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Since unrestricted visits is the first essential for the patientin a mental hospital, let all our mental hospitals throw openwide their doors-and keep them open.-H. G. WooDLEY.(Edzell, Angus.)Vaccinia versus Poliomyelitis.-Relative to Dr. MacIver’ssecond communication (March 17), I would say that in urbanareas in the’United States smallpox vaccination takes placealmost universally before the child is a year old. In somerural areas this vaccination will not be given until the childenters school, but I would not hazard a guess at the percent-ages concerned. Many children are re-vaccinated on goingto school, and in the Service almost 100% of children as wellas parents are vaccinated every three years. Unfortunatelypoliomyelitis still occurs among our personnel. It is to be hopedthat Dr. MacIver’s observation is correct, for it would be justone more good argument for vaccination against smallpox-a disease we can control.-Colonel CHARLES H. MORHOUSE,M.D. (Third Air Force, Ruislip, Middlesex.)

Production of Codeine.-Dr. Williams (March 17) showsa lamentable lack of knowledge of the pharmacology of aceta-nilide and related compounds, and appears to be unaware ofthe excellent work that has been done in this field by Brodieand others (B. B. Brodie, J. Axelrod, J. Pharmacol. 1948, 94,22, 29; F. B. Flinn, B. B. Brodie, Ibid, p. 76: B. B. Brodie,J. Axelrod, Ibid, 1949, 97, 58). Acetanilide is a dangerousdrug because the body de-acetylates part of it into aniline.It is not generally considered, however, that it causes agranu-locytosis. Similarly, phenacetin is partially de-acetylatedinto another, though less dangerous, amine, p-phenetidine.The active non-toxic metabolite of acetanilide and of phena-cetin is n-acetyl-p-aminophenol, which is Panadol’. ’.To convert n-acetyl-p-aminophenol inco acetanilide the body

would have to de-hydroxylate it-a process that is unknownfor phenols which are metabolised in the reverse direction byfurther oxidation, conjugated with glucuronic and sulphuricacids, or excreted unchanged.More than two million doses of 7n-acetyl-p-aminophenol have

already been given to humans, and there have been no authen-ticated reports of toxic effects. All the available evidencesuggests that panadol is a safe analgesic and one that is

unusually free from side-effects, which is the main reason forusing it.-L. M. SPALTON, B. PHARM., director, Bayer ProductsLtd. (Kingston-on-Thames.)

1. Times, March 9, 1956.

Medicine and the Law

Death due to Penicillin

AN anaphylactic reaction to penicillin caused the death, onFeb. 3, of a man of 34 who the day before had undergonetonsillectomy at the Radcliffe Infirmary, Oxford.1 At the

inquest the patient’s doctor said that last October he hadattributed symptoms in this man to hypersensitivity to

penicillin. A dermatologist had concluded that a rash whichhad developed was due to a throat infection. After the

operation penicillin was ordered (nothing then being known ofthe hypersensitivity). A rash developed, and the treatmentwas changed. A staff nurse noted this in the change book butdid not remove the patient’s name from the penicillin list.On Feb. 3 another nurse, about to inject penicillin, was told bythe patient that he was hypersensitive. She relied on the list.

Obituary

Sir MORTON SMART

Sir Morton Smart, G.o.v.a., D.s.o., manipulative surgeon toKing George VI and consultant in physical medicine to theRoyal Air Force, died on March 16 at the age of 78. He wasborn in Scotland, the third son of John Smart, R.S.A., andgraduated M.B. from the University of Edinburgh in 1902.

During the South African war, he had seen active service andin the 1914-18 war he again served j1s a combatant, this timeas a commander in the R.N.V.R., and was in charge of a gun-boat flotilla at the Dardanelles. This background of Serviceexperience sharpened his interest in the problems of reablement.He was especially concerned with the application of his

specialty to the problems of the casualties of war and industry,and in 1940 he addressed a committee of the House ofCommons on Physical Medicine in War-time.

