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general malaise, and great pain, most marked in theaffected joints. Locally there is a small circumscribedswelling and slight tenderness, but no cases of abscessformation or of necrosis have been observed, nor hasthere been any disturbance of the function of the

renal, vascular, or haemopoietic systems. The reactionsubsides completely in 24 or at most 48 hours and thepatient feels perfectly well. Combined with the sulphurtherapy, such external applications as hot air, baths,massage, and passive movements should be persistedin, and it is important that these should not beomitted, for it is only during the sulphur treatmentthat their maximum benefit can be obtained. Theresult of the treatment on the joints is that there israpid diminution of pain, the swelling decreases,and the range of movement is markedly increased,while the general condition of the patient correspond-ingly improves. Acute affections which respond tosalicylates were not treated by this method.

COMMITTEE ON THE USE OF PRESERVATIVESIN FOOD.

As we recently announced, a deputation of medicalofficers of health and others to the Ministry of Health,urging the need for further control in the use of foodpreservatives, received the gratifying assurance thata committee was being appointed to consider thewhole question. The personnel of this Committee is asfollows : Sir H. C. Monro, K.C.B. chairman; ; Prof.W. E. Dixon, M.D., F.R.S. ; Sir A. D. Hall, K.C.B.,F.R.S.; Dr. J. M. Hamill ; Mr. 0. Hehner, F.I.C. ;Prof. F. G. Hopkins, F.R.S. ; Dr. G. R. Leighton ;Dr. A. P. Luff ; Dr. C. Porter; Mr. G. Stubbs,F.I.C. They are asked to inquire into the use ofpreservatives and colouring matters in food and toreport :-

]. Whether the use of such materials or any ofthem for the preservation and colouring of food is

injurious to health, and, if so, in what quantities doestheir use become injurious.

2. Whether it should be required that the presenceof such materials and the quantities present in foodoffered or exposed for sale should be declared.The secretary of the Committee is Mr. A. M. Legge,

of the Ministry of Health, Whitehall, S.W., to whomall communications should be addressed.

LEGITIMATE REQUIREMENT OF OPIUM.- IN the July number of the Contemporary Review

appears an article by Sir William Collins dealing withthe present position of the opium traffic. It will beremembered that Sir William Collins, together withMr. (now Sir) William Max-Muller, signed, on behalfof the British Government, the Convention draftedat the First International Opium Conference held atThe Hague in 1912. Since 1919 the League of Nationshas been entrusted with the carrying into effect of theConvention, in so far as the States which are membersof the League are concerned. We have repeatedlyreferred to the work of the Advisory Committee onOpium, appointed by the Council of the League tosupervise the execution of the Convention.l TheCommittee has continued the work formerly carriedout by the Netherlands Government in endeavouringto secure ratification of the Convention by all the

Powers, and has made an attempt, in cooperationwith the Health Committee of the League, to ascertainthe amount of opium, morphia, cocaine, and heroinrequired for legitimate consumption, but so far withinconclusive results. The problem of the " legitimate "needs of one country and another has given rise tomuch discussion, particularly with regard to India.The Indian Government takes its stand on thefindings of the Royal Commission of 1895, to theeffect that prohibition of poppy cultivation and themanufacture and sale of opium in British India wouldinvolve the destruction of the heavy export trade inBengal opium to China and elsewhere, and would

1 THE LANCET, 1921, ii., 518, 1230 ; 1922, i., 1004.

inflict a heavy loss of public revenue on the Govern-ment and people of India. The Commission alsofound that opium was a " universal householdremedy," that it was " extensively administered toinfants," and that it was used as a stimulant andprophylactic against malaria and fever. The Indo-Chinese trade, however, was terminated in 1917 ;some 14,000 chests of Indian Government opium areannually exported to meet the " legitimate require-ments of the non-China markets "-the latter includingthe Straits Settlements and North Borneo. TheIndian Government condemns opium-smoking as" essentially a social vice," and, speaking generally,it is their policy to " confine the use of the drugwithin the narrowest possible limits." The manufac-ture of opium for smoking in India is said to beprohibited except by the individual for his own use.With regard to China, it is to be regretted that thiscountry, whieh was reported to be free from poppycultivation in 1917, has since resumed a large produc-tion of opium, by the action of provincial governorsin defiance of commands from Peking. In a recentissue we dealt with the estimated legitimate needs ofChina-2000 oz. for a population of 400 millions witha yearly sickness incidence set at 20 millions. 2 Atthe session of the Advisory Committee held at Genevain June, the United States representatives pressedfor liinitation of production of the drugs dealt within the Convention to the amounts required for strictlymedicinal and scientific purposes. This propositionwas apparently approved subject to a reservation onbehalf of the Government of India, and to a declara-tion that so long as opium-smoking is not, as theConvention of 1912 contemplated it should be,suppressed, opium raised for that purpose is to bedeemed legitimate. Sir William Collins in his articledescribed a personal inquiry into the legitimate useof the drugs in question, as follows :-

" With the assistance of Mr. Langford Moore, pharmacistto St. Bartholomew’s Hospital, I have recently ascertainedthat at ten of the larger London hospitals, treating 70,000in-patients and 550,000 out-patients a year, the amount ofopium used is about 40 lb. per annum, of morphia 5 lb.,and of cocaine just over 9lb. These relatively modestamounts, which suffice for the legitimate medical treatmentof 620,000 sick and injured persons in a year, contraststrikingly with the hundreds of thousands of kilograms ofopium annually raised, and the tons of morphia and cocaineannually manufactured and exported."

These findings form another useful indication of theactual quantity of drugs of addiction which is necessaryfor the use of the world ; it is for the League of Nations,with the aid of the United States, to strive for

prevention of any output in excess of that quantity.

SIMULTANEOUS OBSERVATIONS ON GASTRIC

AND DUODENAL SECRETIONS.

THE interesting studies on human digestive secre-tions which have emanated from the Department ofPhysiology of the University of Edinburgh have beenextended by the introduction of a new technique.We recently published 3 an article by Dr. A. R.Matheson and Dr. S. E. Ammon describing thevigorous secretion of gastric juice which appears inthe fasting human stomach in response to a hypodermicinjection of histamine. In the current number of theEdinburgh Medical Journal Drs. R.-K. S. Lim, A. R.Matheson, and ’. Schlapp give a preliminary account4of their latest work. They introduce two tubes, thefirst into the duodenum, the second into the stomach,and by applying continuous aspiration to both ofthese they are able to recover the main bulk of thesecretions both of the stomach and the duodenum ;the method has the great additional advantage thatthe duodenal secretion is unadulterated with gastriccontents, these being removed separately. Threeexperiments on normal subjects are described ; in allof these a marked increase in gastric secretion was

2 THE LANCET, June 23rd, p. 1274.3 THE LANCET, 1923, i., 482.

4 Edin. Med. Jour., July, 1923.