The Pharmaceutical Journal
Vol 278 No 7444 p346
24 March 2007

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Taking the winds of March with beauty more
Social offenders in primary care need attention more
Degrading the environment threatens East Africa more
Global aftermath of a regional nuclear war more

Taking the winds of March with beauty

March is celebrated as the month of yellows in nature. Coltsfoot lines the edges of forest paths and road verges, while in the dimmer and damper recesses clumps of the lesser celandine are to be found and higher on the borders of the hillocks comes the brilliant gorse. But the most sensational must be the daffodils, which are the glory of the glades and which, as Shakespeare wrote, “come before the swallow dares, and take the winds of March with beauty”.

In some parts of Britain there are celebrated glades where the wild daffodil excels itself. In the 1930s the railway authorities ran “daffodil specials” from London so that city dwellers might enjoy a spring treat.

For more than a century daffodil cultivation was part of a farmer’s function in Cornwall and the Isles of Scilly and it remains important to this day. Naturally, there are snags in organising a business concerned with daffodil culture. It involves heavy work during a short season and there are recognised health hazards arising from the irritation the juice may cause in pickers who fail to take precautions.

A number of folk remedies derive from daffodils. An infusion of the roots induces vomiting if drunk, and was once resorted to for treating spring agues. A plaster made from the root with barley has been applied to the skin to remove swellings.

The juice, with honey, frankincense, myrrh and wine, has been dropped into infected ears to arrest oozing. It is the basis of an ointment called narcissimum. Powerful daffodil flowers induce emesis, and an infusion or syrup from them relieves catarrh. The bulbs cooked in error for onions have caused severe poisoning.

A glade of daffodils may indicate the site of an ancient monastic establishment and, perhaps for this reason, it was thought to bring trouble if the blooms were picked and placed where chickens or geese were laying, since hatching would be prevented.

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Social offenders in primary care need attention

An editorial in the 10 February issue of the BMJ draws attention to the plight of some individuals involved in social offences when seeking help from providers of primary care.

The public in general views doctors as trusted practitioners. More than 90 per cent of people regard them as truthful and 80 per cent as helpful in times of stress. However, most social offenders do not trust their general practitioners enough to ask them for help in the face of high levels of distress, self-harming behaviour and emotional problems.

Childhood abuse and early traumatic life events carry increased rates of neurotic disorders, including substance misuse. Only a minority of people consult a doctor for emotional or psychological problems, preferring to approach family members or friends for help in a crisis. Men are less likely to seek help than women and sufferers from sexual assault or domestic violence are less likely to look for help. Offenders who seek care but who have complex social and psychological problems are difficult to deal with, as are those who suffer from drug abuse and fail to engage with primary care services.

The relationship between doctor and patient should ideally involve co-operative partnership with shared decisions, the patient being encouraged to set the pace. Medical intervention can help only when combined with other factors such as housing support, educational facilities, access to work and special input from probation services and voluntary workers.

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Degrading the environment threatens East Africa

A note in the 9 March issue of Science refers to one of the perils facing humans in view of climate change. Soil erosion and land degradation offer serious threats to developing countries. These factors not only diminish the security of food supplies and threaten various terrestrial ecosystems, they also cause substantial damage to marine life offshore.

Historical records can help us to put modern phenomena in perspective. In East Africa, a region particularly vulnerable to the loss of fertile soil, records from Kenya are instructive. Records reaching back 300 years have been used in studies of the ratio of barium to calcium in corals situated in shallow coastal waters. These records offer useful indications of the degree of soil erosion, because most of the barium flux to seawater results from river discharge at the site of sampling. The records show that shortly after 1900 the ratio of barium to calcium started to increase steadily following a period of low values in the preceding two centuries. The initial increase could be attributed to British settlement of the fertile Kenyan highlands about that time.

The Kenyan findings offer a warning that without new soil conservation measures the future outlook for East Africa is bleak. Kenya’s growing population and the resulting increase in intensive land use will add to the damaging effect of the increasing rainfall that is expected as the result of global warming.

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Global aftermath of a regional nuclear war

In a commentary in the 2 March issue of Science, a group of environmental scientists has considered the possible consequences of nuclear conflict on a regional rather than a global scale. They emphasise that, although global nuclear warfare may not be a serious threat today, regional-scale conflicts might be envisaged. Acquiring nuclear weapons is widely viewed as a potent political, military and social tool, strengthening international status and insurance against aggression.

Eight nations are known to possess nuclear weapons and 32 others, including Argentina, Brazil, Japan, South Korea and Taiwan, have fissionable material to make their production feasible. If conflict broke out, the calculated fatality rates would be terrifying, particularly in China, India and Pakistan. In addition, fires ignited by nuclear bursts would release smoke into the upper atmosphere, where the effects of the carbonaceous particles would be worse than after major volcanic eruptions, upsetting aerial circulation of heat and absorbing light. Indirect effects on surface land temperatures, precipitation rates and the length of the growing season would seriously degrade agricultural productivity. This would result in worldwide effects outside the immediate combat zone. Transport, energy distribution and medical, social and political infrastructure might be limited to some extent, but little could be done about the climate anomalies.

Nuclear proliferation, political instability and urban demographics may together constitute the greatest danger to the stability of human society since the dawn of humanity.