LISTEN UP and APPLY THE PRESSURE

LISTEN UP

Wherever you sit on the iPod debate, some runners couldn’t cope without their choice tunes when things turn bad. “Bend Your Arms to Look Like Wings by Funeral For A Friend has got me through the most evil miles,” says Lina Martino from Tipton Harriers (tiptonharriers.co.uk). “It reminds me of a time when I was having trouble finishing my PhD and was breaking up with someone, so when I hear it, it reminds me I’ve been through worse times and will come out better for it.” Jess Holmes from Ealing prefers the spoken word: “When I’m on the brink of throwing in the towel, I use an audiobook. Comedy novels take my mind off things.”

APPLY THE PRESSURE

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Make dropping out simply not an option. “I always make promises – to myself and others,” says Glen Comish

SAVOUR IT

Call us masochists, but actively embracing the pain could be the answer. Jessica Hall from the Wimbledon Windmilers (windmilers.org.uk) says: “When it’s all going horrid, I remember the words of one RW forum member who said: `Anyone can do an enjoyable run on a nice day when you feel great, but it’s the ones you don’t want to do, when you don’t want to carry on that make the difference.”” George Gandy, Loughborough University’s director of athletics, revels in the fact that the going’s tough. “I think, ‘Nobody in the world would do this – except me!’ The satisfaction generated can sometimes outweigh the nastiness of the conditions, making you feel really good about yourself.” from Huddersfield. “A few years ago when I was struggling with niggles and dropping out of races, I told my family: ‘No matter what, I will finish today.’ It’s simply too embarrassing to drop out after you’ve done that.” Some of us make promises with fate instead. “I tell myself if I run to the top of this hill in under two minutes, that important meeting will go okay,” says Liz Syndercombe from Hook. “It makes me feel more positive about that meeting when I nail the run.” If you need another step into the unknown you can try 5-htps supplement. For more information read more 5 htp reviews.

With only weeks to go until the Flora London Marathon 2009, your hard training and progress take a moment to reflect on all so far. With race day front of mind now’s the time to put together the final piece of the jigsaw and think about your race-day nutrition and hydration strategy. That way, when you get to the start line, you’ll be in the best condition possible, fully prepared and confident of achieving your marathon goal whatever this may be.

Since January, we’ve shared our analysis of last year’s 34,500 Flora London Marathon finishers here in Runner’s World and revealed some surprising findings about long-distance runners and the marathon distance. Taking the time to really think about the challenge that lies ahead will make a world of difference as you prepare to run 26.2 miles. So, in this final article before April 26, we want to take this opportunity to summarise our key findings and explain how these relate to your race-day nutrition and hydration plans.

Trelissick Estate Summer 10K

Most of the people who signed up for this summer evening race were probably anticipating pleasant running conditions set against the stunning scenery of Cornwall’s Fal Estuary. They all have prepared not only for running, but to look good in their summer outfits. They had special laser hair removal treatments to their skin. Learn more how does laser hair removal work. Instead of the expected perfect summer time there was a thick blanket of rain, which made for some very wet surfaces underfoot, and heavy mist obscuring the views.

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Over the first 2km the course rose and fell several times on rough grassland, including a hill of some zoom at the zkm point, where the only supporters on the course were stationed. As well as the risk of slipping on wet grass, there was a minefield of fresh cowpats, so keen eyes were needed to pick the best route through.

Once negotiated, the route joined an undulating woodland path that followed the river estuary for 4km and at one point passed a water station that had been left unmanned – the only blip in an otherwise well-organised race. From here, runners made their way with trepidation to a steep hill at 7km that they’d been warned about by the race director. He hadn’t been kidding: most were reduced to walking the 3oom climb, dashing any remaining hopes of a PB.

Competitors then cautiously navigated their way down a dark woodland path where any obstacles on the track were practically invisible, and negotiated one last twisting 3oom climb before enjoying a fast, flat soorn sprint to the finish, buoyed by the clearing mist and watery sunshine.

Like the sound of this? Try… Standish Hall Winter 1oK,

A challenging off-road multi-lap course officially described as ‘undulating’, but with more than one steep climb to keep runners on their toes.

