ity, and vision, he placed at the disposal of the A. E. F. the experience and training facilities of the medical services of the French armies and of the British Expeditionary forces in France. He organized a system for the training of officers of the medical service of the Army of the United States in their duties at the front which contributed to a remarkable degree to the success attained in the treatment and evacuation of battle casualties." For meritorious service with the British at their front during the War, King George conferred on Dr. Ashford the Cross of St. Michael and St. George of England, making him a Companion of the Order.

The end of the war in Europe meant for Dr. Ashford the resumption of hostilities against those microscopic enemies of mankind with which no peace can ever be made. Within a few weeks, he was back in his laboratory.

In 1919, Cuba and the United States together selected two sanitary officers to study and report upon a mysterious flare-up of malaria in the city of Havana. North Americans in Havana feared that mosquito control was weakening: Cubans were apprehensive lest they be misjudged in view of the provisions of the Platt Amendment stipulating an adequate system of mosquito prevention. Dr. Ashford, chosen by the Government of the United States, with Dr. Guiteras, designated by the Cuban Government, found out-and what is in general more difficult, convinced their respective Governments-that the malaria in Havana was by no means the menace at first supposed. The existent cases were being supplied by the removal of laborers from malarial centers in other provinces to Havana hospitals, where they were bitten in early evening by the anopheles mosquito, which is fond of flying around in the cool of the day. These mosquitoes were bred chiefly in ditches and holes caused by the abnormal rapidity with which Havana was spreading out and building up. The joint investigation practised by the two physicians resulted not only in the speedy reduction of malaria but in its practical disappearance from Havana.

Dr. Ashford through all these years had been cherishing a great dream of a school of medicine in the American tropics under the Stars and Stripes. In 1906, seeing that the treatment

and prevention of hookworm disease in Porto Rico had become automatically a public health service, and as such should be continued under the Department of Health, Dr. Ashford and his associates had recommended the reorganization of that Department under a Commissioner, and the establishment of an Institute of Tropical Medicine to be manned by the members of the old Porto Rico Anæmia Commission. Underlying the plan was the hope of the establishment, whenever money and the powerful patronage of a recognized northern university could be obtained, of a School of Tropical Medicine in Porto Rico.

The Institute was founded according to plan, and it took up its being in the basement of the Red Palace, historic residence of Spain's Lieutenant-Governors. Within a month the Institute was definitely and demonstrably a success: so great a success that it soon developed into all that had been hoped for; and "the great northern university" was not slow in appearing. To cut forward after the fashion of a cinematograph, we may say that the School of Tropical Medicine of the University of Porto Rico, under the auspices of Columbia University, was formally opened in San Juan in the fall of 1925. The beautiful Spanish Renaissance structure which now houses it shelters the only school of tropical medicine in the tropics under our flag; and its amazingly productive work has already won recognition in the four corners of the world. An international scientific center, it is not surprising that its first graduates were a young Jesuit from Spain, training himself for work as head of a Leper's Institute, and a Hindu who is now giving his own people the benefit of his Porto Rican study. Dr. Ashford's has of course been a guiding voice in the School of Tropical Medicine from its beginning, and before. In 1926 he was appointed Professor of Tropical Medicine and Mycology in Columbia University, detailed to post-graduate instruction in the School of Tropical Medicine in San Juan.

Meantime, in his private investigations, Dr. Ashford had rounded another corner and turned up a tangled trail, a very perplexing trail for tropical medicine. That it leads by devious and jungly degrees up a high mountain no student of the science could doubt; but, until Dr. Ashford turned his attention that way, for more than one hundred and fifty years no one had even got a

toe-hold on the slope. The problem was tropical sprue. Just as uncinariasis is the poor man's disease in the tropics, sprue is the infirmity of the well-to-do; an urban disease, endemic in cities and towns of tropical and warm-climate countries throughout the world, with a range in Asia, for example, from Ceylon, India, and Cochin China to Korea. Sprue is prevalent in our own Southern States, though it is not usually recognized as such.

