COLONEL Edward B. Vedder, M.D. Information Page

Col Edward Vedder

This is a picture of a young Capt Vedder 1908?

There are many noteworthy military physicians recorded in the annals of history. This paper deals with one of the most overlooked of these great military physicians. This great physician/scientist early work laid the foundation for many other great scientists and concurrently saved thousands of lives. Col Edward B. Vedder, better known for his work with chemical warfare, was one of the great pioneers of vitamin deficiency research. Vedder's early work with thiamine deficiency (beriberi) was key to the conquering of this disease around the world. Vedder's impact, particularly upon Robert Williams, was instrumental to some of the greatest advances in nutritional biochemistry made in the twentieth century. Choosing a military career over fame or fortune, Col Vedder consistently demonstrated a love of service over self. Vedder's influence was far-reaching, both military and civilian. Truly, Col Vedder was a giant and many have stood upon his shoulders! This is his story.

The United States is blessed with the finest collection of armed forces in the world. There are many reasons why this is so. However, we can attribute much of our success in this area to the outstanding physicians and scientists whose research has supported our soldiers, sailors, marines, and airmen. While some of the advances in medicine have come from outside the military, many great medical discoveries have occurred within the confines of the United States Military Medical Service. It is important that we acknowledge the great sacrifice made by the men and women who were at the forefront of such great discoveries. As the great Sir Isaac Newton penned in a letter to Sir Robert Hooke in 1676, "If I have seen farther than others, it is because I was standing on the shoulders of giants".1 One of the more unrecognized of our "giants" is late Army physician Col (Dr.) Edward Vedder.

Col. Vedder was born in New York City in 1878 ².  ²He was the son of Henry and Minnie Vedder.  ²His father was a noted minister, historian, and author.^{2, 3}  Henry Vedder would have a life-long influence on his son. His most notable traits, those being selflessness, an unquenchable thirst for knowledge, and great integrity, were also shared by his son (personal communication, Mrs. Martha Vedder). It was in such an environment that the young man was molded. In 1895, Col Vedder enrolled at the University of Rochester. This was the same institution that his father had attended.² He attained academic success at an early age earning a Bachelor of Philosophy at the age of 20.³ He spent the next four years of his life at the University of Pennsylvania where he attended medical school.² After graduation, he remained at the University of Pennsylvania for further study and research with Dr. Simon Flexner.² Their research was focused on dysentary.² Dr. Flexner would later become the first director of Rockefeller Institute for Medical Research. As a physician with a great inquisitive nature, Col. Vedder's time with Dr. Flexner would lay the foundation for a great career in medical research. It is also probable that this was Vedder's first foray into tropical medicine. In a fortuitous bit of fate, three years before their meeting, Dr. Flexner had spent time with American troops and natives in the Philippines (Manila) where he found a strain of dysentery causing bacillus that became known as the Shigella flexneri.⁴ The allure of the Philippines, with it's unusual diseases and seemingly unlimited potential for medical research, must have captivated Col Vedder. It is with but a little imagination that one can imagine Col Vedder listening with great attention to Dr. Flexner telling of his experiences in the Philippines and unidentified microorganisms causing much affliction. Col Vedder received a Master of Science degree from the University of Pennsylvania in 1903.² At this time, Vedder reached a crossroad in his professional career. Although he was fond of clinical medicine, he was infatuated with clinical research. However, he was also a great patriot, having a great love of country that was instilled by his father (personal communication, Mrs. Martha Vedder). With these things in mind, Col Vedder chose to pursue a lifelong career where he "could have it all". Near the turn of the century, the United States Army was an excellent choice for a research career (personal communication, Mrs. Martha Vedder). In 1903, he was commissioned in the United States Army and spent one year at the Army Medical School in Washington D.C .^{2, 5} From 1904-1906, Vedder was assigned to the Philipines in the guerrilla war against the Moros.⁵ After a short return to the United Staets, Vedder would return to the Phillipines in 1909 for a second tour.^{2, 5}