HANNAH ALDERSON,17, BRISTOL, 44:43 It was a lot more cross-country than I was expecting and a pretty tough run but I really enjoyed it and there was a great atmosphere. I’d do it again.”

Health beside the others

Relief stress while travel

If you haven’t travelled on the latest Inter-City trains recently, you don’t know what you’ve been missing. Adjustable seating, automatic doors, and double glazed windows. Even air conditioning.

Then there’s our new Farmhouse Grill that offers you a delicious, three-course meal, any time. Or the modern bar for a snack or a drink.

It all adds up to the quietest, smoothest, most comfortable way of travelling you can imagine. And medical research shows that when you travel by Inter-City, you’re faced with a great deal less stress and strain.

Take a look at the report, below. Then take another look at the photograph on the left. That’s what today’s Inter-City is about. That’s why you should give it a try. And find out what it can do for you. Soon. A medical research team from Leeds University has monitored the heartbeats of 24 businessmen measuring the stresses and strains imposed by travel, comparing driving a car and travelling by train.

THERE is an Arab philosophy about health and cinnamon rolls recipe. They say that health is the digit one, love is zero, glory zero, success zero. Put the one of health beside the others and you are a rich man. But without the one of health, everything is zero. —Jack Denton Scott, Passport to Adventure

Some ways in which you can help to conquer cancer

1. Send a donation, however small, to the Cancer Research Campaign.

2. Leave a legacy to the Cancer Research Campaign.The appropriate words to use in a will are:”I bequeath to the Cancer Research Campaign (British Empire Cancer Campaign for Research) the sum of £ .. ..” or,”I devise and bequeath the residue of my estate to the Cancer Research Campaign (British Empire Cancer Campaign for Research):’

3. Offer your help to your local committee. You’ll find a number in your local ‘phone book under Cancer Research Campaign—or call the number below and we’ll put you in touch.

4. Support any local events or flag days in aid of the Cancer Research Campaign.

This year the Cancer Research Campaign will contribute more than 6 million to research into all forms of cancer (including leukaemia) in the U.K.The Campaign has one of the lowest expense-to-income ratios of any charity. In fact, 93 pence out of every pound donated is spent on research.

Healthy advices

Start using PROTEI-NAIL on those peeling and breaking nails of yours now, and if you persevere with it you could have long, strong nails to show off along with your tan by the autumn. For nails take about 3 to 4 months to grow out from base to tip and it’s the growing part of them that Protei-Nail feeds with the proteins they need to be strong and healthy. Each morning and evening massage a little Protei-Nail well into your nails and cuticles. If you would like any more information about Protei-Nail write to me at 25 Berkeley Square, London W1X GAB.

Hay fever, bronchitis, asthma, catarrh, even sleepless nights can be helped by negative ionisation. Medion’s AIRTONE Ionizers which fill the air with negative ions are used with great success by many sufferers of respiratory complaints throughout the world. In fact, Med ion Ionizers are used and recommended not only by doctors in this country but also in South Africa, Japan and on the Conti­nent. Medion have a booklet which explains all about negative ionisation and which tells you how it could help you. For a free ed pills online copy of ‘A Short How and Why of Air-Ionization’ write to me.

Try Eversun: there’s more than one kind of skin. Dark or fair, all of us react to the sun in individual ways. If your skin sensitivity is low, you’ll need a low Eversun protection strength. Likewise, highly sensitive skin needs a high degree of Eversun protection and a lot of organix moroccan argan oil. Not only to stop sunburn, but peeling too. Another holiday hang-up you can forget about this year. Because Eversun also puts paid to parched skin. Absorbed quickly with no stickiness, it contains moisturisers to keep your complexion fresh – and help you tan. This summer, Eversun makes it Fun to be in the sun. For man, woman Ind child. Because never again will burned, parched or peeling skin be part of vetting a good tan. Eversun is another quality product from he cosmetic division of Roche Products Ltd., he makers of Pantene. Available from Boots, nost chemists and department stores.

