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TRAFFIC IN DANGEROUS DRUGS
550
MATERIALS FOR RESTORING FRONT TEETH
and with doses of 1.0 to 2-0 mg. a fall in ventricular rate is seen within an hour, and a maximum effect in six to seven hours. After a single dose of 1.0 or 1.5 mg., the ventricle returns to its original rate in
about three days. Six hours after the initial dose, further doses of 0-5 or 1.0 mg. may be given daily till a full therapeutic effect is obtained. A maintenance dose of 0-5 mg. was found to correspond to 2 c.cm. of standard digitalis tincture. These results suggest that digoxin is rapidly eliminated from the body. Nausea and vomiting are produced by all potent preparations of digitalis when given in sufficient quantity, probably by a reflex from the heart, and digoxin is neither more nor less liable to produce these effects than the tincture. Similarly both digoxin and the tincture seem equally liable to cause extrasystoles. The other glucoside, digitalinum verum, given intravenously in doses of 2.5 to 5.0 mg., produces its preliminary and maximum effects on the heart-rate in much the same time as digoxin, and their duration is also comparable. It is ineffective, however, by mouth, it does not lower the heart-rate, and it gives rise to abdominal discomfort and diarrhoea, the result of a direct action on the bowel. To sum up, we have in digoxin a pure digitalis glucoside, requiring no standardisation, which is of uniform potency, and is capable of producing rapid ventricular slowing when given by mouth or intravenously to patients with auricular fibrillation. Digitalinum verum, another pure glucoside, has the same effects when administered intravenously, but is of no value when given by mouth. TRAFFIC IN DANGEROUS DRUGS
THE convention for the limitation of the manufacture and distribution of dangerous drugs of 1931, having received the required number of ratifications, If its object is to be came into force on July 13th. achieved it will require to be universally applied, and its effectuation will depend upon the legislative and administrative measures adopted by the several contracting parties. To this end a model administrative code has been issued by the League of Nations in the hope that governments will have regard to it when giving effect to the convention. The completed returns for the year 1931 have led the advisory committee on traffic in opium to think that in that year the manufacture of narcotics approximated to the estimates of world requirements for medical consumption which were put forward by the League of Nations. There is, however, ground for believing that clandestine factories for the manufacture of morphine and heroin have sprung up in various parts of the world, and that poppy cultivation on a large scale is being carried on in several of the provinces of China. The exports from France in 1932 were reported to be 155 kg. of morphine, 22 kg. of heroin, and 55 kg. of cocaine. The representative of Germany informed the advisory committee that a supplementary law had been promulgated to restrict further the manufacture of narcotic drugs. The Portuguese delegate assured the committee that a new policy was contemplated in Macao with a view to suppress the traffic in prepared opium with which that port has long been associated. The Bangkok agreement, which dealt less drastically with the suppression of opium smoking than was provided for by the Hague Convention of 1912, has been ratified by Great Britain, France, and the Netherlands. At the request of the representative of Italy, the secretariat of the League has been instructed to make inquiry (1) as to the annual value of the lawful consumption of opium,
coca leaves, and manufactured drugs, and (2) as to the annual loss of wages among addicts, and the expenditure incurred by the different States on preventive measures, treatment, and suppression in connexion with addiction. In pursuance of the resolution passed by the assembly of the League two years ago with a view to limit cultivation of the the opium poppy and the harvesting of coca leaves, questionnaires are about to be forwarded to producing States, members of the League, and to non-member States. Replies to the questionnaires, when received, are to furnish the data for the conference on the limitation of raw materials which was desiderated by the assembly. The advisory committee has suggested a meeting of representatives of Persia, Turkey, and Yugoslavia, as principal producing countries, with one or two independent persons, in order to devise an agreement on the limitation of production. Presumably, representatives of China and India will be invited to assist in such investigation.
