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THE THIRD INTERNATIONAL CONGRESS ON CHILD ABUSE AND NEGLECT

in the rate, but this may have been effected by those who withdrew because of timolol side effects. "Sudden death" was defined in this series as death within 24 hours of the onset of new symptoms of heart disease or unwitnessed deaths and may thus include a number of mechanisms. It would be interesting to know if the reduction in sudden death occurred in any particular subgroups of the treated and placebo groups for example, smokers. Further, the reduction in infarction in the first six months suggests other factors may be relevant. Does it mean that, after a myocardial infarct, all patients should have beta blockers in the absence of a reason to the contrary, and if so for how long? The trial does not answer this question and requires further analysis and discussion. Certainly it will lead to the more widespread use of beta blockade after myocardial infarction. Since twenty-nine per cent of the patients withdrew because of side effects, it is to be hoped that we can soon identify those who are at increased risk for sudden death and for whom a beta blocker may become part of the normal care. JOHN B. HICKlE.