§ 2.45 p.m.
§ BARONESS SUMMERSKILLMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ [The Question was as follows:
§ To ask Her Majesty's Government how they propose to bring to the notice of every practising doctor the warning issued in the British Medical Journal, that drugs in extensive use for various diseases, including, rheumatoid arthritis, are responsible for serious damage to the eyes].
§ LORD NEWTONMy Lords, if the noble Baroness is referring to the possible side effects of chloroquine, they were brought to the attention of all National Health Service doctors in May, 1960. The warning is incorporated in the Comprehensive Prescribing Handbook, which they all have.
§ BARONESS SUMMERSKILLMy Lords, may I ask the noble Lord if he has read the article? I am talking about the article in the current issue of the British Medical Journal. I have just refreshed my memory, and a large number of drugs are mentioned, including chloroquine, which is used widely for rheumatoid arthritis. But may I draw his attention to Melleril? It was discovered that a drug, N.P.207, which was a tranquilliser, caused complete 176 blindness. That, I hope, has been withdrawn from the market; but I have just telephoned a chemist and I understand that Melleril, which is also mentioned, is still on the market, although this causes only eye damage. The same happens with chloramphenicol. But so far as chloroquine is concerned, would the noble Lord agree with me that, in view of the fact that this drug is being widely prescribed for rheumatoid arthritis to-day, the doctors of the country should have their memories refreshed, bearing in mind this article, and that they should be told that every patient taking this drug should have a periodical examination of the eyes because the damage is irreparable? That is the advice of the British Medical Association.
§ LORD NEWTONYes, my Lords, I have read the article in the British Medical Journal to which the noble Baroness has referred. In fact, I read the other one, too, in the same edition, which was issued on March 31 of this year. One of these two articles, the one by Mr. J. N. Ormrod, is concerned particularly with chloroquine, and I have already told the noble Baroness the position about that. The other article discusses, in addition to chloroquine, four other drugs. One of them is called 1, 7 di(p-dimethylamino-phenoxy) heptane, and the article points out that the use of this drug is being discontinued. As to two other drugs, thioridazine (or "Melleril", as the noble Baroness called it) and chloramphenicol, the article says it would seem that the complications from them have been noted only after unusually high doses.
Further about chloramphenicol, Professor Clifford Wilson of the London Hospital wrote a signed article about this drug in the Prescribers Journal in December of last year and that article concluded as follows:
Chloramphenicol has a wide range of antibacterial activity, but unfortunately carries a risk of serious damage to the bone-marrow. Although it is still the antibiotic of choice in typhoid fever, in other infections it should be replaced by others which are equally effective and safer.I should perhaps add that the Prescribers Journal is circulated every two months to all doctors in the National Health Service. The fourth and last drug mentioned in the article in the 177 British Medical Journal is called piperidylethylchlorophenothiazine, and this drug, my Lords, was never on the market.I have mentioned the facts about this article in the British Medical Journal at some length because I think one must keep these matters in perspective. One would not like the public to imagine—and I know the noble Baroness would agree with me about this—that doctors neglect their professional duty of keeping themselves informed about discoveries, either good or bad, which are reported from time to time in their professional journals.
§ BARONESS SUMMERSKILLMy Lords, is the noble Lord aware that he has mentioned drugs that I have not mentioned at all? To make a case, he has mentioned to noble Lords here drugs which may be off the market; and, of course, I would not be so irresponsible as to bring them to the notice of the House. I have brought to the notice of the House three drugs which are being widely distributed, and I am shocked to think that the noble Lord has treated the matter in a rather frivolous manner.
§ LORD NEWTONMy Lords, with respect to the noble Baroness, I should have thought I treated it in a most serious and responsible manner.
§ LORD NEWTONI would just say to the noble Baroness that, if she will he good enough to look again at her own Question on the Order Paper, she will see that she invites the attention of Her Majesty's Government to warnings issued in the British Medical Journal. The British Medical Journal is issued every week; she did not say to what particular issue she referred, and I naturally assumed that she was referring to the last one, which contains two articles, as I say, about retinal damage.
§ BARONESS HORSBRUGHMy Lords, may I ask the noble Lord whether, after hearing what has been said by the noble Baroness, he does not think that it would be the duty of Her Majesty's Government to warn the public against the danger of taking remedies prescribed by the medical profession?