34 It is obvious that medical meetings are likely to be better attended when held in places such as New Orleans, Hawaii, or Aspen, Colorado, rather than in Memphis, St. Louis, or Cleveland. The American College of Chest Physicians is particularly adept in its choices, and its recent annual meeting in New Orleans was better attended than ever. While most U.S. cities, especially those in the Mid-West, are mirror images of each other, New Orleans is obviously different. Where else is one offered a mint julep or a plantation gin sling for breakfast ? Where else can one see an antique-dealer specialising in Sevres and Bavarian rococo furniture next door to an oyster bar with a drunk lying on the doorstep, and with the smell of rotting garbage
permeating everywhere ?
certainly
England
a
wise choice for
not sure are
now
SIR,-Your leading article, Dangerous Fever, (Nov. 16, 1184) deprecates consultant militancy as damaging to the Health Service, but misses the point that it is the very deterioration in the Service which is the root cause for consultant concern. The damage has already been done by inflation and social change, and the process will accelerFew of us believe that in this day anything short of ate. militancy will produce the public awareness and political reappraisal necessary to prevent further collapse. The problems run far deeper than arguments about money and contract terms, which simply reflect immense frustration and a feeling of fighting for survival. We have been pointing out for more years than we can remember the growing shortage of trained quality nurses, the high proportion of foreign junior staff, the disparity between
a
Now
work-load, and the grossly exaggerated doctors choose to work in attempting " to preserve and restore " the service. Tinkering with the problems makes them worse; for example, reducing junior hours without increasing staff or reducing the workload eventually leads to costly overtime, or inefficiency, waste, and a poorer service. The solution like the problems must be far-reaching. If a greater proportion of the national income cannot be allocated to health then we must accept that the country can afford only a limited service and decide how it is to be limited. We must look again at alternative ways, including contributions from patients, of increasing the health budget. If working hours are reduced we must see that there is adequate time and staff to continue an efficient caring service. We must make a career in nursing and in the hospital service more attractive, and restore morale by once again rewarding ability, integrity, and continued
what the " new
English " is that our being taught along with the " new results are anything like the following
hours which
maths.", but if the piece of prose that I read (or dreamed I read) the other day, then the prospects for the future of our language are truly awe-inspiring. At this moment in time it would be an overly simplistic view of the high alumina concrete situation to regard it merely as a failure adequately to monitor the appropriate technology. With an equal degree of legitimacy it could be held to be typical of the misuse of energy by the developed nations. In this day and age it does no longer seem, quite "
apart from any reservations function-wise as to the final product, a viable argument that the utilisation of energy in quantities over and above that deployed in conventional Portland cement is justified by the advantageous turn-round in time terms at the factory of products fabricated from the alternative material. Hopefully, this particular point need no longer give rise to an on-going problem with the decision of Her Majesty’s Government to abort the manufacture of high alumina concrete beams by withdrawing the appropriate B.s.s. This covert assumption of some measure of culpability by Government should at least help to de-escalate any confrontation which might have been developing between manufacturer and customer. With the low profiles currently being adopted by the various protagonists it furthermore becomes a matter of speculation as to the present commercial viability of those members of the construction industry who had latched on to this particular process, particularly in view of the current cash-flow imponderables throughout the construction sector. At the end of the day the disadvantageous economic effect on the country as a whole can only meaningfully be assessed after thoroughgoing and concentrated surveys have been completed on those buildings where high alumina components have been deployed and when feasibility studies have been finalised to indicate the optimum remedial
procedure." The burden of work created by reorganisation has as heavily on our district financial officer as on the rest of us, and he had got behind with his letters of acknowledgment for gifts to our endowment fund. It was not, however, the lateness of one such letter which alarmed us, so much as its content: " the delay in replying to your earlier correspondence in no way implies that generous gifts such as the legacy left by Miss Blank to the hospital are in any sense unwelcome, quite the reverse in our present state of financial depravity."
pressed
the Editor
p.
career structure
I am children
to
A CURE FOR DANGEROUS FEVER
Depraved, decadent, perhaps;
but well worth a visit, and scientific meeting.
In
Letters
and
most
industry. The alternative, that the hospital staff at all levels will give up and cease to care, must not be allowed to happen. Hospital for Women at Leeds, 25 Hyde Terrace, Leeds LS2 9LN.
I
R. R. MACDONALD.
* ** On July 13 (p. 89), at a time when sanctions and resignation were in the air over the issue of private beds, we said: "... if the consultants had threatened complete withdrawal from the N.H.S. unless money was provided to restore it, then their position would have been much more tenable." A leader on the consultants’ contract appeared in our issue of Nov. 23 (p. 1237); and another on this and some broader issues is to be found on p. 21 this week.ED. L.
THE PINEAL AND NEOPLASIA
SIR,-In most reviews of the pineal gland, as in your leader of Nov. 23 (p. 1235), no mention is made of a substantial body of data suggesting a relation between the pineal and neoplastic growth. Before the 1960s, there were over a dozen reports of inhibition of tumour growth by injections of pineal extracts (see Kitay and Altschule1 for review of literature before 1960). Other investigators 2 -reported that pinealectomy 1.
...
2. 3. 4. 5. 6.