Sprue is a corrosive thinning of the entire digestive tube, from a raw tongue down, with almost intolerable gaseous distension, an exhausting white diarrhoea, emaciation, anæmia, and, unless cured, death by inanition. When Dr. Ashford began his investigations, the cause of sprue had not been discovered: but it was not long to remain obscure. He had found in 1914 that a little yeast-like body, which he named Monilia psilosis, was constantly associated with this condition; and after more than a decade's careful study of its points of difference from other yeast-like bodies, after experiments with animals and blood reactions, he has come to the conclusion that, just as thrush of infants is produced by a similar yeast on a background of physiological exhaustion, sprue is produced by Monilia psilosis on a background of physiological exhaustion of digestion, a very usual condition in the tropics. In other words, Dr. Ashford believes that the true problem of sprue, and of thrush, is the condition of malnutrition which permits the little organisms to colonize and produce the familiar pictures we call thrush or sprue.

No lay commentator can say as yet whether Dr. Ashford is entirely right; but we do know that he has been eminently successful in treatments according to his theory ("The characteristic of a true theory," said Pasteur, "is its fruitfulness!"). We know too that a man, vigorous and still young, with a typically Celtic mixture of large-mindedness and large-heartedness, considerably enlivened by a power of wrath no less Celtic, is unlikely to rest content with past laurels. The next quarter-century promises, for many reasons, to be the greatest yet known to tropical medicine. It may confidently be predicted that not least among the causes contributing to that greatness will be the present and future work of Dr. Bailey K. Ashford.

WHAT IS WAR GUILT?

BY SIR THOMAS BARCLAY

I

It is not without significance that in Article 231 of the Versailles Treaty the responsibility for the war is not based on the declarations of war as set out in the preamble, but on "aggression of Germany and her allies". In other words, it is not the war or the declarations of war alone that constitute the guilt of the enemy, but their aggressive character. Since the signature of the Treaty, Germany's culpability as the aggressor has never ceased to excite controversy among international jurists, and now the question has become more acute than ever in connection with the discussion on the proposal to outlaw war altogether.

The controversy as to the nature of an aggression, however, is no new one. The object of this article is to exhume some diplomatic attempts in the past to define the term, and to show how far we are still from a clear understanding of its bearing. In any case, it will be seen that the exception from outlawry, of resistance to an aggression, involves an element of uncertainty which might defeat the object of the principle it is sought to establish. Furthermore, we must bear in mind that no war in recent times has been entered upon by any State without alleging that acts of the enemy had provoked it. If both parties charge each other with being the aggressor, who is to decide whether the one who declares war or the one alleged to have provoked the declaration is in fault? We have no difficulty in agreeing that a nation cannot abandon the right of self defense against invasion, or the duty of being on its guard against the consequences of some grievance, real or artificial, of a restless neighbor.

The term "defensive" merely describes the military character of the hostilities and may be treated as leaving the question of responsibility untouched.

II

As far back as the middle of the Eighteenth Century, Montesquieu held that the real author of a war was not the sovereign who declared it, but the one who made it necessary.

We all know the ordinary sense of "aggression". The definition of the word in diplomatic usage is, "the first act leading to hostilities".

Littré, in his great dictionary, qualified this definition to make it tally with contentions of French statesmen of then still recent character. "It is possible," he says, "that he who attacks is not necessarily the aggressor; the aggression may consist of something quite different from the attack." If the attack is provoked, it is not an aggression.

The word has now become more familiar through the use of it in the Covenant creating the League of Nations. Under it, according to the much debated Article X, the Members of the League undertake to respect and preserve as against "external aggression" the territorial integrity and existing political independence of all Members of the League. In case of any such aggression, or in case of any threat or danger of such aggression, it further provides that the Council shall advise upon the means by which this obligation shall be fulfilled.

In the abortive Geneva Protocol of 1924, there were a number of more or less subtle provisions, concerning what constitutes an aggression, entailing intervention of the Council and the application of the sanctions provided by the Covenant. Disobedience to an order of the Council, said the Protocol, would constitute the disobedient State an aggressor and entail the application of these sanctions.

There was no question in the Protocol of an unprovoked aggression, because it was assumed that all States would be subject, in case of any difference between them, to the orders of the Council, and in fact it implied the possibility of both parties in such a case being aggressors, in which emergency all the rigors of the Covenant would have been brought to bear against both of them. This looks like a reductio ad absurdum, and in fact it shows the danger of reasoning beyond the actual data of experience.