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organelles, cells, tissues, organs/organ systems, nervous system, theperson (experience and behaviour), two-person, family community,culture/subculture, society/nation, biosphere. The BHMA

underlines the point that the four most common medical conditions,cardiovascular disease, cancer, arthritis, and respiratory disease, areincreasingly being related to life style, diet and nutrition,environmental factors, and psychosocial stress. The report makes itclear that any discussion of therapy should include the self-healingpotential present in all human beings and must take into account theimportance of diet, exercise, relaxation, meditation, counselling,psychotherapy, and human support in the process of recovery.Discussion of drug treatment should also bear in mind the

relationship between the pharmaceutical industry and the medicalestablishment.

THE PSYCHOLOGICAL DIMENSION OF CANCER

Two cancer psychiatry research groups are to be established atthe Royal Marsden Hospital, London, and at the Christie Hospital,Manchester. The Cancer Research Campaign is to provide 1 1million over five years to fund the units, which will be under thedirectorship of Dr Steven Greer, reader in psychological medicine,King’s College School of Medicine and Dentistry, London, andInstitute of Psychiatry, and Dr Peter Maguire, senior lecturer inpsychiatry, University of Manchester. At a press conference inLondon on June 26, Prof Tim McElwain, head of the section ofmedicine at the Institute of Cancer Research and the RoyalMarsden Hospital, described how the diagnosis of cancer couldwreck a person’s life. While some patients coped well, many werebadly damaged by the whole process of being a cancer patient, aprocess which might entail not only the physical trauma of cancertreatment but also the psychological trauma of poorcommunication. Professor McElwain hoped that the two researchgroups would be able to interpret for oncologists the kind ofpsychological treatments that might be found to benefit the patient.Dr Greer drew attention to the results of his investigation (LancetMarch 30,1985, p 750), into a small group of women with breastcancer which suggested that a fighting spirit had a positive effect onthe outcome of the disease. Anecdotal evidence of the psychologicalprofile of the typical cancer patient has a long tradition. Dr Greeremphasised that although this line of research was of interest, theoverriding aim of the groups was to provide help for patients whichmight help survival. Video clips highlighted the kind of problemsexperienced by cancer patients. One woman with cervical cancer,for example, no longer wanted to make love with her husband,partly because of pain and partly because she felt that he was toblame for the cancer. Such a situation could provoke a marital crisis.Dr Maguire emphasised the difficulties medical staff had in

communicating with the cancer patient: young people, for instance,were often put through repeated aggressive courses of treatmentand kept in hospital simply because doctors could not accept that theperson was going to die and might be happier dying in peace athome. Doctors also often preferred to reassure the patient ratherthan answer a direct question, such as "How long have I got?".

POVERTY AND HEALTH

Two reports published recently draw attention to the effectpoverty has on patterns of eating. A discussion document! from theBritish Dietetic Association expresses concern about the type offood eaten by low income groups. Adults in the lowest incomegroups consume twice as much sugar and preserves, for instance, asthose in the highest income groups. The BDA fears that somepeople are not only unable to afford any necessary dietarymodifications but also actually unable to afford sufficient food.Certain groups of the population are particularly vulnerable,especially children of families on supplementary benefit; pregnantwomen; ethnic minorities; disabled people; elderly people; andpeople who require special diets. The association urges the

1. Can I Afford the Diet? A discussion paper available from the British Dietetic

Association. Available (price £3.28) from BDA, Daimler House, Paradise Street,Birmingham.

Government to examine the provision for food and therapeutic dietsfor people on supplementary benefit or family income supplement.The second report,2 from the London Food Commission, reviewsthe evidence of inadequate diet in a number of social groups,including 15-25-year-olds, women, elderly people, and homelesspeople. The cost of a healthy diet was found to be 35% more thanthe average amount spent on food by people on low incomes. Thesepeople often do not have access to cheap food outlets, such as bigsupermarkets. Between 1980 and 1983 food spending by lowincome households rose by only 6-1% compared with 15-6% forrich households. One study has shown that many members of lowincome families miss meals for lack of money. All the medicalconditions which are related to diet, such as heart disease, perinataland infant mortality, obesity, and dental caries, are more commonamong people with low incomes.

SUGAR AND HEALTH

NEARLY jC400 million was spent on dental treatment in Britain in1984. Speaking at a meeting of the McCarrison Society on July 4,Prof Aubrey Sheiham, professor of community dentistry in theUniversity of London, analysed the total cost of dental treatment inthat year: filling 31 million teeth, C159 million; crowning 2 millionteeth, C 107 million; 103 000 instances of bridgework, ,24 million;15 million instances of root fillings, ;E25 million; scaling andpolishing, £ 80 million. Professor Sheiham described what all thisdental activity meant in people’s mouths: 95% of 15-year-olds had 5teeth which had been treated by a dentist; 26% of adults in Britainhad no teeth; 50% of adults had some form of dental prosthesis; andthe average 35-44-year-old had 19 teeth decayed, missing, or filled,Professor Sheiham attributed this devastation to sugar in the diet.He borrowed a quotation from 1983:3 "In all the experiments I havecarried out I have never found it possible to induce caries inmonkeys without the addition of sucrose to their diet."

