R E I-1 0 R T 
to 
ASSOCIATE CO IIITTEE ON ARM MEDICAL RESEARCH 
National Research Council of Canada 
THE EFFECT OF QiJLPii/UJlAZIEE PROPHYLAXIS w RIFPIRiTORY 
LPH.Tj'OH _OF SERVING SOLDIERS 
Col. ?*?. Lloyd O.B.E., V,D.S R,C,A.ii!,0„ 
I. Field trials concerning the effect of Sulphadiazine, 
given prophylactically, on the incidence of Respiratory infection 
among serving soldiers were commenced in Gamp Borden Command on the 
24th Oct. 1944- and terminated on the 15th A nr* 1945, (Auth, H.Q, 5 
27-7-340-1 dated 21 Sep. 44). 
II. OBJECT 
The object of these trials was to determine the problems and 
difficulties of such e. measure, using the minimum dose of .Sulphadiamine 
which under service conditions would re .vice the incidence cf Respiratory 
Infection to a significant degree, and to determine the results that 
could reasonably be expected there from* The test was not to bo of 
the 1 hothouse1 variety but practical and workable under all conditions 
Ill* HAN 
1, Seven units v/ere selected representing a cross section of the fury* 
To each of these was attached a trained HOC called the ‘Host RC, who 
reported to the Senior Test NGO (\7*0,II) in the office of the Senior 
Medical Officer* These NCOs \;ere all experienced in the Qurrtermaster•? 
Dept, and had considerable experience in the Medical Inspection Rooms of 
Units, They worked under the supervision of the Unit ideciical Officers 
and the Senior Hygiene Officer 1espeotimely, the latter advising the 
Director of the test and giving constant supervision as he visited the 
units on his routine inspections, 
2, From the seven units were selected 5*000 healthy soldiers who were 
divided into equal groups in their respective unite end the huts in which 
they slept identified by the letter rA?3 for the first group an. I the letter 
nBn for the second group as the case may be. Under a carefully prepared 
plan of control in each unit ell the men who slept in CA:: huts were ids sued 
with one “A1* tablet each morning at roll call immedh tely a fir aunkering.. 
Similarly, every man who slept in a hut marked UE* was issued v:1th a tt3K 
tablet each morning. Accurate daily records were kept 0f every mn inder 
test who reported sick from any A man was considered clok if he 
was absent from duty or treining for one day or more because of illness and 
he was only counted as one case no matter how many days ho was a brent from 
duty. In this way at the commencement of the test there were 2«500 men 
who received an t!A” tablet each, morning and. 2,500 men living under exactly 
the same conditions who received a SSB-* tablet each morning> It v&f not 
known by those taking part in the test what those tablets contained, In 
each hut “A11 and “B11 groups v/ere selected so that soldiers doing similar 
duties or training v/ere divided equally between the groupsc 
PROCIDURI: IN HUT AND COMPANY OR S QUA FRO IT OH.b.CF 
3, At reveille as each name was called the NGO in charge or hut 
handed that man one tablet which he was asked to swallow, ff he vbicoted 
no compulsion vras used. If he persisted the Coy, (Squad, etc) Ccnru for 
was asked to move him to a non-test hut. This was not always dene* t’'on 
a man reported sick his name was taken by the Coy. (Squad, etc) Orderly 
Sgt, v/ho entered the number of his hut end whether it was in an ty.1' or 
“BH hut on a s^eorally marked HFM 292* Since the test hut - in any Coy, were well known, the Orderly Sergeant knew at onoe the correctness 
of this record. 
