Away in a manger, no crib for His bed
The little Lord Jesus laid down His sweet head
The stars in the bright sky looked down where He lay
The little Lord Jesus asleep on the hay
The cattle are lowing the baby wakes
But little Lord Jesus no crying He makes
I love Thee, Lord Jesus look down from the sky
And stay by my side, 'til morning is nigh.
Be near me, Lord Jesus, I ask Thee to stay
Close by me forever and love me I pray
Bless all the dear children in Thy tender care
And take us to heaven to live with Thee there.
Scripture reference: Luke 2:7
Although this children’s song often carries the appellation “Luther’s Carol” one thing we can be certain of; Martin Luther had nothing to do with it. Indeed, the cloying sentimentality of the words places them strictly in the late Victorian era. After all, the adjective “sweet” to describe the head of the baby could only come from then and the conceit that a baby was so “good” he would not cry hardly belongs to the earthy Martin Luther. It is possible that they were written for the 400th anniversary of Luther’s birth in 1883.
The words of the first two stanzas originally appeared in a Little children's book: for schools and families. By authority of the general council of the Evangelical Lutheran Church in North America (Philadelphia, J. C. File, 421 Market Street, 1885). They were not among the other Christmas carols, but as a "Nursery" hymn, the very last item in the volume. The date of copyright is June 16, 1885, but the preface is dated "Christmas 1884". They next appeared in Dainty Songs for Little Lads and Lasses by James R Murray (Cincinnati, Ohio: The John Church Co., 1887). Murray gave the song the heading “Luther’s Cradle Hymn”.
Despite extensive research, no-one has been able to find the author of the hymn. The German version did not appear until 1934 and is clearly a translation from the English. All we can say that is that it a late Victorian song, probably written by someone within the American Lutheran tradition.
The author of the third stanza is not much clearer. A collection published by Charles H Gabriel in 1892, called Gabriel’s Vineyard Songs gives the third stanza for the first time. Bishop William F. Anderson says John Thomas McFarland wrote it sometime between 1904-08, while the Bishop was Secretary of the Board of Education. Obviously, the dates are too far off to accept the story at its face value, particularly since McFarland's claim comes second-hand. The circumstances as related by Bishop Anderson permit the interpretation that the Bishop merely thought McFarland had just written the stanza for his use, whereas actually he had written it much earlier for another occasion. Or McFarland may have simply copied it for the Bishop from some source known to him, and the Bishop deduced his authorship from the fact that the copy was in McFarland's hand. In either case, the 1892 publication renders the Bishop's story suspect, and additional evidence must be found before McFarland can be safely credited with the writing of the third stanza.
McFarland was educated at Simpson College, Iowa Wesleyan University, and the Boston University School of Theology. He pastored in Iowa, Illinois, Rhode Island, New York, and Kansas. He also served as Secretary of the Board of Sunday Schools in New York City, secretary of the Sunday School Union, and editor of Sunday school materials for the Methodist Episcopal Church.
According to Richard Hill in an article from December 1945 the carol has been published in 41 different settings. In America, the song is usually sung to the tune “Mueller”. Who was Mueller? From 1921 to 1945 among the collections in which “Away in a Manger” appears, fifteen have come out for Martin Luther as the composer of this particular melody and fifteen for Carl Mueller. Several collections in the early twenties give no composer at all, and after 1934 a trend developed to pass off the problem entirely by giving the origin of the tune simply as "German" or "Traditional." Carl Mueller in German is about the same as John Smith in English, and no particular Carl Mueller has been discovered to accept the attribution. On the other hand the tune first appeared in 1887 in James R Murray’s publication and two years later, the tune is credited to JRM.
Murray is at least known to have been a musician. From 1856-1859, Murray studied at the Musical Institute in North Reading, Massachusetts, under Lowell Mason, George Root, William Bradbury, and George Webb. In 1862, in the midst of the American civil war, Murray enlisted as an Army musician. His first song, “Daisy Deane,” was composed in a Virginia camp in 1863. After the war, he returned home to teach piano, but soon joined the Root & Cady publishing house in Chicago, Illinois, as editor of The Song Messenger. He stayed with Root & Cady until the great Chicago fire of 1871, when he returned to Andover and resumed work as a music teacher. In 1881, Murray moved to Cincinnati, Ohio, to work for the John Church Company, editing The Musical Visitor, and taking charge of the publishing department. Under the circumstances, there would seem to be no reasonable grounds on which Murray's claim to having composed the setting can be denied.
In the UK the song is sung to an entirely different tune known as “Cradle Song”.
The tune “Cradle Song” was composed for the hymn by W. J. Kirkpatrick On October 2, 1895, William J. Kirkpatrick sent in proof sheets of seven songs, either by himself or his chief collaborator, John R. Sweney. On Dec. 9, 1895, Cranston & Curts registered a small pamphlet containing these seven songs, plus some additional material. The title of the pamphlet was: Around the world with Christmas. A Christmas exercise. Words arranged by E. E. Hewitt. Music by John R. Sweney and Wm, Kirkpatrick. Cincinnati, Chicago, and St. Louis: Cranston & Curls; New York, Boston, Pittsburgh, and San Francisco: Hunt & Eaton. The service is made up of the usual mixture of recitations and vocal numbers, the latter ranging from "The Doxology" to a song by George F. Root. Halfway through, the service begins to justify its title by introducing numbers depicting "Christmas in England," "The Land o' Cakes" [Scotland], "The German Fatherland," "Denmark," "Austria," and lastly a carol, "All over the world". "Luther's Cradle Hymn," music by Kirkpatrick, is used to exemplify "The German Fatherland”. It is notable that the third stanza is included (10 years before McParland is supposed to have written it!) Note the inclusion once more of the third stanza. Although Kirkpatrick was not misled into thinking that Murray’s setting went back to Luther, he apparently believed that the poem was typical of Germany – sufficiently typical to make the Germans forget that the music was written for the occasion by Kirkpatrick himself. This is just another of the absurd contradictions that everyone seems to have peacefully accepted.
Kirkpatrick (1838-1921) was a prodigious hymn writer. Most of the sources say that he was a native of Pennsylvania, although David J. Beattie maintains with considerable assurance in his The romance of sacred song (London and Edinburgh, Marshall, Morgan & Scott, Ltd., 1931, p. 184) that he was born in Ireland. At any rate, he was in Pennsylvania by a comparatively early age, and during the Civil War served as a fife major with the 91st Regiment Pennsylvania Volunteers. During the twelve years that followed, according to Beattie, he "was connected with a furniture manufacturing company, but in 1878 he abandoned all commercial pursuits and gave his undivided attention to the writing of sacred music, gradually gaining the ear and admiration of the English-speaking world."
It was Kirkpatrick's setting that first carried the words beyond the confines of the United States, but not to Germany, where it remained virtually unknown. Sankey played a part in carrying his earlier productions to England, and once he was known over here, it is only natural that his setting of the "Cradle Hymn" would reach these shores. His popularity here was further facilitated by his almost unbelievable productivity, which supplied a hymn on almost any conceivable subject. As a rough indication of how many hymns he must have written, his widow, Lizzie E. Sweney Kirkpatrick of Germantown, Pa., renewed the copyright on his setting of "Away in a manger" on Jan. 26, 1923. She assigned the rights of one group of 1049 of his hymns to the Hope Publishing Co., on March 3, 1924, and this was by no means his total output.
Saturday, December 22, 2007
Friday, December 21, 2007
O little town of Bethlehem
O little town of Bethlehem, how still we see thee lie!
Above thy deep and dreamless sleep the silent stars go by.
Yet in thy dark streets shineth the everlasting Light;
The hopes and fears of all the years are met in thee tonight.
O morning stars together, proclaim the holy birth,
And praises sing to God the King, and peace to men on earth!
For Christ is born of Mary, and gathered all above,
While mortals sleep, the angels keep their watch of wondering love.
How silently, how silently, the wondrous Gift is giv’n;
So God imparts to human hearts the blessings of His Heav’n.
No ear may hear His coming, but in this world of sin,
Where meek souls will receive Him still, the dear Christ enters in.
O holy Child of Bethlehem, descend to us, we pray;
Cast out our sin, and enter in, be born in us today.
We hear the Christmas angels the great glad tidings tell;
O come to us, abide with us, our Lord Emmanuel!
Scripture references Job 38:7, Micah 5:2, Matt 2:1, Matt 2:6.
Rector Phillips Brooks (1835-1903) wrote the words to O Little Town of Bethlehem in 1868, three years after a pilgrimage to the Holy Land. He was inspired by the view of Bethlehem from the hills of Palestine especially at night time hence the lyrics of O Little Town of Bethlehem.
Brooks was a native of Boston and Harvard educated, and was to become one of America’s greatest preachers, yet his early life was a failure as a Latin teacher in his home city. He joined the Christian ministry and it was while he was Rector of Holy Trinity, Philadelphia that he wrote the hymn. He was later elevated to the (Anglican) Bishopric of Boston. If you visit Copley Square in Boston you will see, reflected in the mirror glass of the John Hancock building, Trinity Church, completed in 1877, and designed by H. H. Richardson in the Romanesque Revival style. It is located on the eastern side of the square. Considered Richardson's tour de force, the 1893 Baedeker's United States pronounced it "deservedly regarded as one of the finest buildings in America." On this church you will see a plaque commemorating Brook’s ministry and his writing of this carol.
He was a giant of a man, who stood 6 feet 8 inches, also had a big heart that endeared him to old and young alike. It was said that his personality radiated tenderness, sweetness and a passionate sincerity. There were toys in his office for the many children who visited him. It was a familiar sight to see the beloved bishop sitting on the floor playing a game with a group of children.
He never married but other people's children became like a family to him. When he died unexpectedly in 1893, at the age of 58, everyone was overwhelmed with grief. It was a child who put his death in a beautiful light. When told by her mother that Bishop Brooks had gone to heaven, she simply said, "Oh Mama, how happy the angels will be to see him in heaven”
His church organist in Philadelphia, who was also the Sunday School Superintendent, Lewis Redner (1831-1908), wrote the melody to O Little Town of Bethlehem for the Sunday school children's choir. Mr. Redner sat down at the piano to find just the right tune to carry the descriptive words. But nothing he wrote seemed to fit. On the night before the Christmas Eve service he felt defeated, so he went to bed. During his fretful sleep it seemed that he heard music. Immediately, he got up and wrote down the melody just as it is sung today in America. When he joyfully presented it to Rev. Brooks he said: "I think it was a gift from heaven." The children sounded like a choir of angels as they sang the new carol written just for them. Brooks wanted to call the tune “Lewis” after Redner, but he demurred and as a compromise the tune became known as “St Louis”.
Despite its popularity in America it was hardly known in England until it appeared in the English Hymnal of 1906 with a different tune. Ralph Vaughan Williams wrote “Forest Green” based on a traditional English folk song, “The Ploughman’s Dream” which comes from Forest Green, Near Ockley in Surrey and this is the tune usually sung, but another beautiful melody is used in the Nine Lessons and Carols from Kings. Christmas Carol by Sir Henry Walford Davies. Sir Henry was born in Oswestry and educated at the Royal College of Music, having been a choir boy for the Queen at St George’s Chapel, Windsor Castle. He was Master of the King’s Music from 1934-41. Illustrious indeed, but less famous than Vaughan Williams, perhaps the greatest English composer of the 20th Century who was awarded the Order of Merit, the highest civilian award available in Britain and restricted to only 24 members at any one time.
