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may have little mathematical knowledge, but couldalso devise mathematical machinery suited to hisneeds. As the author puts it : " When Newtonfound he wanted a calculating tool, he invented thebinomial theorem, and from a modification of thishe later invented a system of ’fluxions ’ which iscommonly called the Calculus.’ Later, again,when he wanted to calculate the shape of bodies ofleast resistance he invented a further modificationwhich is now known as the ’calculus of variations."’Newton was craftsman as well as natural philo-

sopher ; Colonel de Villamil crediting him with havingmade with his own hands the " Newton " chair,now in the Library of the Royal Society, and hisoutlook was modern in that he carefully dissectedthe eye while investigating light and vision. Findingthe refracting telescope imperfect, he invented andbuilt the reflecting instrument, grinding the lenseswith his own hands, an exploit that can be paralleled,though rarely, to-day. Of his personal surroundingsthe " inventary " discovered by the author inSomerset House conveys many entirely new valuabledetails. There is, for instance, the curious and

suggestive detail that the whole colour schemeof his furniture was red. By means of this docu-ment Colonel de Villamil has brought to light so

much itemised evidence that it would be quitepossible to reconstruct Sir Isaac’s actual surroundings,were his house in existence. As it is, it will requireonly a small effort of the imagination to form amental picture of Newton as he lived and worked,far more complete than could be built up in the caseof many modern contemporaries, and for this

physicists and men of science throughout the worldwill be grateful. ____

THE TRAFFIC IN NARCOTIC DRUGS.

AT the last meeting of the Assembly of the Leagueof Nations in September it was claimed that the

League is now in possession of an effective instrument"’ four securing the limitation of manufacture andthe regulation of distribution of narcotic drugs."The Assembly, nevertheless, expressed the viewthat such limitation of manufacture was but the" first step towards the limitation of the productionof the raw material." It accordingly proceeded toinstruct the Opium Advisory Committee to undertake,as soon as possible, the collection of material for afurther conference on the limitation of the productionof opium and of the cultivation and harvesting of thecoca leaf. The representatives of some of the pro-ducing countries were not slow to point out the- economic difficulties in which the contemplatedlimitation of production would involve them, thePersian delegate remarking that the opium exportsfrom his country amounted to 25 per cent. of its

foreign trade. The report of the League of NationsOpium Commission in the Far East, dealt with in THELANCET of Oct. 31st, fully confirms the contentionthat the radical method of dealing with the abuse ofnarcotics and the illicit traffic therein is by controlof production at the source. The Assembly indeedrecorded their opinion that " the enormous ravagescaused by the illicit traffic revealed the fact thatquantities of narcotics greatly in excess of those neededfor medical and scientific requirements are beingproduced and circulated throughout the world."While there has been some recent reduction in theworld manufacture of morphine and cocaine thisappears to have been offset by an increase in theproduction of heroin. In 1930 more than 10 tonsof pure narcotic drugs have leaked into illicit traffic.

A conference is now sitting at Bangkok to deal withthe traffic in opium " prepared " for smoking in theFar East, where the problem is complicated by avast amount of smuggling. The evil has attainedto such proportions that one of the American" observers " has reported to his Government thatcomplete prohibition is the only method whereby itcan be overcome.

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END-RESULTS OF OPERATIONS FORPEPTIC ULCER.

THE comparative merits of resection and gastro-enterostomy for gastric and duodenal ulcers, as judgedby the test of time, are discussed 1 boy Dr. ErikBrattstrom, of Prof. Petren’s Surgical Clinic in Lund,Sweden. His material consists of the patientsoperated on for chronic gastric or duodenal ulcerbetween Jan. 1st, 1900, and Dec. 31st, .1920. * The

subsequent fate of these patients was investigatedsome 2 to 11 years after the operation, and thisfirst inquiry was completed in 1923. In 1930 asecond investigation of the same material was carriedout. The pathological changes were approximatelythe same in the two groups, one of which consistedof 93 patients treated bv resection, and the otherof 60 patients treated by gastro-enterostomy. Theobservation period for those living was, for theresection series, 8 to 21 years, and for the gastro-enterostomy series, 21 to 29 years. Good resultscould be claimed for 78 per cent. of the resections,and for 66 per cent. of the gastro-enterostomies.The incidence of cancer of the stomach developingafter the operation was twice as high in the gastro-enterostomy group as in the resection group.Dr. Brattstrom concludes : " If then, finally, weshould inquire into the question that constitutes themain object of the present investigation, namely,a comparison between the resected cases and thosetreated by gastro-enterostomy, we find an undoubtedlygreater percentage of good results on the part of theresections." He finds, however, that what he callsthe " stability " of the results after operation was .

