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LEPTOSPIRA BALLUM IN SMALL RODENTS
1050 ADVERTISING INQUIRY COMMITTEE
SIR,—Ishould like
enlist the support of your readers for an investigation into the advertising of medical and paramedical products, which this committee has undertaken as one of its activities. The committee came into being after a debate in the House of Commons in November, 1958; the reaction to this debate by members of the public, and in the Press, pointed to a considerable and widespread interest in the subject. The first meeting was held at the House on March 4, under the chairmanship of Sir Henry Turner, and it was then resolved that the committee should conduct a series of independent inquiries into all aspects of advertising. In the sphere of the maintenance of health, the aim of the inquiry is to assess the statements made by some advertisers, in the Press and on the television screen, about the remedial value of their products. Two points made in the first progress report, submitted at the committee’s second meeting on April 29, to
were :
thirty drug preparations with a sedative action, and described as " tension-relieving " or " soothing ", are available to the public without prescription, in any chemist’s shop, as the law now stands. In some people at least, this ready access to sedative drugs may encourage a morbid dependence. (2) There appear to be no reliable data on the extent of (1)
Some
self-medication as a social problem in this country. Advertising Inquiry Committee, 49, Cresswell Place, London, S.W.10.
DESMOND O’NEILL.
LEPTOSPIRA BALLUM IN SMALL RODENTS
SIR,—The failure
to demonstrate Leptospira ballmn antibodies in small rodents in Scotland despite the recovery of the organism from the kidneys of the same animals1 confirms some findings in Georgia, U.S.A. While some of the information which follows has been published, the observation concerning the absence of Lepto. ballum antibodies in mice has not. In 1954 and early 1955, Lepto. ballum was isolated from 69
mice, Mus. musculus (Linnaeus); 2 roof (Linnaeus); 4 old field mice, Peromyscus polionatus (Wagner); and 2 cotton rats, Sigrnodorz laispidus (Soy and Ord). field-dwelling rats, Rattus
house
rattus
These isolations were made from kidney suspensions inoculated with one tube each of Chang’s semisolid medium with 10°. rabbit serum; Chang’s semisolid medium with 15" horse serum; Fletcher’s semisolid medium with 10% rabbit serum; and Fletcher’s semisolid medium with 15°- horse serum.2 After inoculation the tubes were incubated at 28 "C for 30 days, and isolates were confirmed at the Leptospira Research Laboratory, Communicable Disease Center,
Chamblee, Georgia. the fact that
isolated from house mice and field mice, no serum-antibodies by complement fixation or agglutination tests were demonstrable in our laboratory. Because of this, serial dilutions of Lepto. ballum cultures were inoculated subcutaneously into 100 white laboratory mice (Mus. musculus domesticus [cFw]) and subsequent cultures made and sera tested for leptospira antibodies. Again, when kidney tissue cultures were frequently positive, no demonstrable Lepto. ballum antibodies were found. Other mammals seem to develop antibodies at least to the complement-fixing leptospiral antibodies3 and most probably agglutinating antibodies, as attested by the literature on serological surveys. This is in agreement with similar observations by Dr. Broom and Dr. Coghland. Communicable Disease Center, JOHN F. WINN. Chamblee, Georgia. 1. Broom, J. C., Coghland, J. D. Lancet, 1958, ii, 1041. 2. McKeever, S., Gorman, G. W., Chapman, J. F., Gallon, M. M., Powers, D. K. Amer, J. trop. Med. Hyg. 1958, 7, 646. 3. McKeever, S., Schubert, J. H., Gorman, G. W., Grimes, R. D. Amer. J. vet. Res. 1959, 20, 192.
Despite
Lepto. ballum
was
PHÆOCHROMOCYTOMA IN PREGNANCY SIR,—With reference to our article on this subject in your issue of April 18, it has been brought to our notice that one sentence of the history of case 2 could be misinterpreted. The perirenal air insumation revealed a rounded opacity over the upper part of the left kidney (6g. 2), which was thought to be the normal gastric fundus. It has been the intention to prove or disprove this by giving the patient some barium by mouth in order to locate the gastric fundus, but she developed acute pulmonary oedema on the following day For the sake of brevity in the article, we had to say that the shadow was regarded as normal even though further radiology. might have
disproved this.
MARJORIE BENNETT GORDON MATHER.
