84 stance, quantitative analysis of visual-contrast and other thresholds is expected to yield the type of information obtained from diagnosis of inherited colour defects. Studies with the objective technique of fundus reflectometry,s wherein the patient’s retina is bleached, have revealed correlates with visual defects in retinitis patients,6and have lately been confirmed and extended.7 In the early stages of retinitis pigmentosa, a patient’s ability to see in the dark is determined solely by the amount of rhodopsin that can be bleached. Combined with fundamental work on receptor regeneration and phagocytosis,8 these studies have helped to narrow the number of tasks to which priorities have to be assigned. In the laboratory, acquisition of normal control data continues--e.g., determination of the senile variation of human photoreceptor morphology.9 Work is also progressing in the immunological sphere. Retinal pigment epithelium is now known to be antigenically distinct from photoreceptors.1o In the case of rat dystrophieswhich do not seem to be typical of those of man6-it seems clear that the phagocytosing pigment epithelium has no stomach for photoreceptors.11 Thus the present research efforts cannot be said to be negligible. It is not ideas that are lacking but people to carry them through. Until Government revises its policy on fundamental research, the best hope lies in social adjustment based on genetic considerations.
INTERFERON TREATMENT OF HERPES ZOSTER IT is easy to become sceptical about the use of interferon in human diseases-the idea was put forward so long ago and so little of substance has emerged. Some encouragement is to be had from work just reported by T. C. Merigan and colleagues,’ who conducted three successive trials, each in 30 patients, with two different. batches of human leucocyte interferon of increasing potency and purity. The more highly purified interferon. was given at two dosages-1-7 and 5.1 x 105 uAg/ day-and in general the higher dosages and the purer interferon gave better results. The trial was doubleblind, placebo-controlled, and randomised and the groups were comparable by several criteria. The patients mostly had lymphomas or solid tumours, were under treatment by radiotherapy or chemotherapy, and were first seen about three days, and later about two days, after the onset of herpes zoster. In the 45 interferontreated patients there were fewer complications such as
meningoencephalitis or segmental paresis-1 case against 6 in 45 controls. Only the highest dose reduced progression in the dermatome first affected. In the second two trials, the frequency of postherpetic neuralgia was reduced from 8/29 to 2/29, and the number of patient-days of pain during hospital admission was almost halved. There is therefore no doubt that interferon improved the clinical course of herpes zoster in 5. Weale, R. A. Vision Res. 1962, 1, 354. 6. Highman, V. N., Weale, R. A. Amer. J. Ophth. 1973, 75, 822. 7. Ripps, H., Bnn, K. P., Weale, R. A., Proc XXIII int. ophth. Congr. Kyoto, 1978. 8. Young, R. W. ibid 9. Marshall, J. ibid. 10. Reich-D’Almeida, F., Rahl, A. H. S. Nature, 1974, 252, 307. 11. Reich-D’Almeida, F., Hockley, D. J. Exp. Eye Res. 1975, 21, 347. 1. Merigan, T. C., Rand, K. H., Pollard, R. B., Abdallah, P. S., Jordan, G. W. Fried, R. P. New Engl. J. Med. 1978, 298, 981.
such
patients; and probably
the improvement was cliniuseful. There were no side-effects apart from a cally reduction in reticulocyte-count in all cases and a reduction in circulating granulocytes in patients given the highest dose. There are few rigorously controlled clinical trials to show that human interferon is useful in a herpes-virus infection of man. (In one such trial Jones and others2 found interferon drops effective in ulcerative herpetic keratitis.) Interferon is still scarce and progress will be slow; but the work must continue.
PUNISHING PARENTS PUNISHMENT has been defined haviour that reduces the future
as a
consequence of be-
probability of that
be-
haviour,’ and most parents would argue that the admonitions, deprivations, and blows by which they their children’s behaviour have roughly that aim. But punishment is not necessarily painful4 though it has to be regarded as noxious. According to the definition given above, the application of a stimulus cannot be regarded as a punishment unless it works. This neatly isolates punishment from other noxious parental behaviours ranging from prickliness to gratuitous violence. It serves to separate maintaining discipline from exhibiting bad temper. Aside from whether it works at the time, it is of interest to know whether punishment has long-term effects. Lefkowitz et al.’ have followed a group originally seen as eight-year-olds for over ten years to see whether the punished will punish. Sex differences, intelligence, and sociocultural variables stood between the individuals’ own experience and their proclivity to punish their own (as yet hypothetical) children. The duller boys with more aggressive fathers are likely to be punitive in their turn, and are currently rated more aggressive. Duller girls mimic their mothers’ violent treatment of them. Lefkowitz and co-workers believe that lower intelligence reduces the scope for finding nonpunitive alternatives in child-rearing, but they acknowledge that less intelligent children may incur more punishment by being more frustrating to teach. However, it is very difficult to decide either in prospect or in retrospect, whether a parent’s "punitive" behaviour was provoked or merely gratuitous. Motive is relevant since it might explain why some people argue,6so strenuously, along with Jeremy Bentham, that "all punishment is mischief and that beatings sow the seeds of future child abuse, whereas others feel that the reason behind the decline in classroom behaviour, and increasing vandalism and delinquency, is the abandonment of the precept "chasten thy son while there is hope, and let not thy soul spare for his crying".’ Before we can give really sound advice about the role of punishment in child-rearing, we need to know whether all punishment grows into violence, and indeed whether people who have known punishment have any positive qualities which the others are less likely to achieve.
regulate
B. R., Coster, D. J., Falcon, M. G., Cantell, K. Lancet, 1976, ii, 128. N. H., Holz, W. C. in Operant Behaviour (edited by W. K. Honig) New York, 1966. 4. Johnston, J. M. Am. Psychol. 1972, 27, 1033. 5. Lefkowitz, M. M., Huesmann, L. R., Eron, L. D. Archs gen. Psychiat. 1978,
2. 3.
