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SPERM MORPHOLOGY, SMOKING, AND TEMPERATURE
1377
submersion of the British Isles in the North Sea. But what about a lesser
degree
of action? What if
one or two or
three
explosions
occurred or were caused to occur in our major cities eliminating as, Eastwood indicates, much of the local medical potential? What do the rest do-those who are not affected? Sit tight and hope nothing will happen to them-or bluster about ineffectually because no one has any idea what to do, or any plan to work on? While any plan would be unlikely to cope entirely with the eventuality, lack of plans could only magnify the catastrophe. Perhaps someone in the D.H.S.S. can reassure us that such plans exist. If so, they should be known and considered throughout the country’s medical community-if not then they should be started forthwith. Birmingham Hospital, Birmingham B9 5ST East
R. A. THOMPSON
ACUPUNCTURE IN CHINA
SIR,-We have recently returned from a scientific symposium in Shanghai and were able to discuss the account given in your Feb. 28 editorial of the
current
status
of acupuncture in
China.
Acupuncture is still widely used in the hospitals of Shanghai for analgesia and anaesthesia, and to suggest that acupuncture is a myth and a hoax on the authority of Der Spiegel, a newspaper not noted for its objectivity, is not in the Lancet tradition. Transcutaneous electrical nerve stimulation is routinely used for acupuncture anaesthesia with premedication (diazepam) and on occasion oxygen via an open mask during operation. Chinese anaesthetists have always recognised both the value and the limitations of acupuncture analgesia and use it selectively, taking account of the type of surgery and the personality of the patient. Conventional anaesthesia also has an important role. Acupuncture is widely employed in the treatment of musculoskeletal disorders, tension headaches, and so on. Numerous accounts of the use of acupuncture have appeared in the English-language ChineseMedical Journa4 to none of which you refer. None of our Chinese colleagues were aware of the allegations reputedly made by Geng Xichen and Tau Naihuang, and as these colleagues included the director of the department of internal medicine of the second medical college in Shanghai, the chief of the editorial board of the Shanghai Medical Information Centre, and the heads of three other teaching hospitals in the Shanghai area, we believe your account of acupuncture as presently practised in China is inaccurate. Boehringer Ingelheim, Bracknell, Berkshire
JULIAN H. SHELLEY
Royal Sussex County Hospital, Brighton
D. A. CHAMBERLAIN
SPERM MORPHOLOGY, SMOKING, AND TEMPERATURE
SIR,-Barbara Godfrey’s reply (April 25, p. 948) to the paper by Professor Evans and colleagues (March 21, p. 627) is in accord with 1 my own thinking, but for different reasons. The demonstration that hypothermia of the testis results in improvement in poor semen (including morphology), and the relation2,3 between increased intrascrotal temperature and abnormal sperm forms confronts us with a variable powerful enough to alter the outcome of an otherwise well planned experiment. I seize this occasion not to enter into the merits of smoking’s effect upon sperm morphology, but rather to invite scientists to measure testicular or scrotal temperature when doing research on infertility, semen quality, varicocele, and
so on.
Department of Urology, Cabrini Medical Center, New York, N Y. 10003, U.S.A.
ADRIAN W. ZORGNIOTTI
A, Sealfon A, Toth A. Chronic scrotal hypothermia as a treatment for poor quality Lancet 1980; i: 904. 2 Zorgniotti A, MacLeod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril 1973; 24: 854 3. Zorgniotti A. Testis temperature, infertility and the varicocele paradox. Urology 1980; 1. Zorgniotti semen
16: 7.
