JAN. 26, 1963 CORRESPONDENCE able to give a detailed account of the acoustic and visual illusions or hallucinations he had experienced. Some of his observations depended on the posture of the head. It took 24 hours to get the patient back into a normal mental state. Another patient with a carcinoid syndrome treated with 1 g. of aldomet a day showed a markedly increased sleeping tendency and some motor retardation during the use of the medication. In both cases the removal of the drug caused a reversal of the symptoms observed, which prompted us, however, to warn against the use of a-methyldopa in the carcinoid syndrome in patients who are not hospitalized or under close medical supervision.2-1 am, etc.,

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average superannuable income of the 80 main Swansea principles for the year ended March 1974, a figure which included seniority payments. Published surveys have suggested that the local work load is up to twice the national average. Since April 1974 reorganization has brought all sectors of the profession into management participation with an everincreasing number of managers in the Health Service whose duties and salaries are published. The nearest managers to the general practitioner are those at district level and the regional medical officers. For a five-day week they average a superannuable income of £7,500. General practitioners, with other clinicians, provide more than a five-day service but are unique in having to provide their own locums for sickness, study, and annual leave from income; and since reorganization participation in management through a host of new advisory committees, completely unpaid, make further inroads into the unsocial (leisure) periods. Kindersley recognized a shortfall in remuneration from 1966 which is still uncorrected and increasing. Achievements with dynamism, buying added years, and threshold awards are only tinkering with the problem when the basic contract is faulty. We owe a duty to our dependants and successors to correct the discrepancy or our principal concern, the patient, will find the standard of his primary care in jeopardy.-I am, etc.

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