With his wife Lillie, Col Vedder arrived in the Philippines. His son, Henry Clay Vedder II was born there in 1911.^{2, 5} Henry would later follow his father's footsteps and serve as a combat surgeon with General Patton in the Second World War.² He also served in Korea and retired as a Lieutenant Colonel.² At the time of their arrival in 1909, the Philippines had been under United States control for a little over ten years.⁶ Among the many ailments and afflictions that accosted the soldiers and sailors in the Philippines were dysentery, parasitic infections, dengue, smallpox, malaria, beriberi, plague, and others.⁷ The importance of keeping the fighting men healthy was considered to be of such importance that a tropical disease board was commissioned to study and research the diseases affecting both humans and animals in the Philippines.⁷ Great strides were made by these boards.⁷. Many of the problematic issues were assigned to board members with skill, training, or similar experiencse with the particular disease.⁷ One disease for which there were few with experience was beriberi.⁷ From the experiences of his previous assignment and perhaps his work with Dr. Flexner, Capt Vedder took it upon himself to tackle the beriberi problem.⁷ Previous military physicians, much like the thought of the time, had attributed beriberi to a bacterial origin.⁷ However, Capt Vedder was not convinced. This is truly remarkable given his training with Dr. Flexner and probable indoctrination with the germ theory in medical school in the 1890s. Although difficult in an austere environment, Capt Vedder engrossed himself with the literature of the day.⁸ The thoughtful, thorough nature of his review was akin to the way his father had researched the many texts he published (personal communication, Mrs. Martha Vedder). It was not surprising that Vedder carefully dissected the papers and compared it with his own clinical observations. Vedder soon became an expert in the field.⁸ While space limits the review of the beriberi literature of Vedder's day, a short history of beriberi will shed light on the paradigms that Vedder faced.

Beriberi is disease caused by a deficiency in thiamine.^{8, 9} The manifestations of beriberi vary widely and this disease can occur in both adults and infants.^{8, 9} There is an abundance of other works that discuss the clinical aspects of beriberi 8-12 and the intent of this paper is not to review them. However, it must be noted that beriberi was a very serious problem causing thousands of deaths a year in the Philippines at the time Vedder was stationed there. ⁸ The appearance of beriberi caused great fear in the communities it affected because it was well known that when one case develops, many more soon follow.⁸ Beriberi has been known to man for almost 3,000 years.⁸ The occurrence of beriberi has been worldwide. However, it has become a prevalent problem in the Far East in the past 200 years.⁸ In addition, it was also seen in situations where individuals were kept in close quarters (insane asylums, prisons, prisoner of war camps, among sailors, etcÉ).⁸ Very early work (1850-1870) into the etiology and treatment of beriberi focused upon food.^{8, 9, 11} This fact is understandable given that scurvy, perhaps the most similarly characterized disease of the time, was understood to be diet related.¹³ One of the earliest proponents of a nutritional component of beriberi was the Dutch physician G.F. Pop who observed that beriberi was related to poor rations. ⁸ The Dutch surgeon Van Leent further proposed that specific components were deficient.12-14 He published a paper in 1879, based on his observations in the East Indies, that beriberi was caused by a uniform diet resulting in a deficiency in both fat and protein.¹⁴ Another military officer, the Japanese surgeon Kanehiro Takaki, changed the recommended ration given to the Japanese Navy. This change in diet resulted in a dramatic decrease in the incidence of beriberi.^{8, 14, 15} There were many others who also noticed an association between beriberi and food during 1860-1880.⁸

The possibility that food may play a role in beriberi was largely discredited with the acceptance of the germ theory of disease.¹³ During the later part of the 19th century, the work of Pastuer, Lister, and other pioneers of bacteriology had a tremendous impact upon the medical community.⁸ In short order, many medical advances were made because of the identification of a particular microorganism as the causative agent of a disease.⁸ To the current reader, it may be empting to overlook the tremendous change in paradigms that the acceptance of the germ theory generated. However, with diseases such as tuberculosis, cholera, bubonic plague, and diphtheria validated by the germ theory, it would have been difficult for this theory not to dominate current thinking.⁸ It not surprising that bacteriology soon became the chief cornerstone for medical education.⁸ Williams eloquently points this out by stating "all young physicians were so imbued with the idea of infection as the cause of disease that it presently came to be accepted as almost axiomatic that disease could have no other cause."⁸ This is no doubt the learning environment that Vedder was surrounded in during his early medical education. By 1913, Vedder reported that eighteen different individuals had "proven" microorganisms were responsible for beriberi.⁸