U.PROCEDURE AT THE UNIT f-DICAL INSPECTION ROOM 
The special Test NCO issued to each Test Hut NCO i/c every throo 
days a bottle of tablets marked with a plain nAn (Red) or 55Bn (Black) 
sufficient for his particular hut, Tablets wore counted and signed for 
and a record kept. Each Hut NCO got only one kind of tablets. At the 
morning sick parade the Medical Officer examined each soldier, asked 
him what hut he slept in, whether he was taking tablets and if so what kind* 
He checked the man’s answers with the 292 when he entered his diagnosis 
on that form. If the man was suffering from a Respiratory Infection 
the Medical Officer put a plain cross before and after his diagnosis, 
thus (X Coryza X), 
5. The Test NCO then reviewed all 292:s* If he found Respiratory 
Infection which had not been marked by the Medical Officer he immediately 
drew the fact to that Officer's attention and if a mistake had occurred 
it was corrected at once. Having assured himself on this point he then 
proceeded to the hut of every man who was in the test whom the M,0, had 
marked as having Respiratory Infection, and the hut orderly verified 
the correctness of the menrs statements. If possible he saw the man 
and asked him whether or not he had taken the tablets, and questioned the 
Hut NCO as to whether he had given the tablets. When every step had been 
double checked the Test NCO prepared a return known as MThe White Form1’ 
which consolidated the following information for the Unit: Name, Number* 
Hut Number, Provisional Diagnosis and Final Diagnosis of all those having a 
a Respiratory Infection, Those in ttAw Huts and who had taken *’A!1 tablets 
who had been either excused duty for one or more days or sent to hospital 
were entered on the upper half of the form; on the lower half of the form 
similarly a consolidation was made of all those who slept in nBn Huts and 
had taken "B” tablets. These White Forms were prepared serially through- 
out the experiment and sent daily to Camp HQs, Nil reports being required, 
the serial number of the form coincided with the day of the test; serial 
99 gave the situation on the 99th day and so on0 
6.HOSPITAL RETURNS 
The special Test NCO also examined all men in the unit who returned 
from hospital each day. If any man had been previously sent to hospital 
while under test the NCO prepared a ’’Blue Form'-’ also serially numbered in 
which was reported the man’s name* number, hut number and ’’A” or ,:B” 
with the hospital diagnosis and the number of days in hospital. The serial 
number of the white form on which he had originally been reported to HQs 
was carefully checked and entered. This Blue Form and the White Form 
for that day were securely stapled together and. sent to Camp Headquarters, 
7.PROCEDURE AT COMMAND HEADQUARTERS 
A specially trained CQHS received the reports from all units daily. 
Under the direction of the Senior Hygiene Officer this NCO reviewed each 
return and compared the data thereon with the copies of the original 292!s 
made at the time the man reported sick. If all was correct he then 
compared the hospital diagnosis with the original diagnosis as made by the 
Unit Medical Officer, If the hospital diagnosis was not one of Respiratory 
Disease Infection the case was eliminated from the record. If the diagnosis 
was changed the fact was noted as the Final Diagnosis on the original 
White Form, In this manner it was possible to make certain that every 
case of Respiratory illness among soldiers under tost was correctly 
reported and correctly recorded B, All Medical Officers and M.I.R, NCOs were warned to watch for 
reactions, and to be especially vigilant with every case of illness 
no matter how slight and to see that it was investigated* with the 
exception of the Director of the test and the Senior Jfygiene Officer 
no one knew the composition of either the "A” tablets or the "S’1 tablets* 
2. CONDITIONS IN UNITS 
In most units and in all training units there is a constant 
flow of men in and out. These conditions were accented because, 
though the segregation of men under test would have produced much more 
impressive results, it is also true that such results would hot have 
been reduplicated in a practical application of the method under service 
conditions. It is estimated that 1% of the men under test changed 
three times over or more during the five and one half months it 
continued. It follows that many of the men after having taken the 
tablets for a month or six weeks passed out of the tost to be 
replaced by 9 rev men* who had had no prophylaxis. The subsequent 
favourable record of the "lost” men was replaced by the higher rate 
of the •raw1 men for the 15 to 20 days necessary to immunize them. 
This higher rate is included in the record of the treated group, 
10, With regard to the numbers of men involved, the intention was to 
have 5,000 at all times under test. It soon became impossible to 
obtain this number of men without interfering with training. As a 
result daily counts were made and an average of 3,994 was maintained 
for the five and a half months of the tost. Of these 2020 were ”A” 
Huts and 197A were in nD” Huts, This is compensated for by expressing 
the results in rates per thousand or rates per thousand per annum. 