Kitay, J. I., Altschule, M. D. in The Pineal Gland: a Review of the Physiologic Literature. Cambridge, Mass., 1964. Rodin, A. E. Cancer Res. 1963, 23, 1545. Das Gupta, T. K., Terz, J. Nature, 1967, 213, 1038. Das Gupta, T. K., Terz, J. Cancer Res. 1967, 27, 1306. Das Gupta, T. K. Surg. Forum, 1969, 19, 83. Barone, R. M., Das Gupta, T. K. J. surg. Oncol. 1970, 2, 313.
permeating everywhere ?
certainly
England
a
wise choice for
not sure are
now
SIR,-Your leading article, Dangerous Fever, (Nov. 16, 1184) deprecates consultant militancy as damaging to the Health Service, but misses the point that it is the very deterioration in the Service which is the root cause for consultant concern. The damage has already been done by inflation and social change, and the process will accelerFew of us believe that in this day anything short of ate. militancy will produce the public awareness and political reappraisal necessary to prevent further collapse. The problems run far deeper than arguments about money and contract terms, which simply reflect immense frustration and a feeling of fighting for survival. We have been pointing out for more years than we can remember the growing shortage of trained quality nurses, the high proportion of foreign junior staff, the disparity between
a
Now
work-load, and the grossly exaggerated doctors choose to work in attempting " to preserve and restore " the service. Tinkering with the problems makes them worse; for example, reducing junior hours without increasing staff or reducing the workload eventually leads to costly overtime, or inefficiency, waste, and a poorer service. The solution like the problems must be far-reaching. If a greater proportion of the national income cannot be allocated to health then we must accept that the country can afford only a limited service and decide how it is to be limited. We must look again at alternative ways, including contributions from patients, of increasing the health budget. If working hours are reduced we must see that there is adequate time and staff to continue an efficient caring service. We must make a career in nursing and in the hospital service more attractive, and restore morale by once again rewarding ability, integrity, and continued
what the " new
English " is that our being taught along with the " new results are anything like the following
hours which
maths.", but if the piece of prose that I read (or dreamed I read) the other day, then the prospects for the future of our language are truly awe-inspiring. At this moment in time it would be an overly simplistic view of the high alumina concrete situation to regard it merely as a failure adequately to monitor the appropriate technology. With an equal degree of legitimacy it could be held to be typical of the misuse of energy by the developed nations. In this day and age it does no longer seem, quite "
apart from any reservations function-wise as to the final product, a viable argument that the utilisation of energy in quantities over and above that deployed in conventional Portland cement is justified by the advantageous turn-round in time terms at the factory of products fabricated from the alternative material. Hopefully, this particular point need no longer give rise to an on-going problem with the decision of Her Majesty’s Government to abort the manufacture of high alumina concrete beams by withdrawing the appropriate B.s.s. This covert assumption of some measure of culpability by Government should at least help to de-escalate any confrontation which might have been developing between manufacturer and customer. With the low profiles currently being adopted by the various protagonists it furthermore becomes a matter of speculation as to the present commercial viability of those members of the construction industry who had latched on to this particular process, particularly in view of the current cash-flow imponderables throughout the construction sector. At the end of the day the disadvantageous economic effect on the country as a whole can only meaningfully be assessed after thoroughgoing and concentrated surveys have been completed on those buildings where high alumina components have been deployed and when feasibility studies have been finalised to indicate the optimum remedial
procedure." The burden of work created by reorganisation has as heavily on our district financial officer as on the rest of us, and he had got behind with his letters of acknowledgment for gifts to our endowment fund. It was not, however, the lateness of one such letter which alarmed us, so much as its content: " the delay in replying to your earlier correspondence in no way implies that generous gifts such as the legacy left by Miss Blank to the hospital are in any sense unwelcome, quite the reverse in our present state of financial depravity."
pressed
the Editor
p.
career structure
I am children
to
A CURE FOR DANGEROUS FEVER
Depraved, decadent, perhaps;
but well worth a visit, and scientific meeting.
In
Letters
and
most
industry. The alternative, that the hospital staff at all levels will give up and cease to care, must not be allowed to happen. Hospital for Women at Leeds, 25 Hyde Terrace, Leeds LS2 9LN.
I
R. R. MACDONALD.
* ** On July 13 (p. 89), at a time when sanctions and resignation were in the air over the issue of private beds, we said: "... if the consultants had threatened complete withdrawal from the N.H.S. unless money was provided to restore it, then their position would have been much more tenable." A leader on the consultants’ contract appeared in our issue of Nov. 23 (p. 1237); and another on this and some broader issues is to be found on p. 21 this week.ED. L.
THE PINEAL AND NEOPLASIA
SIR,-In most reviews of the pineal gland, as in your leader of Nov. 23 (p. 1235), no mention is made of a substantial body of data suggesting a relation between the pineal and neoplastic growth. Before the 1960s, there were over a dozen reports of inhibition of tumour growth by injections of pineal extracts (see Kitay and Altschule1 for review of literature before 1960). Other investigators 2 -reported that pinealectomy 1.
...
2. 3. 4. 5. 6.
Kitay, J. I., Altschule, M. D. in The Pineal Gland: a Review of the Physiologic Literature. Cambridge, Mass., 1964. Rodin, A. E. Cancer Res. 1963, 23, 1545. Das Gupta, T. K., Terz, J. Nature, 1967, 213, 1038. Das Gupta, T. K., Terz, J. Cancer Res. 1967, 27, 1306. Das Gupta, T. K. Surg. Forum, 1969, 19, 83. Barone, R. M., Das Gupta, T. K. J. surg. Oncol. 1970, 2, 313.
