1 PM. His testimony was corroborated building up as generally happens.
It
The Pre-disaster Syndrome
To the Editor:\p=m-\OnFriday, Oct 21,
1966, at 9:15 AM, a massive coal-tip
slid down a mountainside onto the
Welsh mining village of Aberfan,
destroying several houses and part
of the school. One hundred and six-
teen children and 28 adults were
killed, the majority being buried
alive in black mud and slurry. I
visited Aberfan the following day
and was appalled by the devasta-
tion and human suffering. Being in-
terested in precognition, it occurred
to me that there might be many
people in Britain and possibly else-
where who had experienced some
forewarning of a tragedy of such
magnitude. I therefore appealed
through the national press for per-
sons claiming any foreknowledge of
this disaster to send me details of
their experiences. I received 76 let-
ters in response, some 60 of which
required further investigation.
Twenty-two of the accounts have
since been verified as being reported
to others before the disaster oc-
curred and 2 were recorded before
the event. Thirty writers (aged 11
to 73 years, with females prepon¬
derating in a ratio of 5:1) dreamed
of the disaster or parts of it six
weeks to a few hours beforehand.
The remainder claimed to have had
visions or to have sensed the di¬
saster by clairvoyance, a few in spir¬
itualist gatherings. The fact that
seven persons, while in no way fore¬
seeing the particular incident, had
marked feelings of mental and phys¬
ical unease beforehand may be of
medical interest. Their symptoms
appeared to be relieved either by
the occurrence of the disaster or by
their hearing news of it. The med¬
ical literature has not revealed ref¬
erence to this phenomenon as such,
or to a comparable clinical entity.
Case 1:—A Bristol man, aged 50
wrote, "I commenced work at 8 AM on
the morning of the disaster and all the
morning felt the presence of unseen
forces around me, making it difficult
for me to concentrate on my work."
Between 9:10 and 9:30 am he re¬
marked to a colleague, "I feel quite
peculiar, as if I should understand
something." By 10 am the feeling was
gone, and he heard of the disaster at
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by a witness.
Case 2.—A Kent man, aged 31, wrote
that four nights before the disaster,
while he was lying in bed, the thought
suddenly struck him that on Friday
something big, something terrible was
going to occur. Death was clearly felt.
He claimed that this thought was in
no recognizable way associated with
his ordinary train of thoughts, but was
"an intruder." The following morning
he told the girl in the office, "On Fri¬
day something terrible connected with
death is going to happen." He could
not say where or how. He did not see
Aberfan or any Welsh town and had
no idea how his premonition was going
to be fulfilled, but it bothered him all
week. On Friday morning he said to
the girl, "Today is the day it is going
to happen," and he could not dismiss
the thought from his mind until he
heard the news of Aberfan that eve¬
ning. His story was verified hy the
office girl.
Case 3:—A London woman, aged
52, wrote, "At approximately 4 AM on
the morning of the disaster I awoke
choking and gasping with the sensa¬
tion that the walls of my room were
caving in. I have had this same ex¬
perience prior to two other disasters,
but on the morning of the Aberfan
tragedy it was particularly terrifying."
A witness wrote that she had de¬
scribed her symptoms to him at ap¬
proximately 8 am. He said that she
had complained of a very unpleasant
feeling consisting of choking sensations,
inability to catch her breath, and in¬
tense depression. She was in excellent
health at the time and had not had an
unpleasant dream.
Case 4:—A London man, aged 44,
wrote, "Around midnight on the night
before the disaster I was half asleep,
but aware of what I was saying when
I remarked twice to my wife that
there was going to be an earthquake
within the next 24 hours. She asked
me where, but I could not say. I
seemed to feel the ground trembling as
if an earthquake was taking place at
that time. I have had this experience
six times before and on five occasions
there has been a major earthquake
within 24 hours. I had never told any¬
body about my pre-earthquake experi¬
ences before, but on this occasion I
deliberately decided to settle the ques¬
tion once and for all by committing
myself to a prediction and chance
being ridiculed by my family if I
were proved wrong. As it happened
there was no earthquake, but a dis¬
aster which resembled one. In this
sense my prediction was wrong." His
experiences were verified in detail by
his wife.
