ENTERIC FEVER IN INDIA.

A Report of the enquiry carried on at the Central Research
Institute.

I.—INTRODUCTION.

THE enquiry with which this report deals was commenced in April 1906 at
the Central Research Institute; it was conducted by Lieutenant-Colonel D.
Semple, R.A.M.C. (retired), Director, Central Research Institute, and Captain.
E. D. W. Greig, I.M.S., who was placed on special duty for the purpose.

     In December 1906 the services of Lieutenant-Colonel F. Wyville Thomson,
I.M.S., and in January 1907 the services of Captain D. Harvey, R.A.M.C.,
were placed at the disposal of the Government of India (Home Department) for
employment in connection with the enquiry. The services of Lieutenant-Colonel
Wyville Thomson, I.M.S., were replaced at the disposal of the Military Depart-
ment on the 3rd of September 1907. Assistant Surgeon Paras Ram, Captain
F. N. White, I.M.S., and Captain E. C. Hodgson, I.M.S., joined the Central
Research Institute to assist in the enquiry in January, August, and September,
1907, respectively.

     On July 19th, 1907, Lieutenant-Colonel Semple proceeded on six months'
leave to England, and Captain E. D. W. Greig, I.M.S., was appointed officiating
Director.

     In the case of enteric fever, as in the cases of Malta fever and malaria, after
the discovery of the causal agent, a considerable period elapsed before any
important fact was added to our knowledge of the disease. During this interval
preventive measures had to be of the nature of general sanitary precautions. In
attempting to carry out such measures a large amount of energy became
dissipated, because, until we have precise knowledge, it is necessary to guard.
against every conceivable source of infection. As more knowledge of disease is
acquired the most usual source of infection becomes apparent and it is possible to
concentrate attention on it, with the result that preventive measures become more
effective and cause a marked reduction in the incidence of the disease. Clearly
one of the most important questions to answer is: Where is the virus of the
disease stored in nature ? Because if this is ascertained, we are able to explain
why disease persists from month to month and year to year, and it is possible to
direct measures against this receptor of the virus and thus prevent fresh infection.
The additions to our scientific knowledge of Malta fever furnish an excellent