One remarkable setting, seldom heard in churches, marries the words with the music of “House of the Rising Sun”, the Eric Burden hit of the sixties.
Above thy deep and dreamless sleep the silent stars go by.
Yet in thy dark streets shineth the everlasting Light;
The hopes and fears of all the years are met in thee tonight.
O morning stars together, proclaim the holy birth,
And praises sing to God the King, and peace to men on earth!
For Christ is born of Mary, and gathered all above,
While mortals sleep, the angels keep their watch of wondering love.
How silently, how silently, the wondrous Gift is giv’n;
So God imparts to human hearts the blessings of His Heav’n.
No ear may hear His coming, but in this world of sin,
Where meek souls will receive Him still, the dear Christ enters in.
O holy Child of Bethlehem, descend to us, we pray;
Cast out our sin, and enter in, be born in us today.
We hear the Christmas angels the great glad tidings tell;
O come to us, abide with us, our Lord Emmanuel!
Scripture references Job 38:7, Micah 5:2, Matt 2:1, Matt 2:6.
Rector Phillips Brooks (1835-1903) wrote the words to O Little Town of Bethlehem in 1868, three years after a pilgrimage to the Holy Land. He was inspired by the view of Bethlehem from the hills of Palestine especially at night time hence the lyrics of O Little Town of Bethlehem.
Brooks was a native of Boston and Harvard educated, and was to become one of America’s greatest preachers, yet his early life was a failure as a Latin teacher in his home city. He joined the Christian ministry and it was while he was Rector of Holy Trinity, Philadelphia that he wrote the hymn. He was later elevated to the (Anglican) Bishopric of Boston. If you visit Copley Square in Boston you will see, reflected in the mirror glass of the John Hancock building, Trinity Church, completed in 1877, and designed by H. H. Richardson in the Romanesque Revival style. It is located on the eastern side of the square. Considered Richardson's tour de force, the 1893 Baedeker's United States pronounced it "deservedly regarded as one of the finest buildings in America." On this church you will see a plaque commemorating Brook’s ministry and his writing of this carol.
He was a giant of a man, who stood 6 feet 8 inches, also had a big heart that endeared him to old and young alike. It was said that his personality radiated tenderness, sweetness and a passionate sincerity. There were toys in his office for the many children who visited him. It was a familiar sight to see the beloved bishop sitting on the floor playing a game with a group of children.
He never married but other people's children became like a family to him. When he died unexpectedly in 1893, at the age of 58, everyone was overwhelmed with grief. It was a child who put his death in a beautiful light. When told by her mother that Bishop Brooks had gone to heaven, she simply said, "Oh Mama, how happy the angels will be to see him in heaven”
His church organist in Philadelphia, who was also the Sunday School Superintendent, Lewis Redner (1831-1908), wrote the melody to O Little Town of Bethlehem for the Sunday school children's choir. Mr. Redner sat down at the piano to find just the right tune to carry the descriptive words. But nothing he wrote seemed to fit. On the night before the Christmas Eve service he felt defeated, so he went to bed. During his fretful sleep it seemed that he heard music. Immediately, he got up and wrote down the melody just as it is sung today in America. When he joyfully presented it to Rev. Brooks he said: "I think it was a gift from heaven." The children sounded like a choir of angels as they sang the new carol written just for them. Brooks wanted to call the tune “Lewis” after Redner, but he demurred and as a compromise the tune became known as “St Louis”.
Despite its popularity in America it was hardly known in England until it appeared in the English Hymnal of 1906 with a different tune. Ralph Vaughan Williams wrote “Forest Green” based on a traditional English folk song, “The Ploughman’s Dream” which comes from Forest Green, Near Ockley in Surrey and this is the tune usually sung, but another beautiful melody is used in the Nine Lessons and Carols from Kings. Christmas Carol by Sir Henry Walford Davies. Sir Henry was born in Oswestry and educated at the Royal College of Music, having been a choir boy for the Queen at St George’s Chapel, Windsor Castle. He was Master of the King’s Music from 1934-41. Illustrious indeed, but less famous than Vaughan Williams, perhaps the greatest English composer of the 20th Century who was awarded the Order of Merit, the highest civilian award available in Britain and restricted to only 24 members at any one time.
One remarkable setting, seldom heard in churches, marries the words with the music of “House of the Rising Sun”, the Eric Burden hit of the sixties.
Thursday, December 20, 2007
Silent Night
Stille Nacht! Heil'ge Nacht!
Alles schläft; einsam wacht
Nur das traute hoch heilige Paar.
Holder Knab' im lockigen Haar,
|: Schlafe in himmlischer Ruh! :|
2. Stille Nacht! Heil'ge Nacht!
Gottes Sohn, o wie lacht
Lieb' aus deinem göttlichen Mund,
Da uns schlägt die rettende Stund'.
|: Jesus in deiner Geburt! :|
3. Stille Nacht! Heil'ge Nacht!
Die der Welt Heil gebracht,
Aus des Himmels goldenen Höhn,
Uns der Gnaden Fülle läßt sehn,
|: Jesum in Menschengestalt! :|
4. Stille Nacht! Heil'ge Nacht!
Wo sich heut alle Macht
Väterlicher Liebe ergoß,
Und als Bruder huldvoll umschloß
|: Jesus die Völker der Welt! :|
5. Stille Nacht! Heil'ge Nacht!
Lange schon uns bedacht,
Als der Herr vom Grimme befreit
In der Väter urgrauer Zeit
|: Aller Welt Schonung verhieß! :|
6. Stille Nacht! Heil'ge Nacht!
Hirten erst kundgemacht
Durch der Engel Alleluja,
Tönt es laut bei Ferne und Nah:
|: "Jesus der Retter ist da!"
Stille Nacht! Heil'ge Nacht! was written by a German priest named Joseph Mohr on Christmas Eve 1818. Joseph was the son of Franz Mohr, an itinerant mercenary, and as he was away most of the time, Joseph was brought up by foster parents. The head of the household was a Roman Catholic priest named Hiernle. Joseph himself was ordained in 1815 after serving in several parishes came to minister in the village church of St Nicholas, Oberdorf in Upper Austria, near Salzburg.
Today books, films and Internet sites are filled with fanciful tales purporting to tell the history of "Silent Night." Some tell of mice eating the bellows of the organ creating the necessity for a hymn to be accompanied by a guitar. Others claim that Joseph Mohr was forced to write the words to a new carol in haste since the organ would not play. A recent film, created for Austrian television places Oberndorf in the Alps and includes evil railroad barons and a double-dealing priest, while a recent book by a German author places a zither in the hands of Franz Gruber and connects Joseph Mohr with a tragic fire engulfing the city of Salzburg. You can read claims that "Silent Night" was sung on Christmas Eve in 1818 and then forgotten by its creators
One story of how the carol was written goes like this. As the snow fell outside the newly built small church in Oberdorf on Christmas Eve, preparation for midnight mass was interrupted by the announcement from local schoolmaster and organist Franz Gruber that the organ had broken down irreparably. Mohr was so upset that he left the preparations and wrapped up well to visit some parishioners. As he trudged through the thick snow he came to the home of a poor laborer whose wife had just delivered a new baby. As he walked wearily back to the church, the snow silently fell, snow on snow, giving brightness to the calm, dark night. It reminded him of the Nativity scene and the words “Stille Nacht! Heil'ge Nacht! Alles schläft; einsam wacht“ came to his mind. Arriving back at the church with the words still ringing in his mind he soon penned four simple stanzas describing the wonder and majesty of the first Christmas.
As the organ had broken down, Mohr insisted that the schoolmaster tune up his old guitar. Together they hummed the simple tune that we know today. The girls of the village took up the tune and the whole carol was sung for the first time that very night.
When Christmas was over the organ was repaired by Karl Mauracher and Gruber played the new carol for him. Mauracher loved it straight away, but it was ten years before it became popular.
However, a manuscript was discovered in 1995 in Mohr's handwriting and dated by researchers at ca. 1820. It shows that Mohr wrote the words in 1816 when he was assigned to a pilgrim church in Mariapfarr, Austria,
The four Strasser children, Caroline, Joseph, Andreas and Analie had become popular Tyrolean singers (like the von Trapp’s) and they introduce the song into their repertoire as “The Song of Heaven”. At Christmas 1832 they sang it for the King and Queen of Saxony and since then it has been ever popular.
The first English version was by Bishop John F Young (1826-85) but we sing the translation by Stopford Augustus Brooke, an Irishman who left the Church of England to preach in Bedford Chapel (Bunyan’s) and translated the carol as “Still the night, holy the night”
Silent night Holy night
All is calm all is bright
'Round yon virgin Mother and Child
Holy infant so tender and mild
Sleep in heavenly peace
Sleep in heavenly peace
Silent night, holy night,
Shepherds quake at the sight.
Glories stream from heaven afar,
Heav'nly hosts sing Alleluia;
Christ the Savior is born;
Christ the Savior is born.
Silent night, holy night,
Son of God, love's pure light.
Radiant beams from Thy holy face,
With the dawn of redeeming grace,
Jesus, Lord, at Thy birth;
Jesus, Lord, at Thy birth.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Still the night, Holy the night,
Sleeps the world, hid from sight,
Mary and Joseph in stable bare,
Watch o'er the child, beloved and fair,
Sleep in heavenly peace,
Sleep in heavenly peace.
Still the night, Holy the night,
Shepherds first saw the light,
Heard resounding clear and strong,
Far and near, the Angels song,
Christ the Redeemer is here,
Christ the Redeemer is here.
Still the night, Holy the night,
Son of God, love's pure light,
Love is smiling from thy face,
Strikes for us now the hour of grace,
Saviour since thou art born,
Saviour since thou art born.
Alles schläft; einsam wacht
Nur das traute hoch heilige Paar.
Holder Knab' im lockigen Haar,
|: Schlafe in himmlischer Ruh! :|
2. Stille Nacht! Heil'ge Nacht!
Gottes Sohn, o wie lacht
Lieb' aus deinem göttlichen Mund,
Da uns schlägt die rettende Stund'.
|: Jesus in deiner Geburt! :|
3. Stille Nacht! Heil'ge Nacht!
Die der Welt Heil gebracht,
Aus des Himmels goldenen Höhn,
Uns der Gnaden Fülle läßt sehn,
|: Jesum in Menschengestalt! :|
4. Stille Nacht! Heil'ge Nacht!
Wo sich heut alle Macht
Väterlicher Liebe ergoß,
Und als Bruder huldvoll umschloß
|: Jesus die Völker der Welt! :|
5. Stille Nacht! Heil'ge Nacht!
Lange schon uns bedacht,
Als der Herr vom Grimme befreit
In der Väter urgrauer Zeit
|: Aller Welt Schonung verhieß! :|
6. Stille Nacht! Heil'ge Nacht!
Hirten erst kundgemacht
Durch der Engel Alleluja,
Tönt es laut bei Ferne und Nah:
|: "Jesus der Retter ist da!"
Stille Nacht! Heil'ge Nacht! was written by a German priest named Joseph Mohr on Christmas Eve 1818. Joseph was the son of Franz Mohr, an itinerant mercenary, and as he was away most of the time, Joseph was brought up by foster parents. The head of the household was a Roman Catholic priest named Hiernle. Joseph himself was ordained in 1815 after serving in several parishes came to minister in the village church of St Nicholas, Oberdorf in Upper Austria, near Salzburg.
