- Email: [email protected]
RETIREMENT OF MEDICAL RESEARCH-WORKERS
279 that is possible-it is not always-but if chemical analysis is to be successful, the instructions must be followed. I should expect a medical graduate who had devoted a year to fundamental study in chemistry to be an acquisition to any chemical pathological laboratory. Before the late war-my knowledge is not up-to-date-the University of London regulations demanded one year of chemistry for the holder of the 2nd M.B. who wished to attempt the special B.SC. in chemistry (known elsewhere as an honours B.SC.). My knowledge of chemistry suggests that the University regulations, as they were, represented the truth more closely than do the views put forward by Dr. Hendry. I believe that many of your readers must have shared my regret at the way in which Dr. Hendry worded his references to Professor Cappell.
ARTHUR JORDAN.
Sheffield.
be to Dr. Librach’s
SIR,-Sympathetic (Jan. 28) on the stimulant value of academic departments, his " queen bee " analogy contains a crucial misconception. everyone must
views
The question is, who fertilises whom ? Surely it is the task of the professor to implant ideas in those around him and, when the work has grown, to act as midwife ? Dr. Librach’s call for charitable funds deserves the widest support. The Mental Health Research Fund concluded recently1 that the most pressing need in psychiatric research is for new university departments with permanent academic posts to extend and complete, as they put it, the structure started in the National Health Service and Mental Health Acts. It is to promote such developments that the Fund has opened a
E250,000 appeal. Beckenham,
Kent.
RETIREMENT OF MEDICAL RESEARCH-WORKERS "
SIR,-The arguments in the excellent letter by Aged 60 " (Dec. 17) can be backed by more in favour of continuing research as long as the worker is able to do
NO CHAIR as
spots. It is, therefore, our practice to issue 100 ml. narrownecked bottles containing 5 ml. of Nf4 HCI, with a crystal of thymol added, for urine collection. One final point: orange syrup or similar pharmacopoeal flavouring agents do not adequately disguise the taste of histidine; but commercial (highly sweetened) orange-squash does so if 60-80 ml. is added to the 150 ml. of water in which the 15 g. dose of histidine has been dissolved. It then loses any medicinal stigma. O. A. N. HUSAIN Group Laboratory, Lambeth Hospital, L. ELLIS. S.E.11. London,
so.
With failing health, it is understandable that mental abilities may decline; but why should health fail at any specified age? If health is maintained, the longer one lives the more tricks are learnt, and the swifter and more powerful one’s research becomes; besides research-workers are among those afflicted with that " divine curiosity ". While they are alive, they must always be investigating something. If retirement means " time for gardening ", it will undoubtedly turn into horticultural experimenting; but the equivalent effort in a medical context could be of much more benefit to humanity. Again, the individuality of the research-worker is an asset not to be wasted at any age. Amidst all the modern array of
instrumentation, the brain is still by far the most important research tool; and there is no substitute for the imaginative individual. So long as a man is capable of this he is rare and valuable, and should be kept active for the nation’s sake. To weave the gerontological aspect into a scheme for keeping researchers researching, as your correspondent suggests, is particularly appropriate. If by such a study it became possible to stave off the senility which always ultimately wastes each lifetime of intellectual growth, the scheme’s yield in terms of salvaged achievements would be considerably multiplied. For similar reasons to your other correspondent, I sign
attack of
an
approach, Fox. RICHARD FOX.
CONVENTIONAL VOLTAGE ELECTROPHORESIS FOR FORMIMINO-GLUTAMIC-ACID DETERMINATION SIR,-For some weeks now we have been using the procedure described by Dr. Kohn and his colleagues2 and find this method of detection quite adequate. In fact, using a potential of about 350-400 V, some separation occurs between the FIGLU and glutamic-acid spots on cellulose-acetate strips; and this system does not require
cooling. As the peak excretion of FIGLU after histidine load is around the 6th hour,3 we also find that a 3-8 hour or, better still, a 4-7 hour period of collection gives the strongest FIGLU spot and is undoubtedly the ideal period sample to test. But a satisfactory simple outpatient screening test is needed; and we have been testing the early-morning specimen of urine (7-8 A.M.), histidine having been administered late the night
before (10-11 P.M.).
