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British Medical Journal Weighs in With Oddball Findings

TIMES MEDICAL WRITER

Red stimulants work much better than the same medicine in a green pill, and blue tranquilizers are more effective than yellow ones. Physicians’ handwriting is no worse than that of other executives. Smoking causes baldness. Blowing up too many balloons can be hard on your lungs. Those who attend concerts live longer.

Those were among the unusual conclusions of papers in the British Medical Journal’s annual Christmas issue, for which editors hoard some of the more interesting papers they receive during the year. None are made up.

A team from the University of Amsterdam examined what little is known about the effects of a pill’s color--not a trivial matter because placebo effects are often quite powerful in evaluating drugs.

They found that red, yellow and orange pills are associated with a stimulant effect, while blue and green pills are tranquilizing. Hypnotics, sedatives and anti-anxiety drugs should be green, blue or purple, they said.

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In one study, 100 medical students were told they would randomly receive either a sedative or a stimulant. In fact, they received either a pink or a blue placebo. Sixty-six percent of those taking the blue placebos felt less alert, compared to only 26% of those taking the pink.

Manufacturers should use great care in coloring new drugs, the team concluded.

In regard to writing prescriptions for drugs, Dr. Donald M. Berwick of the Institute for Healthcare Improvement in Boston and David E. Winickoff of Cambridge University asked 209 physicians and administrators to provide a hurried handwriting sample. The legibility of the writing was then assessed by four different raters.

Berwick and Winickoff concluded that, contrary to widely held beliefs, doctors’ writing was no less legible than that of others. In fact, the handwriting of executives was worse by far. Women’s handwriting, regardless of their occupation, was generally more legible than men’s.

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Struck by the fact that smokers show wrinkles and other signs of premature aging, Dr. J. G. Moseley of the Leigh Infirmary in Leigh, England, and Dr. A. C. C. Gibbs of the Christie Hospital in Manchester investigated further. They studied the 606 new patients who attended the clinic over a three-month period, noting whether they had hair, its color and whether or not they smoked.

Adjusting for age, they concluded that smokers were 4.4 times as likely to have gray hair as those who did not smoke. Among males, smokers were 1.9 times as likely as nonsmokers to be bald. “This may offer a promising line of approach in health education against smoking,” they concluded.

Dr. Stuart Elborn and his colleagues at Belfast City Hospital wrote about a 24-year-old man hospitalized for lung problems. Two days earlier, he had blown up 20 party balloons over a one-hour period. Although he was fine then, at admission he experienced severe pain and shortness of breath. Air bubbles could be felt under the skin over his back and buttocks and there was a “crunching sound” when he breathed.

The man recovered after treatment with painkillers, antibiotics and fluids. The Belfast doctors then tested the air pressure necessary to inflate the balloons and found that it was sufficient to damage the alveoli, the tiny sacs in the lungs where air is absorbed. The damage allowed air to escape into body cavities.

And finally, as part of a large study examining risk factors for death, Dr. Sven-Erik Johansson of the Swedish Central Bureau of Statistics in Stockholm and his colleagues examined death rates for more than 15,000 people between the ages of 16 and 74.

When they made allowances for all other factors known to increase the likelihood of dying--such as smoking, alcohol consumption, educational attainment, income, exercise and so forth--they found that people who attended more than 12 cultural events per year, such as church services and the theater, were found to be significantly less likely to die. In the 10-year follow-up, those who did not attend such events were 1.57 times as likely to die as those who did.

“We conclude that this is probably a fruitful line” for further research, the team wrote.


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