Case 5:—An Essex man, aged 43,
wrote, "The sensations I received be¬
fore the Aberfan horror were totally
different from those I generally get
before a disaster. There was no slow
just hit me 24 hours beforehand with¬
out warning. I began to tremble all
over and found it difficult to concen¬
trate on my work. A lady sitting next
to me asked if I was ill. I said that a
big disaster in this country was im¬
minent which would cost many lives.
I could not and never have been able
to pinpoint the place of the occur¬
rence. On other occasions I experience
extreme lethargy when it seems as if a
band of steel compresses my head.
This can last up to two weeks before a
disaster and while in this state I am
sometimes able to say what vehicle
will be involved, plane, train, car, etc.
and very occasionally get glimpses of
the surrounding countryside. When I
saw pictures of the Aberfan disaster
in the newspapers the following day I
realized that I had seen this place, yet
I had had no vision. It is not until I
know of the actual happening that the
full realization floods back, then the
relief I receive after the tension disap¬
pears completely blankets out all I
have previously felt or seen."
Case 6:—A Middlesex woman wrote
that at approximately 9:45 am on the
morning of the disaster she became
exceedingly depressed at work and felt
that she was choking and suffocating.
She also smelled what she described
as an "awful smell of death" ("an
earthy decaying smell") similar to that
which she had experienced before the
death of some of her relatives. A
workmate confirmed the symptoms in
writing, and added, "She gradually
became more composed and had com¬
pletely recovered by 3 PM. None of
us knew about the disaster until after
this time."
It is difficult to attribute these
experiences to coincidences alone.
Admittedly they were collected af¬
ter the event, but in six instances
there is supporting written testi¬
mony from others who witnessed
symptoms or confirmed that experi¬
ences were reported to them before
the disaster occurred or before the
subjects became aware of it. De¬
spite individual variations, they all
seemed to have symptoms in ad¬
vance of the catastrophe. These in¬
cluded general nonspecific feelings
of unease, apprehension, depression,
loss of concentration, and in one
instance a compelling thought. In
addition, these percipients had a
sense of oppression and two experi¬
enced dyspnea, choking sensations,
and feelings of suffocation before
the disaster.
Some people appear to be unduly
sensitive to impending earthquakes
and other major calamities. Such
persons have been aptly termed
"human seismographs." Symptoms
 appear to build up for a variable in¬
terval before a disaster and then
abate rapidly afterwards. Relief
may be masked by the shock of
realization that these personal ex¬
periences seem in some way to be
related to the calamity itself (a
type of déjà vu). Unlike those who
claim more definite precognition of
the impending event, these persons
are generally unable to determine
the nature or possible situation of
the impending tragedy.
Is this a hitherto unrecognized
medical or psychosomatic svndrome
akin perhaps to the psychologically
induced "sympathetic projection of
pain"? (Lancet 2:1414, 1966). What
proportion of people are affected in
this way? Why should some indi¬
viduals appear to be sensitive to
human suffering or illness occurring
at a distance? Does collective dis¬
tress, in particular, generate some
kind of "mental shock wave" which
can then in certain circumstances
be detected by others in advance? I
realize, of course, that it still re¬
quires to be proved that these per¬
sons do not react in this strange
way in the absence of impending
disasters.
In an attempt to answer some of
these and other questions a scheme
has been launched in Britain where¬
by those experiencing any form of
premonition have been invited to
report their experiences to the
science correspondent of a London
newspaper (The Evening Stan¬
dard ). These will then be logged and
analyzed for year. It is possible
a
that "peaks" or "patterns" will
emerge from the incoming material
which may then be found to coin¬
cide with the occurrence of some di¬
sasters. Should this preliminary ven¬
ture prove successful, it might then
be possible to develop a type of "ear¬
ly warning system" utilizing pre¬
cognition in an attempt to prevent
disasters. In the meantime I would
welcome the experience of those
who claim to have symptoms (ir¬
respective of their nature) in ad¬
vance of major calamities.
