a result of fermentation. And that fermentation depended on 
the presence of “bacteria. Six years later, he proved that a certain 
disease of silk worms was due to “bacteria. Then he learned something 
else. He learned that heat could kill some of the “bacteria he had dis- 
covered, Next, Pasteur attempted to keep some bacteria alive; he wanted 
to experiment with them. 
He succeeded in 1 in chicken "broth the.germs that caused 
cholera in chickens. One*day he made an experiment hy injecting into 
a well chicken some of the chicken "broth in which were the ’’growing” 
germs. The chicken became sick and died. He tried this over and over 
■again,. Today, when we grow some germs on special tyoe of fcod, such 
as broth, we refer to the broth as a culture. One day Pasteur injected 
a well chicken v/ith some broth with .germs that were a little older (per- 
haps several weeks) than he had used in previous experiments. To his 
amazement the. chicken did not die. Hurriedly, he started another al- 
ters by adding chicken cholera germs to -chicken broth. He allowed the 
culture to grow the saxac number of days'as all previous cultures, ex- 
ceo't the one that failed to .cause the death of the chicken in his last experiment. Then he was ready' for another experiment. Into a well 
chicken he injected a portion of the culture, just as he had done in 
so many past experiments. The chicken died as was expected. Into the 
chicken that had been injected with the old culture, he injected ano- 
ther portion of the new culture, What would happen? Would the chicken 
live or die? The chicken lived. This was an amazing fact. He did not 
understand it, hut gave much thought to this phenomenon.. 
In 18j6, another great scientist, Koch hy name, succeeded in do- 
ing something that no one had been able to do so far. To go back a 
moment to the subject of cultures: Up to the time of Koch's discovery, 
no one had been able to grow just one type of germs in a culture. For 
some reason, cultures always contained other types of germs in addition 
to- the on; type particilarly desired. Koch was the first person to 
succeed in gcowing a pure culture. Moreover, he mads another disco- 
very of great value. No one knew the cause of the disease called an- 
thrax., which afflicted cattle, frequently causing death. He went a 
step further than anyone else when he cut open an animal dead of anth- 
rax. The spleen was large and congested. From it he obtained some 
bacteria which he grew in pure culture. When he injected some of 
these germs into a well animal, it resulted in a sickness that was like 
the sickness of other animals suffering from the disease anthrax. In 
other words, Koch was the first man to successfully grow a pure culture 
of some germ. Eo was also successful in showing that anthrax was due 
to one particular .gem. Some people who heard about these experiments 
began, bo have doubts about the orthodox bo] iefs of the causes of disease 
In ISBh, the great Russian scientist. Mctchnikoff, caused great 
excitement in that new group o.f scientists, like Par-tour and Koch, who were so wrapped •up in their work. Metchnikoff had made careful studies 
of "bacteria. What did they do- in: the:;'body\of : a itan? What- did the? .. an's 
body do to the germs? He made this .great discovery: ■ Certain cells of 
the blood could "eat1’ the tiny bacteria. This phenomenon he called ■ 
phagocytosis. 
Meanwhile, all over Europe there was a great stir among scient- 
ists. Some argued that these discoveries were fantastic; others said 
it was all magic; still others rushed to Koch, Pasteur, Metchnikoff and 
other experimenters in order that they might see for themselves. While 
some men wrote articles to prove the impossibility of the existence of 
germs, others quickly learned the skills or technique of such men as 
Pasteur and Koch. Although they sought no reward, such men, driven on- 
ward by curiosity, soon found that bacteria were the causes of several 
other diseases. Between 1SS0 and 1890 they discovered the bacteria 
which were the cause of leprosy, gonorrhea, tuberculosis, typhoid fever, 
lobar pneumonia, diphtheria and tetanus. 
Research or the search for new facts, was directed toward finding 
a way in which this new knowledge could be used constructively, that is, 
to some worthwhile use. 
In 1S9U, Behring succeeded in making diphtheria antitoxin. Per- 
sons, mostly children, suffering from; this dreadful disease, were given 
diphtheria, .antitoxin. The results were astounding. Instead of dying, 
the stricken patients got well. 
Thus, in a relatively short space of time, the following techni- 
ques had been developed; obtaining bacteria from diseased men and ani- 
mals; culturing bacteria; segregating or isolating from a mixture of 
bacteria growing in a culture, one particular type of bacteria, which 
could be grown into a pure culture; studying phagocytosis; making anti- toxin. From this time onward, facts began to replace the guesswork; 
the theories and the fantastic beliefs of the past. Indeed, a new 
era in medicine and public health was to follow’ closely upon the dawn 
of technique. Chapter 3. 
BACTERIA 
We nowproceed to a study of bacteria. Germs, micro-organisms, 
organisms and microbes are other names for bacteria. 
Suppose an Eskimo asked you to tell him what an automobile was 
like? To give him an answer which would be intelligent, it would be 
necessary to describe as accurately as possible the weight, size, shape, 
color, speed, etc. He might ask you what it eats. Then you would sud- 
denly realize that it would be necessary to tell him that an automobile 
did not oat, because it was not alive. "But”, he asks, "it moves, it 
has speed?". 
In a study of bacteria, similar characteristics must be presented. 
Definition of Bacteria. Bacteria (bacterium, singular) are minute, 
one-celled, plant like, microscopic organisms. 
Distribution. They are universally distributed in soil, air, wa- 
ter and the human body. The mouth and throat contain enormous numbers. 
Milk and butter contain millions. In the large intestine of man, there 
are countless numbers; and a large part of the solid matter of the feces 
is made up of bacteria. 
Size of Bacteria. ..An average sized bacterium is about 1/25,000 
of an inch in size. 
Shapes of Bacteria. There are three main shapes: 
1. Bacilli (bacillus, singular) - rod-shaped organisms. 
2. Cocci (coccus, singular) - round or oval shaped organises. 3. Spirilla (spirillum, singular) - small, comma-shapei 
or cork-screw-shaped organisms which are motile. 
Structure of Bacterial Cell. 'It is composed of a cell wall 
and cell content, including nuclear material. Through the cell wall 
pass food and waste products, both in solution (liquid form). 
Motility. Some bacteria can propel themselves by swishing back 
and forth the flagellae attached to their cell wall. 
Fig. 1-Flagella of a typhoid bacillus. 
Reproduction. Bacteria multiply by division. That is, bacter- 
ium divides into halves, which grow into two bacteria, each capable of 
further division. 
Spore Formation. Certain bacteria, when conditions are unfavored 
change into spores in order that they may be able to resist delet rious 
(harmful) influences better than in the vegetable state. Spores are 
highly resistant to heat, drying, and disinfectants. 
Growth of Bacteria. Bacteria may reproduce by division at an 
average rate of every 20 minutes, but this rate cannot be maintained 
for long. Lack of food, lack of space, and their own. production of 
acid interfere with unmolested growth. However, it has been estimated 
that one bacterium, if unhampered, could produce tons of bacteria 
in 72 hours. 
Environmental factors in the Growth of Bacteria. 
1. Oxygen 
(a) Some organisms grow best in the presence of free oxygen 
They are called aerobes. 
(b) Some grow best in the complete absence of oxygen; others- in, the partial, .absence of oxygen. Both types 
are called anaerobes/ .... 
2. Temperature.. 
(a) Bacteria die if the temperature- over l60° C or 
below - 250° C. 
(b) Bacteria, can carry-on •acti’v.ity.'iat"’temperatures ranging 
from 0° to 90° C, (Water„.fre©zea at 0° C and boils 
at 100° C.) 
(c) For each organism there is: 
1. An optimum temperature, that is best suited to 
its growth. 
2. A minimum, temperature, the lowest temperature 
at which it will grow, 
3. A maximum temperature, the highest temoerat ’~o 
at which it will grow. 
U, The thermal death point, or death range, is the 
temperature which in a given time destroys bac- 
teria. Moist heat (as steam) at 120° 0 for 20 
minutes kills all bacteria and spores because 
moist heat is penetrating. At 100° C (boiling) 
all bacteria, in the vegetative form, are killed 
in 5 to 15 minutes. 
3* Sunlight. Most bacteria are destroyed by sunlight within 
six hours. 
PATHOGENICITY. Bacteria that are capable of producing disease 
in man are called pathogens or parasites. Those bacteria that do not 
cause disease in man are called non-pathogens or saphrophytes.' To say that diphtheria is pathogenic to man, means that diph- 
theria germs can produce diphtheria in man. Germs that are pathogenic 
to man require food, warmth, moisture and darkness - all of which are 
found inside the human body. . 
Non-pathogenic germs are,present in the body of man, mostly in- 
side the intestinal tract; . These germs serve useful purposes. For 
instance, bacteria play an important part in .the digestion of foods. 
Classification of pathogenic organisms: 
1, Protozoa - animal kingdom 
The parasite that causes malaria, .and the -smeba, a single 
celled animal, that produces amebic dysentery are both examples. 
2. Bacteria - vegetable kingdom. 
The bacteria, that cause diphtheria, plague, typhoid, and bo- 
tulism are examples. 1 
The diphtheria germ can cause only one disease,, namely diph- 
theria. • Each disease is. produced hy just one specific germ.. 
3. Picket tsia- 
These are smaller than bacteria. As a rule, they are consi- 
dered to he parasites of insects. 
Among the diseases caused hy rickettsia are: 
Typhus fever 
Trench fever 
Rocky Mountain Spotted fever 
Japanese flood fever or Tsutsugamuski Fever. 
U, Viruses 
Viruses are extremely tiny and only very recently has there 
been construe bed a microscope powerful enough to wseen these very small 
bodies. The following diseases are attributed to viruses: 
Smallpox 
Cowpox 
Chickenpox 
Verruca or warts 
Measles 
Ep id ami c in fluenza 
Mumps 
Radies 
Psittacosis or parrot fever 
Lymphogranuloma inguinale 
Infantile paralysis 
Epidemic encephalitis 
equine encephalitis 
Yellow fever 
Pappataci fever or send-fly fever 
Probable Virus Diseases 
Common cold 
Trachoma 
German measles 
Dengue Fever 
If the cyst (a resting stage of the ameba) that causes amebic 
dysentery were as large as a basketball, the streptococcus (bacterium) 
that makes throats sore would look like a big marble and the, virus of 
influenza would be about the size of birdshot. The head of a pin would 
accommodate between 10 and 20 million viruses of poliomyelitis. 
The disease producing protozoa, bacteria and rickettsia have one 
thing in common - they axe parasites. Parasitism is a way of life, the 
parasite's1 way of life A parasite lives in or on some other form of 
life, receiving food, comfort, moisture—in fact, satisfactory lodgings. 
Moreover, they perform no duties that are in the least bit useful to 
the one who fur rashes lodgings. Chapter U 
INACTION AND IMMUNITY 
Now that you have some conception of the general characteristics 
of bacteria, you are in a position to learn additional facts, which ar* 
essential to a basic understanding of hygiene and sanitation. 
How can bacteria get into -the body? Or to put the question 
another way, at what points can bacteria invade the body? The answer 
is: The body can be invaded at four places. 
1. They can enter via the mouth (intestinal tract) 
2. They can enter via the respiratory apparatus (nose, mouth) 
3. They can enter via the external sexual organs 
U, They can enter via a puncture or tear of the skin or mucuos 
membraneSo 
Sometimes these invasion points are spoken of as portals of entr; 
What do th? bacteria do, once they enter the body? For some un- 
known reason bacteria tend bo go to certain definite parts of the t>ody. 
For example, should pneumonia, diphtheria, and typhoid germs enter via 
the mouth, this would happen; pneumonia, germs would go to the lungs; 
diphtheria germs would go to the thi’oat and tonsils: typhoid germs 
would go to the intestines. And another important feature is multi- 
plication, which would begin almost at once after invasion. 
What might the banteria do to the body (host)? 
The tissues might be affected with such possible results: (l) de- 
generation of cells and tissues, with possible resulting death of , 
cells and tissues. 
(2) hemorrhages in the areas where bacteria destroyed small blood 
vessels* 
(3) the production of an exudate. 7 Moreover these symptoms might occur; fever almost always; in- 
creased metabolism almost always; functional or organic disturbances, 
such as diarrhea, cyanosis or delirium; or, such organic changes as, 
paralysis, deafness, blindness, heart disease. 
What happens to the host? He gets well, dies or he may not be- 
come sick. 
What happens to the parasites? They either win or lose. If they 
are very strcng or powerful (virulent) they may succeed in overcoming 
the host. Or they may be quite weak (avirulent) and the host quite 
strong. In that case the host wins, the bacteria fight a losing 
battle and die out. 
What can the body (host) do to protect itself against the bac- 
teria after they have made a successful invasion? In other words, 
what are the body’s defenses? It is sometimes said that the body lias 
three main lines cf defense. 
The first is the skin. It covers the whole body and like armor 
it protects the tissues beneath from the bacteria vdth which our skins 
come in daily contact. Once it is broken bacteria may enter through 
the break. Some of the bacteria that may enter arc: tetanus, gas 
gangrene, anthrax, streptococci, and staphlococci. 
Nov/ for the second defense. We will assume that bacteria have 
been successful in penetrating the skin or that they have entered the 
body via any of the other three invasion points. In less than 20 mta- 
ut es after the bacteria have entered, the second line defenses are 
called out. It is necessary to digress a moment. At all times blood 
is traveling through all the canals of the body. In the blood are 
many, many, substances,, including certain single cells - red blood 
cells, which carry oxygen from the lungs to every cell of the whole bedy, and white blood.cells, the second line defense. Some of these 
colls have one, two., three or more nuclei, sometimes six or seven. 
Moreover, they have motility, that is, they can move.under their own 
power. . When bacteria get-into the body, these white blood cells or 
phagocytes very quickly direct their energies toward seeking out the 
bacteria. One.of the amazing characteristics of the phagocytes is 
their ability to actually go through the wall, of a small blood vessel. 
Once white cells have squeezed themselves through a blood vessel 
wall,, they immediately proceed to the area of the invaders. The 
general tactics of the phagocytes is first to surround the bacteria, 
thus localizing the field of combat to as small an area as possible. 
Immediately the white cells or phagocytes start active warfare. 
By a complicated process, one phagocyte succeeds in getting a single 
bacterium to pass through its cell wall; the bacterium then finds 
itself inside the phagocyte. This process of neating11 .bacteria con- 
tinues, All phagocytes participate; some of them may be successful 
in cornering and enveloping 20 to 30 bacteria. Cnee the bacteria are 
inside a white blood cell, they are said to be intracellular (within- 
cell). In time the bacteria are broken up and digested, much as is 
food that you and,I sat. But the life of a phagocyte is not long. 
Very soon it begins to degenerate, swell up, end disintegrate (fall 
apart). These degenerated phagocytes, plus blood serum, digested 
bacteria and destroyed tissue (the terrain demolished at the site of 
the battle) constitute what we call pus. 
But who wins?' The invaders or the phagocytes? The answer is 
more-complicated than saying "victory goes to the side with superior 
numbers’1, so we will-postpone an answer .at present. An understanding of the mechanism of the third line of defense 
* ... . 
deserves our attention at this moment. As an aid in comprehending this 
complex system, this question can be asked: Why do people never (c** 
hardly ever) get a second attack of diphtheria, or typhoid fever, or 
measles; In other words, why are they safe from a second attack? 
Instead of saying a person is safe from attack, we express the same 
idea by stating; he is Immune to (safe from) diphtheria, or typhoid 
fever, cr measles. (When a person is not immune to some particular 
disease, he is said to bo susceptible to it). 
Now that you have an understanding of these new words, it is 
possible to unfold the complexities of the third line of defense. Be- 
fore you "got"- measles,, you were susceptible to measles. Aft_r you 
recovered from measles, you were immune to future attacks'of the same 
disease. 
Hew doss one become immune? Let us use typhoid fever as an ex- 
ample, because the mechanism of producing its immunity is easier to 
understand. For the purposes of illustration, we will assume that 
Jones is the subject. Before Jones "gob*1 typhoid fever he was sus- 
ceptible to the disease. Upon recovery, he became immune. 
Let us start at the very beginning. Jones is perfectly healthy. 
He drinks some water from a clear stream (bad personal hygiene). 
There happens to be great numbers of typhoid germs in the cup of water 
he drams. The typhoid bacilli therefore invade by way of the mouth. 
They proceed to the small intestine and prepare to "dig in", that is, 
to burrow beneath the inside lining of the intestine. As they "dig 
in", the second line of defense goes into action. They quickly speed 
to the areas where the bacteria have lined up. The battle goes on. 
As a rule the typhoid bacilli invade in numbers far superior to those 
of the phagocytes. While the white cells are desperately striving to hold the 
enemy, the third line of defense mobilizes on the production line. 
It reminds one of giant war industries which require time to produce. 
The first signal to start production comes from the typhoid gems 
themselves. As they begin to "dig in" Jones* blood and tissues, 
realize that they are dealing with typhoid bacilli. Defense weapons 
must be made - defense weapons which will bo effective against the 
bacilli of typhoid fever. We humans really calculate in a similar 
way. When tanks first appeared on the battlefield, methods of de- 
fending ourselves were considered. In time we developed anti-tank 
weapons. So too we developed anti-aircraft weapons, anti*submarine 
weapons; and the challenge of new offensives is constantly met with 
new defensive weapons. 
Typhoid bacteria attack Jones, ?vhose body in turn produces de- 
fense-weapons, called antibodies. At first the production of anti- 
bodies is too meager to be of any real value. By the third week 
antibodies are rolling off the assembly line in extraordinarily groat 
numbers. From then on, the bacteria, begin to lose. Victory is in 
siffht, 
It is only fair to say that the bacteria do not always lose. 
They may win, that is, cause the death of Jones (the host). For ex- 
ample, the numbers of typhoid germs may be so great that they over - 
come the host before the body has time to produce antibodies in suf- 
ficient numbers to save the day. Or, the bacteria ray succeed in 
burrowing; all the way through the intestine (a very deep fox hole) in 
which case the intestinal contents ooze into the peritoneal cavity, 
reselling in peritonitis, a serious complication (which may cause death), 
fhirdt the bacteria may burrow through the wall of a blood vessel. 
From such a hole, blood excapes, thus causing a serious complication, namely, hemorrhage. The host may die, unless the hemorrhage is stopped 
rather quickly and that requires an operation. 
There is an idea of a theory to explain the production of antibodies. 
It is similar to the law of stimulus and reaction. Sit on a thumb tack 
.(pain is the stimulus) and you Jump up very quickly (reaction). Or, if 
the body gets too warm (stimulus) in a hot climate, sweating (reaction) 
takes place. If you put something very bitter (stimulus) in your 
mouth, you spit it out (reaction). Of course there are many such ex- 
amples, but there is no need of further illustration. The theory of 
antibody formation assumes that bacteria (stimulus) in the body, causes 
antibodies to be made (reaction). It is thought that they are made in 
the blood rather quickly (less than 1 hour) following the appearance of 
bacteria. Moreover, it is believed that antibodies are made of protein, 
which the body furnishes for the purpose. (The white of an egg is pro- 
tein), The theory goes on to say that the antibodies are deadly enemies 
of the germs, that they lock in battle, the final result being the loss 
of both bacteria and antibodies, In an attempt to exclain this leer- 
ing of bacteria, and antibodies, the chemists hers proposed another 
theory. It is really easy to understand, provided you know a little 
about electricity. Bacteria, it has been found, carry a negative 
charge of electricity while immune blood serum (the liquid part of 
blood in whiv.i antibodies,are present) carries a positive charge. 
Hence, bacteria ( - ) and antibodies ( 4 ) are attracted to each other. 
The result is a tangle which results in clumping of bacteria an.6. anti- 
bodies. When bacteria get into such a snarl it reminds one of a fly 
caught in a snider web. 
Now we can return to Jones, We left him a sick man. The phago- 
cytes were fighting and the production of antibodies had Just started. 
Three or four weeks later Jones is out of all danger. Typhoid fever has left him weak, but he will soon be strong again. 
Will he get typhoid again? He probably will not. Why? Because 
his body,possesses,.numerous antibodies which are ready for Immediate 
action should typhoid germs again be successful in invading Jones1 
body. However, should great numbers of typhoid bacilli gain entrance, 
he might suffer a second attack. This assault would probably be 
mild, because the numbers of bacteria, not eliminated by antibodies, 
would be relatively small. 
Would these antibodies protect him from other diseases? Ho. Be- 
cause typhoid antibodies protect only against typhoid germs. Measles 
antibodies protect only against measles viruses. The same is true of 
diphtheria. In fact the same is true of all diseases. For every type 
of bacteria, specific antibodies alone arc of value. 
• Jones has immunity to typhoid fever. He obtained it the- hard 
way. But you, too, have immunity to typhoid. And how did you secure 
it? 
Instead of swallowing live typhoid germs (a, dangerous thing to do) 
you have been injected with dead "bacilli. Those dead germs, composed 
of protein, act as a. stimulus which results in the production of anti- 
bodies within your body J You were susceptible to typhoid fever be- 
fore the injection, now you are immune. Like Jones you are not abso- 
lutely .100$ immune. If you drink unsafe water, you might get typhoid 
fever - you might got more bacilli than your antibodies can handle on 
a minute’s notice. 
Vaccination is the process of protective inoculation against some 
disease, as small pox. For example, vaccination against smallpox is 
dene in this manner: A small amount of lymph (containing small nv bers 
of small pox viruses) from cowpox is rubbed into an area of your sain which has been scratched just enough to break; through the skin—the 
line of first defense. In this manner, the viruses enter the body, a 
local 11 sore" develops and antibodies are produced. Thus you are made 
immune to small pox. 