Commentary from Westminster Blocking of Bill on Tobacco Advertising A BILL which could have had a major effect on cigarette advertising, and possibly thereby reduced tobacco consumption, especially among the young, has been blocked in Parliament by a handful of Conservative M.P.s. Some M.P.s see the blocking as a wholly cynical manipulation of Parliamentary procedure to flout the will of the majority of the Commons; others see it as a perfectly legitimate and proper exercise of the rights of backbenchers to represent constituency interests. A Labour member, Mr Laurie Pavitt, a seasoned Parliamentary campaigner against the tobacco industry, had employed considerable Parliamentary skill in guiding his private Bill through the shoals of the Commons timetable to an expected second reading on June 12. He still does not accept that it has now been sunk irretrievably, and he hopes to refloat on the next favourable tide, which is due on July 10. It is likely that similar manoeuvres by a dedicated minority of Tories will again sink the Bill; in that case, Mr Pavitt declares, he will try again in the next session of Parliament. The Bill arose from the wholly unsatisfactory nature of the agreement concluded between the Social Services Secretary, Mr Patrick Jenkin, and the tobacco advertisers’ association. The tobacco firms gave so little ground in that agreement that even Mr Jenkin was forced to acknowledge failure. Under the circumstances, he told M.P.s, the Government itself was
not
prepared to legislate for curbs on tobacco advertising, since it still preferred the voluntary route. But he could understand that M.P.s might not be satisfied by that state of affairs, and if private legislation were introduced to curb advertising and sponsorship by tobacco firms, he promised that the Government would not instruct Tory M.P.s to vote against such legislation. This was a wise move, since Mr Jenkin was well aware that an instruction to vote against a curbing Bill would be ignored by the majority of Tory backbenchers. If one adds to this the absolute majority on the Labour benches in favour of such restrictions, there is a very clear majority in the Commons for firm action against the tobacco companies. Mr Jenkin’s own private attitude to the tobacco companies is unclear. But at least his Under-Secretary, Sir George Young, has proved a committed and energetic opponent of the tobacco firms. The manufacturers and advertisers have few friends in the Commons. But it has turned out that a few are all they need to safeguard their interests.
Taking Mr Jenkin at his word, Mr Pavitt introduced a private Bill with two principal provisions: it would give the Secretary of State for Social Services statutory power to direct tobacco firms to reduce their advertising to whatever level he thought right; it would also virtually eliminate sponsorship of sports, arts, and other events by tobacco companies. (Sports promoters, at least, say there are plenty of other non-tobacco firms willing to step into the breach.) Lack of spare legislative time is the threat to most private Bills. Only if they excite little opposition from other backbenchers, and if they have at least the tacit support of the Government, do they prosper. Mr Pavitt’s Bill seemed to fulfil both these requirements. It was with some pleasure, then, that 48 hours before his Bill was due for second reading Mr Pavitt found it was to come up for debate after two apparently non-controversial measures. The
submersion of the British Isles in the North Sea. But what about a lesser
degree
of action? What if
one or two or
three
explosions
occurred or were caused to occur in our major cities eliminating as, Eastwood indicates, much of the local medical potential? What do the rest do-those who are not affected? Sit tight and hope nothing will happen to them-or bluster about ineffectually because no one has any idea what to do, or any plan to work on? While any plan would be unlikely to cope entirely with the eventuality, lack of plans could only magnify the catastrophe. Perhaps someone in the D.H.S.S. can reassure us that such plans exist. If so, they should be known and considered throughout the country’s medical community-if not then they should be started forthwith. Birmingham Hospital, Birmingham B9 5ST East
R. A. THOMPSON
ACUPUNCTURE IN CHINA
SIR,-We have recently returned from a scientific symposium in Shanghai and were able to discuss the account given in your Feb. 28 editorial of the
current
status
of acupuncture in
China.
Acupuncture is still widely used in the hospitals of Shanghai for analgesia and anaesthesia, and to suggest that acupuncture is a myth and a hoax on the authority of Der Spiegel, a newspaper not noted for its objectivity, is not in the Lancet tradition. Transcutaneous electrical nerve stimulation is routinely used for acupuncture anaesthesia with premedication (diazepam) and on occasion oxygen via an open mask during operation. Chinese anaesthetists have always recognised both the value and the limitations of acupuncture analgesia and use it selectively, taking account of the type of surgery and the personality of the patient. Conventional anaesthesia also has an important role. Acupuncture is widely employed in the treatment of musculoskeletal disorders, tension headaches, and so on. Numerous accounts of the use of acupuncture have appeared in the English-language ChineseMedical Journa4 to none of which you refer. None of our Chinese colleagues were aware of the allegations reputedly made by Geng Xichen and Tau Naihuang, and as these colleagues included the director of the department of internal medicine of the second medical college in Shanghai, the chief of the editorial board of the Shanghai Medical Information Centre, and the heads of three other teaching hospitals in the Shanghai area, we believe your account of acupuncture as presently practised in China is inaccurate. Boehringer Ingelheim, Bracknell, Berkshire
JULIAN H. SHELLEY
Royal Sussex County Hospital, Brighton
D. A. CHAMBERLAIN
SPERM MORPHOLOGY, SMOKING, AND TEMPERATURE
SIR,-Barbara Godfrey’s reply (April 25, p. 948) to the paper by Professor Evans and colleagues (March 21, p. 627) is in accord with 1 my own thinking, but for different reasons. The demonstration that hypothermia of the testis results in improvement in poor semen (including morphology), and the relation2,3 between increased intrascrotal temperature and abnormal sperm forms confronts us with a variable powerful enough to alter the outcome of an otherwise well planned experiment. I seize this occasion not to enter into the merits of smoking’s effect upon sperm morphology, but rather to invite scientists to measure testicular or scrotal temperature when doing research on infertility, semen quality, varicocele, and
so on.
