Coronaries
Sir: I am increasingly aware of tile value of John Rowan Wilson s column. I think we would symP,. thise more with his views on t°,` coronary because of his father s early tragedy (November 11). 14e was right, I feel, about unwq; ranted social service meddling I" doctor's drug prescribing habits too often it is assumed tranqt1,11: users are placebos whereas t''' busy doctor often spots the blues attack and knows how effective at tidying over these drugs sir' Moreover the accountability, par cularly important in terms money supply, of social servic' departments, as with any salarY, may need probing. But having a brother coill; mended for introducing cricke`. into the Philippines who stic,, cumbed to the premature agell disease on the Cricket Club 0„ India's steps aged thirty-six tear': me to question Dr Wilsons
somewhat bow-and-arrow approach to the coronary. We have done this before with Dr Cyriak's pleas for physical medicine and are left trailing by our continental neighbours, whose departments dealing with that Other flabby complaint of orthopaedic disc lesions save countless millions in sick pay and the weeks Of ' conservative' anguish ! The evidence accumulates about stress and the coronary. Raised lipids in examination candidates, among competitive drivers, bus drivers rather than conductors, GI Vietnam war victims undergoing not just the stress of battle but the frustratiop of queried purposes. It isn't so much the stress of success; bringing work home, voluntary effort and often responsibility connote a vocational approach. Rather it is those irritable, dissatisfied perhaps obsessional People the Swedish report claims to be coronary sufferers whose frustrations lead to the attack, that screening may isolate. In their own Way they may be the salt of the earth — the chemists bombarded daylong with public problems, the Skilled artisan on whom the buck of delegated work and shop floor difficulties stops. Most doctors have a feeling that this is important, — and they know the effect of tension on the blood vessels.
We don't know enough research as yet but if the old diseases of the third world have escaped the Public health net, this is the disease that is sweeping civilisation and the respite of expensive bypass operations, currently the affluent country's vogue, will surely force cheaper thoughts of Prevention.
G. P. Walsh Norwood, Gorse Road, Blackburn
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