Today books, films and Internet sites are filled with fanciful tales purporting to tell the history of "Silent Night." Some tell of mice eating the bellows of the organ creating the necessity for a hymn to be accompanied by a guitar. Others claim that Joseph Mohr was forced to write the words to a new carol in haste since the organ would not play. A recent film, created for Austrian television places Oberndorf in the Alps and includes evil railroad barons and a double-dealing priest, while a recent book by a German author places a zither in the hands of Franz Gruber and connects Joseph Mohr with a tragic fire engulfing the city of Salzburg. You can read claims that "Silent Night" was sung on Christmas Eve in 1818 and then forgotten by its creators
One story of how the carol was written goes like this. As the snow fell outside the newly built small church in Oberdorf on Christmas Eve, preparation for midnight mass was interrupted by the announcement from local schoolmaster and organist Franz Gruber that the organ had broken down irreparably. Mohr was so upset that he left the preparations and wrapped up well to visit some parishioners. As he trudged through the thick snow he came to the home of a poor laborer whose wife had just delivered a new baby. As he walked wearily back to the church, the snow silently fell, snow on snow, giving brightness to the calm, dark night. It reminded him of the Nativity scene and the words “Stille Nacht! Heil'ge Nacht! Alles schläft; einsam wacht“ came to his mind. Arriving back at the church with the words still ringing in his mind he soon penned four simple stanzas describing the wonder and majesty of the first Christmas.
As the organ had broken down, Mohr insisted that the schoolmaster tune up his old guitar. Together they hummed the simple tune that we know today. The girls of the village took up the tune and the whole carol was sung for the first time that very night.
When Christmas was over the organ was repaired by Karl Mauracher and Gruber played the new carol for him. Mauracher loved it straight away, but it was ten years before it became popular.
However, a manuscript was discovered in 1995 in Mohr's handwriting and dated by researchers at ca. 1820. It shows that Mohr wrote the words in 1816 when he was assigned to a pilgrim church in Mariapfarr, Austria,
The four Strasser children, Caroline, Joseph, Andreas and Analie had become popular Tyrolean singers (like the von Trapp’s) and they introduce the song into their repertoire as “The Song of Heaven”. At Christmas 1832 they sang it for the King and Queen of Saxony and since then it has been ever popular.
The first English version was by Bishop John F Young (1826-85) but we sing the translation by Stopford Augustus Brooke, an Irishman who left the Church of England to preach in Bedford Chapel (Bunyan’s) and translated the carol as “Still the night, holy the night”
Silent night Holy night
All is calm all is bright
'Round yon virgin Mother and Child
Holy infant so tender and mild
Sleep in heavenly peace
Sleep in heavenly peace
Silent night, holy night,
Shepherds quake at the sight.
Glories stream from heaven afar,
Heav'nly hosts sing Alleluia;
Christ the Savior is born;
Christ the Savior is born.
Silent night, holy night,
Son of God, love's pure light.
Radiant beams from Thy holy face,
With the dawn of redeeming grace,
Jesus, Lord, at Thy birth;
Jesus, Lord, at Thy birth.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Still the night, Holy the night,
Sleeps the world, hid from sight,
Mary and Joseph in stable bare,
Watch o'er the child, beloved and fair,
Sleep in heavenly peace,
Sleep in heavenly peace.
Still the night, Holy the night,
Shepherds first saw the light,
Heard resounding clear and strong,
Far and near, the Angels song,
Christ the Redeemer is here,
Christ the Redeemer is here.
Still the night, Holy the night,
Son of God, love's pure light,
Love is smiling from thy face,
Strikes for us now the hour of grace,
Saviour since thou art born,
Saviour since thou art born.
Wednesday, December 19, 2007
Once in royal David's city
Once in royal David's city
stood a lowly cattle shed,
where a mother laid her baby
in a manger for his bed:
Mary was that mother mild,
Jesus Christ her little child.
He came down to earth from heaven,
who is God and Lord of all,
and his shelter was a stable,
and his cradle was a stall;
with the poor, the scorned, the lowly,
lived on earth our Savior holy.
And, through all his wondrous childhood,
he would honor and obey,
love and watch the lowly maiden
in whose gentle arms he lay:
Christian children all must be
mild, obedient, good as he.
For he is our childhood's pattern,
day by day like us he grew;
he was little, weak and helpless,
tears and smiles like us he knew.
and he feeleth for our sadness,
and he shareth in our gladness.
And our eyes at last shall see him,
through his own redeeming love;
for that Child who seemed so helpless
is our Lord in heaven above;
and he leads his children on
to the place where he is gone.
Not in that poor lowly stable,
with the oxen standing round,
we shall see him; but in heaven,
set at God's right hand on high;
when like stars his children crowned,
all in white shall wait around.
Scripture references: Luke 2:7, Phil 2:7, I John 3:2.
Cecil Frances Humphries (1818-1895) wrote this hymn and published it in 1848 in Hymns for Little Children. A year later, H. J. Gauntlett discovered Miss Humphries' poem and set it to music.
Cecil Frances was the daughter of well-to-do Dublin landowner, Major John Humphries. This was a household where children knew their place, so she would hide her poems, written since the age of nine, under the carpet. Her father discovered her secret and provided a box for their reception, the contents of which she was allowed to read to the family on Saturday evenings. Her godsons complained that they could not understand the Creed, so she promptly set about writing verses to help them. From this small beginning she became the prolific author of over 400 hymns. The best known apart from “Once in Royal David’s city” are “Jesus calls us o’er the tumult”, “There is a green hill far away” and “All things bright and beautiful”.
Just as she was resigning herself to being ‘left on the shelf’ she married the outstanding clergyman, the Rev William Alexander, who was later to become Bishop of Derry and Archbishop of Armagh, Primate of all Ireland. Readers should understand that these were positions in the Anglican Church – a minority sect in Ireland which is divided between Roman Catholics and Presbyterians. The couple lived most of their married life in the north in Strabane and Londonderry.
Although a very shy person, possibly because of myopia, she was nevertheless a great worker for women and children. Her hymns went into a hundred editions for the deaf mutes of Londonderry and she was a strong supporter of the Home for Fallen Women (as unmarried mothers were known in those days).
Once in Royal David’s City is written from a woman’s point of view. She clearly sympathized with the “lowly maiden in whose gentle arms he lay”. In a world dominated by men she has been called subversive by modern feminists. Did she see Mary as a model for her fallen women?
The world over, the carol is sung to the tune “Irby” by Henry John Gauntlet who became the organist at his father's church at Olney, Buckinghamshire at the age of 9. He was intended for a career in law and remained a lawyer until he was almost forty years of age, when he abandoned that profession and devoted himself to music. He was organist at a number of leading London churches and eventually the degree of Mus. Doc. was conferred on him by the Archbishop of Canterbury, he being the first to receive such a degree from that quarter for over 200 years. He did much to raise the standard of church music both mechanically and musically. In 1852 he patented an "electrical-action apparatus" for organs. He wrote much music and over 1000 hymn tunes, and edited a large number of hymn books.
Since 1919, the King's College Chapel has begun their Christmas Eve service, Festival of Nine Lessons and Carols, with "Once in Royal David's City" as the processional. The first verse is sung by a member of the Choir of King's Chapel as a solo. The second verse is sung by the choir, and in the third verse the congregation joins. Excluding the first verse, the hymn is accompanied by the organ. It is estimated that there are millions of listeners worldwide who tune in to this service.
stood a lowly cattle shed,
where a mother laid her baby
in a manger for his bed:
Mary was that mother mild,
Jesus Christ her little child.
He came down to earth from heaven,
who is God and Lord of all,
and his shelter was a stable,
and his cradle was a stall;
with the poor, the scorned, the lowly,
lived on earth our Savior holy.
And, through all his wondrous childhood,
he would honor and obey,
love and watch the lowly maiden
in whose gentle arms he lay:
Christian children all must be
mild, obedient, good as he.
For he is our childhood's pattern,
day by day like us he grew;
he was little, weak and helpless,
tears and smiles like us he knew.
and he feeleth for our sadness,
and he shareth in our gladness.
And our eyes at last shall see him,
through his own redeeming love;
for that Child who seemed so helpless
is our Lord in heaven above;
and he leads his children on
to the place where he is gone.
Not in that poor lowly stable,
with the oxen standing round,
we shall see him; but in heaven,
set at God's right hand on high;
when like stars his children crowned,
all in white shall wait around.
Scripture references: Luke 2:7, Phil 2:7, I John 3:2.
Cecil Frances Humphries (1818-1895) wrote this hymn and published it in 1848 in Hymns for Little Children. A year later, H. J. Gauntlett discovered Miss Humphries' poem and set it to music.
Cecil Frances was the daughter of well-to-do Dublin landowner, Major John Humphries. This was a household where children knew their place, so she would hide her poems, written since the age of nine, under the carpet. Her father discovered her secret and provided a box for their reception, the contents of which she was allowed to read to the family on Saturday evenings. Her godsons complained that they could not understand the Creed, so she promptly set about writing verses to help them. From this small beginning she became the prolific author of over 400 hymns. The best known apart from “Once in Royal David’s city” are “Jesus calls us o’er the tumult”, “There is a green hill far away” and “All things bright and beautiful”.
Just as she was resigning herself to being ‘left on the shelf’ she married the outstanding clergyman, the Rev William Alexander, who was later to become Bishop of Derry and Archbishop of Armagh, Primate of all Ireland. Readers should understand that these were positions in the Anglican Church – a minority sect in Ireland which is divided between Roman Catholics and Presbyterians. The couple lived most of their married life in the north in Strabane and Londonderry.
Although a very shy person, possibly because of myopia, she was nevertheless a great worker for women and children. Her hymns went into a hundred editions for the deaf mutes of Londonderry and she was a strong supporter of the Home for Fallen Women (as unmarried mothers were known in those days).
Once in Royal David’s City is written from a woman’s point of view. She clearly sympathized with the “lowly maiden in whose gentle arms he lay”. In a world dominated by men she has been called subversive by modern feminists. Did she see Mary as a model for her fallen women?
The world over, the carol is sung to the tune “Irby” by Henry John Gauntlet who became the organist at his father's church at Olney, Buckinghamshire at the age of 9. He was intended for a career in law and remained a lawyer until he was almost forty years of age, when he abandoned that profession and devoted himself to music. He was organist at a number of leading London churches and eventually the degree of Mus. Doc. was conferred on him by the Archbishop of Canterbury, he being the first to receive such a degree from that quarter for over 200 years. He did much to raise the standard of church music both mechanically and musically. In 1852 he patented an "electrical-action apparatus" for organs. He wrote much music and over 1000 hymn tunes, and edited a large number of hymn books.
Since 1919, the King's College Chapel has begun their Christmas Eve service, Festival of Nine Lessons and Carols, with "Once in Royal David's City" as the processional. The first verse is sung by a member of the Choir of King's Chapel as a solo. The second verse is sung by the choir, and in the third verse the congregation joins. Excluding the first verse, the hymn is accompanied by the organ. It is estimated that there are millions of listeners worldwide who tune in to this service.
Tuesday, December 18, 2007
Hark the Herald Angels Sing!
Hark the herald angels sing
"Glory to the newborn King!
