Journal of the Royal Society of Medicine Volume 83 November 1990 2 Brismar B, et al. Diagnosis of thrombosis by catheter phlebography after central venous catheterisation. Arch Surg 1981;194:779 3 Brismar B, et aL Bacteriology and phlebography in catheterisation for parenteral nutrition. A prospective study. Acta Chir Scand 1980;146:115-19 4 Freund HR. Chemical phlebothrombosis of large veins. Arch Surg 1981;116:1220-1 5 Wakefield A, et aL Thrombogenicity oftotal parenteral nutrition solutions (1). Gastroenterology 1989;97:1210-19 6 Wakefield A, et at Thrombogenicity of total parenteral nutrition solutions (M. Gastrenterology 1989;97:1220-8 7 Wakefield A, et aL Procoagulant activity in gastroenterology. Gut 19908,31:23941 8 Abecassis M, et aL Dimethyl prostaglandin E2 prevents the development of falminant hepatitis and blocks the induction of monocyte/macrophase procoagulant activity after murine hepatitis virus strain 3 infection. J Clin Invest 1987;80:881-9 9 Abecassis M, et al. Treatment of fulminant hepatic failure with a continuous infusion ofprostin UR (PGE1). Hepatology 1987;7:1104 10 Wakefield A, et aL Thrombogenicity of total parenteral nutrition solutions. Effect on induction of endothelial cell procoagulant activity. Gastroenterology 1989;97: 1220-28
Medical student selection Tachakra in his letter (June 1990 JRSM, p 145) states that the main purpose of the brief interview at St Mary's Hospital is to reject candidates who would not fit into the individual medical school's ethos. There is a widespread assumption amongst medical schools that a brief unstructured interview defines an applicant's personality profile and is useful in the selection process. This-improbable assumption lacks supportive evidence. When will medical school selectors gain insight into the limitations of what they do? G D ROBERTS A PORTER
37 Upper Gordon Road Camberley, Surrey GU15 2HJ
The art of resuscitation Dr John Griffin (August 1990 JRSM, p 520) should have dated the resuscitation by William Tossach 13 years earlier. On 3 December 1732, James Blair had been rescued from a fire in a coal mine (he was not apparently drowned). Tossach, a Scottish surgeon in Alloa, found 'there was not the least pulse in either heart or arteries, and not the least breathing could be observed: So that he was in all appearance dead. I applied my mouth close to his, and blowed my breath as strong as I could: but having neglected to close his nostrils all the air came out of them: Wherefore taking hold of them with one hand, and holding my other on his breast at the left pap, I blew again my breath as strong as I could,;raising his chest fully with it; and immediately I felt six or seven very quick beats
of the heart.' Blair recovered consciousness in an hour and walked home within four'. The recommended use by the Royal Humane Society in 1774 ofmouth-to-mouth respiration (with the other measures as stated by Dr Griffin) was superseded in 1782 by the promotion of bellows instead2. Yet even this idea did not last long, for within 50 years the Society had only warmth and rubbing left on their list of recommendations. ROBERT G RICHARDSON Apple Tree Cottage French Street Westerham Kent TN16 1PW
References 1 Tossach W. A man dead in appearance recovered by distending the lungs with air. Medical essays and observations, 5th edn, vol. V, part II: 108-12. Published by a Society in Edinburgh, 1771 2 Hawes W, ed. Transactions ofthe Royal Humane Society from 1774-1784: with an appendix of miscellaneous observations on suspended animation, to the year 1794. Printed by Ino. Nichols and sold for the Society by Rivingtons, Dilly, Johnson and Hookham
Relationship between longevity and lifeline I have read with interest the evidence in the article by Newrick et al. (August JRSM 1990, p 499) of an association between the length of lifeline in the palm and the age of death of the subject and it is exactly what I would have expected, For many years I have found in the occult sciences rich sources of diagnosis and healing, but I do not think that the same criteria can be applied to them as to orthodox scientific experimentation. A palmist can often see clearly what has happened in the past by the strengths and weaknesses of the lines in the palm, and if there is a long clear lifeline he can predict longevity. But in many instances the future is not so easy to determine because there may be a break in a lifeline to show that a certain phase of existence has come to end, or else there may be a blurring and faintness due to illness. A period of crisis may well be indicated but often the life of the individual continues and the markings of the palm go on developing. So, although I welcome the orthodox medical practitioners' willingness to move towards a more holistic and psychodiagnostic approach to patients, I am disturbed at the prospect that evidence collected from dead people's hands might be used to measure the potential for recovery of the living with all the psychological trauma that such predictions might bring. S LEWIS 18 KnoH Court Farquhar Road London SE19 lSP