Using this form of collection the FIGLU spot found in cases of folic-acid deficiency is definitely weaker and often about half as strong as that from a 3-8 hour sample. It is, however, still clearly discernible; and this method has the merits of simplicity and convenience for the patient. It is possible that a mild folic-acid deficiency may be missed in this way; and the better method is a day-time 4-7 hour period of collection. As no quantitative estimation is contemplated in a screening test, any one sample of urine passed during this period should be satisfactory. It is necessary, however, when using the weaker tests to ensure immediate preservation of the urine after voiding, as not only does the FIGLU get destroyed in alkaline or infected urine, but the glutamic-acid content increases in inverse proportion, and this may cause confusion in interpretation of the 1. See Lancet, 1960, ii, 1130. 2. Kohn, J., Mollin, D. L., Rosenbach, L. M. Lancet, Jan. 3. Knowles, J. P., Prankerd, T. A. J., Westall, R. G. ibid.
14, 1961, p. 112. 1960, ii, 347.
myself "AGED 58 TREATMENT OF DRUG ADDICTION
Dr. Stungo’s letter of Jan. 28, I certainly did not intend to evade his question, but apparently he did not understand that when I stated that only one patient had relapsed I meant that only one patient had relapsed. Incidentally, of all the patients we have treated she is the only one who did not return to report to us. This I think also answers Dr. Stungo’s last question.
SIR,-In reply
to
We do not regard a patient as free from addiction until he or she has been clear for several months and is in good physical condition and making a satisfactory social and economic adjustment to life. In the series of patients included in our article of Dec. 24, 31 have been clear for a year. We can only state that our patients with very few exceptions have tended in our first contacts to minimise the amount of drugs they are taking, and for a time at least seem unable to cut out illegal supplies. They are preoccupied with the fear that they may have a real accident or that they may have to face up to, for example, a heavy engagement if they are musicians, and that we will not believe them. I used the word " finally " deliberately in the sentence to " avoid the temptation to augment income by selling drugs ", because this buying and selling of drugs is one of the most difficult activities to eliminate entirely. At least 4 of our patients endeavoured to obtain increased supplies so that they would be able to sell a few grains of heroin or cocaine. They were unsuccessful and no longer are our patients, but we hear of
ARTHUR JORDAN.
Sheffield.
be to Dr. Librach’s
SIR,-Sympathetic (Jan. 28) on the stimulant value of academic departments, his " queen bee " analogy contains a crucial misconception. everyone must
views
The question is, who fertilises whom ? Surely it is the task of the professor to implant ideas in those around him and, when the work has grown, to act as midwife ? Dr. Librach’s call for charitable funds deserves the widest support. The Mental Health Research Fund concluded recently1 that the most pressing need in psychiatric research is for new university departments with permanent academic posts to extend and complete, as they put it, the structure started in the National Health Service and Mental Health Acts. It is to promote such developments that the Fund has opened a
E250,000 appeal. Beckenham,
Kent.
RETIREMENT OF MEDICAL RESEARCH-WORKERS "
SIR,-The arguments in the excellent letter by Aged 60 " (Dec. 17) can be backed by more in favour of continuing research as long as the worker is able to do
NO CHAIR as
spots. It is, therefore, our practice to issue 100 ml. narrownecked bottles containing 5 ml. of Nf4 HCI, with a crystal of thymol added, for urine collection. One final point: orange syrup or similar pharmacopoeal flavouring agents do not adequately disguise the taste of histidine; but commercial (highly sweetened) orange-squash does so if 60-80 ml. is added to the 150 ml. of water in which the 15 g. dose of histidine has been dissolved. It then loses any medicinal stigma. O. A. N. HUSAIN Group Laboratory, Lambeth Hospital, L. ELLIS. S.E.11. London,
so.
