EUGENE GARFIELD INSTITUTEFORSCIENTIFICINFORMATION- 3501MARKETST,PHILADELPHIA,PA19104 The 101 Most-Cited Papers from the British Medical Jownd Highlight the Important Role of Epidemiology in Medicine

Number 7 February 16, 1987 The British Medical Journal began pub- Medical Journal, but of these only 20 per- lishing in 1840 as the organ of the Provin- cent are eventually published.s (p. 243) The cial Medical Association (PMA), a group current editor, Stephen Leek, who authored of physiciartspracticing in the provinces out- a 1985 book on peer review in medicine,4 side England’s major cities. They had follows extensive refereeing practices (a re- banded together in 1832 to share their indi- cent review of which appears in a 1986 ar- vidual medical experiences with one another ticle in Schokwly Publishing.s) He alw sub- in much the same fashion as the metropoli- scribes to the rule promulgated by Franz tan physicians who had earlier formed their Ingelfinger, former edkor of the New En- own society and journal. The PMA”s first gland Journal of Medicine. The essence of periodical was called 7he Provincial Medi- the Ingelfinger rule is that articles submit- cal arrd Surgical Journal; in 1853 it merged ted to a journal cannot have been previous- with the Lmdon Journal of Medicine to be- ly published in, or be simultaneously sub- come the Association Medical Journal. Four mitted to, other joumals.b The British Med- years later the PMA acknowledged its grow- ical Journal is also a founding member of ing memkaship throughout Great Britain by the frstemational Committee of Medical renaming the society the British Medical Journal Editors-the Vancouver Group— Association. The journal was rdso re- which is responsible for issuing the Uniform named. 1Today the British Medical Journal Requirements for the Submission of Manu- is the third largest general medical journal scripts to Biome&cal Journals and guidelines in the worldz and, as the official organ of on multiple publication. These requirements the British Medical Association, is sent free are now followed by over 300 biomedical to its 70,000 members; the journal also journals throughout the world. has over 20,000 nonmember subscribers Since 1840 the British Medical Journal throughout the worlds (p. 239) has published over 50,000 papers, letters, This weekly journal primarily publishes and other items. In this study my ISI” col- peer-reviewed, clinically oriented papers in- leagues and I identified and then examined tended to “educate, inform, and entertain” the 101 British Medical Journal items most physicians from academia to general prac- cited in the 1955-1985 Science Citation tice to administration. These papers consti- Index@ (NY ). (See Bibliography.) Of tute about half of the journal’s pages each these, 99 are research papers and 2 (W.J. week. The remaining pages of the journal Irvine and A.W. Liley) are notes published comprise letters, book reviews, social-pol- in the preliminary communications section icy articles, topical items, and “leading ar- of the journal. The citations received by the ticles” commissioned to keep physicians up- 101 items range from 182 to 803. The me- to-date with the latest advances in medicine dian citation rate is 240. The notes received and to explain their uses in clinical settings. 186 (Irvine) and 264 (Liley) citations. Every year over 5,000 items, including The articles in the Bibliography represent 2,900 letters, are submitted to the British over 5 percent of those.British Medical Jour-

