Oct 25, 1975 - DR KATHLEEN A BURGESS (Forfar, Angus) writes: In 1939 when I was a ... Dr A H McLEAN Ross (UCLA Medical. Centre, Los Angeles) ...
BRITISH MEDICAL JOURNAL
231
25 OCTOBER 1975
Points from Letters through a 0-22-,m Millex filter unit to ensure sterility. We have avoided using preserved heparin because of the paucity of information about the chronic toxicity of chlorocresol in humans. Animal studies' carried out many years ago suggest a lack of toxicity but the recent report by Drs B W Hancock and Anne Naysmith (27 September, p 746) associates hypersensitivity reactions to heparin injection with the chlorocresol preservative. We would be interested to know if DR KATHLEEN A BURGESS (Forfar, Angus) other centres have experienced problems writes: In 1939 when I was a fourth-year during extended administration of heparin medical student at Edinburgh University we preserved with chlorocresol. had a short course of lectures on public health. The lecturer, Colonel Percy Lelean, Wein, R, Quarterly Yournal of Pharmacy and Pharmacology, 1939, 12, 212. told us that in order to lessen the risk of rat-borne disease, especially in large ports, ships had to undergo "six-monthly biannual deraticisation" (sic). There must be a moral International language of science in this somewhere, because, although I have Mr B M CAVANAGH (Department of Modern forgotten almost everything else he told us, I Languages, University of Liverpool) writes: still remember about the treatment meted . . . Mr S C Cooper (6 September, p 594) out to ships. raises a banner of hope for the salvation of English from foreign depredation. An international language planned for ease and clarity should appeal to scientists. Free from Emergency call systems the confusing idiom-and the appalling Mr G T WATTS (General Hospital, Birming- spelling-of English, it would be well within ham) writes: Almost every hospital in Britain the capability of almost all, whether to write now has an emergency call system for or to speak in international communication, patients who develop cardiac arrest or res- and it would have no political associations piratory obstruction. . . Might I suggest to impede its adoption. Surely a wonderful that the necessity for this is obsolete and is idea? I may be going a little beyond Mr a reflection of inadequate training of the Cooper's intention, but this idea is no dream. staff of hospitals. It should be possible for The thing has been done, and well done. every trained doctor or nurse to pass an The easy unambiguous language is there for endotracheal tube and perform external the taking; Esperanto or "regularised Eurocardiac massage. Training in this is easy with pean," with 85 years of fairly extensive usage, the mannikins commercially available Which some 10 000 printed works, regular could be supplemented by instruction from periodicals, and technical vocabularies all anaesthetists in the operating theatre. If staff complete. . . . It may not be as rich as the have training in this way more lives could best English of the few, but is surely better be saved and there would be less hardship than the murdered English of the many.... to patients elsewhere w'hen it was necessary for on-call emergency doctors to leave their other work. Promuse and performance Mr P R B PEDLOW (Hitchin, Herts) writes: How can anyone confidently pay out for Closure of abdominal wounds by adhesive the promise of "added years" or increased strips lump sum on future retirement when it has Dr A H McLEAN Ross (UCLA Medical become accepted that any government of the Centre, Los Angeles) writes: In their recent day can withold pay increments agreed and report on the use of Steristrip tapes in contracted on taking a job only a couple of wound closure (20 September, p 696), Mr years ago? . . . D J T Webster and Mr P W Davis report that almost one in five of the "taped" wounds showed evidence of tape peeling Prepared for a disaster? despite the precautions taken prior to application. This problem could be substantially Mr W H RUTHERFORD (Royal Viotoria Hosreduced if not eliminated by the application pital, Belfast) writes: In your leading article of tincture of benzoin, either in spray or (27 September, p 723) . . . you say that at paint-on form, to the surrounding skin before the end of the symposium at Haslar "a strong tape placement.... plea was rightly made . . . for a national policy to be formed for the medical aspects of disaster management." The plea was for a national policy not only for medical aspects Hypersensitivity to chlorocresol-preserved but all aspects. Disaster management is heparin interdisciplinary, and the services involved Professor D MATTINGLY and Mr A J NUNN come under at least three separate ministries. (Royal Devon and Exeter Hospital (Won- Civil defence used to provide a co-ordinating ford), Exeter) write: ... In this hospital we structure, but this has been abolished. have used preservative4ree dry heparin and, Because to date our disasters have been more recently, preservative-free heparin relatively small the efforts of each service solution 1000 U/nil (Evans Medical) to pre- separately and some voluntary co-operation pare infusions. Solutions are administered at regional level have been enough to main-
"Bright ring of words" Dr A H ABRAHAMS (Oxford) writes: This morning I opened my post after reading Sir George Pickering's letter (11 October, p 104). I found a letter from his old hospital-, the Radcliffe Infirmary, telling me that. the neighbour of one of my patients had "suicided."
tain a fair degree of competence. A disaster 50 times as large as we have yet had is a very real possibility. For such an event, a national rather than a regional response would be necessary, and for this we are wholely unprepared.
Behavioural medicine Dr K E SCHMIDT (Tone Vale Hospital, Taunton, Somerset) writes: While I fully agree with Dr I G Tait (4 October, p 41) that something needs to be done in this field, I am not so sure that the still largely datacollecting-oriented desciplines he mentions (sociology, anthropology, social psychology), even if "digested," are the answer or even a good answer. I feel, on the other hand, that the value of the approach roughly suggested by Dr Tait would appear to lie mainly in good mental health and lowering of the incidence of psychosomatic and psychosocial disorder, apart from much of psychiatric disorder in the narrow sense. This is therefore probably a good moment to draw your readers' attention to the forthcoming conference (symposium) on "Primary prevention of psychiatric disorder" in Papeete, Tahiti, French Polynesia, in the first week of March 1976. The conference, with which I am associated, is jointly organised by the World Psychiatric Association and the South Pacific Commission, from both of which further details can be obtained....
NHS family planning services Miss A M PLATr (Queen's Park Hospital, Blackburn) writes: I share the astonishment of Dr A A Templeton and his colleagues (4 October, p 46) that there has not been stronger reaction to the agreement made between the profession's negotiators and the DHSS to introduce item-of-service payments for family planning work done under the NHS. Many gynaecologists, like myself, already undertake this work. If it is done as an extra commitment outside NHS sessional time it is reasonable that we should expect due payment. We receive a salary for work done in sessional time and to offer extra payment for certain procedures is an insult to our professional integrity. It should be made clear to our negotiators and to the DHSS that our integrity is not for sale in this way.... Royal Medical Benevolent Fund Dr G S LOWE (Middlesbrough) writes: I note that the time for contributing to the Royal Medical Benevolent Fund Christmas Appeal is with us again. Several years ago my wife and I ceased to send Christmas cards to those whom we see fairly frequently, especially at Christmas time, and as a result were left with a surplus from our usual spending on Christmas cards and stamps, which my wife sent to the Ladies' Guild. Noting the price both of Christmas cards and of stamps this year, may I commend this procedure, as by so doing the coffers of the fund should be considerably swelled at a time of increasing need.
