Progressive external ophthalmoplegia and heart block.

and parents do not consider aspirin as a drug and they should be questioned specifically about salicylate ingestion. Often it is admitted only after three or four sessions of history taking or when relatives other than parents are quesgtioned. Salicylates are valuable in ,t-he treatment of acute rheumatism and rheumatoid arthritis but are grossly overprescribed for relatively trivial and self-limiting conditions in childhood. The medical profession must shoulder responsibility for this, particularly those doctors who prescribe aspirin for children without examining them. Moreover, aspirin is easily obtainable without prescription and i,ts value is constantly extolled in advertisements. The dangers of chronic aspirin ingestion by adults are well recognized and every paediatrician is aware of ithe perils of acute aspirin poisoning. It is also well known that 70% of adults who take aspirin over a long period lose about 2 ml of blood per day but there have been no studies of the effects of chronic aspirin ingestion on normal children. These cases reported here emphasize that chronic aspirin ingestion in childhood is not uncommon, often goes undetected, and may cause serious anaemia.