40 mzl items cited at least 50 times in the Worcester Royal Infh-mary, the paper dis- 1955-1985 SCI. Table 1 provides the cita- cusses campylobacter enteritis. tion breakdown, by groups of 100 citations B.N.C. Prichard and P.M.S. Gillarn, or less, for those British Medical Journal University College Hospital Medical articles cited 50 or more times. Only 9 items School, University of London, authored have received 400 or more citations; 28, “Treatment of hypertension with propran- more than 300; and 73, at least 200 citations. 0101,” the third most-cited paper, with 520 The majority of the articles-1 ,029—were citations. This 1969 paper continues to be cited between 50 and 74 times. cited— 12 times in 1986. As yet, the authors of these three papers Methods have not published commentaries in the As mentioned earlier, the 101 articles Cita~ion Ckzrsics series that appears in Cur- were chosen by examining citation data rent Contents” each week. These are auto- culled from the 1955-1985 SCI. Only cita- biographical accounts of informal events tions from journals and other serials are in- leading up to a paper’s publication. How- cluded. While the SCZdoes include citations ever, Alice M. Stewart, Department of So- to textbooks and other monographs, they are cial Medicine, University of Oxford, one of not treated as sources. The purpose of this the authors of the fourth most-cited article, analysis was simply to ident@ the 1(K)most- did comment on the survey of childhood ma- cited “classic” articles from this prestigious lignancies she wrote with Josefine Webb and medical journal. Using citation counts as the David Hewitt, also then at Oxford. Accord- sole selection criterion, we previously iden- ing to Stewart’s commentary, their work tified a similar series of Citation Classicsw was “a triumph for a small group of epi- for the Annals of Internal Medicine,7 demiologists... [who] were anxious to dis- JAMA-Joumal OJthe American Medical cover why the post-war increase in leuke- Association,8 Z%e Lmcet,g and the New mia had produced an early peak of leuke- England Journal of Medicine. 10No hypoth- mia mortality consisting only of lymphatic eses were proposed about the types of items cases, but.. even with the increase, leuke- that might appear in the list. mia remained a rare cause of childhood Selection of papers was limited by the 31 deaths. ” An association between fetal irra- years of citation data covered by the diation and cancer was later identified by the 1955-1985 SC1. Understandably, older pa- group. 12 pers that received the bulk of their citations The fifth most-cited work, by Martin G. prior to 1955 were not identifkd. This prob- Lewis, Chester Beatty Research Institute, lem will be remedied, however, once the Institute of Cancer Research: Royal Cancer SC1 is extended back to include citations Hospital and Royal Marsden Hospital, Lmn- from papers published in the first half of the don, and six colleagues, has been referenced twentieth century. 445 times since 1969. In his commentary Lewis says that this work “resulted in one Five Most-Cited Papers and Citation of the first detailed studies of humoral im- Ckssics munity in a human tumor system. ” 13At the The most-cited paper in the Bibliography, end of his commentary, which illustrates the by Andrew W. Kay, Western Intlrmary, type of information not usually included in University of Glasgow, Scotland (803 cita- scientific papers and that authors are encour- tions), describes the ‘‘Effwt of large doses aged to share in Citation Classics, he also of histamine on gastric secretion of HC1,” relates the sad news that three of his or’ ‘the parietal cell response in man to large coauthors-D.C. Bodenham, R.L. Ikono- doses of histamine. “~ 1 It is now over 30 pisov, and G. Hamilton Fairley–are de- years old but continues to be cited occasion- ceased, the latter the victim of a terrorist ally. The second most-cited work is of mom bomb attack in London. 13 recent vintage. Published in 1977 by Seven additional papers in the Bibliogra- M .B. Skirrow, Public Health Laboratory, phy, two coauthored by W .H. W, Inman, Table 1: Citation-frequency distribution of Bn”tish Research at Mill Hill. His autobiographyl’t Medical Joumd articles cited 50 or more ties in the has recently appeared. While the number of 1955-1985 SCF. A total of 1,969 articles were distinguished physicians in the Bibliography examined. Percent of Tutat is obvious, the Nobel Prize reflects basic Number of Number of Articles preclinical research. Citations Artidea Examined Exactly 303 authors appear