The Pharmaceutical Journal
Vol 276 No 7403 p660
3 June 2006

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A backward glance at the Middle East more
Touching wood, avoiding ladders — ways to make us feel in control more
Trouble brewing under the ice of the Antarctic more
Are you happy or unhappy? / Curing the curable more

A backward glance at the Middle East

An editorial in the 25 March issue of The Lancet reminds us that the Middle East is at present the most neglected health area in the world, mainly because it features in the press as a prime centre of violence and disorganisation. However, it must not be forgotten that a great deal of credit for early medical discoveries must go to physicians living in the Middle East during the first millennium of our era. Prominent among these pioneers is the Persian, Ibn Sina, known to most as Avicenna, who was the author of the 10th century textbook known as ‘The canon’. He was also the first to discover the contagious nature of pulmonary tuberculosis. He laid emphasis on the importance to health of dietetics, climate and environment.

Another Persian, Al-Razi, known in the West as Rhazes, advocated an ethical basis for medical practice and is claimed to have given the first accurate account of smallpox. A Damascus physician, Ibn Al-Nafis, born in 1213, pioneered scientific peer review and described the pulmonary circulation centuries before William Harvey introduced us to it.

It is unfortunate that despite such initiatives by local health professionals the status of medicine in the Middle East should be heavily compromised by political unrest and lack of infection control in our own day. A United Nations report has recently paid attention to what it calls three deficits of the Arab world defined as knowledge, empowerment of women in society, and freedom. The poverty of education has resulted in large numbers of illiterates, and the past standard of scientific and clinical advancement has gone. Gender inequality, and the disruption caused to public services, including hospitals, by ongoing conflicts call for a radical change in local and international attitudes towards health problems. The challenge is urgent and widespread.

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Touching wood, avoiding ladders — ways to make us feel in control

The term “superstition” defies close analysis. It has so many attendant connotations that it cannot be used with any objective scientific accuracy. Compilers of dictionaries have defined it nevertheless as “a belief or notion, not based on reason or knowledge of the ominous significance of a particular thing, circumstance, occurrence, proceeding or the like”.

Superstitious behaviour always has been, and still is, as widespread and various as the human race. A note published in my local newspaper dated 6 May has provided food for thought on the topic of superstition. It states that roughly two thirds of people admit to regularly touching wood, for example, to avert trouble lurking in the background and about half making a point of never walking under an extended ladder. Some fifth of the population would not hesitate to cancel or postpone an event important for them, such as a wedding ceremony, if it fell on Friday the 13th of the month.

Psychologists who specialise in personality studies have agreed that, no matter how scientific, modern or enlightened a society, superstitions will continue to exist, largely because we inhabit an essentially unpredictable world over which, whatever our technical advances, we have little real control.

I have been conscious that I dislike putting a foot on the demarcation lines between pavement slabs and automatically tread in the spaces for no reason of which I am aware. The habit stems from childhood days and is no doubt connected with the common school game of “lines and spaces”. I find myself also stepping gingerly over repair lines in a tarmac road.

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Trouble brewing under the ice of the Antarctic

The polar regions of the earth give rise to considerable misgivings from time to time, particularly now that we expect rising sea levels as the result of thawing of polar ice. However, the problem may be far more deep-seated than most people imagine. Antarctica has a covering ice sheet of average depth some 4km and has apparently a complicated structure of which we rarely dream.

A comment by Jim Giles in the 20 April issue of Nature reports a strange situation. It has long been recognised that there are lakes under the Antarctic ice. The seventh largest lake on earth, Lake Vostok, has been the subject of controversy since plans to drill into it have raised the question of how that might contaminate surface waters. The suglacial lakes have been isolated for millions of years and might harbour unique microbial ecosystems with unknown capabilities. It is not known whether subglacial lakes are subject to cycles of filling and rapid flushing or are relatively stable. Some 150 subglacial lakes have been identified in Antarctica and there may be thousands more. Water from melting ice pressurises such lakes and causing the formation of substantial rivers. Duncan Wingham, a physicist at University College, London, fears that explosions of such lakes might prove catastrophic.

A Russian drilling team plans to breach Lake Vostok by 2007, and the borehole currently ending 100m above the surface of the lake could contaminate the water with drilling fluid. Those proposing the drill argue that pressure in the lake will force water into the borehole where it will freeze and cap any possible contamination. But it is not known what would happen if a large subglacial lake discharged into the ocean above. Accidental microbial contamination could well spread to other subglacial lakes and spell disaster.

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And I quote…

Are you happy or unhappy?
“There come moments in all our lives when we say to ourselves, ‘What does it matter whether I feel happy or not?’ Now this mood is of all moods the most insidious and dangerous. The next step is to say to ourselves, ‘I will, I will, I will be unhappy!’ And it is then that we begin giving ourselves up to that dark underflow of the will to destruction which, if it does not exist in the nature of the First Cause — as it sometimes seems to do — certainly exists as an appalling and most real element in the nature of all men and women,”
— John Cowper Powys: ‘The art of happiness’ (1935)

Curing the curable
“Medicine can only cure curable diseases, and then not always.”
—Chinese proverb

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