MATERIALS FOR RESTORING FRONT TEETH are three materials which can be used for front teeth-gold, porcelain, and a translucent cement. Gold is the most ancient of these, but it is not necessary to be very old to remember tedious hours spent in the dental chair while gold foil was hammered into a tooth piece by piece. The value of gold for this purpose depends on its property of welding in the pure state, the solid plug being very stable and undergoing little change even over many years. The drawback is that gold filling in a front tooth is easily observed, and when gold was the- only material available people unfortunate enough to have carious front teeth were compelled to carry about visible signs of the dentist’sattention. To-day gold is little used for filling front teeth, though in the form of the gold inlay, in which a reproduction of the cavity is cast and cemented in, it is still much used for back teeth. But while this method avoids hammering the prime defect of a filling completely unlike a tooth in colour remains. Yet at the annual meeting of the British Dental Association held in Leicester there were still advocates of cohesive gold for front teeth. Prof. W. H. Gilmour, who openeda symposium on their restoration, stressed the great value of its strength and permanence. An increasing number of the public however dislike intensely the glitter of gold in the front of the mouth. The use of a porcelain inlay cemented into place was advocated by Mr. C. S. Morris. This is of considerable strength and is capable of matching a tooth almost exactly, but it requires an elaborate and expensive electric furnace, the technique is difficult and takes time, and restorations in porcelain are necessarily expensive. A serious defect is that the cement used to fix the inlay into place in time darkens and spoils the appearance. As an inlay porcelain is little used, though in the limited field of crowns it is the last word in refinement, for it can be employed without destroying the pulp and gives a restoration quite indistinguishable from natural teeth. Ground porcelain filling, in the manner devised by W. Dall, and advocated by Mr. S. F. Webb, is wrong in principle as it necessitates the removal of sound tissue in order to make the cavity fit the inlay. Silicate or translucent cement, advocated by Mr. G. N. Groves, is placed in the cavity in a plastic form which rapidly sets. It is not adhesive, a fault it shares with gold and porcelain, and its edge strength is poor compared
THERE
filling
1 Brit. Dent.
Jour., July 15th.
MATERIALS FOR RESTORING FRONT TEETH
and with doses of 1.0 to 2-0 mg. a fall in ventricular rate is seen within an hour, and a maximum effect in six to seven hours. After a single dose of 1.0 or 1.5 mg., the ventricle returns to its original rate in
about three days. Six hours after the initial dose, further doses of 0-5 or 1.0 mg. may be given daily till a full therapeutic effect is obtained. A maintenance dose of 0-5 mg. was found to correspond to 2 c.cm. of standard digitalis tincture. These results suggest that digoxin is rapidly eliminated from the body. Nausea and vomiting are produced by all potent preparations of digitalis when given in sufficient quantity, probably by a reflex from the heart, and digoxin is neither more nor less liable to produce these effects than the tincture. Similarly both digoxin and the tincture seem equally liable to cause extrasystoles. The other glucoside, digitalinum verum, given intravenously in doses of 2.5 to 5.0 mg., produces its preliminary and maximum effects on the heart-rate in much the same time as digoxin, and their duration is also comparable. It is ineffective, however, by mouth, it does not lower the heart-rate, and it gives rise to abdominal discomfort and diarrhoea, the result of a direct action on the bowel. To sum up, we have in digoxin a pure digitalis glucoside, requiring no standardisation, which is of uniform potency, and is capable of producing rapid ventricular slowing when given by mouth or intravenously to patients with auricular fibrillation. Digitalinum verum, another pure glucoside, has the same effects when administered intravenously, but is of no value when given by mouth. TRAFFIC IN DANGEROUS DRUGS
