CAMPAIGN FOR INDEPENDENCE IN MEDICINE

1305 CAMPAIGN FOR INDEPENDENCE IN MEDICINE

SIR,-I wish to comment on the

case presented by the CamMedicine. While I endorse the need in paign Independence for a vigorous private medical-care sector in the United Kingdom, I take issue with the conflicting ideals that, on the one hand, we should preserve an area of free enterprise, but, on the other, expect that the facilities for this should be provided within the public sector. We should actively defend our right to practise private medicine, but we must also be enterprising enough to ensure that the facilities to do so are provided outwith the National Health Service. The retention of pay-beds will always appear to cater unfairly for a small minority, however one tries to justify their existence. The wholehearted support of the profession and the lay public for private practice will be obtained only when it is seen to be self-supporting and not dependent on N.H.S. facilities. Those doctors who are campaigning for the retention of private facilities within the N.H.S. must realise that this could seriously damage the cause of the right of private practice to exist in this country.

for

Raigmore Hospital, Inverness IV2 3UJ

FINLAY KERR

Chromatid gap in metaphase figure from cultured

lymphocytes of patient

with toxoplasmosis.

tion,

BANK HOLIDAYS IN HOSPITALS

SIR,—Iwonder how many patients could have been seen or operated on had not Tuesday, June 1 been designated as an extra Bank Holiday? The Department that institutes workingand reports on waiting-lists and talks grandiosely of and throughput, at the same time accedes to what seems to have been a generally unsolicited extra holiday. If additional leave had to be given why should it be designated as a Bank Holiday, instead of simply increasing the leave entitlement ? The situation now is that the Hospital Service is on an emergency only basis for nearly two weeks around Christmas, five days at Easter, Spring and Summer-with May Day yet to come. Senior medical staff may be seen in deserted corridors disconsolately looking for a friendly face without a clerical officer or administrator in sight. If supporting staff are employed it is at a cost of double-time pay and a day off in lieu. When, if ever, did the management side that agreed to all this last work in a general hospital? Quite simply, we cannot afford all this "idle plant".

parties

turnover

Bridgend General Hospital Bridgend, Glamorgan

D. E. B. POWELL

CHROMOSOME ABNORMALITIES IN TOXOPLASMOSIS

SIR,—We should like to report a cytogenetic study in 19 patients with acute (9) and chronic (10) toxoplasmosis. Criteria for defining the stage of infection included: (i) recent clinical history of fever, systemic symptoms, and adenopathy; (ii) serological assessment by ascending titres of Sabin-Feldman reac1.

Thierman, E., Abt, W., Niedmann, G. Bol. Chil. Parasitol. 1966, 21,

82.

hzmagglutination,

cases, needle

and the stage of the illness. Chromosome studies were

a

complement-fixation test.In

7

performed

on

peripheral,

cul-

tured, P.H.A.-stimulated lymphocytes, by the classic tech-

nique.2 At least 60 metaphase figures were analysed by two different observers who did not know the diagnosis. A repeat blood-culture was possible in 5 of the 9 acute cases. 6 of the acute cases

had received

no

treatment, and 3 had been treated

with

pyrimethamine and sulphamethoxipiridazine in the usual doses for twenty-one days. All chronic cases had received no drugs for the eight months before the study. Chromosome abnormalities were divided into: (i) chromatid breaks and gaps; (ii) numerical aberrations (aneuploidy and endoreduplications); and (iii) pulverisations. The cytogenetic abnormalities in the 5 patients with positive findings are summarised in the accompanying table. Perhaps the most interesting observation is the high frequency of pulverisation, an abnormality which is rarely seen in blood-cultures from control individuals. In this aberration chromosomes appear very

fuzzy, and their hazy outlines give the impression that they are about to disintegrate. We have found only one report of chromosome abnormalities after in-vitro infection of blood-cultures with Toxoplasma gondii,4 and to the best of our knowledge this seems to be the first report of chromosome abnormalities in lymphocytes of patients with toxoplasmosis. Some possible mechanisms can be excluded. Detailed questioning of the patients allows us to eliminate recent viral illness, X-ray exposure, or drug ingestion as a cause. Moreover, 2.

Moorhead, P. S., Nowell, P. C., Mellman, W. J., Battips, D. M., Hungerford, D. A. Exp. Cell Res. 1960, 20, 613. 3. Lubs, H. A., Samuelson, J. Cytogenetics, 1967, 6, 402. 4. Varela, G., y Caballero-Servin, A. Gac méd. Méx. 1968, 98, 619.

CHROMOSOME ABNORMALITIES IN TOXOPLASMOSIS

’Control studies on normal individuals in our laboratory give

and

aspirate of a lymph-node confirmed the ætiology

maximum of 2% abnormal cells.