Peace on earth and mercy mild
God and sinners reconciled"
Joyful, all ye nations rise
Join the triumph of the skies
With the angelic host proclaim:
"Christ is born in Bethlehem"
Refrain
Hark! The herald angels sing
"Glory to the newborn King!"
Christ by highest heav'n adored
Christ the everlasting Lord!
Late in time behold Him come
Offspring of a Virgin's womb
Veiled in flesh the Godhead see
Hail the incarnate Deity
Pleased as man with man to dwell
Jesus, our Emmanuel
Hail the heav'n-born Prince of Peace!
Hail the Son of Righteousness!
Light and life to all He brings
Ris'n with healing in His wings
Mild He lays His glory by
Born that man no more may die
Born to raise the sons of earth
Born to give them second birth
Come, Desire of nations, come,
Fix in us thy humble home:
Rise, the woman's conquering Seed,
Bruise in us the Serpent's head:
Sing we, then, with angels sing,
"Glory to the new-born King!
Glory in the highest heaven,
Peace on earth, and sins forgiven."
(Scripture references: Gen 3:15, Isa 7:14, Isa 9:6, Hag 2:7, Mal 4:2, Matt 1:23, Luke 2:13-14, 2 Cor 5:19, Phil 2:6-7.)
Today is the 300th anniversary of the birth of Charles Wesley, so what other carol could I choose but this one? His other Christmas hymn, "Let earth and heaven combine", while containing some apt phrases and welcome theology, is definitely the lesser example of his art.
Hark the herald was written by Charles Wesley (1707-88), and first published in 1739 as ‘Hark, how all the welkin rings/Glory to the King of Kings’. 'Welkin' means the 'vault of heaven' or more prosaically, the 'sky'. The story is told that in the year that Wesley 'consciously believed' he was on his way to morning service when he heard the church bells ringing as if the sound was coming from heaven and he remarked "Hark, how all the welkin rings glory to the King of Kings". It was as if the whole sky rang with God's glory. It's not the sort of remark you would make today unless you were cultivating an air of quaintness.
The version known today is the result of alterations by various hands, most notably George Whitfield, Wesley's rather more Calvinistic co-worker, who changed the opening couplet to the familiar one we know today. Whitefield also cut out several verses. The original is made up of ten four-line verses and ends:
Come, desire of nations, come,
Fix in us thy humble home;
Rise, the woman's conquering seed,
Bruise in us the serpent's head.
Now display thy saving power,
Ruin'd nature now restore;
Now in mystic union join
Thine to ours, and ours to thine.
Adam's likeness, Lord, efface,
Stamp thy image in its place.
Second Adam from above,
Reinstate us in thy love.
Let us thee, though lost, regain,
Thee, the life, the inner man:
O, to all thyself impart,
Form'd in each believing heart.
Wesley disliked Whitefield's version and refused to sing it. "You have no Biblical warrant for presuming that the angels sang. They proclaimed Christ's birth."
Various hymn-books, including the influential English Hymnal of 1906, have subsequently attempted to revive Wesley’s original, without success and since 1987hymn books have tended to emasculate the hymn, putting in 'we' and 'us' instead of 'man', making it what I call a 'hermn' rather than a 'hymn'. To me they are no better than:
Hark! the herald angels sing
Beecham’s pills are just the thing
Two for a woman, one for a child,
They will make you meek and mild.
The tune, ‘Mendelssohn’, was adapted in 1856 by W H Cummings (1831-1915), the organist from Waltham Abbey, from the second movement of Festgesang an die Künstler, a choral cantata, composed in 1840 by Felix Mendelssohn (1809-47) and dedicated to marking the quatercentenary of Gutenberg’s invention of movable type.
One of the original tunes that "Hark! How all the welkin rings" was sung to was also used as a tune for "Amazing Grace". Many hymns in the eighteenth century consisted merely of printed words without music. It was left to those leading the singing to choose an appropriate tune based on the metre of the verse. Wesley himself, however, envisaged his lyrics sung to the same tune as his Easter hymn, "Christ the Lord is Risen Today."
The tune that is now almost always used for this carol is based on a chorus composed by Felix Mendelssohn in 1840, part of his cantata Festgesang ("Festival Song") to commemorate the printer Johann Gutenberg and the invention of his printing press. The cantata was first presented at the great festival held at Leipzig. Festgesang's second chorus, "Vaterland, in deinem Gauen", was adapted in 1855 by William Hayman Cummings. Mendelssohn said of the song that it could be used with many different choruses but that it should not be used for sacred music. This may be because the melodic and harmonic structure of the tune are similar to the Gavotte of Bach's Orchestral Suite No. 4; indeed Mendelssohn (who has always been linked with the music of Bach) may simply have adapted Bach's music for his chorus, as was proposed by Nigel Poole with his (transposed) arrangement of the Gavotte as Bach's Christmas Carol.
"Glory to the newborn King!
Peace on earth and mercy mild
God and sinners reconciled"
Joyful, all ye nations rise
Join the triumph of the skies
With the angelic host proclaim:
"Christ is born in Bethlehem"
Refrain
Hark! The herald angels sing
"Glory to the newborn King!"
Christ by highest heav'n adored
Christ the everlasting Lord!
Late in time behold Him come
Offspring of a Virgin's womb
Veiled in flesh the Godhead see
Hail the incarnate Deity
Pleased as man with man to dwell
Jesus, our Emmanuel
Hail the heav'n-born Prince of Peace!
Hail the Son of Righteousness!
Light and life to all He brings
Ris'n with healing in His wings
Mild He lays His glory by
Born that man no more may die
Born to raise the sons of earth
Born to give them second birth
Come, Desire of nations, come,
Fix in us thy humble home:
Rise, the woman's conquering Seed,
Bruise in us the Serpent's head:
Sing we, then, with angels sing,
"Glory to the new-born King!
Glory in the highest heaven,
Peace on earth, and sins forgiven."
(Scripture references: Gen 3:15, Isa 7:14, Isa 9:6, Hag 2:7, Mal 4:2, Matt 1:23, Luke 2:13-14, 2 Cor 5:19, Phil 2:6-7.)
Today is the 300th anniversary of the birth of Charles Wesley, so what other carol could I choose but this one? His other Christmas hymn, "Let earth and heaven combine", while containing some apt phrases and welcome theology, is definitely the lesser example of his art.
Hark the herald was written by Charles Wesley (1707-88), and first published in 1739 as ‘Hark, how all the welkin rings/Glory to the King of Kings’. 'Welkin' means the 'vault of heaven' or more prosaically, the 'sky'. The story is told that in the year that Wesley 'consciously believed' he was on his way to morning service when he heard the church bells ringing as if the sound was coming from heaven and he remarked "Hark, how all the welkin rings glory to the King of Kings". It was as if the whole sky rang with God's glory. It's not the sort of remark you would make today unless you were cultivating an air of quaintness.
The version known today is the result of alterations by various hands, most notably George Whitfield, Wesley's rather more Calvinistic co-worker, who changed the opening couplet to the familiar one we know today. Whitefield also cut out several verses. The original is made up of ten four-line verses and ends:
Come, desire of nations, come,
Fix in us thy humble home;
Rise, the woman's conquering seed,
Bruise in us the serpent's head.
Now display thy saving power,
Ruin'd nature now restore;
Now in mystic union join
Thine to ours, and ours to thine.
Adam's likeness, Lord, efface,
Stamp thy image in its place.
Second Adam from above,
Reinstate us in thy love.
Let us thee, though lost, regain,
Thee, the life, the inner man:
O, to all thyself impart,
Form'd in each believing heart.
Wesley disliked Whitefield's version and refused to sing it. "You have no Biblical warrant for presuming that the angels sang. They proclaimed Christ's birth."
Various hymn-books, including the influential English Hymnal of 1906, have subsequently attempted to revive Wesley’s original, without success and since 1987hymn books have tended to emasculate the hymn, putting in 'we' and 'us' instead of 'man', making it what I call a 'hermn' rather than a 'hymn'. To me they are no better than:
Hark! the herald angels sing
Beecham’s pills are just the thing
Two for a woman, one for a child,
They will make you meek and mild.
The tune, ‘Mendelssohn’, was adapted in 1856 by W H Cummings (1831-1915), the organist from Waltham Abbey, from the second movement of Festgesang an die Künstler, a choral cantata, composed in 1840 by Felix Mendelssohn (1809-47) and dedicated to marking the quatercentenary of Gutenberg’s invention of movable type.
One of the original tunes that "Hark! How all the welkin rings" was sung to was also used as a tune for "Amazing Grace". Many hymns in the eighteenth century consisted merely of printed words without music. It was left to those leading the singing to choose an appropriate tune based on the metre of the verse. Wesley himself, however, envisaged his lyrics sung to the same tune as his Easter hymn, "Christ the Lord is Risen Today."
The tune that is now almost always used for this carol is based on a chorus composed by Felix Mendelssohn in 1840, part of his cantata Festgesang ("Festival Song") to commemorate the printer Johann Gutenberg and the invention of his printing press. The cantata was first presented at the great festival held at Leipzig. Festgesang's second chorus, "Vaterland, in deinem Gauen", was adapted in 1855 by William Hayman Cummings. Mendelssohn said of the song that it could be used with many different choruses but that it should not be used for sacred music. This may be because the melodic and harmonic structure of the tune are similar to the Gavotte of Bach's Orchestral Suite No. 4; indeed Mendelssohn (who has always been linked with the music of Bach) may simply have adapted Bach's music for his chorus, as was proposed by Nigel Poole with his (transposed) arrangement of the Gavotte as Bach's Christmas Carol.
Monday, December 17, 2007
While shepherds watched
While shepherds watched
Their flocks by night
All seated on the ground
The angel of the Lord came down
And glory shone around
And glory shone around
"Fear not," he said,
For mighty dread
Had seized their troubled minds
"Glad tidings of great joy I bring
To you and all mankind,
To you and all mankind."
"To you in David's
Town this day
Is born of David's line
The Savior who is Christ the Lord
And this shall be the sign
And this shall be the sign."
"The heavenly Babe
You there shall find
To human view displayed
And meanly wrapped
In swathing bands
And in a manger laid
And in a manger laid."
Thus spake the seraph,
And forthwith
Appeared a shining throng
Of angels praising God, who thus
Addressed their joyful song
Addressed their joyful song
"All glory be to
God on high
And to the earth be peace;
Goodwill henceforth
From heaven to men
Begin and never cease
Begin and never cease!"
Tate and Brady sound like a couple of disreputable Irishmen and given the bawdy version of this carol I had the impression that they were jobbing songsters who lived in London pubs and knocked this one out for the price of a few beers. In fact Nahum Tate was Poet Laureate during the reign of Queen Anne and he collaborated with Nicholas Brady to produce Tate and Brady's 1700 supplement to their psalter, New Version of the Psalms of David of 1696.
It is believed that Tate (1652-1715) wrote the words which are based on Luke 2:8-14. The tune to which it was first sung and which is most commonly used in the United Kingdom and the Commonwealth is ‘Winchester Old,’ a tune that appears in Este's (pronounced East) Psalter of 1592, derived from Christopher Tye's setting of the Acts of the Apostles in 1553. It was arranged by George Kirbye, an East Anglian about whom little is known until Este employed him to arrange some of the 1592 tunes. Tye was a Cambridge man who became Master of Choristers at Ely Cathedral in 1541 and later Rector of Doddington in 1560, the richest living in England - he still got into financial difficulties. Thomas Este was the most important musical publisher during the reign of Elizabeth the First. His printing works were in Aldergate Street. Kirbye became Churchwarden of St Mary's Church, Bury St Edmunds, having been music master in the household of Sir Robert Jermyn of Rushbrook.
