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this effect has been repeated daily for several weekswithout apparent harm. The lethal dose for rabbitsis similar to that of caffeine, and the symptoms ofpoisoning are erection of the hair, slowing of the

respiration, general weakness and defalcation. It willbe interesting to see what uses, if any, will be foundin therapeutics for this new vasodilator drug.

ORTHOPTISTS

THE term orthoptics is now applied to the treat-ment of concomitant strabismus by remedial exerciseswith the object of establishing stereoscopic vision andreducing the angle of squint. A number of instru-ments are used for this purpose but all are based onWorth’s amblyoscope. One of the most importantmodern improvements on this instrument is thearrangement which allows the trainer to keep the

patient’s eyes under observation throughout treatment.Mechanical devices which permit the independentaction of each arm of the instrument and which varythe intensity of the lighting of the pictures seen witheither eye are of considerable service. It is generallyagreed that the best age for the treatment of squintby orthoptic training is between four and seven years.After this although in a few instances results are

satisfactory in most improvement is meagre. Anorthoptic trainer requires patience, ingenuity andresource in order to keep the interest of child patientsand to make them persevere with irksome exercises.Most of this work in hospitals and in private practiceis done by women who have taken a one-year coursein elementary optics, the anatomy, and physiology ofthe extra-ocular muscles, refractive errors and squint.The practical work consists of methods of investiga-tion, therapeutics and lectures in hospital procedureand medical etiquette. It is good that this last subjecthas been introduced for in private practice orthoptistshave been apt to retain patients as long as two yearsunder treatment without referring them to an

ophthalmic surgeon. Also in the past patients havebeen encouraged to return direct to the orthoptistwithout attending their ophthalmic surgeon first.Orthoptists are now on the national register of medicalauxiliary services. There are 59 names on the register,of which 10 are in London, 2 in Wales, 4 in Scotland,1 in Northern Ireland and 1 in Canada. There is nodoubt that orthoptic training is of value in some

cases of squint, particularly when the angle of thesquint is relatively small (10°-15°), in young children,and before and after operation. There are, however,other cases in which it is a waste of time and effort.It is difficult to foresee how many orthoptists shouldbe trained until some statistics have been preparedand assessed. Certainly one should be attached to

every eye hospital and to everv large general hospitalwith an eye department. The prospects in privatepractice are probably fairly good in large towns, fora persistent squint is a lifelong disfigurement.

HEALTH WORK OF THE LEAGUE

Prof. Jacques Parisot, president of the health com-mittee of the League of Nations, in reporting thework of the 31st session of that committee to thecouncil of the League, says that " in spite of the warthe health organisation is still very much alive, thatgovernments are relying on it, and that faithful to itsmission it will continue to be inspired by that spirit ofindustry and devotion to the public cause in which itsstrength lies, and will give still further proof of itsutility." Failing full meetings during the war anemergency subcommittee of five members, with powerto act, will be appointed. The epidemiological intelli-gence service and the Singapore Bureau will carry onas usual. The continuance of national committees

dealing with nutrition, housing and physical fitness isurged. A commission on pharmacopoeias is contem-

plated for 1940, but questions dealing with museumsof hygiene, international lists of diseases and trainingof visiting nurses are relegated to the background.The health committee is in need of some increase ofstaff and looks to the committee on economic questions,which is considering the organisation of the technicalwork of the League, to deal with the matter. Attentionis called in the committee’s report to the valuablework of the Singapore Bureau, which is in frequentcommunication with 180 ports concerning the occur-rence of epidemic diseases. Credit is taken for thework undertaken by the League in China in organisinga new health service, with a quarantine system,improved hospitals and modern medical education. Itis claimed that " here, for the first time in history,is an example of unselfish international collaborationfor the economic and social reconstruction of a countrywhich was backward from the point of view of moderntechnology." The report concludes with the reminderthat " epidemic disease has taken advantage of everymechanical advance in transportation and of everywar or great disaster to spread more widely and tostrike a more deadly blow.... Man’s best chancefor better health, longer life and greater freedomfrom disease lies in the kind of international co6pera--tion that is being carried on by the League’s healthorganisation. This is the newest and most effectiveweapon in the war against the ancient diseases."

THE EIGHTEENTH CENTURY

IN the preface to his remarkable book, "History ofScience, Technology and Philosophy in the EighteenthCentury," 1 Professor ’ olf writes: " At a time whenlarge sections of the civilised world are reverting tobarbarism, it is especially stimulating to study the agein which Europe was struggling, and successfullystruggling, towards a state of enlightenment." Theword " struggling " needs emphasis, since the closingyears of the century saw the execution of one of itsgreatest men of science under circumstances resem-bling those in Central Europe today. One is tempted,even though it is against the modern view, to disso-ciate men of science from the politics of their age.In the eighteenth century, as in the present one, theywere struggling towards enlightenment against the

problems of Nature and the difficulties of thought,while large sections of the population came under thesway of the unmerciful. Nevertheless, whatever mayhave been the ultimate degree of enlightenment inthat century, none can deny the charm of the age ofcultured courts, ene5-clopdias, adventurers andquacks. The history of the sciences, as given in Pro-fessor Wolf’s book, is instinct with this fascination.In medicine, the eighteenth century saw the develop-ment of clinical training by Boerhaave, Van Swieten, deHaen and others, with their realisation of the valueof the study of physiology, biology, chemistry andphysics. At the same time the Hunters and MatthewBaillie, among others, insisted on the essential import-ance of a knowledge of anatomy. At the close ofthe century there appeared the first English treatiseon morbid anatomy. Professor Wolf cites as the

outstanding advances: percussion of the chest, vac-cination for smallpox, cold sea-water douche baths fortyphoid, and a revolt against blood-letting and exces-sive use of drugs. Most interesting are the missedopportunities which he mentions. Hales’s work onthe variations of blood-pressure in health and diseasewas not applied to diagnosis, and De Borden’s theory1. By Abraham Wolf, M.A., D.Lit. professor of logic and

scientific method in the University of London. London:George Allen and Unwin Ltd. 1938. Pp. 814. 25s.