on the 101pa- pers. Doll is listed on 11of these, while Ves- 5(KI 4 0.2 400-499 5 0.3 sey wrote 5, G.M. Besser and A.B. Hill 300-399 19 1.0 each are represented by 4, K.G.M.M. Al- 200-299 45 2.3 berti, R. Hall, Inman, and A.S. McNeilly 100-199 432 22.0 75-99 435 22.1 authored 3 each, and 23 authors wrote 2 pa- 50-74 1,029 52.3 pers. Many of the papers by these authors are companion pieces on the same subject Committee on Safety of Medicines, London, about the relationship of oral contraceptive published back-to-back in the British Medi- use to thromboembolic disease, have been cal Journal (N. Hurwitz, J.I. Mann, Speizer) or similar papers published within discussed in Citation Classics commentar- ies. The other five papers were authored by a year of one another (I. Aird, Doll, Ves- D.J.R. Laurence, M.O. Thorner, F.E. sey); three of Doll’s works contain the re- Speizer, M.P. Vessey, and B.M. Wright. sults of an originrd study (two 1964 papers) Vessey’s paper, coauthored with Sir Richard and a follow-up published in 1976. Doll, also discusses oral contraceptives and However, each of these “paired” papers venous thromboembolism. Vessey, inciden- contained enough unique information that tally, is also coauthor on both of the Inman researchers cited them more often by them- articles. selves than in conjunction with their com- panion papers. For example, 101 articles co- Author Information cited both of Aird’s papers that examine the Numerous studies at 1S1have demonstrat- relationship of blood groups to various types ed that Nobel Prize winners consistently of cancer. The 1953 paper received an ad- publish classic papers. However, only one ditional 213 citations and the 1954 article, of the authors in the list of 101 British Med- 165 citations from 1955 to 1985, Doll has ical Journal articles, Sir Peter Brian Med- threx papers in the Bibliography that discuss awar (UK), is a Nobel laureate. He was mortality in relation to smoking. Thirteen honored in 1960 with Sir Frank Macfarlane articles eo-cited these papers. However, 162 Bumet (Australia), recently deceased, for co-cited the two 1964 papers. their discovery of acquired immunological The two Hurwitz papers in the Bibliog- tolerance. Medawar is represented in the raphy were published back-to-back in the Bibliography by two papers written with first British Medical Journal in 1969, but they authors R.E. Billingham, then at the Uni- have been co-cited in only 32 articles. How- versity of Birmingham, and L. Brent, Na- ever, Mann’s articles on oral contraceptives tional Institute of Medical Research, Medi- and myoeardial infarction, also published cal Research Council (MRC), London. consecutively, in a 1975 issue of the jour- These works discuss skin homografts and nal, were co-cited together in 127 papers, tissue transplantation, activities that proved while Speizer’s two papers were similarly important to the later Nobel Prize-winning co-cited in 122 articles. The full citation research on acquired immunological toler- count for each paper can be found in the ance. According to Medawar, “he was ter- Bibliography. ribly sorry that the [Nobel] distinction could not be so far subdivided as to have includ- Multiple Authorship and Age of Papers ed my friends Bill [Billingham] and Leslie In the past 20 years various scholars have ~rent]. ”14 (p. 137) noted a growing trend toward multiple au- Until his recent illness, Medawar was di- thorship of scientific papers. Papers pub- rector of the National Institute of Medicrd lished in journals such as 7ke Lancer, New 42 England Journal of Medicine, Annals of In- example, the University of London, listed ternal Medicine, and Surgery, Gynecology, 54 times by authors in the Bibliography, in- and Obstetrics have all experienced a rise cludes 13 papers from St. Bartholomew’s in mean authorship in the last decade. 15-17 Hospital Medical College, while the MRC, In this study only 12 papers list just one with a total of 21 papers, has 10 from its author. Of the remainder, 31 have 2 authors; Biostatistics Unit in Cambridge. 