Nicholas Brady (October 28, 1659–May 20, 1726) was born at Bandon, County Cork, Ireland. He received his education at Westminster School and at Christ Church, Oxford; but he graduated at Trinity College, Dublin. He was a zealous promoter of the Revolution (probably the Glorious revolution of 1688) and suffered in consequence. When war broke out in Ireland in 1690, Brady, by his influence, thrice prevented the burning of the town of Bandon, after James II had given orders for its destruction; and the same year he was employed by the people of Bandon to lay their grievances before the English parliament. He soon afterward settled in London, where he obtained various preferments including Chaplain to King William III. At the time of his death, he held the livings of Clapham and Richmond, and rich livings though they were, he was often in debt, and had to start a school in Richmond to pay his way.
Nahum Tate was born in Dublin in 1652, the son of Faithful Teate, an Irish clergyman. He graduated from Trinity College, Dublin and by 1676 had moved to London and was writing for a living. The following year he had adopted the spelling Tate, which would remain until his death, in 1715. Tate published a volume of poems in London in 1677, and became a regular writer for the stage. "Brutus of Alba, or The Enchanted Lovers" (1678), a tragedy dealing with Dido and Aeneas, became the libretto for Henry Purcell's opera Dido and Aeneas. He produced bowdlerized versions of Shakespeare's Richard II, King Lear(with a happy ending) and Coriolanus. Of the famous New Version of the Psalms of David (1696), only "While Shepherds watched", and "As pants the hart" continue to be sung, but he was also responsible for "Through all the changing scenes of life", which we sang at our wedding.
Of his numerous poems, the most original is Panacea, a poem on Tea {1700). He succeeded as poet laureate in 1692. In 1702 he was appointed Historiographer-Royal, but because of his intemperate ways he died in 1715 within the precincts of the Mint at the London Refuge for Debtors, Southwark, where was hiding from his creditors.
Until 1782, "While shepherds watched" was the only Christmas carol officially sanctioned by the Church of England
It was set to music in America 1812 in Harmonia Sacra. David Weyman's adaptation of "Christmas", taken from an aria in the 1728 opera Siroe by George Frideric Handel was arranged by Lowell Mason in 1821, and it is now this version which is most commonly used in the USA.
It has been set to numerous other tunes, most commonly "Martyrdom", written by Hugh Wilson in 1800 but with an arrangement by Ralph E. Hudson from around 1885, and "Shackelford" by Frederick Henry Cheeswright from 1889.
My own favorite is Sweet bells with the chorus:
Sweet bells, sweet chiming Christmas bells,
Sweet bells, sweet chiming Christmas bells,
They cheer us on our merry way, sweet chiming bells.
They cheer us on our merry way, sweet chiming bells.
Of the many parodies the one we sang at school was:
While shepherds washed their socks by night
All seated round the tub
A bar of Sunlight soap came down
And taught them how to scrub.
The last stanza of the carol is disliked by those of a Reformed persuasion as being Universalist.
"All glory be to God on high and to the earth be peace; goodwill henceforth from heaven to men begin and never cease." is a mistranslation of Luke 2:14. The NIV has "Glory to God in the highest, and on earth peace to men on whom his favor rests."
and the NASV "Glory to God in the highest, and on earth peace among men with whom He is pleased." and the Amplified Bible Glory to God in the highest [heaven], and on earth peace among men with whom He is well pleased [[a]men of goodwill, of His favor] which all stress that peace is to the Elect. On the other hand. the NKJV has "Glory to God in the highest, and on earth peace, goodwill toward men and Young's literal translation has "Glory in the highest to God, and upon earth peace, among men -- good will" are not so particular.
Their flocks by night
All seated on the ground
The angel of the Lord came down
And glory shone around
And glory shone around
"Fear not," he said,
For mighty dread
Had seized their troubled minds
"Glad tidings of great joy I bring
To you and all mankind,
To you and all mankind."
"To you in David's
Town this day
Is born of David's line
The Savior who is Christ the Lord
And this shall be the sign
And this shall be the sign."
"The heavenly Babe
You there shall find
To human view displayed
And meanly wrapped
In swathing bands
And in a manger laid
And in a manger laid."
Thus spake the seraph,
And forthwith
Appeared a shining throng
Of angels praising God, who thus
Addressed their joyful song
Addressed their joyful song
"All glory be to
God on high
And to the earth be peace;
Goodwill henceforth
From heaven to men
Begin and never cease
Begin and never cease!"
Tate and Brady sound like a couple of disreputable Irishmen and given the bawdy version of this carol I had the impression that they were jobbing songsters who lived in London pubs and knocked this one out for the price of a few beers. In fact Nahum Tate was Poet Laureate during the reign of Queen Anne and he collaborated with Nicholas Brady to produce Tate and Brady's 1700 supplement to their psalter, New Version of the Psalms of David of 1696.
It is believed that Tate (1652-1715) wrote the words which are based on Luke 2:8-14. The tune to which it was first sung and which is most commonly used in the United Kingdom and the Commonwealth is ‘Winchester Old,’ a tune that appears in Este's (pronounced East) Psalter of 1592, derived from Christopher Tye's setting of the Acts of the Apostles in 1553. It was arranged by George Kirbye, an East Anglian about whom little is known until Este employed him to arrange some of the 1592 tunes. Tye was a Cambridge man who became Master of Choristers at Ely Cathedral in 1541 and later Rector of Doddington in 1560, the richest living in England - he still got into financial difficulties. Thomas Este was the most important musical publisher during the reign of Elizabeth the First. His printing works were in Aldergate Street. Kirbye became Churchwarden of St Mary's Church, Bury St Edmunds, having been music master in the household of Sir Robert Jermyn of Rushbrook.
Nicholas Brady (October 28, 1659–May 20, 1726) was born at Bandon, County Cork, Ireland. He received his education at Westminster School and at Christ Church, Oxford; but he graduated at Trinity College, Dublin. He was a zealous promoter of the Revolution (probably the Glorious revolution of 1688) and suffered in consequence. When war broke out in Ireland in 1690, Brady, by his influence, thrice prevented the burning of the town of Bandon, after James II had given orders for its destruction; and the same year he was employed by the people of Bandon to lay their grievances before the English parliament. He soon afterward settled in London, where he obtained various preferments including Chaplain to King William III. At the time of his death, he held the livings of Clapham and Richmond, and rich livings though they were, he was often in debt, and had to start a school in Richmond to pay his way.
Nahum Tate was born in Dublin in 1652, the son of Faithful Teate, an Irish clergyman. He graduated from Trinity College, Dublin and by 1676 had moved to London and was writing for a living. The following year he had adopted the spelling Tate, which would remain until his death, in 1715. Tate published a volume of poems in London in 1677, and became a regular writer for the stage. "Brutus of Alba, or The Enchanted Lovers" (1678), a tragedy dealing with Dido and Aeneas, became the libretto for Henry Purcell's opera Dido and Aeneas. He produced bowdlerized versions of Shakespeare's Richard II, King Lear(with a happy ending) and Coriolanus. Of the famous New Version of the Psalms of David (1696), only "While Shepherds watched", and "As pants the hart" continue to be sung, but he was also responsible for "Through all the changing scenes of life", which we sang at our wedding.
Of his numerous poems, the most original is Panacea, a poem on Tea {1700). He succeeded as poet laureate in 1692. In 1702 he was appointed Historiographer-Royal, but because of his intemperate ways he died in 1715 within the precincts of the Mint at the London Refuge for Debtors, Southwark, where was hiding from his creditors.
Until 1782, "While shepherds watched" was the only Christmas carol officially sanctioned by the Church of England
It was set to music in America 1812 in Harmonia Sacra. David Weyman's adaptation of "Christmas", taken from an aria in the 1728 opera Siroe by George Frideric Handel was arranged by Lowell Mason in 1821, and it is now this version which is most commonly used in the USA.
It has been set to numerous other tunes, most commonly "Martyrdom", written by Hugh Wilson in 1800 but with an arrangement by Ralph E. Hudson from around 1885, and "Shackelford" by Frederick Henry Cheeswright from 1889.
My own favorite is Sweet bells with the chorus:
Sweet bells, sweet chiming Christmas bells,
Sweet bells, sweet chiming Christmas bells,
They cheer us on our merry way, sweet chiming bells.
They cheer us on our merry way, sweet chiming bells.
Of the many parodies the one we sang at school was:
While shepherds washed their socks by night
All seated round the tub
A bar of Sunlight soap came down
And taught them how to scrub.
The last stanza of the carol is disliked by those of a Reformed persuasion as being Universalist.
"All glory be to God on high and to the earth be peace; goodwill henceforth from heaven to men begin and never cease." is a mistranslation of Luke 2:14. The NIV has "Glory to God in the highest, and on earth peace to men on whom his favor rests."
and the NASV "Glory to God in the highest, and on earth peace among men with whom He is pleased." and the Amplified Bible Glory to God in the highest [heaven], and on earth peace among men with whom He is well pleased [[a]men of goodwill, of His favor] which all stress that peace is to the Elect. On the other hand. the NKJV has "Glory to God in the highest, and on earth peace, goodwill toward men and Young's literal translation has "Glory in the highest to God, and upon earth peace, among men -- good will" are not so particular.
Sunday, December 16, 2007
Joy to the World!
Joy to the world! The Lord is come.
Let earth receive her King
Let every heart
Prepare Him room
And Saints and angels sing
And Saints and angels sing
And Saints and Saints and angels sing
Joy to the world, the Saviour reigns
Let Saints their songs employ
While fields and floods
Rocks, hills and plains
Repeat the sounding joy
Repeat the sounding joy
Repeat, Repeat, the sounding joy
Joy to the world with truth and grace
And makes the nations prove
The glories of His righteousness
And wonders of His love
And wonders of His love
And wonders and wonders of His love
No more will sin and sorrow grow,
Nor thorns infest the ground;
He'll come and make the blessings flow
Far as the curse was found,
Far as the curse was found,
Far as, far as the curse was found.
He rules the world with truth and grace,
And gives to nations proof
The glories of His righteousness,
And wonders of His love;
And wonders of His love;
And wonders, wonders of His love.
Rejoice! Rejoice in the Most High,
While Israel spreads abroad
Like stars that glitter in the sky,
And ever worship God,
And ever worship God,
And ever, and ever worship God.
These are the words written in 1719 by Isaac Watts based loosely on Psalm 98. Isaac was born locally in Southampton. His father was a deacon at Above Bar Congregational Church (It is still there, rebuilt in the middle of a shopping center. I have been there many times and sat under the feet of Leith Samuel who ministered there for nearly 30 years) John Watts was imprisoned twice for his Dissenter views. Isaac was a precocious child. By the age of 13 he had learned Hebrew, Greek, Latin and French. When he was 15 he complained to his father about the stodgy nature of the hymns at that morning's services. He was promptly told that if he could do better then he had better do so. By that evening he had written a hymn based on Revelation 5
Behold the glories of the Lamb
Amidst the Father's throne
Prepare new honours for His name
And songs before unknown.
