Correspondence MEDICAL JOURNAL doctors are possibly unaware that an estimate of 10%°, of all admissions to general wards have had an alcohol-dependency. Alcoholism is excluded from the curricula of medical schools. Few doctors therefore understand anything about alcoholism. Workers with alcoholics learn about the illness from the patients themselves. If a true conception of illness is accepted there is no need for shame to be attached to alcoholism. Recovered alcoholics are fortunate people. Recovered medical alcoholics can greatly help by revealing their identity and assisting in information about this disease by enlightening their colleagues and making themselves available for consultation to sufferers from the disease. I hope my personal experiences can be turned to good effect.-I am, etc., NEIL PANTON. Southampton, Hants. Porphyrinuria SIR,-In Dr. Norman Gitlin's recent communication (11 January, p. 96), the most significant positive finding is the "strongly positive porphobilinogen." Also significant, in a negative sense, is the very modest abnormality in urinary uroporphyrin excretion. This would argue against any "acquired porphyria." On the other hand, it is hard to attach much significance to elevated urinary coproporphyrin in a patient with obvious alcoholic liver disease. Can we be sure that the patient's pain and even the hyperlipaemia' are due to " Zieve's syndrome" and not to acute intermittent or variegate porphyria (possibly precipitated by an alcoholic bout and/or inanition) ? What is badly needed in this case to put these factors in proper perspective is quanrtitation of urinary porphobilinogen (elevated in both acute intermittent and variegate) and faecal protoporphyrin (elevated in variegate).-I
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