If you’re a back sufferer, an ordinary bed won’t do your bad back any good at all. Quite frankly, it just can’t give the kind of support you need. So if you’re sleeping on a bed that’s in bad shape, that’s the way your back’s going to feel in the morning. What you really need is a bed that’s made specially for you. A bed that supports you better than any other. A bed that does it without sacri­ficing comfort.

Well, now you can relax. There is such a bed. It’s called the Dunlopillo Firmrest. And it cares for your back in a remarkable way. Firmly yet gently. Firmly, because it has a foam mattress with an extra firm base, stabilised to give deep seated support. Gently, because above its latex foam heart there’s a soft Dulon top layer for comfort. So, all night long the mattress moulds itself to your shape, adjusts itself perfectly to your weight. Until every inch of your body is supported. And underneath the mattress, there’s a specially designed platform divan, covered with firm foam to give orthopaedically correct support. If you suspect you’ve been giving your present bed the benefit of the doubt for long enough, just post the coupon for our 28 page, full colour brochure. And we’ll tell you a lot more about Firmrest and other Dunlopillo beds.

The body is the hero pt.5

The Vital Weapon

DOCTORS who treat cancer patients accepted what happened as proof of the importance of the immune sys­tem in fighting malignancies. They then began to look for ways to bring the immune systems of their own patients into play, to gear up the sys­tems, even if still normal, to make an even better fight. Just as Jenner, Pasteur, Salk and Enders had used the body’s immune system to con­quer infectious diseases, this new generation of doctors began trying to use it to conquer cancer.

They have not yet been fully suc­cessful, but there is hope. If the studies and theories show that the failure of the immune system is somehow involved with either the beginnings of cancer or its continu­ing growth and spread, then any condition that would gear up the system should help destroy or at least retard its spread.

Researchers began to re-examine what had been reported as sponta­neous cures of cancer. When they reviewed the original reports, they found that some of the patients who had had regressions had them after having contracted and sur­vived a severe bacterial infection.

The connection between infection and cancer cures had been reported earlier. William Bradley Coley, a New York surgeon, in 1891 report­ed the case of a dying patient who had an inoperable sarcoma (a type of cancer) of the neck. The sarcoma regressed after a severe strep infec­tion of the face, which was followed shortly by a second strep infection.

In the 1960s, researchers follow­ing Coley’s lead began to use newly available materials that, when in­jected, were known to heighten an animal’s immune response. One of the materials they used was called BCG (for Bacillus Calmette-Guer­in), a live bacterium related to the bacillus that causes tuberculosis. Indeed, 68 years ago it was the tubercle bacillus; but after 13 years of growing and regrowing it in a special broth, Albert Calmette and Camille GuCrin, two French immu­nologists, finally changed it into a bacillus that had lost its disease-producing properties, yet was still close enough to the original bacil­lus to be used as a vaccine against tuberculosis.

Cancer researchers removed tu­mours from cancerous mice and in­jected the tumour cells into healthy mice, including some that had been previously inoculated with BCG ba­cillus. The results were fairly con­clusive. Forty-five per cent of those mice infected with BCG before be­ing given the cancer cells were able to inhibit the growth of the injected tumours, while those without BCG could not.

Additional work on tumour growth in BCG-infected mice, rats, hamsters and guinea pigs confirmed

these first observations that pre-treatment with BCG could, in about half the cases, gear up the immune system of these pretreated mice to inhibit cancerous growths.

Scientists looked for other verifi­cation that stimulation of the im­mune response retarded cancers, and found it in Quebec, where it is common practice to immunize children against tuberculosis with BCG. The medical records indicate there was a decreased incidence of childhood leukaemia in these immu­nized children when compared with children who were not immunized with BCG.

Following these leads, scientists at the University of California at Los Angeles used BCG to increase the immune response in patients suffering from malignant mel­anomas of the skin. Some patients, but not all, have been cured by the treatment, being free of disease for two years or more.

The great question today remains how to bring about spontaneous cures for all people with cancer. It is a question whose answer must go hack to the brutal realities of the first warm seas. Then, as now, it is not sufficient to get rid of go per cent or even 99 per cent of any new­ly developing abnormal cells. The pressures to live, to grow, to divide, to rule, are just too great. Each and every cancerous cell must be hunted down and killed.