Department of Urology, Cabrini Medical Center, New York, N Y. 10003, U.S.A.
ADRIAN W. ZORGNIOTTI
A, Sealfon A, Toth A. Chronic scrotal hypothermia as a treatment for poor quality Lancet 1980; i: 904. 2 Zorgniotti A, MacLeod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril 1973; 24: 854 3. Zorgniotti A. Testis temperature, infertility and the varicocele paradox. Urology 1980; 1. Zorgniotti semen
16: 7.
Commentary from Westminster Blocking of Bill on Tobacco Advertising A BILL which could have had a major effect on cigarette advertising, and possibly thereby reduced tobacco consumption, especially among the young, has been blocked in Parliament by a handful of Conservative M.P.s. Some M.P.s see the blocking as a wholly cynical manipulation of Parliamentary procedure to flout the will of the majority of the Commons; others see it as a perfectly legitimate and proper exercise of the rights of backbenchers to represent constituency interests. A Labour member, Mr Laurie Pavitt, a seasoned Parliamentary campaigner against the tobacco industry, had employed considerable Parliamentary skill in guiding his private Bill through the shoals of the Commons timetable to an expected second reading on June 12. He still does not accept that it has now been sunk irretrievably, and he hopes to refloat on the next favourable tide, which is due on July 10. It is likely that similar manoeuvres by a dedicated minority of Tories will again sink the Bill; in that case, Mr Pavitt declares, he will try again in the next session of Parliament. The Bill arose from the wholly unsatisfactory nature of the agreement concluded between the Social Services Secretary, Mr Patrick Jenkin, and the tobacco advertisers’ association. The tobacco firms gave so little ground in that agreement that even Mr Jenkin was forced to acknowledge failure. Under the circumstances, he told M.P.s, the Government itself was
not
prepared to legislate for curbs on tobacco advertising, since it still preferred the voluntary route. But he could understand that M.P.s might not be satisfied by that state of affairs, and if private legislation were introduced to curb advertising and sponsorship by tobacco firms, he promised that the Government would not instruct Tory M.P.s to vote against such legislation. This was a wise move, since Mr Jenkin was well aware that an instruction to vote against a curbing Bill would be ignored by the majority of Tory backbenchers. If one adds to this the absolute majority on the Labour benches in favour of such restrictions, there is a very clear majority in the Commons for firm action against the tobacco companies. Mr Jenkin’s own private attitude to the tobacco companies is unclear. But at least his Under-Secretary, Sir George Young, has proved a committed and energetic opponent of the tobacco firms. The manufacturers and advertisers have few friends in the Commons. But it has turned out that a few are all they need to safeguard their interests.
Taking Mr Jenkin at his word, Mr Pavitt introduced a private Bill with two principal provisions: it would give the Secretary of State for Social Services statutory power to direct tobacco firms to reduce their advertising to whatever level he thought right; it would also virtually eliminate sponsorship of sports, arts, and other events by tobacco companies. (Sports promoters, at least, say there are plenty of other non-tobacco firms willing to step into the breach.) Lack of spare legislative time is the threat to most private Bills. Only if they excite little opposition from other backbenchers, and if they have at least the tacit support of the Government, do they prosper. Mr Pavitt’s Bill seemed to fulfil both these requirements. It was with some pleasure, then, that 48 hours before his Bill was due for second reading Mr Pavitt found it was to come up for debate after two apparently non-controversial measures. The