Despite being offered a University education he chose to attend a non-conformist Academy at Stoke Newington.(Perhaps Moreton's Academy for Dissenters where Daniel Defoe and Samuel Wesley were educated) Stoke Newington itself is worth a study. Notable residents were Mary Wollstonecraft (buried in St Peter's Bournemouth), author of A Vindication of the Rights of Women and mother of Mary Shelley, the author of Frankenstein, who ran a girls' school with her sister Eliza from 1784 to 1786, and the poet Ann Letitia Barbauld, Andrew Rutherford, an eminent 19th-century researcher on microscopy and microorganisms, and the poet and banker Samuel Rogers. The religious impulse in Newington Green, however, remained strong, and several Christian Missions, including the Mildmay and South Indian, were established in the mid-19th century. The China Inland Mission, on the west side of the Green, was founded in 1872 by missionary James Hudson Taylor.
Isaac became Pastor of Mark Lane Independent Chapel in 1701 by the age of 26, but in poor health he resigned in 1712 and for the next 36 years lived in the home of Sir Thomas Abney, devoting his life to writing. He died in Stoke Newington in 1748, the author of 600 hymns. There is a monument to him in Westminster Abbey.
The tune, "Antioch" was originally called "Comfort" and was published anonymously in The Congregational Harmonist of 1828. It's origin is from Handel's Messiah - the opening chords are much like those of the chorus "Lift up your heads". In 1836 it crossed the Atlantic and was renamed "Antioch" by Lowell Mason, one of the greatest American musical reformers and one of the first to agitate for universal musical education. He was born in Medfield Massachusetts in 1792 first worked making straw hats and then as a bank clerk. All this time he had been conducting church choirs and writing music an eventually he accepted a post in Boston as a Professor of Music and choir leader. In 1835 he received the first honorary degree as Doctor of Music from any American College.
"Joy to the World" is one of the best-known and best-loved of Christmas carols. It contains a message of joy and love replacing sin and sorrow. It may also be interpreted to be about life after the second coming of Christ. The hymn is significant for its widespread use throughout Christian denominations and for the musical stature of the people who created it.
This is the modern version of the hymn:
Joy to the world, the Lord is come!
Let earth receive her King;
let every heart prepare him room,
and heaven and nature sing,
and heaven and nature sing,
and heaven and nature sing.
Joy to the world, the Savior reigns!
Let all their songs employ;
while fields and floods, rocks, hills, and plains
repeat the sounding joy,
repeat the sounding joy,
repeat the sounding joy.
No more let sins and sorrows grow,
nor thorns infest the ground;
he comes to make his blessings flow
far as the curse is found,
far as the curse is found,
far as the curse is found.
He rules the world with truth and grace,
and makes the nations prove
the glories of his righteousness,
and wonders of his love,
and wonders of his love,
and wonders of his love.
Let earth receive her King
Let every heart
Prepare Him room
And Saints and angels sing
And Saints and angels sing
And Saints and Saints and angels sing
Joy to the world, the Saviour reigns
Let Saints their songs employ
While fields and floods
Rocks, hills and plains
Repeat the sounding joy
Repeat the sounding joy
Repeat, Repeat, the sounding joy
Joy to the world with truth and grace
And makes the nations prove
The glories of His righteousness
And wonders of His love
And wonders of His love
And wonders and wonders of His love
No more will sin and sorrow grow,
Nor thorns infest the ground;
He'll come and make the blessings flow
Far as the curse was found,
Far as the curse was found,
Far as, far as the curse was found.
He rules the world with truth and grace,
And gives to nations proof
The glories of His righteousness,
And wonders of His love;
And wonders of His love;
And wonders, wonders of His love.
Rejoice! Rejoice in the Most High,
While Israel spreads abroad
Like stars that glitter in the sky,
And ever worship God,
And ever worship God,
And ever, and ever worship God.
These are the words written in 1719 by Isaac Watts based loosely on Psalm 98. Isaac was born locally in Southampton. His father was a deacon at Above Bar Congregational Church (It is still there, rebuilt in the middle of a shopping center. I have been there many times and sat under the feet of Leith Samuel who ministered there for nearly 30 years) John Watts was imprisoned twice for his Dissenter views. Isaac was a precocious child. By the age of 13 he had learned Hebrew, Greek, Latin and French. When he was 15 he complained to his father about the stodgy nature of the hymns at that morning's services. He was promptly told that if he could do better then he had better do so. By that evening he had written a hymn based on Revelation 5
Behold the glories of the Lamb
Amidst the Father's throne
Prepare new honours for His name
And songs before unknown.
Despite being offered a University education he chose to attend a non-conformist Academy at Stoke Newington.(Perhaps Moreton's Academy for Dissenters where Daniel Defoe and Samuel Wesley were educated) Stoke Newington itself is worth a study. Notable residents were Mary Wollstonecraft (buried in St Peter's Bournemouth), author of A Vindication of the Rights of Women and mother of Mary Shelley, the author of Frankenstein, who ran a girls' school with her sister Eliza from 1784 to 1786, and the poet Ann Letitia Barbauld, Andrew Rutherford, an eminent 19th-century researcher on microscopy and microorganisms, and the poet and banker Samuel Rogers. The religious impulse in Newington Green, however, remained strong, and several Christian Missions, including the Mildmay and South Indian, were established in the mid-19th century. The China Inland Mission, on the west side of the Green, was founded in 1872 by missionary James Hudson Taylor.
Isaac became Pastor of Mark Lane Independent Chapel in 1701 by the age of 26, but in poor health he resigned in 1712 and for the next 36 years lived in the home of Sir Thomas Abney, devoting his life to writing. He died in Stoke Newington in 1748, the author of 600 hymns. There is a monument to him in Westminster Abbey.
The tune, "Antioch" was originally called "Comfort" and was published anonymously in The Congregational Harmonist of 1828. It's origin is from Handel's Messiah - the opening chords are much like those of the chorus "Lift up your heads". In 1836 it crossed the Atlantic and was renamed "Antioch" by Lowell Mason, one of the greatest American musical reformers and one of the first to agitate for universal musical education. He was born in Medfield Massachusetts in 1792 first worked making straw hats and then as a bank clerk. All this time he had been conducting church choirs and writing music an eventually he accepted a post in Boston as a Professor of Music and choir leader. In 1835 he received the first honorary degree as Doctor of Music from any American College.
"Joy to the World" is one of the best-known and best-loved of Christmas carols. It contains a message of joy and love replacing sin and sorrow. It may also be interpreted to be about life after the second coming of Christ. The hymn is significant for its widespread use throughout Christian denominations and for the musical stature of the people who created it.
This is the modern version of the hymn:
Joy to the world, the Lord is come!
Let earth receive her King;
let every heart prepare him room,
and heaven and nature sing,
and heaven and nature sing,
and heaven and nature sing.
Joy to the world, the Savior reigns!
Let all their songs employ;
while fields and floods, rocks, hills, and plains
repeat the sounding joy,
repeat the sounding joy,
repeat the sounding joy.
No more let sins and sorrows grow,
nor thorns infest the ground;
he comes to make his blessings flow
far as the curse is found,
far as the curse is found,
far as the curse is found.
He rules the world with truth and grace,
and makes the nations prove
the glories of his righteousness,
and wonders of his love,
and wonders of his love,
and wonders of his love.
Epidemiology
I wrote about the epidemiology of myelodysplastic syndrome (MDS) five years ago and I have now been asked to update the chapter. The only big change has been the publication of SEER figures. The Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute (NCI) is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from 17 population-based cancer registries covering approximately 26 percent of the US population. The SEER population groups closely mirror the US population mix, though rural populations are slightly under represented and non-white populations slightly over represented.
SEER suggests that the incidence of MDS is 3.6 per 100,000 which is exactly the same figure that the British LRF study came up with some 15 years ago (this sampled 16 million of the British population), and the same as the German Dusseldorf study (looking closely at 1.2 million) concluded 10 years ago. So why do I doubt it?
The first reason is that I have had experience at diagnosing MDS and I know it isn't easy. In MDS, the abnormal cells do not come labelled, they have to be recognized through rather subtle changes. The neutrophils don't have so many granules in their cytoplasm and their nuclei don't have so many lobules. You get a ring of iron (or more commonly part of a ring) around the nucleus of the erythroblasts in the bone marrow - but this doesn't show up with normal stains - you have to stain for it in a special way. The megakaryocytes are too small or not lobulated properly. There are sometimes too many blasts in the bone marrow - but the blasts often don't look quite like blasts, more like promyelocytes. Just like CLL the patients are usually asymptomatic when they present and they are spotted because someone does a blood test. Often the blood count figures are normal, so it takes a close look at the blood film by an expert to make the diagnosis, and even then a bone marrow may be necessary to be sure. Until I learned how to recognize MDS in 1981, I had missed 76 cases in the past 5 years.
The second reason is that cancer statistics draw on cancer registries, and cancer registries rely on hospital admissions and death certificates for their figures. Since MDS rarely gets mentioned on death certificates and many patients are never admitted to hospital, the diagnosis is never recorded in many cases. The LRF study went to the only group of people who could accurately diagnose MDS, the haematologists. They were asked to record every case that they diagnosed over a five year period. The figure of 3.6 per 100,000 excluded patients over-80 years of age - the very people in whom it is commonest. When these were included in a later publication the incidence rose to nearly double what had been previously thought.
The third reason that I doubt the figures is a four-fold variation between different towns and cities. The highest incidence found was in our own laboratory at 12.7 per 100,000. The main factor that accounted for this difference was how interested the local hematologist was in the disease.
Even 12 per 100,000 is an underestimate of the true incidence because when we set about screening for the disease in people over 50, by undertaking an unnecessary blood count we found a prevalence of about 1 in 500! There is a lot more out there than one might expect.
Of course it doesn't really matter, because most of these cases will never be of clinical significance - just as cases of MGUS or monoclonal B-cell lymphocytosis will never draw attention to themselves. Almost certainly most cases of prostate cancer picked up by PSA screening and many cases of breast cancer picked up by mammography would never have troubled the surgeon.
SEER suggests that the incidence of MDS is 3.6 per 100,000 which is exactly the same figure that the British LRF study came up with some 15 years ago (this sampled 16 million of the British population), and the same as the German Dusseldorf study (looking closely at 1.2 million) concluded 10 years ago. So why do I doubt it?
The first reason is that I have had experience at diagnosing MDS and I know it isn't easy. In MDS, the abnormal cells do not come labelled, they have to be recognized through rather subtle changes. The neutrophils don't have so many granules in their cytoplasm and their nuclei don't have so many lobules. You get a ring of iron (or more commonly part of a ring) around the nucleus of the erythroblasts in the bone marrow - but this doesn't show up with normal stains - you have to stain for it in a special way. The megakaryocytes are too small or not lobulated properly. There are sometimes too many blasts in the bone marrow - but the blasts often don't look quite like blasts, more like promyelocytes. Just like CLL the patients are usually asymptomatic when they present and they are spotted because someone does a blood test. Often the blood count figures are normal, so it takes a close look at the blood film by an expert to make the diagnosis, and even then a bone marrow may be necessary to be sure. Until I learned how to recognize MDS in 1981, I had missed 76 cases in the past 5 years.
