1280

AFLATOXIN

K. R. HILL.Pathology Department,Royal Free Hospital,London, W.C.1.

SIR,-In your annotation of May 16, although men-tioning the presence of a toxic metabolite of aflatoxin B incows’ milk, you omitted to mention that toxic groundnutmeal may also affect the livers of such mammals. Incalves the following experimental liver lesions have beendescribed 1: (1) hepatic centrolobular necrosis, (2) ductalcell hyperplasia, (3) veno-occlusive disease. This last

finding is of particular interest since until recently it wasconsidered to be caused only by the pyrolizidine group ofalkaloids giving rise to acute seneciosis in man, horses,cattle. and sheen.

A GENETIC THEORY OFINFLAMMATORY POLYARTHRITIS

R. AUGUSTIN.

J. A. SPIERS.

Immunochemistry Unit forCancer Research,

Department of Bacteriology,University of Liverpool.

Department of Theoretical Physics,Clarendon Laboratory, Oxford.

SIR,-A year ago you published a paper in whichDr. Burch proposed a somatic mutational theory to

explain the clinical behaviour of inflammatory polyarthritis. 2In response to objections by Mr. and Mrs. Maynard

Smith,3 he elaborated his mathematical argument 4; buthis critics were not satisfied.5 Our own examination ofthis problem suggests that, while the mathematicalexpressions used by the Maynard Smiths 3 follow

correctly from Burch’s orginal postulates, Burch’s ownexpressions 4 do not follow from these.We have ourselves devised a graphical method for

comparing clinical data with theoretical predictions.With adequate data, this method would enable one easilyto find the best fit between theory and observation. Anaccount of our method, and the conclusions we havedrawn from it, is obtainable, in photographic typescript,from The Lancet, 7, Adam Street, London, W.C.2.

WOMEN MEDICAL GRADUATES

SIR,-Dr. Whitfield (Feb. 15) suggests that, becausemany women doctors marry and, for a time at least, ceaseto practise, the loss to medicine is formidable, and" universities might well consider reducing their intake ofwomen medical students ". I hope they will not do this;for the only just way of choosing any student for medicineis on merit alone, and choice by sex could mean a greatloss of talent and ability.The need for married women as part of the nation’s

man-power was evident in a debate in the House ofLords last June, when it was recognised that we mustprovide the services needed to enable such women towork outside the home. The supply of these services-nurseries, nursery schools and so on-has not caught upwith the demand. Similarly, in medicine, little trouble hasbeen taken to find ways in which the married woman cancontinue her professional work. In my own view-and

opinions differ over this-she should go on with this workeven during the early years of marriage and childbearing;but more help and thought are needed to enable her to dothis.A medical school chooses its students. Surely, having

them under its wing for 5-7 of their more impressionable1. Hill, K. R. Vet. Rec. 1963, 75, 481.2. Burch, P. R. J. Lancet, 1963, i, 1253.3. Maynard Smith, S., Maynard Smith, J. ibid. 1963, ii, 357.4. Burch, P. R. J. ibid. p. 636.5. Maynard Smith, S., Maynard Smith, J. ibid. p. 738.

years, it should be able to give them a sense of responsi-bility, vocation, and purpose, so that they realise the

importance to the community of their work as doctors ?Unapologetically,

Birmingham, 16. MEDICAL GRANDMOTHER.

" NORMAL " INTELLIGENCE

JAMES R. MATHERS.

SIR,-Dr. Kinsbourne (May 16) says that a boy withI.Q. 125 is of " normal " intelligence. Is this a proper useof the word ?

The word relates to a criterion or standard. It is mostuseful when used in the sense of " optimal "-for example,when we talk of normal body-temperature, or when we say apiece of mechanism is functioning normally. It is much lessuseful when it is used in the sense of " average ". In inorganicmeasurements no doubt there is usually an equivalence betweenthe average and the optimum; but this is not true of biologicalmeasurements, and, the more complex the organism or functionto be measured, the less true it tends to become.1One can usually tell from the context that an author who

says " normal " means either optimal or average-orperhaps both. But an I.Q. of 125 is, I feel sure, unmistak-ably abnormal.

Birmingham.

JAUNDICE ASSOCIATED WITH BENZIODARONEDr. H. LEE and Dr. G. F. DEVEY write from the medical

department of Genatosan, Ltd. (Loughborough,Leicestershire):

" We should be grateful for the cooperation of practitionersin obtaining information relating to the coincidental occurrenceof jaundice in any patients treated with the long-actingcoronary vasodilator, benziodarone (’ Cardivix’). In the pastsix months five such cases have been reported to us, and anyfurther examples which might come to light would help us indeciding whether the drug is involved. Full clinical detailswould be appreciated and treated in confidence."

Public Health

Typhoid FeverIN the Aberdeen outbreak of typhoid fever,2 at the beginning

of this week confirmed cases in hospital numbered 224 andsuspected cases 17.3 The medical officer of health suggestedthat the second wave of cases might be on the decline4; and,except for special groups in special circumstances, he wasdiscouraging immunisation, which would not help someonewho was already incubating the disease.

Last week a 7-lb. tin of imported corned beef was believedin Aberdeen to be the likely source; the contamination wasthought to have occurred abroad.5 The machine used for

slicing the infected meat, which was also used for cutting othercold meats, had become infected.5 Three of the staff of theshop which sold the infected meat had themselves becomeinfected by eating some of it; and 1 of these was apparentlyresponsible, through faulty hygiene, for the second wave ofcases.4The infected corned beef may have been part of a consign-

ment imported thirteen years ago by the Ministry of Agri-culture, Fisheries, and Food.6 A spokesman said that theMinistry did have a stockpile of corned beef. This was regu-larly examined, and from time to time surplus stocks weredisposed of through the trade. 6

1. See Neill, S. A Genuinely Human Existence. London, 1959.2. See Lancet, May 30, 1964, p. 1225. 3. Times, June 2, 1964.4. ibid. June 1.5. ibid. May 27.6. ibid. May 30.