1186 of mussels and 120 samples of oysters have been submitted for bacteriologicalexamination by the percentage-clean method.2 Only 4 of the oyster samples were found to be unsatisfactory. 2 were exploratory samples from areas being considered for use, and 2 were from an area where a cleansing plant was under investigation. 24 mussel samples were found to be unsatisfactory, but nearly all of these were from an area which was being very closely watched and which, as a result of investigation and joint was brought up to standard. Officers of the Company were also initially responsible for the present control which is exercised on imported frozen prawns and shrimps and, since January, 1973, 154 samples, 93 of them cooked and 61 uncooked, have been examined before release. All the samples of mussels, oysters, prawns, and shrimps have been examined by an enrichment technique for Vibrio parahcemolyticus, but it has not been found. This work is carried out with the active and informed cooperation of the trade.

action,

Fishmongers’ Hall, London Bridge,

N. A. SIMMONS G. R. WATKIN.

London EC4 9EL.

LEAD IN DRINKING-WATER AND MENTAL RETARDATION

SIR,-We have been ence

The

about

very interested in the

drinking-water, lead, following comments may be

correspond-

and mental retardation. of value:

(1) Where the total lead in drinking-water has been measured, values in excess of 100,000 (j!.g. per litre have been found. (2) From our own research all major towns in the United Kingdom have water-supplies which are more plumbisolvent than the World Health Organisation’s recommended limit. (3) Our letter3 in 1967 is still pertinent. It is indeed good practice to run water to waste before filling the morning’s first kettle.

Municipal Laboratory, Mount Pleasant, P.O. Box 147, Liverpool L69 3BX.

THE COST OF DEATH SIR,-The calculations of the article, The Cumulative Cost of Death (May 3, p. 1023), are as frightening as its implications. Ivan Illich, so often talked’of in these pages, would have turned his eyes towards the Mexican skies and wept large salty tears if he had read this article. The authors are obviously out to demonstrate the logic of giving huge grants to people such as themselves involved in research into cardiovascular diseases. If we find " the cure " for ischasmic heart-disease, then in ten years the country will save itself E7000 million, and presumably we will all be enjoying the benefits of that vast amount, holidaying in Florida and sending our daughters to finishing schools in Switzerland. They make this implication by showing how much money has been saved by " curing" (sic) renal failure. There are some discrepancies, however. According to their figures the cost of keeping one year’s potential deaths from renal failure alive is E2-3 million, and then the cost the next year, when one assumes they will still be

having to dialyse some 75 % of the first year’s " cured ", is still only E2’3 million. Then one begins to speculate that after ten years they would have a phenomenal number of people to dialyse and we are convinced they will not be able to do it on E2-3 million a year, in fact they may have to build huge dialysis palaces, and train more staff, who unfortunately will have to be taken away from those actually contributing to the G.N.P. Then there is the crucial question of what they will do when all these people reach retiring age and are producing nothing whilst still on the machines. At this stage, in order to balance the books, it may be necessary to switch off the machines. Then, if with all the money they are courting from" people in search of a fantasy world, they similarly " cure ischaemic heart-disease, we can envisage a future where an ever-growing percentage of the population is hooked up to machines in order to survive and produce. 6 Howe Street, Edinburgh EH3 6TD.

PETER PRESTON RICHARD SMITH.

C. D. REED J. A. TOLLEY. ANATOMY AND MEDICINE 1975

"

APPARENT

"

URINARY INFECTIONS

SIR,-Dr Mummery and others4 described an outbreak of Enterobacter cloacae infection occurring mainly in men who had been catheterised that was controlled eventually by the sterilisation of glass urinals. As men with indwelling catheters do not normally use glass urinals a simple cause for these infections was not immediately obvious. However, a few weeks ago I witnessed a senior nursing sister (for 7 years in charge of a urological ward) filling a sterile container " purporting to be an M.s.u." from an unsterile glass urinal. It seems possible that this outbreak in reality was " only an apparent " infection due to such a faulty method of specimen collection. In this age of selective culture media and sophisticated colony counting, when almost any effete organism can be grown, I write again to warn bacteriologists to suspect even " the impossible " before making elaborate deductions from their laboratory findings. Wynd House, Rudby,

Hutton

Yarm, Cleveland. 2.

3. 4.

ROGER HOLE.

Knott, F. A. Memorandum on the Principles and Standards Employed by the Worshipful Company of Fishmongers in the

Bacteriological Control of Shellfish in the London Markets. Fishmongers’ Company, London, 1951. Lancet, 1967, i, 894. Mummery, R. V., Rowe, B., Gross, R. J. ibid. 1974, ii, 1333.

SiR,—These are troubled times. Vice-chancellors and the U.G.C. are preoccupied with the difficulties of maintaining a viable university system-no less-in this country. Medical deans and others are grappling with the extremely serious implications for the recruitment of clinicians to academic departments which arise from extra-duty payments of N.H.S. staff below the rank of consultant. Added to this the Merrison report may -catalyse more radical revisions of the medical curriculum. In this climate are we justified in pleading yet another special case ? Professor Coupland’s letter (May 3, p. 1028) indicates that we are; indeed that we must do so now if we are to preserve the infrastructure of any form of rational medical education. Few would dispute that recruitment of medically qualified career anatomists has now effectively ceased. This is not due to a lack of interest in the subject, because many young men and women elect to spend an extra year on an intercalated B.SC. course in the morphological sciences in addition to the five required for their medical degree. It must be added, however, that all these able individuals are recruited to modern departments of the type outlined by Professor Coupland rather than to the virtually extinct " traditional " departments which exist largely in the folk memory of ageing clinicians and are-regrettably-portrayed in your leader (April 19, p.

903).

The question is therefore " do we need a balance of doctors in anatomy departments ? " and the answer is " undoubtedly " yes! for the following reasons:

Letter: "Apparent" urinary infections.

1186 of mussels and 120 samples of oysters have been submitted for bacteriologicalexamination by the percentage-clean method.2 Only 4 of the oyster sa...
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