RESISTANT GONOCOCCI

850 and found that the arteries and tendons contain more calcium than other tissues on it. Judging by the data from animal experiments-and there would not be much left of physiology or pharmacology if such data were not valid for man-the 19patients under a high calcium intake must have had increased deposits of calcium in the vessels as a result of the treatment ; nay, more, a simple calculation shows that a pronounced positive calcium balance, extending over 15 months, and even over 18 weeks, must have caused an enormous accumulation of calcium in these patients, part of which without the slightest doubt must have been deposited in the vessels. The calcium obviously is somewhere in the organism ; and this proves that no reliance whatever can be placed on X-ray in an investigation of this kind. But let us disregard this vital fact for a moment. At any rate one case out of the 19 has shown an increase of arteriosclerosis demonstrated by X-ray whilst under treatment. Kesson and McCutcheon say that this was not due to the high calcium intake. But have they produced valid evidence that this is so ? They have not, and they cannot produce such evidence. It is clear that they must admit, to put it at its lowest, that there is a possibility that in one case arteriosclerosis increased as a result of the treatment I They naively say that they supplemented the ordinary diet with calcium. Clearly a calcium intake which causes a positive balance for 15 months is not given in the interest of the patient. At the beginning of the experiment they could not know the results of this high calcium administration, and according to their -own showing there is a possibility that they have actually inflicted an injury on at least one of the

patients.

while if

an unnecessary amount of calcium passes out via the kidney it causes unnecessary renal strain. There is not a shadow of doubt that the additional chalk must in many instances cause injury and shorten life. The attack on my calcium experiments can have only one object-to confuse the issue and to mislead. Let me. quote what I really say : " In considering it [the adulteration of our bread] the matter in this volume can be disregarded entirely " (p. 10). I have always maintained that the onus of proving their case rests with the authority which forced the added calcium on us. They must produce solid reasons why the adulteration of our bread has become necessary, and they must prove that it cannot possibly do harm. It will be seen from my letter in your issue of Oct. 12 that those responsible for the added calcium have virtually admitted that when the recommendation was made there was no valid reason for it. On p. 9 of my book I say : " No physician outside bedlam would suggest that a high blood-pressure case should consume extra doses of blood-pressure raising And this is exactly what is being inflicted substances." on many people today. I have suffered calumny and persecution because of I was prevented from my expression of these views. obtaining a research-worker during the war, and it has been quite impossible for me to get a paper published on calcium in relation to hypertony, apart from the intrinsic merit of my effort, simply because no editor dared to offend a highly placed personage ! This book was published almost a year ago, yet only one medical journal has dared to review it up till now. And it is quite clear that the only type of review you dare to publish is the one you have actually published ; and you have atoned for it by the prompt publication of that precious article with which I deal in this letter. Well, my book is available, and your readers may judge. My experience is not a happy augury for the shape of things to come, when we shall have fully fledged Government scientists. I. HARRIS. Liverpool.

4. Harris et al.

definite unstained areola could be seen around the isolated stained gonococcus, and this was assumed to indicate the presence of a capsule. When this areola was demonstrated in the first urethral smears taken on admission it was possible to predict with confidence that chemotherapy would fail. The gonococci involved were thought to be specifically resistant to sulphapyridine as this was the only drug generally accessible for selftreatment in South Africa. I write to you now because the same phenomenon is appearing in a small group of penicillin-resistant gonorrhoea cases under my care : it may indicate some link between the capsulated gonococcus and resistance to a specific drug, though not necessarily to all forms of chemotherapy at the same time (the first two penicillinfast cases later yielded to sulphathiazole). Certain strains of capsulated gonococci have been described academically, and the coincidence of capsule and resistance in these cases may be merely accidental. All the same the. relation might be worth investigating with better facilities. W. S. PARKER, Surgeon. S.S. Arundel Castle. A MORAL PROBLEM

By adding calcium to bread the authorities concerned are conducting a larger experiment-on forty million human beings ! Everybody admits that millions and millions of people do not need the added chalk. The possibility of their suffering injury by it cannot be excluded. These millions are exposed to an unnecessary risk. As a matter of fact it is certain that an intake of such a potent substance as calcium in unnecessary quantities must inflict injury. If it is retained it is bound to do harm,

.

RESISTANT GONOCOCCI

SiR,-In the autumn of 1943 I had the care of a number of gonorrhoea cases at Mombasa. At that time sulphapyridine was the only remedy available. It soon became apparent that a high proportion of infections contracted in South African ports were resistant to sulpha drugs; so much so that the arrival of a ship from, the south was the inevitable prelude to a further batch of cases to be In most of these a, treated by traditional methods.

High Blood Pressure, London, 1937.

SIR, Your annotation last week raised several interesting points. Personally I hope that a serious effort will be made to collect together the results of all the experiments carried out on prisoners in German camps, and that anything of value will be published. The reasons given against such publication seem to me to be simply pernicious sentimentality. If I myself hadbeen a victim, and some results of value or of interest had been obtained from my death, I am sure that I should have preferred to know that this knowledge would have been used and that I had not died entirely for nothing. At times I have felt a good deal of sympathy for some of those who were responsible for carrying out the experiments. Accounts of the trials leave little doubt that many of the so-called scientists were men of noacademic standing, with no idea how to carry out an experiment, and some were no more than irresponsible sadists ; all these deserve the appropriate treatment at the hands of the courts. But others were serious researchworkers. If one were given the chance of using prisoners for experiments which one believed to be of great, importance and value to mankind, what would one do, particularly if government propaganda had convinced one that the victims were dangerous criminals who wereanyhow condemned to death, and likely to die in some particularly abominable manner ? This is indeed a moral issue, and I am not at all sure what I should myself have done. I have always been most fortunate, in that I have been able to obtain willing and cooperative volunteers when I have wished to carry out experiments on man, but there are many types of investigation for which I believe that one must hesitate to use such subjects. while capital punishment is retained, condemned murderers should be given the opportunity of volunteering to serve as subjects for experiments. The question is rather different when the victims are innocent prisoners, though to a keen research-worker with little contact with the world outside his laboratory and who believes what his government tells him the answer may be simpler. The method in which these results should be published requires careful consideration. At all costs sensationalism must be avoided, and it might perhaps be as well to grade " them as confidential " and make them available only to bona-fide investigators. Otherwise the press should be taken into the confidence of those responsible for the editing of the reports before publication ; the average journalist is a responsible person, and in this way accurateand unobjectionable reporting would be ensured. KENNETH MELLANBY. Department of Entomology, London School of Hygiene and

Tropical Medicine.