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Panax ginseng occupies an important place among the tonic remedies of Oriental medicine. Pharmacological investigations show that crude ginsenosides can increase non-specific resistance of an organism to various untoward influences. The effects of purified derived derivatives have only recently become better studied in immunological and cell growth studies in animals and in man. This has now provided some evidence to suggest that ginseng is a drug that contains many derivatives with different pharmacological properties, which could be useful in clinical medicine.

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SUMMARY Two newborn infants, male (A) and female (B), with lethal hyperammonaemia are described in the same family. In both, symptoms started on the second day of life. Lethargy and hypotonia were the most prominent initial findings and were followed by convulsions and coma. In both, blood ammonia levels rose to 570 ,umol/l (798 ,ug/100 ml) a few hours before death, which occurred on the third and fourth day of life respectively. Assay of liver urea cycle enzymes in baby B showed a complete absence of mitochondrial carbamyl phosphate synthetase activity. cousins. Baby A was the product of the third pregnancy of the mother. The first had resulted in a miscarriage during the fourth month of pregnancy. The second baby was a term male who died 12 hours after birth without definite diagnosis, but with symptoms similar to those of babies A and B.Baby A appeared well at birth. Glucose-water feedings were started and he remained well until the end of the first 24-hour period when he became progressively lethargic, hypotonic, and refused feeds. During the second day his condition deteriorated, with tachypnoea, abdominal distension, and generalised tonic-clonic convulsions. He was transferred to the neonatal unit of this hospital at 40 hours.On admission he was comatose with frequent episodes of generalised convulsions. The primitive reflexes were lacking. The fontanelle was normal. Palpation of the liver and spleen was difficult because of the abdominal distension. Intravenous glucose 10 % was started and diazepam and phenobarbitone were given for the convulsions. A few hours after admission episodes of apnoea started and intubation with artificial ventilation was required. In spite of protein restriction and supportive measures, the baby died at 56 hours. During the last few hours of life, he expelled a characteristic odour of ammonia during respiration.Laboratory data included a normal blood count, blood glucose, and serum electrolytes, and calcium.Spinal tap was normal and blood and CSF cultures negative. Chest x-ray was normal, and aspartate and alanine transaminases (SGOT and SGPT) were 230 on 9 May 2018 by guest. Protected by copyright.