871 in South Africa and would be
faculty
acceptable anywhere
overseas.
The name given to our university by Dr Gude is not correct; it is the Medical University of Southern (not South) Africa and it is open to Blacks of all Southern African nations, even those outside of South Africa. The university is near Ga-Rankuwa which is 31 km (19 miles) from the centre of Pretoria in the Transvaal in the Republic of South Africa. There are many White people in South Africa, both Mrikaans and English speaking, who have the welfare and interests of our Black fellow citizens at heart and who offer real and practical help. Uninformed articles such as that by Dr Gude help nobody, certainly not the Blacks. Medical
University of Southern Africa,
Pretoria
0002, South Africa
C. R. STUART
iods. We wonder if this lack of control was really due to the inefficacy of chloramphenicol: in two patients (cases 1 and 5) blood cultures seem to have converted from positive to negative while the patients were on chloramphenicol alone, and in serum bactericidal assay titres while patient 5 was on chloramphenicol alone were 1/8 and 1/16 at nadir and peak serum
concentrations, respectively. concerned about strains of H. influenze resistant We do believe that chloramphenicol, an alternabactericidal for H. injluenzae in vitro, and we would be interested in any other reports of the success or failure of chloramphenicol alone in H. injluenzae endocarditis. We
too are
ampicillin. tive drug, is
to
Division of Clinical School of Medicine,
Pharmacology,
JOHN A. COOPER
Johns Hopkins University, Baltimore, Maryland 21205, U.S.A.
PAUL S. LIETMAN
HUMANISM IN MEDICINE
SiR,—Icould not agree more with Dr Agnew (Sept. 17, p. 596). How many times as medical students have we been whisked through wards, invading patients’ privacy with hardly the time even for a mere "hello and goodbye"? How many times have we heard a misinformed patient, intimidated by our presence, ask a fellow student "What is the matter with me?" only to be told abruptly, "It’s nothing really, and you wouldn’t understand anyway" thus disguising the speaker’s own ignorance ? The main motivation to study medicine is no longer a feeling for humanity, but the desire for a stable, comfortable life, and a respectable position-how many times have we been reminded that we are now members of the elite. What opportunities are there for more humanitarian medical students? To specialise one has to conform to the habits of the department, or there is always the rat-race of academia. Like Dr Agnew, I think Mother Teresa has found the ideal solution-I only hope I have the strength to follow her example. 2 Chemin de Tavernay, 1218 Geneva, Switzerland
SHARNE S. SHEEHEY
CHLORAMPHENICOL IN HÆMOPHILUS ENDOCARDITIS
SIR,-You state’ that "Strains of H. influenzce resistant to ampicillin, though rare, may be hard to eliminate because the alternative drugs, such as chloramphenicol, tend to be bacteristatic rather than bactericidal." We wish to make two points about this statement. First, there is evidence in vitro that chloramphenicol, at reasonable concentrations, is bactericidal against Ncemophilus inf!uenzae.2-4 Furthermore, since you express concern over ampicillin resistance, we would point out that five strains of ampicillin-resistant H. influence were susceptible in vitro to chloramphenicol (minimum inhibitory concentration
faculty
acceptable anywhere
overseas.
The name given to our university by Dr Gude is not correct; it is the Medical University of Southern (not South) Africa and it is open to Blacks of all Southern African nations, even those outside of South Africa. The university is near Ga-Rankuwa which is 31 km (19 miles) from the centre of Pretoria in the Transvaal in the Republic of South Africa. There are many White people in South Africa, both Mrikaans and English speaking, who have the welfare and interests of our Black fellow citizens at heart and who offer real and practical help. Uninformed articles such as that by Dr Gude help nobody, certainly not the Blacks. Medical
University of Southern Africa,
Pretoria
0002, South Africa
C. R. STUART
iods. We wonder if this lack of control was really due to the inefficacy of chloramphenicol: in two patients (cases 1 and 5) blood cultures seem to have converted from positive to negative while the patients were on chloramphenicol alone, and in serum bactericidal assay titres while patient 5 was on chloramphenicol alone were 1/8 and 1/16 at nadir and peak serum
concentrations, respectively. concerned about strains of H. influenze resistant We do believe that chloramphenicol, an alternabactericidal for H. injluenzae in vitro, and we would be interested in any other reports of the success or failure of chloramphenicol alone in H. injluenzae endocarditis. We
too are
ampicillin. tive drug, is
to
Division of Clinical School of Medicine,
Pharmacology,
JOHN A. COOPER
Johns Hopkins University, Baltimore, Maryland 21205, U.S.A.
PAUL S. LIETMAN
HUMANISM IN MEDICINE
SiR,—Icould not agree more with Dr Agnew (Sept. 17, p. 596). How many times as medical students have we been whisked through wards, invading patients’ privacy with hardly the time even for a mere "hello and goodbye"? How many times have we heard a misinformed patient, intimidated by our presence, ask a fellow student "What is the matter with me?" only to be told abruptly, "It’s nothing really, and you wouldn’t understand anyway" thus disguising the speaker’s own ignorance ? The main motivation to study medicine is no longer a feeling for humanity, but the desire for a stable, comfortable life, and a respectable position-how many times have we been reminded that we are now members of the elite. What opportunities are there for more humanitarian medical students? To specialise one has to conform to the habits of the department, or there is always the rat-race of academia. Like Dr Agnew, I think Mother Teresa has found the ideal solution-I only hope I have the strength to follow her example. 2 Chemin de Tavernay, 1218 Geneva, Switzerland
SHARNE S. SHEEHEY
CHLORAMPHENICOL IN HÆMOPHILUS ENDOCARDITIS
SIR,-You state’ that "Strains of H. influenzce resistant to ampicillin, though rare, may be hard to eliminate because the alternative drugs, such as chloramphenicol, tend to be bacteristatic rather than bactericidal." We wish to make two points about this statement. First, there is evidence in vitro that chloramphenicol, at reasonable concentrations, is bactericidal against Ncemophilus inf!uenzae.2-4 Furthermore, since you express concern over ampicillin resistance, we would point out that five strains of ampicillin-resistant H. influence were susceptible in vitro to chloramphenicol (minimum inhibitory concentration