Dr. WILLOUGHBY-LYLE

We hear with regret of the death on March 13 of Dr. HerbertWilloughby-Lyle. An indomitable little man, full of energyand activity, he lived to the age of 85. And he lived to thefull. He was a famous physiology coach in his youth, a first-class ophthalmologist in his prime, a vivid medical teacher, andfor over 20 years dean of King’s (whose medical school hecompleted by his own exertions). His association with theschool began as a student and ended as dean emeritus; itstretched from 1887 to 1931 and amply qualified him to turnhistorian. His book, King’s and Some King’s Men, appearedin 1935 and he published an addendum five years ago. Hewas a highly individual and lovable character, who will not beforgotten by his school or by the thousands he served. Twoof his family, Mr. T. Keith Lyle and Dr. Eric Lyle, are mem-bers of the medical profession.

News

The trials with an oral attenuated live-virus poliomyelitis vaccine,now being carried out in Northern Ireland under the direction ofProf. G. W. A. Dick, are being extended to include medical studentsand children whose parents have agreed to their receiving the vac-cine. Only those volunteers with no antibody to one or other typesof virus will be given the vaccine.

On Feb. 25 the degree of M.D. of the University of Cambridge wasconferred on Robert Marshall, D.N. Phear.tand Arnold Pines; thedegree of M.B. on J. A. Eddington and J. F. M. Newman; and thedegrees of M.B., B.CHIR. on J. F. Garner.

The Royal Society of Tropical Medicine and Hygiene has awardedthe Manson medal for 1956 to Brigadier J. A. Sinton, V.C., F.R.s.

CORRIGENDA: Prevention of Hay-fever.—’Piriton’ maleate, men-tioned in Dr. Stathers’ letter (March 10), ischlorpheniraminemaleate.

Chest Radiography in Pneumoconiosis.-In our leading article lastweek, the last sentence in the second paragraph should have begun ;"When allowance is made for Durham miners going to the coalfaceten years later than their Welsh colleagues..."

Births, Marriages, and Deaths

BIRTHS

WESLEY-JAMES.—On March 10 at Southmead Hospital, Bristol, toJacqueline (formerly David), wife of Dr. Oliver Wesley-James,a son.

Vacancies

ACADEMIC AND EDUCATIONALInst. of Cancer Research, S.W.3. Clin.

Research Path.Oxford University, Nuffield Dept. of

Orthopaedic Surgery. GraduateAsst. A.

St, Andrew’s University. RefresherCourse for G.P.’s. 18th-29th June

Inst. of Laryngology & Otology, &Royal National T. N. & E. Hosp.W.C.I. Course for Cons. Otologists.lst, 2nd & 3rd May.

St. Andrew’s University. Courses ofInstruction for D.P.H. & D.P.D.Oct. 195ti/June 1957.

Tuberculosis Educational Inst. (Dee-side San. Aberdeenshire). ClinicalCourse, 18th. 19th & 20th April.

Edinburgh University. Regius Prof.

I Glasgow Royal Infy. McIntyre Clin.Research Scholarship.

,

Bristol Univerity. Asst. Lecturers ’,(Grade III) or Demonstrators inPhysiology.

University of London. Readershipin Clin. Path.

Singapore. University ol Malaga. Sr. ’

Lectureship in Orth. Surg. ’,National Assoc. for Prevention of T.B.,

Edinburgh. Post-grad. Fellowship.

I St. Andrew’s Uuiversity, Queen’s s

College, Dundee. Asst, in Path. ;

ADMINISTRATIVENewcastle R.H.B. Deputy Sr. Admin.M.O. ’

ANAESTHETICSLambeth, S.E.11. Locum Reg.t. George’s, S.W.1. Reg. ’

Hackney Group H.M.C. Sr. H.O.Hosp. for Sick Child., W.C.I. Reg.North Middlesex, N.18. H.O.Royal National T.N. & E., V. Reg.University College Hosp., W.C.1.

P.-t. Cons.Chesterfield Royal. Reg.Dublin. St. Laurence’s. Asst. Anaes.Dudley, Stourbridge & Dist. Sr. H.O.Manchester. Crumpsall. Sr. H.O.Manchester. South Manchester H.M.C.

Sr. H.O.Manchester R.H.B. Cons.Newcastle R.H.B. Reg.Nottingham Gen. Reg.Sheffield R.H.B. Cons.Sheffield United Hosps. Reg.Taplow. Canadian Red Cross Mem.

Sr. H.O.U.S.A. Cambridge, Mass. Residencies