(1971(3) 29 of the 35 HS patients were boys and 13 had an abnormally small penis and illdeveloped scrotum. Only 2 were sibs. Parents averaged 40th centile for height. 4 children developed growth-suppressing antibodies, and had to cease treatment. The mean standard deviation score (SDS) for height at diagnosis was -4 7, range -2 6 to -7-3. Bone age SDS averaged -3-2, range -0-8 to -5-7. Skinfold SDS averaged +0 91. Limb muscle width SDS averaged about -3*0. GH peak in insulin hypoglycaemia averaged 4-7 ± 0.7 ,uU/ml, range 1 to 13.(4) A category of partial growth hormone deficiency is defined as patients with GH peaks of 7-20 IiU/ml inclusive and height velocity SDS in the year before treatment between -1 and -2. Total HS patients have GH peaks of 1 to 6 ,j.U/ml inclusive and height velocity SDS of <-2. Partial HS patients are accelerated by HGH and should be treated; but their average acceleration is below that of total HS patients.(5) There was a highly significant relation (r = -0 64) between blood GH peak level and pretreatment height velocity in the HS patients.(6) The LBW patients were 10 boys and 7 girls; all the boys had normal genitalia. The average height SDS at diagnosis was -3-7; parents' height centile averaged 50th, bone age SDS -1-8, skinfold SDS -0Q9. GH peaks were all above 30

The Working Party on human growth hormone (hGH) has during the past decade developed a system for the evaluation and treatment of patients suffering from hGH lack. Today there are nineteen measurement centres in the United Kingdom at which patients are assessed and where the effects of therapy are monitored. The current supply of hGH, which is prepared from pituitary glands collected by pathologists in the National Health Service, is just enough to meet demand, but research conducted on behalf of the Working Party suggests that hGH deficiency is more common than has been thought and that the prevalence may be as high as one in 10 000. If, as is hoped, patients are diagnosed younger and more patients with partial deficiency are recognized, demand may soon outstrip supply. Work is in progress to define better methods of hGH production and optimal dose regimens, both of which will help to minimize the problem of supply and demand. A few children have anti-hGH antibodies, which block growth as a result of treatment. Improved hGH production techniques may result in a less antigenic product and the resolution of this problem. Many of the Working Party's activities began as research and have evolved into service. Because of this shift in emphasis, and although much research is still to be done, responsibility for provision of treatment with hGH transferred from the Medical Research Council to the Department of Health and Social Security in July 1977.

SummaryThe prevalence of Addison's disease (chronic adrenal failure) has not been widely investigated and is usually given as 39 in a million. We conducted a prevalence study using a postal survey of general practitioners in Coventry. Three quarters (1391188) replied, representing 79/85 (93%) of the practices. Thirty cases of Addision's disease were found from a total patient list of 323 852, of which a third were tuberculous in origin and twothirds non-tuberculous (12I30 autoimmune, 8/30 unclassified). We conclude that Addison's disease is 2.4 times more common than previously reported. The tuberculous group was older, 65 vs 52 years (p<0.05), and had had the disease for longer than the non-tuberculous group, 20 vs 12 years (p<0.05). There was no significant difference in the age at diagnosis.

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