11. TIME OF TEST 
It was visualized when the test was authorized that there would be 
a relatively high incidence of Respiratory Infection because of the 
winter weather* Fortunately for the Army but unfortunately for our 
results the expected increase in R,I* did not occur. The increase of 
patients in hospital (CBMIi) during January, February and March 1945 
was only 100 daily over the average summer count for the last throe 
ycars«an increase of only 25%, For this reason the results obtained 
must be viewed in an entirely different light to those obtained in the 
United States at the height of a pandemic of Respiratory Disease, In 
fact the significance of these results is enhanced by the lack of an 
epidemic * 
12, ATTITUDE OF THE: MEN 
The Commending Officers having been interviewed by the Director of 
the Test and their cooperation assured, the Company Officers, under the 
CO's orders, explained to their own men the reasons for and plan of the 
test. At first a relatively high percentage of the men refused the 
tablets without explanation. It was then discovered that the word had 
got around, due possibly to the publicity given to V.D, Prevention, that 
the tablets contained saltpetre or some such substance to be given to 
soldiers surreptitiously to reduce V.D* To moot this it was found 
necessary to post a notice in each hut putting the case as fairly and 
forcibly as possible and to include a frank statement to the effect that 
these tablets had nothing whatever to do with V.D, Control, (Copy att*d 
Appendix ”B” ), This notice was signed by the Director as S.M.O, Such 
efforts had considerable effect and. the number of men who swallowed 
the tablets materially increased. IV, R:. .ULTS 
1. General 
In spite of the faithful cooperation of all concerned there 
v:as still, as there always will be, a proportion of the men who 
did not actually take the tablets. Every effort was therefore made 
to arrive at a figure which would, enable a correction to bo made 
to allow for this important factor. However, it is felt that this 
correction should not bo applied to the results except for purposes 
of scientific analysis. It is altogether unlikely that an instrument 
of this kind would bo used except in the emergency of a threatened 
epidemic or a pandemic,. Since when this tost was made it was a healthy 
year with little increased incidence of Respir tory Infection present, 
the probable results in the face o" an epidemic might reasonably be 
doubled. In this case results obtained in Camp Borden under the 
conditions which have been noted almost exactly duplicated the results 
obtained in the United States during the epidemics of 194-3 and 1944* 
2. EFFORTS BY UNITS 
The results are reported both as actual cases and as rates per 
thousand per annum. Since the latter alone gives the true comparative 
picture it will form the basis of discussion. Tables I for “A11 Huts 
and II for 11BM Huts give a breakdown by units of cases as they occurred, 
reported bi-monthly and divided into those excused duty (Fx) and admitted 
to hospital (Hp), 
Cases ’’A" Huts Fx 252 Hp 150 Total 402 
Cased "B” Huts Fx 149 Hp 109 Total 2^8 
A-B 102 144 
3. DAILY r0UFTS AMD RATES 
A daily count of men under test arranged in bi-monthly groups 
with a consolidation of cases and rates per thousand per annum calculated 
therefrom is presented in Table III* The first period Nov 1-15 is 
discarded for the record duo to the difficulties in taking tablets 
referred to in Sec III, para 12 above. In Chert I these rates are 
graphically represented* These points should be noted, 
1, The 11D11 Hut men start the test with double the illness rate 
of the nAns, 
11, In two weeks of prophylaxis the positions are reversed, “A” 
has risen from 108 to 314 while "B” has fallen from 224 to 204, 
111, Favourable progress continued till 31 Dec when nB,!s are 5 
of "A". 
IV, The effect of a general laxity in taking tablets during Xnas 
and New Year wiped out the favourable results to Sfa by the 
15 January, 
V, From that tine on favourable results increase until the warm 
weather of 15 Mar-15 Apr reduces the rate to MAM“224 and 11 Bw 
154> still a significant difference* 4. MftM DAS SAVED 
A consideration of the tables shows that there wore 144 men 
saved from illness by the prophylaxis. This works out at thirty 
five percent of those who were ill or a reduction of Illness by 
164- per thousand healthy men per annum. The average time lost while 
ill for each nA:t tablet man was 5.6 daysa The man days saved per 
year per thousand men is therefore 9J.84. man days. 
5. BREAKDOWN by diseases 
Table IV shows the breakdown by the various types of Respiratory 
Disease. The only one not materially decreased by the prophylaxis was 
bronchitis. No explanation can be offered for this fact® 
6. REACTIONS 
During the five and a half months that Sulphadiazine was administ- 
ered there were three cases of dermal reaction only of which one was 
doubtful. Though they were admitted to hospital none were actually ill* 
The first case B-A63006 Tpr Atkinson, W,H, developed an itchy 
rash of the ‘scarlet fever1 type on 11 Dec he is said to have 
been taking nB!1 tablets for throe weeks—but his urine was neg, 
for sulpha. He had also been taking service vitamin tablets (other 
cases have occurred with a similar rash definitely from these 
tablets). His rash cleared in 36 hours and he returned to duty. 
Doubtful case. 