Yellow fever vaccination is performed by inoculating yellow f,ver 
viruses, which have been greatly weakened. Bacteria and viruses, you 
recall, tend to become stronger or, as we say, virulent, when they live 
and grow in a host. On the other hand they tend to lose their viru- 
lence and become weak when they grow in culture media. In fact it is 
necessary to attenuate them (cause them -to lose virulence) before they 
can be employed for purposes of inoculation. Great numbers of atten- 
uated bacteria or viruses cause the production of antibodies. But 
they are too weak to cause the disease. 
One mors example of a method of vaccination. * Tetanus bacilli 
have the property of producing a liquid poison, called toxin. This 
toxin is the trouble maker when it gets into cur bodies. The toxin 
stimulates antitoxin, which acts like other antibodies. When some of 
the powerful tetanus toxin is collected, a little formalin is added; 
it is then allowed to remain in a bottle at a certain temperature for 
a month or so. By this time the toxin is much weakened, and hence 
ready for inoculation. The weak toxin (now called toxoid) stimulates 
antibody formation, the object of vaccination. 
Until recently we gave anti-tetanus serum to anyone who might 
develop tetanus (for example, persons with gunshot wounds). Anti- 
tetanus serum is really horse’s blood scrum containing tetanus anti- 
bodies, Such a serum was obtained by injecting a well horse with 
some tetanus toxin. When antibodies had developed, the hosse was bled of a quart or so of "blood, the serum portion of which contained 
t e tanus antiDodies. 
One final remark. . Listed "below are the factors which determine 
whether, or not a disease will develop in a person; 
1. Susceptibility, 
2. Virulence or disease producing power of the organisms. 
3. The number of germs that successfully invade the body. 
' 4, The invasion point. 
Tetanus bacilli do not cause disease when they tenter 
via the mouth. 
5*- The defenses of the body. 
In a weakened condition all defenses are below par. Chapter 5 
COMMUNIGAELS DISEASES AMD THEIR CLASSIFICATION 
What is a communicable disease? "A communicable disease is a 
disease caused by the invasion of the tissues of the body by living 
organisms which can be and are transferred from one human host to another. 
The term "communicable disease" is synonymous witn infectious diseases, 
contagious diseases and epidemic disease." 
Communicable diseases are usually classified as (l) "BPIBTMIC, 
when there occurs in a limited time among a limited population an un- 
usual number of cases of a communicable disease; (2) FAKDBMIC, when 
V 
the population concerned is much larger - that of an entire country, or 
even a continent; (3) ENDEMIC, when the disease is prevalent in the 
usual numbers that is observed in a given population and there is no 
increase in the number of cases." 
What is the purpose of Hygiene and Sanitation? The purpose of 
Hygiene and Sanitation is twofold; (l) To present for study the under- 
lying facts or principles of communicable diseases - their causes and 
their method of spreading, and (2) to present for further study: (a) the 
methods which men, in cooperation with each other, can employ to de- 
fend themselves as a group. 
We speak: of; fire protection, "bomb protection, safety first, and 
many other measures "based on guarding our good health. Hygiene and 
sanitation is another way of saying "Guard your own health and the 
health of the group in which you live." 
In a "broad general way it can "be said that certain principle fac- 
tors play a part in the development of communicable diseases. These 
factors are: 
1. Sources of Infection or Bases of Supply of Bacteria, 
2. Transmission Agents or Supply Lines (Vehicles). 3. Environmental factors. 
Susceptibility of Individuals. 
The above is given below in more detail. : 
1. Sources of infection - these are important facts. 
The bacteria that cause communicable diseases are, always in 
circulation. There are only three places where they canbe found: 
a. in cases or those people who are sick as a result of some com- 
municable disease. Cases have; the infecting organism in their 
bodies, and they have certain symptoms of sickness. 
b. carriers, or those people who carry in their body the infecting 
organisms of some disease. They have no symptoms; they are not 
sick. 
c. infected animals or those animals that have in their bodie:. the 
organisms of some infectious disease. 
Tetanus and gas gangrene are not usually thought of as communicable 
diseases. 
From the above sources or supply bases come all organisms which 
cause infectious diseases. 
It is obvious that 100 bases of supply of typhoid germs (100 cases) 
are a much greater danger to a community than would be- 5 bases of sup- 
ply. To put it another way, 100 bomber planes overhead can supply vastly 
more bombs than can 5 bomber planes. 
2, Transmitting agents. 
In getting supplies from one plane to another, transportation is 
necessary. Army supplies are transmitted by air, by water, and by land- 
-some examples of the latter are: railroad and truck. Parasites are 
carried from supply bases to susceptibles by means of the followi:-0 transmitting agents or linos of communicationi 
1. Food, including milk 
2. Water 
3. Insects 
u. Contact 
a. Direct 
1. Kissing 
2. Sexual Intercourse 
b. Indirect 
IMPORTANT FACTS 
1. AIR , 
a. sneezing 
b. coughing 
c. spitting 
2. RINGERS 
3. Flies 
4. Foinites 
a. Substances other than food that nay harbor or 
transmit organises. They get genes as a result 
of being handled by cases or carriers. ‘ Examples 
are; cigars, cigarettes, musical instruments 
played by the mouth, mess gear, handkerchief, 
books, magazines, linen, etc. 
When these vehicles carry pathogenic'organisms in sufficient numbers 
to cause disease, they become dangerous from the point of view of a 
community’s health. A break in any of the measures used to control their 
transmission, may lead to an epidemic or pandemic. 
3. Environmental factors. 
We can defend ourselves by adjusting our environment in such a nay that the lines of communication are broken down and ineffectual as a 
means of transmitting disease from a source to well people. Your en- 
vironment is made up of those people and things that you think of as 
your surroundings. Some examples are: 
water ventilation 
drinking and lathing heating 
food lighting 
milk mess hall 
garbage movies 
sewerage post-exchange 
latrines restaurants 
insects patients 
barracks other well people 
Certain control measures to prevent illness areta. ieffect all the 
time. Laxness of control may lead to epidemics. For instance, food 
and water may become dangerous as a result of negligence, the acts of 
enemy agents, or as a result of the hazards of warfare.. 
Scarcity of water may lead, to a dirty body, lousiness and disease; 
typhus fever for example. 
U, Susceptibility 
Epidemics are .more apt to develop if the number of susceptible 
individuals is large rather than if the number is small. Consider, for 
example, the possibilities of a typhoid epidemic in a camp of 20,000 men 
none of whom is immunized; as contrasted to a camp of 20,000 men, all of 
whom are immunized? 
Secondly, it can be stated in a general way that susceptibility to 
disease increases when the following conditions are- present; malnutri- 
tion or excessive fatigue, or,both, Classification of Communicable Diseases 
Communicable diseases classified according to their method of 
transmission as: 
1. Venereal Diseases 
These diseases a.re spread by direct contact (kissing and 
sexual intercourse), rarely by indirect contact, 
2. Respiratory Diseases. 
These diseases are transmitted by contact (kissing, air, fingers, 
flies, fomites). 
3. Intestinal diseases 
These diseases are transmitted by food and water; fingers, 
flies and. fomites, 
]4. Insect borne diseases. 
These diseases are transported by insects, such as mosquitoes, 
lice, fleas, flies and ticks. 
5. Miscellaneous diseases. 
These diseases are not spread in the usual meaning of the 
word, hence are combined together in a miscellaneous group, Chapter 6 
PRINCIPLES OF DEFENDING THE BODY AGAINST BACTERIAL INVASIONS 
In order to keep ever before us the basic principles, it 
is justifiable to repeat what has been stated before: certain, 
basic factors play a part in the creation of communicable diseases. 
They are: 
1, The sources of infection 
2, The transmitting agents 
3, Susceptibles 
/+. Envir onment al fact or s. 
There are two methods of defending the body against invasion 
by parastic organisms; 
1. Natural defenses 
Such as skin, phagocytes, and antibodies, 
2, Artificial defenses or the application of control 
measures based upon the principles of communicable disease. 
These include all the methods we employ in an effort to 
add to the defenses that nature gives, without any effort 
on our part. The methods employed arc- measures to maintain 
health. 
Since a study of natural defenses was presented in Chapter 
IV, we will proceed at once to a study of the artificial methods. 
i'. Artificial defenses against 
1* The sources of infection. They are cases, carriers, and 
infected animals. There are two definite measures of value; 
a. Make the source non-infectious• This means that a procedure muse be used which- will 
remove the offending organisms from the body. Some 
methods are: 
(1) The use of drugs such as quinine: (used for 
treatment of malaria): sulfa drugs; (pneumonia, 
meningitis due to meningococci, c 
and some other diseases; arsphenamine (sypnilis). 
(2) the use of serum (antibodies) in such diseases as pneumonia, 
meningococcic, meningitis, and anthrax, 
(3) The use of antitoxin in such diseases as: diphtheria, 
te tanus, anti s c ar let fe ve r. 
(4) The use of fever therapy in some typos of complications 
due to gonorrhea, 
(5) The use of medical or surgical procedures as a means of 
eliminating the parasitic organisms from carriers, 
b. Elimination of certain sources of infection (infected cattle) 
(1) Tuberculous cattle may excrete the germs of tuberculosis 
in the discharges from the respiratory tract and in the 
feces, urine and milk. To prevent the transmission of 
tuberculosis from cattle to man by milk and milk products 
(cheese, butter, ice cream) animals with tuberculosis 
are eliminated by destruction, 
c. Isolate the sources of infection. 
I 
(1) Isolation 
When it is impossible to make cases non-infectious, the 
method of isolation is employed as the only means of pro- 
tecting the "crowd” from a source. Since the object 
to protect the community, a case is kept either indoors at home or in a hosptial away from other members of the 
community, until he is no longer a source of parasitic 
organisms - the offending organisms leave the body short- 
ly after the patient becomes again well. 
(2) Concurrent disinfection 
Since a case harbors parasitic germs, it is necessary to 
take measures to constantly destroy the germs that 1 save 
his body in sputum, droplets,•vomitus, feces, and urine 
by means of various agents - such as boiling water, 
steam, chemicals, and sunlight. 
(3) Terrainal dis i nfec tion 
Furthermore, after the patient becomes well and leaves 
his room, it is necessary to clean his surroundings 
thoroughly for the express purpose of destroying any 
pathogenic organisms, which came from his body during 
his illness. Chemicals, gases, soap and water, and 
sunlight are the usual disinfecting agents employed. 
2, Transmitting agents (supply lines, communication lines, vehicles) 
The primary object is to "cut the lines of communications"• For 
example, moss sanitation interferes with the progressive advance 
of pathogenic organisms - to interfere with military advance, 
land nines may be used. Purifying water (killing pathogenic 
organisms) for drinking purposes might be comparable to destroy- 
ing an enemy transport ship. 
Insects are another type of transmitting agents. Our attack 
is based on their characteristics. For example, it is in w :;r 
that one finds mosquito eggs, which later develop into larvae, 
pupae, and finally into adults• Tfe use one typo of offensive measure? to eliminate their breeding places and another 
•type to destroy the larvae, and the pupae. On the other hand, the 
flying adults' force- us to employ defensive instruments of 
self protection. Compared to modern warfare, there is not a 
great difference. Certainly attempts are made to eliminate 
airplane factories (breeding places) by bombing them to ruins; 
furthermore efforts are directed toward the destruction of 
planes on the ground; and lastly is it not true that flying- 
planes often force their adversaries to make use of such 
defensive devices as bomb shelter, helmets, blackouts, and 
anti-aircraft gunfire and fighter planes? 
Contact, the fourth principal means of transportation, is 
a little more complex than the other lines of transportation. 
There are inportant ways to keep the air from becoming a danger- 
ous system of carrying .germs uo usj (1) proper bed spacing is 
an example of heeding the sensible remark: "Keep your distance”; 
(2) a proper ventilation, which allows bacteria laden air to 
be removed. 
Good personal habits imply good personal hygiene. . Such 
habits are: covering sneezes and coughs with a handkerchief; 
careful washing of our hands before eating as well as equally 
careful washing after going to the latrine; and lastly the 
excellent rule, to put into our mouth nothing which wo do- not 
fully intend to eat. 
3. Susceptibles 
Vie can think of the susceptibles as the la st ; ne 
of defense, and serious slip-ups in defense at this point nay lead to real trouble - a sick individual, 
maybe an epidemic, 
There are four general ways in which susceptibl.es may 
obtain protection in addition to their own natural defenses j 
1. Providing an environment that will prevent or limit 
the dissemination of infective material - ventilation, 
heating, lighting, and cleanliness; insect control; 
rodent control, 
(ENVIRON! 1ENTAL INSURES) 
2. Measures designed to maintain the health and vitality 
of the soldier: proper clothing, exercise, sleep, and 
PERSONAL HYGIENE. 
3. IHHUNZATION 
U, The ISOLATION of the sick, the QUARANTINE of contacts, 
separating them from the wall in order to prevent 
further spread of the disease. 
Summary 
The body can be defended against the invasion of bacteria 
by: 
A, Natural deiense s: 
1, Skin 
2, phagocytosis 
3, Antibodies 
B« Artificial defenses against 
1. The sources 
a, Make sources non-infactions by use of• 
(1) drugs, serum, antitoxin, fever therapy b. Eliminate certain sources of infection 
c. Insolation of the sources by: 
(1) isolation 
(2) concurrent disinfection 
(3) terminal disinfection 
2, The transmitting agents 
3. The susceptifclcs 
(1) Enviromental noasures 
' 
(2) Measures to maintain health 
(3) Immunization 
(h) Isolation and quarantine 
NOTE CONCERNING T?*S ABOVE OUTLINE 
A word of-caution should be said about this outline* Do r >t 
lot its simplicity lead you to hope for simple answers of how to 
control (defend against) contain diseases. However desirous this 
would bo, it is impossible because there is so much overlapping. 
For Inctance, mosquito control cernes under such topics: (1) 
control of transmitting and (2) environmental measures. Another 
example is that of the importance of the fingers in spreading 
disease. This subject could be partially covered under the heading 
"control of transmitting agents". To receive the full consideration 
it deserves it is further discussed under the subject of personal 
hygiene. CHAPTER 7 
VENEREAL DISEASES 
I. The five diseases claimed as venereal are- 
A. Gonorrhea.. - Caused by the gonococcus. 
B. Syphilis. - Caused "by a cork screw-shaped organism; the 
Treponema, pallidum 
C. Chancro id. - Caused "by the bacillus of Ducroy. 
D. Lymphogranuloma inguinale.- Caused by a filterable virus 
E. Granuloma inguinale« - Probably caused by Donovan body. 
IX. Importance 
Venereal diseases axe the most important cause of non- 
effectiveness ( see glossary) among troops. 
III. Sources of Infection 
A. The infected prostitue is the primary source. 
IV. Transmission 
A. Primary by direct control (sexual intercourse) 
B. Only rarely, and under certain conditions, is syphilis trans- 
mitted by the common drinking cup, and other fomites (cigars 
cigarettes, mouth musical instruments): kissing; or by being- 
bitten by a woman who has open lesions (sores)in her mouth. 
V. Control measures, 
A. Prevent exposure to venereal infection. 
B. Prevent the development of the infection in exposed indiv- 
idual (prophylaxis). 
C. Educational measures. 
Eor details of control, see Chapter XXV 
Following are some brief statements regarding the nature of 
several venereal diseases, gonorrhea and syphilis. GONOEJRHEA. 
1. It is the commonest cause of congenital blindness. The 
application of control measures is evidenced by the fact that state 
laws require that silver nitrate be instilled into the eyes of the 
new-born in order to kill any gonococci that may be present, 
2. It is the commonest cause of sterility in women. 
3* Alcohol ( even beer and wine) and intercourse often cause 
the "cured” case to start over again (not a. new infection). 
SYPHILIS 
History 
1905 - Schuman discovered the spirochete, the cause of syphilis. 
1910 - Erlich discovered arsphenamine. 
1913 - Noguchi found spirochetes in the brains of paretics. 
Transmission 
1. By direct contact 
a. Sexual 
b. Kissing 
c. Examination of infected patients and as a result of accident 
or carelessness, becoming infected. 
2. By indirect contact ( unusual) 
a. Cigarettes, drinking cups, etc. 
3. Congenital (born with the disease) 
Stages ,01 syphilis 
1. Chancre - appears 10 - bO days after exposure. 
2. Secondary - spirochetes in blood, mucous patches, skin, and 
often in the spinal fluid. 3. ,Latent period - 2 weeks to 30 years in duration. 
4. Tertiary 
Systems of the Body That On Become Involved 
Skin and mucous membrane 
1. Macular eruption (skin eruption) 
2. Condylomata ( warts) 
3. Mucous patches 
4. Gummata 
Bones 
1. Pains in hones in early stages 
2. Headaches and neuralgias 
3. Periostitis 
4. VLrtehrae 
5. Arthritis 
Circulatory System involved in 13$ of cases 
1, Aortitis 
2, Aortitic insufficiency 
Re spi rat0 ry sy st em 
1. Hoarseness 
2. Aphonia (loss of voice) 
3. Ulceration of larynx 
4. Gumma of lungs. 
Digestive 
1, Stomach pains - occasionally, much like duodenal ulcer pains 
2. Liver - frequent involvement 
a. Gumma. 
h. Hepatitis 
c. Cirrhosis Kidneys (rare) 
1. Nephrosis 
Nervous system 
1. Meningeal syphilis 
2, Cerebrospinal syphilis 
a. Vascular 
b. P ar enchynat ous 
(1) Paresis 
(2) Tabes dorsalis 
Eyes 
1. Optic neuritis 
75$ become blind in 5 years without treatment 
22$ become blind in 3 years with treatment 
100$ become blind in 2 years with treatment 
Treatment consists of: 
a. Subdural injections 
b. Pever treatments 
Below is a brief outline of some of the features of tabes 
dorsalis and paresis. 
Tabes dorsalis - locomator ataxia 
1. Pain, types of 
a. Legs - lightning in character 
b. Crises, types of 
(1) Gastric 
(2) Rectal 
(3) Laryngeal 
2. Ataxia - incoordination 3. Senses 
a. Anaesthesia, hypesthesia 
b. Position sense lost - (toe, etc,) 
U. Loss of sphincter control of urinary bladder, causing 
a. Dribbling 
'3- Optic atrophy ( blindness) 
a. Resulting from optic neuritis 
6. Trophic changes 
a. Charcot joint - knee, ankle, hip 
(i) Due to a loss of the muscular protection of the joint. 
7. Motor pal-sies 
a. Lid drooro (eye) 
b. Double vision 
Paresis - 
General - occurs in 31° of all cases 
it is three times more common in men than women 
there is a general shrinking of the brain. 
Symptoms and Signs - 
Stage I 
Personality changes 
Irritability 
Careless about clothes 
Poor judgment 
Ab s ent mindedness 
Inability to concentrate 
Slow to understand 
Depression or 
Euphoria Tremors in 
Hands 
Tongue 
Speech 
Slurring of words: as "Methodist Episcopal’1 and "third riding 
artillery brigade.n 
Stage II 
Euphoria, grandiose ideas (wealth, power) 
Depression 
anxiety, fear, self accusation 
S implo dementi a 
Paranoid ideas 
Th. re may be seizures - epileptiform 
Stage III 
Great weakness end death 
Bedridden 
NOTE 
Many people who do not have syphilis have many of the symptoms 
of paresis. Because you can!t concentrate, as .an example, don’t 
think you have syphilis. This is a common error people make on 
reading about diseases. 
Lastly, a word about congenital syphilis 
Of bSp,000 cases under treatment in the United States, 
60,000 are congenital, and congenital syphilis can be 
prevented. Fig* 1 Dirgrna to shot 'hov; organisms cm b transmitted by contact. 
Contact between the source end susceptible may be direct, (kissing); 
or it maybeiidirc ct (air, food, fingers, fsmites, etc.) CHAPTER -S 
THE RESPIRATORY DISEASES 
The Respiratory Diseases are: 
Bronchitis, acute 
Chickenpox 
Coryza (common cold) 
Diphtheria 
Influenza 
Laryngitis, acut e 
Measles 
Meningitis, epidemic 
Mumps 
Plague, pneumonic 
Pneumoni a 
Poliomyelitis 
Scarlet Fever 
Septic Sore Throat 
Smallpox 
Tonsillitis, acute 
Tuberculosis 
Vincent1s Angina 
Whooping Cough 
G-eneral Remarks: 
1. Respiratory diseases are the leading cause of admission to 
the sick report, 
2. They are especially prevalent during the winter and spring, 
and when large groups of recruits (crowds) are assembled, 
3. Some of these diseases many of us have had during childhood- 
childhood diseases such as Measles, mumps, chickenpox, diphtheria. 
and whooping cough. 
k. It is important to prevent the "insignificant” common cold 
as much as possible because the presence of a cold probably allows 
pneumonia to develop mors easily, 
5. Respiratory diseases arc primarily spread by contact. 
6. The Control of Respiratory diseases is difficult because: 
(1) They are easily transmitted, (2) People are generally 
susceptibile to them, (3) The scarcity of specific protective 
measures. 
