1148
The reaction is specific for paracetamol, and there is nointerference from the sulphate and glucuronide conjugatesof paracetamol. In addition, presence of the followingsubstances at the 50 (1.g. per ml. level does not interferewith the reaction: amitryptiline, amphetamine, caffeine,chlordiazepoxide, chlormezanone, chlorpromazine, chlor-propamide, cocaine, diazepam, diphenhydramine, di-
phenyldantoin, dihydrocodeine, imipramine, indomethacin,lorazepam, meprobamate, methadone, methaqualone,morphine, nitrazepam, oxypertine, pentazocine, pentobarbi-tone, promethazine, salicylate, strychnine, theophylline,tolbutamide.
Metabolic Studies Department,Sterling-Winthrop Research and
Development Division,Edgefield Avenue,
Newcastle upon Tyne NE3 3TT.JOHN P. GLYNNSTEPHEN E. KENDAL.
SURVIVAL OF THE GENETICALLYINCOMPATIBLE FETAL GRAFT
SIR,—Dr Finn (April 12, p. 835) proposed an attractivehypothesis to account for the non-rejection of the fetal
allograft. He postulated that shared surface-repellentmolecules prevent contact of maternal and fetal immuno-competent cells. ,
We have previously suggested that oc-fetoprotein (A.F.P.)could potentially abrogate maternal lymphocyte immuneresponses against the fetus.1 Murgita and Tomasi 2,3demonstrated suppression of humoral immune responses,mixed lymphocyte reactivity, and mitogen-induced lympho-cyte transformation by A.F.P. A.F.P. may serve as a naturalimmunosuppressive agent that abrogates potentiallyharmful maternal immune responses. A.F.P. is a majorserum-protein in the fetus which crosses the placentalbarrier to the maternal circulation where it could serve asan immunosuppressive agent.4
Furthermore, A.F.P. may inhibit lymphopoiesis: we havereported a patient with haemochromatosis and lympho-cytosis who developed an A.F.P.-positive hepatocellularcarcinoma and lymphopenia. Her total lymphocyte countsduring a 24-year period were 2305 per c.mm. at 37 years ofage, 10,089 per c.mm. at 46 years, 9920 per c.mm. at
54 years, and then plummeted to 1366 per c.mm. afterthe appearance of an A.F.P.-synthesising hepatoma. Thelymphopenia may have resulted from factors other thanA.F.P., but this speculation merits consideration.
Other mechanisms in addition to surface-repellentmolecules need to be considered to explain the non-rejectionof the fetus. We have suggested that combined fail-safemechanisms, including placental barriers, blocking anti-bodies, hormones, and possibly A.F.P. and other fetal
proteins 6 may act concertedly to prevent maternal rejec-tion of the fetus. The placenta is an endocrine organstrategically placed to optimise the impact of the immuno-suppressive effect of oestrogen, progesterone, cortisol,prolactin, and chorionic gonadotrophin.7-1o
Commonwealth of MassachusettsMedical Center,
55 Lake Avenue North, Worcester,Massachusetts 01605, U.S.A. DAVID T. PURTILO.
1. Purtilo, D. T., Hallgren, H. M., Yunis, E. J. Lancet, 1972, i, 769.2. Murgita, R. A., Tomasi, T. B.J. exp. Med. 1975, 141, 269.3. Murgita, R. A., Tomasi, T. B. ibid. p. 440.4. Purtilo, D. T., Yunis, E. J. Lab. Invest. 1971, 25, 291.5. Purtilo, D. T., Kersey, J. H., Hallgren, H. M., Fox, K. R., Yunis,
E. J. Am. J. clin. Path. 1973, 59, 295.6. Gaugas, J. M. Transplantation, 1974, 18, 538. 7. Medawar, P. B., Sparrow, E. M. J. Endocr. 1956, 14, 240.8. Waltman, S. R., Burde, R. M., Berrios, J. Transplantation, 1971, 11,
194. 9. Munroe, J. J. J. reticuloendothelial Soc. 1971, 9, 361.
10. Han, T. Clin. exp. Immun. 1974, 18, 529.
Obituary
WILLIAM JAMES HAMILTONM.D., Hon.D.Sc.Belf., D.Sc.Glasg., F.R.C.S., F.R.C.O.G.,
F.R.S.E.
Prof. William Hamilton, professor emeritus of
anatomy in the University of London since 1971, diedon May 3 at the age of 71. The passing of this dis-tinguished anatomist and embryologist will be mournedby the many, at home and abroad, who have a vividrecollection of him as teacher, colleague, or friend.He received his medical education at the Queen’s
University, Belfast where, in a career of exceptionalbrilliance, he obtained first-class honours in the B.SC.
examination in 1926, and in the M.B. in 1929. He proceededto the M.sc. in 1931 and then went as a lecturer in anatomyto Glasgow University, where he was awarded the D.sc.degree in 1934, and where, under the influence of ThomasHastie Bryce, he developed his life-long passion forembryology. From Glasgow he went to St. Thomas’sHospital Medical School as deputy director of anatomy,and he was appointed to the chair of anatomy in the
University of London at St. Bartholomew’s HospitalMedical College in 1936. In 1945 he returned to Glasgowas regius professor of anatomy, but personal reasons,combined with the prospect of starting up a new department,led him to accept the appointment to the newly createdchair of anatomy at Charing Cross Hospital MedicalSchool in 1947, and he remained in post there until hisretirement in 1970. During this period he was presidentof the Anatomical Society of Great Britain and Ireland in1953-55. As dean of Charing Cross Hospital MedicalSchool in 1956-62, he succeeded in obtaining for theschool chairs in obstetrics and gynaecology, surgery, andmedicine, in that order, over the short space of 3 years.It was also during his deanship that plans were laid for thenew hospital and medical school at Fulham, and he playeda leading part in determining the existing integratedpattern of buildings.
In 1933 he married Maimie, only daughter of SamuelYoung of Belfast; and it was a source of great joy to himthat his four sons all became members of the medicalprofession (two of them are consultant surgeons), and thathis daughter became a distinguished dental pathologist.
T. W. G. writes:
" With the late J. D. Boyd, his life-long friend andcolleague, Hamilton did as much as anybody to establishembryology as a basic science of particular relevance tomedicine. As a professor of anatomy he was the protagonistof innovations in teaching which resulted in the humanbody being presented to medical students as a dynamic,developing, functioning, and eventually ageing entity inwhich structure and function are closely related. Theclinical relevance of what he taught was always prominent;and he did much to make radiological and surface anatomyintegral parts of the preclinical course.
" Hamilton understood fully the processes of producingbooks, and any book associated with his name was of avery high standard, largely because he had familiarisedhimself with the art of illustration and the techniques ofprinting and plate-making. His main efforts in this areawere directed to Human Embryology (now in its 4th edition),
’ Surface and Radiological Anatomy (now in its 5th edition),and a comprehensive work on the human placenta. Heedited a textbook of topographical anatomy, the 2ndedition of which he was hoping to see published in theautumn. In recent years he had been heavily involved inproducing films for teaching, in which developmental