Christian Eijkman , the Nobel-prize winning scientist who had studied with Robert Koch, was definitely influenced by the germ theory. As a Dutch military physician assigned to the East Indies, he saw first hand the massive problems that beriberi presented.^{8, 12, 14}  After leaving the East Indies for two years to recover from malaria, Eijkman returned with two prominent scientists with the goal of isolating the causative organism of beriberi.¹⁴ The two accompanying scientists, Pekelharing and Winkler, returned to Holland after one year and announced they had discovered a bacillus that caused beriberi. ^{8, 14}  Eijkman was left behind to isolate and identify the organism.^{8, 14}  While conducting experiments with chickens, Eijkman accidentally discovered those that ate polished rice developed a condition very similar to beriberi.^{8, 14} He named this condition polyneuritis gallinarum.⁸  Initially, Eijkman did not realize this to be a nutritional deficiency. Rather, he considered the possibilities of a toxin or microorganism in the rice. By 1906, Eijkman did attribute beriberi to a diet high in starch.⁸ However, he did not attribute it to a particular deficiency until years later.⁸ Eijkman's primary contribution to beriberi research was the establishment of a reproducible animal model.⁸ Eijkman left the far east ten years before Vedder's arrival. Gerrit Grijns, an associate of Eijkman, followed his work and made several important discoveries. Grijins proved that several nutritional components (i.e. fats) were not protective in nature and stated that the lack of "a protective substance" was causing the disease.⁸ Others, including Vorderman, Braddon, Fletcher, Fraser, and Stanton, noted that epidemiological evidence supported a role of food (specifically white rice) in the development of beriberi.⁸ At the time of Vedder's arrival in the Philippines, the cause and treatment of beriberi was still very much a contentious matter.⁸

By the beginning of 1910, Vedder, having immersed himself with the current research, was ready to take action. He was particularly impressed with the recent work of Fraser and Stanton.⁸ Fraser and Stanton had provided the strongest proof of a deficiency occurring in beriberi.¹⁶ During experiments with laborers, they demonstrated that the alcoholic extract of rice was effective in treating beriberi.⁸  Fraser and Stanton presented their work at the first meeting of the Far Eastern Association of Tropical Medicine.¹⁶ Fraser and Stanton were the first scientists of the twentieth century to propose unequivocally that beriberi was caused by a nutritional deficiency. This was a very bold statement for that time! Luckily, Vedder had the foresight to attend the Far Eastern Association of Tropical Medicine meeting.⁸ He was sufficiently impressed by this presentation, along with the previous work of Eijkman and Grijns, to understand the importance of quick implementation of diets low in white rice and the requirement for further research.⁸ Vedder was also convinced, unlike the vast majority of his peers, that the polyneuritis seen by Eijkman was the same as human beriberi.⁸ It was with this newfound enthusiasm that Vedder and Williams first met.^{8, 16}

In the fall of 1910, Vedder went to the Bureau of Science, which was staffed with American scientists, for assistance in isolating the agent he thought was in the extract of rice polishings that may cure beriberi.⁸ Although an expert chemist in his later years, his experience up to this point primarily included bacteriology and clinical medicine.8 The director of the Bureau pointed him in the direction of a new addition to his staff, a young twenty-four year old chemist named Robert Williams.⁸ Like Vedder, Williams was brought up in a very religious home.¹⁷ Until the age of 10, he lived in Nellore, India, the son of Missionaries. ¹⁷ During this time, he saw incredible suffering including beriberi.¹⁷ This experience would serve him well in both his experiences with Vedder and later in life when he would be a key player in greatly reducing thiamine deficiency worldwide. Williams and Vedder found themselves to be very compatible right from the start. Although only eight years older than Williams, Vedder was an excellent mentor, confidant, and friend.⁸ Williams had attended the University of Chicago, where he earned both Bachelor and Master of Science degrees in chemistry.⁸ He had returned to the Far East hoping to obtain a job with the Bureau of Science.¹⁷ Before his meeting with Vedder, the young Williams had no clear direction in his life's professional direction.⁸ This was about to change in a dramatic manner.

