The Pharmaceutical Journal Vol 267 No 7160 p208
11 August 2001

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In a maze
Breaking the cocaine habit
Edward the tragic

In a maze

Mazes and labyrinths are strange things. They have been constructed by people of almost all cultures, from Scandinavia to Australia and Peru to the Far East, although they seem to have featured most in those centres of civilisation, Crete and Egypt.

Sometimes mazes and labyrinths are regarded as synonymous. Purists insist that they are distinct, a labyrinth being a structure comprising a complicated, winding passage through which it is possible to find a way to the centre, whereas a maze involves a network of intercommunicating paths involving the penetrator in repeated choices of route which, with one exception, lead to dead ends and call for a new attempt.

A famous labyrinth dating from about 2000BC near Lake Moeris in Egypt comprises about 3,000 linked apartments, half of them underground. The notorious Cretan labyrinth, designed by Daedalus for King Minos, and housing the Minotaur, must really have been a maze, since it was necessary to lay down a guideline thread to discover the route from its recesses. The Lemnian labyrinth was a structure through which the wanderer had to thread his way among 150 stone columns. In Clusium, Lars Porsena of Etruris constructed a maze for his tomb. Theodorus in 540BC constructed the Samian labyrinth.

In Britain the famous Woodstock maze was designed by Henry II in 1176 to conceal his Fair Rosamond from the attention of the Queen. The hedge maze at Hampton Court Palace is the oldest survivor of its type, and of the 100-odd turf mazes once known in Britain only eight survive intact.

Turf and stone mazes, where the boundaries are only ankle-high, are of course far easier to negotiate than the hedge type, where barriers impede sightings. One of the most interesting mazes of this type is on the island of St Agnes in Scilly, attributed to a lighthouse keeper in 1729 and sadly disturbed by fanatical dowsers in 1989. Indeed, there are many modern labyrinths on the Isles of Scilly, constructed of large pebbles from the shore, and either circular or square in design.

It is thought that the original mazes in folklore were intended not as puzzles but for some ritual reason. Coiled patterns in turf were intended to be run round without touching the banks, then reversing at the centre and retreating to the periphery without clashing with other performers. John Aubrey in 1686 records that a Dorset maze was run regularly by young people on holy days, and sometimes by schoolboys at other times. And Aubrey mentions a famous maze at Tuthill Fields in Westminster, popular during summer fairs.

In our own times, gardens are sometimes laid out with mazes composed of box hedges, but a recent novel idea has been the construction of seasonal mazes in crop of maize. The past few years have seen a small but growing number of such mazes built across Britain and open to the public. One current example is on a 450-acre farm near Saltash in Cornwall. A six-acre area was ploughed and sown with maize in May, in the shape of a Cornish shield and involving two wooden bridges. The dense crop is chest-high, and provides a colour scheme of black and gold, with a tin mine at the centre. After September the crop is due to be harvested and fed to the livestock, the maze to be regrown next season. This certainly represents a novel approach to the ancient art of maze and labyrinth construction.

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Breaking the cocaine habit

Cocaine is notoriously troublesome when individuals who adopt it for recreational purposes find themselves dependent on it and attempts are made to break the habit. A communication from behavioural neuroscientists at the National Institutes of Health in Maryland, published in Nature for 12 July, reports some findings of a study of cocaine craving in rats. It is believed that during the first few weeks of a withdrawal programme in cocaine addicts they become sensitised to environmental cues associated with their drug which stimulate them to further craving. Evidence from the laboratory indicates that the onset of craving is delayed and that it does not decay but increases progressively over a period of two months during withdrawal. Rats were trained to press a lever to obtain an injection of cocaine, and then allowed to press it without the reward. When they ceased to perform without the reward, the action was temporarily restored when some form of stress was present.

The results support clinical observations that a delayed-onset cocaine craving syndrome develops during the first two months of abstinence and probably lasts for longer. During the period when most of the nervous adaptations that attend withdrawal in chronic cocaine addiction are declining progressively, craving afflicts the individual and renders him vulnerable to relapse after periods well beyond the acute phase of drug withdrawal. Memories of past stimulating experiences with cocaine are probably a trigger to set off the renewed craving.

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Edward the tragic

It is well known that Edward VI, son of Henry VIII and Jane Seymour, had a regrettably short life, dying in 1553 of a lingering illness. His mother died only 12 days after the birth of Edward, of an undetermined cause. His father took detailed precautions against infection of his successor, insisting on twice-daily scrubbing of floors, rapid removal of soiled dishes, careful preparation of the boy’s food and his isolation from ordinary people, especially any who might show signs of sickness. Edward was given a separate household while still in infancy, and apparently thrived, but at the age of 14 years and six months had a rash and a febrile illness which seems to have been the precursor of his early demise.

In the New England Journal of Medicine for July 5, three doctors — Grace and Frederick Holmes of Kansas and Julia McMorrough of Boston — have offered an explanation of why Edward’s life was cut short in 1553, when he was only 15. In April 1552 he had an acute febrile illness and rash, which he recorded in his journal as “the measles and the smallpox”. He had a family history of chest diseases, but made a rapid recovery, followed eight months later by a rough cough, shortness of breath, swelling of the legs, failing pulse and probably cyanosis. His physicians, George Owen, William Butts and John Chambre, were aware that he was then suffering from tuberculosis. It was observed by Richard Morton in the 17th century that consumption might follow acute febrile illnesses such as measles and smallpox. Later this effect was attributed to immunosuppression, induced by the childhood fevers. It is now thought that measles virus inhibits the production of interleukin-12.

It seems obvious that, in spite of the many precautions taken by King Henry to keep his royal heir away from contagion and infection, he had come into close contact with at least one person of his entourage who was suffering from tuberculosis. Thus, Edward was probably carrying the germ of this illness prior to developing his measles. The reactivation of the tubercle bacillus by this common childhood infection was the event that resulted in the lad’s untimely death.

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