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.

1306 culture contamination (such as by mycoplasma) is unlikely, since there were no other such aberrations in our laboratory at that time. We assume that what we have observed is very likely to be the result of this parasitic infection. Pavan and Basile5 demonstrated that certain protozoan (microsporidiæ) produce changes in larval chromosomes of Rynchosciara angela. This finding supports our belief that these aberrations could be produced by Toxoplasmagondii. Further studies with more patients and other tissue-culture systems appear warranted. Department of Cell Biology and Genetics and Unit of Parasitology, University of Chile, Santiago, Chile 5. Pavan,

RENÉ G. MILET* WERNER ABT DANIEL GALLEGOS

C., Basile, R. Science, 1966, 151, 1556.

’Present address: Department of Medical Genetics, Montreal Children’s tal, 2300 Tupper Street, Montreal, Quebec H3H 1A6, Canada.

Hospi-

Obituary WILLIAM MacADAM M.A., M.D., B.Sc. Glasg., F.R.C.P. Prof. William MacAdam, honorary consultant

opinions were always based on clear, logical thought. He, along with all the consultants of the hospital, served on the Board of Governors of the Leeds General Infirmary until the fomation of the National Health Service; and even after his formal retirement from hospital work he was coopted on the house committee for a further period. He was an active member of the senate of the University of Leeds, working conscientiously to sustain the links between the teaching hospital and the university, particularly in respect of the teaching of students. During his active years he served as external examiner in medicine in several universities, including Newcastle and St. Andrews. He was a founder-member of the British Society of Gastroenterology, and an active worker on the committees in Leeds and the North of England for the British Medical Association. His hobby was work, though he enjoyed his weekend round of golf. He became a serious student of philosophy and had a wide knowledge of history. He is survived by his wife, Irene, herself a doctor, a magistrate, and a worker in many fields of social activity in Leeds and the North, and by two sons and a daughter, who are all doctors. L.N.P. There will be

phys-

ician to the General Infirmary, Leeds, and emeritus professor of medicine in the University of Leeds, died on May 19. He was born in 1885 in Helensburgh, Scotland, where he received his early education at the Hermitage Grammar School. He had a distinguished undergraduate career at the University of Glasgow, graduating M.B. (with honours) in 1909, and, as the best student of his year, being awarded the Brunton memorial prize. He held some resident appointments in Glasgow following which he became McCunn and Carnegie research scholar in pathological chemistry in the University of Glasgow. He graduated M.D. (with honours) in 1914. He

the Army in 1915 as pathologist to the Military Hospital at Netley. He subsequently served with the army in India from 1916, first as officer-in-charge of the Bombay central pathological laboratory, which serviced 7 war hospitals, and later as officer-in-charge of the pathological laboratory serving 2 military hospitals in Baghdad and Mesopotamia. He went to Leeds after the war in 1919 as assistant pathologist to the university department of pathology, and while there he published various papers relating to amoebic dysentery, alkalosis, the cholesterol content of the blood in anaemia, and the variations in the gastric secretion in the normal individual. Deciding to move over to clinical medicine, he was appointed medical tutor in the University of Leeds and Leeds General Infirmary in 1922, and honorary assistant physician to Leeds General Infirmary in 1925. His skills as a clinician were quickly recognised, and during the next few years he was appointed honorary consultant physician to the General Hospital, Halifax, to the Clayton Hospital, Wakefield, and to the General Hospital, Skipton. He became professor of medicine and head of the department in the University of Leeds in 1932, a post which he held for 13 years to 1945, when he became emeritus professor of medicine. He became an outstanding clinical teacher, regarding teaching as his principal university duty. His teachings were carefully prepared and were attended by large numbers of students. As a clinical colleague equipped with a vast knowledge of general medicine and pathology, he gave exceptionally lucid and helpful clinical opinions on different cases. As head of his department, Professor MacAdam became gradually involved in administrative duties. Thus he was chairman of the medical faculty at Leeds General Infirmary from 1942 to 1945, a period when the future of hospitals and of medical practice was under discussion by the Government. He participated locally in discussions on this subject and his

joined

a

memorial

Saturday, June 19, upon Tyne. on

at

meeting for Dr Gerald Nehgan at 3 P.M. Royal Victoria Infirmary, Newcastle

the

News Pædiatrics in the United States

Today to be given by Dr Edwin L. Kendig (Richmond, Virginia) at 12.30 P.M. on Wednesday, July 21, at the Royal Northern Hospital, London N7 6LD. This is the title of a lecture

Royal Society of Medicine Lord Ashby of Brandon, F.R.S., will give a Jephcott lecture at 6 P.M. on Wednesday, July 1, at 1 Wimpole Street, London W1M 8AE; the title is Protection of the Environment-the Human Dimension.

Prof. John Hedley-Whyte has been appointed the first incumbent of the David S. Sheridan chair of anaesthesia and respiratory therapy at Harvard Medical School. A lecture on therapy of fungal infections will be given by Dr Y. M. Clayton at 5 P.M. on Monday, June 14, at the Institute of Dematology, St. John’s Hospital for Diseases of the Skin, Lisle Street, Leicester

Square, London WC2H 7BJ.

The certification of mental patients and Sections 25, 26, and 29 is the subject of a lecture to be given by Dr M. W. P. Carney at 1 P.M. on Wednesday, June 16, at Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ. A Charles Tomes lecture will be given by Prof. R. A. Cawson at 3 Friday, June 18, at the Royal College of Surgeons of England, Lincoln’s Inn Fields, London WC2A 3PN; the subject is problems and paradoxes of Candida albicans infections. P.M. on

Corrigenda Mechanism of Renal Hypertension.-In this article by Dr J. J. Brown and his colleagues (June 5, p. 1219) the last sentence of the legend to fig. 4 should read: "The lower regression (D) is for normal subjects infused with angiotensin, the upper (E) for renal hypertension

[from fig. 2]". Prevention of Vitamin-D Deficiency in Asians.-In the article by Dr J. Pietrek and others (May 29, p. 1145) the three months in fig. 1 should have been December, 1973, March, 1974, and June, 1974.

Chromosome abnormalities in toxoplasmosis.

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 Indepe...
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