The Second case on 15 Jon 45 - B~5239'7 Cpl< Morris* P, developed 
a generalised rash of the Erythema Multiforme type over the areas 
of the skin that are exposed to the sun when wearing summer 
clothing (shorts and shirts)* He had been taking !lBn tablets for 
six weeks and his urine was positive for sulpha. Rash lasted seven 
days with no subsequent ill effects. 
The third case on 19 Feb A5 - B-3.66285 Pte Truesdell, F,R, 
developed a rash of the Rubella type. His urine was positive and 
the rash latent 36 hours. 
Counting three cases gives a rate of 105 per thousand for 5s mens. 
7. PERCENTAGE OF TEST, JEN ...TAKING.TABLETS 
Difficulty was experienced in getting men under test to actually 
take the tablets offeredc In spite of the measures adopted to persuade 
them a certain number did not always accept the tablets and others 
accepted them but did not swallow then, A careful check was made of 
this point in all units and from the counts made throughout it is 
estimated that 53% of the men actually took the tablets while did 
not actually swallow them* 
It might therefore be argued that if a reduction in 
Respiratory Disease amounting to 35% took place with only 
53$ of the men under test actually swallowing the tablets, 
then if 100$ had swallowed them there would have been a 
reduction of 66$ in Respiratory Disease0 Calculated in 
rates per thousand per annum of healthy men this would moan 
a reduction in illness of 309 per V. SUIIXRY 
Purpose 
To obtain familiarity with the administrative problems 
arising out of a large scale prophylactic measure. To tost the 
possibility of rapidly putting such a measure into effect on the 
threat of an epidemic and to test its effectiveness under 
Canadian conditions. The test was to coincide with the 'epidemic 
period* of Respiratory Diseases. 
Conclusions 
1. No epicemic of Respiratory Infection occurred during 
the period of the test (See Chart #3 for comparisons) 
therefore the results are the most conservative that 
can be expected* 
2. Only 47$ of the men under test actually swallowed the 
tablets, no compulsion being used* This fact constitutes 
a problem in the event of the use of the measure to check 
an epidemic* 
3. Reactions to the drug were mild and negligible in number, 
1,5 per thousand over 5J- months, 
4* The test showed a reduction in Respiratory Disease of 
35$ (or I64. per M, per annum) due to the prophylaxis. 
This is likely to be doubled under epidemic conditions 
and moderate compulsion, 
5, The measure can be carried out by the normal administrative 
organization of any unit (Regt, or Bn.) having a Medical 
Officer and staff attached. The medical supervision must 
be efficient and strict* 
6, The plan can be put into effect in 24 hours provided the 
necessary tablets are available, 
7* It may take 14 to 21 days before maximum effect is apparent 
if no epidemic exists, 
8, A special directive is required to point out the salient 
features (attitude of men, necessity must be explained, 
reactions provided for ates,). Table I 
Units 
A- 
■19 
A-22 
No, 
1 TR 
• 
o 
TR 
No 
.3 TR 
TSR 
A- 
■10 
Total 
Total 
Dates 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
”'Both 
ilt 
Nov 
1-15 
1 
- 
_ 
2 
2 
2 
1 
1 
6 
3 
9 
o 
<1 
16-30 
1 
1 
2 
3 
2 
4 
— 
3 
1 
3 
8 
2 
19 
11 
30 
Dec 
1-15 
1 
_ 
6 
1 
— 
4 
2 
2 
7 
* 
11 
5 
27 
12 
39 
Dec 
16-31 
_ 
_ 
7 
_ 
6 
3 
2 
_ 
13 
— 
1 
5 
3 
34 
6 
40 
Jan 
1-15 
2 
— 
— 
2 
8 
6 
6 
2 
4 
1 
4 
• 
5 
2 
29 
13 
42 
Jan 
16-31 
8 
4 
— 
2 
2 
11 
4 
7 
_ 
— 
— 
8 
5 
40 
11 
51 
Feb 
1-15 
1 
1 
3 
2 
6 
6 
7 
6 
1 
X 
1 
9 
10 
28 
25 
53 
Feb 
16-28 
1 
— 
1 
1 
8 
10 
— 
_ 
5 
7 
1 
7 
5 
23 
23 
46 
Mar 
1-15 
2 
_ 
1 
— 
1 
5 
2 
15 
8 
1 
1 
4 
8 
19 
29 
48 
Mar 
16-31 
1 
_ 
3 
7 
14 
5 
3 
_ 
_ 
1 
- 
2 
21 
15 
36 
Apr 
1-15 
2 
1 
- 
- 
7 
2 
3 
2 
- 
- 
- 
- 
- 
- 
12 
5 
17 
TOTAL 
19 
3 
25 
9 
41 
49 
46 
37 
58 
10 
12 
3 
57 
42 
258 
153 
411 
Record Total 
252 
150 
402 
%or 
purpose 
53 of this record the 
count wi 
11 beg 
in with Nov 
16- 
-30, the 
period 
Nov 1- 
•15 being discarded. 