18, 3; 18, 4; 8, 5; 2, 6; 3, 7; 3, 8; 4, 9; 1, 10; and 1, 11. Of course, the group of Table 3: Itemized breakdown of the three affiliations papers in the Bibliography is only a small that appear most often in the Bibliography. sampling of articles drawn from just one Nmnber of T:mes journal, and the papers’ publication dates are Instkutinn Appeared Name of in the clustered rather heavily in two decades. Institution Bibliography Forty-three articles were published in the 1970s, 38 in the 1960s, and 18 in the 1950s. University of Lmndon 54 Table 2 provides the chronologic distribu- St. Bartholomew’s Hnspikd Medical 13 tion of all 101 papers by decade of publi- College cation. Universi~ College Hospital Medical 12 Schonl Table 2: Chrono[ogic distribution of publication dks King’s College Hospital Medical 7 of the 101 British Medical Jourrwl papers mnst cited Schnol in the 1955-1985 SCP. Royal Postgraduate Mtilcal Schnol 7 Decade of Number of London Schonl of Hygiene & Tropicsl 4 Publication Papers Medicine Middtesex Hospital MdlceJ Scheol 4 1920s 1 2 1930s o Guy’s Hnapitsl Medical Schonl St. Tbomss’s Hospitat MdIcal Schnnl 2 1940s o 1950s la Institute of child Health 1 London Hospital Medical College 1 1960s 38 St, Mary’s Hospital Medical Schnol 1 1970s 43 19s0s 1 MRC (Medical Research Council) 21 T.J. Crow, Division of Psychiatry, Clin- ical Research Centre, MRC, London, wrote Bkoststistics Unit, Cambridge 10 Nationel Institute of Medical Research, 3 the most recent paper in the Bibliography, London a 1980 review on the moiecular pathology Clinical Effects of Rallation Research I of schizophrenia. It is the ordy paper in the Unit, Edinburgh Clinical Research Cenere, London 1 table from the 1980s. The oldest paper is Demyelinating Disease Unit, 1 A. Cecil Alport’s 1927 article on ‘‘Heredi- Newcastle upnn Tyne tary familial congenital hemorrhagic ne- Epidemiology Unit, CarrMf 1 Gastroenterology Unit, f.modon 1 phritis, ‘‘ cited 235 times between 1955 and Group Metabnlic HaemndynsrrricLker 1 1985. The second oldest paper, from 1951, Disease, f..ardon was mentioned earlier, authored by Billing- MRC 1 Snciai Medical Research Unit, London 1 ham, P.L. Krohn, and Medawar. Geographic and Institutional Information University of Oxford 13 Alport was affiliated with the University Rsdcliffe Infnnsry 6 of London, St. Mary’s Hospital Medical Department of SUCisland Community 2 School, 1 of 73 institutions listed by the au- Medicine Nuftleld Department of Clinical Medcinc 2 thors of the 101 papers. Seventeen of these Department of Phsnnacology 1 affiliations appear more than once in the list. Department of Sncial Medicine 1 The three with the greatest number of papers University Mrnratory of Physiology 1 are the University of London, the MRC, and the University of Oxford. These institutions All the institutions represented are located in turn represent many smaller colleges and in just 12 countries; not surprisingly, the UK schcmls, which are itemized in Table 3. For has the greatest number of papers-90. The Table 4 Geqraphic areas reprewnted by tie 101British troversial research. See, for example, our Medical Journal papers most cited in the 1955-1985 SCf@, in descending order of the number of papers recent study of the 100 most-cited papers from JAJL4-Jownal of the American Med- ical A.ssociation,a which compared their landmark Serieslg to our list of 100 articles. The citation and source-item data con- tained in the SC1and used in this study can UK 90 6 Australia, Bulgaria, also be separated into spcxific categories for Denmark, S. Africa, Sweden. US more sophisticated analyses of journals and England 82 articles. For example, the types of journal Scotland 6 items-letters, original articles, reviews, and N. Ireland 3 Wales 3 so on—that give out and receive references Denmark 4 1 Sweden, UK can be identified, and then these can be ex- Sweden 4 3 Denmark, UK, US amined to ascertain which types are most Finland 30 us 3 2 Sweden, UK cited. Impact factor, the average number of Australia 2 1 