J. C. Barker, MD
Shelton Hospital
Shrewsbury, Shropshire
England
The Physician's Mail
To the Editor:\p=m-\Thereis a solution
to the advertising and to the un-
necessary mail that comes to us in
great numbers (199:674,1967).
Sometime during 1965 I became
interested in the problems of medi-
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cal advertising and samples. I start-
ed to check the mail personally and
found that most of my samples were
unsolicited. The advertising litera-
ture consisted of material printed
regularly in medical literature,
which was frequently brought in by
salesmen.
I asked several salesmen who visit
regularly to stop the mail. Almost
all of them explained that their
mailings were effected by special
outfits, and not by their companies.
Taking a name off the list is ex-
pensive, and they protest doing it.
I hoped that after Jan 1, 1966, the
samples would decrease, especially
in connection with the new law re-
garding amphetamines, barbiturates,
etc. To my dismay, I found out that
since samples did not have to be
registered and counted, the mailing
did not stop. I even continued to
receive amphetamines.
I did two things. I notified all
the representatives that unless mail
stopped I would no longer see them.
I wrote to the AMA to have my
name removed from all the adver¬
tising lists.
As a consequence, most of the
literature and the samples have
stopped coming from companies
which have representatives in this
locality. There are one or two ex¬
ceptions, but men from these com¬
panies do not come to see me. Ap¬
parently some companies do not
feel it is worthwhile to make ex¬
ceptions about sending advertising.
A drawback to my "campaign"
was that some worthy publications
stopped coming. This was unexpect¬
ed, but I was reinstated on the
mailing list after sending special
letters to the publishers. I was will¬
ing to pay for my subscriptions as
a price for getting rid of unwanted
mail.
Very little mail comes to my of¬
fice these days, and relatively few
samples, mostly from outfits that
are not represented locally. Every¬
one seems to be happy: the mail¬
man, my secretary, and even I.
Though I have not had complete
success, I am satisfied that I have
been able to accomplish something,
not just complain.
Edmund Goldenberg, MD
Binghampton, NY
A physician can have his name re¬
moved from the mailing list used
by
any manufacturing firm, publisher, etc,
but the physician must insist upon
such removal. The manufacturing firm
or publisher will try to convince the
physician that it is impossible to re-
move the name from promotional
mailings, because the firm does not
want to spend the money for such re¬
moval. If the physician finds that the
business firm refuses to remove the
name, then he can bring the matter to
the attention of his local postmaster.
However, the physician will find that
his name will reappear on many dif¬
ferent mailing lists rented by the man¬
ufacturing firm or the publisher, and
that he will probably have to contact
the firm at frequent intervals.—Ed.
Corticosteroids in
Infectious Mononucleosis
To the Editor:\p=m-\A paper by Charles
E. Bender, MD (199:529, 1967)
evaluates the effect of treatment
with corticosteroids on the outcome
of infectious mononucleosis. This
was done by comparing patients
preselected for such treatment with
those receiving no steroid, on a ret-
rospective basis. An attempt was
made to remove extraneous differ-
ences by selecting an untreated
"control" patient for each steroid-
treated patient on the basis of simi-
larity in age, sex, disease status,
and time of "treatment."
It is most difficult to establish
comparable groups in this way. In-
evitable uncontrolled differences are
not taken into account. Moreover,
the author says:
The usual approach to an assess-
ment of drug effect by assignment of
patients to treatment and control
groups was inappropriate because of
the well recognized dangers of steroid
therapy and because many students
treated by the Student Health Service
are minors.
This seems almost to guarantee the
existence of differences between the
groups unconnected with treatment
effects.
There appears to be no good rea¬
son why a study like this could not
be done prospectively, by first se¬
lecting a group of patients suitable
for steroid therapy and then divid¬
ing them into two subgroups at ran¬
dom, one of which will receive
steroid and the other a placebo. The
procedure should, of course, be done
"blind" as regards both the patient
and the physician assessing the out¬
come. Such a study could give an
unequivocal answer to the question
asked.
It is difficult to understand v/hy it
was considered inappropriate (pre¬
sumably for ethical reasons) to ran¬
domize patients into a control and
a treated group, when the disease is