SULPHADIAZINE PROPHYLAXIS TEST 
Number of Cases Excused Duty and Admitted to Hospital 
"A" TABLETS (Placebo) 
Ex - Excused Duty 
Hp - Hospital Units 
A- 
19 
A-2 2 
No.l 
TR 
No. 2 
TR 
No 
.3 TR 
TSR 
A- 
10 
Total 
Total 
Dates 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Ex 
Hp 
Both 
o' 
< 
1-15 
« 
1 
1 
1 
1 
— 
1 
1 
1 
4 
1 
5 
2 
12 
7 
19 
Nov 
16-30 
_ 
1 
2 
2. 
4 
1 
1 
— 
2 
2 
1 
2 
1 
13 
6 
19 
Dec 
1-15 
1 
1 
3 
8 
_ 
2 
— 
1 
1 
— 
2 
1 
1 
2 
8 
15 
23 
Dec 
16-31 
- 
- 
2 
1 
2 
1 
1 
1 
— 
mam 
1 
2 
5 
1 
11 
6 
17 
Jan 
1-15 
4 
_ 
_ 
3 
9 
6 
5 
3 
4 
mm 
1 
1 
4 
1 
27 
14 
41 
Jan 
16-31 
5 
_ 
1 
1 
5 
3 
5 
3 
— 
2 
3 
5 
2 
24 
11 
35 
Feb 
1-15 
2 
— 
1 
1 
3 
1 
1 
8 
1 
3 
3 
6 
18 
12 
30 
Feb 
16-28 
_ 
mm 
1 
1 
2 
2 
5 
1 
6 
2 
3 
4 
17 
10 
27 
Mar 
1-15 
1 
mm 
5 
3 
2 
5 
7 
1 
1 
1 
1 
7 
17 
17 
34 
Mar 
16-31 
mm 
mm 
— 
1 
5 
2 
2 
2 
2 
1 
2 
4 
7 
14 
21 
Apr 
1-15 
1 
- 
- 
- 
3 
2 
- 
1 
- 
- 
3 
- 
- 
1 
7 
4 
11 
TOTAL 
14 
2 
11 
18 
32 
29 
22 
19 
29 
9 
22 
8 
31 
31 
161 
116 
277 
Record 
Total 
149 
109 
258 
/■ 
*For 
purposes 
of this 
record 
the 
count 
wi 11 
begin with 
. Nov 
16- 
-30, the 
period 
Nov 1- 
15 being discarded. 
Table II 
SULPHADIAZINE PROPHYLAXIS TEST 
Number of Cases Excused Duty and Admitted to Hospital 
"B” TABLETS (.5 gms Sulphadiazine) 
Ex - Excused Duty 
Hp - Hospital Table III 
"A" Huts with "A” Tablets 
MB" Huts with "Bn 
Tablets 
Average 
Cases 
Rate 
1 
Average 
Cases 
Rate 
Period 
Daily Count 
Resp. 111. 
Per M. 
Daily Count 
Resp. 111. 
Per M. 
Hlo-v 1-15 
2001 
9 
— 
108 
2037 
i 
19 
224 
Nov 16-30 
2268 
30 
313 
I 
2231 
19 
204 
Dec 1-15 
2260 
- - . . . - - . - - - - 
39 
- - 
414 
2118 
23 
261 
Dec 16-31 
2257 
40 
425 
2069 
17 
197 
Jan 1-15 
1949 
42 
517 
2104 
41 
468 
Jan 16-31 
2143 
« 
571 
2075 
35 
405 
i 
Feb 1-15 
2131 
53 
597 
I 
1813 
30 
397 
Feb 16-28 
1876 
46 
1 
588 
1880 
27 
345 
Mar 1-15 
1776 
48 
649 
1813 
34 
450 
Mar 16-31 
1735 
36 
498 
1 
1809 
\ ... . .. 
21 
! 
279 
Apr 1-15 
1825 
j.:l .. 