a little more favourable for the gastro-enterostomiesthan for the resections.

STERILISATION OF YEASTS AND FUNGI.

SOME recent laboratory experiments by E. Kadischdeserve notice because his observations affect not

only dermatologists but all who are trying to discovertherapeutic weapons against the mycotic group of

organisms. His paper, of which the second instal-ment has now appeared,2 is highly technical, but theconclusions may be quoted. He finds that smallpieces of cloth smeared with the agar-culturedcolonies are a practical, reliable, and easily handledmaterial for sterilisation tests. The resistance of theorganisms is often variable, and sometimes greaterthan was expected-both facts being probably depen-dent on the protective character of the agar in whichthey grow. The resistance of the naked organismdepends on its type and age. Yeasts are more

resistant than mycelial fungi of the epidermophytongroup, and Aspergillus niger, which he regards as apure parasite, is more resistant than the pathogenicvarieties of fungi. Alcohol he finds to be a valuabledisinfectant, and thymol will kill Oidium albicans(the cause of thrush) in a concentration of only 1/2000in glycerin broth in 48 hours. A 1 per cent. solution

1 Acta Chir. Scand., 1931, vol. lxviii., Fasc. IV.-VI.2 Dermat. Woch., Sept. 12th, p. 1433.

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of thymol in commercial alcohol proved a reliable anti-mycotic agent, and it is interesting to note that anincrease in the concentration of the drug did not haveany marked influence in reducing the times-minutesfor the mycelial group, and hours for the yeasts-in which the results were achieved. Kadisch statesthat silk stockings, for instance, can be disinfectedof all mycotic organisms, both fungi and yeasts,by six hours’ immersion in this fluid.

GYNÆCOLOGY IN VIENNA,

THE large volume before us 1 describes the techniqueof operative gynaecology employed at the First

University Women’s Clinic, Vienna, and the resultsobtained there. The opening section is devoted to adescription of the precautions against infection,anaesthesia. (including a very detailed descriptionof local and sacral anaesthesia), post-operativecomplications, general operative technique, and

preparatory and after-treatment. The second sectionis given to anatomy, and the third and last sectionto descriptions of the various gynaecological operations,starting with cancer of the cervix, to which 160 pagesare devoted, mostly occupied by a detailed description,with plates, of the extended vaginal operation whichis chiefly used by the authors, though a very full andbeautifully illustrated description of radical abdominalhysterectomy is also given. The numbers of casesdealt with are impressive. Thus between the years1901 and 1920 were seen 1787 cases of cancer of thecervix, and from 1921 to 1925 a further 461 cases, ofwhich 258 were operable-an operability-rate of 56 percent., the primary mortality-rate being 6.6 per cent.In most cases the extended vaginal operation wasdone. From Jan. lst, 1921, to May 31st, 1922,161 cases were seen, and of these, 92 came to operation,82 of which were done by the vaginal route, and 10by the abdominal. In this group the primarymortality was 9-8 per cent., the five-year cure-

rate being 26-7 per cent. of all cases seen (161).The results which are given in detail will repay carefulstudy. Few cases seem to have been treated by radium,and the results obtained are, on the whole, poor,though of 249 inoperable cases treated by radiumbetween 1913 and 1919, 26 (10.5 per cent.) were wellin 1924. From 1921 to 1925 (five years), 921 myomaswere seen in the clinic, 620 of which came to operation.In 349 vaginal hysterectomy was done with onlyone death, while supravaginal hysterectomy was