Bulgaria, UK citations given to a journal’s articles during S. Africa 2 2 UK a specified period of time, can also be cal- Bulgaria 1 I Australia, UK New Zealand 10 culated to help normalize the varying rates of citation between journals from different gap between it and the two next most-listed fields. Two recently published articles use countries-Denmark and Sweden with four SC] data, obtained from customized com- each—is quite large. (See Table 4.) Accord- puter printouts prepared by 1S1,to examine ing to the British Medical Journal, about 25 generaJ medical journals such as the British percent of the articles they now receive and Medical Journal and the New En@mdJour- publish every year are from authors over- nal of Medicine. lg,zo seas.’2 Unfortunately, it is not within the scope Conch3sion of this essay to discuss all the different ways that Xl data can be used to analyze articles This concludes our study of the 101 most- and journals. cited Bn”tish Medical Journcd items. While citation counts alone do not always identify My thanks ~ A~ig~il k. &ssom, Karen important papers, they can help us quickly Maguire, and Giliian Wilson for their help recognize articles that contain lasting or con- in the preparation of this essay. @lea?1s( rttm NCES 1.BonthC C. Medkatcnnumudcrtion.rtmold andthe new ! development of medical jcwnals in Bntam. Bril. Med. J. 285:105-8, 1982. 2. Somethingof ourselves.Bnr. Med. J. 2SI: 1306, 1980 3. Grey-T&er E & Sntherfand F M. History of rhe Bri/i~h Medical ,4mocuuion. Vol. II. 1932-19SI. Lxmdon: British Medical Association, 1982. 375 p, 4. Lock S. A dij?culr balance. London, Nuftield Provmcml Hospmds Trust, 1985. 172 p. 5. hk S & SmithJ. P.xr revmvat work.Scholarly Pub/. 17,343-16, 1986. 6. The rules of the game, Bn’t. Med. J. 289:1475-5, 1984. 7. Garffeld E. 101 Cimtion Cfo.rsics from AnnaLr of Intend hfedicuw. .%ays of an injlxmtion xciefuut. the awards of science and OIher essays. Philadelphia: 1S1 Press, 1985. Vol. 7. p, 374-84 8 —-—. DM hundred Citation Cfassicr from 7he Journal of the dmmican Medical -?xm”m’on. JAMA-J, AM. Med. Assn. 257(1):52-9, 1987, 9. —. ItIll classics rlnm lke lzrneer. Op. nr. Vnl. 7. p. 295-305, 10. —. 100classics fmm the New E@md Journal of Medicine. fbid. p. 186-93. 1 I. Kay A W. Effectof large @es of hisrrmrine on gasuic secretion of HCI. BriL Med. J. 2:77-80, 19.53. 12. Stewart A M. Citation Classic. Commentary on Brh. Med. J. I 1495-508, 1958. flkurert J T, cd, ) rlmwmporary cfamics in clinical mediciiw. Philadelphia 1S1 Press, 1986, p, 123. 13. Lewis M G. Citation Classic. Commentary on Brir. Med. J. 3:%7-52, 1%9. Current Comenfs/2#e Science-$ 28(16): 19, 22 April 1985. 14. Me&war P. Mmzoir’ of a thinking radish. Oxford, UK: Oxfnrd University Press, 1986.209 p. 15. Strub R L & Black F W. Letrer to editor. (Multiple authorship.) .hncef 2; IOW- i, 1976, 16. Bin-man K D. ,’Hanging from the masthead”: refledinns on authurahip. &m. lnlem. died. 97:.5Q5, 1982, 17. Dardik H. Muttip!r authorship, Surg. Gynecol. Obsrer. 145:418, 1977. 18. Meyer H S & Ltmdkq G D, da. Fijyons Lvw?mark arricks in medicim: !& JAMA cenrenniai series. Chicago, IL .American Medical Asmciadon, 1985.486 p. 19. Garneld E. Which medical juwnats have Ore greatest impact? AM. fntem. Med. 105:313-20, 1986, 20. Sfraw J G. Citation anatysis of mcdicd journals published in 1977. On press. )

44 BIBLIOGRAPHY The 101 most-cited Bridsh Medical Journal articles from the 1955-1985SCP, in alphabetic order by first author, Asterisks (*) indicate articles with CirrrdonCkz.r.rics@commentaries. The issue number, year, and edition of Cur- rent Crmrents” in wh!ch these commentaries appeared are in parentheses. Readers should be aware when scanning this table that the Bridsh Medicaf Joumof’s system of numbering each volume changed in 1980 frnm a yearly cycle of volume numbers to a consecutive volume numbering system cm’ricdover from one year to the next. They starred with #280 rather tharr #1 tn account for the earlier volumes of the journal that had been numbered 1, 2, 3, or 4 each y=.

