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The following contains a preliminary account of the work on the Etiology and Pathology of Trench Fever which has been done at the Lister Institute in connection with the War Office Committee on Trench Fever under the Chairmanship of Major-General Sir David Bruce, F.R.S. A first account from the Clinical side has been published in a paper by Major Byam, R.A.M.C., and his colleagues at the New End Military Hospital, Hampstead, and read before the Society for Tropical Medicine and Hygiene in May of last year. We have been mainly dependent for our material on Major Byam and the rest of the Medical Staff of the New End Hospital and are very much indebted to them for their help and courtesy. We are under an especial obligation to Lieut. Ll. Lloyd, R.A.M.C., who has carried out that part of the entomological work done at the Hospital, taking immense pains in supervision and in obtaining the material which we required.

The forms under consideration resemble Rickettsia prowazeki—the supposed cause of typhus fever—which occurs in lice that have fed on typhus fever patients.

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The points to which I have specially directed my attention are (1) the variability of the Meningococcus and the usual directions which variation takes;(2) the question of a difference between Sporadic and Epidemic strains;(3) the occurrence in cases of Meningitis of certain other Gramnegative organisms which have some resemblance to the Meningococcus. VARIATIONS.The differences observed amongst the strains of Meningococcus which I have cultivated have not concerned the morphology nor the staining reactions.