carried out in 176 cases with six deaths, and totalabdominal hysterectomy in 69 cases with six deaths ;the total death-rate in the series being 1-6 per cent.Cancer of the cervical stumps the authors found to berare, only eight cases in 1253 supravaginal hysterec-tomies. As the frequency of cancer of the cervixin the general population is 0-025 per cent., theconclusion is reached that subtotal hysterectomypredisposes to cancer in the stump. Since howeverthe patients know that menstruation has finished,and therefore do not expect bleeding, they comeearly, and so most cases are operable. The absenceof menstruation and accompanying hyperaemia tendto limit infiltration of the parametrium, so that of 13cases in the authors’ experience only two were inoper-able. Of metropathia hsemorrhagica 580 cases wereseen in the five years from 1921 to 1925 ; of these,

1 Gynäkologische Operationslehre. By Dr. Heinrich Peham,Professor of Obstetrics and Gynæcology at the I UniversityFrauenklinik in Vienna, and Dr. J. Amreich, Privat dozentin the University, and sometime Assistant at the Frauenklinik.With 448, mostly coloured, original illustrations. Berlin:S. Karger. Pp. 766. RM.140.

239 were treated by vaginal hysterectomy, of whichfour died, and 332 were treated with X rays-success-fully in all but seven cases. In treatment of cancerof the body, operation by the vaginal route is againfavoured. The results from radium have been poor; xit was used in nine cases, of which seven were operable,and only one of them was completely cured. For retro-version the Baldy operation is preferred. Eighteenpages and 15 colour plates are occupied with inter-positio uteri. A feature of the book is the beauty ofthe illustrations, all but two of which are original.The book, which is a notable addition to gynaeco-logical literature, constitutes the last work from thepen of the late Prof. Peham, and really amounts to arecord of his unique and lifelong experience.

SERUM IN ACUTE POLIOMYELITIS.

THE value of immune serum in the treatment ofthe acute stages of anterior poliomyelitis is nowfirmly established,1 but it is difficult to get a readyand sufficient supply. In America some workershave adopted the practice of collecting and poolingsmall quantities from patients recovered from thedisease. This, however, is not altogether devoid offallacies, as Shaughnessy, Harmon, and Gordon a

have shown, since they found that of seven personswho had been attacked by poliomyelitis from 6 to 24months previously in only four was the serum potentto neutralise the virus. But in addition theseworkers confirmed the previously recognised fact thatthe serum of many people who have never sufferedfrom the disease contains immune bodies in highconcentration. For these reasons H. K. Faber 3,

urges firstly, that all convalescent serum intended tobe used therapeutically should be tested, and,secondlv, that bv testina the serum of transfusiondonors a large and readily accessible supply ofimmune serum could be obtained. It was foundthat 77 per cent. of the donors tested were immuneand use was made of this fact in the recent epidemicin California with satisfactory results. M. Neustaedter 4has attacked the problem from a different aspect.Despite Flexner’s original failure, he has attemptedto immunise horses to the virus of poliomyelitis,and he succeeded in producing a serum which is

capable of protecting monkeys from large intra-cerebral injections of potent virus. Pettit and otherFrench workers have confirmed his findings and reportthe successful use of this serum clinically. In thiscountry R. W. Fairbrother and W. T. J. Morganhave done a good deal of work on the immunisationof horses, and a limited supply of their serum isavailable for tria1,1 but so far they have not drawnconclusions about its clinical efficacy.5 5 Meanwhilethese results are of great interest, and prompt oneto hope that eventually we shall have a supplyof efficient serum for use whenever necessary.

VITAMIN STANDARDS.

I THE vitamins enjoyed an important rise of statuswhen they became the subject of a conference calledin London last June by the League of Nations HealthOrganisation, in connexion with the meeting of thePermanent Commission on Biological Standardisation.Here was a case of wise foresight ; before the ahaoa

1 See THE LANCET, Oct. 31st, p. 977.2 Proc. Soc. Exper. Biol. and Med., 1930, xxvii., 742.

3 Jour. Amer. Med. Assoc., 1931, xcvi., 935.4 Ibid., p. 933.

5 THE LANCET, Sept. 12th, p. 584.