19s5-198s citations Bibfiographk Data

314 Akd I, Bentalf H H & Fraser Roberts J A. A relationship between cancer of stomach and the ABO blond groups. Brif. Med. J. 1:799-801, 1953. Univ. London, Roy. Postgrad. Med. Sch. and Londnn sch. Hyg. Trop, Med., England, 266 Aird 1, BentaU H H, Mehigaa J A & Fraser Roberts J A. The blood groups in relation to pqrtic rdcerarion arrd carcinnms of colon, recrom, breast, and bronchus, Brir. Med. J. 2:315-21, 1954. Univ. London, Roy. PostWad. Med. sch. rmd London Sch. Hyg. Trop. Med.; Burden Neurnl, fnst., Merit. Res. Dept., Bristol, England. 280 Afexanderaon B, Evans D A P & S]nqviat F. Steady-state plasma levels of nortriptyline in twins: influence of gerretic factors srrd dmg therapy. Brif. Med. J, 4:764-8, 1%9. Ksrnlinska Inst., Dept. Phannaccd., Stnckholm, Swedeu Univ. Liverpml, England. 280 AlfkanrrA C. Prnteztion afforded by sickfe-cell trait against subtertian malarial infection. Brir. Med. J. 1:290-4, 1954. Univ. Oxford, Radcliffe Infirm., England. 235 A@urt A C. Hereditary famifial congenital haemnrrbagic nephritis. Btif. Med. J. 1:504-6, 1927. Univ. Lmrdnn, St. Mary’s Hosp. Med. Sch., England. 407 Asberg M, Crorrhofm B, Sjnqvkt F & Tuck D. Relationship between plasma level and therapeutic effect of rrnrtriptylirm Brit. Med. J. 3:331-4, 1971. Ksrolinska Inst., Dept. Psychiat., Stockfroti, Linkoping Univ., Sch. Med., Sweden. 272 AtMme H, Hayward J L, Kkrgman D J & Wayte A B. Trcamr+nt Of r=lY br~st c~cer: a repnrt after ten years of a clinicaJ triaf, Bn”t. Med. J. 2:423-9, 1972. Univ. London, Guy’s Hosp. Med. Sch., England, 313 Be$aer G M, Parke L, Edwards C R W, Fnreyth I A & NfcNeiffy A S. Gafactomhoea: successful treatment with reduction of plasma prolactin levels by bcnm-ergncryptinc. Brif. Med. J. 3:669-72, 1972. Univ. Lzmdon, St. Bartholomew’s Hosp. Med. CoIl., Univ. Reading, Natf. Irrst, Res. Dairying, England. 197 Bigga R, Dougkm A S, Macfarlane R G, Dacke J V, Pitney W R, Merskey C & O’Brfen J R. Christmas disease. A cotilrion previously mistaken for hemophilia. Brif. Med. J. 2:1378-82, 1952. Univ. Oxford, Radcliffe Infirm.; Univ. London, Roy. Postgrad, Med. sch.; South Devon E@ Comwsff Hosp., Plymouth, Engfand; Univ. Capetown, ScmehAfrica. 188 14kfflrrghamR E, Krobrr P L & Medawar P B. Effect of corrisrme on survivsf of skirr homografta in rabbits. Bn’t, Med. J. I: 1I57-63, 1951. Univ. Birmingham, Depts. Znol. and Anat., England. 182 Brent L & Madawar P B. Tksue transplantatinrx a new apprnach to the “typing” problem. Brir. Med. J. 2:269-72, 1%3, MRC, Natk. Inst. Med. Res,, London, Engfrmd. 