1027 a downward curve for social-service with the plunge timed to start three years ahead. But when the next white-paper appears, it is found that the downturn has been pushed one more year into the future. There was, too, a penitential appearance by that outright champion of the big-spending league, Sir Keith Joseph, who movingly bewailed his own profligacy in his Elephant and Castle days and even repented somewhat of his Health Service reorganisation, which he defended with such unyielding stubbornness at the time, but which he now recognised had thrown up a further proliferation of costly administra-
strated, shows
Letters
spending,
tors.
Clearly, in the light of these and other speeches made from the Opposition benches in the past few days, we are now going to see a transformation in the Conservative Party. The Government, one can take it, is no longer going to be condemned for its parsimony at every turn, whether it is for opposing the ending of the Earnings Rule, or for failing to sanction new hospitals or extensions to old ones in at least two out of every three towns represented by a Conservative M.P. Clearly, from now on, we can depend on Opposition M.p.s to observe the same rules of austere selfdenial which they have been prescribing for the Chancellor. Or can we ? We shall see. The only comfort Mr Healey had to offer in the health and welfare field was his announcement that new child allowances, covering the first and subsequent to be introduced-though not until children, were " the earliest practicable date ". An interim April, 1977, benefit would, however, be introduced to cover the first child in one-parent families and that would start in April, 1976. Additionally, he was accepting the recommendation of the Finer Committee that the additional personal allowance claimed by the single parent with a dependent child should be increased to make the single parent’s tax allowances level with those of a married man. The sizable all-party group which has been harrying the Government to implement the Finer report regarded this as better than nothing, but still a long way short of justice. As the Labour M.P. for Welwyn and Hatfield, Mrs Hayman, pointed out, the tax concession, welcome though it is, does nothing for the worst-off families who, being too poor to pay tax, are therefore too poor to benefit from concessions. As expected, the Chancellor increased the tax on cigarettes, with an average increase of 7p per packet. This statement was greeted with cries from some parts of the House of " not enough ". Mr Healey also took a passing swipe at private medicine by saying he would tax the benefits enjoyed by those whose employers operated a private health scheme. And he nonchalantly lopped off the E21 million plan for a mid-. term census, on whose paramount necessity the Government had been insisting before a somewhat sullen House less than a month before. The money saved by cancelling the census, one notes, is almost enough to pay for the interim child allowances for one-parent families. Perhaps that will be some small consolation for the trail of dejected demographers which Mr Healev rrmRt have 1&ft
hehind him.
DAVID MCKIE.
to
the Editor
HYPERTHERMIA AND CANCER
SIR,—The letters from Mr Turnbull (March 15, p. 643) and Mr Teasdale (April 12, p. 852) on the possible dangers of using hot-water bottles on cancer prompt me to join in the correspondence, as I have long been interested in the effect of heat on living cells. Since 1860 when Erasmus Wilson, F.R.C.S.,l drew the attention of the profession to thermo-therapeia (the heat cure), a voluminous literature has appeared on this subject. Following the clinical observations that certain bacterial and other infections which resulted in a sustained hyperthermia caused some cancers to regress, or entirely disappear, a considerable amount of clinical and experimental work has been done, particularly during the past 70 years, in an attempt to exploit the use of heat. On perusing the literature, different workers have- drawn attention to the fact that heat can kill malignant cells, or can accelerate their growth, or have no effect whatsoever, according to the type, location, and stage of development of the cells, the level of temperature maintained, and the duration of its application.
Although Mr Turnbull and Mr Teasdale refer to the possible stimulatory effects of heat from hot-water bottles, nevertheless there are those (e.g., Crile 2) who have observed marked regression of metastatic carcinoma of the breast by treating the involved skin with moist heat packs or hot water at 42 °C for 24 hours or 48 °C for hour. It was Dr Gilchrist, in the discussion on the paper by Woodhall et al.,3 who urged the profession to look to the electronic industry to provide the expertise enabling us to heat organs inside the body to any degree we wish and thus inhibit or destroy the tumour, but we should remember Crile’s statement (in Shingleton et a1.4) : "Ihave one grave warning to make and that is, in dealing with heat you are dealing with one of the most dangerous agents that there is. For goodness’ sakes go to the laboratory and work this out in detail before you apply it to the human." ,
It is a sad reflection upon our technological progress that during the past 100 years we have not really come to grips with this powerful tool, and since heat is of such fundamental importance in stimulating, retarding, or destroying living cells it is imperative, if we are to advance in this field, that in addition to clinical, animal, and tissueculture work we elucidate the mechanism or mechanisms which are operative at the molecular or sub-molecular level, because there is some evidence that if we employ heat empirically, on the one hand, it may encourage some tumours to proliferate faster,5 and, on the other hand, and perhaps much more important, it is possible to induce thermoresistance to malignant cells surviving heat application.s Department of Microbiology, Welsh National School of
Medicine, The Royal Infirmary, Cardiff CF2 1SZ. 1. 2. 3. 4. 5. 6.
R. A. HOLMAN.
Wilson, E. Br. med. J. Oct. 13, 1860, p. 789. Crile, G. Cleveland clin. Q. 1961, 28, 75. Woodhall, B., Pickrell, K. L., Georgiade, N. G., Mahaley, M. S., Dukes, H. T. Ann. Surg. 1960, 151, 750. Shingleton, W. W., Bryan, F. A., O’Quinn, W. L., Krueger, L. C. ibid. 1962, 156, 408. Brett, D. E., Schloerb, P. R. Archs Surg. 1962, 85, 1004. Selawry, O. S., Goldstein, M. N., McCormick, T. Cancer Res. 1957, 17, 785.
strated, shows
Letters
spending,
tors.