Sports injuries

We are all aware that exercising is good for us. Some people will take up running or jogging to get their needed exercise and others will take part in a sport but either way, it is always possible to be injured whether we play or run. This type of accident can be caused by improper gear, poor training and also by just not being in shape. When the proper stretching or warm-ups are not done, that to can cause an injury.

You can probably guess the most common types of sports injuries. Knee injuries are very common as are swollen muscles, fractures, dislocations, strains, sprains, shin bone pain and injuries to the Achilles tendon. If you or someone you know has been injured in some way, either by exercising or while playing a sport, the first thing to do is to stop whatever it was you were doing. To continue to move can only cause more harm.

The treatment needed can be easily remembered by the letter RICE ( rest, ice, compression and elevation) to reduce swelling, relieve pain and to speed the healing process. Later pain relievers can be taken and to do your best to keep the injured ares from moving. Any injury that was not caused by you can be grounds for an accident claim. To know for sure, a visit to AccidentClaims.org is where any injured person can discuss their injury with a legal professional to get all their questions answered. If you know you have a case to file, that is also where you can start your claim by filling out the online form and submitting it. Injuries can take place absolutely anywhere, from in your own home, at your place of work or while on the road.

The body is the hero pt.4

Like Moss on a Tree

THE granulocytes and macro­phages in our bloodstream are only part of our immune system. Indeed, if they were all we had, we would not survive long. Those children born with immuno-deficiency have all the granulocytes they need, yet they die within months from infections.

By themselves, granulocytes aren’t fast enough; with bacterial infections, a few minutes is too long. Once through the skin and into the bloodstream, a bacterium would be on its way to the brain or lungs long before the first granulocyte could possibly reach it. We need more, and we have it. This second part of our defence system we call anti­bodies.

Most of what we know about anti­bodies has been learnt only in the last ten years. We know now that they are really nothing more than a kind of protein circulating in our bloodstream. But proteins have a special ability—they can be made to fit round almost any “foreign” structure.

When exactly a cell first used its proteins to couple with the surface of a different cell, we don’t know. It appears to have occurred in the most primitive group of living ver­tebrates, the jawless fishes. In the warm, teeming Palaeozoic seas, there must have occurred a muta­tion, a chance event. A protein, used by those hagfishes and lam­preys for some other purpose, must suddenly have changed its structure and then been able to attach itself to part of the surfaces of foreign par­ticles that entered these fishes’ bodies.

Like the more primitive earth­worm, the jawless fishes had the an­cestors of our granulocytes within them. But now there was some­thing else — a protein that could fix itself to the attacker and hold it. The primitive granulocyte had help.

The lampreys and hagfishes are still with us, unchanged in almost 40o million years. We can bring them into the laboratory and see in them our own immunologic begin­nings. If you take skin from another species and graft it on to these fishes, they will, like ourselves, re­ject the graft. But while we reject it in a few days, the lampreys and younger. Cellular immune respon­ses universally decline with age to a quarter or less of their value in younger animals, no matter what the species, and in humans as well. These are apparently unalterable immunologic facts, and their im­plications in regard to our body’s protecting itself from a continually developing supply of potentially cancerous cells are obvious, if not conclusive.

Most evidence concerning our immune system and the develop­ment of cancer has come from hu­mans who have been put on drugs that suppress their immune res­ponses; for example, in kidney-transplant patients. If we want transplanted organs to survive, immuno-suppressive drugs which interfere with the transplant recipi­ent’s antibodies must be given until the new organ is finally accepted—if it ever is. Yet the suppression of the patient’s immunologic system is not a specific suppression, just for his newly transplanted organ. It is a general suppression that will affect his immune response to any foreign substance.

Thus, one would expect to find more cancers in people who have had their immune systems inter­fered with artificially than non-suppressed people their own age. And when such a group was exam­ined, the results did indeed tend to support this theory. The US Na­tional Institutes of Health reported in 1974 on some 9,000 transplant patients and found about 70 cases of cancer (not including skin cancer)—significantly more than the inci­dence of naturally occurring cancer in people of their same age group in the general population.