The second reason is that cancer statistics draw on cancer registries, and cancer registries rely on hospital admissions and death certificates for their figures. Since MDS rarely gets mentioned on death certificates and many patients are never admitted to hospital, the diagnosis is never recorded in many cases. The LRF study went to the only group of people who could accurately diagnose MDS, the haematologists. They were asked to record every case that they diagnosed over a five year period. The figure of 3.6 per 100,000 excluded patients over-80 years of age - the very people in whom it is commonest. When these were included in a later publication the incidence rose to nearly double what had been previously thought.
The third reason that I doubt the figures is a four-fold variation between different towns and cities. The highest incidence found was in our own laboratory at 12.7 per 100,000. The main factor that accounted for this difference was how interested the local hematologist was in the disease.
Even 12 per 100,000 is an underestimate of the true incidence because when we set about screening for the disease in people over 50, by undertaking an unnecessary blood count we found a prevalence of about 1 in 500! There is a lot more out there than one might expect.
Of course it doesn't really matter, because most of these cases will never be of clinical significance - just as cases of MGUS or monoclonal B-cell lymphocytosis will never draw attention to themselves. Almost certainly most cases of prostate cancer picked up by PSA screening and many cases of breast cancer picked up by mammography would never have troubled the surgeon.
Saturday, December 15, 2007
2nd anniversary
Today I start my third year as a blogger. I have posted 470 items in the past two years. Of these 141 have been about health matters, mainly about CLL but also about how to provide a decent health service for all. Sixty have been about religion - one of the subjects I promised to blog about. I had also promised to blog about cricket, but such comments are scarce; only 19 on the whole of sport. What about poetry? Well there are 25 blogs about poetry.
Politics, another of my favored topics does well with 70 articles. Literature does less well with 29, but I hadn't anticipated that I would write so much about film, which I have done 31 times. Music fared less well - only four articles.
Oh, and there were eleven jokes.
Politics, another of my favored topics does well with 70 articles. Literature does less well with 29, but I hadn't anticipated that I would write so much about film, which I have done 31 times. Music fared less well - only four articles.
Oh, and there were eleven jokes.
Monday, December 10, 2007
Gethsemane
James was killed with a sword early in the Book of Acts. We hear a lot about Peter and John, but little about their constant companion, yet there he was at the raising of Jairus’s daughter, at the Transfiguration and now in the Garden he was one of the favored three; allowed to draw most closely to Jesus during his earthly life. Three points where Jesus showed his Godly power, his Godly glory and his human vulnerability were three points available only to his most intimate companions. The remaining eight were told to “sit here while I pray.”
The experience of Gethsemane is one that we can barely contemplate. We tend to underestimate it because Jesus, the God-Man, can withstand anything, can’t he? But this was Jesus at his most human. Was he afraid? I’m sure he was. He was well aware of what he was about to face. Not just the humiliation, the illegal trial, the spitting, the slapping, the punching, the scourging, the tearing of his beard, the carrying of the heavy cross, the nails, the hanging, the thirst; but more than that, the wrath of God, the whole anger of His own father on every soul that had sinned or would ever sin. Afraid? Why would he not be? He would be bearing it not with all the resources of the Godhead, but alone at his most human. The blessed communion of Father and Son was wrenched apart.
No wonder he prayed that if possible the hour might pass from him. How would you react? How would I?
Is there any way I can escape from this. Of course, he could still escape. He knew Judas was coming to betray him. He could slip away. Israel is a small country. The border is not far. He wouldn’t even need to tell his disciples; those that were not asleep were some way back. He’d slipped through crowds wishing to kill him before; it was easy enough for him.
Was he tempted with thoughts like these? There was no certainty that he would go through with it. It wasn’t inevitable. Escape was an option.
He goes back to Peter, James and John and finds them sleeping.
“Could you not keep watch with me one hour? Watch and pray so that you will not fall into temptation.”
Jesus knew what it was to be tempted by Satan. After his baptism he had spent 40 days in the wilderness fasting and in his weakened state Satan had tempted him with food and possessions and power. What temptations would Satan have put before the disciples? These were the inner three; the special ones privy to Jesus’ most personal moments. But they were also the ones who came to Jesus and asked to sit one on his right and one on his left; and the one who said to Jesus, “should all desert you I will stand by you.”. They could be tempted by pride and ambition. As we know from what happened later, they could be tempted to take the cowardly way out.
Jesus returns to pray. “If it is possible take this cup from me.” The metaphor of a cup would have been a familiar one to Jesus; it was used by Isaiah, Jeremiah, Ezekiel, Habakkuk and Zechariah and signified the wrath of God. Others have drawn parallels with Socrates drinking his cup of Hemlock. There is a difference, though. Socrates had no choice, he was condemned to death. Jesus could have declined to drink. His death had to be a voluntary one. It has been fashionable lately to think of God as a bloody tyrant who sacrificed his own son. Wilfred Owens’s poem pictured him as such.
‘But Abram would not so, and slew his son
And half the seed of Europe, one by one.’
But it was not so. Hebrews 12:2 tells us, “Jesus… who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God.”
He chose the cross, knowing what it would cost. In the garden he endured the anticipation of it. How did he manage? He prayed.
The three witnesses were able to convey how he prayed and how we can learn from him.
1] Humbly. He fell to the ground. If ever anyone could dare to be equal with God it was Jesus, yet he prostrated himself. What is our attitude in prayer? Bodily posture may help us to remember who we are before Him.
2] Aloud. I know he hears our innermost thoughts, but silent prayer leads to daydreaming, don’t you find?
3] Focused on God’s love. He prays not to ‘Almighty God, Creator and Controller of the Universe, redeemer of Mankind who will one day come and wake the dead’ or some such formula that distances God from us, but to ‘Abba’ the first word a baby utters in the presence of a parent, a word so full of love and intimacy.
4] Focused on God’s power, “Everything is possible for you.”
5] Focused on God’s will. “Yet not what I will, but what you will.”
6] Finally, he persevered in prayer. Despite the sleep of his disciples, he kept returning to his prayer.
We can face any hardship, suffer any disgrace, endure any torture if we take it to the Lord in prayer.
Joseph Medlicott Scriven wrote only one poem in his life. He was due to be married, but his fiancé drowned on the evening before the marriage. His mother, lying on a bed of sickness was distraught. To comfort her he wrote this poem.
What a friend we have in Jesus, all our sins and griefs to bear!
What a privilege to carry everything to God in prayer!
O what peace we often forfeit! O what needless pain we bear!
All because we do not carry everything to God in prayer.
The experience of Gethsemane is one that we can barely contemplate. We tend to underestimate it because Jesus, the God-Man, can withstand anything, can’t he? But this was Jesus at his most human. Was he afraid? I’m sure he was. He was well aware of what he was about to face. Not just the humiliation, the illegal trial, the spitting, the slapping, the punching, the scourging, the tearing of his beard, the carrying of the heavy cross, the nails, the hanging, the thirst; but more than that, the wrath of God, the whole anger of His own father on every soul that had sinned or would ever sin. Afraid? Why would he not be? He would be bearing it not with all the resources of the Godhead, but alone at his most human. The blessed communion of Father and Son was wrenched apart.
No wonder he prayed that if possible the hour might pass from him. How would you react? How would I?
Is there any way I can escape from this. Of course, he could still escape. He knew Judas was coming to betray him. He could slip away. Israel is a small country. The border is not far. He wouldn’t even need to tell his disciples; those that were not asleep were some way back. He’d slipped through crowds wishing to kill him before; it was easy enough for him.
Was he tempted with thoughts like these? There was no certainty that he would go through with it. It wasn’t inevitable. Escape was an option.
He goes back to Peter, James and John and finds them sleeping.
“Could you not keep watch with me one hour? Watch and pray so that you will not fall into temptation.”
Jesus knew what it was to be tempted by Satan. After his baptism he had spent 40 days in the wilderness fasting and in his weakened state Satan had tempted him with food and possessions and power. What temptations would Satan have put before the disciples? These were the inner three; the special ones privy to Jesus’ most personal moments. But they were also the ones who came to Jesus and asked to sit one on his right and one on his left; and the one who said to Jesus, “should all desert you I will stand by you.”. They could be tempted by pride and ambition. As we know from what happened later, they could be tempted to take the cowardly way out.
Jesus returns to pray. “If it is possible take this cup from me.” The metaphor of a cup would have been a familiar one to Jesus; it was used by Isaiah, Jeremiah, Ezekiel, Habakkuk and Zechariah and signified the wrath of God. Others have drawn parallels with Socrates drinking his cup of Hemlock. There is a difference, though. Socrates had no choice, he was condemned to death. Jesus could have declined to drink. His death had to be a voluntary one. It has been fashionable lately to think of God as a bloody tyrant who sacrificed his own son. Wilfred Owens’s poem pictured him as such.
‘But Abram would not so, and slew his son
And half the seed of Europe, one by one.’
But it was not so. Hebrews 12:2 tells us, “Jesus… who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God.”
He chose the cross, knowing what it would cost. In the garden he endured the anticipation of it. How did he manage? He prayed.
The three witnesses were able to convey how he prayed and how we can learn from him.
1] Humbly. He fell to the ground. If ever anyone could dare to be equal with God it was Jesus, yet he prostrated himself. What is our attitude in prayer? Bodily posture may help us to remember who we are before Him.
2] Aloud. I know he hears our innermost thoughts, but silent prayer leads to daydreaming, don’t you find?
3] Focused on God’s love. He prays not to ‘Almighty God, Creator and Controller of the Universe, redeemer of Mankind who will one day come and wake the dead’ or some such formula that distances God from us, but to ‘Abba’ the first word a baby utters in the presence of a parent, a word so full of love and intimacy.
4] Focused on God’s power, “Everything is possible for you.”
5] Focused on God’s will. “Yet not what I will, but what you will.”
6] Finally, he persevered in prayer. Despite the sleep of his disciples, he kept returning to his prayer.
We can face any hardship, suffer any disgrace, endure any torture if we take it to the Lord in prayer.
Joseph Medlicott Scriven wrote only one poem in his life. He was due to be married, but his fiancé drowned on the evening before the marriage. His mother, lying on a bed of sickness was distraught. To comfort her he wrote this poem.
What a friend we have in Jesus, all our sins and griefs to bear!
What a privilege to carry everything to God in prayer!
O what peace we often forfeit! O what needless pain we bear!
All because we do not carry everything to God in prayer.
Friday, December 07, 2007
Anti-oxidants
Christmas is coming so why not indulge yourselves. Red wine is good for you and chocolate is better. It's all down to anti-oxidants those marvelous substances that mop up free radicals.
At least that's what the advertisers are telling us. Is it true?
Much has been made of the 'J' shaped curve and alcohol. This says that the more you drink the more unhealthy you are except when you get down to small amounts. The curve seems to say that drinking a small amount of alcohol is healthier than drinking none at all. When it gets down to near zero the curve takes a small tick upwards like the tail on a 'J'. Ah! say the retailers, that's because of the anti-oxidants. Red wine is full of them.
But consider who the non-drinkers are. There are those who are teetotal for religious or moral reasons. Then there are the recovering alcoholics. There are the chronically sick who are denied alcohol on doctor's orders. Then there are those who lie to interviewers. It's hardly surprising that as a group they are not as healthy as those who drink a bit. Is red wine good for you because of the revasterol? or because it is drunk by well-to-do people who are careful about their diets and can afford private health care?
