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A total of 142 seronegative volunteers were given one of the following rubella vaccines: Cendehill, HPV77. DE-5, RA27/3, or a new Japanese vaccine, To-336. To-336 vaccine produced a slightly higher geometric mean antibody titre (G.M.T.) (65.7) than did the HPV77. DE-5 (63.1) or RA27/3 vaccine (61.9) but the G.M.T. induced by Cendehill vaccine was much lower (39.3).Reactions, particularly joint symptoms, occurred least commonly after vaccination with To-336 vaccine. Joint symptoms occurred within seven days of menstruation in 30 out of 37 (81%) vaccines (P

Sixteen patients suffering from phenacetin nephropathy were seen at one London hospital between June 1964 and January 1970. There were five deaths, three of them following a surgical operation. Phenacetin nephropathy occurs far more frequently than is generally considered. Unless patients are asked about the consumption of phenacetin routinely the diagnosis is usually missed. It is recommended that phenacetin and paracetamol should be available only on a doctor's prescription.

The content of drug-resistant coliform bacteria in faecal specimens collected before admission from patients awaiting non-urgent surgery were compared with specimens collected in hospital. Resistant strains of Escherichia coli were isolated from 52% of preadmission specimens and were present in large numbers in 28%. Tetracycline, sulphonamide, and streptomycin resistance were commonest: 60% of resistant strains carried transmissible R factors and multiple resistance was commoner than single. No characteristically resistant intestinal bacteria of any genera were found in hospital specimens as compared with those from outside.

A follow-up study of girls in a London remand home during the years 1966-8 showed that 20.6% of those taking non-narcotic drugs on admission, but only 1% of non-drug-taking control admissions, had used narcotics by June 1970. Narcotic use on admission and progression to narcotic use were associated with frequent drug taking, marked involvement in a drug milieu, and a high incidence of personal morbidity. Adolescents who use illicit drugs and have a history of court appearances for any reason are particularly vulnerable to subsequent narcotic usage and other forms of serious drug abuse.

From a re-analysis of the case notes of patients with Royal Free disease it is concluded that there is little evidence of an organic disease affecting the central nervous system and that epidemic hysteria is a much more likely explanation. The data which support this hypothesis are the high attack rate in females compared with males; the intensity of the malaise compared with the slight pyrexia; the presence of subjective features similar to those seen in a previous epidemic of hysterical overbreathing; the glove-and-stocking distribution of the anaesthesia; and the normal findings in special investigations. Finally, a deliberate attempt by one of the authors to produce an electromyographic record similar to that reported in Royal Free disease was successful.

The environmental and body temperatures of two groups of elderly women have been measured. One group was living in a local authority home (L.A.H.) and the others in their own homes in North London. The L.A.H. provided a constant environmental temperature which was at all times higher than that of the private houses. In the latter group the ambient temperature was higher in bed-sitting rooms than in houses with separate living rooms and bedrooms. Body temperatures in summer were similar throughout both groups. In winter the skin and mouth temperatures of the subjects living independently were lower than those in the L.A.H. Four subjects who had low mouth temperatures measured during two consecutive winters did not prove to have lowered deep body temperatures. The diet of these four subjects was similar in respect of all nutrients to that found in other groups of subjects of the same age, and in relation to published dietary standards was adequate in all respects.

Thick sections (30mu unstained) cut from blocks of lung tissue from 100 consecutive necropsies for the years 1936, 1946, 1956, and 1966 at the Archway Hospital, London, have been searched for asbestos bodies. The incidence rose progressively-0, 3, 14, and 20% respectively. The rise was not explained by the increasing age of death in the later years or by the likely effects of changes in the areas within London in which the deaths occurred. There was no similar increase in the incidence of other bodies in the lungs which might be mistaken for asbestos bodies. The rising incidence is shown to fit reasonably with a model based on the hypothesis that the risk of inhaling asbestos increases in relation to the cumulative total of asbestos imported into the country from 1910 onwards. The rising incidence does not fit a model in which the risk depends simply on the current level of asbestos imports.

A mathematical model has been constructed to assist in planning the future requirements of a combined haemodialysis and transplantation centre. It has been used to predict the number of patients in the dialysis unit, the general wards, and at home on dialysis, as well as providing further information on transplantation rates and overall costs. The model can be adapted for units with different facilities from our own. It can be primed with data from an individual unit or with pooled data from the whole country. The purpose of this paper is to demonstrate the methodology of a particular statistical approach.

Sera from 87 patients with acute sporadic viral hepatitis were tested for the presence of the Australia-SH antigen. Forty-three were positive by the complement-fixation test, but only 24 of these reacted in the gel-diffusion test. The antigen was equally distributed in infectious and serum hepatitis. The relationship of naturally occurring antigen-positive hepatitis to the Willow-brook MS-2 type is discussed.

A study of 289 children aged 12-14 years found to be Heaf test positive at routine testing was made to determine the likely cause of the positive tests. Only 12% of children grade 1 Heaf positive were likely to have had a previous infection with Mycobacterium tuberculosis, 49% were likely to have had infections with atypical mycobacteria, and in 39% no cause for the positive Heaf test was found.The positive Heaf test seems to us to be too sensitive. Both a negative and grade 1 positive should be regarded as not significant and these children given B.C.G. vaccine. Heaf grades 2, 3, and 4 should be regarded as significant and the children investigated for M. tuberculosis infection.

A large representative sample of psychotic women of reproductive age was selected from patients admitted to a London mental hospital during 1955–63 and followed up during the years of developing community care. Before first admission the probability of marriage of schizophrenics was three-quarters of that of corresponding normal women, and after admission it was just over one-third of normal. Fertility of schizophrenics was slightly reduced both before and after illness, and much of this reduction remains due to their being in hospital. The probability of marriage and fertility of women suffering from severe affective disorders was very similar to that found in the corresponding general population. Despite a lessening of differentials between patients and normal women since the impact of community care the probability of marriage of schizophrenics with abnormal personalities is still significantly reduced.

During the first 12 months of a total population survey 249 patients were seen with viral hepatitis. A total of 215 of these were tested for hepatitis B antigen (HB Ag) by radioimmunoassay and 32 (15%) were positive. More than five times as many men (27) as women (5) were HBAg positive and 19 of the men were between the ages of 20 and 39 years. There were only four drug addicts among those tested, two of whom were positive, as were two of the four patients who were tattooed. Sixty out of 86 children (under 15 years) were tested for HBAg and none was positive.

Eight cases of chlorodyne dependence seen in a London drug clinic are described. These cases and the results of an inquiry among pharmacies in central and south London suggest that this form of drug dependence is commoner among younger people than has been supposed and that the total number of chlorodyne-dependent people in Greater London may exceed 1,000. The prognosis for cure is poor. We recommend that the supply of chlorodyne, now available without prescription to the public, should be restricted.