324 THE LEAGUE OF NATIONS AND NARCOTIC DRUGS

fractures the best treatment is held to be reductionand plaster, or wire extension. Operation shouldbe done only in exceptional cases. Compoundfractures which come under treatment within eighthours should be dealt with by excision and primarysuture of the wound, reduction of the fracture, andfixation in plaster ; if necessary by wire extension.The results obtained in this way seem to be some-what better than by simultaneous operation on thebones.

AMINO-ACETIC ACID FOR ANOREXIA

THE fact that most of the myopathy patientsunder his care reported a gain in weight and a stimula-tion of the appetite after treatment with amino-acidtherapy led Dr. Howard A. Beard 1 to study the effectof this therapy in otherwise normal individuals whocomplained of anorexia, under-weight, and nervous-ness. None of the patients studied had put on weightor increased their appetites on any previous dietaryor medical regime. Amino-acetic acid was given in10-20 g. daily doses in water, milk, or fruit juicesfor three to twelve weeks to eight patients, whoseincrease in body-weight after treatment varied from7 to 24 lb. In one patient whose under-weightwas associated with hyperchlorhydria and astheniatreatment was continued for 24 weeks, the patientgaining 13 lb. In all cases the anorexia, nervousness,and fatiguability are said to have disappeared andstrength was increased. The ages and sex of theadult patients are not stated, but it is recorded thatthe treatment was also tried with considerable successin the department of paediatrics at the LouisianaState University Medical Centre on 15 children whowould not eat a sufficient amount of food for theirbody’s needs.

THE LEAGUE OF NATIONS AND NARCOTIC

DRUGS

THE last report of the Advisory Committee on theTraffic in Dangerous Drugs to the Council of the

League of Nations is of unusual interest. It recordswith satisfaction the progress in effective controlover the legitimate manufacture of narcotics andreveals " the alarming situation in the Far East "for which " a remedy has yet to be found." Littleadvance appears to have been made towards draftinga convention to control the cultivation of the opiumpoppy and the harvesting of the coca leaf. Theinformation invited by a questionnaire issued bythe Secretariat of the League in 1933 is said to be" still very incomplete." The Turkish Government" did not admit the urgency for an international

agreement restricting its liberty of action in thismatter " while the Iranian representative " did notthink that the problem was yet ripe for practicalconsideration." The representative of China, anotherlarge producer of opium, favoured the conveningof an international conference with a view to drafta convention to limit the cultivation of the poppy,as this would be "a great encouragement to theChinese Government in accordance with their six-year plan of suppression." It was, however, stronglyurged in the committee that " the proposed conferenceshould not be indefinitely delayed owing to lack ofinformation from the producing countries." Thecommittee finally adopted a resolution to dissociatethe question of the control of the coca leaf from thatof the limitation of the cultivation of the opiumpoppy. -The committee, while reiterating the con-viction that " measures of controlling cultivation

1 American Medicine, June, 1936, p. 340.

of the opium poppy are urgently needed," postponedto its next meeting the examination of the principleswhich might serve as a basis for a convention andthe appointment of a preparatory committee for thepurpose of drawing up a preliminary draft convention.Meanwhile the governments of the producing countriesare to be requested to furnish by Jan. 31st, 1937,the information for which they were asked in thequestionnaire of 1933. As regards the situationin the Far East the committee reported " an enormousproduction of opium, clandestine manufacture,and widespread illicit traffic in narcotic drugs, themanufacture and traffic being carried on in part byforeigners, principally Japanese and Koreans, livingunder extra-territorial jurisdiction " in China andliable to penalties which could only be described asderisory. This state of things is the more inexcusableseeing that under chapter iv. (articles 15-19) of theHague International Opium Convention of 1912the Treaty Powers, with colonies and leased territoriesand concessions in China undertook to restrict theuse and illicit import of narcotics into such territories.The Chinese authorities are struggling to effect intheir six years the suppression of opium-smokingand the cultivation of the poppy, and withDraconian severity had executed 970 persons duringthe year 1935 for breaches of narcotic laws.

THE L.C.C. MENTAL HOSPITALS AND G.P.I.

THE London County Council passed a resolution inFebruary last suggesting that its mental hospitalscommittee should prepare a report on general paralysisand the modern treatment of syphilis as shown by thecases admitted to the Council’s mental hospitals duringthe three years 1932, 1933, and 1934. Since 1924,when a malaria laboratory was established at Horton,that hospital has undertaken the treatment of mostof the female cases of general paralysis from all

hospitals. In 1931 it opened a special treatmentcentre for male general paralytics and in 1935 itreceived 61 per cent. of the total cases. The diagnosishas been confirmed by clinical symptoms, post-mortem findings, and serological tests of the cerebro-spinal fluid. The medical superintendent has comparedthe records of 113 men admitted between 1912 and1914 with an equal number admitted after 1932. Thesymptomatology seems to be much the same, manicand depressed types being rare in comparison withgrandiose and dementing. The recent records showa larger proportion of confused cases, but this may bepartly due to the difficulty of distinguishing betweenconfusion and dementia. Even nowadays patientsare still admitted in an advanced stage when treat-ment is almost hopeless, and there is still roomfor earlier diagnosis. The report states definitely thatbefore the advent of modern therapy there was noreal recovery from general paralysis ; the death-ratewas 86-8 per cent. and the discharge rate only 3-4per cent. although it included ill-advised with-drawals by relatives. On an average the patientslived between one and two years after admission.The comparative figures for the recent years showa discharge rate of 19-8 per cent. and a treatment rateof 85 per cent., the death-rate having been reduced to40’8 per cent. In most cases the cure is permanent andmany of the discharged are now successfully fillingpositions of responsibility. The best results recordedindicate that of all cases admitted modern therapycan yield a recovery rate of 25 per cent., and a death-rate reduced to 30 per cent. The inquiry also revealeda definite decrease of general paralysis since 1930.One reason for this is earlier diagnosis, leading to