The Pharmaceutical Journal
Vol 276 No 7404 p688
10 June 2006

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Chronic fatigue syndrome affects one in a thousand more
Playing the organ can be hazardous to your health, claims the European Union more
Tobacco: “The ruin and overthrow of body and soul” more

Chronic fatigue syndrome affects one in a thousand

Chronic fatigue syndrome is the subject of discussions in The Lancet for 13 May and New Scientist for 20 May. It is claimed to affect one person in every thousand in the UK.

Symptoms include muscle cramps, sleeplessness, weakness and headache. These are sometimes so mild as to call for no response from the sufferer but cognitive behavioural therapy has proved helpful and research has been carried out to determine which component of the therapeutic procedure is most beneficial. Both overactivity and underactivity of the immune system occur and it is thought that the control of certain viruses may prevent the onset of chronic fatigue syndrome, otherwise known as myalgic encephalomyelitis.

One determining factor in some individuals may be overloading of the lymph ducts. Damage to the head from a blow, or chemical or emotional trauma, can increase stress on the sympathetic nervous system and lead to engorgement of the lymph ducts and contribute to fatigue and pain. Swollen lymph vessels may be felt beneath the skin even when they are not visible — soft tissue massage has been successfully employed to bring relief.

Sometimes a deficiency of omega-3 and omega-6 fatty acids from a poor diet is found and treatment with essential fatty acids and evening primrose oil brings relief. However, viral infections that depress the immune system often play a part and the underlying problem varies from person to person so that there is no general solution to the problem.

Further research into the syndrome calls for provision of more funds. Graded exercise therapy offers a helpful approach. The overwhelming evidence is that a biopsycho-social treatment is likely to profit the patient more than the usual biomedical one.

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Playing the organ can be hazardous to your health, claims the European Union

One of the most curious — one might almost say insane — effects of directives emanating from the EU’s deliberations is a threat to church organs.

A batch of directives due to come into force in July appears to be aimed at reducing the disposal of toxic metals into landfill sites, claims a criticism published in Chemistry World for May. By reducing the amount of lead and other toxic metals being dumped as components of electrical equipment such as mobile telephones, the argument goes, health hazards throughout Europe may be reduced.

Unfortunately for lovers of organ music, pipe organs situated in churches and other institutions, being electrically powered, come within the specifications of the directive. The sound pipes of an organ are composed of a tin and lead alloy. This enables precise adjustments to be made to the timbre of the sound, according to experts from the Institute of British Organ Building.

Under the European directive, any new organs made would have to do without lead in their pipes. Naturally, manufacturers of organs are making strenuous efforts to gain exemption from this curious ban, and EU member states have been asked to clarify to what extent a pipe organ falls within the scope of the relevant directive.

Organ builders, though they welcome the constructive approach of the European Commission, nevertheless maintain that there is a sad lack of understanding of the wide range of problems that arise in the normal process of building a pipe organ. The experts insist that the unique sound made by an organ pipe is only made possible if lead is one of its constituents. Moreover, they claim that the directive is bizarre because ageing organ pipes do not get consigned to waste dumps in the ordinary course of events. They are too valuable for that, and are recycled if appropriate.

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Tobacco: “The ruin and overthrow of body and soul”

“The ruin and overthrow of body and soul” — in such words did Robert Burton dismiss the tobacco habit in his ‘Anatomy of melancholy’ of 1651. Since Burton’s time plenty of critics have endorsed the verdict but progress in limiting the consumption of tobacco in one form or another has been conspicuous by its absence.

Quite what tobacco’s attraction is for a user is difficult to define and we can only put the continuation of the habit under the heading of a drug addiction. This is defined by psychologists as the inability to avoid certain drugs, initially brought about by excessive exposure at some time. A comment in the 27 May issue of The Lancet over the signature of a host of experts and part of the World Health Organisztion’s Framework Convention for Tobacco Control makes clear some of the problems.

Studies during the 1950s offered strong evidence that tobacco use in any form is harmful but since then the global epidemic of tobacco-assisted disease has broadened and escalated. The focus of the problem has shifted geographically and there are different mortality trends in different countries. Some epidemics are now past their peak while others are in their early stages — for example, in young Spanish women.

The evident failure of governments to counteract the cunning marketing strategies of the global tobacco industry has been obvious — as, indeed, has their activity in deriving every greater tax income from the habit.

It is important to discover how the tobacco habit may be prevented from becoming a menace to younger persons. A few countries have reduced the rate of smoking below 20 per cent, but the industry is fast gaining markets in developing areas, with leading brands of cigarettes being manufactured in China. No form of the drug has yet been shown to be safe.

Working groups of the International Agency for Research on Cancer have shown that any exposure to environmental tobacco smoke is carcinogenic for humans. The main hazard is to individuals who start to smoke in early adult life and then continue. In the US there are still about one million new smokers every year and unless they stop the habit about half will die in middle age. It is estimated that worldwide 30 million people start to smoke every year.

Everything should be done to stop children and young adults starting to smoke. A major gain in public health in the next 20 to 40 years will come from dissuading established smokers from continuing. Unless worldwide tobacco control can be accomplished there will be one billion related deaths during the current century, compared with 100 million during the last one.

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