328 Bullen J J, Rogers H J & LA@ L. Iron-birrdhg proteins in milk and res~sram!eto Kcclw?chia coli irrfection in infants. Brit. Med. J. I :69-75, 1972, MRC, Natf. brst. Med. Res., London, Engfsn& Dept. Agricult. Fkheries Scotfsod, Rowett Res. Inst., Aberdeen, Scotfrmd. 236 Burn J H & Rand M J. Noradmrrafinein artery wefls sod its dispaaal by resecpirre Brir. Med. J. 1:903-8, 1958. Univ. Oxford, Dept. Pharmscol., Engfsrrd. 224 Caltre D B, Teycherme P F, Cfaverfa L E, E.@man R, Greenacre J K & Petr& A. Bromocriptirre in Parfdnsonism. Brir. Med. J. 4:442-4, 1974, Univ. fmndon, Roy. Postgcad. Med. Sch., England. Caaprrry E A & Ffefd E J. Specific lymphncyre sensitization in carrcer: is there a common antigen in irumsn mrdignant ncojdasia? Bolt. Med. J. 2:613-7, 1971. MRC, Oemyelinating Dis. Urtit, Newcm+rkeupon Tyuc, Enghutd. 227 CbamberMn D A, White R J, Howard M R & Smkth T W. Plasma digoxin concentrations in patients with are’ialfibrillation. Brit. Med. J. 3:429-32, 19’70.Univ. Lmrdnn, St. Bartbnlomew’s Hosp. Med. CoU., f3n@n& Massachusetts Oen. Hosp., Cardiac Unit, Buston, MA. 199 CO&.m A J, Sp@ W G S, Mackk R M & Thomas C E. Postoperative depression of tUlOOUr- directed cell-medated immunity in patierxa with mahgnarrt disease, Brir. Med. J. 4:67-70, 1972. Univ. Glasgow, Depts. Patbol. and Dermstol., Scotfsnd. 284 Coltart D J & Shand D G. Plasma propranolol levels in the quantitative assessment of& adrenergic blockade in mrm, Brir. Med. J. 3:731-4, 1970. Univ. London, St. Bartholomew’s Hosp. Med. Colt., England, 208 Court Brawn W M & Dull R. Mortafhy fmm cancer and nther causes after rd]odrerspy for ankylosing spondylitis. Brir. Med. J. 2:1327-32, 1965, MRC, Clin. Effects Radiat, Res. Unit, Edkrburgh, Scotfan& Sioarat. Unit, Cambridge; Univ. London, Univ. Coil. Hosp. Med. Sch., England. 45 .- 1955-19s5 Citations Bibfingrrrpfdc Data 191 Crawhall J C, Scowerr E F & Watta R W E. Effect of penicihrnine on cystinuria. Brit, Med. J. 1:588-90, 1%3. Univ. London, St. Bartholomew’s Hosp. Med. Coil., England, 182 Crow T J. Molccufar pathology of schizophrenia: more than one disease prncess? Brh. Med. J. 280:66-8, 1980. MRC, Clin. Res. Crr., London, EngJand. 192 Crowther D, Powlea R L, Bateman C J T, Beard M E J, Gauci C L, Wrigley P F M, Malpaa J S, Fairley G & Scott R B. Management of adult acute myelogenous leukaemia. Brif. Med. J. 1:131-7, 1973. Univ. Landon, St, Bartholomew’s Hosp. Med, Call,; Imperial Cancer Res. Fund, Dept. Med. Oncol.; Inst. Cancer Res.: Roy. Cancer Hosp., Roy. Marsden Hosp., London, England. 