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897 :traffic in indian hemp originates with the Indian, Arab, or negro seaman and extends by way of the dock areas of London to the West End, where it is smoked and peddled on a small scale by a few coloured men. During the year there were only 20 instances of prescriptions forged with a view to obtaining narcotics illegally. The smallness of this number probably reflects less the true demand for illegal narcotics than the known efficiency of preventive legislation. (The duties of doctor and dentist in this respect have lately been described in the new edition of a Home Office memorandum. 6) Drug addiction is, of course, much less rare than these figures indicate ; for some of the commoner drugs of addiction do not come within the province of the report. RUSSIA, EUROPE, AND W.H.O. THE second session of the executive board of the World Health Organisation opened at Geneva on Oct. 25 with a setback. Telegrams were read from the U.S.S.R. and Byelorussian members, the former stating that he would not come because the late receipt of the agenda did not’ allow him to contribute usefully to the discussion, and the latter that he was " prevented " from attending. Although the board replied that it deeply regretted their absence, and still hoped they would be able to come later in the three weeks’ session, nothing further was heard. This Russian action certainly did not stem from the delegates themselves, or the health authorities, and must have been political in origin. We trust that the Soviet leaders will speedily return to their former view that world collaboration for health is possible and that one of the few remaining bridges between the East° and West should not be permanently destroyed. The remaining 16 members, including those from Poland and Yugoslavia, did valuable work. The most important item was perhaps the 1950 budget, which - incredible as it may seem-must be ready this month. Discussion of the principles involved led back to the basic question whether a serious effort can be made to raise the level of health of the peoples of the world or whether W.H.O. must content itself broadly with the old-style inexpensive activities of its predecessors. 7 From a body of individuals " technically qualified in the field of health " there could be but one answer, and, after brilliantly dispelling certain hesitations, the director-general, Dr. Brock Chisholm, received the board’s mandate to prepare for the next assembly a New Look budget for 1950. Meanwhile the board learned with satisfaction of the establishment of the first of the W.H.O.’s regional organisations, that for South-East Asia, with headquarters at New Delhi, and approved the appointment of Colonel C. Mani, at present the member of the board nominated by India, as regional director. It also decided to leave to the director-general the complicated and thorny subject of allocations to countries for programmes of assistance by means of demonstration teams, experts, fellowships, and medical literature, for , which a total of about$P/2 million can be used in 1949. A pleasant interlude from administrative matters was afforded .by the account of the vast B.C.G. vaccination programmes being undertaken by the Scandinavian Red Cross Societies and the International Children’s Emer- gency Fund and of the proposed epidemiological and statistical research arising out of them. 8 Discussion of a proposal by the member from France, Prof. J. Parisot, to reduce the number, length, and cost of organisational meetings of the governing bodies was deferred to the third session.’ Now that the end of the organisational 6. Dangerous Drugs Acts, 1920 to 1932 : Memorandum as to Duties of Doctors and Dentists. D.D.101, 5th ed. H.M. Stationery Office. Pp. 12. 3d. 7. See Lancet, July 3, p. 17. 8. Ibid, Nov. 27, p. 855. stage of W.H.O. is in sight, it should clearly be possible to reduce the budget allocations for meetings of the executive board and the assembly, and also the undue demands on the time both of the members of these bodies and of the secretariat. W.H.O. has not, as yet, followed UNESCO in overloading the administrative side of the staff,9 but it must ’constantly gizard against the similar danger of spending too much time and money on meetings of its governing bodies. On Nov. 15, immediately after the meeting of the executive board, there was a two-day conference of representatives of European countries. Of 23 invited, 16 sent representatives, including Bulgaria, Czecho- slovakia, Hungary, Poland, and Yugoslavia-but not the -Russians. The assembly had decided that, as the headquarters of W.H.O. are to be in Geneva, a regional organisation in the full sense of the constitution- will not be necessary for Europe, and that a special temporary administrative office for the health reconstruction of war-damaged countries should be set up instead. The object of the conference was to advise the director- general on the tasks of such an office-i.e., the health needs of Europe which might be met by W.H.O. in 1949 and 1950-and on its location and staffing. Dr. C. van den Berg (Netherlands), who was elected chair- man, had a somewhat difficult task because the Czecho- slovak delegation, supported by their colleagues from eastern Europe, persisted in trying to reverse the assembly’s decision and set up a complete regional organisation, to be located in Czechoslovakia. In view of the very limited funds available, agreement might well have been reached on the compromise proposal of the vice-chairman, Dr. B. Kozusznik (Poland), that a special office should be established provisionally at Geneva, but for the unexpected and stubborn intervention of the delegate of Denmark in favour of Copenhagen. Despite this failure to achieve unanimity, useful informa- tion was provided for the secretariat in drawing up plans for 1949 and 1950. RAPID DIGITALISATION RAPID digitalisation is required by the patient in distress from congestive heart-failure due to a rapid ventricular rate from auricular fibrillation or other causes. Over thirty years ago Eggleston introduced a method by which dosage was calculated from body- weight. By this method dosage was unnecessarily large ; but today, on the other hand, the tendency is to give far too little digitalis and needlessly postpone the relief it gives. In an inquiry by William Evans and his colleagues 10 twenty patients with auricular fibrillation, heart-failure, and high ventricular rate were each given a series of digitalis drugs, with an interval of 3 to 14 days between each drug to allow the rate of ventricular contraction to rise again. The criterion adopted was the extent of ventricular slowing within 4 hours-a standard which is fully justified because there is reason to think that ventricular slowing is as much the result as the cause of improved myocardial functions Results are usually believed to be better with redigitalisation after a short interval than when the patient is digitalised for the first time ; but this difficulty was overcome by administering the preparations in a different order in the various patients. Three drugs-’ Digoxin,’ lanatosid C, and digitaline (Nativelle)-were found to be the best. Digoxin by mouth was effective within 4 hours, usually with a dose of 2 mg. and always with a dose of 3 mg. Intravenous digoxin 1.5 mg. produced still quicker results, but such rapidity is rarely essential and may be attended with some slight risk. Intravenous strophanthin 9. See New Statesman and Nation, Nov. 20, p. 431. 10. Evans, W., Dick, P., Evans, B. Brit. Heart J. 1948, 10, 103. 11. Luten, D. Clinical Use of Digitalis. London, 1936. Gold; H. Science, 1943, 97, 125.
