A study has been conducted in general practice comparing two brands of lozenges, Merocaine (Merrell) and Tyrozets, (M.S.D.), in the management of acute sore throat and pharyngitis. Eighty-eight patients entered the between-patient study and each completed a diary card covering symptoms experienced and dosage used for each of the two drugs. The doctor reported upon the appearance of the throat and added antibiotics in cases of necessity, which was approximately for one-third of patients. Merocaine proved to be significantly superior to Tyrozets in producing rapid pain relief (within 15 minutes) and reduction of faucial and pharyngeal injection.

It is well known that the differentiation of mycoplasma and L-forms of bacteria is very difficult because of their biological similarity. Therefore, the aim of our investigations was to find possible criteria for differentiating between these microorganisms. Hence, we conducted the following comparative investigations of the morphology of L-forms of bacteria and mycoplasma, their antigenic peculiarities, behavior in tissue cultures and their capacity to produce a certain pathogenic effect in experimental infection of susceptible species of animals. A short review of these works is given in this paper. MaterialsIn all of the studies, the same cultures of stable L-forms and mycoplasma were used.The following L-forms were used: L-form of Salmonella typhi ( N 152 L), Gform of p-hemolytic Streptococcus group A obtained experimentally from Streptococcus type 2 (N 10-S) and its reversed L-form, two strains of L-forms of streptococci (N 409 L and N 406 L) isolated by us from the blood of rheumatic patients' and their reversed forms ( N 409r and N 406r). All these cultures of L-forms have now lost the capacity to revert. In addition, L-forms of the known strains of streptococci (AEDL) and gl8L and their parental cultures were tested (AED) type 12 and (g18) of the type 19.The following mycoplasma cultures were used : Mycoplasma hominis 1, M . salivarium (cultures received from Dr. D. G . ff Edward, Kent, England), M . laidlawii, M . aguluctiae (cultures received from Dr. W. Kohler, Jena, Germany), mycoplasma isolated from tissue cultures Hep-2, CMH, HeLa, A-1. The methods used for these studies are given briefly in each section. ResultsThe comparative investigations of the morphology of L-forms and mycoplasma were conducted by phase-contrast microscopy combined with Zeitraffer filming. This technique permits observation of the peculiarities of microstructures and their development and multiplication. The cultures were inoculated on proper media under optimal conditions of growth for L-forms and mycoplasma and observed with different types of cameras.As is known, the absence of a rigid cell wall in the L-forms of bacteria and mycoplasma conditions their polymorphism and plasticity. In the structure of the colonies, we, as well as other scientist^,"^ observed granular and globular *

Forty patients in general practice with rheumatoid arthritis or osteoarthritis were identified as suffering from moderate pain and tenderness and moderate stiffness in excess of 30 minutes. After discontinuation of non-steroidal anti-inflammatory drugs for 2 weeks, a crossover study was conducted comparing the benefits of flufenamic acid, 100 mg, four times daily with placebo. At the same time, paracetamol at a dose up to 8 x 500 mg daily, could be used for pain which the patient judged to be unrelieved. Thirty-four patients completed the two 3-week test periods and twenty-one patients were improved in relation to morning stiffness and pain by flufenamic acid and twelve patients by placebo--a difference greater than would have occurred by chance (p = 0.05). At the same time, paracetamol consumption was reduced significantly fron a mean of 91.29 tablets to 60.68 tablets for each 3-week period. Side-effects occurred in ten patients on placebo and fifteen patients on flufenamic acid. One patient on each medication had to discontinue for multiple side-effects. Diarrhoea occurred in two patients on flufenamic acid and in one patient on placebo. Flufenamic acid is clearly effective and side-effects do not occur more often than would be expected by chance when compared with placebo.

A double-blind trial was carried out in 12 patients with chronic recurring tension headache to compare the effectiveness of treatment with an analgesic combination ("Syndol") and placebo. Treatment was confined to the period of an attack and the response in the 46 attacks studied showed that, in those of mild to moderate severity, significantly more patients had initial relief within 15 minutes after active treatment than after placebo, and significantly fewer tablets were required to produce complete remission of symptoms for more than 48 hours. The interval between attacks, however, was not significantly affected by active drug or placebo. Severe attacks, which occurred only in the periods assigned to active treatment, required significantly more tablets and a day longer for complete remission.

A double-blind study of terfenadine and placebo in 110 patients suffering from hay fever (confirmed by skin tests) was conducted. A novel technique was applied using an escape envelope containing a reference drug which could be taken under controlled conditions if, after 48 hours, the patient experienced no relief. Significantly more patients on placebo opened the envelope than patients taking the active drug. Terfenadine was demonstrated to be an effective drug in hay fever and produced no more drowsiness than placebo.