Vedder, however, did have a clear vision of the problem. He knew that he needed expert assistance with analytical chemistry. If he could only isolate the beriberi preventing substance from the extract of rice polishing, he was sure many lives could be saved.⁸ In addition, he was concerned about the health of the armed forces stationed in the Philippines. In the Philippines, the American troops were not directly affected to a great extent by beriberi.^{6, 8} However, it is quite certain that Vedder was aware of the great number of military members of other countries affected as reported by Takaki in Japan and Eijkman in Indonesia. ^{8, 12, 15} Without the knowledge of the causative or protective agents, the disease could afflict American forces at any time. In addition, the health of Filipino scouts, whose job it was to provide security and protection for the American forces, was greatly affected.^{6, 8} The effectiveness of these scouts was severely affected by beriberi. ⁸ To attest to this seriousness, as many as 1 in 300 individuals of Manilla died each year of beriberi.⁸

There were many reasons for Williams to not or minimally support Vedder. First, the Bureau of Science had previously experienced mixed results when working with beriberi.⁸ If more experienced researchers had not had a great deal of success, why would he? Second, Vedder had not yet made a name for himself on the island. Investment of time and energy in collaboration with him could end up being a waste of time and money or possibly even embarrassing. And last, Williams had no experience with this kind of work. Surely Vedder had the same reservations about him.⁸ As a novice to biomedical research, Williams was not in a position to adequately judge or value the information that Vedder initially shared with him.⁸ Vedder did have three major intangibles that made his proposal irresistible.  First, his enthusiasm about beriberi was unmatched.⁸ Second, Vedder communicated the importance of beriberi research in unequivocal terms.⁸ And perhaps most importantly, Vedder had more confidence in Williams that Williams had in himself.⁸ Vedder "knew" that Williams could do the job! Williams took Vedder's word at face value and accepted the invitation to collaborate.8 Williams worked with Vedder for one year before he was furloughed to the United States.⁸ At this point, both Williams and Vedder suspected they were dealing with a nitrogenous substance that was effective in treating both polyneuritis in fowl and beriberi in humans.⁸ Williams returned to the Philippines a year later in 1912 only to be told by Vedder that Casmir Funk had published a paper on a beriberi preventing substance.⁸. In reality, Funk's substance was nicotinic acid, but Vedder and Williams had been "scooped".⁸  Vedder would leave the Philippines the next year.

One of the great accomplishments of Col Vedder was the first documented treatment for infantile beriberi.^{7, 8} The extract from rice polishing that he used to treat the thiamine deficient infants saved countless lives and conclusively demonstrated that beriberi was a deficiency disease and not the result of a toxin in the mother's milk.^{7, 8} Vedder's preparation was considered key to reducing the beriberi death rate in Manila from ten percent of all births in 1914-16 to around two percent in 1927-30.¹² Those that did die from beriberi were not given the preparation.¹⁸ Vedder had returned for a third tour in the Philippines in the late 1920s and he must have been delighted to see this reduction.

Vedder, who like his father was an excellent communicator, saw a great need to share the information he had gained. The text that was of primary use to the student of beriberi in Vedder's day was published by a member of the British Colonial Service, W. L. Braddon, entitled "The Cause and Prevention of Beriberi".⁸ While a leap forward in many respects, Braddon theorized that the cause of beriberi was a toxin in the rice.¹⁹ In 1913, Vedder published the appropriately titled Beriberi that was surprisingly complete and thorough (15 detailed chapters) considering Vedder's short time working with the disease. ^{7-9, 11} As Williams mentions in his landmark text on thiamine in 1938 "This publication was very influential among medical circles in the East because of its careful analysis of the evidence and because Vedder himself had been a moving spirit in eradicating beriberi from the Philippines Scouts by introducing unpolished rice into their ration".⁹ Vedder's text quickly became the reference of choice and influenced countless physicians treating patients stricken with beriberi.⁹ This book, along with other articles published by Vedder, was the turning point for convincing the scientific community that thiamine deficiency was not due to a toxin, but rather due to a deficiency. Another important aspect of this book was that it drew attention to researchers in the United States of the work done in the Far East.¹²

With the exception of beriberi, the most significant non-military contribution made by Vedder was with vitamin C.⁸ His work was important in that it settled a controversy over what the "antiscorbutic vitamin" was.²⁰  Working for many years in his spare time and covering multiple challenging assignments, Vedder's work on synthesizing Vitamin C came just a few weeks after C.G. King reported it. ^{8, 10, 20} Although not the first to synthesize Vitamin C, Vedder's work was independent, ingenuous, and significant.¹⁰ In addition, Col Vedder, along with Dr. George Rommel, proved unequivocally that beriberi can be seen in swine given a diet low in thiamine such as rice or cottonseed.^{8, 21} It is of note that beriberi in swine is not seen today due to sufficient thiamine in their diet (personal communication, Nathan C. Johnson, DVM).

