The Pharmaceutical Journal
Vol 276 No 7389 p242
25 February 2006

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Environment and the healthy child more
Unholy heritage of the Goths and Vandals more
A matter of spleen and black bile more

Environment and the healthy child

An editorial in the 4 February issue of The Lancet draws sorely needed attention to the difficulty of achieving a healthy environment in which a growing child will thrive.

During the past three decades most regions of the world, with the exception of Afghanistan and several African countries, have shown consistent reductions in child mortality rates. Overall, there has been more effective control of communicable and neonatal risk factors.

Now experts are turning their attention to the environment in which children grow up. Nevertheless, a report recently issued by the Commission for Environmental Co-operation with special reference to North America shows that much remains to be tackled in the sphere of public health as it impinges on children.

Three priority areas for which there is evidence of ill health attributable to environmental factors are asthma and respiratory disease, environmental threats from lead and other toxic metals, and water borne diseases. The commission has underlined exposure to tobacco smoke, the presence of lead in the home and a lack of access to sources of treated drinking water as particular problems.

The physical environment from which children should be guarded includes water of poor quality, ambient air pollution and chemicals used as food additives. Growing children are particularly vulnerable to these factors because of their rapid development and close contact with their immediate environment.

But health outcomes are affected by numerous social, economic and demographic factors that are not always included in overall surveys of the environment. The influence of some contaminants is often overlooked. There are still divergences of opinion over the causes of asthma, for example.

More research into how human health and human environment interact is pronounced essential. Until a more clear-cut picture is available it is difficult to develop an international approach to environmental health improvement. But we can surely and with heavy justification ensure so far as possible that our children are not exposed to tobacco smoke, filthy water and the nasty chemicals that commercial operations throw at us all.

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Unholy heritage of the Goths and Vandals

A Germanic people, described by Pliny and Tacitus as the Vandili, comprised a group of folk which included the Goths, the Vandals and the Burundians, having their origin in the area now known as Poland. They enjoyed a reputation, even in those days when violence was more or less expected, of indulging in destructive habits for no other reason than a delight in destroying what other people had created.

In about AD200, the Vandals moved south and divided into two groups, the Hasdings and the Silings, who came into conflict with the Roman Empire, crossing the Rhine in AD406, where now stands Mainz, and the Pyrenees in AD411. By AD439 they had captured Carthage and established a kingdom that was eventually crushed by Belisarius, the general of the Emperor Justinian, in AD533. Despite this suppression, the Vandals managed to despoil Rome of many works of art in AD455. It was such negative acts that earned them the reputation in later ages as wanton destroyers.

Today we have to reckon with our own class of vandals, for the most part individuals, who go about causing apparently senseless damage that affects the rest of society. People who throw bricks through church windows or who batter or burn memorial plaques usually seem to lack motive. Some vandals may act under the influence of drugs — particularly alcohol. It is regrettable that law enforcement agencies are bent on punishing rather than investigating and explaining why such things happen, so that their root cause can be revealed.

Some vandalism has strange religious roots and the wanton destruction by the Taliban of ancient monuments falls within this category. In our own region we have seen recently the destruction of bronze age menhirs by so-called “born again” farmers, the setting fire to holed stones and the wanton attacks on labyrinth designs in a north Cornwall valley, not to mention deliberate alterations of prehistoric stone arrangements by people who should know better.

Meddling with artefacts of archaeological significance is not to be defended. As Graham Clark put it in his ‘Archaeology and society’ (1939): “By helping to develop the historical imagination, the power to stand aside from one’s own, and to inherit the life of past ages, archaeology nourishes one of the few faculties peculiar to man, and for this reason alone is worthy of our special regard.”

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A matter of spleen and black bile

In the 5 January edition of Nature there is an interesting review b Laura Spinney of an exhibition in national galleries in Paris and Berlin. Called “Melancholy, genius and insanity in the West”, it seeks to follow the changing attitudes to melancholy over the centuries.

Melancholy has been claimed as a source of inspiration by intellectuals, mystics, artists and scientists. The ancient Greeks recognised it as something creative, but with the arrival of Christianity it acquired something of a diabolical significance. Medieval thinkers recognised no creativity in it and it came to be associated with dementia and hallucination.

To the Greek philosophers melancholia arose from the spleen and black bile, with autumn as its season, dusk its favoured time of day, earth its element and Saturn its planet. After the Renaissance it was hailed as a source of divine inspiration. Among the children of Saturn were social outcasts as well as all individuals of miserable temperament. The werewolf became part of the associated phenomena. Melancholic landscapes were bare and dotted with ruins. In the 17th century Don Quixote was a melancholic dreamer. Music was thought to lift those afflicted, and David played his harp to soothe Saul.

With the coming of the enlightenment, divergent medical and artistic ideas arose. The diagnosis monomania was used and then the broader one of bipolar depression covered the manic and the depressive phases of the condition. Artists came to see solitude and meditation in it.

There is no longer a specific concept of melancholy and recourse was made to the artistic one described by Victor Hugo as “more than gravity and less than sadness”.

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