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126 medical officers more into their confidence, telling them where and when the battle was to be, the wounded might be more quickly, more comfortably handled. All the Regular officers of the R.A.M.C. as they read this book will realise how great is their responsi- bility, for on them hinges the evacuation of the wounded, and it is they who must firmly claim, from those above them, the personnel and material, the transport, sanitary sections, or what not, without which they cannot do their best for the soldiers trusted to them. Sanitary sections should accompany the very first troops of any expedition ; they prevent diseases. Civil practitioners will find (at p. 601) that army doctors are not doing surgical operations all the time, but that the most useful service a medical officer may have within his power to do for the sick may be to see how many of 300 camels he can get to a particular place and where each camel will be able to take two wounded to hospital, for every camel lost means two wounded delayed. The last chapter on transport by stretcher and ambulance is a record of wonderful ingenuity, evoked by the vastly different conditions of the various theatres of the war. In France the wounded were removed in trench stretchers, in the mountains of Macedonia in travois, camels carried them in Palestine, sand carts in Sinai, country boats and river steamers in Mesopotamia, hammocks in East Africa, sledges in Russia. Trains and motor ambulances were always the most desired, but horse-drawn ambulances, with teams of four horses, still proved of value, for they can travel over fields and rough ground cut up by shells, where no motor ambulance can move. Air transport of wounded is not mentioned, although we are told of a medical officer who was carried some hundred miles in a seaplane in Russia to see a patient. An unexpected discovery of the war was the particular suitability of the educated native of Uganda for work in the medical corps. Enlisted mainly from the mission schools, and subsequently given the status of soldiers, a thousand of them were employed in small parties from Abyssinia to Durban ; their non-commissioned officers were found fit to be put in charge of large groups of porters in a native hospital. Praise is also given to the undaunted conduct of an Indian field ambulance at Gallipoli, of the Egyptian camels and their drivers on the Sinai desert, and to the travois mules in Macedonia, all unperturbed by shell fire. The maps and pictures in the volume are most helpful ; the statistics of illness would be more enlightening if in every case the numbers were given of the troops to which they refer. The volumes, indispensable as they are, are too many for any officer to carry in his kit. A short but pregnant resume of the series, a sort of Medical I Officers’ Pocket Book, would serve to make the - lessons of the last war, often so hardly learnt, available ° to those who will have to struggle with the difficulties of the next. Details may then be different but principles must still count. AN ENGLISH-SPEAKING OPHTHALMOLOGICAL CONVENTION. IT has been decided by the Ophthalmological Society of the United Kingdom and its affiliated societies to hold in London next year a Convention of English-speaking ophthalmological societies and asso- ciations, and invitations have been issued to the presidents of all such bodies in the different parts of the British Empire and the United States of America asking them to appoint official delegates or repre- sentatives on the occasion. The date suggested is from July 14th to July 17th, inclusive, and the Convention will be inaugurated by a reception given by the President and Council of the Royal College of Surgeons of England at the College on the evening of July 13th. The programme for the four days’ work has been already arranged. Each morning, two afternoons, and one evening will be occupied in the scientific work of the Convention. The Bowman Lecture will be delivered by Sir John Parsons, the chairman of the committee for scientific business and publication, there will be a discussion on the micro- scopy of the living eye, and selected speakers will also take part in a debate on the evolution of binocular vision. The rest of the time will be taken up by visits to various institutions of ophthalmological interest, while receptions have been arranged, a banquet and a garden party. Those taking part in the Convention who are not members of the Ophthal- mological Society will pay a fee of .62, while for ladies accompanying members of the Convention, who wish to become associate members, the fee will be 10s. The President of the Convention is Mr. E. Treacher Collins, who can be addressed at 17, Queen Anne- street, London, W. 1. THE STANDARDISATION OF DYSENTERY SERUM. THE therapeutic value of aritidysenteric serum is not a subject upon which anyone who had experience of epidemic dysentery during the war will have any doubts. Where serum was freely used excellent results generally followed. In most cases a polyvalent preparation was employed, and it is more than prob- able that had any monovalent serum been available even better results might have been obtained, since there is no definite evidence that the different types of dysentery bacilli produce a common and unique toxin. The standardisation of dysentery serum is a matter of some difficulty, and at the present time we are far from the realisation of the same accuracy of titration which is possible for diphtheria and tetanus antitoxins. The difficulties are both that of technique and that of inadequate information. We are unable to produce the same sharply marked animal results as with the two last-mentioned infections, and knowledge is hazy as to the undoubted toxicity of the dysentery bacillus. A recent work from the Kitasato Institute of Japan, published under the auspices of the League of Nations, has made an attempt to narrow down the issues in this field, and to clarify the principles of the standardisation of dysentery serum. The authors of this paper concern themselves solely with the Shiga variety of bacillary dysentery, and as a first step towards the end in view have endeavoured to find out the best way of preparing a potent and stable dysentery toxin. They find that in broth cultures the toxicity rises pretty sharply for a couple of weeks and thereafter falls off again, the develop- ment of maximum toxicity corresponding to the development of a late alkalinity of the medium which reaches its maximum at about the same time as the toxin content. The toxin thus prepared is fairly stable, but by no means absolutely so. Its toxicity is well marked, 0-05-0-1 c.cm. being generally fatal to rabbits. It does not, however, appear to be as toxic as is an autolysed extract of the bacterial bodies. Having obtained adequately toxic preparations for the estimation of the protective powers of anti- toxins, the authors proceeded to compare antisera prepared by the injection of a number of pre- parations. The experiments are not sufficiently numerous to give convincing results, but, with this proviso, it appears that serum obtained by injecting horses with fresh cultures of dysentery bacilli, sus- pended in saline, is likely to be more potent than that prepared by the injections of sterile toxins and broth cultures, both of which are more lethal to the animals than is the first-named preparation. The actual standardisation of antitoxin was found to be fraught with great difficulties, not the least being the wide variation in individual susceptibility met with in the rabbits upon which the experiments were made. For example, one animal may be capable of withstanding several times the dose which 1 The Standardisation of Dysentery Serum. League of Nations, Health Organisation. First report by Kiyoshi Shiga, M. Kawamura, and K. Tsuchiya. The Kitasato Institute for Infectious Diseases, Tokyo, Japan. Geneva. 1924.