187 Cudworth A G & Wnodrow J C. Evidence for HL-A-linktzl genes in “juvenile” dlahctes mellitus. Brit, d-fed J. 3:133-5, 1975. Univ, Liverpnnl, Dept. Med., England. 306 Davidann W M & Robertson Smith D. A morphological sex difference in the pelymorphonuclear neutrophil leukocytes. Btir. Med. J. 2:6-7, 1954. Univ. Lmrdon, King’s CoIl. Hosp. Med. Sch., ErrgJand. 251 Dent C E. Some problems of hyperparathyroidism. Brir. Med. J. 2:1419-25, 1%2, Univ. London, Univ. CoIl. Hosp. Med. Sch., England, 333 Dent C E, Richerra A, Rowe D J F & Stamp T C B. Osteomalacia with long-term anticonvulsant thempy in epilepsy. Bri/. Med. J. 4:69-72, 1970. Univ. London, Univ. Coil. Hosp. Med. Sch. and St. Bartholomew’s Hosp. Med. COIL, England, 201 Drill R & Hill A B. A smdy of the aetiology of carcinoma of the lung. Erif. Med. J. 2:1271-86, 1952. MRC, Biostat. Unit, Cambridge; Univ. London, London Sch. Hyg. Trop. Med., England. 287 Doll R & Hill A B. Lung cancer and other causes of death in relation to smoking, Brir. Med. J. 2:1071-81, 1956. MRC, Biostat. Unil, Cambridge: Univ. Jxmdmr, London Sch. Hyg. Trop. Med., England, 385 Dell R & Hill A B. Mortality in relation to smoking: ten years’ observations of British doctors. Brif. Med. J. 1:1399-410, 1964. MRC, Biostat. Unit, Cambridge; Univ, London, Univ. Coil. Hosp. Med. Sch., England. 247 Doll R & Hill A B. Mortality in relation 10 smoking: ten years’ observations of British dnctors, Brir. Med. J. 1:1460-7, 1964. MRC, Wjostat, Unit, Cambridge; Univ. London, Univ. Coil. Hesp. Med. Sch., England. 357 Dell R & Peto R. MortaJity in relation to smoking: 20 years.’ observations on male British dnctom, Brir. Med. J. 2:1525-36, 1976. Univ. Oxford, Radcliffe Infmn., Engkri. 287 Elwnnd P C, Cnchrarre A L, Burr M L, Sweetnam P M, Wflimns G, Welsby E, Hrrghea S J & Renton R. A mndomized controlled trial of acetyl saJicylic acid in the secondary prevention of mortality from myocardisl infarction. Brir. Med. J. 1:436-40, 1974, MRC, Epidemiol, Unit, Cardiff, Wales; Nicholas Res. Inst., Slough, England. 312 Evans D A P, Manley K A & McKuaick V A. Genetic control of isoniazid metabolism in man. Brif. Med. J. 2:485-91, 1960. Johns Hopkins Univ., Sch. Med., Baltimore, MD. I86 Evered D C, Ormeton B J, Smith P A, HtdJ R & Bird T. Grades of hypethyroidism. Bn’f. Med. J. I :657-62, 1973. Univ. NewcastJe upnn Tyne, Depts. Med. and Clin. Binchem.; Roy. Victoria Infirm.; Newcastle upnn Tyne Hnsp,, Dcpt, Haemstol., England. 194 Fefix R H, [ve F A & Dahl M G C. Cutaneous and ocular reactions to practolol. Brir. Med. J. 4:321-4, 1974. Univ. NewcaatJe upen Tyne, Dept. 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