In 1968, as a result of a nearly tragic mistake, the importance of the immune system in combating and controlling cancer was at least partly proved beyond dispute. For the first time in six years of success­ful kidney transplants, a cancerous kidney was placed in an immuno­logically suppressed person.

Of course, the surgeons involved didn’t know there was cancer in the transplanted kidney; they had done everything possible, as they always do, to make sure that the kidney was normal. But there is no way to detect a small tumour in the centre of a normal-looking kidney if the cancer has not grown big enough to show itself.

After the transplant, the patient was put on the routine high doses of immuno-suppressive drugs. Within days, the kidney began to enlarge; it looked as if there were some kind of acute rejection going on, some abnormal response, but the kidney’s function remained nor­mal. A few days later, a routine chest X-ray revealed an abnormal shadow, a mass in the patient’s chest. It hadn’t been there on the chest film taken just four days before, and it didn’t have the con­tour of pneumonia or some other infectious process; it was definitely a tumour. But how could it have grown so large in just four days?

A day later another mass was seen in the other lung. The patient was taken back to the operating theatre, and the transplanted kid­ney was found to be cancerous. The masses in the patient’s lungs were apparently metastatic cancer that had come from the kidney. The doctors were startled at how fast it had spread and grown. In a matter of days a kidney cancer that usually takes months, if not years, to be­come evident in the kidney itself had literally taken over this patient. All immuno-suppressive therapy had to be stopped.

Within days, as the patient’s im­mune system came back to normal, the masses in his lungs began to dis­appear and his transplanted kidney shrank. But, as the patient began to reject his cancerous cells, he also began to reject his transplanted kid­ney. The doctors had no choice. The kidney was removed, and the patient was put back on an artificial kidney. He survived with no fur­ther evidence of cancer.

The body is the hero pt.3

A Mighty Army

WE can best understand what our immune system means, what has to be given us in order that we survive, by looking at diseases in other living things. For instance, bacteria, virus­es and fungi cause diseases in plants as well as in humans and animals. But illness in plants is, for the most part, a localized process. With vir­tually no circulation, there is no quick movement of contagion from one site to another.

We humans do not have the lux­ury of time. The total blood volume in our body circulates once every 13 seconds; 6o quarts of blood pass to the brain and the kidneys per hour, and return to the heart at the same rate. These tremendous volumes give us the ability to run, to keep enough oxygen and sugar moving to our legs and arms so that our muscles can move even after hours of exertion.

But the price paid for all this quickness and power is a severe one. A bacterium from a cut in your fin­ger can reach your brain in a little more than four seconds. A pneumo­coccus in your lungs can reach the bones of your arms in three seconds.

The requirements to ensure our protection with a circulatory system such as we have are so overwhelm­ing it is numbing to think of what is involved. Yet, astonishingly, the protection is there. It is the end result of aeons of finely honed chemical responsiveness : a group of chemical protectors and microbial killers so quick and so vicious that, despite our size, our circulatory sys­tem, all our human mistakes, mis­deeds and blunders, we survive.

In earthworms and some octo­puses — the earliest beginnings of truly integrated multicellular ani­mal life—we find a primitive circu­lation. And in that circulation we find a still more primitive kind of cell. Under the microscope the cells can be seen moving slowly, search­ingly, through the earthworm’s body, constantly picking up bits and pieces of cellular debris and ingest­ing them. These primitive cells act as an internal refuse system. But they also serve another function : they will attack any bacterium they meet, throw themselves against it in a struggle older than life, and keep at it until one or the other is dead.

The descendants of these primi­tive cells, which we have inherited, are today called “white cells,” or granulocytes. They were first defined by Elie Metchnikoff, who worked in the laboratory of Louis Pasteur. After millions of years of evolv­ing along with us, the granulocytes have become more vicious and more mobile, and have acquired a whole new arsenal of their own bac­terial inhibitors and poisons. They are now able to consume bacteria more quickly and are even able to move towards the microbes rather than just wait for them to come past. They can sense where the enemy is and where they must go to meet him, and there are literally thou­sands of millions available to us.