7. Rot infrequently milk (usually unpasteurized) carries these 
respiratory diseases; Scarlet fever, diphtheria, septic sore throat. OUTLINE OE CONTROL MEASURES 
SOURCES CQNTHOL MEASURES 
I. Cases, Carriers isolation, disinfection 
1RAESMISSI0N 
II. Contact 
A. direct 
1. kissing Personal hygiene (P.E) 
B. indirect 
Prevent overcrowding 
1. air - -— — —Barracks cleanliness 
Ventilation 
a. Sneezing, coughing, talking Personal Hygiene 
2. lingers - - Personal Hygiene 
3. fomites -P.H.; Mess sanitation 
III. Susceptibles - - Protective Measures 
a. suitable clothes 
b. quarantine suspects 
c. medical inspection 
d. hospitalize suspects 
e. immunization 
f„ P.H. Personal Hygiene CHAPTER 9 
INTESTINAL DISEASES 
The Intestinal Diseases are: 
Typhoid Fever 
Paratyphoid Fever 
Common Diarrhea 
Bacillary Dysentery 
Protozoal Dysentery 
Cholera 
Helminthic Infestations (worms) 
Undulant Fever 
Food Infection 
Botulism 
Undulant Fever is not, strictly speaking, a communicable disease, 
as it is not normally transmitted from person to person. However, it 
can be transmitted from animals to man by food, and for this reason, it 
is included in this group, 
1. Carriers of typhoid fever, amebic (protozoal) dysentery, or 
other of the intestinal diseases are relatively common, 
2• Common diarrhea occurs more frequently than any of the other 
diseases, due to: (1) living in close quarters, (2) poorly 
constructed or improperly maintained latrines which allow 
flies to spread the causative organisms. 
3. Typhoid fever, like cholera, lingers where sanitation is 
primitive. 
4, Prevention of intestinal diseases rests solely on the sanitary 
control of feces and urine, 
5* It has been said that intestinal diseases are caused by the 
transmission of the causative organisms "from one mail’s 
intestine to another marJs gullet,” 
6, The sources of infection are forever present among the military 
and civilian populations, 
7. The prevalence of these diseases depends upon the degree of 
control measures inforced. 8. The causative organises invade the body via the ioouth, 
9. Pood and water are by far the commonest means of transporting 
the organisms. 
10. The organisms of typhoid fever, tuberculosis, bacill ry dysentery, 
common diarrhea, amebic dysentery, and undulant fever, as well as 
the common parasitic worms are usually carried by food. Typhoid 
fever, the common diarrheas, and undulant fever are most commonly 
transmitted by milk. OUTLINE OE CONTROL MEASURES 
SOURCES CONTROL 
I. cases, carriers isolation and quarantine 
and infected animals disinfection 
TRANSMISSION 
II. Rood •— Inspection of food 
Protection of food 
Preparation of food 
Clean utensils 
Serving Pood 
Pood handlers 
Proper waste disposal 
III. Water Protect raw water by 
proper sewage disposal 
Purification 
IV. Plies Fly control 
V. Hands Personal hygiene 
Susceptidles Protective measures; 
Qp.arant ine 
Medical inspection 
Hospitalize suspects 
Immunization 
Personal hygiene CHAPTER 10 
INSECT BORNE DISEASES; 
Definition, Insect-borne diseases jure those diseases which are usually 
tran.smitted by blood sucking insects. 
Diseases of this group are; 
Malaria Relapsing lever 
Yellow Fever Filariasis 
Dengue Rocky Mountain Spotted Fever 
Plague Tularemia 
Tophus Trench Fever 
Sp i deni c encephali t i s 
The insects (vectors) are: 
mosquito tick 
flea fly 
louse bedbugs (Furopean) 
Source 
Transmitting Agent 
Susceptible 
Malaria 
B1 ackwal er Pe ve r 
Yellow fever 
Dengue 
Pilariasis (Bancroft 
type) 
Epidemic encephaliti s 
Cases . 
Infected animals — 
Mosquito 
Cases 
Typhus, endemic 
Plague 
Tularemia 
certain rodents 
(rat, squirrel, etc) 
rat 
flea Source 
Transmitting Agent 
Susceptible 
(typhus , 
(Trench fever 
(tularemia, 
(Relapsing fever 
cases 
infcct ed animals - 
body louse 
cases 
infected animal - 
(t ryp ano somi .as i s 
(tularemia 
(filariasis 
Fly 
(Rocky Mountain 
Spotted fever 
(tularemia 
(Relapsing fever 
cases 
infected animal 
Ticks 
General Remarks 
1. Insect borne diseases are usually transmitted by blood sucking insects, 
2. Insects which transmit diseases to human beings or animals are known 
as vectors. 
3. Trench fever, typhus fever, and-relapsing fever are true military 
diseases in the sense that they prevail to a much greater extent 
among troops than in civilian communities. 
U, The Rickettsial diseases are: typhus fever, Rocky Mountain Spotted 
fever, tsutugamushi and trench fever, 
5. An incomplete list of infected animals is: monkeys, prarie dogs, 
squirrels, rabbits, woodchucks, end rats. 
6, Transmission of insect borne diseases is accomplisued by the vector 
first sucking blood from an infected person or animal and later biting 
a susceptible individual. Infection may occur either from the insects 
act of injecting salivary fluid as it bites, or by the feces, glandular secretions, or bodily fluids of the insect being ground 
into the skin in the act of scratching. 
7. Some of the organisms which cause insect-borne diseases oust pass 
through, .a stage of development of several days in the body of the 
insect host before the insect is able to infect another person. 
Thus, there is an incubation period. This is called "biological 
transmission". Malaria is an example of this type of transmission* 
8. The organisms of certain other diseases such as bubonic plague may be 
transferred to susceptible individuals without undergoing any change 
within the body of the insect. This is termed "mechanical transmission" 
There is no incubation period, 
9. Many insects live parastically on animals, in which case the animals 
are called hosts. 
OUTLINE OE CONTROL MEASURES 
Sources Control 
Cases - - -isolation, drugs, disinfection 
Infected animals - control or destroy 
Transmitting Agents 
Insects — - - - - - 1, destroy insect in some of the 
stages of its life cycle. 
2. prevent or inhibit breeding 
or continued existence of 
adults by modifying environ- 
ment al condit ions, 
Susceptibles 
Men, 
1. Protect man from 'bites. 
2. drag prophylaxis 
3. drug treatments; 
4. Hospitalization 
5. Immunization Chapter 11 
KISCaLAlEOUS DISUSES 
The Miscellaneous Diseases to be discussed are: 
Lockjaw (tetanus) 
Gas gangrene 
Rabies 
Scabies 
Ringworm "Dhobie itch" (trichophytosis) 
Poison ivy, poison oak, poison sumac (plant dermatitis) 
Anthrax 
Infectious Jaundice 
Trachoma 
'■N 
Scurvy 
1 
Pellagra ’ Diseases due insufficiency of vitamins 
\ 
Beri-ber5 | 
.J 
General Remarks: 
1. The organisms of tetanus and gas gangTena are to be found in animal 
manure, human feces, soil and street dust. 
2. Rabies is a disease of mad dogs. Transmission is by the bite of 
the rabid (mad) dog. 
3. Scabies and ringworms are transmitted by direct contact with in- 
fested persons and indirectly by use of underdo thing, gloves, 
shoes, socks, etc., of such persons. 
U. Scurvy, pellagra and beri-beri are throe diseases that result from 
an insufficient amount of certain vitamins over a period of time. 
Each disease, except those of faulty diet, shall be discussed 
separately below. Thu dietary diseases are discussed in Chapter 17* 
pages 102 and 103. LOCKJAW (TETAFJS) 
I* General. Tetanus is commonly called "lockjaw." It is a serious 
disease, having a mortality which may be as high as SO percent. 
It is caused by the tetanus bacillus which is an anaerobic organism 
(one which lives in the absence of oxygen). Tetanus bacilli enter 
the body by way of wounds. The size and appearance of the wound 
bear no relation to the severity of the illness which may develop 
if tetanus bacilli are present. These organisms are most apt to 
appear in wounds which have been contaminated, with soil or road dust, 
especially deep puncture wounds in which foreign bodies have lodged, 
or wounds entering joints. These are among the common types of 
wounds encountered in war. The tetanus bacillus is easily dee:~oyed 
by ordinary antiseptics, but, in the "spore"or resting form, it may 
live for a long time in the soil, withstanding wide ranges of temper- 
ature. Thus, any wound, unless superficial and clearly inflicted, 
must be considered a possible source of tetanus, 
11. Control Meac.ires. 
A. Treatment of the wound. Any wound other than small, super- 
ficial scratches should be treated by skilled medical per- 
sonnel, This is especially true of puncture wounds from nails 
or from spikes on athletic shoes. The treatment should be 
obtained promptly so that wounds may be cleaned out before, 
tetanus bacilli gain a foothold, 
B, Specific measures 
1, In the past Tetanus antitoxin has been routinely admin- 
istered to all cases incurring wounds in war, or under 
circumstances which suggest the possibility of tota: 
The dose is 1,500 units for adults and 750 emits for 
children. It should be given as soon as possible after the wound is incurred. It gives a fairly high degree of 
protection against tetanus, hut has the important difficulty 
in use that many persons have severe reactions. These are 
termed serum reaction or anaphylactic shock, A medical 
officer can determine with reasonable certainty hy a pre- 
liminary test whether antitoxin may he safely given. It is 
important for any person to inform the medical officer as to 
whether he has had asthma, hay fever, or reaction to any pre- 
vious dose of antitoxin. 
2, A form of vaccine called "tetanus toxoid" has been developed. 
This gives better protection than tetanus antitoxin, and is 
also safer in use. In time of war it may be given to all 
soldiers either at the time of enlistment or before they enter 
a theater of operations. Any man wounded will then be given 
additional injection of the toxoid as directed. 
BASIES 
I, General. 
A, Rabies is a communicable disease of animals transmissable to 
man. It may occur in any animals but is most prevalent among 
dogs. In the dog it may occur in a furious excited form, or 
in a dumb and depressed form in which the animal is very weak 
and finally becomes paralyzed. The excited form is more common. 
B. Usually the virus or organism of rabies is transmitted by ino- 
culation of saliva through a wound or abrasion of the skin or 
mucous membrane. The saliva is injected into the skin by bit- 
ing, but it may be transmitted by the Hexing of injured skin 
surfaces by sick animals or by handling sick animals. The organism cannot be transmitted through unbroken skin, by in- 
gestion of contaminated food or drink, or by contaminated 
fomites, While the disease occurs in cats, squirrels, rate, 
wolves, coyotes, foxes, horses, cattle, sheep, and swine, „ lese 
animals are not common sources of infection for man. An 
average of 50 percent of persons bitten by a mad dog will de- 
velop rabies, unless properly treated. 
II, Control Measures 
A, Control of rabies depends on the prevention of the disease in 
dogs, treatment of wounds, and prophylactic treatment to pre- 
vent the development of the disease. 
B. Bogs can be protected against rabies by specific vaccination 
which s hould be repeated each year, A metal tag giving the 
date the treatment was given should., be attached to the collar 
of the dog. 
C. When a case of rabies develops in a dog, or when a, dog is ex- 
posed or suspected of being exposed, to the infection, two 
doses of the vaccine should immediately be given and- the ani- 
mal held in quarantine for 1 month. When dogs cannot be vac- 
cinated, those exposed or suspected of being exposed to the 
rabies, infection should be held in quarantine for at least 
6 months. 
D. A person bitten by a mad dog, or by a strange and unknown dog, 
should report to a medical officer for treatment of the wound 
and a course of prophylactic vaccination. This vaccination 
is highly effective. If possible, the dog which bit the in- 
dividual should be captured and observed to determine whether 
it had rabies. SCABIES 
I. General 
',4 A. Scabies, also known as seven-year itch, is an acute inflam- 
matory condition of the skin due to the presence of the Sarcoptes 
scabiei or itch mite. The female is responsible for the 
disease, as she burrows into the skin in order to lay her eggs, 
while- the.male remains on the surface. After laying from 25 
to 50 eggs, she usually dies. The eggs hatch in about 5 days. 
The larval and nymphal forms pass through four stages to be- 
come adults in about three weeks. The larvae also bore into 
the skin to find protection and food. The activity of the mites 
is greatly influenced by the temperature. Active burrowing 
takes place only when the skin is warm. The newly matured 
females end the males are found under the scales and crusts of 
the skin. 
B. Scabies is am important condition because of its adverse affect 
on the morale and efficiency of the individual or groups. It 
entails an average loss of time of about 10 days in cases ad- 
mitted to quarters and hospital. Complicated caises are fre- 
quently in hospitals for several weeks. 
C. The source of infestation is the person with scabies. Direct 
body contact is the common mode of transfer, but indirect con- 
tact through clothing, blankets, or equipment may occur. 
Clothing from infested individuals may harbor the live para- 
sites for at least 11 days. 
D. Itchiness between the fingers and upon the back of the hands is 
usually the first symptom. The parts most affected are the webs of the fingers, backs of the hands, occasionally the 
palms3 flexor surfaces of the wrists end arms, lower part of 
the abdomen, the buttocks, the inner surfaces of the thighs, 
and the genitals. The lesions are rare upon the feet. The 
primary lesion is a vesicle or papule. Burrows are not found 
in all cases; they are most common between the fingers. They 
consist of straight or tortuous lines from l/S to l/2 inch in 
length and ending in a slight elevation. Along the lines are 
numerous black dots, the excreta of the female. The itching 
is usually intense, and is especially bad at night, 
E, The diagnosis should be confirmed by a, medical officer, but 
company commanders should, be able to recognize the condition. 
A positive diagnosis can be made by finding the mitos in the 
burrows, A hand lens is an aid in this search. The location 
of the lesions on tho hands, wrists, elbows, knees, and geni- 
tals aids in differentiating scabies from the earatch marks 
duo to body lice, 
II, Control Measures 
A, General, A medical officer should supervise the disinfestation 
of a group of individuals having scabies. Hospitalization is 
not essential except for single or scattered cases. Eradi- 
cation of existing infestation depends on proper diagnosis, 
disinfestation of skin, clothing, and blankets. The spread of 
scabies from infested recruits or isolated C3.ses is controlled 
by securing body cleanliness, cleanliness of clothing; an:., 
blankets, and by preventing overcrowding. 
B. Special measures. Group quarantine should be established for 
all patients until treatment is completed. Men who have re- 
ceived treatment should be re-inspectcd 10 days after completion of the treatment to be sure all infestation is destroyed. The 
clothing and blankets of men having scabies should be disinfested 
the 
by/method employed for delousing. This should include gloves and 
shoes. 
C. Disinfestation of the skin. Disinfestation of the skin is acco.n- 
' piished only by treatment that destroys all forms of the parasite. 
Bathing with hot wafer and free use of green soap well scrubbed in 
for 10 or 15 minutes is essential to remove the crusts and scales. 
The soap is then removed with hot water and. the body thoroughly 
dried. Sulphur ointment is then thoroughly applied to the entire 
body, from the neck to the tips of the fingers, and toes. It 
should be well rubbed in. This treatment is repeated on each of 
the following 2 days. On the fourth day a cleansing bath con- 
cludes the treatment. 'All clothes, blankets, and equipment used 
during the period of treatment are then disinfested. Individuals 
should be carefully inspected about 1 week following treatment. 
* Itching may continue for several days after treatment, even in 
successfully treated cases. 
"HINGWOEM," "PHOBIC ITCH11 (T5ICISPHTI0SI3) 
I. General.' The terms trichophytosis" or "ringworm" comprise a group of 
skin infections due to parasitic fungi. Numerous different rungi may 
‘ be responsible forthese' infections, and all parts of the human body 
mhy be - involved. All of these infections tend to become chronic, and 
gH thrive in warm weather or under other conditions which result in 
prespiration. They are very common in all walks of life. They may 
be so mild as to be barely noticeable, or so severe as to be completely disabling. 
A. Types of Ringworm; 
1. Ringworm of the scalp. 
2. Ringworm of the heard, 
3. Ringworm of the body. 
U. "Dhobie itch" attacks the skin about the genitals, 
and may attack other regions of the body. 
5. Ringworm of the extremities. 
a. Ringworm of the extremities is variously called 
ndormatomycosis," "epidermophytosis", "trichophy- 
tosis", and "athlete’s foot". It consists chiefs 
ly of an inflammation of the skin between the toes 
and on the soles of the feet, but it may also oc- 
cur on the hands. The lesions may appear in var- 
ious forms, including thickening and scaling of 
the skin, excoriation of inf lammed areas, fissures, 
and vesicles (blisters). Usually there is con- 
siderable itching. The infection tends to recur 
when the feet perspire, even after lengthy treat- 
ment . Complete cures are very difficult to obtain. 
b. Ringworm of the extremities is one of the most 
prevalent of all skin diseases, although many cases 
may pass undiagnosed unless their presence is re- 
vealed as the result of examination. The presence 
of this condition in an organisation has an ad- 
verse effect on the morale of the troops. The in- 
fection, if untreated, may become so severe as to 
incapacitate the individual. c. The causal agents of ringworm of the extremities 
♦ 
are most commonly spread by contact of the bare 
feet with the floors, mats, benches, end chairs in 
the ba.th rooms of gymnasiums, club's, and swimming 
pools. Towels, slippers, shoes, or other articles 
• ■ worn next to the skin may also transmit the fungi. 
The fungi may persist for a long time in or on 
these various objects. 
II. Control Measures. 
A. General. The control measures for all the forms of ringworm 
infection are -essentially the same. The main objective is to 
prevent the bare skins of non-infected individuals coming in 
contact with any objects which may'have been contaminated by 
infected persons. 
B. Treatment. All cases of trichophytosis should be promptly and 
adequately treated. Hospitalization is not necessary in all 
cases, but treatment should be administered under the close 
supervision of a medical officer. Self-treatment will often 
aggravate rather than improve the infection. The feet of all 
men should be carefully inspected at the regular monthly in- 
spection and at other foot inspections. All cases of tricho- 
phytosis should be oromotly reported for tr eminent. If numer- 
ous cas-s are found, careful inspection should be made to de- 
termine whether there has been seme slip in sanitary preen; ions. 
C. Care of the feet. Proper care of the feet is particularly im- 
portant in the prevention and control of trichophytosis*. 
especially important to keep the feet dry. Men should be in- 
structed to dry carefully the areas between the toes before putting on socks and shoes after a bath. If the feet tend to 
perspire excessively, the issue foot powder should be applied 
twice daily. Formaldehyde or other drying' solutions should not 
be applied to the feet unless advised by a medical officer. 
D. Foot baths. If ringworm of the extremities is prevalent in a 
command, all bathhouses should be equipped 'With foot baths. 
The tubs should be located at the entrances to the showers c ..d 
should be broad enough so that all individuals will have to step 
in them going to and from the showers. They should, be at least 
6 inches deep, and should be constructed of concrete or rubber. 
They should contain a solution of a grade A calcium hypochlorite 
in the proportion of 1 ounce of the dry chemical to each gallon 
of water. This yields 0,5 percent of available chlorine, A 
fresh solution should be prepared daily. The reason for these 
baths should be carefully explained to all members of the command. 
E, Disinfection. The most effective control measure is aisinfec- 
tion of bathhouse floors and equipment, and by the disinfection 
of towels, swimming or gymnasium suits, and similar articles. 
Bathhouse floors and equipment, including mats, benches, and 
chairs, should be scrubbed daily with soap end water. It is 
also advisable to scrub them with a disinfectant such as 2$> 
cresol, or a solution of calcium hypochlorite, 1 ounce to the 
gallon of water. There should bo removable duckboards in shower 
baths. These should be thoroughly scrubbed, and then exposed to 
the sunlight for several hours each day. Individual slippers 
of rubber are useful, in preventing contact of the bare feet 
with infected surf axes. The exchange or common use of towels, 
gymnasium suits, slippers, shoes, or gloves should be avoided been 
unless they havj*/thoroughly disinfected after use. All art- 
icles that will not be damaged by boiling should be sterilized 
in that manner. Leather and rubber goods can be disinfected 
with a cresol solution. Shoes can be disinfected by a ifo solu- 
tion of thymol in gasoline (without lead)" or alcohol. This so- 
lution is poured into the shoes and allowed to evaporate. 
R. Swimming pools. Swlnasing pools constitute a potent means for 
transmission of fungi unless properly operated. Regulations 
should be drafted for swimming pools providing for: 
1. Restriction on the number of bathers to be allowed in 
the pool at any one time, and also between periods of 
cleaning of the pool. 
2. A thorough bath with soap and water before entering the 
pool. 
3. Continuous disinfection of the pool, preferably with a 
chlorine solution. 
Root baths of calcium hypochlorite before entering the 
pool. 
5. Exclusion of those who are ill. 
POISON IVY, POISON OAK, POISON SUMAC 
W1)Ma!TM57 
I, G-eneral 
A. The poison ivy, poison oak, and poison sumac are the common 
plants that produce skin irritation in susceptible persons. The 
poison ivy is distinguished from other suspected creepers of a 
similar appearance by its possession of three leaves instead of 
five. The poison oak which grows especially in the western part 
of the United States is a shrub or small tree. The poison sumac 
also known as poison elder or dogwood, is a shrub or small tree growing in swampy places. 
B, Tiie harmful part of these plants is the resinous sap which exudes 
from all injured surfaces. It is now certain that the poison is 
not volatile as. was once supposed. Actual contact with the sap 
is necessary; however, contact with the plcant may not be essential 
as the sap can be carried on clothing, tools, and. hands, or trans- 
mitted on the bodies of insects or in the smoke coming from fires 
burning the plants. Sap particles carried in any of these ways 
soon lose their toxic properties by oxidation. This loss is more 
rapid at body temperature and in a moist atmosphere. The poison 
is soluble in alcohol and alkalies. 