Vedder was also one of the first individuals to propose the concept for the existence of vitamins. Casmir Funk is credited with coining the term "vitamine". There is some debate as who actually first described vitamins as Sir Frederick Hopkins used the term "accessory food factors" in 1906.¹² Vedder used his own term calling the substance that which is "necessary to life".⁸ Funk's simpler and bolder term had more appeal and therefore was adopted by the scientific community in lieu of Vedder's terminology.⁸ However, this does not negate the foresight of Vedder in his proposed terminology.

Although a novice biochemist at the time, Vedder was a quick learner.⁸ Working with Chamberlain, he laid the groundwork for the isolation of thiamine that would occur fifteen years later. Vedder's contribution in to the future isolation of thiamine was substantial. His experimentation demonstrated that the substance was not fat soluble, that it strongly adsorbed to bone charcoal from which it was not readily removed, and was crystalloidal in nature.⁸ These were great advances and Vedder was the first to use an adsorbent as a first step in the isolation of the compound.⁸ Williams stated this well : "All the quite marvelous developments of chromatography in recent years and outgrowths of the knowledge of adsorbents which in a true sense began with Vedder in 1910".

Vedder was also the first to demonstrate that fowl with no apparent clinical signs or symptoms of vitamin deficiency had neurological damage to the sciatic nerve.⁸ This was a major finding and demonstrated that there were different degrees of vitamin deficiency and could be affecting many more that originally thought. By 1929, Vedder had published the most complete guide to the clinical symptomology of beriberi.⁸

There are many valuable lessons that the modern military officer can learn from the life of Col Vedder. Perhaps the most important lesson that can be gleamed from Vedder is consistency in which he lived his life. From the very beginning of his career, he embraced the core values of the Army and dedicated his life to helping his fellow solider. Embracement, and living, of the organization's values is a key component for great accomplishments.²⁹ Vedders's sense of duty was second to none. Without complaints, Vedder moved his family, and his research, many times to take on challenging duties. During these transitions, the primary motivator for him was doing what was right for the common soilder (personal communication, Mrs. Martha Vedder). Col Vedder once turned down a promotion to Brigadier General because it would take him away from important research that could save the lives of Army personnel (personal communication, Mrs. Martha Vedder). Selflessness was an integral part of Vedder's inner being. Vedder also demonstrated that military and professional excellences are not mutually exclusive. While more noted for his military specific contributions, his contemporary peers were equally impressed with his medical contributions.³⁰ Vedder was not afraid to take chances, as demonstrated by his unconventional stance that beriberi was caused by a deficiency, and was not afraid of monumental tasks (i.e. eradicating beriberi from the Philippine Scouts, synthesis of Vitamin C, etcÉ). Vedder also communicated his thoughts and findings to both the civilian and military medical communities.^{11, 20, 31, 32}

Col Edward B. Vedder was truly a remarkable man. In the history of the United States Military Medical Service, there are few physicians who have made the combination of both military-specific and civilian medical breakthroughs. A noted communicator, scientist, and officer, Vedder made significant contributions to all of the projects he worked on. A physician with unparalleled dedication, Vedder toiled unrelentingly for many years on various projects. Although most noted for his work with chemical warfare, his often-overlooked work with the nutritional aspects of medicine was crucial to the eradication of beriberi and laid the groundwork for other important scientific discoveries. Vedder's life was a living example of the contributions that are possible by the future military physicians of the United States Armed Services.

References

1               Kaplan R. Science says : a collection of quotations on the history, meaning, and practice of science. New York: W.H. Freeman; 2001.

2               Library. EGM. Rare Books & Manuscripts: The Papers of Edward Bright Vedder (1878-1952). Available at: www.umc.rochester.edu/miner/hom/non_faccoll/vedder.html. Accessed 25 May 2002, 2002.

1               Release UoRN. Educational tradition passed through four generations. Available at: http://www.rochester.edu/pr/News/NewsReleases/general/clayrel.html. Accessed May 15, 2002, 2002.

2               Kohler W. Zentralblatt fur Bakteriologie--100 years ago: the isolation of Shigella. Int J Med Microbiol. 2000;290(1):5-6.

