SEMI-RETIREMENT
1
736 with chest pain there may be more in an advanced stage of the disease than there are among those who first have other symptoms. 7 Taylor and Waterhouse 10 found that only 3% of 332 in whom the illness began with pain had a pneumonectomy, compared with 9% of those in whom the illness began with a cough and 13% of those in whom it began with haemoptysis. Neuman et al., how- ever, noted little difference in the proportion who underwent resection between patients under 40 and patients of all ages. There is probably a greater danger in young people that the correct diagnosis will be missed, for in them lung cancer may not be so readily suspected. As we seem to be in the early stages of what has been termed a " pandemic " of lung cancer 11 this disease might well be put higher on the list for differential diagnosis even in those under 40. 10. Taylor, A. B., Waterhouse, J. A. H. Thorax, 1950, 5, 257. 11. Clemmesen, J. Dan, med. Bull. 1954, 1, 37. 12. Cmd 9752. H.M. Stationery Office, 1956. 2s. 13. Manchester Guardian, May 4, 1956, p. 8. SEMI-RETIREMENT LAST week the National Insurance Advisory Com- mittee recommended that the earnings rules for retire- ment pensions should be relaxed.12 By their terms of reference they could suggest no radical changes, but their report has strengthened public interest in the principles on which our pension scheme is based. The committee recommended, and Parliament has now agreed, that retirement pensioners shall in future be allowed to earn 50s. instead of 40s. a week without loss of pension. and that pensioners earning over 50s. a week shall have sixpence deducted from their pension for each shilling earned between 50s. and 70s. a week. This means that a pensioner can earn up to f5 a week before his pension is extinguished. Probably these changes are as far as we can go without jettisoning the principle of pension on retirement rather than at a fixed age. Whether the principle is worth retaining is another matter. When unemployment was a national bugbear it was sensible to encourage elderly people to retire early and to give them some modest help to do so. But overemployment not underenrploy- ment is now our trouble, and today it might be equally sensible to encourage old people to remain at work as long as possible. Furthermore the proportion of old people in our population will rise steadily in the coming years. The help that they could give us will accordingly become more substantial, and, if need be, make it worth altering or adapting industrial traditions. In his reserva- tion to the Phillips Committee’s report Prof. A. K. Cairncross recast the problem. " Men of 65-70 (he said) should be free to choose not whether to retire but how much to retire." It is doubtful whether our present system of pensions gives them this freedom. In defence of the principle of retirement and its bulwark the limitations of earnings, it is usually argued that employers would use the pensioner to cut wages, and that we cannot afford to pay full pensions irrespective of earnings. The advisory committee note that the abolition of the earnings rule would cost E76 million straight away. In his recent review of the subject Mr. Alan Peacock 13 was not greatly moved by either of these objections. The trade unions, he felt, might be relied on to defend the wage front. The Government Actuary on the other hand, he thought, might be overanxious. Had he not left out of account what the pensioners would bring to the Treasury by their effect on production and by their own increased expenditure ? But Mr. Peacock agreed that the subject was difficult, for we are discussing the pensions problems " without any supporting inquiry into the economic resources of the aged." Our nescience does not cover only the economic problems of the aged but extends to the intricacies of their pattern of employment. Here Mr. F. Le Gros Clark, with the backing of the Nuffield Foundation, is offering ns a series of detailed reports on the kind of jobs that the elderly find for themselves. In his latest report 14 he has continued his inquiries among the employment exchanges, and has discovered that many of the jobs found for the elderly are those that " have survived with us from the largely unmechanised world of the past." Perhaps this is a complementary problem to automation and one which in its way may prove as important. 14. Le Gros Clark, F. Employment Problems of Elderly Men. 1956. Pp. 25. A limited number of free copies available from the Nuffield Foundation, Nuffield Lodge, Regent’s Park, London, N.W.1. 