Bristol.
THE CRANBROOK REPORT
SIR,—Professor Scott Russell (May 2) makes a very important point on the lack of discussion of this report. But the silence is due to the nature of the report rather than the complexity of the subject. Any report which mainly awaits " natural development" and " spontaneous evolution" cannot create a stir in either camp-of those who are satisfied with the status quo (indeed a small camp) and those who would introduce change. Local liaison committees will not bring about early improvements and the status quo becomes more organised and thereby more difficult to change. Masterly inactivity, of course, often produces a good baby, but till the diagnosis is made, it is really no answer to a situation which may in fact demand masterly intervention. But discussion of the report qua report will not solve the main problem. The Cranbrook Committee has laboured, but it has been very much a trial labour ". We must take stock again. "
The demands of the
patient
on
professional skills are very
varied, and the existing facilities are very uneven and unevenly applied. But surely the maternity service is the least complex part of the National Health Service. It serves largely a healthy whose demands fall into easily defined categories. And is there any other branch of medicine which is so rich in available statistics lending itself to diagnosis of the whole problem ? It is probably the easiest aspect of the National Health Service to tackle scientifically. In short, the problem really is simple : how to organise adequate " coverwithout wasting expensive and sometimes thinly spread resources; and how to use professional competence and avoid overlap while ensuring that there are no gaps ?
population
The
of the
problem examining the following aspects : extent
may be clarified
by
(1) Logistics of a maternity service-i.e., the factual data on which there is much agreement: what is adequate antenatal care, what facilities are required by those practising the various items, and their availability. (2) The problem of application-" squaringexisting organisations and vested interests, which range from sheer inertia to more direct financial involvement. (The Doctor’s Dilernma is still very much amongst us, though in a different degree.) Those who deny that this financial aspect has any influence in determining organisation, I refer to the Cohen Committee’s report on general practice in the N.H.S. (para 69) (Practical Difficulties in the Establishment of Health Centres). Professor Scott Russell may be right in saying that we yet ready for a unified service, but it is largely non-professional considerations that block the advances. Our financial interests are so arranged that cooperation is discouraged. (On the introduction of the N.H.S. there was a sudden access of hostility to the local-authority welfare services which were seen to be taking the bread are not
SIR,—Ishould like
enlist the support of your readers for an investigation into the advertising of medical and paramedical products, which this committee has undertaken as one of its activities. The committee came into being after a debate in the House of Commons in November, 1958; the reaction to this debate by members of the public, and in the Press, pointed to a considerable and widespread interest in the subject. The first meeting was held at the House on March 4, under the chairmanship of Sir Henry Turner, and it was then resolved that the committee should conduct a series of independent inquiries into all aspects of advertising. In the sphere of the maintenance of health, the aim of the inquiry is to assess the statements made by some advertisers, in the Press and on the television screen, about the remedial value of their products. Two points made in the first progress report, submitted at the committee’s second meeting on April 29, to
were :
thirty drug preparations with a sedative action, and described as " tension-relieving " or " soothing ", are available to the public without prescription, in any chemist’s shop, as the law now stands. In some people at least, this ready access to sedative drugs may encourage a morbid dependence. (2) There appear to be no reliable data on the extent of (1)
Some
self-medication as a social problem in this country. Advertising Inquiry Committee, 49, Cresswell Place, London, S.W.10.
DESMOND O’NEILL.
