The distribution of the sensitivity to penicillin of gonococci isolated from 631 men and 290 women was analysed in relation to the racial origin of the patients and the type of source contact alleged by the men. No difference in the sensitivity patterns was found between strains from white patients from the United Kingdom and those from immigrants from the Caribbean area. Asian men harboured significantly more insensitive strains than men of other racial groups. Men of Caribbean stock who had been born in this country had significantly more infections due to fully sensitive strains. The reasons for these variations are not known, but one contributory factor may be differences within the racial groups in the proportions of infections contracted from prostitutes.

Three surveys of the sensitivity of pretreatment isolates of gonococci to penicillin, ampicillin, tetracycline, spectinomycin, streptomycin, and co-trimoxazole were carried out during the period 1976-78. Compared with the results of previous surveys in the London area the decline in the proportion of strains of gonococci which are insensitive to penicillin appears to have halted. No changes were found in the levels of resistance to ampicillin, tetracycline, or spectinomycin during the period surveyed, although there was a slight increase in the proportion of strains requiring concentrations of 20 microgram spectinomycin per ml for inhibition. Streptomycin resistance has decreased considerably and 91% of strains are now sensitive to 10 microgram streptomycin per ml.

in ten, and one in three, respectively.In October 792 prescription forms were studied (1201 prescription items), in January 255 (413), and in March 616 (979).In the three individual months 1663 prescriptions were examined (2593 prescription items): 344 (13 2 ',.) of these items were for tranquillisers such as diazepam or tricyclic compounds such as imipramine, while 50 (2 ,O) were for barbiturates either of the short-acting type or as contained in some antacid mixtures or so-called migraine remedies.The actual numbers of barbiturate prescription items in the tested sample were 20 in October, 5 in January, and 25 in March.Examination of the table shows that patients receiving anxiolytic treatment, antidepressive treatment, and sedative measures had their prescription items written more often than not by the receptionist.Percentage of prescriptions zritten by receptionist

(1) An indirect fluorescence test for the detection of anti-gonococcal antibody is described. (2) Positive results at a serum dilution of 1 in 16 or above were obtained with sera from 20 per cent. of males and 61 per cent. of females with bacteriologically proven gonorrhoea. 3-8 per cent. of presumed false positive results were given by sera from patients presumed not to have gonorrhoea. (3) In different groups of sera, tests for IgM anti-gonococcal antibody were positive in 32 per cent. of those from males but in only 43 per cent. of those from females with positive cultures.

Some syphilitic sera still fluoresce with Reiter treponemes as the antigen after treatment with the sorbent used in the FTA-ABS test; this finding indicates incomplete removal of group antitreponemal antibody. Levels of this antibody in normal sera have been studied in relation to the titration of sorbent for use in the test. A comparison has been made of the results of FTA-ABS tests with sorbent and Reiter sonicate and the TPI test on 1141 selected problem sera. Results with the sonicate displayed closer agreement (60.9%) with those of the TPI test than did tests with sorbent 40.8%). The use of sonicate as the sorbing agent is thought to improve the performance of the FTA-ABS test without diminishing its sensitivity.

In a survey of 333 pygmies in the Cameroon 4.5 percent. were found to have clinical evidence of yaws. This was also found in 10 per cent. of the inhabitants of camps in Zaire. The results of VDRL and FTA-ABS tests on a sample of the population are presented. These provide evidence of a very high incidence of treponemal disease, 80 to 90 percent. of the population showing serological evidence of infection. Active transmission is taking place in both areas but more frequently in Zaire.

Although the use of a fluorescent antibody (FA) staining technique to demonstrate N. gonorrhoeae in secretions from patients with gonorrhoea was first described as long ago as 1959 by Deacon, Peacock, Freeman, and Harris, it does not seem to have gained wide acceptance in routine diagnosis.In our laboratory direct and delayed FA methods were first assessed in 1963 (Fry and Wilkinson, 1964).In women the direct method gave more positive results than the delayed which gave slightly more positives than Gram-stained smears or cu]tures on a nonselective medium; it was possible to demonstrate gonococci by the delayed FA method when the organism was overgrown by Proteus on conventional culture plates.Lucas, Price, Thayer, and Schroeter (1967) obtained a similar number of positives in females with the delayed FA method to that with cultures on Thayer-Martin medium.Lind (1969) also obtained a close correlation in both males and females between the delayed FA test and culture on a selective medium, although in a previous study of specimens from females (Lind, 1967) the delayed FA method was superior to culture on a non-selective medium; in the latter study the direct FA method did not offer any advantage over Gram-stained smears.Thin, Williams, and Nicol (1971) found that, in the examination of cervical and urethral specimens from women, direct as well as delayed FA tests gave more positive results than Gram-stained smears or cul- tures ; however, they point out that selective media were not used, and when the plates had only a few colonies after 16 to 24 hrs' incubation all the material may have been removed for the delayed FA test.On the other hand, Martin, Peacock, and Thayer (1965), testing women, found the delayed FA method inferior to cultures on both selective and nonselective media.

In addition to its effect on Trichomonas vaginalis, metronidazole has also been found to be active against the organisms causing Vincent's gingivitis. This has raised the question of its possible action on Treponema pallidum, although Scott-Gray and Murrell (1961) found that a short course of 1-8 g. given over 48 hours did not affect a case of primary syphilis, and Yobs, Clark, and Schroeter (1966) found that large doses did not affect the course of syphilis in rabbits infected with the Nichols strain of Trepomena pallidum. Davies (1967), however, has reported that doses of 2 to 4 g. daily caused the disappearance of Treponema pallidum from the lesions of six patients with secondary syphilis with subsequent healing of the lesions; smaller doses were without effect. Davies, McFadzean, and Squires (1964) have reported that the minimum inhibitory concentration of metronidazole for the cultivable Reiter treponeme is 0 02 [±g./ml. These observations prompted the examination of the effect of serum containing metronidazole on the Nichols strain of Treponema pallidum in vitro.

blood.Inoculated plates were incubated for 24 hrs.at 35°-36°C. in an atmosphere containing CO2, produced by burning a candle in a closed container.This was followed by a further 24 hrs. in the ordinary atmosphere.