15. Belyavin, G. Lancet, 1955, i, 698. POLIOMYELITIS FLOCCULATION REACTION SPECIFIC flocculation reactions take place when a bacterial or viral antigen and its specific antibody are brought together under suitable conditions; macro- scopically visible aggregates or clumps, appearing in antigen-antibody mixtures but not in controls, indicate a positive result. The term " flocculation " covers two phenomena : agglutination reactions, in which suspen- sions of large particles, such as bacteria, are clumped by specific antibody ; and precipitin reactions in which very small particle untigens (often referred to loosely as soluble antigens) are precipitated by their specific antibody. Basically the reaction is the same in both cases. The term flocculation is sometimes used to cover them both. and also to describe the clumping of particles intermediate in size between bacteria and small-particle antigens —for example, viruses. Antigens which floccu- late with their specific sera usually fix complement under appropriate conditions, and flocculation and complement- fixation have been useful techniques in investigating the antigenic properties of viruses and the serological responses of men and animals to infection. Flocculation reactions generally require the use of more concentrated and purified antigens than do complement-fixation tests, and for that reason the latter have been more often applied in virological investigations. Recently Belyavin15 showed that a specific flocculation reaction between influenza virus and antibody could be used for serological investigation of these viruses. Prof. Wilson Smith and his colleagues have followed this by applying the flocculation reaction to the poliomyelitis viruses, and on p. 710 they show very clearly that specific flocculation occurred when purified type-1 and type-3 poliomyelitis-virus antigens were mixed with specific rabbit antisera. There is also preliminary evidence to suggest that specific flocculation may take place with sera of children convalescent from poliomyelitis. The test is likely to be useful in investigating the antigenic structure of the poliomyelitis viruses. On the other hand, it is less likely that without substantial modifications the test will be much used in the routine laboratory diagnosis of poliomyelitis. This is because relatively large amounts of an antigen which has been previously concentrated 38.5 or 77 times are required, and it may be that comple- ment-fixation would be a more economical test to apply to this material. If not, however, the possibilities of a micro-test seem well worth exploring. It would also be important to devise some method of inactivating the virus, if the test is to be used as a routine laboratory procedure. THE next session of the General Medical Council will open on Tuesday, May 29, at 2.15 P.M., when Sir DAVID CAMPBELL, the president, will deliver an address. The Medical -Disciplinary Committee will meet on Wednesday, May 30, at 2 P.M.
Transcript of SEMI-RETIREMENT
736
with chest pain there may be more in an advanced stageof the disease than there are among those who first haveother symptoms. 7 Taylor and Waterhouse 10 found thatonly 3% of 332 in whom the illness began with pain hada pneumonectomy, compared with 9% of those in whomthe illness began with a cough and 13% of those inwhom it began with haemoptysis. Neuman et al., how-ever, noted little difference in the proportion whounderwent resection between patients under 40 and
patients of all ages.There is probably a greater danger in young people
that the correct diagnosis will be missed, for in them lungcancer may not be so readily suspected. As we seem tobe in the early stages of what has been termed a
" pandemic " of lung cancer 11 this disease might well beput higher on the list for differential diagnosis even inthose under 40.
10. Taylor, A. B., Waterhouse, J. A. H. Thorax, 1950, 5, 257.11. Clemmesen, J. Dan, med. Bull. 1954, 1, 37.12. Cmd 9752. H.M. Stationery Office, 1956. 2s.13. Manchester Guardian, May 4, 1956, p. 8.
SEMI-RETIREMENT
LAST week the National Insurance Advisory Com-mittee recommended that the earnings rules for retire-ment pensions should be relaxed.12 By their terms ofreference they could suggest no radical changes, but theirreport has strengthened public interest in the principleson which our pension scheme is based. The committeerecommended, and Parliament has now agreed, thatretirement pensioners shall in future be allowed toearn 50s. instead of 40s. a week without loss of pension.and that pensioners earning over 50s. a week shall havesixpence deducted from their pension for each shillingearned between 50s. and 70s. a week. This means thata pensioner can earn up to f5 a week before his pensionis extinguished.Probably these changes are as far as we can go without
jettisoning the principle of pension on retirement ratherthan at a fixed age. Whether the principle is worth
retaining is another matter. When unemployment wasa national bugbear it was sensible to encourage elderlypeople to retire early and to give them some modesthelp to do so. But overemployment not underenrploy-ment is now our trouble, and today it might be equallysensible to encourage old people to remain at work aslong as possible. Furthermore the proportion of old
people in our population will rise steadily in the comingyears. The help that they could give us will accordinglybecome more substantial, and, if need be, make it worthaltering or adapting industrial traditions. In his reserva-tion to the Phillips Committee’s report Prof. A. K.Cairncross recast the problem. " Men of 65-70 (he said)should be free to choose not whether to retire but howmuch to retire." It is doubtful whether our presentsystem of pensions gives them this freedom.