THE convention for the limitation of the manufacture and distribution of dangerous drugs of 1931, having received the required number of ratifications, If its object is to be came into force on July 13th. achieved it will require to be universally applied, and its effectuation will depend upon the legislative and administrative measures adopted by the several contracting parties. To this end a model administrative code has been issued by the League of Nations in the hope that governments will have regard to it when giving effect to the convention. The completed returns for the year 1931 have led the advisory committee on traffic in opium to think that in that year the manufacture of narcotics approximated to the estimates of world requirements for medical consumption which were put forward by the League of Nations. There is, however, ground for believing that clandestine factories for the manufacture of morphine and heroin have sprung up in various parts of the world, and that poppy cultivation on a large scale is being carried on in several of the provinces of China. The exports from France in 1932 were reported to be 155 kg. of morphine, 22 kg. of heroin, and 55 kg. of cocaine. The representative of Germany informed the advisory committee that a supplementary law had been promulgated to restrict further the manufacture of narcotic drugs. The Portuguese delegate assured the committee that a new policy was contemplated in Macao with a view to suppress the traffic in prepared opium with which that port has long been associated. The Bangkok agreement, which dealt less drastically with the suppression of opium smoking than was provided for by the Hague Convention of 1912, has been ratified by Great Britain, France, and the Netherlands. At the request of the representative of Italy, the secretariat of the League has been instructed to make inquiry (1) as to the annual value of the lawful consumption of opium,
coca leaves, and manufactured drugs, and (2) as to the annual loss of wages among addicts, and the expenditure incurred by the different States on preventive measures, treatment, and suppression in connexion with addiction. In pursuance of the resolution passed by the assembly of the League two years ago with a view to limit cultivation of the the opium poppy and the harvesting of coca leaves, questionnaires are about to be forwarded to producing States, members of the League, and to non-member States. Replies to the questionnaires, when received, are to furnish the data for the conference on the limitation of raw materials which was desiderated by the assembly. The advisory committee has suggested a meeting of representatives of Persia, Turkey, and Yugoslavia, as principal producing countries, with one or two independent persons, in order to devise an agreement on the limitation of production. Presumably, representatives of China and India will be invited to assist in such investigation.
MATERIALS FOR RESTORING FRONT TEETH are three materials which can be used for front teeth-gold, porcelain, and a translucent cement. Gold is the most ancient of these, but it is not necessary to be very old to remember tedious hours spent in the dental chair while gold foil was hammered into a tooth piece by piece. The value of gold for this purpose depends on its property of welding in the pure state, the solid plug being very stable and undergoing little change even over many years. The drawback is that gold filling in a front tooth is easily observed, and when gold was the- only material available people unfortunate enough to have carious front teeth were compelled to carry about visible signs of the dentist’sattention. To-day gold is little used for filling front teeth, though in the form of the gold inlay, in which a reproduction of the cavity is cast and cemented in, it is still much used for back teeth. But while this method avoids hammering the prime defect of a filling completely unlike a tooth in colour remains. Yet at the annual meeting of the British Dental Association held in Leicester there were still advocates of cohesive gold for front teeth. Prof. W. H. Gilmour, who openeda symposium on their restoration, stressed the great value of its strength and permanence. An increasing number of the public however dislike intensely the glitter of gold in the front of the mouth. The use of a porcelain inlay cemented into place was advocated by Mr. C. S. Morris. This is of considerable strength and is capable of matching a tooth almost exactly, but it requires an elaborate and expensive electric furnace, the technique is difficult and takes time, and restorations in porcelain are necessarily expensive. A serious defect is that the cement used to fix the inlay into place in time darkens and spoils the appearance. As an inlay porcelain is little used, though in the limited field of crowns it is the last word in refinement, for it can be employed without destroying the pulp and gives a restoration quite indistinguishable from natural teeth. Ground porcelain filling, in the manner devised by W. Dall, and advocated by Mr. S. F. Webb, is wrong in principle as it necessitates the removal of sound tissue in order to make the cavity fit the inlay. Silicate or translucent cement, advocated by Mr. G. N. Groves, is placed in the cavity in a plastic form which rapidly sets. It is not adhesive, a fault it shares with gold and porcelain, and its edge strength is poor compared
THERE
filling
1 Brit. Dent.
Jour., July 15th.