Clearly, in the light of these and other speeches made from the Opposition benches in the past few days, we are now going to see a transformation in the Conservative Party. The Government, one can take it, is no longer going to be condemned for its parsimony at every turn, whether it is for opposing the ending of the Earnings Rule, or for failing to sanction new hospitals or extensions to old ones in at least two out of every three towns represented by a Conservative M.P. Clearly, from now on, we can depend on Opposition M.p.s to observe the same rules of austere selfdenial which they have been prescribing for the Chancellor. Or can we ? We shall see. The only comfort Mr Healey had to offer in the health and welfare field was his announcement that new child allowances, covering the first and subsequent to be introduced-though not until children, were " the earliest practicable date ". An interim April, 1977, benefit would, however, be introduced to cover the first child in one-parent families and that would start in April, 1976. Additionally, he was accepting the recommendation of the Finer Committee that the additional personal allowance claimed by the single parent with a dependent child should be increased to make the single parent’s tax allowances level with those of a married man. The sizable all-party group which has been harrying the Government to implement the Finer report regarded this as better than nothing, but still a long way short of justice. As the Labour M.P. for Welwyn and Hatfield, Mrs Hayman, pointed out, the tax concession, welcome though it is, does nothing for the worst-off families who, being too poor to pay tax, are therefore too poor to benefit from concessions. As expected, the Chancellor increased the tax on cigarettes, with an average increase of 7p per packet. This statement was greeted with cries from some parts of the House of " not enough ". Mr Healey also took a passing swipe at private medicine by saying he would tax the benefits enjoyed by those whose employers operated a private health scheme. And he nonchalantly lopped off the E21 million plan for a mid-. term census, on whose paramount necessity the Government had been insisting before a somewhat sullen House less than a month before. The money saved by cancelling the census, one notes, is almost enough to pay for the interim child allowances for one-parent families. Perhaps that will be some small consolation for the trail of dejected demographers which Mr Healev rrmRt have 1&ft
hehind him.
DAVID MCKIE.
to
the Editor
HYPERTHERMIA AND CANCER
SIR,—The letters from Mr Turnbull (March 15, p. 643) and Mr Teasdale (April 12, p. 852) on the possible dangers of using hot-water bottles on cancer prompt me to join in the correspondence, as I have long been interested in the effect of heat on living cells. Since 1860 when Erasmus Wilson, F.R.C.S.,l drew the attention of the profession to thermo-therapeia (the heat cure), a voluminous literature has appeared on this subject. Following the clinical observations that certain bacterial and other infections which resulted in a sustained hyperthermia caused some cancers to regress, or entirely disappear, a considerable amount of clinical and experimental work has been done, particularly during the past 70 years, in an attempt to exploit the use of heat. On perusing the literature, different workers have- drawn attention to the fact that heat can kill malignant cells, or can accelerate their growth, or have no effect whatsoever, according to the type, location, and stage of development of the cells, the level of temperature maintained, and the duration of its application.
Although Mr Turnbull and Mr Teasdale refer to the possible stimulatory effects of heat from hot-water bottles, nevertheless there are those (e.g., Crile 2) who have observed marked regression of metastatic carcinoma of the breast by treating the involved skin with moist heat packs or hot water at 42 °C for 24 hours or 48 °C for hour. It was Dr Gilchrist, in the discussion on the paper by Woodhall et al.,3 who urged the profession to look to the electronic industry to provide the expertise enabling us to heat organs inside the body to any degree we wish and thus inhibit or destroy the tumour, but we should remember Crile’s statement (in Shingleton et a1.4) : "Ihave one grave warning to make and that is, in dealing with heat you are dealing with one of the most dangerous agents that there is. For goodness’ sakes go to the laboratory and work this out in detail before you apply it to the human." ,
It is a sad reflection upon our technological progress that during the past 100 years we have not really come to grips with this powerful tool, and since heat is of such fundamental importance in stimulating, retarding, or destroying living cells it is imperative, if we are to advance in this field, that in addition to clinical, animal, and tissueculture work we elucidate the mechanism or mechanisms which are operative at the molecular or sub-molecular level, because there is some evidence that if we employ heat empirically, on the one hand, it may encourage some tumours to proliferate faster,5 and, on the other hand, and perhaps much more important, it is possible to induce thermoresistance to malignant cells surviving heat application.s Department of Microbiology, Welsh National School of
Medicine, The Royal Infirmary, Cardiff CF2 1SZ. 1. 2. 3. 4. 5. 6.
R. A. HOLMAN.
Wilson, E. Br. med. J. Oct. 13, 1860, p. 789. Crile, G. Cleveland clin. Q. 1961, 28, 75. Woodhall, B., Pickrell, K. L., Georgiade, N. G., Mahaley, M. S., Dukes, H. T. Ann. Surg. 1960, 151, 750. Shingleton, W. W., Bryan, F. A., O’Quinn, W. L., Krueger, L. C. ibid. 1962, 156, 408. Brett, D. E., Schloerb, P. R. Archs Surg. 1962, 85, 1004. Selawry, O. S., Goldstein, M. N., McCormick, T. Cancer Res. 1957, 17, 785.