224 
1712 
11 
154 
Total for 
Record 2020 
402 
473 
i 1974 
258 
t 
314 | 
for Record purposes 
SULPHADIAZIRE PROPHYLAXIS TEST 
Daily Average Count of Men in "A” and "B" Huts 
Gases of Respiratory Illness and Rates per Thousand per Annum. Table IV 
CASES OF RESPIRATORY ILLNESS MONO SOLDIERS TAKING 
"A" or "B" TABLETS 
ARRANGED BY DISEASES SHOWING DECREASE DUE TO PROPHYLAXIS 
DISEASE 
"A" 
.Tablets 
"B" 
Tablets 
Effect using as Standard 
Increased 
Decreased 
Cases 
% 
Cases 
% 
Measles 
1 
1 
Chicken Pox 
2 
2 
Mumps 
32 
23 
9 
22$ 
German Measles 
2 
2 
mm 
Scarlet Fever 
1 
1 
— 
Pneumonia 
13 
5 
8 
61$ 
Influenza U.R.I. 
88 
46 
42 
48$ 
Tonsilitis 
24 
26 
2 
CO 
— 
Pharyngitis 
101 
60 
41 
41$ 
Laryngitis 
13 
5 
8 
62$ 
Bronchitis 
23 
33 
10 
43$ 
Tracheitis 
11 
3 
8 
73$ 
Septic 
Sore Throat 
17 
8 
9 
53$ 
Otitis Media 
5 
3 
2 
Pleurisy 
3 
1 
*, 
2 
— 
Coryza 
64 
42 
22 
34$ 
Sinusitis 
3 
6 
3 
- 
- 
- 
TOTAL 
402 
258 
144 
35.8$ 
Under test 5,000 Men Duration of Prophylaxis 5 Mos 
Duration of Record 4-ir Mos 
Remarks; 
Less than 10 cases not given in percent. PH< PFYLAaTIC STJLP A DIAZ IK E TEST, CAMP BORDEK— Races per E'POUSAND Men, 
M An Tabli t .on 
Placebo | 
: MB’’ en 
-QJ5.. j7 &r.) 
jSulf adiazjLne — 
i 
LEGEND 
Period 
of Xnas 
and 
"H&W- ~ r-G Br'I' 
/Leaver Diff. 
Rates per thousand or 
per thousand per annum* 
CHART 2 
Resp5.ratory Infection in Test Bits,Cases, rdth Rates 
"B" 
"A" 
Diff. 
«B« 
Cases 
"A" Chart 3 
Weekly admissions C.B.l.H. Respiratory Disease Appendix B 
THIS IS A 11B11 HUT 
It is most important for the health of the Army (Navy and Air 
Force also) for the Medical authorities to know exactly the best way 
of preventing disease, because prevention is always better than cure. 
Respiratory diseases such as sore throat, tonsillitis, bronchitis, pneumonia, 
etc, if unchecked often leads to such conditions as rheumatism, scarlet 
fever, heart trouble and kidney trouble etc. It has been found that if 
respiratory diseases can be prevented, a man is much more likely to remain 
healthy and free of such chronic conditions, 
2, It is known that infected dust causes respiratory diseases. 
Valuable information was produced by a blanket test in Camp Borden in 
recent months. You are now being asked to help in making these tests 
more complete by taking a small tablet called a •,BM tablet each morning 
when you get up. The purpose of this tablet is to prevent germs that 
you may have breathed in either during the night or* from a theatre etc, 
developing in your system, causing respiratory disease. This tablet will 
not effect you in any other wav any more than an aspirin would, (This 
statement is made by the medical authorities to make it plain that this 
test has no connection with venereal disease prevention,) 
3# Careful records will be kept by the Medical Officer of every 
case of illness and if you will cooperate by doing as you are requested, 
information of the utmost value for the prevention of diseases such as 
scarlet fever, rheumatism, arthritis, brain fever, kidney disease, etc. 
can be gained. The results for the future health of the people of 
Canada are so important that you are urged to do your part in making this 
test a complete success. Remember that YOU may be able to prevent some 
other person from becoming a cripple, 
4. Every war has produced great advances in medicine because medical 
services have been able to produce new and better remedies. So true is 
this, that in the end, more lives may be saved by the improved treatments, 
than were lost during the war. Camp Borden has already done excellent work 
in this regard. You can be of further help in a most important way by 
taking part in this test. 
18 Oct LA 
(F.P. Lloyd)■Col,, RCAMC, 
Senior Medical Officer, 
Camp Borden Command,