1078

an unrelated woman. Both were found to have lymphocyteswith vacuoles-2% and 1-3% respectively. They had five

children, all apparently healthy. There were no vacuoles inthe lymphocytes of one child and 1-0—1-6% in three. However,the remaining girl, aged 5 years, had 17% lymphocytes withvacuoles. At a follow-up examination 2 years later, this girlwas found to display typical signs of the disease.The investigation is continuing with examination of

various control groups to assess how far this method iscritically diagnostic and how it may be improved.

S. RAYNER

J. A. BÖÖK.State Institute for Human Genetics,

Uppsala, Sweden.

1. Colbeck, J. C. Canad. med. Ass. J. 1949, 61, 557.2. Aird, I., Bentall, H. H., Roberts, J. A. F. Brit. med. J. 1953, i, 799.3. Aird, I., Bentall, H. H., Mehigan, J. A., Roberts, J. A. F. ibid. 1954,

ii, 315.4. Clarke, C. A. Lancet, 1955, i, 544.5. Køster, K. H., Sindrup, E., Seele, V. ibid. 1955, ii, 52.

STAPHYLOCOCCAL INFECTION IN INFANCY

J. C. COLBECK.Shaughnessy Hospital,Vancouver, British Columbia.

SiR,—I refer to the annotation on this subject in yourissue of Feb. 1. It is there stated that it is not known how

long hospital epidemic strains taken home by mothersand babies persist in the community.

In 1949 I published a report on a widespread outbreakof staphylococcal infections 1 originating in maternityunits which were caused by what is now known as phage-type 57 but was then referred to as type W. I there

reported a number of instances of long persistence of theepidemic strain in families. The following is an example:

Family no. 1.-" Baby developed pustules when 10 days old.Boils on head at 90 days. Mother had boils on hips. Fatherhad boils on neck when baby four months old. Grandmotherliving with family also had boils on face and hands. The babydeveloped further pustules when 10 months old and the grand-mother more boils on the face: swabbing this family gave thefollowing results: Baby, pustule and nose, W positive; Mother,throat and nose, W positive; father, throat, W positive; Grand-mother, boil and nose, W positive."

Instances are there quoted of carriage up to eighteen months.

During the past four years we have had several experi-ences of families carrying hospital-acquired types (par-ticularly type 81), and intermittently developing boils, &c.,for even longer periods of time.

DUODENAL ULCER AND THE ABO BLOOD-

GROUPS GEORGE PAPAYANNOPOULOS.Clinic of Therapeutics,University of Athens.

SIR,-In 1953 Aird et al. demonstrated an associationbetween the ABO blood-groups and cancer of the

stomach, group A being significantly commoner in

patients with the disease than in controls. An increasedfrequency of blood-group 0 in patients with peptic ulcerwas found also by Aird et awl. and in patients with duo-denal ulcer by Clarke,4 and by Koster et al.5

I have compared the distribution of ABO groups inpatients with duodenal ulcer with that in healthy personsfrom the same localities. The numbers are necessarilysmall, and the results can only be on the borderline ofstatistical significance; but individual series are often

helpful, since large collected statistics of uneven accuracymay miss points of importance.Of 147 patients with a duodenal ulcer, 110 were of the same

social class (Civil servants). The diagnosis was confirmed byserial radiographs. The remaining 37 were all patients underthe surgical unit of the Municipal Hospital of Athens, andwere operated on by the same surgeon. The ages of the patientsranged from 20 to 70 years.For the controls I selected 157 persons. 110 were mostly

friends and relatives of the patients, the rest were volunteerblood-donors registered in the blood-bank of the Greek RedCross. The patients and controls were inhabitants of Athens,but were born in different parts of Greece, and were probablyrepresentative of the whole population.

In the patients with duodenal ulcer, in both sexes combined,the overall frequency of blood-group 0 was 42-1% and thatof group A 40-1% (table I); the corresponding figures in thecontrols were 43-3% for group 0 and 42% for group A.

TABLE I-BLOOD-GROUPS IN PATIENTS WITH DUODENAL ULCER

A statistical analysis of these results was made, comparingthe frequency of group 0 in the controls and in the patientswith duodenal ulcer. The application of the test of indepen-dence, at significance level p=005, gave X2=0’92. Thisindicates that the likelihood of a duodenal ulcer developing isno greater in group-0 than in group-A individuals.

Table 11 suggests that group 0 preponderates in menwith duodenal ulcer and group A in women with duodenalulcer. Similar results were found in the controls.

TABLE II--GROUPS 0 AND A IN PATIENTS WITH DUODENAL ULCER

I analysed these data and found a standard deviation of0-09 for the difference in group 0 between male and female.Since the total number of patients was much greater than 30I applied the test of Gauss-Laplace to the difference. I toundthat t=-0’83 and p=20-33.

There is thus no real evidence of a difference in the

frequency of distribution of group 0 between men andwomen with duodenal ulcer.

I record my sincere appreciation of the help I received fromMr. Const. Athanasiadis, professor of statistics, High School forFinancial Studies, Athens.

ORAL DIURETICS

Mr. JOHN H. FINGERHUT, deputy managing director,Merck Sharp & Dolime Ltd., writes:

" Your editorial on oral diuretics (May 10, p. 1005) wasnoted with interest, and in particular the mention of our newdrug chlorothiazide (’ Saluric ’). The basic N.H.S. cost of8 g. of chlorothiazide was unfortunately incorrectly quoted.This should have been 7s. 6d. and not 9s. 10’l2d- Your readersmay like to know that the average basic N.H.S. cost of chloro-thiazide for maintenance treatment of patients with cardiacoedema is 3s. 9d. per week."

1. Birmingham Post, May 8, 1958.

Medicine and the Law

Damages for Death After PenicillinA farmer, aged 34, was known to be sensitive to

penicillin, but by mistake a nurse gave him a penicillininjection and he died. Damages of E17,500 were

originally claimed, but in view of the fact that the widowwould inherit E5000 from her husband’s estate, thisfigure was reduced to eel 2,500 with costs, to which thehospital board agreed.