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Medical Rfxord. A Weekly Journal of Medicine and Surgery. THOMAS L. STEDMAN, A.M.. M.D., Editor. PUBLISHERS WWI. WOOD & CO . 51 FIFTH AVENUE. New York, November 24, 1906. THE ARMY MEDICAL DEPARTMENT. The report of the Surgeon-General of the Army for the year Vasotec Uses ending June 30, 1906, recentlv issued, shows a gratifying increase in the health of the troops and in the sanitary conditions in the various posts. The n-.ean enlisted strength of the Army, excluding native troops in the island possessions, as reported in the monthly sick reports of the Medical Department, was 56,901, and on returns to tlie Alili- tary Secretary's office, 58,556, the difference repre- senting those temporarily absent from a command. The total number of admissions to sick report was 73,742, an admission rate of 1,295.97. This rate wfas 1,354.89 for the previous year, and 1,903.31 for the sexennial period 1898 to 1903. As in many dis- eases, the same man may be admitted several times, the total number of admissions is, of course, greater than the actual number of cases. The death rate was 6.28 per thousand, compared with 6.75 for the previous year and 16 for the sexennial period 1898 to 1903. As usual, venereal diseases were the most important afifecting the efficiency of the Army, and next to these came malaria. Then followed diar- rheal diseases, but in these there was a most decided improvement, the admission and noneffective rates being 84.67 and 2.87 respectively, compared with 108.36 and 3.87 for the previous year. Alcoholism was next in order, and in this, thanks to the contin- ued prohibition of the canteen, there was an increase in the admission, death, and noneffective rates com- pared with last year. The average enlisted strength of the troops serv- ing in the United States was 42,834. Among these the admission and death rates were 1,305.83 and 6.44 respectivelv ; these were lower than for the previous year, but slightly higher than for 1903. Venereal diseases led the list as causes of admission, and fol- lowing these in order were bronchitis, diarrhea, malaria, and influenza. A study of the causes of death shows that over 42 per cent, were due to ex- ternal causes, and of these 23 per cent, were suicidal and 20 per cent, due to drowning. Among the causes of death from disease, tuberculosis led, with a rate of 0.86, as against 0.68 for 1904; pneumonia, typhoid fever, alcoholism, and appendicitis were next most potent as causes of death. There was a most remarkable and gratifying diminution in the number of admission for typhoid fever during the vear, the total number having been 153 and the rate 3.57, as against 247 and 5.62 for 1904; the death ratio, however, was a little higher than for 1904, 0.30 and 0.27 respectively. There was an improve- ment in the ratios for malarial diseases. General O'Reilly adds his testimony to that of the other officers of the Army regarding the havoc to health and morals wrought by the refusal of Con- gress to restore the canteen feature of the post exchanges. In di.scussing alcoholism, the admission rate for which increased from Buy Vasotec 25.42 in 1904 to 30.22 in 1905, he says : "Many medical officers consider that the abolition of the sale of beer in post ex- changes has had much to do with the increase in alcoholism and venereal disease, by driving the sol- diers to disreputable resorts outside of the post and beyond the control of the post authorities. In that opinion this office concurs." It is strange that the good ladies of the W. C. T. U. and other advocates of compulsory temperance, so called, cannot see that true temperance in the Army would be promoted by restoring the canteen privileges. If soldiers could spend their evenings in innocent games over a couple of glasses of beer at the post exchanges, all, except the most vicious and the confirmed dipsoma- niacs, would be content, and sobriety, a very differ- ent thing from total abstinence, would be promoted. The men resent this motherly restraint, and improve their leave by spending it in the many dives which have sprung up immediately outside the posts since the canteen was abolished. There they drink spirits instead of beer, and, when inflamed with alcohol, consort with the vicious and diseased women attached to the dives. It is a pity the President has not the authority to order the restoration of the canteen Enalapril Vasotec feature of the post exchanges, as he appar- ently had to order the deformed spelling which dis- figures this otherwise interesting report of the Sur- geon-General. He would assuredly do so if he could. The bill to Order Vasotec increase the efficiency of the Medical Department of the Army, which was passed by the Senate in the former Congress, but failed to come to a vote in the House, was introduced in the present Congress, and passed the Senate in Vasotec Mg the spring of Iv Vasotec 1906. It was favorably reported by the Committee on Military Affairs in the House about the same time, but did not come to a vote in the first session. It is to be hoped that this Vasotec 5 Mg vote will be reached early in the second session. "The need of an increase in the Medical Corps," General O'Reilly says, "is evi- denced by the fact that there were on June 30, 1906, 166 civilian physicians employed under contract. The need of increasing the attractiveness of the service is shown by the fact that during the year no progress has been made in filling the nineteen va- cancies now existing, the number of accepted candi- dates commissioned being exactly equaled by the losses occurring during the year. It is impossible for the Medical Department to reach a high degree of efficiency or to escape a