ANOTHER VOICE
Government ignores link between Sunday Times and Herxheimer's Syndrome
AUBERON WAUGH
I n 1981 11-year-old Katie Harrington died from the rare Reye's Syndrome after taking aspirin. This week, her father Mr Clifford Harrington, who with his wife and others now runs the National Reye's Syn- drome Foundation, was quoted in the Sunday Times as announcing that those whose children contracted Reye's Syn- drome after 1982 — when the US govern- ment warned that it was investigating a possible link between the disease and aspirin — have a case for compensation in light of the British Government's delay in issuing a similar caution:
`It's almost like Thalidomide all over again — complacency, secrecy, bureaucratic bung- ling and a lack of care for innocent children,' said Mr Harrington.
There are enough trigger-words in that short speech to set every Lunch-time O'Booze and Glenda Slag whooping. Our old friend Jack Ashley, Labour MP for Stoke-on-Trent, whose misfortune it is to be rather hard of hearing — this has established him as the House of Commons expert on problems of the disabled — has tabled parliamentary questions about the delay. He says he is 'extremely disturbed that children could have died as a result of the Committee on Safety of Medicine's delay'.
So far as I know, Mr Geoffrey Dickens, the Barnsley JP and Conservative MP for Littleborough (who also holds the Royal Humane Society's Testimonial on Vellum for saving lives, awarded in 1972) has not yet pronounced on the subject. But where innocent children are concerned Mr Dick- ens (who has had .two of them) is unlikely to leave it to other MPs to report their out- raged feelings to the newspapers.
When I read last month that Dr Donald Acheson, the Government's chief medical officer, had decided to join the great anti-aspirin scare, my first reaction was one of intense irritation. 1 wrote a piece in the Sunday Telegraph expressing civilised scepticism about the alleged connection between Reye's Syndrome, an extremely rare condition which affects about five per million children under 12, and aspirin, which has probably been eaten by most children since the end of the last war. Of course I had no expert advice to offer on the subject, but by chance I was writing a monthly column in a medical magazine at the time of the last great Paracetamol promotion and had investigated the claims against aspirin then.
It is true, and has always been known, that aspirin aggravates ulcers, causes in- flammation of the lining of the stomach and sometimes mild bleeding. The symp- toms it produces are those of indigestion and flatulence. However, these mild dis- comforts might almost be reckoned an advantage when counted against its excel- lent functions as a painkiller (analgesic), temperature reducer (anti-pyretic), reliev- er of swellings at the joints (anti-arthritic) and protector against strokes (anti- coagulant) since they provide an in-built discouragement to over-indulgence. When the great Paracetamol promotion was at its height, about 12 years ago, scare-mongering promoters let this mild bleeding of the stomach wall be confused with a major internal haemorrhage. Many people accepted it as an article of faith that aspirins were dangerous. Paracetamol, be- cause it had none of the deleterious side- effects of aspirin, was supposed to be completely safe, but in the past 12 years it has emerged as a very dangerous poison indeed. Those who try to commit suicide with aspirin will survive, in nine cases out of ten, with no enduring physical damage. Those who try with Paracetamol will sel- dom survive, and with irreversible kidney damage if they do. Toxicity in Paracetamol is so high that deaths have been reported after taking only two and a half or three times the recommended dose. A bottle of 100 Paracetamol tablets could kill between five and ten adults. A bottle of a hundred aspirins would be unlikely to kill one. However, I judged it prudent to be fairly diffident in my scepticism about the alleged link between aspirin and Reye's Syndrome — a rare complication developing from what seems to be 'flu, more often than not (like pneumonia), or from chicken pox (like shingles), which was identified only in 1963. If American researchers had estab- lished a connection between aspirin and this rare complication, who was Ito argue? However, no sooner had my piece appeared in the Sunday Telegraph than I began to receive letters from learned pro- fessors all over the world: I was absolutely right, the Americans had established no such connection, the fact that some (but not all) children who later developed Reye's Sydrome had previously taken aspirin was only to be expected, owing to the widespread use of aspirin as an anti- pyretic; the claim revealed the fatuity of computer analysis in medicine and compu- ter diagnosis, since just as high a propor- tion of Reye's Syndrome children in Eng- land would probably have been given Lucozade or cocoa in the early stages; the only statistically sound method of investi- gating the alleged link, there being no biochemical link established, would be to count the number of children who took aspirin without developing Reye's Syn- drome, count the number of children who never take aspirin, then count the Reyes Syndrome victims who did and did not take aspirin. But even then the number of victims is so small that correlations would scarcely be significant. Finally and conclu- sively, it now seems probable that Reye's Syndrome is the result of a viral infection which could not be caused by aspirin. But the news of these new developments has not yet reached the Sunday Times which devoted a three-column front-page story to trying to whip up a new Thalido- mide scandal: 'Child deaths: aspirin link was ignored'. It wheeled out Dr Andrew Herxheimer, editor of the Drug and Ther- apeutics Bulletin, which has been urging Paracetamol since October 1984: `Although the case was far from proven, the existing evidence could not and should not have been ignored.' Never can there have been a neater summary of the journalistic condition which might be labelled Herxheimer's Syn- drome: the urge to launch hysterical cam- paigns on health grounds against normallY accepted practices. Already this year we have had the 'passive smoking' scare (effectively demolished in the current Brit- ish Journal of Cancer) and the New Year campaign against driving with under the legal alcohol level. But the Sunday Times has always been riddled with the disease. How many people now remember the Shock Honor Sensation of a suppressed health report on diet revealing that we were all poisoning ourselves on hambur- gers and butter fat? The most hilarious campaign of all has been running for mar*" years now — against the terrible danger of explosion represented by duty-free bottles of liquor in passenger planes. The only cure for Herxheimer's Syndrome, which is almost certainly Sunday Times-linked: must be to cancel the Sunday Times and order a sensible newspaper like the Obser_ ver or the Sunday Telegraph.
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