With failing health, it is understandable that mental abilities may decline; but why should health fail at any specified age? If health is maintained, the longer one lives the more tricks are learnt, and the swifter and more powerful one’s research becomes; besides research-workers are among those afflicted with that " divine curiosity ". While they are alive, they must always be investigating something. If retirement means " time for gardening ", it will undoubtedly turn into horticultural experimenting; but the equivalent effort in a medical context could be of much more benefit to humanity. Again, the individuality of the research-worker is an asset not to be wasted at any age. Amidst all the modern array of
instrumentation, the brain is still by far the most important research tool; and there is no substitute for the imaginative individual. So long as a man is capable of this he is rare and valuable, and should be kept active for the nation’s sake. To weave the gerontological aspect into a scheme for keeping researchers researching, as your correspondent suggests, is particularly appropriate. If by such a study it became possible to stave off the senility which always ultimately wastes each lifetime of intellectual growth, the scheme’s yield in terms of salvaged achievements would be considerably multiplied. For similar reasons to your other correspondent, I sign
attack of
an
approach, Fox. RICHARD FOX.
CONVENTIONAL VOLTAGE ELECTROPHORESIS FOR FORMIMINO-GLUTAMIC-ACID DETERMINATION SIR,-For some weeks now we have been using the procedure described by Dr. Kohn and his colleagues2 and find this method of detection quite adequate. In fact, using a potential of about 350-400 V, some separation occurs between the FIGLU and glutamic-acid spots on cellulose-acetate strips; and this system does not require
cooling. As the peak excretion of FIGLU after histidine load is around the 6th hour,3 we also find that a 3-8 hour or, better still, a 4-7 hour period of collection gives the strongest FIGLU spot and is undoubtedly the ideal period sample to test. But a satisfactory simple outpatient screening test is needed; and we have been testing the early-morning specimen of urine (7-8 A.M.), histidine having been administered late the night
before (10-11 P.M.).
Using this form of collection the FIGLU spot found in cases of folic-acid deficiency is definitely weaker and often about half as strong as that from a 3-8 hour sample. It is, however, still clearly discernible; and this method has the merits of simplicity and convenience for the patient. It is possible that a mild folic-acid deficiency may be missed in this way; and the better method is a day-time 4-7 hour period of collection. As no quantitative estimation is contemplated in a screening test, any one sample of urine passed during this period should be satisfactory. It is necessary, however, when using the weaker tests to ensure immediate preservation of the urine after voiding, as not only does the FIGLU get destroyed in alkaline or infected urine, but the glutamic-acid content increases in inverse proportion, and this may cause confusion in interpretation of the 1. See Lancet, 1960, ii, 1130. 2. Kohn, J., Mollin, D. L., Rosenbach, L. M. Lancet, Jan. 3. Knowles, J. P., Prankerd, T. A. J., Westall, R. G. ibid.
14, 1961, p. 112. 1960, ii, 347.
myself "AGED 58 TREATMENT OF DRUG ADDICTION
Dr. Stungo’s letter of Jan. 28, I certainly did not intend to evade his question, but apparently he did not understand that when I stated that only one patient had relapsed I meant that only one patient had relapsed. Incidentally, of all the patients we have treated she is the only one who did not return to report to us. This I think also answers Dr. Stungo’s last question.
SIR,-In reply
to
We do not regard a patient as free from addiction until he or she has been clear for several months and is in good physical condition and making a satisfactory social and economic adjustment to life. In the series of patients included in our article of Dec. 24, 31 have been clear for a year. We can only state that our patients with very few exceptions have tended in our first contacts to minimise the amount of drugs they are taking, and for a time at least seem unable to cut out illegal supplies. They are preoccupied with the fear that they may have a real accident or that they may have to face up to, for example, a heavy engagement if they are musicians, and that we will not believe them. I used the word " finally " deliberately in the sentence to " avoid the temptation to augment income by selling drugs ", because this buying and selling of drugs is one of the most difficult activities to eliminate entirely. At least 4 of our patients endeavoured to obtain increased supplies so that they would be able to sell a few grains of heroin or cocaine. They were unsuccessful and no longer are our patients, but we hear of