Prof Norman Blacklock, of the department of urology,University of Manchester, described the connection between dietand the urinary risk factors for the formation of kidney stones. A dietlow in sugar and refined carbohydrates, animal protein, dietarycalcium, and oxalate-rich food (such as chocolate) could reduce riskfactors in idiopathic stone formers.

Professor Sheiham summarised the steps required to reducepublic consumption of sugar: foods must be clearly labelled withtheir sugar content, added sugars should be removed from infantfoods and medicines; levels of sugar in commonly consumed foodsuch as cereals and jams should be reduced; the sugar content ofconfectionery and drinks should be reduced; and research intoalternative uses of this high-energy substance should be

encouraged.

DOCTORS IN DETENTION IN SOUTH AFRICA

ACCORDING to the Anti-Apartheid Movement’s healthcommittee (13 Mandela Street, London NWl ODW) anti-

apartheid activists detained during the current state of emergency inSouth Africa include several doctors (Dr V. Chetty, Dr MohamedFahid, Dr Shoko Motala, Dr Tennyson Lee, Dr Abubakar Asbat,Dr Francis Hlahla, Dr Abe Nkomo, Dr Robert Ribiero, and DrRichard Stevens) and the president of the University of Natal/Durban Medical Students Representative Council, Oomie

Jhetham. Some of the doctors are active in the National Medical andDental Association, established in 1982 to campaign on the socialaspects of health in South Africa, notably the effects of apartheid.Others have been active in community organisations opposed toSouth Africa’s apartheid laws. The detainees are being held withoutaccess to lawyers or relatives.

2. Tightening Belts. A report on the Impact of Poverty on Food. By Isobel

Cole-Hamilton and Tim Lang. Available (£5) from the London Food

Commission, PO Box 291, London N5 1DU.3. Cohen B. Br Dent J 1983; 155: 329.

118

Royal Society of MedicineOn July 2 Her Majesty the Queen, Patron of the Society,

accompanied by the Duke of Edinburgh, opened the Society’s newhome at 1 Wimpole Street, London. The premises constitute theoriginal building, which the Society has had since 1912, now muchimproved, and a new building next to it. The re-equipped BarnesHall has seating for 200 people and booths for simultaneoustranslation. The modernised West Hall can seat 120. The library,which contains 500 000 volumes, is now served by 3-7 miles of newshelving. The new Domus Medica has 34 bedrooms for visitingmembers. The cost of the construction, re-equipment, andrefurbishment was C4.5 million.

International Hospital Federation

Dr Errol Pickering, executive director of the Australian HospitalAssociation, has been appointed director-general. He will succeedMr Miles Hardie, who is to retire in 1987.

Royal College of Physicians and Surgeons of GlasgowDame Sheila Sherlock, formerly professor of medicine at the

Royal Free Hospital, London, and Sir John Dacie, formerlyprofessor of haematology at the Hammersmith Hospital, London,have been made honorary fellows.

World Health OrganisationDr Rudolf Slooff, chief epidemiologist of the municipal health

service of Rotterdam, Netherlands, has been appointed director ofthe WHO division of vector biology and control.

Continued Support for the National Rubella Council

The Government has announced that it is to continue its supportof the National Rubella Council for a further two years.

Survey of Whooping Cough and Measles

Action Research for the Crippled Child has commissioned atwo-year survey among medical practitioners, hospitals, social

services, and parents to discover the reasons for low uptake ofvaccination. By 1984, only 63% of children in England and Waleshad been immunised against measles. 97 000 cases were reported in1985. Of children born in 1982, only 64% had been immunisedagainst whooping cough two years later. 60 000-70 000 cases areexpected to be reported in 1986.

Admissions to Mental Hospitals for SchizophreniaIn 1984 there were 25 000 admissions to mental illness hospitals

of people diagnosed as having a schizophrenic psychosis. 54% ofthese schizophrenic psychoses were suffered by men and over a halfwere aged under 35. 79% of discharged patients with a

schizophrenic psychosis had been in hospital for less than threemonths. These are the main points of a statistical bulletin! ofschizophrenia statistics compiled by the Department of Health andSocial Security via the Mental Health Enquiry. The inquiry coversinpatients only.

Dr D. A. Henderson, dean of Johns Hopkins University School of Hygieneand Public Health, has received the Royal Society of Medicine’s Richard T.Hewitt award for his contribution to the eradication of smallpox during histime as director of the WHO campaign.

Dr Frank Wells has been appointed director of medical affairs of theAssociation of the British Pharmaceutical Industry. He will succeedDr Eric Snell, who is to retire.