C. The clinical manifestations appear within a few hours after 
exposure and within 2k hours there is a marked cutaneous irritation. 
The lesions are most marked on the back of the hands and fore arms; 
the face is usually involved, cither primarily or secondarily. In 
... men the penis is often involved, duo to the poison being conveyed 
by the hands. At first there is a marked erythema with some 
swelling, but in a. short time, numerous tiny vesicles appear. 
These may coalesce to form large vesicles. Often they arc in 
rows, due to scratching. Within 2 to '4 days, the lesions rupture 
leaving a weeping raw surface which goes on to form a dry crust. 
As the vesicles are superficial, complications seldom occur and 
the patient is usually well in 2 weeks. The subjective symptoms 
are generally severe, with intense burning and itching and a 
feeling of increased tension of the skin, 
XI. Control Measures. , 
A. General 'measures. Learn to recognize the plants amid avoid them 
when possible. -Destroy the plants in occupied areas. Avoid contamination in camps by requiring all men working in or about 
the plants to — 
1. Wear gloves while at work 
2. Change outer clothing and gloves before associating with 
the other men in the camp. 
3. Keep contaminated tools and implements separate 
k. Barn poisonous vegetation at a considerable distance from 
the camp site and always at such time and place that uhe 
wind will carry the smoke away from the camp, 
5. If possible, choose camp sites where poisonous plants are 
not present, 
B, Personal measures 
l. Contaminated clothing and implements should ho well washed 
with water ( soda, water if possible ) or exposed to the 
direct rays of the sun for several days. 
2, 111 parts of the body that have been exposed to the plants 
should be well washed with a strong soap solution or 
(without lead) 
alcohol. Gasoline ovjkerosene may be used. The washing 
must be prompt and thorough, or else it will tend to spread 
the poison, 
3. Skilledcedical treatment should be promptly sought if the 
skin eruption appears. GAS GAITGEME 
I, General, Gas gangrene is an acute infection occurring in large, 
crushed wounds contaminated with human or animal wastes found in soil. The 
infection is usually associated with compound fractures and large wounds 
that come in contact with the soil, hut it has occasionally followed, 
puncture vounds, Once the disease develops it is extremely difficult 
to control. The mortality is very high* 
II. Control Measures; Control depends on early and. proper surgical 
treatment and the use of sera. The first aid precautions are the s. *ie 
as those for tetanus* PART II 
THE SOURCES OF INFECTION AND THEIR CONTROL Obiter IP. 
THE SOURCES OF INFECTION: THEIR C03EBDL 
Tlie sources of infection, as has been stated are: 
case 
carrier 
infected animal 
Before the control measures are discussed, it is necessary to define 
several words. 
CONTACT - A person who has been closely associated with a sick 
person is known as a contact. 
SUSPECT A .person who has been exposed to a communicable disease 
and is ill, but in whom the symptoms and signs present are insufficient 
to warrant a diagnosis of the particular disease, is spoken of as a suspect. 
Control measures have as their objective the rgjjjoval of the source of 
infection from susceptibles. 
The control measures are carried out by: 
1. ISOLATION - Cases of co* muni cable diseases are hospitalized if 
possible, and are kept separate from other persons. This is termed 
. "isolation1*. Cases, carriers or suspects may be placed in iso- 
lation for treatment and observation. 
2. QUARANTINE - Quarantine is the separation of a. group containing 
individuals who are actual or potential sources of infection 
from the remainder of the command for the purpose of preventing 
the transmission of the infection. 
Group quarantine is the restriction of a contact group under 
conditions which will prevent the spread of the infection to un- 
exposed members of the command, but will permit the grou. as a 
whole to continue training. The group may be a squad, platoon, or even a company. 
3. DISINFECTION - is another method of ]hr eventing the spread of patho- 
genic organisms. It is accomplished by steam, chemicals,sunning, 
or airing. 
a. Concurrent Disinfection 
(1) In respiratory diseases it involves the disinfection of 
such fomites as; wash basins, thermometers, bed .ns, 
urinals. 
(a) Paper napkins, kleenex and similar articles should 
be burned. 
(b) Those attending the patient should wash their hands 
with hot soapy water after each contact with the 
patient. 
(c) A gown should be worn by attendants as a means of 
protection. 
'■ (d) Dishes, see "e,! below, 
(2) In intestinal diseases, it involves'burning or disin- 
fecting articles soiled by excreta. 
(a) Discharges can be disinfected by adding 2% cresol 
solution, or \0% formaldehyde and allowing the mix- 
ture to stand at least 1 hour. 
(b) The volume of disinfectant used should be twice 
that of the material to be’disinfected. 
(c) Urine - Add sufficient cresol to make an approxi- 
mate 2% solution. Mercuric chloride 1:1000 may be 
used in place of cresol. 
(d) Uneaten food - Burn or dispose in such a manner 
that it cannot be a source of bacteria. (e) Dishes and eating utensils should be boiled after 
use, for a period of at least 1 minute. Dishes 
immersed in water at temperature of 160° F for one 
minute will destroy pathogenic organisms. But, 
under practical working conditions, dishes cannot 
be sterilized by heat in the sense that all organisms 
■are destroyed. Because of the difficulties encoun- 
tered, considerable attention is now being given to 
the use of chlorine for this purpose. After the 
dishes have been cleaned by washing and rinsing in 
hot water to remove the soap, they are immersea 
for not less than 2 minutes in a fresh chlorine 
solution of this proportion: one ounce of calcium 
hypochlorite to every 25 gallons of water. Rinse 
water should be 180° F, and not fall below 
170° F at any time during the rinsing period. 
(f) Sheets, towels, pajamas, etc. - Boil or immerse in 
a 2 or 3% solution of cresol, 
(g) Those attending the patient should care for their 
hands as explained above. 
(h) Attendants should wear gowns. 
U. Those diseases that can be treated by means of specific drugs are 
so treated. Such treatment is a means of reducing the potential 
dangers of a case. 
a. Terminal infection - When the patient recovers and loaves the 
hospital, his room and the articles he used should be disin- 
fected. 
(1) In certain diseases only bedsteads, floors and walls must be thoroughly scrubbed with soap and water immediately 
after the patient using it has been transferred. Blan- 
kets and mattresses are aired or sunned in some instances, 
in others they are steamed. 
(2) Amebic cysts are destroyed by a to 5-1 solution of cresol 
The shbrter time .the patient is ill, the shorter time will die'V 0 source. 
Lastly, cattle may be destroyed in certain instances. 3uch an in- 
stance would be tuberculosis. Fig. 2. Diagram to show how pathogenic organisms can get into food. 
of fighting these hazards are designated hy blocked numbers A) to (sp See 
page for detailed explanation 
r pathogenic organisms. PART III 
THE 'THANCUTTING- AGENTS: DETAIL AID APPLICATION Chapter 13. 
TRANSMITTING AGENTS! GENERAL BEMASKS 
As stated in Chapter 5» the transmitting agents are: 
1. Jood 
2. "Water 
3. Contact 
h. Insects 
The next five chapters go into the details cf the manner by which 
these agents transmit disease. To 'understand the facts of transmission 
is one thing; to understand the principles of the control measures is 
equally important. Control measures are merely the methods of prevent- 
ing the development or an increase in the spread of communicable di 
ease. 
Water is used to fight fires. This statement is not made with the 
idea of teaching you some tiling new. It is made, however, to point out 
that water is a control measure to be used in preventing the spread of 
fire. Figure 3# Diagram to show how pathogenic organisms can get into 
water, Methods of "fighting" these hazards are designated by 
, i t •—'■jf 
hlocked numbers as /2.j (Start at j 1|, See page 90 for detailed 
explanation. 
pathogen ic org-ani sm TRANSMIT TING- AGENT 
SOURCE DISEASES 
SU3CEPTI3JF 
Mosquito 
Cases 
Infected Animal 
Ms 1 ar i 3j 
Blackwater Fever 
j Yellow Fever , 
Dengue 
i F11 arias is 
(Bancroft Type) 
Fncepha3.itis 
Flea 
Case 
Ccrtain Roden t s 
(Rats* Squirrels, etc) ■ 
0**.. 
Typhus 
Blague V 
Tularemia. 
Louse 
Gas o 
Inf acted Animal 
T;,’pirns 
Trench Fever 
Tularemia 
lielaps ing Fev er TRAITSMITTING- AGEM? 
SOURCE 
DISEASES 
SUSCEPTIBLE 
Ely 
Case 
Infected Animal 
Trypano son i as;s 
Tularemia 
Filariasis 
Tick 
Case 
Infected Animal 
r 
Rocky Mountain 
Spotted Fever 
Talar emi a 
Relapsing Fever 
r, /. ■/ 
Si// -J / 
' (i t 
Figure — Diagram to enow hew insect-horne diseases are transmitted The above diagrams are a fairly precise means of calling y r 
attention to the essential factors which are of importance in the trans- 
mission of respiratory diseases, intestinal diseases and insect—borne 
diseases. 
The following chapters of Section II, shall deal specifically 
with the following subjects: 
1. Air Control 
2. Water Control 
3. Food Control 
U. Insect Control 
5. Rodent Control 
Section IV of this shall discuss measures to maintain health, 
many of which measures are matters of personal hygiene. 
After a study of Section III, you are in a position to logically 
understand the meaning, purpose and principles of disease prevention 
(control). For instance, turn to page UU. There you can find an . Aline 
of control measures for respiratory diseases. It requires an understanding 
of air control, food control, of measures to maintain health and of per- 
sonal hygiene. Thus, a complex subject has been simplified as much as 
possible. This book can serve you two purposes in the future, should 
you wish to refer to it. First, the brief chapters on the groups of Di- 
seases (Chapter 7 through •■Chap ter 10) present important facts and an out- 
line of control measures. Secondly, Section III presents the various 
control measures in considerable detail. Some of these details are what 
you might call iacts of a practicable value that are a value to yourself. 
Other facts, difficult and unnecessary to learn, but none the less valu- 
able. arc available to those who make the effort to search them out. CHAPTER V4 
CONTROL OR VENEREAL DISEASES 
Control Measures 
A, Responsibility. The venereal disease r-'te of an organization 
is usually a rather close index of the state of discipline, 
training, and administration of that organization. The re- 
sponsibility for venereal disease control rests primarily on 
unit commanders. The principles of transmission of venereal 
disease axe simple and are easily understood by all persons. 
B, Preventions of exposure. * The most important fact to be kept 
in mind by all individuals is that almost all women who will 
permit promiscuous sexual intercourse are infected with 
venereal disease. Sexual intercourse is not essential to health, 
and efforts should be directed toward preventing exposure to 
infection, 
C, Prophylactic measures. In spite of warning, many individuals 
will expose themselves to infection, mechanical and chemical 
means of preventing the development of infection give a fairly 
high degree of protection, but only so when promptly, intelli- 
gently, and thoroughly applied. 
1. Mechanical The condom affords the only practical mechan- 
ical protection against venereal infection. Post exchanges' 
axe required to stock condoms of approved quality. A 
condom will prevent gonorrheal infection, which must enter 
the urethra.. It is not certain protection against 
syphilis, chancroid, or lymphogranuloma inguinale, which 
may enter the skin and tissues about the genitals. Con- sequently, chemical prophylaxis must be given even after a condom 
has been used. 
2. Chemical 
a. Prophylact ic st at ions - The Medical Department is responsible 
for operating sufficient prophylactic stations to serve ade- 
quately each command. In many situations it is advisable to 
establish such stations in civilian communities adjacent to 
Army stations or camps. Prophylactic stations may be establish- 
ed even in bivouacs. Chemcial prophyl.netic treatmeat is given 
in these stations by trained enlisted men of the Medical De- 
partment. Any soldier may' apply for treatment regardless of 
the hour. The chemical prophylaxis given is highly effective 
if administered within 30 to 60 minutes of the time of exposure. 
Its effectiveness decreases rapidly after that time. The 
attendant at the station gives each soldier a 'signed record 
of the treatment, showing the date, hour, and place of treat- 
ment. This treatment cannot be satisfactorily administered 
to a man who is drunk because individual cooperation is necessary. 
b. Prophylactic equipment. The following equipment is necessary 
, for a prophylactic station: 
(1) Protcsrgol soltuion, 2 percent, freshly prepared weekly. 
Keep in amber-colored bottles. 
(2) Bichloride of mercury solution, 1-1,000. Poisonous, Does 
net deteriorate. 
(3) Sufficient calomel ointment, 30 percent. Well mixed. Does 
not deteriorate. 
(U) Sufficient liquid soap in a bottle with a shaker top 
made by inserting a glass tube through the cork. (5) At least 1 dozen serviceable urethral syringes. Keep in 
a closed jar, 
(6) Tongue depressors. .Keep in a closed container. To be used 
to remove the calomel ointment from the jar. 
(7) Sterilizer for syringes. They must be washed thoroughly in 
soap and water, then sterilized by boiling for 5 minutes, 
(8) Sponge- holder, to be used by soldiers in removing syringe-, 
tongue depressors, gauze, and sponges. 
(9) Running water or at least 1 dozen wash basins. 
(10) Sufficient 2-ounce medicine glasses, into which protargol 
is poured before use by the soldier. 
(11) Clock. 
(12) Roll or absorbent paper. 
(13) Towels, linen or paper. 
(lU) Large, easily read labels for everything the soldier is 
required to use, 
(ip) Well lighted room, preferably with an anteroom as a waiting 
room, end a small adjoining room or booths with either a 
large trough with running water or individual porcelain 
troughs in each booth. 
(lb) Sufficient blank forms W.D., M,D. No. 77 (Venereal Trophy1 .is 
Slip) to be made out properly and kept on file for at least 
3 months. When the soldier receiving prophylaxis is from 
another organization, send a duplicate copy of W.D. k.D. 
form Ho. 77 to his commanding officer nent clay. 
(17) Place to wash hands. c. Prophylactic procedure - The prophylaxis oust bo given by 
a trained attendant. Some of the stops in the prophylaxis may 
be self-administered but they should be closely supervised the 
. attendant. 
(1) Examine penis for signs of venereal disease. If any sign 
of venereal disease is seen, do nob administer prophylaxis 
until soldier is seen by a medical officer, 
(2) Have soldier urinate and hash his hands , - 
(3) Havo soldier wash penis, scrotum and adjacent area, of his 
body thoroughly with liquid soap and warm water. Hush off 
with 1-1,000 bichloride of mercury solution, 
(4) 3y means of a. syringe inject a teaspoonful of 2 percent 
protargol into penis. Have soldier close the, opening with 
his thumb and finger and retain the solution for 5 minutes 
by the clock. Too much pressure must not be placed at the 
end of the penis. This is where the germs, if present, 
are likely to be most numerous. Release pressure very 
slightly at intervals to allow for thorough bathing 0:. 
end of opening. 
(3) Have soldier pull back the foreskin; thoroughly rub into 
the penis and surrounding body area about a teaspoonful of 
calomel ointment, 30 percent, Rub in for at least 3 
minutes. Wrap penis.in a towel or paper. Instruct the 
soldier not to urinate for at least *+ hours, if possible, 
3. Emergency. If a soldier has exposed himself and lias neither a 
prophylactic tube nor access to a station, he should empty his bladder, 
and then scrub his genitals and the surrounding skin area with soap 
and water. This may serve to prevent infection. D, Punitive measures 
1. Any individual who knows or "believes that he has contracted a 
venereal disease mast report that fact to his immediate com- 
manding officer without delay. Trial by court martial or other 
disciplinary action for concealing a venereal disease is d:; • 
cretionary with the commanding-officer, No disciplinary acdon 
is authorized for failure to take prophylaxis or for having 
contracted a venereal disease. 
2. Any person in the military service who loses time from duty bo- 
cause of a venereal disease forfeits his pay during the time he 
lost and mast make good the time lost, 
E. Physical inspections. The periodical physical inspections which are 
conducted at least once each month for all enlisted men below the first 
three grades include inspection for evidence of venereal disease. Ad- 
ditional inspections may be arranged if it is believed that some men 
may be concealing venereal disease. These are most effective if 
conducted early in the morning or just after return from outdoor 
activity. 
E, Treatment All cases of venereal disease should be promptly sent to 
the hospital or dispensary for treatment. Early treatment ofit 
far better chances of cure than does delayed treatment. Self- 
treatment and treatment by unskilled individuals are both ineffective 
and dangerous. CHAPTER 15 
AIR AMD ITS CONTROL 
It g03s without saying that air is essential to us. On the other 
hand air can play a part in the transmission of disease, 
I. Air, General Remarks: 
A, A mixture of: 
1. Oxygen 21.00 $ 
2. Nitrogen 73.00$ 
3. Carbon dioxi dot.... 0.03$ 
4. Other gases 0.97$ 
5. Varying amount of water vapor. 
6. Particles of 
a. Dust 
b. Bacteria 
c. Yeasts, etc. 
B, Air affects the physiological functions of the beiy by: 
1. The interchange of gases in breathing. 
2. The regulation of body temperature. 
C, The Chief Physical Properties of Air: • 
1. Temperature. 
2. Humidity 
3. movement of air. 
4. Atmospheric pressure. 
When a person sneezes, coughs, or even talks a fine spray of moisture 
leaves the nose or mouth. This spray can be likened to the spray of water 
from a. garden hose. On these particles of water are numerous germs. Sven 
well people have innumerable bacteria in their mouths. People with 
respiratory diseases spread ( droplet infection) gre,-1 numbers of germs 
when they sneeze, cough, talk, or spit. It is to our advantage to prevent the spread of respiratory diseases. 
Therefore the object of control is to prevent crowding and. the cons went 
close contact between infected persons and susceptibles. 
Control of transmission of bacteria by air; 
1. Prevention of overcrowding by: 
a. Proper bed spacing: The heals of individuals in adjacent 
beds should be as far apart as possible — at least five 
feet. 
b* Head to foot bed arrangement: When the distance between 
the heads of individuals is less than 5 feet, the beds 
should be so arranged that the head of one man is opposite 
the feet of the man in the adjacent bed. 
c. Or a cubicle screen; can be used to protect the heads of 
each individual. Screens, sheets or shelter halves make % 
s erviceabie cub1cles. 
d. Staggering of beds is still another method. 
2. Proper ventilation 
a, A lack of ventilation loads to the accumulation of so called 
''dead air". It lacks freshness. It becomes warm. Bacteria 
accumulate. Body odors become noticeable. 
b. Ventilation is usually obtained by opening windows at the 
bottom on the windward side and at the top on the other 
side. Tents are ventilated by rolling up the sides daily, 
weather permitting, 
3* Cleanliness of barracks. 
a. Spitting on the floor ( droplet spray), dry sweeping of 
the floors, careless coughing; and sneezing can lead to 
the transmission of disease. They are best controlled - -by-proLimiting them. 
b. Cuspidors, • containing a 2% solution of crescl to a depth of 
one to two inches, should be available. They must be cleaned 
daily . 
4. Sunlight. 
a, Windows provide sunlight, which has an antibacterial e_ ct. 
THE SECCITD SEASON JOB. COHT.ROLLING- AIK; COMHCKT 
To be cold or "too warm" orffloggy" is to be uncomfortable. Our 
bodies are constantly giving off heat. If the environment is so warm 
that it cannot take up the heat given off by the body- why then the 
body becomes uncomfortable. In an effort to become comfortable, sweating 
takes place which, on evaporation, cools the warm skin. Were the en- 
vironment less warm, tnc body would not be forced to sweat. 
If on the other hand the environment is too cool, the body becos.es 
cool in an effort- to save heat. The blood vessels contract, the 
temperature of the body falls; there may be shivering. Certainly th.rc 
is discomfort. 
Bodily comfort is under the automatic control of the heat regulating 
center in the brain. To are unable to alter its method of functioning; 
we can however, adjust our environment. The environment can not be 
altered, unless weknow these facts: 
I. Heat is lost from body by; 
A. Kadiation. 
1. Like a radiator. Heat leaves warm skin and goes to 
cooler clothes. 
B. Convection 
1. The carrying away of the heat lost by radiation. If you -•■or iine door of a furnace the air carries'the heat from the hot .coals 
to your body, which feels the warmth, Just as the air carries the heat 
tnat comes from the surface of a hot poker. 
C, h/aporation. 
1. Heat is loot by evaporation of perspiration, the process of 
evaporation abstracting the heat from the body with conse- 
quent cooling. 
D. Pospirption. 
Exanr.le - ivhsn one becomes overheated the heat regelating center 
goes into action, sending the not blood to the surface of the body 
where some of the excess lie at is radiated and conveyed away; 
and perspiration, and respiration are aacelorated. The rotation 
of there physiological functions to the physia-.il properties of 
the air, U mp-raturo, humidity, and movement will not bo discussed, 
XI. effect of the Physical properties of Air on Bodily Comfort, 
A. T crnp nature. 
1. Temperature irfluences convection and evaporation. 
2. Poor ventilation and overcrowding cause poor radiation o: 
heat from the holy and rise of temperature. 
3* Discomfort increases as the room temperature approximates 
that of the body, preventing as it does loss of heat by 
radiation. 
B. Humidity. 
1, Influences output of heat from body by: 
a. Increasing the conductivity of the atmosphere for heat— 
(a cooling influence) and hence cold racis t air is chilling. 
o. Interfering with the evaporation of perspiration ( a 
nesting influence) and hence warm moist air is enervating, 
2* At a temperature of about 6S° F. humidity has comparatively 
little effect. 