These white cells, and an even more specialized version, the macro­phages, are all made in our bone marrow, where they mature and are released into the bloodstream ready to fight. A few are always on patrol in our vessels, but the rest are avail­able in case of attack. The average man or woman has 26,000 million granulocytes and macrophages available. The body can, on com­mand, release them all, and some­times all are needed.

If you take a syringe and with­draw to cc of blood from your arm, separate out the granulocytes and place them in a small dish filled with salt water, they will move about at random. Under the micro­scope they shift around like little amoebae. It is a rather tranquil picture, reminiscent of some types of algae moving slowly along a shoreline.

All you have to do is add one bacterium to the dish, just one, and the whole scene changes. The granulocytes, like alerted deer, sud­denly stop their random move­ments: a certain expectancy and wariness seems to grip them. Hesi­tatingly, almost nervously at first, they move this way and that, as if sensing something. Then, all of a sudden, they move off, one by one, in the direction of the bacterium, creeping slowly, relentlessly to­wards the microbe.

In the body this movement carries the granulocytes out of the blood-vessels towards the place of infec­tion. It is the first movement in an assault by a 126,000-million-man army. So effective is this internal sonar that within minutes of the be­ginning of an infection, the first of the granulocytes are already in the area, attacking the bacteria.

Once started, they fight so deter­minedly, expend so much energy, that they can exist in the battle for at best a short time. But by then their bigger brothers, the macro­phages—which look much like granulocytes but have greater amounts of killing enzymes, more endurance, thicker membranes and larger internal machinery—arrive and take over the attack. When the macrophages are established in the infected area, the granulocytes back of and let them make the fight alone. It is an extraordinary se­quence of events. You can take a drop of pus and, under the microscope, actually see these white cells grab the bacteria and hold them while they empty their granules containing destruc­tive enzymes on to them; you can see the microbes twist and turn, gradually cease their movements and begin finally to break apart. After an infection you can still see some of these white cells, beaten and worn, back in the circulation with hits and pieces of microbial cell walls still inside them, moving through the bloodstream, continu­ing their unending patrols, and ready—even battered and wounded —for the next battle.

The body is the hero pt.2

In the Beginning

THE SCIENCE of immunology is barely Too years old, but the pro­cesses it deals with are as old as the earth itself. The way in which our bodies fight infections evolved along with the oceans and the con­tinents, so that today the antibodies that patrol our circulation, the white cells that guard our tissues, are as fundamental as the rocks we walk on and the air we breathe. end of all that had gone before and might have come after.

There is an idea most of us share, that whatever it was which began in that distant time was a very fragile thing. It is a notion nourished by our humanity and our fears, but also fostered by science itself, which conjures up the view that life is a delicate mechanism, so precariously balanced that even the tiniest insult can shatter it.

Yet whatever it was that hap­pened in those ancient seas has en­dured. Ages have come and gone, land-masses have shifted, the geo­graphy of the oceans has changed, oxygen has permeated the atmo­sphere, temperatures have risen and fallen and risen again; but through it all, despite its seeming fragility, life has survived and prospered. It has filled the earth and the skies, it exists in the deepest parts of the oceans and clings to the highest mountains.

LIFE‘S beginnings are shrouded in mystery; the miracle that brought it about may be hidden forever. But perhaps the greatest mystery is not life’s beginnings but its incredible tenacity. Life’s endurance, its sur­vival, growth and domination—these are qualities as extraordinary as its birth, and of these we do in­deed know something.

The processes that brought life about, and continue to maintain it, started when the newly formed earth had cooled enough for the water, long held in the atmosphere as steam, to condense. Great cur­tains of rain then began to drench the still-smouldering globe, a con­tinual torrent washing the atmo­sphere, cleansing it of the billions of tons of compounds that had been formed there, carrying them down into the newly developing oceans.