753
Medical student selection Tachakra in his letter (June 1990 JRSM, p 145) states that the main purpose of the brief interview at St Mary's Hospital is to reject candidates who would not fit into the individual medical school's ethos. There is a widespread assumption amongst medical schools that a brief unstructured interview defines an applicant's personality profile and is useful in the selection process. This-improbable assumption lacks supportive evidence. When will medical school selectors gain insight into the limitations of what they do? G D ROBERTS A PORTER
37 Upper Gordon Road Camberley, Surrey GU15 2HJ
The art of resuscitation Dr John Griffin (August 1990 JRSM, p 520) should have dated the resuscitation by William Tossach 13 years earlier. On 3 December 1732, James Blair had been rescued from a fire in a coal mine (he was not apparently drowned). Tossach, a Scottish surgeon in Alloa, found 'there was not the least pulse in either heart or arteries, and not the least breathing could be observed: So that he was in all appearance dead. I applied my mouth close to his, and blowed my breath as strong as I could: but having neglected to close his nostrils all the air came out of them: Wherefore taking hold of them with one hand, and holding my other on his breast at the left pap, I blew again my breath as strong as I could,;raising his chest fully with it; and immediately I felt six or seven very quick beats
of the heart.' Blair recovered consciousness in an hour and walked home within four'. The recommended use by the Royal Humane Society in 1774 ofmouth-to-mouth respiration (with the other measures as stated by Dr Griffin) was superseded in 1782 by the promotion of bellows instead2. Yet even this idea did not last long, for within 50 years the Society had only warmth and rubbing left on their list of recommendations. ROBERT G RICHARDSON Apple Tree Cottage French Street Westerham Kent TN16 1PW
References 1 Tossach W. A man dead in appearance recovered by distending the lungs with air. Medical essays and observations, 5th edn, vol. V, part II: 108-12. Published by a Society in Edinburgh, 1771 2 Hawes W, ed. Transactions ofthe Royal Humane Society from 1774-1784: with an appendix of miscellaneous observations on suspended animation, to the year 1794. Printed by Ino. Nichols and sold for the Society by Rivingtons, Dilly, Johnson and Hookham
Relationship between longevity and lifeline I have read with interest the evidence in the article by Newrick et al. (August JRSM 1990, p 499) of an association between the length of lifeline in the palm and the age of death of the subject and it is exactly what I would have expected, For many years I have found in the occult sciences rich sources of diagnosis and healing, but I do not think that the same criteria can be applied to them as to orthodox scientific experimentation. A palmist can often see clearly what has happened in the past by the strengths and weaknesses of the lines in the palm, and if there is a long clear lifeline he can predict longevity. But in many instances the future is not so easy to determine because there may be a break in a lifeline to show that a certain phase of existence has come to end, or else there may be a blurring and faintness due to illness. A period of crisis may well be indicated but often the life of the individual continues and the markings of the palm go on developing. So, although I welcome the orthodox medical practitioners' willingness to move towards a more holistic and psychodiagnostic approach to patients, I am disturbed at the prospect that evidence collected from dead people's hands might be used to measure the potential for recovery of the living with all the psychological trauma that such predictions might bring. S LEWIS 18 KnoH Court Farquhar Road London SE19 lSP
753
