The Pharmaceutical Journal
Vol 274 No 7352 p682
4 June 2005

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Dr or Mr: surgeons’ titles under review more
Detecting the subtle odour of crime more
The disintegration of Utopia on a remote Scottish island more

Dr or Mr: surgeons’ titles under review

A news item in the BMJ for 14 May suggests that, after the intervention of the president of the Royal College of Surgeons, the titles of “Mr” and “Miss” to denote surgeons may be rendered obsolete.

In the past, the distinction between Mr Surgeon and Dr Physician has been rigidly observed. With the introduction of non-medically qualified surgical care practitioners, it is important for patients to know, for their own satisfaction, whether someone treating them is medically qualified or holds other qualifications. Throughout the rest of the world surgeons are called doctors but, in Britain, a distinction has been maintained according to the ancient rules of the guilds to which medical people were affiliated.

The tradition of addressing surgeons as “Mr” or “Miss” originated in the days of the barber-surgeons who were granted a charter by Henry VIII in 1540. By the beginning of the late 18th century physicians and a few surgeons gained university degrees and were then called “Dr”. Other surgeons who owed their skill to an apprenticeship continued to be called “Mr”. In 1745, when the Royal College of Surgeons of London was set up, the distinction continued.

There is no longer any justification for distinguishing surgeons from physicians by using a traditional title. In hospitals the tradition has sometimes been rigidly observed with some surgeons resenting being addressed as “Dr”, but undoubtedly the superstition, as it might be called, has come to the end of its life. People who undergo treatment for diseased conditions have the right to know whether the individual caring for them has taken a medical degree or otherwise.

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Detecting the subtle odour of crime

In vertebrate animals the cerebral cortex underwent development over the ages in connection with the sense of smell. In most animals environmental odours are a critical source of warnings and enticements. Within species, pheromones play a part in social organisation by altering mood and prompting action.

Humans living in civilised circumstances have, however, largely neglected the sense of smell. Those parts of the brain associated with this sense, constituting the rhinencephalon, have tended to diminish in importance, but still exercise a function that may in some circumstances resolve the dilemma of life or death.

In some unusual situations the olfactory sense has vitally affected daily living. An example is the celebrated case of Helen Keller, the American writer. She was deaf and blind from infancy but developed an extremely sensitive olfactory function that enabled her to make contact with her environment as she moved from place to place. Odours such as those from cooking and soiled clothing that others found unpleasant she regarded as pleasant and kindly.

In experiments on human subjects some olfactory stimulants such as clove, lavender, anise, benzene and xylene appear to act only on certain things concerned with smell, whereas others, such as camphor, eucalyptus, pyridine and phenol exert a broader effect and trigger both olfactory and trigeminal nerve endings. It is well known that the human nose, particularly in individuals abusing tobacco and alcohol, is grossly insensitive compared with that of other vertebrates.

The dog, especially, can detect and apparently enjoy faint smells, often disgusting to humans, and has therefore been trained for centuries to follow the trail of animals which are being hunted and of humans who are sought in connection with criminal behaviour.

Moreover, dogs have been trained to detect smuggled or suspect materials carried in vehicles or on the person, including a wide range of drugs.

The latest reports have been of dogs specially trained to detect caches of bank-notes. In South Wales three dogs have recently undergone a week’s training to acquaint themselves with notes loaned by the Bank of England. Notes were concealed in buildings and underground locations, which dogs and their handlers investigated. When a hoard was located the dogs either sat down on the site or gave notice by barking there.

One interesting question arises. Might it be possible for some crook with access to a laboratory to work out a counteracting or overpowering perfume that would serve as a screen and so prevent the sniffer-dogs from detecting or identifying their quarry? It seems obvious that such a cover would defeat its object by revealing the cache to a human investigator, but it remains to be seen whether criminal ingenuity can overcome such a factor.

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The disintegration of Utopia on a remote Scottish island

The island of Hirta, in the Outer Hebrides has become celebrated as an example of what a modern capitalist society can do to an idyllic situation, according to a report published in Nature for 21 April.

Hirta was once a self-sufficient community, but contact with the outside world persuaded the inhabitants to relinquish the island in 1930, and it ceased to be part of the St Kilda society, enthusiastically described by Martin Martin in his renowned ‘A description of the Western Islands of Scotland’, first published in 1703.

The culture was dependent upon the exploitation of seabirds, which were harvested for their meat, oil and feathers. The St Kildan’s produced serious deleterious effects on seabird populations throughout Europe, including the destruction of the last observed great auk in Britain in 1840.

Andy Meharg, a biologist of Aberdeen, who wrote the article, found descriptions in Martin’s book of how the inhabitants recycled their faeces, peat ash and bird residues and applied them to their land as fertiliser for arable food crops. A recent analysis of these soils showed a high contamination with lead, zinc and dioxins. Examination of ancient and recent seabird bones and old peat ash from dwelling floors by lead isotopic methods showed that the pollution came from ash and bones in the compost. Levels of pollutants were very high, with lead and zinc concentrations in the arable soils reaching 500mg per kg. This ranks with the soils of Britain’s most polluted industrial cities.

All this was the result of a small island with only 40 acres of arable supporting a population of about 200 inhabitants since Iron Age times, the dietary protein being derived from massive exploitation of seabird colonies and then recycled as human waste.

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