3. Definitions. 
a. Del it ive humid!ty 
(l) The amount of moisture in the air. 
Dolativo humidity affects tie body by; 
a. Controlling the rate of evaporation of perspiration, 
b. The greater the relative humidity (the more moisture in the- 
nar) 
(l) The loss moisture the air ca3i absorb 
(P.) And hence the slower will be the evaporation of 
per spi ration. 
c. On hot 11 hum! :t days there is a high relative humidity, 
though not necessarily a high temp nature. The drying 
power is poor because of the high percent-age of moisture 
in the air. 
d. On 1!dry" days there is a low relative humidity (desert, 
moutain regions) and one can stand high temperature 
without distress. The drying power is high because the 
air can take up a great deal of moisture. 
0, In cold weather. 
(l) The greater the r.dative humidity the more one mill 
mind the cold, the moisture in this case acting as 
a rapid conductor of heat away from the body, 
C. Movement of Air, 
1. Has an effect cn bodily comfort by influencing convection and evaporation. 
a. A layer of hot moist air collects in the meshes of the clothing 
about the body. The moving air blows this away and mixes 
it with the air in the room, thus cooling and relieving the 
body, 
b. Movement of air associated with minute changes in tempo ware 
has a distinct stiulating effect. This explains the comfort 
produced by an oscillating fan, 
c. Hence, bodily comfort can be achieved within certain limits 
by adjusting our. environment - air temperature, and air 
movement (drait). Chapter lo 
WATHR AMD ITS CONTROL 
All sources of water in the field, must he considered as conta- 
minated ana should he properly treated before use. Surface water (ponds, 
rivers, or small streams) is generally more heavily contaminated chan 
ground water (walls or springs). 
Contamination of water, when it occurs, is caused chiefly by 
sewage from cesspools, latrines and drains. 
The soil is self-purifying:; if it were not, the human race would 
have died out long ago. All water, except rain water caught in cis- 
terns , passes over or through the ~'oil layer of the earth. 
Certain pathogenic organisms remain .alive for long periods of 
time in the soil by changing themselves to highly resistant spores and 
cause what arc known as the ,fsoil11 diseases: tetanus, gas gangrene, 
b c tul i cm, an thrax. 
Tine roost frequent and dangerous form of soil pollution, however, 
is that caused by the human intestinal and urinary wastes, causing 
typhoid and paratyphoid fever; bacillary and amebic dysentery; hookworm 
disease and infestation by round worms. These organisms can withstand 
adverse conditions in the soil better than, others. Hence, they • e 
not readily destroyed. Tl,..y often live long enough to reach streams 
and rivers, thus contaimnating water supplies. It should bo mentioned 
paranthetically that in the tropics soil pollution with fecal material 
is common and that the soil is moist .and warm, thus providing a favor- 
able environment for bacterial growth. 
Water, safe for drinking purposes, is obtained by certain control 
measures, First, turn to page '/4 q;ad study the diagram which shows how water c>-r transmit intestinal diseases. 
COLTRGL MSAGITHSS (Refer to Pig. 3» page 7^) 
The following are control measures: 
1. Proper waste disposal (see Chapter lU), the purpose of which 
is to prevent pathogenic organisms of the excreta of cases 
or carriers from reaching the soil or any water. Besides 
properly constructed latrines to prevent access to flies 
and animals, the excreta of cases and carriers are disin- 
fected. 
2. Protection of a viator Supply by flagging the Stream. 
A. If a stream is to be used as the source of water 'ripply 
of an organisation, it should be marked off in zones, 
indicated by markers, and water guards should bo posted. 
LOCATION OP WATldl SJBO/13 (SlhxA.') 
Pig.5> Flagging the streams affords protection of water supply hy proper use 
of stream from which water is taken for various purposes/ 
3- PURIFICATION 
A. Purification 
Preliminary treatment. The water selected should he 
■as clean as possible, and the heavier organic matter 
removed hy straining or settling. A pit dug U to 5 
feet from the edge of a stream or pond and 3 to U feet below the stream level makes a satisfactory settling has in. Another 
method is to remove both ends from a barrel or oil drum and sink one 
end. in ,.o the bottom of a shallow stream or pond, dipping water from 
inside the barrel. 
• 1* 0? PURIFICATION 
A, Boiling. Boiling is the safest method, but is undesirable 
because of the flat taste and because of the lack of con- 
tainers for boiling other than small quantities. Five 
minutes of boiling is required for sterilization of water. 
B. Chlorination. Chlorination is the choice method and may 
be carried out in the water sterilizing bag (Lister bag), 
in water carts, in small reservoirs, or by the purifica- 
* 
tion units ope raked, by the Corps of Engineers. The 'act 
amount of chlorine required will vary with the character- 
istics of the water being treated. Water containing con- 
siderable organic matter requires considerably more chlo- 
rine than does clear f/ater, 
1. Water sterilizing bag method. The procedure is 
as follows; 
a. Suspend the bag on a tripod. Fill it with 
water to the mark U inches from the too, 
straining the water through cheesecloth. 
The capacity1is gallons. 
b. Draw a small quantity of water through one 
of the faucets into a canteen cup. 
c. Break a tube of calcium hypochlorite into 
the canteen cup, stir with a clean stick, 
then fill the cup two-thirds full of ater. de Empty this solution into the water beg 
and stir thoroughly with a clean stick 
which is long enough to reach to the bot- 
tom of the bag. 
e. Draw at least one-half canteen cup of 
water from each of the faucets and pour 
it back into the water bag. This serves 
to s terilize the faucets, 
f. Wait 30 minutes after chlorination before 
using the water. 
g. When especially trained technical person- 
nel and facilities are available, it may 
bo practical to control accurately the • 
degree of chlorination and thus provide 
a more acceptable water supply when judged 
from the point of both taste and safety. 
This controlled chlorination requires the 
use of an orthotolidine test solut; "n and 
may be employed after the calcium hypo*'- 
chlorite is added to the water in the fol- 
lowing manner: Wait 10 minutes, then wash 
out one of the faucets by allowing a small 
amount of water to run through onto the 
ground. Fill a clean canteen cup two- 
thirds full of water from the same fau- 
cet. Add 1 cC. (15 drops) of orthotoli- 
dine testing solution to the water in the 
cup. Wait 5 minutes .and note the color produced. 
Below is a guide for reading the color reaction between the 
f 
free chlorine and orthotolidine: 
(l) Ho color. Insufficient chlorination. Add more calcium 
hypochlorite. 
(2j Canary yellow. Insufficient chlorination. Add more 
c al c iiom hyp 0 chi 0 r i t e, 
,.',U 
(3) Deep yellow. Satisfactory chlorination. This repre- 
sents about one part per million (p.p.m.) of chlorine. 
(U) Orange red. Overchlorinated. Add more water and teat 
again, 
(5) Bluish green. Alkaline or hard water. Add a few more 
drops of orthotolidine to got a correct color reading, 
h. The cover should be kept on the bag to prevent recontamination. 
The unpleasant taste of chlorine is diminished by allowing 
chlorinated water to stand several hours before use. If for 
any reason orthotolidine testing solution is not available, 
it can be safely assumed that one tube of calcium hyp chlorite 
will adequately chlorinate gallons of water. It will ne- 
ver dangerously overchlorinate this amount of water. 
2, Water cart method. Chlorination may be done directly in water carts, 
sbirring in calcium hypochlorite at the rate of about one tube to 
each 36 gallons of water. The exact amount needed can be deter- 
mined by the orthotolidine test. These carts must be thoroughly 
cleaned at frequent intervals, 
3* Canteen Method. Fill a canteen with rater and dissolve into it the 
contents’ of one tube of calcium hypochlorite, being sure that it is 
evenly mixed throughout. Add,.one canteen cap (6 cc) of this solution to each canteen of water. Wait 30 minutes before drinking the 
water. This method is loss accurate than chlorination in the 
water sterilizing bag and requires very close supervision of 
all individuals. The concentrated calcium hypochlorite solu- 
tion may be prepared in a 1-quart bottle instead of in a canteen. 
C. Usc of icdin e, 
In the absence of calcium: hypochlorite tincture of iodine may bo used 
as a temporary expedient. Two or three drops of tincture of iodine 
will purify one canteenful of water. Thirty minutes should be allowed 
before the water is used. This method is rarely practicable in .. unbat 
since all available iodine 111 generally be needed for treatment of 
wounds, 
U. Cleanliness of hands is essential. It is not only the duty if food handlers 
but the duty of all individuals to maintain high standards of personal 
hygiene. 
So much for water and its control. A few words should be said 
about water discipline, 
TITLE PI3Cl?Lula 
X. Tatar discipline on the March. 
A. In marching 1 mile, a fully equipped soldier generates 90 ca- 
lorics of heat which will require 180 cc. of water to dissi- 
pate. For 3 miles, or 1 hour, cc. of water are required, 
which is a little over 1 pint (U73 cc.). For P hours th sol- 
diers will lose P pints or the equivalent of 1 canteen of 
water. There are too many factors entering into the water 
requirements to dogmatize or standardise the fluid Intake too rigidly. It is sale to assume that the soldier starts the march 
with about 1 pint of extra fluid in his stomach. The following 
diagram shows the ordinary consumption of water on a day’s march; 
Drinks 
remaining 
half can- 
teen ful. 
3 hours. 
Drinks 
remaining 
n canteen- 
ful. 
8 hours. 
]. hour 
6 hour?;. 
0 hour. 
Start of 
march, 1 
pint in 
btomach. 
2 hours. 
Drinks 
\ canteen- 
ful. 
U and.. 5 
hour s. 
Noon rest; 
refill can- 
teen; leave 
camp with 
1 pint in 
s tomach. 
7 hours. 
Drinks 
can- 
teenful. 
9 hours; 
Camp; 
refill 
canteen. 
B. Water should he chlorinated end canteens filled the night 1 "’ore 
a march is started. Chlorinated water in company cans shout .i. he 
available at the noon halt. Chapter 17 
FOOD AM) ITS CONTBDL 
Fool is a transmitting agent. It can carry pathogenic or- 
ganisms, Contaminated food may bo eaten, resulting in the develop- 
ment of disease. To protect ourselves against invasion of patho- 
i 
genic b>: oteria via food, it is necessary to maintain at all times 
offensive and defensive measures. Defense alone will not bring 
success. 
Satisfactory protection can be achieved. Listed below are the 
principle factors, each of which shall be discussed in "detail: 
1. Control of food products of animal origin. 
<?. Inspection of food when received. 
3. Storage of food to protect it from flies, and animals, and 
to prevent deterioration, 
U, Preparation cf food. 
5= Care of cocking and eating utensils. 
6. Contamination of food during preparation and serving. Food 
handlers, 
7. Menus and serving of food. 
8- Disposal of wastes, 
9. M 3s s in spection. 
Those factors are now discussed in detail. 
COTTFCL OF FOOD PRODUCTS OF MUUxL OKI GUT 
Even before fool of animal origin (meat, meat products, poultry 
eggs, fish and other seafoods, as well as all dairy products) is 
purchased, it is inspected by various civil and military inspecting 
agencies (Veterinary Corps) with one purpose in mind. The purpose of inspection is to protect the health of troops. Any food, 
deteriorated or contaminated, is rejected for use in organizational 
messes, 
A, . The meat of a healthy animal is free from bacteria - all bac- 
terial decomposition is due to contamination, subsequent to slaughter. 
Since it is impossible to prevent handling entirely, it can be said 
that all fresh meat is more or less contaminated with bacteria or 
fungi. Under unsanitary conditions the meat may be contaminated 
with pathogenic organisms. 
Non-pathogenic bacteria after invading meat cause decomposition.. 
This process of deterioration can he retarded by placing the meat in 
regrigerators which insure low temperatures which are not conducive 
to rapid bacterial growth. 
Heat properly handled prior to receipt usually remains free from 
decomposition for 6 - 10 days if immediately placed in a temperature 
of about 35° The average refrigerator maintains a temperature of 
from U50 F. to 55* F, and is not satisfactory as a storage for more 
than 72 hours. 
Meats most frequently transmit typhoid fever, food infections, 
dysenteries, diarrheas. In addition tuberculosis, scarlet fever, 
and diphtheria may be carried. Finally meat, especially sausage, 
may carry the toxin of botulism, 
3. Poultry and eggs. Evidence of decomposition, slimy or sour 
carcasses, or any other unsoundness render the carcass unfit for 
food. The diseases common to poultry are not readily communicable 
to man. Sfegs are inspected for freshness, soundness, cleanliness 
of shell, color and size- Unsoundness, a cause for rejection, 
is indicated by: mixing of the white and yolk, blood rings, 
abnormally colored yo3.ks, movable air cells, discolored whites, 
or foreign bodies. Candling and breaking a considerable pro- 
portion of an entire lot are the means of testing for freshness 
and soundness. 
C, -ish and Sea Foods. Details of inspection will be omitted. It 
is perhaps worth while to mention several facts of interest, 
(l) The flesn of fish may contain chemical poisons which pro- 
duce illness in man - most of the fish so affected are found .« i 
the tropics. The poison is usually found in the ovaries, eggs, 
head and liver of the fish. Boiling does net destroy or remove 
the toxin. (2) Some fresh water fish (pike, perch) may contain 
the encysted larvae of the fish tapeworm. Thorough cooking will 
destroy the larvae; while smoking, drying, .salting, or freezing 
will not destroy the larvae. 
D. Milk and Milk Products. All bovines on the dairy farm should be 
free from disease as shown by a thorough examination conducted 
by a qualified veterinarian. Earns should be ventilated to allow 
fresh air to displace old air. Manure should be removed and so 
disposed of as to prevent fly breeding. Milking material should 
be sterilized. Milk must be promptly cooled within 1 hour after 
milking to 50° and maintained at or below this temperature 
until delivered to the pasteurizing plant. All personnel con- 
cerned with milking or the handling of milk should bo faniline 
with the necessity of strictest sanitary precautions (avoid 
droplet infodtion v;f milk; clean hands, etc,) and be required to undergo careful periodical physical examination to assure 
freedom from contagious or communicable diseases. 
Pasteurisation is the heating of all particles of milk, or 
milk products to a temperature of not less than F, and 
holding at such temperature for not less than minutes in 
approved pasteurization apparatus. 
Milk to he sanitary must necessarily he obtained from 
heathy cows and produced and handled under hygienic conditions 
even when it is pasteurized. Cleanliness throughout is essen- 
tial. All milk bottles must he sterilized immediately before 
being used. There must be safe water and steam for cleansing 
and disinfecting purposes. Screens (to keep out flies) should 
be employed in those places where they serve a useful sanitary 
purpose. 
Milk may transmit the following diseases: typhoid fever - 
common diarrhea, undulant fever, septic sore throat, diphtheria, 
scarlet fever, and tuberculosis. 
Milk products are: cheese, butter, ice cream. 
INSPECTION OF POOP WHEN RECEIVED 
All food received at a mess should be inspected by the 
mess sergeant, the mess officer, or the commanding officer of 
the organization. The purpose of this inspection is to deter- 
mine if the food is of proper Quality and free from contamination. 
STORAGE OF FOOD 
Food is stored for two purposes: (l) to prevent deteriorat- 
ion; (2) to protect from dust, dirt, insects, and animals. A, Perishable foods should bo kept at suitable temperatures 
to prevent deterioration. 
3. Peats are kept in refrigerators in permanent posts, while 
vegetables are afforded protection by vegetable bins. Bread 
boxes or storage cabinets should bo well ventilated but 
screened to prevent the access of flies to the food, 
C. In the field, food is usually placed in containers which are 
suspended from trees, immersed in water, or placed underg and 
PROBATION OP FOOD , 
Thorough cooking end immediate serving after cooking are the best 
safeguards against the transmission of communicable diseases by food, 
provided care is taken not to contaminate the food, after cooking. 
Thorough cooking destroys the cysts of: the beef tapeworm, the 
pork tapeworm, the fish tapeworm, and trichinella (causes trichinosis). 
All vegetables that are to be eaten raw, and which cannot be 
peeled, should be thoroughly washed in running water before serving. 
This applies especially to lettuce greens and. radishes which may be- 
come contaminated with pathogenic organisms from materials used as 
fertilizers, especially in the tropics (amebao of dysentery, pin 
worms, etc.) 
CAES OP EATING AND COOPING UTENSILS 
A, All eating and cooking utensils should be sterilised im- 
mediately after use by washing in hot soapy water, followed 
by rinsing in hot clear water. This is necessary to destroy 
pathogenic organisms'. The utensils should then be dried 
by the air. Dish towels should never be used, When not 
in use all utensils should be protected from dust and flies 
(carry bacteria). Dishes which are immersed in water at a temperature of 
l£0°r. for one minute will destroy all pathogenic organisms. 
At a temperature of lUo° F. to - minutes immer- 
sion is required. 
B. Mess Kits. Each individual must sterilize his own kit. 
Fragments of food should he scraped from mess kits into a 
can or pit in the ground before washing. Why? The indivi- 
dual may have contaminated his food. He may bo an early case 
or a carrier. Secondly when wastes are properly disposed, 
flies atro not attracted. 
Mess kits are washed in three galvanized iron cans. 
Two contain hot soapy water and the third hot clear water - 
in eac|i the water is maintained at a near boiling tempera- 
ture. Mess kits are thoroughly washed in each of the two 
cans of soapy water, then rinsed in hot clear water, and 
lastly they arc allowed to air-dry. 
Food particles are buried or burned. 
The waste water is disposed of in a soakage pit or 
trench, (see page 10g) 
There are other methods than the one employing the use 
of three galvanized cans. The principle is the same, 
C, Mess tables should be kept clean by scrubbing with so#p a: I 
water after each meal. A removable middle leaf permits 
cleaning between the boards and the removal of food particles. 
CONTAMINATION OF FOOD DURING PREPAEATION AND SERVING 
A, Food may be contaminated during the process of preparation 
and serving. The most important sources of contamination are intestinal and respiratory discharges transferred to 
the food by food, handlers, Furthermore, contact with con- 
taminated utensils, insects or dust may also serve to infect 
the food, 
E, IQCD HANDLERS 
1. No one should be assigned to duty as a permanent 
food handler who has not boon examined by a medical officer 
and certified to be free from communicable disease and not 
a carrier. Permanent food handlers should be re-examined at 
intervals of not more than 6 months. 
2. Permanent food handlers! certificates should be kept 
posted., 
3. No one should be considered fit for assignment to 
duty as a food handler who, when physically examined, presents 
evidence of acute or chronic inflammatory conditions of the 
respiratory tract, or any signs or symptoms of venereal di- 
sease, intestinal disease, or ether communicable diseases, 
U, No mar is suited for duty as a food, handler, if he 
has had typhoid fever or bacillary or amebic dysentery (he 
may be a carrier). 
3. At times thy feces and urine are examined bacterio - 
logically to determine whether the man is a carrier cf in- 
testinal disease. 
6., Cleanliness. -It is equally important that all mess 
personnel wear clean clothing and have clean.hands at all 
times. The fingernails should be cut short. The hands 
should be washed immediately after visiting the latrine. Convenient facilities for washing the hands must he pro- 
vided.. In addition to washing the hands in soap and water, 
rinsing in a 2 per cent solution of eresol is a valuable 
precaution, 
MENUS Aid) SERVING 0? FOOD 
A. Menus. Menus are prepared for the purpose of affording; 
(l) variety, (2) combinations of food that shall provide 
sufficient calories (for energy), protein, fat, carbohy- 
drates, minerals, vitamins, and liquid. As a result of in- 
sufficient calories over a period of time, a man loses we git. 
Insufficient amounts of vitamin C over a period of time 
leads to scurvy (see miscellaneous diseases, Chapter ll), 
while insufficient amounts of Vitamin B lead to the develop- 
ment of bori-beri. Pellagra is another deficiency disease, 
due to an insufficiency of a part of the Vitamin B complex. 
B, Serving. Food must be served in such a manner that it will 
not be contaminated during the process of serving (droplet 
infection, contaminated fingers, etc.) 
DISPOSAL OF WASTES 
Purpose of Proper Disposal of Wastes - (l) to deny flies a 
breeding place, (2) to deny flies access to material that may be a 
source of pathogenic organisms, (3) to deny flies access to material 
that would attract them to the vicinity inhabitetod by humans, and 
(U) to control nuisances (odors). 
Classification of Wastes- 
lc HUMAN WASTES. Excreta, solid and liquids, and bath water, 
2o KITCHEN WASTES. Liquid and solid. 3. AHIMAL WASTES, Liquid and solid. 
4, RUBBISH, 
Li pi Human Wastes. 
I., Importance of proper disposal. Human wastes play the most 
important role in the transmission of intestinal diseases because 
they (the wastes) are frequently, carried from case or carrier into 
water which is to be used for drinking and cooking, or are conveyed 
to food by the hands, or by insects, rats, and mice-. 
2o Proper disposal is obtained by the use of properly con- 
structed latrines which are properly maintained, 
3* Latrines - general remarks. 
a. Latrines should be fly-proofed. 
bo Latrines should not be dug below the ground water level, 
4, Latrines dug in clay are unsatisfactory since liquids will 
not be absorbed. 
5, Latrines should be placarded, when closed, showing the date 
of closing and the organisation. 
6, Latrines should be located at least ICO yards from any mess, 
and so located that drainage into a source of water supply is impossible 
Latrines and Their Care, 
1, STRADDLE. THDCH SOLID WASTES LATRINES. They are usually one 
foot wide., 2 feet deep* and S to 10 feet long. 
