Mental Health
It is argued that there is alatent period within which any carcinogenic hazard is improbable; or, secondly, that no advantage is to be achieved in withholding imferon from patients with unquestionably refractory iron-deficiency anaemia, if they are left without effective treatment, or given therapy carrying an immediate and known hazard.
Abstract
latent period within which any carcinogenic hazard is improbable; or, secondly, that no advantage is to be achieved in withholding imferon from patients with unquestionably refractory iron-deficiency anaemia, if they are left without effective treatment, or given therapy carrying an immediate and known hazard, as from intravenous iron or transfusions. Having said this, I am, however, quite certain that no one is justified in asserting at the present moment, as the authors do, that the use of imferon in the clinical dosage recommended carries a negligible risk. From the nature of the case we cannot have a useful answer to this question under something of the order of 15-20 years. The statistics of the hazard (if indeed it exists in man) are quite unknown. We cannot therefore say it is negligible. The letter also raises another question. If the results of experimental work with imferon are in practice to be disregarded as an indication towards policy in man, what evidence from experimental work would be acceptable as justifying either the prudent withdrawal of a given preparation or at least a warning statement ? Although the results of animal experimentation are immensely valuable in this kind of problem, they can never be regarded as more than an approximate guide. Agreed that we cannot extrapolate with any certainty to man, it will also be agreed that had the results of animal experimentation with imferon been negative they would certainly (and not unreasonably) have been used as indicative of the preparation's harmlessness. On balance, I believe all the work on imferon originating from H. G. Richmond's most interesting observation, and extended in other papers and correspondence, has been profitable. It appears that the preparation had been used in very many cases without adequate indication, or indeed almost indiscriminately; and a useful result may be considerably to reduce its administration to younger age-groups, and to patients capable of responding perfectly satisfactorily to other means.-I am, etc., Chester Beatty Research Institute, ALEXANDER HADDOW. London, S.W.3.