What came after was a time of struggle, of survival of the fittest. Not the survival of any living crea­tures—there were none yet—but of what those creatures would ulti­mately be formed from, the organic molecules. Thousands of different kinds of sugars, hundreds of differ­ent alcohols, scores of dissimilar aldehydes, all had been washed down into the oceans, forming in the tidewater areas what has been called the “primeval soup.” The molecules which survived that soup did so because of their stability of construction, the number of atoms in them and the types of bonds holding the atoms together.

These struggles were as ruthless as any battle for survival since; only the strongest made it. Thus the chemical processes which go on in our own bodies—the compounds that make up our metabolic path­ways, the sugars and fats that carry our energy, the amino-acids that constitute our proteins, the phos­pholipids that make up our cell membranes—arc the best com­pounds that nature, could develop. fluids in our bodies mimic the primeval seas in which we be­gan. The concentrations of salts, of sodium, potassium and chloride in our bloodstream are the same as those that existed in the earliest seas.

We still carry those seas within us, and the same chemical battles that were fought in them some 3,000 million years ago are being waged today in fighting our infections and controlling our illnesses. The battle­fields may have shrunk from hun­dreds of square miles of ocean to a few cubic centimetres of blood, from bays and inlets to the fluids of kidneys and lungs, but failure now means the same as it did then—the some 3,000 million years’ battle for survival.

But survival and dominance meant more than simply continuing to grow, or merely to exist; it meant protecting whatever growth had been won. Indeed, life and pro­tection have always gone hand in hand.

The evolutionary formation of membranes was the first truly dra­matic example of this intertwining. Now there was a clear way to divide the outside from the inside. The molecules and enzymes that had been evolving in the open seas some­how enclosed themselves in mem­branes, and so were assured an environment in which they would always be dominant.

The ancient seas were suddenly and for ever preserved. By the sim­ple expedient of separating tiny parts of the oceans from the whole, of containing these parts within the membranes, their contents were once and for all kept apart from the changing salt concentrations, from the increasing minerals and alkalis, and from the sludge draining off the continents.

Ice ages would come and go, the oceans would fill with materials, the very air would change; and still the ancient seas—inside the cells—would go on and on unchanged, allowing life to develop in an en­vironment to which its parts were already eminently suited.

Once the chemistry of life was firmly protected within the cell membranes, there began the evolu­tion we are familiar with—the dev­elopment of living creatures—and with it came the beginning of our immune system. For by the time of cellular life, a new pressure had en­tered those early oceans : the need for food. The cell which could bet­ter utilize energy sources to main­tain itself would prosper and, in that prospering, dominate the less-effi­cient cells. The only food source large enough to support life was locked up within the cells them­selves, and so evolution took a violent turn.

Feeding began. Whole species de­voured the species next to them, only to be eaten themselves in turn. The organisms that eventually sur­vived triumphed not only because of differences in their metabolism—a greater ability to utilize available foods—but because of their aggres­siveness and bodily defences.

Those that moved more quickly survived the slower; those that were too sticky to be torn apart continued to exist; those that fought back, that made poisons and chemicals which killed the organisms that were try­ing to kill them, went on to form more of their own. The battles were no longer for dominance but for sheer existence. And those struggles which began back in those early seas, when the first cell turned on its brother, have never ceased.

We live today as we always have, at the bottom of a sea of bacteria and viruses. Plague, wound infections,

the horror of leprosy, the convul­sions of rabies, pus-infected organs, women dying of puerperal fever : it is all one living thing eating an­other, even as it was in the ancient oceans.

No matter how we may wish to view ourselves, despite all our fan­tasies of grandeur and dominion, all our fragile human successes, the real struggle has always been between microscopic adversaries, never more than seven microns—less than 0.0003 inch—wide.

The body is the hero pt.1

We exist today, we have survived to the present, be­cause in the long struggle of evolution there began to develop in our ancestors and then within each of us a system of protection so sophisticated and so powerful that after some 3,000 million years of continuous battle, with all the rup­tured appendices, broken bones, burns, pneumonia and meningitis, we have prevailed and been per­mitted to go on.

From the beginnings of life, more than any cataclysm of nature, our real opponents in the struggle for existence have been thousands of single-cell microbes, always there trying to destroy us along our way. Nowhere can the desperateness of this struggle, nor the implication of how dependent we are on our defenses, be more graphically seen than in the case of children born without the ability to protect them­selves from these microbes.

