Journal of the Royal Society of Medicine Volume 84 October 1991 References 1 Oeser H. Krebskampfung. Stuttgart: Thieme, 1974 2 Maurer H-J. Das Gefihrdungsrisiko bei der Untersuchung mit Rontgenstrahlen und radioaktiven Stoffen zur Friiherkennung von Tumoren. In: Gremmel H, et al., eds. Risiko der Gefahrdung durch die StrahlenExposition in der Medizin. Stuttgart: Thieme, 1976: 119-37

Myalgic encephalomyelitis The exchange of views between Drs Wessely and Wilson in the correspondence columns of the March issue of the Journal (March 1991 JRSM, p 182) highlights the divergence of opinion concerning the nature of myalgic encephalomyelitis (ME). Recognition of ME as a significant health problem in New Zealand dates from an outbreak of 'Tapanui 'flu' in a small country town in 1983. As it seemed possible that the wide range of symptoms could be indicative of impaired capillary blood flow, we studied the filtrability of blood samples from members of ME support groups. We found that subjects who were acutely unwell had prolonged blood filtration times which returned towards normal in the chronic state'. More recently it has been shown that ME symptoms are associated with increased percentages of nondiscocytic erythrocytes2 and the percentage of such cells showed an inverse correlation with wellbeing. The significance of altered red cell shape in the pathogenesis of ME has been discussed3 and it has been found that an injection of vitamin B12 improved wellbeing within 24 h. The loss of symptoms was associated with reduced percentages of nondiscocytes in about 50% of subjects. Those who failed to perceive a beneficial response from the B12 showed no change in red cell shape. Further studies at varying degrees of completion confirm and extend the published observations. Blood samples from individuals with ME in California, Perth, Western Australia and the UK have similar patterns of altered red cell shape to those of their NZ counterparts so the observed change is not simply a NZ phenomenon. A disappointing aspect of ME research is the apparent lack of cooperation among investigators. While immunologists, virologists and behavioural scientists continue to retain entrenched positions, those who suffer the problems and frustrations ofME seem to have been dismissed to the sidelines rather than retained in centre field. L 0 SIMPSON Department of General Practice, University of Otago, Dunedin, New Zealand

References 1 Simpson LO, Shand BI, Olds RJ. Blood rheology and myalgic encephalomyelitis: a pilot study. Pathology 1986;18:190-2 2 Simpson LO. Nondiscocytic erythrocytes in myalgic encephalomyelitis. NZ Med J 1989;102:126-7 3 Simpson LO. The role of nondiscocytic erythrocytes in the pathogenesis of myalgic encephalomyelitis/chronic fatigue syndrome. In: Proceedings ofthe Cambridge Symposium on ME, April 1990 (in press)

Research funding

The problem posed by Dr Hewitt (May 1991 JRSM, p 321) of vast resources being poured into potentially meaningless and irrelevant 'bandwagon' programmes is a common one. Most research funding results from applications for clearly defined projects, with clearly stated objectives and an expected time course of achievement. To achieve the degree of clarity demanded grant applications are normally built around the solid foundation of existing literature. These applications are then subject to peer review involving questions on the applicant's experience in the field, knowledge of the literature, and the extent to which the research programme is likely to be successful. As a consequence of the continuing decline in research funding, applicants failing in any of these are not likely to be funded. The result is that funding goes to those already immersed in a particular area, often approaching it with an exceedingly narrow technical, experimental and conceptual view that makes them an 'authority'. Funding does not go to those who wish to diversify and apply their particular expertise to a new area, or to those whose applications are more speculative and not based sufficiently in a mass of data recently acquired. In practice most major scientific and technical innovations arise by serendipity, as chance observations made by alert and insightful researchers, often in unrelated research programmes. The Americans have recently begun to recognize the artificiality of the existing system and calls are being made for the allocation of research funds by a lottery system. (This would also eliminate 'personality' factors from the game; scientists are only human). The only escape from Dr Hewitt's nightmare (other than random allocation) is for a system of funding in which researchers who have a previous track record of innovative discovery should be funded for research in a general area, not a specific project, for 5-10 years. Their applications would be a record of what they have achieved, as an indicator of potential, not what they would like to achieve. Only by recognizing the present Catch 22 absurdities and by freeing the lively and truly creative intellects of our scientific establishment can we hope to restore real novelty and originality to our research output. T W STONE Department of Pharmacology University of Glasgow, Glasgow G12 8QQ

Surgeons and the risk of contamination during operations The editorial by Williams (June 1991 JRSM, p 327) made interesting reading and contained much that is pertinent to the situation existing in operative dentistry. Infective micro-particle aerosols created by the use of the air turbine are a major source of potential contamination. An extremely effective method of dramatically reducing such contamination by as much as 95% is by the routine use of rubber dam isolation",2. This is a system of using a thin latex sheet tensioned on a

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Research funding.

Journal of the Royal Society of Medicine Volume 84 October 1991 References 1 Oeser H. Krebskampfung. Stuttgart: Thieme, 1974 2 Maurer H-J. Das Gefihrd...
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