Proper care■depends upon: 
(1) each man covering his excrete with earth, 
(2) closing the trench by refilling with earth when the 
contents have reached within 1 foot of the surface 
ground. 
(3) Spraying, if practicable, the trenches each day with 
crude oil. V*- 2. • BEEP PIT LATRINES, In order to make* use of the standard 
quarteringster latrine "box, a deep pit of exact dimensions must he 
dug to conform to the size of the latrine Box, 
The dimensions are.: 2 feet wide, 8 feet long, and *4 to 
10 feet deep. 
Proper care of waste depends upon: 
(l) proper flyproofing to prevent access of flies to fee a. 
material and to prevent the escape of larvae in case 
flies successfully gain entrance and lay their eggs, 
(a) Flyproofing is accomplished by the use of two 
methods. One method prevents- larvae travelling 
sufficiently far from the pit to enable them to 
complete their metamorphosis into flies. Larvae 
are prevented from escaping by setting up a sort 
of "no man.*3 land" - in this case it would be a 
"no larvae!s land". An area of k feet wide all 
around the pit is excavated (dug out) to a depth 
of 6 inches. This area is then covered with bur- 
lap and soaked with crudo oil. In addition the 
burlap hangs down the walls of the pit for a dis- 
tance of 18 inches. The burlap outside the pit 
is covered with earth, tamped down, and more oil 
is added. In the absence of burlap or oil or both, 
soft earth may be hardened by first moistening 
with water and tamping. 
Now for an explanation. "Why go to all this 
trouble?" you ask. There is a reason. The house 
fly lays her eggs on the excreta in the pit. The larvae regain in the pit until they are mature 
(just "before they develop into the next higher 
state of development - the pupa). As maturity 
is reached, they begin to look for a dry place 
in which to pupate. Mature larvae can penetrate 
through loose earth (light loam, or sand end loam) 
for a distance not over feet. Freshly emerged 
adult insects can penetrate loose earth for a dis- 
tance of one foot or more. (See page 138 for a 
description of the fly) 
Surrounding the oiled and burlap treated area, 
there must be a drainage ditch not less than b inches 
in depth. 
The second method of flyproofing is accomp- 
lished by tamping earth around the base of the 
latrine be x to prevent the entrance and exit of 
flics. Self closing seat lids likewise prevent 
flies from coming and going. 
(2) Constant Attention, rendered by a latrine orderly0 
The following points are important: 
(a) Tb 3 contents of the pit, the sides of the pit, 
and the interior of the box should be sprayed 
with crude oil daily, 
(b) The seats should be scrubbed daily with soap and 
water, and twice a week should be scrubbed with a 
2 per cent creoscl solution. They should be dried 
after cleaning. (c) The urine.troughs should he scrubbed daily with 
soap and water,, 
(d) The seat covers should be kept closed when not in 
USSo 
(e) The box should be kept fly tight by repairing it 
as necessary. 
(f) Fly traps should be placed near each latrine. 
£ 
(g) An ample supply of toilet paper should be available. 
(3) Deep pit latrines should be closed when filled to wl 
in 2 feet of *che surface. The box should be removed, 
the pit contents sprayed with crude oil and. covered 
with burlap, and the pit filled with dirt domed 12 to 
IS inches above the surface of the adjacent ground. 
The site should be placarded with the date of closure 
and the name of the organization. The same spot should 
not be used again for at least 1 year. 
3, PAIL LATRIKES. If it is impracticable to dig a pit (rock 
soil, etc.), the pail type of latrine is used. There is nothing 
mysterious about it., nor is it difficult to understand. Pails (buckets) 
are placed, under the seat of a latrine box. 
The psils should contain about 1 inch of a 2 percent solution 
of creosol; they must be removed and emptied daily. Excreta from 
the pails may be disposed of by burial or by incineration. 
LIQUID WASTES 
1. Urino disposal 
a. Urine troughs are used when the soil is able to sock up 
the urine. Such troughs drain into a pit (pit latrine) and are 
constructed of wood. They are lined with tar or else they are made of tin or galvanized iron, 
b. Urine Soakage pits are used when the soil is unable to soak 
up the urine. The pit, U feet square and U feet deep, is 
filled with pieces of broken rock, flattened tin cans, 
or broken bottles. At each corner of the pit are placed 
urinals of 2 inch pipe which extend 8 inches below the sur- 
face of the ground and 30 inches above. In the upper end of 
each pipe is placed a tar paper funnel containing'grass or ■ 
straw. 
Proper care depends upon: 
(1) daily removal of grass or straw and replacement 
with fresh material. 
(2) daily cleansing of funnels with soap and water. 
(3) weekly changing of funnels, 
.1 ' . 
(h) prevention of clogging of the pit by keeping the 
surface free of debris, oil, etc. 
(5) to close the pit - remove the pipes and cover the 
pit with dirt and sod. 
2* Bath water. 
Bath water may bo disposed of in shallow trenches, or even onto 
the surface of the ground if the camp is to be of brief duration. 
Otherwise, a grease trap and soakage pit or trench should be 
installed, since the accumulation of soap will eventually pre- 
vent soakage into tne ground. 
3. BISPO SAL:OF KITCHEN WASTES 
Kitchen wastes are composed of: 
1. Food romnasits. accumulated after meals and in the prepara- 
tion of meals. 2. Water in which kitchen utensils and mess gear have "been 
washed. 
GARBAGE 
It is worth repeating this important fact: garbage affords a 
breeding, place., to flies and a haven to animals in search of food, 
Both flies and animals can play a part in the spread of disease. 
Disposal of Garbage - Methods. 
Garbage can disposed of in the following manner: 
1. BURIAL - If the soil permits, garbage may be buried in trenches, 
which should be 2 to 3 feet deep. When: they are filled to 
within 1 foot of the surface they should be filled with earth 
and tamped down. 
2. SALS or GUT - In this case the ddible portion must be sep- 
arated from the non-edible at the Kitchens. Some non-edibles 
are: coffee grounds, tea leaves, egg shells, banana peels 
and stalks, fish heads and scales, citron rinds: and tin 
cans, paper and other rubbish. • - 
3* HOG FEUDING - Garbage may be fed to hogs, provided they have been 
immunized against hog cholera. Food, should be separated . 
into edible and non-edible portions. 
U, REDUCTION - A reduction plant is Impracticable for a camp or 
cantonment. 
5« Closed IHOIHBFATICU - An apparatus constructed for 'the pur- 
nose of burning garbage. Temperatures of IHOC9 F, to 1300° F. 
are bbtained, 
6. SUMI-CLOSED INCINERATORS - This type is primarily for field 
use. It is so constructed that it is protected from wind and 
rain. It has a good draught. The fact that it will burn the garbage from 1000 troops (5OO to 800 pounds) a day, 
speaks for its efficiency. 
J. QP5M IFCIilSRA-TQP- - type is less practicable since it 
consumes more fuel and is more difficult to operate. It is 
composed of a stack, a trench and a grate or similar material 
to support the garbage. The stack often has the shape of a 
barrel. Stacks may be made of stone or they may be made of a 
50 gallon oil drum open at both ends, A fire is built at the 
intersection of two trenches that form a cross, Over the fire 
is placed a grate uoon which is placed the barrel. 
To obtain success: (l) garbage is added slowly, (2) Gar- 
bage is dumped carefully to avoid breaking or bending the 
top of the stack, and (3) the firebox is cleaned frequently 
to avoid suffocation of the firs as a result of clogging v h 
ashes. 
Disposal of liquid Wastes - Methods 
You have a general idea of sewers. Sewers carry away human and 
kitchen we tes. 
In the field, in the absence of a sewage system, it is necessary 
to resort to other methods. Ihe only practicable method is to use the 
soil as a blotter - to absorb liquid. Of course, absorption can be 
hindered when the pores of the earth are clogged by grease, which is 
characteristic. Grease poured on the ground provides a breeding 
place for flies. 
1, Pour into trenches or pits. This method is satisfactory in 
bivouac, Cn departure, the trenches or pits are filled in 
with earth. 2.. Soakage pits. a second method-of disposal is to construct 
a soakage pit (like urine soakage pits), equipped with a 
grease trap instead of a, urine- trough. 
Let us pause a moment in order to learn about a grease 
trap. . * 
GHRASE TRAPS - Their purpose is to remove grease from liquid 
wastes. Grease hinders absorption. There are two' general 
types.of grease traps. 
a. Filter grease trap Grease can be filtered from 
waste liquid by means of hay, grass, straw, sand, 
. . gravel, or cloth. These are placed in a .bucket, the 
bottom of which has many (perhaps TO) small holes, 
method by which it-operates is not difficult to 
understand-. Liquid waste is poured into such a fil- 
ter grease trap. The hay or straw, filters out t ... 
grease and the remaining waste goes out the bucket 
via the holes into a soakage pit. The filtering 
material is removed as needed and burned. 
b> Baffle grease traps - This type of trap is an in- 
teresting onample of the application of a fact known 
to us all. The fact is this; grease rises to the 
surface of water as it thickens or hardens. Grease 
is fat and fat is lighter than water. Can this 
fact be applied to any practicable value? Yes, If 
a barrel contained greasy water, the water (and 
grease) would escape from any opening present. Ey 
changing the grease to a solid which floats- the 
clue of a method is offered. Grease floats on top of the water. Place'a baffle' (a board) in the 
barrel so as to divide it into two chambers, but 
donTt have the baffle go all the way to bottom. An 
inch from the bottom is satisfactory. The chamber 
which contains the bung (outlet hole) is then 
to act as reservoir for now greasy water. The other 
side can be the one into which waste water is poured. 
Thi-s is how the baffle trap function: Pour some 
cool water into the barrel. Next, pour warm waste 
liquid into the receiving side. As the warm waste 
water comes in contact with the cool water, grease 
forms and floats to the top. The remaining .grease- 
less water is ready to be released from the outlet 
side of the barrel. Remove the cork and out comes 
water free of grease. Retained grease should be 
removed at daily intervals, and the trap emptied and 
scrubbed weekly. 
3. Soaksge trenches - These are employed when condition of the 
ground makes the construction of a soakage pit impractical, 
A soakage trench is made in this manner: dig a square pit- 
1 foot deep. From each corner of the square dig a trench 
1 foot wide and 6 feet long. The depth is 1 foot at the cor- 
ner of the square and 18 inches at the outer end. Next, 
fill the square pit and the trenches with broken rock, broken 
bottles, flattened tin cans, etc. Then install a grease 
trap within the broken rock which fills the square pit. Thus, 
there is provided a relatively large surface area for the purposes of absorption. The filter must remove as much 
debris and grease as possible, otherwise clogging will 
occur, 
ANIMAL WASTES (MANUKS) 
Horse manure is an ideal breeding place for flies. Efforts 
are therefore directed to the prevention of providing such breeding 
places. 
DISPOSAL OH MANURE ~ VARIOUS METHODS 
1. BY DRYING. The manure is scattered by rake and dried in the 
sunlight. When dry, it is removed, then burned or used to fill 
in low areas, 
2. G-IET OR SALE - A satisfactory method of disposal, which requires 
proper collection and transportation. 
3. COMPOSTING, or the close packing of manure on a platform. If 
properly done, it eliminates manure as a breeding place for 
flies. Again, we have here another example of the scientific 
application of accurate knowledge. When manure is closely 
packed, a temperature of F, is reached at a depth of 
1 foot below the surface of the stacked manure. At this temp- 
erature, fly eggs and fly larvae quickly die. Those flies that 
come to feed on the surface can be easily destroyed by larvicides 
(fly poisons). 
There is--a-proper method of composting .manure. The detail 
will not be given he'ree 'They can be found in FM or I'M. 8r-^4 
* 
or in TM 8-220. h* INC HERAT ION - Fresh manure can be dumped on the ground in long * 
windows, sprayed with oil land burned. If dried for 3 - *+ days, 
it may be burned with little or no oil, 
5. AS FERTILIZER - Fresh mamire can be used, but it may lead to a fly 
muisance, since fresh manure contains fly eggs, Sven if plowed 
under, the nuisance is not avoided (larvae can migrate), 
RUBBISH 
Tin cans and burned bones are examples of rubbish. Rubbish is 
disposed of on dumps. Sumps are of sanitary importance because they 
can afford harboring places for rats or organic matter (food) which 
may serve as breeding material or food for flies. 
The dump is situated far enough away from camp in< order to pro- 
duce the least nuisance due to appearance or odors. Tin cans are 
flattened to prevent the collection of water, in which mosquitoes may 
breed. Organic material is burned in an incinerator in order to des- 
troy such material that might attract insects or animals, especially 
rats. 
Often, it is practical to place dumps in unsightly hollows, 
holes or excavations with the idea of filling them up and later 
covering them with vegetation. 
So much for the wastes and their disposal, a big subject of 
great importance. Finally, an outline for sanitary inspection is 
given below. It affords a brief review of those particulars which 
are especially important for the maintenance of a sanitary mess, 
OUTLINE. FOR SANITARY INSPECTION OF-MESS 
The following outline may be followed in making a complete 
sanitary inspection af a mess. It is suggested as a guide only. A* Attendants; - v •. 
Is mess sergeant qualified for position as to ' 
Knowledge of food requirements and-preparation of food? 
Ability to maintain discipline? 
Business ability? 
Are Cooks adequately trained? How? , . . 
Have food handlers all had "food handlers,u examinations 
and been certified as to health condition by the surgeon? 
Are food handlers cleanly as to— 
Clothing? 
Hair? 
Hands (inspect fingernails)? 
Personal habits? Care in washing hadds after urina- 
tion and defecation*- 
Is there a convenient washroom for food handlers? 
B, Menus: 
Does food served correspond with menu posted? 
Are menus well balanced and amount of food adequate? 
Check file of menus and mess account balance sheet* 
Note; $aily food supplied each man should yield at least 3»000 
calories, provide at least 100 grams of protein, and contain 
adequate vitamins, 
C* Food supplies; 
Meat and fish; 
Source* 
Qpality, Freshness. 
Handling. 
Storage .■ 
Preparation. 
Milk and dairy products: 
Same consideration as meat. 
Has bacteriological and chemical analysis been made? 
Is milk raw or pasteurized? 
Fruit and vegetables: 
Is supply adequate and satisfactory? 
Are men educated to their use? 
Canned focus: 
Is supply satisfactory? 
Bread and bakery products: 
Source. 
Quality. 
Delivery method 
Storage. 
D. Food storages; 
Refrigerator: 
Is space adequate? 
Condition and sufficiency 
Cleanliness, 
Disposal of drip water, 
E. Pantries: • 
General,neatness, cleanliness, and adequacy of storage 
facilities. Vegetable storage: 
Have vegetable bins been provided? 
Condition of vegetables in storage. 
Do facilities for storage guard against undue wastage 
by rotting? 
F. Bread Boxes: 
Sufficiency, cleanliness, and neatness, 
G-, Food preparation and serving: 
Refer to cooks1 training. 
Is food served in a reasonably attractive manner? 
H. Police; 
Dishwashing: 
Does the method meet the requirements of Amy Regulations? 
Are trays, dishes, and utensils clean? Look between 
fork tines and around hilt of knife. 
Kitchen utensils; 
Are pots and pans kept grease free? 
Are they properly stored when not in use? 
Are knives and forks clean? Look around handles and 
hilts. 
Is there a knife rack and a knife sharpener? 
Are stoves kept clean? 
Is fuel supply adequate? 
Kitchen police; 
Cleanliness of floors, walls, and ceilings. 
Are dirty rags allowed to accumulate on ledges, top of 
bread box, top of refrigerators, etc,? Are personal 'belongings of mess attendants allowed to 
accumulate in kitchen? 
I, Waste disposal: 
Is waste handled in a cleanly, satisfactory manner inside 
the kitchens and storerooms? 
is vegetable preparation and peeling carried out in a neat 
and satisfactory manner? 
Is waste properly sorted and kept in proper receptacles? 
Ashes. 
Combustible trash and tin cans. 
Edible garbage for piggery. 
Non-edible garbage. 
Are empty cans crashed and perforated before going to the 
trash can? 
Has a trash and garbage stand been provided? Is it kept 
clean? 
Is the surrounding area kept dry and free from soil pol- 
lution? 
Is waste removed at reasonable intervals? 
Are clean containers provided at reasonable intervals? 
How and by whom are containers washed? 
How are wastes disposed of; 
I 
Ashes to dump? Location of dump? 
Combustible trash burned? Where? 
Garbage incindrated? Or sold? 
If garbage is sold, are terms of contract being met as to— 
Frequency of collection? 
Method of collection? Cleanliness of cans? 
J. Insects and rodents?: 
Is mess screened adequately? 
Is there a supply of fly swatters or other fly destroyers? 
Are they used? 
%ve fly traps been proyided and are they kept properly 
halted and set up for use? 
Are roaches and other insects present? If so, what method 
is being used to control them? 
Are rodents troublesome? What steps have been taken for 
fheir destruction? Chapter IS, 
INSECTS AND RODENTS. HOW-TO CONTROL THEM. 
It is customary to regard insects as transmitting agencies; 
and certain rodents as the sources of infection of certain diseases. 
(See pagelUQ) 
Air, water, food and insects—the transmitting agents, the 
lines of communication, the supply lines of disease. Now we come go 
the fourth and last of those supply lines—the insects. 
The insects of importance to us are: 
Mosquito Bedbug 
flea roach 
louse (plural, lice) biting fly 
tick house fly 
The house fly, so important in the spread of intestinal 
■ 
diseases, will he the last insect studied. 
Some rodents of importance are: 
rats rahhit 
mouse prairie dog 
squirrel 
It is imoortant to realize this important fact: the path- 
ogenic organisms responsible for the insect-borne diseases may hr re 
other sources or reservoirs than the rodents listed above. For in- 
stance, the chipmunk, opossum and armadillo can be reservoirs—in 
fact, they often are in some places. The problem of controlling one 
of the diseases of this group becomes more involved as ve learn that 
the organism, causing African sleeping sickness, is Sound in the an- 
telope, oxen, sheep and goats. It is probably true that many disea- ses have their reservoir in more than one animal. Even some birds 
have been found to harbor pathogenic organisms. This much can be 
said; Many mammals and birds are reservoirs for organisms pathogenic 
to man. There are many facts to discover. New knowledge will be cor- 
related. New control measures,will be proposed/and tried. Those 
particular measures which prove valuable in reducing the number of 
sick will in time be accepted, taught and employed. CONTROL OF DISEASE 
Perhaps the most important weapon of control is a knowledge 
of the characteristics of various insects. In order to defend our- 
selves with any degree of success, that is, intelligently, we must 
direct our attack in such a manner that the insect is the loser. 
Because each insect possesses different characteristics, 
we shall discuss each one separately. 
MOSQUITO CONTROL 
A. Characteristics of the mosquito. 
1. Whereas man attains adulthood by passing through infancy, 
puberty and adolescence, the mosquito goes through similar 
stages; egg, larva, pupa, and finally reaches adulthood. 
EGG 
A* ' 
LARVA 
PH A 
/ ADULT 
Figure 6—Metamorphosis of Mosquito 2. Mosquitoes "breed (lay eggs) in water. 
3. The first three stages of their life are spent in water. 
U. The larva is frisky; he is called a "wriggler,r. 
5. Eggs, larvae and pupae are not dangerous, in that they 
cannot transmit pathogenic organisms to man. They are 
in the water and unable to get away, 
6. Like the flying cadet, the mosquito becomes a real stri- 
king power, when it gets its "wings", thus, automatically 
becoming an adult-—a flying adult. 
7. From eggs to a flying adult—only 1c to 18 days ! 
8. The female is the one to fear—she lives on blood, go- 
ing from one person to another, getting a drop here, a 
drop there with each bite, 
9. When she bites someone with malaria, for instance, she not 
only gets the blood, she wants, but she also gets some ma- 
larial parasites. Then she has a bomb load, Jones may be 
the victim, poor Jones. The mosquito may bite him, get 
his blood, and if she has a bomb load of parasibes, Jones 
gets it. No noise, no thunder, just the drone of the es- 
caping mosquito, 
10, There are day bombers (or biters), night bombers, and all 
a: oiwd the clock bombers. 
11., Tne bombers carrying malaria bite only at night, dusk and 
dawn. They arc called Anopheles mosquitoes. 
12. ‘The day biters, called Aedes Sgypti, transmit dengue and 
yellow fever, 
> 
13, Oulex mosquitoes transmit filariasis. They are ready for, action night or day. 
lU. .Anopheles prefer the, country life; they, are usually found 
about streams and swamps. 
15. Aedes do not care for the rigors of the rugged life. They 
are usually found near human habitations (rain barrels, 
buckets, gutters), 
lo. Culex has no particular preferences, "He is the man of 
the world.’1 Swamps, cesspools, habitations—they all ap- 
peal to him. 
17. Some mosquitoes have a range of flight of 1 mile, 
B. Control of Mosquitoes 
Control is based on the characteristics of the, mosquito, - - 
stead of ’’getting them” (eggs, larvae, pupae) "on the ground,” 
we get them on the water. 
Instead of dropping bombs, we can drop chemicals on their 
breeding places (where female bombers are created). 
