parliament

1
1368 are classically far more red-cell precursors. However, it was a feature of the published cases in which there was confusion in the diagnosis.1,2 It seems likely that the excess of white-cell precursors is due to concomitant iron deficiency.5 The patient was later shown to have malabsorption of sugars, fat, and vitamin B12, and the small-bowel-biopsy appearances were compatible with a diagnosis of tropical sprue. She is now fully recovered following folic acid, B12’ and tetracycline therapy. I am grateful to Dr. J. Verrier Jones for permission to report a case under his care, and to him and Dr. F. J. W. Lewis for helpful discussions. Department of Medicine and Pathology Southmead Hospital, Bristol BS10 5NB. T. J. HAMBLIN. SCIENCE AND NON-SCIENCE SIR,-Dr. Eliot Slater’s lecture advocating the exclusion of psychoanalysis from scientific medicine was given at the Institute of Psychiatry-an institute of the University of London. There is indeed much to be said against granting psychoanalysis a place in a university’s faculty of medicine. But it has always seemed strange to me that, though it has been studied for many years, psychoanalysis has never been accorded a place in the universities. After all, many an unscientific subject does have a place in university studies. What has happened in the past is that, since psycho- analysis involves so much difficult and delicate handling of disturbed people, the doctors have said, " Only doctors should do this". And then, when the psychoanalysts have done their best to make their ranks as medically qualified as possible, the doctors have said, " We do not want you here; you are unscientific". So it might be a good thing to found a department of psychoanalysis, staffed by doctors, in the faculty of arts of a university, where they could work independently of the faculty of medicine. Doctors practising psychoanalysis in such a setting might find their colleagues in other departments of the faculty of arts more appreciative, informed, informative, and stimulating than their medical colleagues. They might even eventually be able to make a contribution to scientific medicine. GORDON BANCROFT. 5. Lowenstein, L., Brunton, L., Hsieh, Y. S. Can. med. Ass. J. 1966, 94, 636. Appointments SHAW, J. D., M.B. Sheff., F.R.C.S., F.R.C.S.E. : consultant E.N.T. surgeon, United Sheffield Hospitals. TEARE, H. D., M.B. Cantab.: medical superintendent, King Edward VII Hospital, Sussex. Liverpool Regional Hospital Board: HARLEY, ALEXANDER, M.B. Cantab., M.R.C.P.: consultant cardiologist, South Liverpool hospital group. JONES, N., B.sc., M.R.C.S., D.M.R.D.: consultant radiologist, East and South Liverpool hospital groups. PRIDEAUX, P. R., M.B. L’pool., F.F.A. R.C.S.: consultant ansthetist, Broadgreen and Aintree hospitals. South West Metropolitan Regional Hospital Board: BAYNE, MARY K., M.B. Dubl., F.F.A. R.c.s., D.A.: consultant anaesthetist, Croydon and Warlingham hospital group. FARRINGTON, G. H., M.B. Leeds, F.R.C.S. : consultant surgeon, Kingston and Long Grove hospital group. FOLEY, T. H., M.B., B.SC. Lond., M.R.C.P. : consultant physician, Guildford and Godalming hospital group. GODDARD, P. F., M.B. Lond., M.R.C.PATH.: consultant in chemical pathology, Epsom and West Park hospital group. GRANT, M. E., M.B. N.U.I., D.P.M.: consultant in mental subnormality, Royal Earlswood hospital group. McGRATH, JAMES, M.B. N.U.I., M.R.C.O.G., F.R.C.S. : consultant obste- trician and gynecologist, Kingston and Long Grove hospital group. NOTLEY, R. G., M.B. Lond., F.R.C.S. : consultant surgeon, Guildford and Godalming hospital group. Parliament Tobacco and Snuff Bill Sir GERALD NABARRO asked leave to bring in the Tobacco and Snuff (Health Hazards) Bill. He said that two previous Bills with a similar intent had failed through lack of Parliamentary time, but this one was both a stronger and a wider Bill than either of its predecessors. Three important restrictions would be imposed under the Bill. A " bold, graphic and lurid health warning " would have to be printed on the exterior of all containers and packets of cigarettes and tobacco products, including snuff. Snuff was included simply because it was a tobacco product, even though there might be no hazard to health in its use. If the majority of informed opinion outside and inside the House decided specifically to exclude snuff at a future stage of the Bill, then he would, of course, submit. The second measure proposed in the Bill was to have printed on the outside of all containers of tobacco products the poison content of the manufactured tobacco itself, notably the tar and nicotine. The third provision, which might be introduced into the Bill in Committee if the Government supported the measure, but not otherwise, was a total ban on all advertising by all media of all tobacco products. It was generally believed that this was an acceptable means of containing and eventually restricting the consumption of tobacco, especially in the form of cigarettes. These measures were necessary to counteract the evil influence of tobacco consumption on human health; about 100,000 people died each year as a direct or indirect result of tobacco consumption. It had been calculated that the cost of treatment of a patient with lung cancer, including care in hospital before death, was at least E1000. These cases therefore accounted for an expenditure of E100 million by the Health Service, approximately 5% of the N.H.S. Vote. The Chancellor of the Exchequer had a vested interest in the consumption of tobacco: tobacco duty amounted to El 160 million this year. But human health in Britain was more important than current revenue. The Bill was supported by 11 other members, 4 of them doctors. Mr. MARCUS LIPTON, opposing the Motion, said that he had to declare an interest. He was an honorary member of the Society of Snuff Grinders, Blenders, and Purveyors. There was no evidence whatsoever that snuff-taking was harmful; it had no tar content. However, he would not press his opposition, on the undertaking that all reference to snuff would be excluded from the Bill when, if ever, it was dealt with in Committee. The Bill was given a formal first reading. QUESTION TIME Welfare Orange juice In reply to a question on the possible harmful effects on children’s teeth of welfare orange juice, Sir KEITH JOSEPH, Secretary of State for Social Services, said that the Depart- ment was aware of the danger of the misuse of undiluted fruit syrups, and had decided to place no further contracts for welfare orange juice. It would cease to be available by the end of 1971. Cod-liver oil, which was also supplied under the welfare foods service, was unpalatable to some children, and unpopular with their mothers. Welfare orange juice and cod-liver oil would, therefore, be replaced by a new preparation containing vitamins A, D, and C to be administered in the form of drops. Expectant and nurs- ing mothers, who were at present entitled to vitamin A and D tablets and orange juice, would in future be given vita- mins A, D, and C in single-tablet form. The necessary order would be made early in the new year.