lamentable breakdown on the occurrence of war if Congress does not come to its relief. Nor Buy Vasotec Online can this relief be postponed until war is imminent, for the Vasotec 5mg selection and training of medical officers is a gradual process which requires vears of time, and an efficient medical corps can no more be Vasotec Enalapril created out of hand than a tree can be made to grow in a night." The strength of the Hospital Corps on June 30, 1906, was 3,196, a gain of 136 during the year. The number of female nurses was 97, employed at the Presidio, San Francisco, Fort Bayard, and vari- Nov. 24, 1906] mi;dical record. S27 ous posts in the Philippines. Some embarrassment in recruiting' this corps has been caused by the greater inducements oflfered by the Isthmian Canal Commission, so that now theic is the smallest eligible list from which appointments can be made to the Corps since its organization. Recommendations for similar Vasotec Iv provisions for Army nurses have been made, and as time goes on, the Surgeon-General says, the wisdom and necessity for such become increasingly evident. In accordance with the recommendations made by the Surgeon-General last year, the Secretary of War, on October 21, ordered the establishment at the United States Military Academy, West Point, of a Department of Military Hygiene, with the senior medical officer at the academy as the head of the department and a member of the academic board. This is a great step forward, and will no doubt have a very decided effect in advancing the cause of sani- tation in the .-\rmy. The line officer, having been instructed in the elements of hygiene, and as a result of this having been made to appreciate the value of sanitary measures in maintaining the effectiveness of the troops, will be less inclined to regard such measures as foolish and unnecessary, and to oppose obstacles to the efforts made by the medical officers to enforce them, .\nother recom- mendation made in the report of last year has been adopted, and a permanent board for the study of tropical diseases in the Philippines has been de- tailed, -Xssistant Surgeons Ashburn and Craig con- stituting this board. Experiments have been made during the year with the .so-called "galloping ambulance," a British in- vention, two of which have been purchased for the department. This Vasotec Hctz vehicle is intended for rapid ambulance service with mounted troops, and the results obtained with it so far have been very satis- factory. .\ motor ambulance has also been under trial, and the Surgeon-General is convinced, as a result of this trial, that some type of that class of vehicle will form Vasotec Iv Push a necessary part of ambulance equipment for both post and field. General O'Reilly renews his reconiniendations of last year in regard to the systematic physical train- ing of all soldiers, and strongly urges that the proper steps be taken to carry into effect those recom- mendations. "Commencing with a gymnastic course to develop gradually the weak points in each soldier and give him agility, strength, and the control of his muscles, the course would go on through outdoor athletics to military gymnastics or gvmnastics ap- plied to overcoming the obstacles which the soldier is likely to meet Vasotec 2.5 with in warfare.'' The report presents a Generic Vasotec number of other interesting facts regarding the Army Medical Museum, the library of Vasotec 20 Mg the Surgeon-General's office, the Army Medical School, the work of the Medical Corps in the Philippines, the Army hospitals, etc., and bears witness to the great achievements of the Surgeon- General and his most efficient aids in the Medical Corps against the odds of the indifference of Con- gress and the unreasoning prejudice of some officers in other branches of the service. The medical pro- fession of the countrv- has very good reason to be more than satisfied with its representation in the United States Army. INTESTINAL DISINFECTIO.X. In the treatment of many conditions in which an infection of the intestinal tract with pathogenic bac- teria constitutes one of the features of the disease, the endeavor has been to bring about a more or less aseptic condition of this portion of the alimentary canal by the administration of certain drugs, astrin- gent or antiseptic in character. Considerable doubt, however, has been expressed as to their Vasotec 2.5 Mg value, par- ticularly as to the degree of their disinfectant prop- erties. If their action is germicidal, then, Vasotec 10 Mg it has been suggested, this effect is also manifested against the normal bacterial flora of the intestine, which, as is well known, is essential to the pro])er conduct of the intestinal economy. In addition to this, it has been claimed that an unimpeded growth of these bacteria forms one of the most important means by which the pathogenic invaders are destroyed and eliminated. Intestinal antise]Jtics, therefore, ap- parently work in opposition to the natural defensive efforts of the organism, the development and pres- ervation of which it should be our aim to encourage. This subject was discussed at the recent Congress of German Naturalists and Physicians in Stuttgart, at which some interesting suggestions were brought forward in a paper by Moro ( Miincliencr iiicdi- zinische IVochenschrift, October 9, 1906). He held that the ideal way of combating intestinal infection would be by the introduction int(j the canal of the normal bacteria or by providing conditions in the Purchase Vasotec intestine suitable to the further development of the harmless bacteria alreadv present. The oral admin- istration of bacterial cultures must be ruled out for

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