Instead of blacking out our barracks, we screen our doors and 
windows, 
Instead of putting on helmets, we wear mosquito nets, 
Following is an outline of mosquito control measures: 
I. Elimination of breeding places. 
II. Destruction of mosquito larvae and adults, 
III. Protection of man from the bites of mosquitoes. 
IV, Isolation of cases and carriers to prevent infection of 
mosquitoes, 
V, Treatment of oases and carriers. I, Elimination of breeding places.■ 
A. Filling of small depressions wliere water collects, 
B. Drainage of small ponds or swamps. 
C. Stream training - effective But requires considerable labor. 
D. Emptying water containers. 
II. Destruction of larvae (measures must be repeated every 7-10 days), 
A. Oiling surface of water with a thin film. 
■ * 
B, Paris green poison spread on surface of water, 
1. Spread by 
a. Hand, 
bc Hand blowers, 
c. Airplanes, 
• C. Panama larv icide (a phenol larvicide), 
1. Sprayed; mixed, with the water. 
D, Destruction by natural enemiesr 
1, Stocking ponds or small streams with certain minnows 
or fish, 
III, Destruction of adults. 
A. Swatting. 
B. Spraying. 
1, This is of value in buildings. 
G. Hand catching, 
1. Slow and difficult. 
2, Used mostly to secure specimens for identification. 
IV. Protection of the individuals. 
A. Screening, B. Mosquito nets, 
C. Repellants, 
1. Citronelle 
2. A mixture of 1 part Epsom, salts and 10 parts" water-daubed 
on the skin is moderately effective in repelling mosquitos. 
D. Medical prophylaxis, 
1, Qpinine 
2. Atabrine. 
LICE 
The louse, or '’cootie”, is a. small wingless insect parasitic 
upon mammals and birds. It is important to give lice recognition. 
Though insignificant in size, they can carry such a disease as ty- 
phus fever. Furthermore, lice thrive in conditions of crowding— 
conditions which are likely to occur in wartime. If persona,! clean- 
liness is difficult to maintain, because of war conditions, lice r*-e 
more apt to retain their lodgings (man’s body) for a longer period 
of time than usual. 
We usually think of three types of lice: body lice, head louse, 
and pubic louse ("crabs”). 
Characteristics of lice: 
1. Life cycle; egg (nit), larva, adult. 
2. The adult is about l/l6 inch in length. 
3. All threb types of lice depend on human blood for life. 
k. The higher the temperature, the more food they need. 
A. At 9S° F. they can live 2 days without food. 
B, At 10U° F. they die within 12 hours without food. 5. Location on the human body, 
A. Head louse, 
a. Remains attached to the hairs of the head. 
B. Crab louse, 
a. Mainly about genital region. 
b. May be attached to haris of any part of body. 
C. Body louse. 
a. Attached to clothing except when eating, 
6. Spread of lice, 
A. By adult lice; or by eggs being dropped off the body 
in straw, debris, blankets, clothing, or latrine seats. 
Eggs may be attached to hairs that come from the head. 
B. By sexual intercourse, 
7. Destruction of lice, 
A. Lice and eggs killed in 5 minutes by dry heat of 131° E. 
and in 1 minute at 155°F. or 
B. By boiling in water 30 seconds, 
8. Mode of transmission of diseases. 
A. Not by act of biting, as you might suppose. 
B. They defecate as they feed. The viruses in the excreta 
are scratched into the skin by the person bitten, 
9. Factors that predispose to lice infestation, 
a. Overcrowding, 
1. Lice readily pass from person to person when 
infested persons sleep near each other, 
b. Insufficient bathing and laundry facilities. 
c. Neglect of personal cleanliness. 
d. Intercourse with infested persons. Met;~.o(ls of control of lice: 
Delousing, ridding the body, clothes and equipment of lice, 
is the principle method of control. 
1. Delousing must be universally effective throughout the 
unit. . All individuals, their clothing, and their equip- 
ment should be disinfested simultaneously. If one in- 
dividual is missed, reinfestation of the ehtlmjunit 
will soon occur. Prompt action should be taken at the 
first indication of lice in a unit. 
2. Delousing of a unit includes the following procedures: 
a. All individuals to bathe thoroughly and to shav' 
various parts of the body if necessary, (discussed 
below). 
bt Cljthing and equipment to be deloused. (discussed 
b>: 1 sv). 
c. Latrines, beds, and any objects possibly harboring 
lice to be disinfested or destroyed. 
d. Clean clothing to. be issued to all individuals. 
A. Disinfestation of the body. 
I. Bathing. 
a. General. Bathing is an essential part of any do- 
lousing program and should be performed while clo- 
thing and equipment are being deloused. It may be 
carried on either in a fixed installation such as 
a quartermaster bathing and delousing unit or ' „ 
means of improvised shower baths. An excellent soap to use*is made .as follows: 
Boil one part of ordinary issue soap in'fou^ 
. ‘ parts of water/ 
* ' • ■ »’ - r 
: Add two parts of kerpsene. , ■ 
Mix with four-pajts pf water, 
h. Shov/ers. 
f ■ t 
1. A simple device, for bathing can be madk *£rom a 
water sterilizing bag suspended from a staffold 
or a tree limb. One faucet, of the bag’is re- 
placed by a rubber tube, in the end of which Is 
placed a short section of pipe closed at one end 
and perforated in numerous places 'to act as 
■ shower head. A stone-filled soakage pit should 
be constructed underneath the shower, being co- 
vered with boards on which tte men may stand, A 
grease trap should be installed if ’the pits are 
to be in use for more than 2 days. 
2. A large ,tin can, such as a gasoline cah, with a 
perforated bottom may be suspended from a-tree 
or platfprm. In its operation one man pours 
water through the can while* another bathes, .• ' 
3. A more elaborate device may be made by insert- 
ing a small perforated tin can into a hole cut 
in the bottom of a barrel. The valve is con- 
structed of a plunger which fits into the can. 
This plunger is controlled by means of a 1c or 
. and handle within reach of the bather. c. .. Shaving.. Bathing wi th soap will not always-destroy' 
ell of the-eggs attached' tc the hairs of the "body. 
I 
wherp infestation is evidenced by"* the presence erf 
eggs on the hairs or by indication of louse bites, 
the hair in the armpits, about the genitals, and 
if necessary on the chest and legs should bo shaved 
and clipped. In peacetime, shaving'should .be-.routine- 
ly employed for the removal of crab lice. If at any 
time shaving or clipping is not practicable, the in- 
fested parts of the body should be thoroughly scrubbed 
with vinegar, kerosene, or gasoline (lead free). This 
■will remove the eggs as well as the adults, 
d. Shampooing. If head lice are present, disinfesta 
tion can be accomplished by loosening the eggs from 
the hairs by the thorough application of vinegar fol- 
lowed by shampooing the scalp with hot, soapy water 
containing 25 per cent of kerosene. This removes 
the detached eggs and kills the adult and larval forms. 
After shampooing, the hair should be combed with a 
fine-toothed comb to remove any nits not removed by 
washing. Where practicable the hair should be clip- 
ped short. 
B, Disinfestation of clothing and equipment. 
X. General. Improper treatment will damage certain materials. 
Steam will not seriously affect cotton or woolen cloth, 
but will seriously damage articles made of leather, felt, 
or webbing. Boiling water will shrink -woolen cloth., heat is practically harmless for all articles except wod, 
which it will damage somewhat. 
II. Available methods. Oat side of permanent installations and 
delousing units, the disinfastation of J2I0 thing and equipment 
is done by means of one of the following methods; 
a. Mobile disinfestor (quarteruaster function). 
b. Serbian barrel type of disinfestor. Serbian barrel 
type disinfesters are company installations. They 
consist of a barrel or a similar container for the 
material to be disinfested. In the lower part of 
them there is a receptacle for water and an improvised 
furnace or firebox. •, 
c. Improvised hot air disinfesters. Clothing and equipment 
may be placed in ovens, boxes, or cans and subjected to 
dry heat. Small buildings or dugouts may be convert e« 
into hot air disinfectors by installing heating apparatus 
which will heat the air to lo0° 3T. Clothing should bo 
hung loosely and exposed for about 30 minutes, 
d. Hot irons. Clothing can be delousod by removing the 
adult lice by hand and then killing the eggs by ironing 
the cloth, especially the seams, and folds, with:a.hot- q 
iron. An ordinary sadiron or a piece of iron pipe or 
scrap iron with a wooden handle may be used for this, 
purpose. This method is laborious and uncertain, 
e. Hot water. Cotton, linen, or silk clothing may be disin- 
fested by immersion in water for 1 minute. This 
will kill the virus of the insect-borne diseases as well as the lice. A temperature of 135° 3T, for 
will kill lice, hut will not destroy the viruses. This 
method should not he used for wool, leather, felt or web- 
material . 
f. Storage. Storage of infested clothing and equipment 
will accomplish disinfestation hy depriving the lice of 
a food supply. The exact time required is dependent 
on the temperature. A safe rule is keep articles in 
storage at least 38 days. In this time, successive 
hatches of eggs will have hatched, and the larvae and 
adults will have died. This method is frequently very 
practicable for disinfesting clothing and blankets in 
hospitals and camps, providing storage facilities are 
available and clean clothing and equipment are 
available. The storage rooms should be kept dry. Freshly 
* 
infested articles should not be placed with those that 
have been in storage for some time. No article should 
be removed from a room until all articles have been in 
storage at least JO days. 
g. Chemicals. Leather, web materials, shoes and hats which 
cannot be disinfested by other means should be immersed 
in a 5 percent solution of cresol for JO minutes. Cloth- 
ing may be disinfested in 2 percent cresol, but this is 
rarely advisable. ELSAS 
The flea is a blood-eueking insect, parasitic upon men and other 
uaamals,. It is wingless, However, its remarkable power of leaping 
enables it to ngo places”. These little insects prefer to live on 
rats, but should rat lodgings become scarce, they usually leap over 
to a man and settle down. Of course rats are the commonest reservoir 
of plague bacilli, which a flea may get in a mouthful of blood. The 
bacilli may be transmitted- to us by the flea] 
Characteristics of the flea. 
1. Life cycle: egg, larva, pupa, adult 
2. The larva is a footless, wo rial ike maggot which is very active. 
3. The rat flea is the most common vector of bubonic plague and 
endemic typhus. 
Control of Ideas 
i- 
A. Elimination of animal hosts. inclination of animal hosts is 
the essential control measure. It must include attention 
not only to nts and squirrels but also to pet dogs and ca 
1, Pet animals may be freed of adult fleas by a variety 
of commercial preparations. Washing in 3 per cent solution 
of cresol or 10 per cent emulsion of kerosene, followed 
by thorough rinsing, will also destroy fleas. While 
pots are being treated, blankets or bed occupied by them 
should simultaneously bo disinfected, 
2. Rats are not only important as reservoirs of infection of 
bubonic pi .ague and typhus fever but also factors in the 
spread of several other diseases. Control of ravs is 
a difficult problem. The supervision ox rat-control campaigns is a normal function of tjie Medical Department, The 
principle control measures are discussed pn xUl . 4 /f 
'' ' ' : ’1 
B. Destruction of fleas*- .fleaS in buildlfigs,. may be defetfdydd 
- , - r . r 
by scrubbing the interior of the rooms with so&py wate^ 
1 * * * 
containing 10 per cent kerosene and 5 -per cent ere sol'.,: 
> \ 4 
floor should be thoroughly wet. Barns and barnyards may 
be disinfected by spraying with a creosote oil 'containing■ 
10 per cent tar acids. - 
TICKS 
Ticks are small hardy, six-legged, wingless insects, parasitic 
upon mammals and birds,, 
Character.! sr ics of Tiars; 
1. Life cycle: egg, larva, nymph, adult 
2. The pathogenic: organism that causes Rocky Mountain Spotted 
Fever,passes from the female tick to the eggs she’lays. From 
the eggs the organisms are passed"successively to the larva, 
nymph, and adult, 
3. Adults can live 2 years without food, 
Extremedy cold Weather will not kill ticks in any stage, 
CONTROL 0? TICKS 
Control Measures ..... 
1, Burn infested buildings if latter rare of little value. 
2, Insecticide for infested floors, walls and furniture, 
A, Kerosene or cresol, 
3, Control of their wild animal hosts on whom larval and rymph 
forms feed. , 
A. Squirrels, rabbits, prairie digs, woodchucks may be 
eradicated from infested areas, This is difficult, to say the least. 
a. Trapping, shooting, poisoning, 
b. Burning undei^rush. 
U. Sheep grazing helps rechj.ce number of ticks, 
5. Control of individual.s in tick infested areas. 
A. Individuals should daily examine their exposed 
. ■* 
skin cond promptly remove the ticks, since ticks 
may not infect a person until some time after 
attaching themselves to the skin, 
3x1113 ue S 
I, Gvierv.l 3 Bedbugs exist wherever they can live in close 
association r: % man, They frequently become a serious pest in 
barracks and gu nuthouses. It has not been proved that bedbugs transmit 
-any disease to man, .Because they are bloodsucking insects,however, 
it is possible that they may transmit any disease in which 'there is 
a blfcod stream infection. It has been said that European bedbugs 
transmit some diseases, 
II. Ch ranteristics. 
A, Bedbugs develop through the egg and larva,. to become ■ 
adults. The eggs are white, oval in shape, and about 1 millimeter 
long. They aie deposited in cracks, crevices, and any place which 
affords protection and concealment, 
B, Bedbugs feed at night. They are capable of surviving for 
6 mo nths. wi thout food, 
C, . Bedbugs are usually spread from place to ’place in clothing, 
bedding, baggage, or furniture. They hide in the seams of mattm-ses 
and pillowcases and in cracks and crevices of any wooden or metal 
structure. Ill. Control Measures. 
A. Fumigation, the*hit)si effective bedbug control 
measure "but should not 3S attempted by untrained 'po^cymej.* 
.By ,Liquid insecticides. Liquid insecticides are‘effective if 
thoroughly and repeatedly' useS, An’.effectIve 'uixture^forgfh&s: *• 
purpose is kerosene containing 10 per cent-'of';cresol..or 5- 
r 
per cent of turpentine. Kerosene, alone used/- A'kero sene- 
or alcoholic, extract of pyrethiTim Is also..effective. A paint 
brush.should be used in the application of the liquid insecticide, 
(A spray is not as effective). This procedure should be 
repeated three or four trees at intervals of 1 week to kilo, 
all developing eggs. Sterna should be used to eradicate' bedbugs 
from mattresses, blankets, and other bedding. Dry cleaning 
with gasoline and washing in hot water will usually eliminate 
them. Hand picking, brushing, and shaking: is recommended. 
Fleming the cracks of steel cots with a blowtorch is quite 
effective. Kerosene aay be used as a repellent •; by-saturating 
vicks of woolen material anrt placing thtm in the coil, springs 
of metal cots. Fresh applications of kerosene shoulcl.be made 
weekly, 
BOACHaS AHD ANTS. 
I. General. Beaches and ants are not transmitting agencies for any 
insect-borne diseases. They are, however, serious nuisances in 
mosses and may transmit intestinal diseases by contamination of food, 
II, Control. 
A. The ii.ost important control measure is to deprive ants and 
roaches of an available food supply by cleanliness of the mess; and by protection of food supplies "by refrigerators and screened cabinets. 
The placing of table end refrigerator legs in cans containing water 
will protect food from ants. 
B, Sodium fluoride should be placed in cracks and comers and 
about water pipes two or three tjmes a week. Spraying of cabinets,' 
comers, and cracks in the wall with the issue liquid insecticide will 
destroy many roaches. This is best dene at night. 
C, Complete eradication of ants can be accomplished only if their 
nest is found and destroyed. Onco located, the nest may be destroyed 
by pouring boiling water or kerosene into it. 
HIES 
There are many varieties of flies. The house fly is one variety. 
It especially attracts our attention because of the part it plays in 
the transmission of intestinal diseases. House flies breed rapidly 
in manure, human feces, garbage or yard filth. The house fly and 
brown rat have one thing in common. They are filthy. They prefer 
filthy food and a filthy environment. However, they are not so highr- 
brow, that they refuse to enter clean mess halls, clean kitchens, 
and sick rooms. Elies seek out the moisture about our nose, eyes, 
and mouth; the moisture in wounds and sores. They quickly pass from 
one person to another. They visit those who are in a natural sleep as 
well as those in a drunken sleep. 
To digress a moment; Horseflies can mechanically transmit tularemia 
Mango flies, a variety of horse fly, carry loa loa, a filarial disease. 
Characteristics of housefly. 
1. Development. The fly passes through four stages—the egg, the 
larva, the pupa, and the adult. The eggs are deposited by the adult 
female in masses of 150-200 in warm, moist organic materials, pre- ferably horse manure. The larvae are worm-like creatures; 
they are-motile'and feed on or&me material. Upon maturity 
they migrate, to a dry cool place and pupate. Larvae are 
quickly killed at a temperature of 115° f. The pupa 
lasts 2-8 days. The adult emerges from the pup 
case and is ready to fly as soon as its wings harden. 
HOUSE FLY : STAGE OF DEVELOPMENT 
Larva: 
•fee 3: . 
Pupa; 
'Acini t 
Fig, J Metamorphosis of the House Fly.' 
2, They breed by choice in horse manure, human excreta, and 
fcrmentory vegetable wastes. 
3. Larvae must have moisture, warmth, and soluble foovi for 
development, 
k% Temperatures over 115° F, kill larvae and eggs. 
5. Larvae tend to migrate from the breeding material prior 
to pupation. 
6. Larvae and adults are able to crawl through loose manure 
or earth, 
7. Adult flies are attracted to food by odor. 
8. They tend to go toward light. 
9. They tend to rest on vertical surfaces and hanging objects, 
10. The optimum temperature for breeding is 80° - 95° 3T. 
11, The range of flight is 200 1,000 yards. 12. The number is greatest in the late summer and early fall. 
4 ' . ! 
13. Continuous breeding may occur during the winter in heated 
buildings. 
lU. A single fly may carry 6,000,000 bacteria upon its surface and 
28,000,000 in its intestinal tract! 
Control Measures? 
I. Control of breeding places. 
A. Proper disposal of hoTse manure. 
a. By composting a temperature of lUO - l60° P. is 
reached at a depth of 1 foot below the surface 
of the manure. 
B, Proper disposal of human excreta denies flies access 
to excreta. 
G. Proper disposal of garbage, denies flies access to 
garbage. 
II. Larvicidss. 
A. Used chiefly in connection with compost piles and 
latrines. 
B, Exanples; 
1. Waste motor oil, 
2. Crude oil. 
3. Cresol ) 
Kerosene ) as a mixture. 
Fuel Oil ) 
III. Destruction of adult flies. 
A. Swatting. 
B. Poisons, 
C. Ply sprays. D. Fly paper and wire. 
E. Fly traps. 
1. The most common means of destruction of flies in 
camps is the use of fly traps, 
a. Principles of Hy Trap. 
(l) Two main parts. 
(a) Bait chamber is the lower, darker part 
into which flies go, being attracted 
by the odor of bait, 
(b) Trap chamber is the upper, lighter 
part connected with bait chamber 
by a small opening through which 
flies crawl toward the light after 
having fed on the bait. 
BOEmS 
Eats, mice, squirrels are rodents. Only a few are mentioned 
of this vast group which comprises more than l/3 of all living 
mammals. Rats are the chief interest to us, because they are the 
main reservoir of plague bacilli and because they are the nhomeM 
of the rat flea. Beside acting as a reservoir, they may be instru- 
0 
mental in spreading trichinella parasites end some of the tapeworms. 
Rats may be classified as; Brown rats, black rats, and roof 
rats: 
Rats are very destructive. They gnaw wooden bins and 
floors in search of grain and other foods. In the year 1919' it was 
estimated that rats in the United States caused $167,000,000 property 
damage. 
140 Characteristics of Hats; 
1. They are primarily nocturnal animals. 
2. Great travelers, since they are found 
a. on ships. 
h, in "boxcars. 
3. Intelligent and cautious. 
U. The "brown rat; 
a. Cannot climb. 
(l) Hence keeps mainly to lower floors and basements. 
b. A burrowing animal. 
(l) Will burrow into hardest soil to live and breed. 
c. Great gnawing ability. 
d. Will eat anything without reference to its degree of 
freshness or decay. 
5. Black rat and roof rat. 
a. Excellent climbers. 
b. Live in hollow walls, garrets, boxes, barrels, etc. 
c. Clean habits, 
(l) Prefer to eat grain, and fresh, clean food. 
RAT CONTEOL 
I. Control Measures. 
A. Suppressive measures. 
1. Preventing rats from reaching a food supply and places 
where they can nest and breed. 
B, Destructive Measures. 
1. Poisoning. 
2. Trapping. 3. fumigation. 
U, Use of -natural enemies. 
II. The suppressive measures of control are; 
A, Ratproofing 
1. Especially temporary "buildings for storehouses. 
2. Methods. 
a. Concrete floors and walls or 
h. Brick and stone walls, closing all occlusions 
with metal flashings, grating, or screening. 
3. Buildings not ratproofed. 
a.- Elevate the floor. 
h. Put food in containers. 
III. The destructive measures of control are: 
A, Poisoning, 
1. An effective method if there are large numbers of rats. 
2. Will not kill all of the rats, because 
a. Many soon learn not to touch the bait. 
3. Methods which are non-poisonous to children, dogs, 
cats. 
a. Use of red squill mixed with food.' 
b. Use of barium carbonate with food. • 
k. Methods which are poisonous to all animals. 
a. Arsenic oxide, phosphorus, strychnine, thallium. 
5. Bait. 
a. Preparation 
b. Handle with rubber gloves «nd forceps. 
c. Distribute in late- afternoon. d. Distribute along rat runways. 
(l) -Alongside walls or.similar objects. 
6. Pre-baiting. 
a. Use of unpoisoned food several days prior to use 
of poisoned food. 
