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Vol 272 No 7282 p66
17 January 2004

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Onlooker

Benevolent eccentric more
Thought for food more
Insight into how MDMA dangerously raises body temperature more


Benevolent eccentric

Last month saw the bicentenary of the birth of the remarkable and incredibly eccentric cleric Robert Stephen Hawker at Stoke Damerel, Plymouth. He was educated at Cheltenham Grammar School, where at the age of 18 he published a book of poems entitled ‘Tendrils by Reuben’. From there, in 1823, he attended Pembroke College, Oxford, where he gained his arts degree in 1828. He married early in life and with his wife moved to Morwenstowe in north Cornwall, where he was appointed vicar in 1834.

Hawker was a prolific writer of poetry, his most famous example being the “Song of the western men”, with its memories of Trelawney and the “twenty thousand Cornish men will know the reason why”, which was composed as early as 1826. He was dismissive of the established custom of clerics dressing in black, and was to be seen wearing a claret-coloured coat, blue fisherman’s jersey and long sea-boots, or a red-brown cassock and a pink brimless hat. He often rose in the pulpit in red gloves. He insisted on yellow stationery, which he had specially made for his use. His handwriting was bold, his voice powerful. He was usually accompanied to church services by a dog and nine or 10 cats. He forbade the lighting of fires in the vicarage when jackdaws were nesting in the chimneys and he objected vigorously to neighbouring farmers shooting rooks.

On many other matters Hawker was a progressive. He instituted what later became widely accepted, a special harvest festival celebration. His sympathy for his poor parishioners was exceptional for his time, and he did his best for any shipwrecked mariners who came to grief under his cliffs. He erected in his churchyard the white figurehead of the Caledonia, wrecked in 1842 with a sole survivor, and buried beneath it the remains of the drowned crewmen.

Despite his vigorous approach to what he saw as social evils, he was much given to meditation and contemplation. With the flotsam of local wrecks he made himself a hut on the edge of the cliffs, where he sat and thought. It is there to this day, and to sit there and look out on the treacherous reefs below is an inspiring experience that we can share with Hawker, especially when the gales beat on the coast and the sea rages.

In 1875, Hawker was taken to Plymouth by his second wife, Pauline, for medical attention, but he deteriorated and was in severe pain, suffering a paralytic stroke and dying before the end of the year. During his illness he had recourse to opium for relief. On his deathbed he joined the Church of Rome, for which he had always held deep sympathy.

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Thought for food

A leading article in The Lancet for 15 November 2003 is calculated to provide food for thought and thought for food. It is based on a Food Standards Agency discussion on the diet of our children and the influences that play a part in determining what they choose to eat. It is found that television advertising promotes the consumption of sugar-laden breakfast cereals, sweetened soft drinks, sugary confectionery and savoury snacks. Added to this is a growing tendency to promote fast foods, which are not now considered the best choice for a child's dietary regimen.

The problem is that such public promotion affects children’s food preferences, prompting them to pester their parents into buying articles they would otherwise avoid as unhealthy. It has been shown that children who watch more food advertisements devour more snacks and calories. Unfortunately, the lures dangled by food outlets are fun, fantasy and unusual taste, rather than healthy and nutritious fare. Fat, sugar and salt tend to be high in such products and as a result the incidence of obesity is rising year by year, having advanced during the past 10 years to 8.5 per cent in six-year-olds and 15 per cent in 15-year-olds. As a result, type 2 diabetes, previously encountered only in middle-aged or older individuals, is being seen in children of school age. Heart disease, raised blood pressure and osteoarthritis are later complications of obesity.

Techniques in selling junk food includes the use of popular celebrities in advertising — bizarrely, often sports celebrities who should know that fitness demands careful dieting. Such promotional tactics must somehow be counteracted. “Confectionery has to be removed from supermarket checkouts, and pharmacies should not be selling it at all,” claims The Lancet. This is a welcome recommendation that is long overdue. And at the same time, the promotion of healthy food articles such as vegetables and fruits should be in the forefront of industry’s advertising campaign.

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Insight into how MDMA dangerously raises body temperature

The concept of a “recreational drug” should be vigorously stamped out, since it makes a mockery of recreation, which is defined as an activity calculated to restore a sense of balance and tranquillity to a frame that has suffered some kind of environmental stress.

Recently we have heard much about abuse of methylenedioxymethamphetamine (MDMA, “ecstasy”) as a “recreational drug”. More insight into the toxic effects of MDMA is offered in a commentary by biomedical investigators in Nature for 27 November 2003. They remind us that a United Nations report has estimated an increase of 70 per cent in the misuse of MDMA between 1995 and 2000 and that this has been accompanied by an increase in the number of hospital casualties and deaths.

Most of the deaths have been attributed to a syndrome involving persistent hyperthermia leading to the breakdown of skeletal muscle, which results in failure of kidney and other organ systems. Brown fat is rich in mitochondria containing uncoupled protein-1 (UCP-1), which plays an important role in mediating thermoregulation.

The related UCP-2 and UCP-3 may also play a role in this process. However, there are indications that UCP-3 may not regulate body temperature under normal physiological conditions but might be concerned with pathological thermogenic responses like that to MDMA.

Experiments in mice have suggested that UCP-3 is required for the rise in skeletal and body core temperature associated with MDMA administration. The temperature response in individuals taking excessive amounts of MDMA varies and this variation may relate to the uncoupling activity of their skeletal muscle. The same uncoupling proteins UCP-2 and UCP-3 may also affect the toxicity of ephedrine, methamphetamine and cocaine, which are also capable of inducing a hyperthermic reaction.

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