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study-age, use of tobacco and coffee, and physical fitness-and they present reasons for regarding them as of smallimportance.

In the second paper Pollin and Goldin 5 report a con-trolled symptom study of intravenous adrenaline in 12schizophrenic and 12 healthy men. None experiencedpsychotic symptoms or a

" break with reality ", although2 of the schizophrenics became rather more disturbedsubsequently. Both groups experienced increasedarousal, narrowing of the field of attention (especiallytowards inner body experience), consequent difficulty incommunicating and concentrating, and feelings of

anxiety. Some normals described this anxiety as differentfrom real-life anxiety. On the whole the schizophrenicswere less able to cope with the experimental situationbefore the infusion, showing more anxiety towards itthan the normals but less anxiety in response to adrenalineitself. Such differences in response to an experimentalsituation rather than to the experiment itself is an

important source of error in " controlled " studies.In excretion studies of DL-7-3H-adrenaline-D-bitartrate

LaBrosse et al.4 found, from assay of tritium-labelledmetabolites in the urine, that practically none, or none atall, of the infused adrenaline could have been metabolisedvia adrenochrome or its products in either schizophrenicor normal subjects. Although neither concluded norconclusive, these studies do not so far vindicate theadrenochrome-adrenolutin theory of schizophrenia.

PREVENTIVE EFFECTS OF ISONIAZID

IN 1957 the United States Public Health Service 6

reported the short-term results of a trial involving 2750children with asymptomatic primary tuberculosis, halfof whom received isoniazid for up to a year and the otherhalf a placebo. A further instalment of this study givesthe results of three years’ observation of 2571 of the 2750originally admitted to the trial. 7 During the year oftreatment, adverse pulmonary changes occurred in 36 ofthose receiving isoniazid, compared with 52 of thosereceiving a placebo. Even more striking are the figuresfor extrapulmonary changes, which developed in 6 ofthose receiving isoniazid, compared with 33 of those

receiving a placebo.These findings confirm those described in France by

Lotte and Rouillon.8 These workers, however, usedisoniazid combined with p-aminosalicylic acid (P.A.S.).In 59 infants with primary tuberculosis half of whom weretreated with this combination of drugs Lorber 9 failed tofind any benefit. Follow-up studies are planned both inFrance and in the U.S.A." to determine the ability ofisoniazid alone or in combination with P.A.S. to preventreactivation of the disease. Findings in one country orcommunity may not apply to another. Possibly, for

example, in an area where primary resistance to isoniazidis highly prevalent in adults, the results of giving isoniazidalone may be relatively unsatisfactory. Meanwhile animportant advance has been made. As lately as 1956Debre said: " The important problem is whether all casesof primary tuberculosis-whether latent or not-should betreated as soon as they are recognised." This problemseems to have been clearly resolved.

’

5. Pollin, W., Goldin, S. ibid. p. 50.6. Amer. Rev. Tuberc. 1957, 76, 942.7. Mount F. W., Ferebee, S. H. New Engl. J. Med. 1961, 265, 713.8. Lotte, A., Rouiilon, A. Bull. Inst. nat. Hyg. 1960, 15, 5.9. Arch. Dis. Childh. 1961, 36, 669.10. Debré, R. New Engl. J. Med. 1956, 255, 794.

THE FLEXIBLE EMPLOYER

EVEN nowadays when there is a shortage of staff, anemployer is often reluctant to engage married women,because he regards them as unreliable. They need time offwhen their children are ill or on holiday. They do not taketheir work seriously. They are not interested in promo-tion. They put the interests of their families before theirjob. These, where they exist, are real disadvantages to anemployer, and not unnaturally he would prefer, if he couldchoose, to employ men or unmarried women. But he is notlikely to have the choice, for it is improbable that he willbe able to rely on men workers alone, and, if the presenttrend towards early marriages continues, there will soonbe few unmarried women over the age of 21.

Women fought long and hard for equality with men,recognising that equality meant not only equal rights andequal chances, but also equal hours and conditions. Thereare still women who feel like this today; but on the wholemarried women are not interested in being " equal " withmen. Though many want an opportunity to work outsidetheir homes, they want to be able to do so withoutneglecting their other obligations. From an examinationof the problems of married women workers and of thosewho employ them, based on a questionary sent to everytenth member of the Institute of Personnel Management,Dr. Viola Klein has formed the impression that in mostfirms married women are still regarded as a temporaryexpedient to meet a temporary labour shortage. Few

managements (apart from those traditionally employinglarge numbers of women) have accepted the idea thatmarried women have come to stay. Adjustments to fitthem into office or factory routine are mostly made ad hoc,and not as part of a policy. Until the employer comes toregard married women as a substantial and useful part ofhis normal personnel, he will not devise working condi-tions which will allow them to pull their full weight.Many hospitals have already applied this lesson to their

nurses and now employ married women part-time, oftenwith excellent results. They have been slower to apply itto married women doctors. Yet the serious shortage ofjunior hospital staff could probably be met at least partiallywith their help, and it would seem worth while to tryadapting the work to suit their needs. (The Chancellor ofthe Exchequer might also be prevailed on to offer them,and other married professional women, reasonable taxconcessions.) Some hospital work, especially among out-patients and long-stay patients, could probably be donebetter by part-time doctors than by full-time doctors whochange every six months or two years. Fewer full-timeresident doctors-and they are becoming increasinglydifficult to find-would then be needed. Some casualtyand acute ward work could, if necessary, be done bypart-time doctors on rotas. Even where the arrangementwas not ideal, it would be better than not having thework done at all because of shortage of staff. Alreadythere is a move to draw the married woman into generalpractice on a part-time basis.2 Until it has been triedin the hospital, there is no excuse for leaving necessarywork undone on the grounds of shortage of junior staff.

1. Klein, V. Employing Married Women, Institute of Personnel Manage-ment, Occasional Paper No. 17, 1961. 7s. 6d.

2. Cockram, J., Bolton, A. Lancet 1961, ii, 1314.

We much regret recent delays in the distributionof The Lancet, caused by the Post Office dispute.