Respiratory muscle weakness in Charcot-Marie-Tooth disease. A field study.

A field study on respiratory muscle function and basic pulmonary mechanics was conducted at an international convention of 200 individuals with Charcot-Marie-Tooth disease. Forty patients with respiratory symptoms were evaluated; 15 had significant respiratory muscle dysfunction and 25 were normal. The results suggest that proximal upper limb involvement in individuals with Charcot-Marie-Tooth disease is a simple but significant predictor of respiratory muscle dysfunction.

Of mulattos, mischlinge, and Minsky's machines.

Hegel once remarked that "what experience and history teach us is that people and governments never have learned anything from history or acted on principles deduced from it." Historically, efforts to define a human being sufficiently equipped biologically or politically to meet a set of factitious standards for inclusion in the community of mankind have invariably resulted in unspeakable injustices. The continuing exclusion of the human fetus from this community is another (and the latest) tragic example of the historical myopia of which Hegel spoke.

PIP: The search for answers to the question of how to classify, measure, and define human life has an ignoble history contaminated by political rather than moral considerations. In the US during slavery, in Nazi Germany, and in South Africa, those defined as nonwhite have been classified as nonpersons. The unspeakable social and political injustice inherent in theses chapters of history is echoed in current efforts to define the point at which a fetus becomes a human being. The 1973 US Supreme Court ruling authorizing abortion introduced the concept of viability as the criterion for human life. At the time, viability was generally considered to commence at 27 weeks; however, recent advances in neonatal intensive care technology have since reduced this to 23 weeks and, by the year 2000, viability should be in the 12-week range. This trend has led to a new standard for personhood--sufficient brain development to permit consciousness. The absurdity of this approach is demonstrated by reference to the rapidly developing artificial intelligence field. Leaders of this field assert that the difference between humans and computers is only a matter of degree; they are 2 species in the genus of information processing systems. Given the ability of supercomputers to reprogram themselves, possess artificial senses, and even produce offspring, the question of whether robots should be granted civil rights arises. To carry the consciousness standard to its logical conclusion, once technology makes it possible to extend a microcomputer cable to an 8-week fetus, that fetus should qualify for personhood. All such efforts to define a human being on the basis of its ability to meet a set of factitious standards are bound to lead to unspeakable injustices.

Vacuum aspiration for second-trimester abortion not recommended.

QUESTION: Recently I observed the use of vaccuum aspiration in an attempt to induce abortion in a woman 16 weeks' pregnant, after dialation of the cervix to 14 mm under paracervical block anesthesia. Only amniotic fluid and a segment of the umbilical cord could be aspirated. The patient was returned to bed, and an oxytocin (Pitocin) infusion was begun. She aborted 24 hours later with no complications. Why is this procedure considered inferior to amniocentesis and saline solution instillation as a technique for inducing abortion? ANSWER: Transcervical rupture of the fetal membranes for the purpose of inducing second trimester abortion is unreliable as a method and is fraught with the most serious complication of intrauterine infection (Schwartz, R.H.: Septic abortion, Philadelphia, J.B. Lippincott, 1968, p. 17). On the other hand, Roufa et al. (Clinical Obstetrics and Gynecology 14:119, 1971) report no failures of abortion and only 1 significant intrauterine infection in 229 patients aborted in the second trimester by the hypertonic, intraovular, saline solution instillation method. The cervicovaginal portion of the reproductive tract is bacteriologically a contaminated area teeming with a variety of organisms. White and Koontz (Obstetrics and Gynecology 32:402, 1968) cultured the cervices of 57 pregnant women in all trimesters of pregnancy, and a significant number of these women harbored pathogens. In general the skin is preferable to the cervicovaginal tract as a route of entry into the intraovular space.