Despite our abhorrence of death, there are diseases where the illness is so grim, the pain and suffering are so bitter and constant, that even with our fear of loss, our terror of the unknown, death does not seem so frightening nor, when it comes, such a horrible burden. Combined immuno-deficiency is one of these illnesses. It is a disease afflicting in­fants born seemingly perfect but without our vital chemical inherit­ance floating in their bloodstreams. So grotesque is their dying that everyone—parents, doctors, nurses, friends — welcomes their death, wondering why these children were ever born at all.

At about two months of age, the average infant begins to have six to eight colds a year. They are usually short-lived affairs—a few days of runny nose, crankiness, a little diarrhoea, and the baby is well again. But for the unfortunate child born without an immune system, the dry, hacking coughs go on and on, the fevers persist. What every parent is sure will pass, does not.

The parents fight a growing sus­picion. After all, the child had been healthy before this cold—absolutely normal since birth. What they don’t know is that during those early months of normalcy their infant, like any other newborn baby, was protected from the viruses and bac­teria in the air he breathed, in the water he drank and in the food he ate, by preformed antibodies trans­ferred from his mother.

These antibodies were the special guardians that her body had already made to protect her, and that just before birth had entered her baby’s bloodstream to protect him at de­livery and for a short time after. But, like any protein, they eventu­ally break down, and if the infant has no ability to make his own, he will be left unprotected within a few months of birth.

When the first cold does not go away, the parents take their baby to their paediatrician. The doctor finds nothing unusual. Yet within a few more days the baby is obviously worse. It has now been almost two and a half weeks since he first be­came ill. Anxious and confused, the parents call the paediatrician again. They have talked to other families, to friends, and they know that nor­mal colds do not last this long. They realize that something is wrong, and angrily they confront the doc­tor, expecting medicine to live up to its claims. Feeling abused himself, the paediatrician may in despera­tion, to placate the parents or be­cause of his own growing suspicion that this child is not quite right, admit the infant to hospital.

On his rounds the next morning, he notices some spots in the baby’s mouth. The mother had seen them herself a week ago, but dismissed them as congealed milk or pieces of cereal. But the doctor knows they are not food and cannot be removed.

It is not a cold this time, but a mould called Candida albicans that will grow on any warm, moist sur­face. Every paediatrician will, in the course of a year, see ten or 15 infants with these greyish plaques growing in their mouths. The popu­lar term for this condition is “thrush,” and in most cases, despite its prevalence, it is a mild condition managed by the infant himself. If severe, it can be controlled by anti-fungal medications until the child’s own immune system can come into play.

Like all antibiotics, however, these medications only buy time. They hold organisms in check, they retard their growth, they may even kill a few; but in the end it is the body itself that must clean up the battlefield, seek out and destroy that last final microbe. All the great medical breakthroughs in infec­tious diseases, all the drugs and technical achievements have done nothing more than assist the body’s own immune system. They give us an edge, the time to mount a de­fence, but nothing more.

We have all been lulled into a sense of security by medical achieve­ments, as if the achievements them­selves were the answer. But nothing works for the baby born with immuno-deficiency disease. The fungus continues to grow.

Horrified, the parents watch while medicine fails. They see the greyish plaques creep down the front of their baby’s face, out of his nose. They watch it spill on to his chin and neck. The plaques begin to crack and bleed; the round, pudgy face becomes distorted. Hun­gry, yet unable to eat, the baby struggles and squirms; his mouth begins to rot. The fungus starts down the back of his throat, down his oesophagus into his stomach. He begins to cough up blood.

The doctor by now knows what is wrong and tells the parents. But without being told, without even knowing what the word immuno­deficiency means, it is obvious to them that their baby is in a desper­ate battle. His body, silently, franti­cally, is fighting for its life.”Eventually,” the doctor informs them, “he will acquire an infection that will be too much for him, and he will die.”

“How long?” asks the father.

“No more than two years.”

Were all of us born with the same deficiency, the child’s fate would be ours, his brief history that of our whole race.