B. Trapping. 
1. An effective method, but' it requires more skill and 
labor than poisoning. ' ’• 
a. Rats become suspicious of traps unless skillfully 
set. . • 
2. A good method for use in large warehouses or storerooms, 
if used persistently and systematically. 
a. Can be used constantly to- destroy new arrivals. 
3* Types of traps. 
a. Snap traps (springs). 
- b. Cage traps. 
(l) Rats soon become suspicious. 
U. Bait. . 
a. Pried bacon, fish, cheese, liver, tomatoes, 
doughnuts, fresh bread, cantaloupe. 
5. Trap setting. 
a. Use large bait and fasten securely.’ 
b. Place along rat runways. 
c. To remove odor of human hands it is necessary to 
scald or flame frequently. 
d. Can deodorize traps by 
(l) Dipping in hot melted paraffine. C. Fumigation (use of a gas) 
1. Hydrocyanic acid gas and sulfur dioxide. 
a. Too difficult to use in the field very effectively. 
2. Carbon monoxide. 
a. Pipe or rubber hose from automobile exhaust to rat 
hole or burrow, etc. 
(1) Use rich mixture on carburetor. 
(2) Use gas for 10 minutes. 
(3) Holes and burrows should be as air tight 
as possible by sealing the cracks and 
openings. 
3. Carbon disulphide on balls of cotton or waste may be 
plugged in rat burrows. This is more effective in 
damp weather or when ground is damp. PART IV 
SQSCEPTISLES: THEIR PROTECTION CHAPTER 19 
On what principles are communicable diseases based? Why do people 
get sick? What can you do about it? Since the days of Pasteur, a vast 
storehouse of knowledge has accumulated. Curiosity, facts, study, trial 
and error have lead to the development of certain principles or funda- 
mental facts. These principles never change, hence we can refer to them 
as laws. Military HYGIENE is the study and understanding of these laws. 
SANITATION is the application of these laws. It is the art by which we 
adjust our living conditions and ourselves in accordance with the laws 
of hygiene. It is a law that water can transmit the germs which cause 
typhoid fever. The art of making the water safe (purification) for human 
consumption, is an adjustment we make. Such an adjustment is a sanitary 
measure. 
Personal Hygiene is a term with which we are familiar. Actually 
it refers to those laws of hygiene that are applicable to an individual. 
However, the term has come to mean the application of certain measures 
whose purpose is to maintain one’s own health by means, of proper care 
of: (l) body, (2) equipment, and (3) the area one occupies. 
Susceptibles may be protected by; 
1. Isolation of cases or quarantine of contacts. 
2. Immunization. 
3. A suitable environment. 
U. Measures to maintain health. 
1. Isolation and Quarantine 
The isolation of the sick and the quarantine of contacts, separate 
them from the susceptibles in order to prevent further spread of the 
disease. Disinfection is a part of isolation and quarantine, 
2. Immunization is another means of protecting susceptibles. There are vaccines for the following diseases: typhoid and paratyphoid fever, 
smallpox, cholera, diphtheria, tetanus, yellow fever, typhus and plague. 
3. Environment 
Susceptibles can gain varying degrees of protection hy providing an 
environment which will prevent or limit the spread of infective mater- 
ial. 
Examples are: 
a. Proper housing 
(1) Ventilation 
(2) Heating 
(3) Lighting 
(U) Cleanliness 
■* * . .y . f . * 
h. Insect control. 
c. Eodent control. 
d. Eood control. 
e. Proper waste disposal. 
h. Measures to maintain health. 
These measures are designed to maintain health and vitality. Some 
of these measures are carried out for us (environmental); some we can 
only do ourselves (personal). Eor example, our food is bought, in- 
spected, stored, cooked and served by those skilled in these techniques. 
On the other hand, your hands are washed and your teeth are brushed by 
yourself. Such personal functions are measures of personal hygiene. 
To separate in detail the environmental measures from the personal is 
practically impossible, because of overlapping, and, because measures 
that are personal today may be environmental tomorrow. 
Environmental factors: 
1. Pood 
Good food, nutritionally prepared, properly prepared, and served is vitally necessary to good health. 
2. Clothing. * 
Proper and adequate clothing protects the soldier from undue 
exposure to adverse climatic conditions, maintaining his general 
resistance to many diseases, especially the respiratory group. 
3. Activity. 
Outdoor work and exercise improve the general health. 
h. Best. 
, Rest, relaxation, and sleep are next to food in importance in 
maintaining health. Loss of sleep lowers the vitality. 
5. Health warning. 
Much can he done to prevent and control communicable diseases 
by heeding the warnings of early sickness. 
Personal Hygiene. 
fJ’he following outline divides personal hygiene into (l) the hy~ 
gierac care of onefs person and (ll) the care of the area you occupy. 
.A. Nutrition. 
1. Loss of appetite is a warning either of 
a. A mental disorder 
(l) Emotional state, 
(a) Worry, remorse, jealousy, heavy responsibili- 
ty, or 
b. A physical disorder 
(1) Ifcre strain 
(2) Improper posture 
(3) Improperly fitting shoes. 
2. Dietary requirements 
a. An adequate diet is composed of the following: (1) Vitamins 
(a) Sufficient vitamins are present in the Army 
ration. 
(2) Green vegetables provide hulk, vitamins, acids, salts, 
and extractive matters. 
(3) Sugar and Starches provide fuel. 
(U) Fats and oils in moderate amount are needed. 
(5) Minerals, as salt, calcium, magnesium, etc., are 
present in the ration in sufficient quantities. 
(6) Water - necessary for life. Most people drink too 
little. 
h. Constipation 
(l) May result from 
(a) Insufficient hulk in diet. 
(h) Insufficient exercise. 
(c) Improper posture and hody tone. 
(d) Neglect to respond to impulse to move howels. 
c. Riles for Regulation and Control of the Diet. 
(1) Keep the mouth clean and healthy to avoid spread 
therefrom of germs to the alimentary tract. Visit 
the dentist periodically to avoid the possibility of 
any dental defect and to insure complete cleanliness. 
(2) Correct any hody defects that affect nutrition, such 
as emotional conditions, eye defects, and errors of 
posture. 
(3) Avoid eating immediately before or after heavy ex- 
ercise or after bathing. (U) Satisfy dietary requirements as to proteins* fats, 
carbohydrates, salts, water, and vitamins. Have the 
calorie (fuel) intake adequate to the needs. 
(5) Have enough bulk in the diet and secure a daily bowel 
movement by hygienic living and regularity in habits. 
(6) Be careful of uncooked and unsanitary foods. They 
may contain disease germs. 
(7) Eat food regularly and in moderation, eating it slow- 
ly and masticating it thoroughly. Most people eat too 
much. 
(S) Food should be kept from insects and animals; they 
may carry disease. Mess kits and dishes should be 
washed in boiling water to cleanse them and to kill 
any disease germs. Cooks and mess attendants should 
observe scrupulous cleanliness in ell these respects 
in their person. 
(9) Food that seems stale or spoiled should not bo eaten. 
(10) Do not eat in dirty lunch rooms and restaurants. 
(11) M abundance of water should be taken, but too large 
an amount should not be taken when overheated, in 
adult should consume at least eight glassfuls of 
liquid daily. There is little danger of taking too 
much. Remember that water forms fully two-thirds of 
the body weight (about ten gallons in an average 
individual). 
(12) Be careful not to drink unclean water which mi ht 
contain disease germs. 
(13) Do not drink cold water rapidly when overheated or drink anything excessively hot at any time. 
(lU) Coffee, tea, and cocoa in moderation are not harm- 
ful and in many instances prove very "beneficial. 
i 
Intoxicating liquors are harmful. 
(15) Drink from your own glass and eat from clean dishes. 
Do not exchange pipes, cigars, musical instruments 
played "by the mouth, and gas masks with others. 
(16) Do not he careless in the disposal of the excretion 
of the body. These create a nuisance, serve as a 
breeding place for flies and animals, and may spread 
disease. 
(17) If there is any question about your physical health, 
any matter about personal hygiene, consult a medical 
officer who will assist you, and nature, in maintain- 
ing the health that is your birthright. 
B. Dental Hygiene 
1. Brush teeth and rinse mouth twice a day, after meals (to 
remove food particles). 
2. Use rotary movement. 
C, Care of the Skin 
1. At least 2 baths a week; daily bath preferable, 
a. Special attention to 
(l) Armpits, genitals, crotch, feet. 
2. Cleanliness of body helps to prevent disease. 
3. Cold baths (below 65° D.) act as a stimulant. 
U, Warm baths (90° - 93° D.) are soothing and sedative. 
5. Daily shaving 
6. Washing the hands is a "must” before eating meals, and 
after visiting the latrine. D. Care of the Hair 
1. Keep short and combed. 
E. Care of the Nails 
1. Keep short and clean. 
2. Should be cut straight across; 
a. Avoid ingrown toe nails, 
E, Clothing 
1. Wool is valuable because: 
a. Being closely woven it can hold air in its meshes; 
this is a poor conductor of heat and consequently feels 
warm. 
b. Can absorb moisture without feeling wet. 
2. Color. 
a. Dark clothes absorb heat. 
b. White clothes reflect heat. 
3. Underclothing should be 
a. Washed frequently and well dried. 
(l) Damp clothing acts as an excellent soil for gems. 
U. Clothing should not restrict the circulation. 
5. Raincoats are impermeable to air. 
a. Not useful in active occupations and while undergoing 
exertion. 
G-. Care of the Beet. 
1. Proper fitting shoes and socks are absolutely essential. 
2. New shoes. 
a. Should not be used on a march. 
b. To ,rBreak in": 
(l) Stand in about 2g- inches of water for 5 minutes and then walk about, allowing shoes to diy 
on the feet. 
(2) Waterproofing 
(a) Use Neat’s foot oil which makes them 
impermeable to air. 
(b) Not to be done, if your feet tend to persT ‘ re. 
3. Bathing. 
a. Dry well between toes to help prevent ’’athlete’s foot.” 
b. Should be done at the end of a day’s march. 
c. Softens toe nails. 
(l) A good time to cut nails. 
U. Blisters. 
H, Hygiene of the Respiratory Tract. 
1. Best defense of respiratoiy diseases is a healthy body. 
2. Don’t pull hairs or secretions from inside of nose. (IM- 
PORTANT). 
3. Droplet infection from sneezing, coughing and spitting, 
spread diseases. 
a. Pneumonia. 
b. Colds. 
c. Influenza. 
d. Tuberculosis, and others, 
I. Care of the Eyes. 
. 1. Never rub the eyes. 
a. There may be germs on the hands. 
2. Avoid strains. 
a. In reading and close work, 
(1) Light should be on level with top of head. 
(2) Light should illuminate over the shoulder. b. Proper reading distance from eye to book. 
(l) About ,lU inches. 
c. Hold book on a level with eyes. 
d. Never read in recumbent position, because it 
(l) Causes strain on the muscles of downward rotar- 
tion. 
J. Care of the Ears. 
1. Never put anything in your ear. 
a. Exceptions: nA baseball bat or your elbow. 
b. Sharp objects may puncture ear drum. 
K. Sleep 
1. During sleep nature repairs damages incident to the 
day!s activities. 
2. Average person requires 7-2 hours out of every 2U to 
maintain efficiency and preserve vitality. 
3. Most benefit from sleep comes under the favorable con- 
ditions of 
a. Eresh air. 
b. Clean bedding. 
c. No crowding of sleeping quarters. 
L. Physical Exercise. 
1. Value 
a. Educates the nervous centers which have to do with 
perception of ideas and with intellectual operations. 
2. Posture. 
a. Good posture puts the minimum of strain upon the body. 
M. Weight and Health. 
1. Obese people are more subject to disease. 2. A sudden drop of weight to the extent of 10 Ihs. de- 
serves immediate medical investigation. 
N* Hygiene of the G-enito-Urlnary System. 
1. Thorough frequent bathing of genitals. 
2, Venereal Diseases. 
I. Personal equipment. 
A. Mess gear. 
1. Thorough cleaning in hot water. 
B. Clothes> 
1. Cleanliness. 
2. Care of clothes - keep in repair, keep neat. 
3. Proper fitting. 
U. Airing and sunning of Blankets when there are no laundry 
facilities. 
C. Toilet articles. 
1. Good toothbrush, dental floss. 
2. Shaving equipment. 
3. Handkerchief to cough and sneeze into. 
II. The area you occupy. 
A. Proper disposal of excreta. 
1. Bury feces. 
2. Urinate so as not to contaminate 
a. Camp site. 
b. Stream, ponds, etc. 
3. Don!t spit 
a. In buildings. 
b. On pavements. c. In conveyances. 
2. Proper disposal of other wastes, 
a. Pood particles, 
h. Garbage, 
c. Refuse. 
3* Cleanliness and neatness of 
a. Bunk. 
h. Clothes. 
c. Trunk. 
d. Your floor or ground space, whether temporary or 
permanent, 
RESPONSIBILITY POP. MILITARY HYGIENE AND SANITATION 
A. The Medical Department is responsible for; 
1. Matters affecting the health of the Army, 
2. Matters affecting the location of camps. 
3* Matters effecting the source and methods of purification of 
the water supply. 
U. Methods and efficiency of waste disposal. 
5. Matters affecting the food supply. 
6. Mess sanitation. 
7. The suitability of clothing and housing of troops. 
8. Efficiency of training in personal hygiene and sanitation. 
9. The elimination .of insects. 
10. Performing physical examinations end inspection. 
11. The execution of immunisation. 
B* The Quartermaster Corps is responsible for: 
1. The operation of water systems. 2. The operation of sewage disposal systems. 
3. The operation of dclousing plants. 
U, The operation of incinerators and dumps under certain con- 
ditions. 
5. Certain work connected with the control of mosquito breed- 
ing places. 
C, The Corps of Engineers is responsible for; 
1. The procurement and purification of water. 
2. The disposal of wastes under certain conditions. 
Finally, you come to the end of this course. You have learned 
something about hygiene and sanitation. You have been instructed 
primarily in certain principles. Details have not been particularly 
stressed, except in those instances where knowledge of certain details 
might save you unnecessary illness. This book, however, contains a 
varying number of details - and that is perhaps the greatest value of 
the book to you. How do you disinfect urine? Of course you don’t 
remember. But you can look it up in the book. By doing so, you are 
making use of a reference. Facts are always better than guesses. 
In summary, 13 worthwhile measures have been listed below for 
your benefit. 
I. Do not drink water which has not been declared potable by a 
medical officer unless it has been purified by boiling or 
chlorination. Do not take water from a water sterilizing bag 
by dipping a cup into the bag or putting your mouth to the 
faucet. 
II. Do not soil the ground with stools or urine. Always use the 
latrine or the night urine can, provided in the company street. and available facilities. 
X. Wear clothing of proper weight for the climate. Clothing 
should fit loosely. Wet clothing, particularly shoes and 
socks, should he changed as soon as possible. 
XI. Keep the hair cut short and the fingernails clean. 
XII. Never throw pieces of food or refuse around the camp or in 
the trench. Such debris attracts flies, and flies carry 
disease organisms. 
XIII. If possible, avoid all contact with diseased persons. 
XIV. Avoid venereal diseases. These diseases are almost always 
contacted by sexual intercourse with an infected woman. 
If sexual intercourse is had, report as soon as possible 
(value decreases with every hour's delay) to the hospital 
or other designated place for "prophylaxis. " This prophy- 
lactic treatment must be carried out thoroughly and the 
directions followed exactly if its full protective value is 
to be obtained, 
XV Relax completely during rest periods on a march. Aerobic germs which require oxygen for life 
Anaerobic gems which cannot live in the presence or partial presence 
of oxygen 
Case a person with the gems and symptoms of a communicable 
disease. 
Carrier a person with the gems, but no symptoms of a communicable 
disease. 
Cleaning This terra signifies the removal by scrubbing and washing 
as with hot water, soap, and washing soda, of organic 
matter on which and in which bacteria may find favorable 
conditions for prolonging life and virulence; also the 
removal by the same means of bacterial adherence to 
surfaces. 
Communicable disease - a disease caused by the invasion of the 
tissues of the body by living organisms which 
can be and are transferred from one human 
host to another. 
Contact A "contact0 is any person or animal known to have been 
sufficiently near to an infected person or animal to have 
been presumably exposed to the transfer of infectious 
material directly or by articles freshly soiled by such 
material. 
Contact- Refers to the spread of disease by means of contact. When 
a disease is transmitted by contact, the organisms or 
viruses, remain in the material in which they are discharged 
from the body. Examples - gems in sputum, urine, feces. 
Direct contact. The infecting organisms are passed 
directly, without the intervention of any object or substance 
and usually by inoculation, from the tissues of the infected 
person to the tissues of the susceptible individual. Sexual 
intercourse spreads venereal diseases, if the source is 
infected. Kissing spreads or transmits measles, mumps, 
smallpox, and many other respiratory diseases. 
Indirect contact. The infecting organisms are passed 
indirectly as by cigarettes, drinking cups, towels, etc., 
from a source to the tissues of a susceptible. 
Delousing - Dolousing refers to the process by which a person and his 
personal apparel are treated so that neither the adults nor 
.the eggs of the varieties of lice that infest man, survive. 
Discharges Includes excreta and any abnormal matter (as pus) 
eliminated from the body. 
Disease- In general, any departure from a state of health; an illness, 
or sickness. 
Disinfection.-- The destruction or great weakening of the infectious 
agent by physical or chemical means. 
Disinfesting - By disinfesting is meant any process, such as the uco 
of dry or moist heat, gaseous agents, poisoned food, 
trapping, etc., by which insects and animals known 
to be capable of conveying or transmitting infection 
may be destroyed. Epidemics —- or outbreaks of disease will develop when there is 
present a highly virulent micro-organism and a sufficient 
number of persons who are susceptible to that particular 
micro-organism. The spread of the disease is influenced 
by whether or not susceptibles come in contact with the 
infective organisms. The best means to prevent this, 
and hense, control the spread of epidemics is to 
detect new cases as early as possible, and isolate 
them. 
Excreta - Eespiratory secretions, feces, urine, vomitus, sweat. 
Fermentation Decomposition due to the influence of a ferment. For 
example, a weak alcoholic solution may change into 
vinegar as a result of fermentation. 
Filtrable virus The term "filtrable virus” as defining the 
etiological agent of certain diseases is used in 
the sense of a casual agent differentiated from other 
kinds of infectious agents such as bacteria, protozoa, 
etc. Many of these filtrable viruses can be grown 
in vitro in the presence of living susceptible cells, 
and such cultures will produce, regularly, typical 
diseases in animals and in man. The term "filtrable 
virus” has a significance comparable to that of 
bacterium, spirochaeta or protozoon and is as definite 
\ . 
a description of an etiological agent as is the state- 
ment that the typhoid bacillus causes typhoid fever. The 
idea conveyed by the statement that a filtrable virus is 
etiological agent is that the cause of this disease is known, even though present knowledge does not permit 
further precision in distinguishing among filtrable 
viruses except "by reference to the name of the disease 
produced by each. 
Fumigation - Fumigation means a process hy which the destruction of 
insects, as mosquitoes and body lice, and of animals, as 
rats, is accomplished hy the use of gaseous agents. 
Host -— Any animal or plant upon which another organism lives 
parasitically. The rat is the host of the rat flea. 
Incubation Period. The period between the time a person is first 
infected with a communicable disease until the 
first clinical symptoms appear is known as the 
incubation period. 
Infection. The invasion of the tissues of the body by pathodgenic 
orgainsms, resulting in injury and followed by certain 
reactions (heat, pain etc.) 
Infectious liable to be ccmraunicable by infection. An infectious 
disease is one caused by parosites, such as bacteria, 
protozoa, or fungi; it may or may not be infectious. 
Infestation An invasion by animal parasites. 
Ingestion The act of taking food, medicines, etc,, into the body. 
Metamorphosis Change of shape or structure, particularly a change 
from one stage cf development to another stage, as 
insects. Non effective rate Refers to the number of men sick per daily 
in the hospital or quarters per 1C00 strength. Its 
purpose is to determine the number of troops in a given 
command that are physically fit for duty on a given day, 
or the average non-effectiveness caused, by a disease 
during a selected period of time. 
Example; 
T r • * 
Size of command ., 5C0 
Number sick in hospital 
or quarters 12 
Therefore, 
the non-effective rate per 
1000 2U 
Phagocytosis— is the ability of the white blood cells of the body, 
particularly the polymorphonuclear leucocytes 
("polys1’), to engulf and destroy the invading 
micro-organisms. 
In seme diseases the polymorphonuclear leucocytes are 
unable to overcome the infection and death results. 
In a way the polys are like a small powerful 
regular army, able to resist and often defeat certain 
types of enemies (bacteria). 
Potable Pit to drink. 
Putrefaction the decomposition (decay) of animal or vegetable 
matters. 
Sources of Infection This term refers to those humans and animals 
that are storehouses or supply bases for 
pathogenic organisms. Susceptibles persons who may or can catch a communicable disease 
if certain "conditions are right" for example 
lack of vacination, presence of very virulent germs, 
lowered resistance of the susceptible, etc. 
Symptom Any evidence of disease; Example fever, chill, skin 
rash. 
Transmitting Agent This term refers to those agents that transmit 
(carry) pathogenic organisms from one place 
to another. Examples are: air, food, water, 
insects. 
Virulence The ability of pathogenic bacteria to produce disease 
is known as virulence. This virulence is increased 
by suitable food, moisture, temperature, such as 
found in the human body.