ï~~160) WAR MED)ICINE I f4Td'3 may be discharged duty in a week and that a third more may go back by the end c&-the second week. In perhaps a fifth of the cases the duration is three or four weeks and the small remainder run a course up to two months. With very rare exceptions complete recovery results. Menwho are subject to blepharitis and conjunctivitis are more sensitive to gas. Following exposure to mustard gas one sees a considerable number of patients, mostly those of unstable nervous system, who complain of photophobia and blepharospasm of a functional nature. The ocular membranes in these cases are normal or show at most a slight hyperemia. Such cases should, after a careful examination, be treated as purely functional treatment. TREATMENT. Mustard gas burns of the eye, although tending toward spontaneous recovery, deserve careful supervision and treatment, since good treatment will shorten their convalescence, make them much more comfortable and ensure a complete recovery, except perhaps in the rarest instances. The eyes should be protected from light but not bandaged. The patient should be kept in a moderately shaded ward. Eye shades which are satisfactory can be made out of three or four thicknesses of the blue paper in which various hospital supplies are wrapped. The eyes should be gently irrigated in severe cases every three or four hours with some bland solution. Normal saline, soda bicarbonate 1 per cent., or boric acid are all good, best heated to about 100 F. before using. Following this a drop of liquid paraffin may be instilled or in the later stages argyrol in a 25 per cent. solution is found to be soothing. Castor oil theoretically is good, as mustard gas is dissolved by animal and vegetable but not by mineral oils. In practice, however, it is found to be more irritating than liquid paraffin. Atropin should be used in all cases in which the cornea is involved and a 1 per cent. solution instilled twice a day will usually be found to keep the pupil well dilated. As a rule, atropin may be discontinued in two or three days, but not in those cases with marked corneal involvement. Cocain should not be used as a routine, but is valuable for the first examination of the eye to relax the spasm of the lids. Dionin in 5 per cent. solution has been tried in gas cases but discarded. When hyperemia of the conjunctivae exists for a long time a mild astringent collyrium may be used. As the irritation subsides the corneal condition clears and the injection begins to disappear. Then it is very important to get these patients up and to accustom them to a greater degree of illumination. 151LANUfn.l I lVLNZU IE M Ltl. -rr IJ~iU 1N VI11. /ibj) AN INFLUENZA EPIDEMIC IN SOLDIERS. ~~-;(+t t i F BY SAMUEL BRADBURY, M.D., FIRST LIEUTENANT. M. R. C., UNITED STATES ARMY. DURING the early summer of 1918 an epidemic of what was probably influenza occurred in this regiment, 11th Engineers, and for a time seriously impaired its working strength. The explosive nature of the epidemic, the comparative mildness of the disease and short duration of illness in each case, the absence of complications and yet the extraordinary manner in which the disease cut down the number of effectives are of interest. The daily incidence of new cases and the number of days each man spent in quarters were determined from the daily sick reports of the companies. Remarks on the disease itself and on the temperature associated with it are from notes and temperature charts prepared during the latter part of the epidemic. In May and until June 13 the entire regiment was camped on a wooded hill, the tents being scattered under the trees to obtain the best concealment, but company grouping being maintained. On the latter date the regiment moved and on arrival at the new location, on June 15, camp was pitched in the regulation manner in an open field. On June 18 Company E left this camp, moving about one hundred miles, and on June 19 Company C and the Headquarters Detachment moved about ten miles distant. The remaining companies preserved their original locations and arrangements until the early part of July, when the epidemic had subsided. During all of this period the weather was very dry and at each camp dust from the roads was very heavy. It is thought that the railway journey, with the men crowded into box cars, had considerable influence in the increase of the infection in all companies after June 13. In the whole epidemic cases occurred in two distinct groups: The first group, May 19 to June 8, included 95 cases, 65 of these being in Company B, and the second group, of 518 cases, June 9 to July 3, occurred throughout the regiment, with but 9 cases in Company B, and of these 6 were in the company officers, where the infection had not been previously. The Medical, Transportation and Headquarters Detachments each had its epidemic, but these cases have not been included in this report. One note was made in the cases in the Medical Detachment; the enlisted men here were caring for the sick, were thus freely exposed and nearly the whole detachment was taken ill during the first period.