767

is hoped, allow greater flexibility in meeting the chang-ing demands and patterns of cancer research and givenew opportunities to able young men and women.The efficacy of this reorganisation will depend,

inevitably, on the ability and humility of individualscientists, particularly as they get older. But the

approach is surely a sound one that is long overdue inseveral other institutions concerned with multidisci-

plinary basic research.

Reports of work in progress in the Fund’s laboratoriesinclude a useful summary of the studies on the relationbetween hormonal status and breast cancer in women.The most significant observation so far is the associationbetween the amounts of androgen and corticosteroidmetabolites in the urine and the course of the establisheddisease. Further progress towards both prevention andmore rational treatment is hampered by the need forbetter analytical methods and for information on tissuesensitivity to hormonal stimuli.

Q FEVER

THERE is no reason to doubt the view put forward byMarmion and Stoker 1 that in the United Kingdom themain source of Q fever is the drinking of raw milk. Insome districts sheep and their products play a part, butsheep-farming is a more restricted occupation than dairy-ing. Nevertheless all who have taken an interest in thisdisease must have been struck by the number of infec-tions in those who always drink heat-treated milk andwho have had no contact with any kind of agriculture.This situation is confirmed in a recent survey 2 in north-west England which showed that of 41 patients withQ fever only 6 gave an unequivocal history of drinkingraw milk, while 5 more had had a rather tenuous contactwith a possible source of infection. (The story of apatient’s habits can be misleading: we recall a postmanwith brucellosis who admitted only at the third time ofasking that he often helped his farmer brother at calvingtime.) It seems that rickettsias are long-lived andresistant parasites. The association of typhus with oldclothes was well known in Dublin, and if the rickettsiascan survive for many years in the faeces of lice it is

possible that they may do the same in cow dung. Themassive infections among the soldiers in the Italian

campaign seem to have been caused by inhaling the dustin byres used as sleeping quarters.3 On a farm cow dung,wet or dry, is almost everywhere, and Rickettsia burnetiis far commoner in cattle than in man. It would be ofinterest if someone would develop a simple test-perhapsby a precipitin reaction-for the presence of dung indust.

No recent attempt has been made to map the occur-rence of R. burneti in domestic animals. It would be an

expensive and time-consuming pursuit, and since Q feveris not a deadly disease and of no economic importanceto the farmer the project will probably have to wait. Themap published in this survey to illustrate the location offarms found to produce infected milk is not very informa-tive. ’It is not clear whether all dairy farms were tested;and most infected farms may have been found in thosedistricts where dairying is a common occupation.

1. Marmion, B. P., Stoker, M. G. P. Br. med. J. 1958, ii, 809.2. J. Hyg., Camb. 1969. 67, 125.3. Caughey, J. E., Dudgeon, J. A. Br. med. J. 1947, ii, 684.

The survey includes an examination of small groupsof those who might be especially exposed to infection byreason of their occupation. 28% of veterinary surgeonsshowed complement-fixation-test (C.F.T.) titres of 1/20 ormore, while the figure for employees in slaughter-houseswas 33%. For those who worked on farms the figureswere 9-2% for men and 17% for women. All these

figures were higher by far than those found in blood-donors and patients at an antenatal clinic. Of the 7005patients who formed the basis of the survey (and weresuffering, we presume, from some illness requiringinvestigation) 146 gave a c.F.T. of 1/20 or more, and it isassumed that these had had Q fever at some time in thepast. This may be so, and the high figures from veterinarysurgeons and slaughtermen support this view; but thereare dangers in the assumption that specific antibodiesare the result of infection. In this series a single c.F.T.titre of 1/128 was accepted as evidence of infection, butthere were 2 children giving this figure who were

shown to have some other ailment. Q fever is mainly adisease of men, but among farm workers there were morefemales than males with titres above normal but with noevidence of disease. A similar phenomenon was latelydescribed for brucellosis.* The interpretation of sero-logical evidence is tricky and should not be carried toofar. 41 cases of Q fever in a population of about 7 millionsdoes not present a grave threat to the public health, butthis survey shows that the disease may arise anywhereat any time and most commonly presents as pneumonia.If there were more awareness of this possibility, thedisease would probably be diagnosed more often.

WOMEN’S RIGHTS

EVEN Mrs. Pankhurst would have been satisfied withthe interim report 5 of the Parliamentary Labour Partystudy group on discrimination against women. Thereport outlines the ambiguous position of women in theexisting scheme of social security benefits and calls forequal pay, equal earnings-related contributions, and equalbenefits. It proposes that the working married womanshould pay her full contribution and get full benefit. Butwhen a woman has young children and is dependent onher husband, she should not have to pay contributions,although this period would count towards her final

pension. At such times she could obviously not claimsickness and unemployment benefit, but she would behelped by increased family allowances. If she does notwish to return to work after her youngest child hasreached school age, she should then make flat-rateinsurance contribution for benefits on her own behalf.The report is particularly concerned with the plight ofwidowed, divorced, separated, and unmarried mothers.It suggests that, if they are unemployed, such womenshould receive a resettlement allowance for twelve

months, and, if they have children under school age, at theend of this time the benefit should be extended until thelast child goes to school. In addition, a substantial single-parent benefit should be paid for each child until thechild can support himself.

4. Boycott, J. A. Lancet, Feb. 1, 1969, p. 255.5. Towards Equality: Women and Social Security. Copies (1s. 6d.)

may be had from the Labour Party, Transport House, LondonS.W.1.