In defence of the principle of retirement and itsbulwark the limitations of earnings, it is usually arguedthat employers would use the pensioner to cut wages,and that we cannot afford to pay full pensions irrespectiveof earnings. The advisory committee note that theabolition of the earnings rule would cost E76 million
straight away. In his recent review of the subject Mr.Alan Peacock 13 was not greatly moved by either of theseobjections. The trade unions, he felt, might be relied onto defend the wage front. The Government Actuary onthe other hand, he thought, might be overanxious. Hadhe not left out of account what the pensioners wouldbring to the Treasury by their effect on productionand by their own increased expenditure ? But Mr.Peacock agreed that the subject was difficult, for weare discussing the pensions problems " without anysupporting inquiry into the economic resources of theaged."
Our nescience does not cover only the economic
problems of the aged but extends to the intricacies oftheir pattern of employment. Here Mr. F. Le Gros Clark,with the backing of the Nuffield Foundation, is offeringns a series of detailed reports on the kind of jobs that theelderly find for themselves. In his latest report 14 he hascontinued his inquiries among the employment exchanges,and has discovered that many of the jobs found for theelderly are those that " have survived with us from thelargely unmechanised world of the past." Perhaps thisis a complementary problem to automation and one
which in its way may prove as important.
14. Le Gros Clark, F. Employment Problems of Elderly Men.1956. Pp. 25. A limited number of free copies available fromthe Nuffield Foundation, Nuffield Lodge, Regent’s Park,London, N.W.1.
15. Belyavin, G. Lancet, 1955, i, 698.
POLIOMYELITIS FLOCCULATION REACTION
SPECIFIC flocculation reactions take place when a
bacterial or viral antigen and its specific antibody arebrought together under suitable conditions; macro-
scopically visible aggregates or clumps, appearing in
antigen-antibody mixtures but not in controls, indicate apositive result. The term " flocculation " covers two
phenomena : agglutination reactions, in which suspen-sions of large particles, such as bacteria, are clumped byspecific antibody ; and precipitin reactions in whichvery small particle untigens (often referred to loosely assoluble antigens) are precipitated by their specificantibody. Basically the reaction is the same in bothcases. The term flocculation is sometimes used to coverthem both. and also to describe the clumping of particlesintermediate in size between bacteria and small-particleantigens —for example, viruses. Antigens which floccu-late with their specific sera usually fix complement underappropriate conditions, and flocculation and complement-fixation have been useful techniques in investigating theantigenic properties of viruses and the serologicalresponses of men and animals to infection. Flocculationreactions generally require the use of more concentratedand purified antigens than do complement-fixation tests,and for that reason the latter have been more often
applied in virological investigations.Recently Belyavin15 showed that a specific flocculation
reaction between influenza virus and antibody could beused for serological investigation of these viruses. Prof.Wilson Smith and his colleagues have followed this byapplying the flocculation reaction to the poliomyelitisviruses, and on p. 710 they show very clearly that specificflocculation occurred when purified type-1 and type-3poliomyelitis-virus antigens were mixed with specificrabbit antisera. There is also preliminary evidence tosuggest that specific flocculation may take place withsera of children convalescent from poliomyelitis. Thetest is likely to be useful in investigating the antigenicstructure of the poliomyelitis viruses. On the other hand,it is less likely that without substantial modifications thetest will be much used in the routine laboratory diagnosisof poliomyelitis. This is because relatively large amountsof an antigen which has been previously concentrated38.5 or 77 times are required, and it may be that comple-ment-fixation would be a more economical test to applyto this material. If not, however, the possibilities of amicro-test seem well worth exploring. It would also be
important to devise some method of inactivating thevirus, if the test is to be used as a routine laboratoryprocedure.
THE next session of the General Medical Council willopen on Tuesday, May 29, at 2.15 P.M., when Sir DAVIDCAMPBELL, the president, will deliver an address. TheMedical -Disciplinary Committee will meet on Wednesday,May 30, at 2 P.M.