Brigadier Peter Tower is to become director general of the British HeartFoundation. He succeeds Brigadier Christopher Thursby Pelham, who isretiring.

Applications are invited for 6-month fellowships, sponsored by BritishTelecom, enabling Chinese scientific research workers to visit the UK:Royal Society (ref CD), 6 Carlton House Terrace, London SW1Y 5AG.

A$50 000 research grant is offered by the Pfizer Hospital ProductsGroup for an original invention in the area of medical care: Dr GeorgeFlouty, Pfizer Hospital Products Group Award for Innovation, Pfizer1. Copies of DHSS Statistical Bulletin no 1/86, Mental Illness Hospital and Units in

England: Schizophrenia Statistics 1981-84 may be obtained (£1) from theInformation Division, Canons Park, Government Building, Honeypot Lane,Stanmore, Middlesex HA7 1AY.

Hospital Products Group, 235 East 42nd Street, New York, NY 10017,USA.

Prof Max M. Cohen (Toronto) will speak on The Role of

Prostaglandins in the Aetiology and Treatment of Peptic Ulcer at ameeting to be held at the Chace Postgraduate Medical Centre, Chase FarmHospital, The Ridgeway, Enfield, Middlesex, on Wednesday, July 16, at1 pm.

’

Prof I. V. Allen (Belfast) will speak on Multiple Sclerosis--a Disease ofthe Reticuloendothelial System at a meeting to be held at the WolfsonLecture Theatre, National Hospital, Queen Square, London WC1N 3BG,on Thursday, July 17, at 5.30 pm.

An international symposium of the British Diabetic Association willtake place at the Barbican Centre, London, on July 23-25: Secretariat,Conference Associates BDA, 27A Medway Street, Westminster, LondonSW1P 2BD (01-222 9493).A reunion dinner for comrades of St Hugh’s Military Hospital for

Head Injuries will be held on Saturday, July 26. Inquiries to John Potter,Wadham College, Oxford OXl 3PN (0865 42564).

Corrections

Viruses in Acute Childhood Encephalopathy.-The sentence beginning online 12 of the third paragraph of Prof G. T. Stewart’s letter (July 5, p 40)should have read: "In the National Childhood Encephalopathy Study, 211 ofthe first 1000 patients ...".

"Inodilators".-In the first row of Prof L. H. Opie’s table (June 7, p 1336)"DA1 +’DAz + (31" should not have appeared opposite "&bgr;-agonists".

International Diary

1986

International symposium on Drug Dependence-Risk-benefitAssessment of Agonist-antagonist Analgesics: Stockholm,Sweden, Aug 2 (Stockholm Convention Bureau, Box 1617, S-111 86Stockholm).

27th annual Advanced Seminars in Dermatology: Lake Tahoe,Nevada, Aug 20-24 (University of California San Francisco, ExtendedPrograms in Medical Education, Room 569-U, San Francisco, CA94143, USA).

l lth scientific meeting of the International Society of Hypertension:Heidelberg, West Germany, Aug 31-Sept 7 (Miss A. Bondaray, ConferenceCoordinator, VIP International Conference Services, 42 North AudleyStreet, Grosvenor Square, London W1A 4PY).

Anglo/US conference on Options in Care for Old People: Manchester,UK, Sept 1 (Mrs B. Beeby, Conference Secretary, Department of GeriatricMedicine, Teaching Unit 4, University Hospital of South Manchester, NellLane, Manchester M20 8LR).

Symposium on Doppler and 2-D Echocardiology: Washington DC,USA, Sept 7-13 (Dr J. L. Weiss, Department of Medicine, Johns HopkinsHospital, Baltimore, Maryland 21205, USA).

9th international workshop in Gynaecological Microsurgery: Leuven,Belgium, Sept 8-12 (Center for Microsurgery, Mr I. Laermans, ProvisoriumI, Minderbroederstraat 17, 3000 Leuven).

3rd international conference on Measurement in Clinical Medicine: :

Edinburgh, UK, Sept 9-11 (Conference Secretariat, Institute ofMeasurement and Control, 87 Gower Street, London WC1E 6AA).

Golden Jubilee conference and Northen European meeting on Epilepsy:York, UK, Sept 13-16 (Scientific Secretariat, Sunderland House,Sunderland Street, Macclesfield, Cheshire SK11 6JF).

lst international workshop in Nerve and Vessel Microsurgery:Leuven, Belgium, Sept 13-18 (Center for Microsurgery, Mr I. Laermans,Provisorium I, Minderbroederstraat 17, 3000 Leuven).

37th annual scientific meeting on Radiodiagnosis: Singapore, Sept 13-19(Dr Angus Robertson, 2 Heathcote Crescent, Millswood, S.A. 5034,Australia).

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International symposium on Gynaecological Oncology: London, UK,Oct 13-14 (Symposium Secretary, Institute of Obstetrics and GynaecologyQueen Charlotte’s Maternity Hospital, Goldhawk Road, London W6 OXG).