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Page 1: Parliament

1368

are classically far more red-cell precursors. However, it was afeature of the published cases in which there was confusion inthe diagnosis.1,2 It seems likely that the excess of white-cellprecursors is due to concomitant iron deficiency.5The patient was later shown to have malabsorption of

sugars, fat, and vitamin B12, and the small-bowel-biopsyappearances were compatible with a diagnosis of tropicalsprue. She is now fully recovered following folic acid,B12’ and tetracycline therapy.

I am grateful to Dr. J. Verrier Jones for permission to report acase under his care, and to him and Dr. F. J. W. Lewis for helpfuldiscussions.

Department of Medicine and PathologySouthmead Hospital,Bristol BS10 5NB. T. J. HAMBLIN.

SCIENCE AND NON-SCIENCE

SIR,-Dr. Eliot Slater’s lecture advocating the exclusionof psychoanalysis from scientific medicine was given at theInstitute of Psychiatry-an institute of the University ofLondon. There is indeed much to be said against grantingpsychoanalysis a place in a university’s faculty of medicine.But it has always seemed strange to me that, though it hasbeen studied for many years, psychoanalysis has never beenaccorded a place in the universities. After all, many anunscientific subject does have a place in university studies.What has happened in the past is that, since psycho-

analysis involves so much difficult and delicate handling ofdisturbed people, the doctors have said, " Only doctorsshould do this". And then, when the psychoanalysts havedone their best to make their ranks as medically qualifiedas possible, the doctors have said, " We do not want youhere; you are unscientific". So it might be a good thingto found a department of psychoanalysis, staffed by doctors,in the faculty of arts of a university, where they couldwork independently of the faculty of medicine. Doctors

practising psychoanalysis in such a setting might findtheir colleagues in other departments of the faculty of artsmore appreciative, informed, informative, and stimulatingthan their medical colleagues. They might even eventuallybe able to make a contribution to scientific medicine.

GORDON BANCROFT.

5. Lowenstein, L., Brunton, L., Hsieh, Y. S. Can. med. Ass. J. 1966,94, 636.

AppointmentsSHAW, J. D., M.B. Sheff., F.R.C.S., F.R.C.S.E. : consultant E.N.T. surgeon,

United Sheffield Hospitals.TEARE, H. D., M.B. Cantab.: medical superintendent, King Edward VII

Hospital, Sussex.

