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for a certain period of their pregnancy, and suggested that itsadministration to newborns might produce a similar favourableresult. I examined this possibility in single-born babies of over2500 g., excluding those affected by rhesus antibodies. Everysecond infant received phenobarbitone, 5 mg. intramuscularly,and the others acted as controls. The kind of drug and its pur-pose were unknown to the staff. The initial injection was givenimmediately after birth and at first further ones were given dailyfor four days. The results were less favourable than thoseobtained in the infants born to women given phenobarbitoneduring pregnancy, undoubtedly because those infants had aconcentration of phenobarbitone in their blood at birth.2’

Consequently the number of further injections was increasedto three daily for three days-i.e., ten in all. However, theoptimal dosage has not yet been determined.Of the 82 infants treated so far 10 had neonatal icterus,

whereas there were 19 among the 74 controls (P==0-03). If,instead, the above-mentioned 1469 infants with an incidence ofneonatal icterus of 22-6% are used as controls the favourableeffect of phenobarbitone is still more significant (P=0-006).Maximum serum-bilirubin concentration was 15-7 mg. per100 ml. among’the 82 treated infants and 25-2 mg. per 100 ml.among the 1469 controls. The accompanying figure comparesthe number of infants with maximum serum-bilirubinconcentrations of > 10 mg. per 100 ml. in both groups.Although the numbers in these two series are small, the

results seem to show that treatment with phenobarbitone helpsto prevent neonatal icterus, and are an encouragement to

continue the study.

DYRE TROLLE.

Department of Obstetrics and Gynæcology,University of Copenhagen,Rigshospitalet, Denmark.

HEART-BLOCK IN MYOCARDIAL INFARCTION

SIR,—I should like to offer two criticisms of the paper byDr. Scott and his colleagues.22

Firstly, no definite statement as to the design of the studyis made. Apparently it was a retrospective study in whichpatients were not distributed randomly into " drug-treated

"

and " paced " groups; hence, although the two groupsappeared similar on clinical evaluation, some statement shouldhave been included indicating whether or not the investigatorsfelt that any bias had occurred in their placement.

Secondly, no statistical analyses were performed. A simpleX2 test of the mortality data is as follows:

CHRONIC LUNG-ABSCESS AND CARDIACMURMURS

SIR,-Chronic lung abscesses, especially in the upper lobes,acquire blood-supply from the chest wall through the sub-clavian artery, thus causing a sustained systolic murmur, oroccasionally a continuous murmur. When such a murmur isproduced on the left side, it may be confused with cardiacmurmurs at the pulmonary area. In order to determinewhether blood from the subclavian artery substantially con-tributes to these murmurs, I have been using a simpleprocedure.The patient is first auscultated with his left arm hanging over

the side of the bed; the arm is then lifted, the left hand placedon the head, and the chest again auscultated. The blood-flow

21. Melchior, J. C., Svensmark, O., Trolle, D. Lancet, 1967, ii, 860.22. Scott, M. E., Geddes, J. S., Patterson, G. C., Adgey, A. A. J., Pantridge.

J. F. Lancet, 1967, ii, 1382.

through the subclavian artery is now much reduced, and anyresultant decrease in the loudness of the murmur demonstratesthat the murmur is dependent on the blood-flow from thesubclavian artery.

P. K. KRISHNANKUTTI.Madras 10,

India.

WILLIAM LESLIE LOGIE

Dr. E. H. BENSLEY (vice-dean, faculty of medicine, McGill Uni-versity, Montreal 2, Quebec, Canada) writes: " I am seeking informa-tion about McGill University’s first graduate, Dr. William LeslieLogie, who graduated in medicine on May 24, 1833. I should be most

grateful for any help which readers of The Lancet may be able toprovide."

MYASTHENIA-GRAVIS COMMITTEE

Dr. M. J. LANGE (Department of Endocrinology, New EndHospital, London N.W.3) writes: " Efforts are being made to forma myasthenia-gravis committee, under the auspices of the MuscularDystrophy Group of Great Britain, and it is hoped to arrange aninaugural meeting cum social in London in the early spring.Myasthenic patients who would like to join the committee shouldwrite to the organising secretary, Miss Brenda Reid, 92 RoxburghStreet, Kelso, Roxburghshire, or to me."

In England Now

A Running Commentary by Peripatetic Correspondents

WILL a mere half-crown, I wonder, at all depress the medi-cine appetite ? I stood a few months since, no better than myneighbours, in the well-appointed local store of one of ourgreat national pharmaceutists while the pharmacist reacheddown from a back-room shelf a little tube of cortisone oint-

ment, prescribed, free at the time, by our kind G.P. to dampthe family’s reactions to wasp, bee, nettle, ant, and smallburn or scald. Having looked round I looked down, andthere, all bright and glittering in the showcase air, and allin new clothes were all the old friends-the pain-killer, theacne and general skin-cure, the cough-suppressor, the head-cold extinguisher, the tired-eye brightener, the ’flu banisher,the acidity-neutraliser, the wind-absorber, the fretted-nerve soother, the sluggish-bowel stimulator, the vitamin

supplementer. I guess it’s neither national nor new. " Sweet

drugs " circulated in Homer’s time; sixty years ago many amedical student marvelled to watch those quart bottles, theapparent raison d’etre for all that dreary waiting, roll over thedispensary counter into the shopping-bag; and I have heardthat south of Panama no self-respecting citizen can face theday without a

" shot " or two. Plus ça change-and if I helddrug-firm shares, I should not blench.

Public Health

Influenza

IN England and Wales deaths from influenza declined from990 in the week ended Jan. 12 to 730 in the week ended Jan. 19.New sickness-benefit claims fell from 403,947 in the weekended Jan. 16 to 330,448 in the week ended Jan. 23. TheLondon Emergency Bed Service reports that both total appli-cations and applications for admission of patients with pneu-monia are now about normal for the time of year. Returnsfrom the Royal College of General Practitioners show that thenumber of cases newly diagnosed as influenza rose to 266-2 per100,000 (provisional) in the week beginning Jan. 11, comparedwith 204-3 per 100,000 the previous week; but the number ofcases diagnosed as acute bronchitis has declined, and there hasbeen a substantial fall in cases diagnosed as pneumonia andpneumonitis. The general trend is encouraging.