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suMMARY A double-lumen tube with a mercury weight attached to its distal end was positioned in the small intestine of six subjects who were to undergo an elective laparotomy. The tube and the technique for its localization were exactly similar to those used in previous intestinal perfusion experiments.Marked 'concertinaing', or gathering of the small intestine proximal to the mercury weight, was seen at laparotomy in all six subjects. The ratio between the mean intestinal length from the mercury weight to the ligament of Treitz after removal of the tube to that with the tube in situ was 3.0 (2.5-3.8). Mean total jejuno-ileal length was 421 (320-521) cm. In five of the six subjects the distal end of the tube was more than half way between the ligament of Treitz and the ileo-caecal valve although it was only 100-120 (mean 108) cm from the incisor teeth.Segmental perfusion studies of the human jejunum involve a much longer length of small intestine than is generally assumed-by a factor of approximately 3. Such studies assess absorption rates over a substantial proportion of the small intestine and are not confined to a short segment of proximal jejunum. The nutritional significance of such studies in which amino acids, peptides, and carbohydrates are investigated is increased. Studies designed to measure absorption rates from the ileum should be treated with caution as part or all of the perfusion segment may be past the ileo-caecal valve.Gathering or 'concertinaing' of the small intestine as a response to an intraluminal tube is well recognized (Hirsch, Abrens, and Blankenhorn, 1956;Shields, 1972). Double or triple-lumen tubes are frequently used for estimating absorption rates of amino acids, peptides, carbohydrates, electrolytes, and water from the human small intestine, and

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Impetigo, a contagious superficial pyogenic infection of the skin, can be treated orally or topically. Nowadays oral erythromycin is the treatment of choice, although flucloxacillin is preferred in areas where the causative micro-organisms are resistant to erythromycin. Topical mupirocin ointment has shown itself to be as effective as oral therapy in many cases and is less likely to be associated with unwanted effects. The availability of 2 forms of therapy-oral and topical-means that treatment can be tailored according to the preferences of the patient. Consequently, drug therapy is more likely to be used appropriately. Arguments for and against the prescribing of each form of therapy are presented.