Liverpool Regional Hospital Board:HARLEY, ALEXANDER, M.B. Cantab., M.R.C.P.: consultant cardiologist,

South Liverpool hospital group.JONES, N., B.sc., M.R.C.S., D.M.R.D.: consultant radiologist, East and

South Liverpool hospital groups.PRIDEAUX, P. R., M.B. L’pool., F.F.A. R.C.S.: consultant ansthetist,

Broadgreen and Aintree hospitals.

South West Metropolitan Regional Hospital Board:BAYNE, MARY K., M.B. Dubl., F.F.A. R.c.s., D.A.: consultant anaesthetist,

Croydon and Warlingham hospital group.FARRINGTON, G. H., M.B. Leeds, F.R.C.S. : consultant surgeon, Kingston

and Long Grove hospital group.FOLEY, T. H., M.B., B.SC. Lond., M.R.C.P. : consultant physician,

Guildford and Godalming hospital group.GODDARD, P. F., M.B. Lond., M.R.C.PATH.: consultant in chemical

pathology, Epsom and West Park hospital group.GRANT, M. E., M.B. N.U.I., D.P.M.: consultant in mental subnormality,

Royal Earlswood hospital group.McGRATH, JAMES, M.B. N.U.I., M.R.C.O.G., F.R.C.S. : consultant obste-

trician and gynecologist, Kingston and Long Grove hospitalgroup.

NOTLEY, R. G., M.B. Lond., F.R.C.S. : consultant surgeon, Guildfordand Godalming hospital group.

Parliament

Tobacco and Snuff Bill

Sir GERALD NABARRO asked leave to bring in the Tobaccoand Snuff (Health Hazards) Bill. He said that two previousBills with a similar intent had failed through lack of

Parliamentary time, but this one was both a stronger anda wider Bill than either of its predecessors. Three importantrestrictions would be imposed under the Bill. A " bold,graphic and lurid health warning " would have to be

printed on the exterior of all containers and packets ofcigarettes and tobacco products, including snuff. Snuffwas included simply because it was a tobacco product, eventhough there might be no hazard to health in its use. Ifthe majority of informed opinion outside and inside theHouse decided specifically to exclude snuff at a futurestage of the Bill, then he would, of course, submit. Thesecond measure proposed in the Bill was to have printedon the outside of all containers of tobacco products thepoison content of the manufactured tobacco itself, notablythe tar and nicotine. The third provision, which mightbe introduced into the Bill in Committee if the Governmentsupported the measure, but not otherwise, was a total banon all advertising by all media of all tobacco products. Itwas generally believed that this was an acceptable meansof containing and eventually restricting the consumptionof tobacco, especially in the form of cigarettes. Thesemeasures were necessary to counteract the evil influenceof tobacco consumption on human health; about 100,000people died each year as a direct or indirect result oftobacco consumption. It had been calculated that the costof treatment of a patient with lung cancer, including carein hospital before death, was at least E1000. These casestherefore accounted for an expenditure of E100 millionby the Health Service, approximately 5% of the N.H.S.Vote. The Chancellor of the Exchequer had a vestedinterest in the consumption of tobacco: tobacco dutyamounted to El 160 million this year. But human healthin Britain was more important than current revenue. TheBill was supported by 11 other members, 4 of them doctors.Mr. MARCUS LIPTON, opposing the Motion, said that he

had to declare an interest. He was an honorary member ofthe Society of Snuff Grinders, Blenders, and Purveyors.There was no evidence whatsoever that snuff-taking washarmful; it had no tar content. However, he would notpress his opposition, on the undertaking that all referenceto snuff would be excluded from the Bill when, if ever, itwas dealt with in Committee. The Bill was given a formalfirst reading.

QUESTION TIME

Welfare Orange juiceIn reply to a question on the possible harmful effects on

children’s teeth of welfare orange juice, Sir KEITH JOSEPH,Secretary of State for Social Services, said that the Depart-ment was aware of the danger of the misuse of undilutedfruit syrups, and had decided to place no further contractsfor welfare orange juice. It would cease to be available bythe end of 1971. Cod-liver oil, which was also suppliedunder the welfare foods service, was unpalatable to somechildren, and unpopular with their mothers. Welfareorange juice and cod-liver oil would, therefore, be replacedby a new preparation containing vitamins A, D, and C tobe administered in the form of drops. Expectant and nurs-ing mothers, who were at present entitled to vitamin A andD tablets and orange juice, would in future be given vita-mins A, D, and C in single-tablet form. The necessaryorder would be made early in the new year.