Jones, Azrin,
35, 186. 6. Maurer, A. Am. Psychol. 7. Proverbs, xviii, 19.
1974, 29, 614.
INTERFERON TREATMENT OF HERPES ZOSTER IT is easy to become sceptical about the use of interferon in human diseases-the idea was put forward so long ago and so little of substance has emerged. Some encouragement is to be had from work just reported by T. C. Merigan and colleagues,’ who conducted three successive trials, each in 30 patients, with two different. batches of human leucocyte interferon of increasing potency and purity. The more highly purified interferon. was given at two dosages-1-7 and 5.1 x 105 uAg/ day-and in general the higher dosages and the purer interferon gave better results. The trial was doubleblind, placebo-controlled, and randomised and the groups were comparable by several criteria. The patients mostly had lymphomas or solid tumours, were under treatment by radiotherapy or chemotherapy, and were first seen about three days, and later about two days, after the onset of herpes zoster. In the 45 interferontreated patients there were fewer complications such as
meningoencephalitis or segmental paresis-1 case against 6 in 45 controls. Only the highest dose reduced progression in the dermatome first affected. In the second two trials, the frequency of postherpetic neuralgia was reduced from 8/29 to 2/29, and the number of patient-days of pain during hospital admission was almost halved. There is therefore no doubt that interferon improved the clinical course of herpes zoster in 5. Weale, R. A. Vision Res. 1962, 1, 354. 6. Highman, V. N., Weale, R. A. Amer. J. Ophth. 1973, 75, 822. 7. Ripps, H., Bnn, K. P., Weale, R. A., Proc XXIII int. ophth. Congr. Kyoto, 1978. 8. Young, R. W. ibid 9. Marshall, J. ibid. 10. Reich-D’Almeida, F., Rahl, A. H. S. Nature, 1974, 252, 307. 11. Reich-D’Almeida, F., Hockley, D. J. Exp. Eye Res. 1975, 21, 347. 1. Merigan, T. C., Rand, K. H., Pollard, R. B., Abdallah, P. S., Jordan, G. W. Fried, R. P. New Engl. J. Med. 1978, 298, 981.
such
patients; and probably
the improvement was cliniuseful. There were no side-effects apart from a cally reduction in reticulocyte-count in all cases and a reduction in circulating granulocytes in patients given the highest dose. There are few rigorously controlled clinical trials to show that human interferon is useful in a herpes-virus infection of man. (In one such trial Jones and others2 found interferon drops effective in ulcerative herpetic keratitis.) Interferon is still scarce and progress will be slow; but the work must continue.
PUNISHING PARENTS PUNISHMENT has been defined haviour that reduces the future
as a
consequence of be-
probability of that
be-
haviour,’ and most parents would argue that the admonitions, deprivations, and blows by which they their children’s behaviour have roughly that aim. But punishment is not necessarily painful4 though it has to be regarded as noxious. According to the definition given above, the application of a stimulus cannot be regarded as a punishment unless it works. This neatly isolates punishment from other noxious parental behaviours ranging from prickliness to gratuitous violence. It serves to separate maintaining discipline from exhibiting bad temper. Aside from whether it works at the time, it is of interest to know whether punishment has long-term effects. Lefkowitz et al.’ have followed a group originally seen as eight-year-olds for over ten years to see whether the punished will punish. Sex differences, intelligence, and sociocultural variables stood between the individuals’ own experience and their proclivity to punish their own (as yet hypothetical) children. The duller boys with more aggressive fathers are likely to be punitive in their turn, and are currently rated more aggressive. Duller girls mimic their mothers’ violent treatment of them. Lefkowitz and co-workers believe that lower intelligence reduces the scope for finding nonpunitive alternatives in child-rearing, but they acknowledge that less intelligent children may incur more punishment by being more frustrating to teach. However, it is very difficult to decide either in prospect or in retrospect, whether a parent’s "punitive" behaviour was provoked or merely gratuitous. Motive is relevant since it might explain why some people argue,6so strenuously, along with Jeremy Bentham, that "all punishment is mischief and that beatings sow the seeds of future child abuse, whereas others feel that the reason behind the decline in classroom behaviour, and increasing vandalism and delinquency, is the abandonment of the precept "chasten thy son while there is hope, and let not thy soul spare for his crying".’ Before we can give really sound advice about the role of punishment in child-rearing, we need to know whether all punishment grows into violence, and indeed whether people who have known punishment have any positive qualities which the others are less likely to achieve.
regulate
B. R., Coster, D. J., Falcon, M. G., Cantell, K. Lancet, 1976, ii, 128. N. H., Holz, W. C. in Operant Behaviour (edited by W. K. Honig) New York, 1966. 4. Johnston, J. M. Am. Psychol. 1972, 27, 1033. 5. Lefkowitz, M. M., Huesmann, L. R., Eron, L. D. Archs gen. Psychiat. 1978,
2. 3.
Jones, Azrin,
35, 186. 6. Maurer, A. Am. Psychol. 7. Proverbs, xviii, 19.
1974, 29, 614.
