The purpose of this paper is to place on record the available figures relating to cases of tetanus which occurred in Home Military Hospitals during the Great War of 1914–1918. It may be considered that some of the tables give no very useful or practical information, but they are nevertheless recorded in order that medical officers at the outbreak of some future war may have the opportunity of learning what was done for the prevention and treatment of tetanus during this war. For example nothing can be gained from a study of the figures given in this analysis with regard to the curative or therapeutic value of antitetanic serum, but it may be of some antiquarian interest half a century hence to know the amount given and the mode of administration in the years 1914–1918.

The work on the meningococcus described in this report was begun in 1916 in connection with the measures instituted by Lieut.-Colonel M. H. Gordon, C.M.G., for the preventive control of cerebro-spinal fever in the Army.

The large red Oriental Hornet (Vespa orientalis Fabr.) must be extremely familiar to all who served in Mesopotamia. The Rev. F. D. Morice, who has been good enough to identify my specimens, tells me that it can barely be distinguished from Vespa crabro L., the European hornet, except by its colour. It is widely distributed in the Mediterranean countries up to lat. 47° N. and occurs S. to Abyssinia and Madagascar, E. to India, and also as an introduced species in certain parts of S. America.

In a recent number of this Journal1, I have pointed out that the well-known antagonistic action of Ca to Na, was probably at the bottom of the peculiar “defense rupture” action of Ca, as described by Bullock and Cramer2, in relation to infection with the organisms of gas gangrene.

THE following experiments form part of the general scheme of research undertaken with the object of providing a sound scientific basis for methods of fish preservation and storage.

The bacteriological part of the investigation was first undertaken by the author a year ago and the time has been spent in endeavouring to become acquainted with the peculiarities and characteristics of herring bacteria. There is still a large amount of work to be done in this field before practical experiments on a large scale can be carried out to yield really satisfactory results.

An enquiry (1) instituted in 1916 showed that from 1 to 2% of rail-borne milk was sour on arrival at its destination, with the result that in London alone there was a loss of some 90,000 gallons of milk annually. That this loss was not confined to the London milk was brought out by the fact that a similar loss was found to obtain in the north of England.

Examination of the records of a large number of quantitative Wassermann tests has suggested a new and simple criterion of a positive reaction. This is based upon a comparison of the amounts of complement giving complete lysis with any given serum, and with the negative control, respectively. Reasons are given for regarding this criterion as more satisfactory than that in common use. Details are given of the methods employed for the selection of a negative control serum, the estimation of degrees of lysis, and the provision of a suitable range of amounts of complement.

In tests of 40 samples of milk from the supply of the city of Edinburgh:

(1) The bacterial content was, on the average, high but not abnormally so when compared with that of the milk supply of other cities. It ranged from 20,000 to 29,000,000 per c.c.

(2) The results of the reductase test corresponded well with the bacterial counts and the test is recommended for obtaining a good rough idea of the bacterial numbers present, where results are required in a short time.

(3) About half of the samples contained lactose-fermenting organisms in unduly high numbers; this is attributed chiefly to the lack of attention to cleanliness in production.

(4) The value of the fermentation test for speedily indicating the nature of bacterial contamination is pointed out. In a general way the test corroborated the results of counts of the lactose fermenters and indicated that a number of the samples, which did not produce blown curds, contained large numbers of undesirable organisms.

(5) Taken as a whole, the results seem to indicate not so much particularly high contamination as contamination of a very undesirable nature. They point to the necessity of educating the producer and distributor in the principles underlying the production of clean milk and emphasise the importance of proper control of the industry from this point of view.

1. The Wilson-Weil-Felix agglutination reaction with cultures of Proteus “X 19” was Positive in dilutions of the serum ranging from 1 in 40 to 1 in 2560 in 22 out of 23 cases of Typhus Fever occurring in Ireland. In one case the reaction was still negative at the time of the patient's death on the 14th day of the disease. As controls, sera from the following gave completely negative results in a 1 in 20 dilution: 50 cases of Influenza, 12 cases of Trench Fever and 15 cases of Syphilis.

2. The agglutinins in Typhus serum for B. proteus “X 19” are completely destroyed by heating at 65° C. for half an hour.

3. Ten sera were tested for presence of immune body by means of the Complement Fixation test. The results were negative.

4. A coliform bacillus isolated from the urine of one case was agglutinated by the sera of twenty cases—the only ones examined—in dilutions varying from 1 in 40 to 1 in 640.

Sixty-two controls gave negative results with a 1 in 40 or higher dilution of their sera.

5. Absorption experiments indicated that the agglutinins for B. proteus “X 19” and this coliform bacillus were distinct.

6. The literature dealing with the heterologous agglutinins met with in the serum of Typhus Fever has been consulted and the various hypotheses that have been put forward to account for their presence have been examined. It is suggested that under the stimulus of infection with the Typhus Fever virus, some bacterium which is a normal inhabitant of the human intestine produces agglutinins for itself and group agglutinins for numerous other micro-organisms especially for Proteus “X 19,” Proteus “X 2,” and various members of the Colon-typhoid group.