3               Williams RR. Edward Bright Vedder - A Biographical Sketch. The Journal of Nutrition. May 1962;77:1-6.

4               Bayne-Jones S. The evolution of preventive medicine in the United States Army, 1607-1939. Washington,: Office of the Surgeon General Dept. of the Army; for sale by the Supt. of Docs. U.S. Govt. Print. Off.; 1968.

5               Gillett MC, Center of Military History. The Army Medical Department, 1865-1917. Washington, D.C.: Center of Military History U.S. Army : For sale by the Supt. of Docs. U.S. G.P.O.; 1995.

6               Williams RR. Toward the conquest of beriberi. Cambridge,: Harvard University Press; 1961.

7               Williams RR, Spies TD. Vitamin Bb1s (thiamin) and its use in medicine. New York,: The Macmillan company; 1938.

8               Williams RR. Williams-Waterman Fund for the combat of dietary diseases, a history of the period 1935 through 1955. New York,: Research Corp.; 1956.

9               Vedder EB. Beriberi. New York,: William Wood; 1913.

10            Carpenter KJ. Beriberi, white rice, and vitamin B : a disease, a cause, and a cure. Berkeley: University of California Press; 2000.

11            Carter KC. The germ theory, beriberi, and the deficiency theory of disease. Med Hist. 1977;21(2):119-136.

                  14.       Carpenter Kj Fau - Sutherland B, Sutherland B. Eijkman's contribution to the discovery of vitamins. J Nutr. 1995;125(2):155-

                  163.

12            Itokawa Y. Kanehiro Takaki (1849-1920)--a biographical sketch. J Nutr. 1976;106(5):581-588.

13            Swazey JP, Reeds K, National Cancer Institute (U.S.). Today's medicine, tomorrow's science : essays on paths of discovery in the biomedical sciences. Washington: U.S. Dept. of Health Education and Welfare Public Health Service National Institutes of Health : 1978.

14            Fame NIHo. Profile of Robert R. Williams. Available at: http://www.invent.org/hall_of_fame/154.html. Accessed May 20, 2002, 2002.

15            Vedder EB. Medicine; its contribution to civilization. Baltimore,: The Williams & Wilkins Company; 1929.

16            Fraser DW. Vitamins and vitriol: W.L. Braddon's epidemiology of Beriberi. Am J Epidemiol. 1998;148(6):519-527.

17            Vedder EB. A study of the antiscorbutic vitamin. Military Surgeon. 1932:505-515.

18            Rommel GM, Vedder EB. Beriberi and cottonseed poisoing in pigs. Journal of Agricultural Research. 1916;5(2):489-493.

19            Sidell FR, Takafuji ET, Franz DR. Medical aspects of chemical and biological warfare. Washington, D.C.

20            Vedder EB, Walton DC. The medical aspects of chemical warfare. Baltimore,: Williams & Wilkins company; 1925.

21            Donovan JG. I came back from Bataan. Greenville, SC: Blue Ridge Publishing; 1997.

22            Davis DR. In Memoriam: Roger John Williams

1893-1988. The Journal of Applied Nutrition. 1988;40(2):121-125.

1               Bailey H. The Vitamin Pioneers. Emmaus, PA: Rodale Books; 1968.

2               Carpenter KJ, Harper AE, Olson RE. Experiments that changed nutritional thinking. Proceedings of a minisymposium. Atlanta, Georgia, April 1995 and Washington, DC, April 1996. J Nutr. 1997;127(5 Suppl):1017S-1053S.

3               e-Museum N. Christiaan Eijkman Ð Nobel Lecture. Available at: http://www.nobel.se/medicinelaureates/1929/eijkman-lecture.html. Accessed May 14, 2002, 2002.

4               Johnson NH. Core Values Improve Laboratory Operations. Laboratory Medicine. 1997;28(19):630-631.

5               Williams RR. Who's who in the beri-beri vitmain field. Science. 1934;79:410.

                  31.       United States. Surgeon-General's Office., International Congress of Hygiene and Demography. Papers by officers of the Medical Corps,

                  U.S. Army, Read before the fifteenth International Congress on hygiene and demography, Washington, D.C., September, 1912. Washington,: Govt. Print. Off.; 1913.

6               Vedder EB. Syphilis and public health. Philadelphia and New York,: Lea & Febiger; 1918.