John Dobbing

Weighing babies in clinics

SIR,-Dr T Bewley and Dr A H Ghodse (11 June, p 1876) report that over the past three years there has been a pronounced increase in the prescribing of controlled drugs (notably methadone, dipipanone-cyclizine (Diconal), and methylphenidate (Ritalin)) to addicts by private general practitioners. They suggest that unduly liberal prescribing practices and lack of precautions on the part of some practitioners result in the illicit resale of surplus drugs (in part at least to pay for private treatment). We in no way dissent from their general position that some private prescribing is injudicious and excessive. Nor would we disagree that such prescribing contributes both to the spillage of prescribed drugs onto the illicit market and to an increased risk of physical complications (as is associated, for example, with the injection of crushed tablets of Diconal or Ritalin). We, however, take issue with important parts of their arguments thereafter.

Less listening, more discussion.

and the astute pathologist (I)r D Eakins) noted that the lymph node attached to the gall bladder showcd classical sarcoid. When she Xwas admitted on that occasion hcr x-ray film showed infiltrative changes and her EGG showed first-degree heart block xwith dropped beats and left bundle-branch block. hus there was definite active sarcoidosis at the age of 88 years, though not actually acute sarcoidosis as rcported by Dr Brown and his colleagues.

The Blood—Brain Barrier

Training of shoe-fitting assistants at short courses by manufacturers can never be of much value except to impart technical knowledge, and must for the present depend upon the managers interest and ability. When the economics of providing skilled fitting services have been settled there will be a call for high-grade training courses. These can be provided by technical establishments in conjunction with trade organizations as soon as the need and demand arise. It is one of the prime objects of the newly established Society of Shoe Fitters to establish these facilities and to provide the high standard of shoe services Dr. HoUlman would approve. -I am, etc., F. H. GEORGE, London, W.2. President, Society of Shoe Fitters.

Aspirin and Gastro-intestinal Haemorrhage.

SJR,-The article by Dr. L. Th. F. L. Stubbe (Journal, November 1, p. 1062) showing the loss of occult blood after administration of aspirin is alarming when related to the vast quantities of aspirin consumed by the general public. These results are supported by the work of Dr. W. H. J. Summerskill and Dr. A. S. Alvarez published the same week in the Lancet (November 1, pp. 920 and 925). Not only will these results make the consideration of all salicylic therapy a necessity, but raise questions outside the direct controI of the medical profession. Prescribing may be controlled, but what of the vast consumptionby public purchase, and the false idea of safety ? Should not control be exercised ? It is realized that aspirin may not be placed on the Poisons List, but manufacturers should at least be mAde to include a warning on their packings. Is there no method of legislation to enforce this ?-I am, etc.,