LEPTOSPIRA BALLUM IN SMALL RODENTS
SIR,—The failure
to demonstrate Leptospira ballmn antibodies in small rodents in Scotland despite the recovery of the organism from the kidneys of the same animals1 confirms some findings in Georgia, U.S.A. While some of the information which follows has been published, the observation concerning the absence of Lepto. ballum antibodies in mice has not. In 1954 and early 1955, Lepto. ballum was isolated from 69
mice, Mus. musculus (Linnaeus); 2 roof (Linnaeus); 4 old field mice, Peromyscus polionatus (Wagner); and 2 cotton rats, Sigrnodorz laispidus (Soy and Ord). field-dwelling rats, Rattus
house
rattus
These isolations were made from kidney suspensions inoculated with one tube each of Chang’s semisolid medium with 10°. rabbit serum; Chang’s semisolid medium with 15" horse serum; Fletcher’s semisolid medium with 10% rabbit serum; and Fletcher’s semisolid medium with 15°- horse serum.2 After inoculation the tubes were incubated at 28 "C for 30 days, and isolates were confirmed at the Leptospira Research Laboratory, Communicable Disease Center,
Chamblee, Georgia. the fact that
isolated from house mice and field mice, no serum-antibodies by complement fixation or agglutination tests were demonstrable in our laboratory. Because of this, serial dilutions of Lepto. ballum cultures were inoculated subcutaneously into 100 white laboratory mice (Mus. musculus domesticus [cFw]) and subsequent cultures made and sera tested for leptospira antibodies. Again, when kidney tissue cultures were frequently positive, no demonstrable Lepto. ballum antibodies were found. Other mammals seem to develop antibodies at least to the complement-fixing leptospiral antibodies3 and most probably agglutinating antibodies, as attested by the literature on serological surveys. This is in agreement with similar observations by Dr. Broom and Dr. Coghland. Communicable Disease Center, JOHN F. WINN. Chamblee, Georgia. 1. Broom, J. C., Coghland, J. D. Lancet, 1958, ii, 1041. 2. McKeever, S., Gorman, G. W., Chapman, J. F., Gallon, M. M., Powers, D. K. Amer, J. trop. Med. Hyg. 1958, 7, 646. 3. McKeever, S., Schubert, J. H., Gorman, G. W., Grimes, R. D. Amer. J. vet. Res. 1959, 20, 192.
Despite
Lepto. ballum
was
PHÆOCHROMOCYTOMA IN PREGNANCY SIR,—With reference to our article on this subject in your issue of April 18, it has been brought to our notice that one sentence of the history of case 2 could be misinterpreted. The perirenal air insumation revealed a rounded opacity over the upper part of the left kidney (6g. 2), which was thought to be the normal gastric fundus. It has been the intention to prove or disprove this by giving the patient some barium by mouth in order to locate the gastric fundus, but she developed acute pulmonary oedema on the following day For the sake of brevity in the article, we had to say that the shadow was regarded as normal even though further radiology. might have
disproved this.
MARJORIE BENNETT GORDON MATHER.
Bristol.
THE CRANBROOK REPORT
SIR,—Professor Scott Russell (May 2) makes a very important point on the lack of discussion of this report. But the silence is due to the nature of the report rather than the complexity of the subject. Any report which mainly awaits " natural development" and " spontaneous evolution" cannot create a stir in either camp-of those who are satisfied with the status quo (indeed a small camp) and those who would introduce change. Local liaison committees will not bring about early improvements and the status quo becomes more organised and thereby more difficult to change. Masterly inactivity, of course, often produces a good baby, but till the diagnosis is made, it is really no answer to a situation which may in fact demand masterly intervention. But discussion of the report qua report will not solve the main problem. The Cranbrook Committee has laboured, but it has been very much a trial labour ". We must take stock again. "
The demands of the
patient
on
professional skills are very
varied, and the existing facilities are very uneven and unevenly applied. But surely the maternity service is the least complex part of the National Health Service. It serves largely a healthy whose demands fall into easily defined categories. And is there any other branch of medicine which is so rich in available statistics lending itself to diagnosis of the whole problem ? It is probably the easiest aspect of the National Health Service to tackle scientifically. In short, the problem really is simple : how to organise adequate " coverwithout wasting expensive and sometimes thinly spread resources; and how to use professional competence and avoid overlap while ensuring that there are no gaps ?
population
The
of the
problem examining the following aspects : extent
may be clarified
by
(1) Logistics of a maternity service-i.e., the factual data on which there is much agreement: what is adequate antenatal care, what facilities are required by those practising the various items, and their availability. (2) The problem of application-" squaringexisting organisations and vested interests, which range from sheer inertia to more direct financial involvement. (The Doctor’s Dilernma is still very much amongst us, though in a different degree.) Those who deny that this financial aspect has any influence in determining organisation, I refer to the Cohen Committee’s report on general practice in the N.H.S. (para 69) (Practical Difficulties in the Establishment of Health Centres). Professor Scott Russell may be right in saying that we yet ready for a unified service, but it is largely non-professional considerations that block the advances. Our financial interests are so arranged that cooperation is discouraged. (On the introduction of the N.H.S. there was a sudden access of hostility to the local-authority welfare services which were seen to be taking the bread are not