The anti-oxidant story owes more to marketing than to science. If we got rid of free radicals by consuming more anti-oxidants would it help us to live longer? I worry about what would happen to our white cells, which make use of free radicals when they kill bacteria. In the clinical trials that have taken place where people have been randomized to take anti-oxidants or placebo, there has been no difference between the two groups.
There may be something in anti-oxidants, but there are so many confounding variables in observational studies that we just don't know.
If you are tempted to scoff mince pies this Christmas because of the raisins therein, beware of the fat in the pastry.
At least that's what the advertisers are telling us. Is it true?
Much has been made of the 'J' shaped curve and alcohol. This says that the more you drink the more unhealthy you are except when you get down to small amounts. The curve seems to say that drinking a small amount of alcohol is healthier than drinking none at all. When it gets down to near zero the curve takes a small tick upwards like the tail on a 'J'. Ah! say the retailers, that's because of the anti-oxidants. Red wine is full of them.
But consider who the non-drinkers are. There are those who are teetotal for religious or moral reasons. Then there are the recovering alcoholics. There are the chronically sick who are denied alcohol on doctor's orders. Then there are those who lie to interviewers. It's hardly surprising that as a group they are not as healthy as those who drink a bit. Is red wine good for you because of the revasterol? or because it is drunk by well-to-do people who are careful about their diets and can afford private health care?
The anti-oxidant story owes more to marketing than to science. If we got rid of free radicals by consuming more anti-oxidants would it help us to live longer? I worry about what would happen to our white cells, which make use of free radicals when they kill bacteria. In the clinical trials that have taken place where people have been randomized to take anti-oxidants or placebo, there has been no difference between the two groups.
There may be something in anti-oxidants, but there are so many confounding variables in observational studies that we just don't know.
If you are tempted to scoff mince pies this Christmas because of the raisins therein, beware of the fat in the pastry.
The secret of American healthcare funding
How much does the American taxpayer pay for healthcare? Official figures for 2005 suggest that 45.4% of healthcare funding comes from the government. This is in the form of Medicare, Medicaid, County Hospital Emergency Rooms, the VA and other direct government funding arrangements. The rest of the funding comes from private insurers who charge premiums to employers and to individuals.
But wait a minute there are many public employees; who pays for their health insurance? That's right; the government. In fact a quarter of all employer contributions to insurance premiums comes from the taxpayer - around $120 billion a year.
And that's not all. There are tax subsidies for private insurance, mainly benefiting wealthy taxpayers - these amount to nearly $190 billion a year. In all the American taxpayer pays 9.7% of GDP on healthcare, a greater proportion of taxpayers money than any country on earth except Norway (a small country of 4.6 million people that owns half the oil in the North Sea), Luxembourg (a small country of half a million people mostly employed in banking) and Switzerland (a small country of 7.5 million people mostly employed in banking and making chocolate and cuckoo clocks).
The taxpayer already funds 60% of healthcare costs in America.
But wait a minute there are many public employees; who pays for their health insurance? That's right; the government. In fact a quarter of all employer contributions to insurance premiums comes from the taxpayer - around $120 billion a year.
And that's not all. There are tax subsidies for private insurance, mainly benefiting wealthy taxpayers - these amount to nearly $190 billion a year. In all the American taxpayer pays 9.7% of GDP on healthcare, a greater proportion of taxpayers money than any country on earth except Norway (a small country of 4.6 million people that owns half the oil in the North Sea), Luxembourg (a small country of half a million people mostly employed in banking) and Switzerland (a small country of 7.5 million people mostly employed in banking and making chocolate and cuckoo clocks).
The taxpayer already funds 60% of healthcare costs in America.
Thursday, December 06, 2007
Quality of life
It is becoming essential that clinical trials include estimates of quality of life improvements in their assessments. Recently published is such an assessment of the German CLL4 trial which showed better remissions and longer progression-free survivals, though no difference in overall survival, for younger patients treated with fludarabine plus cyclophosphamide than for fludarabine alone.
Their conclusion is: fludarabine-based chemotherapy results in a small to moderate improvement of quality of life in CLL patients. The disease-associated symptoms of fatigue, insomnia, and appetite loss improved little to moderately after chemotherapy, at least in patients who responded to therapy. No significant differences in quality of life between both treatment arms were observed. The quality of life in CLL patients is significantly impaired compared with the general population, especially regarding role functioning, social functioning, and fatigue symptoms. Because CLL is still an incurable disease with conventional chemotherapy, measurement of quality of life ought to have an important role in future clinical trials.
Unfortunately, quality of life assessments were not made during the chemotherapy, so it was not really possible to look at the impairment in quality of life made by the increased toxicity and weigh up whether the very marginal extra improvement in quality of life was worth going through the toxicity.
Their conclusion is: fludarabine-based chemotherapy results in a small to moderate improvement of quality of life in CLL patients. The disease-associated symptoms of fatigue, insomnia, and appetite loss improved little to moderately after chemotherapy, at least in patients who responded to therapy. No significant differences in quality of life between both treatment arms were observed. The quality of life in CLL patients is significantly impaired compared with the general population, especially regarding role functioning, social functioning, and fatigue symptoms. Because CLL is still an incurable disease with conventional chemotherapy, measurement of quality of life ought to have an important role in future clinical trials.
Unfortunately, quality of life assessments were not made during the chemotherapy, so it was not really possible to look at the impairment in quality of life made by the increased toxicity and weigh up whether the very marginal extra improvement in quality of life was worth going through the toxicity.
Tuesday, December 04, 2007
Escalating costs of cancer drugs.
Sir, for $500 I can give you 11 months to live; or with today's drugs, I can give you 22 months but it will cost $250,000. So says New Scientist in a scary look at the escalating costs of new cancer drugs.
What had occasioned this article is the announcement of a new deal on Velcade in myeloma, which NICE turned down earlier in the year as not cost effective.
After months of negotiations, the NHS will pay over £24,000 for each successful course of the drug for patients who have tried one other therapy but relapsed. Crucially, it will only pay if blood tests indicate that the drug is working.
There is a real problem with the funding of new cancer drugs. In Sweden, high prices mean that a maximum of 1 in 5 people with the colon cancer receive the drugs they need.
Until recently patients in New Zealand and Australia had to pay up to US$70,000 of their own money for a year's treatment with the drug Herceptin. Only an outcry from patients forced the health systems in these countries to pay for the drug. Even then, the New Zealand government chose to fund only a nine-week course, with patients having to make up the difference if their doctors prescribe a full year's treatment. However, despite the pharmaceutical company suggesting that a year's treatment is needed, an independent, though smaller, Finnish trial suggests it might be equally effective to take the drug for just nine weeks, and that by doing so patients may suffer fewer heart problems, one of Herceptin's acknowledged side effects.
Even in America, 1 in 8 cancer patients have defaulted on debt payments due to their treatment costs and have been contacted by a debt collection agency, according to a survey in 2006 by the non-profit Kaiser Family Foundation, even though they have some form of health insurance. For those without insurance, the proportion is far higher. There are also concerns that publicly funded healthcare agencies, including Medicare in the US and the NHS in the UK, are finding it increasingly difficult to afford the expensive drugs that patients now widely demand.
Identifying exactly how much or how little of a drug is needed is an obvious way to cut costs. The result might be to cut into the manufacturers' profits, so they are unlikely to run such trials themselves unless they are made a condition of the drug being approved. “Governments and healthcare providers and professionals should not sit back and relax once a drug is approved,” says one expert. “They need to be more active in conducting post-marketing studies that address questions that are not just in the interests of the pharmaceutical companies.”
Hence the NIH is running a trial of low dose rituximab in CLL using Ron Taylor style doses. We can expect further de-escalating studies.
What had occasioned this article is the announcement of a new deal on Velcade in myeloma, which NICE turned down earlier in the year as not cost effective.
After months of negotiations, the NHS will pay over £24,000 for each successful course of the drug for patients who have tried one other therapy but relapsed. Crucially, it will only pay if blood tests indicate that the drug is working.
There is a real problem with the funding of new cancer drugs. In Sweden, high prices mean that a maximum of 1 in 5 people with the colon cancer receive the drugs they need.
Until recently patients in New Zealand and Australia had to pay up to US$70,000 of their own money for a year's treatment with the drug Herceptin. Only an outcry from patients forced the health systems in these countries to pay for the drug. Even then, the New Zealand government chose to fund only a nine-week course, with patients having to make up the difference if their doctors prescribe a full year's treatment. However, despite the pharmaceutical company suggesting that a year's treatment is needed, an independent, though smaller, Finnish trial suggests it might be equally effective to take the drug for just nine weeks, and that by doing so patients may suffer fewer heart problems, one of Herceptin's acknowledged side effects.
Even in America, 1 in 8 cancer patients have defaulted on debt payments due to their treatment costs and have been contacted by a debt collection agency, according to a survey in 2006 by the non-profit Kaiser Family Foundation, even though they have some form of health insurance. For those without insurance, the proportion is far higher. There are also concerns that publicly funded healthcare agencies, including Medicare in the US and the NHS in the UK, are finding it increasingly difficult to afford the expensive drugs that patients now widely demand.
Identifying exactly how much or how little of a drug is needed is an obvious way to cut costs. The result might be to cut into the manufacturers' profits, so they are unlikely to run such trials themselves unless they are made a condition of the drug being approved. “Governments and healthcare providers and professionals should not sit back and relax once a drug is approved,” says one expert. “They need to be more active in conducting post-marketing studies that address questions that are not just in the interests of the pharmaceutical companies.”
Hence the NIH is running a trial of low dose rituximab in CLL using Ron Taylor style doses. We can expect further de-escalating studies.
Saturday, December 01, 2007
Cancer Scare Story
A headline in today's Times of London highlights Government plans to 'target' cancer treatment in the NHS. Stung by reports that cancer patients survive less well in the UK than elsewhere in Europe they are to concentrate resources on cancer care.
My first response is that someone is riding a hobby horse. I suspect it is the College of Radiologists who are trying to get the Government to buy more radiotherapy machines. Now that may well be a good thing, but it certainly lowers morale for cancer sufferers if they think that they are not getting the best that is available.
I strongly suspect that cancer statistics are inaccurate. I once asked a famous epidemiologist about this and he replied that he thought the figures about right as around 30% of people who are supposed to have cancer don't have it while around 30% of those who are supposed not to have cancer do have it. I hope he was joking.
A statistic that I often quote concerns prostate cancer which became ten times commoner in the USA during the 1990s as a result of the availability of the PSA test. The NHS restricted access to this test and as a result it became only two and a half times more common in the UK. There was much mockery traveling East across the Atlantic. Britain lags behind. Urologists in America became very busy. Cures multiplied but despite this the numbers of deaths from prostate cancer barely altered. Extra operations in the NHS bring no financial reward. We did not see a great burgeoning of prostate surgery, although more people had prostatic biopsies (a cynic might say that if you badger your doctor for a PSA you deserve to have a prostatic biopsy). In the UK the number of deaths from prostate cancer also stayed the same. In fact pro-rata it stayed the same as it was in America. What did become commoner in America was post-operative impotence and incontinence. But then this just produces more work for urologists.
Cancer statistics in the UK are obtained from death certificates and hospital admission diagnoses. They are bolstered by histopathology reports. Of course, not everybody with cancer gets admitted to hospital and even if they do the diagnosis may be wrong. Autopsies are getting more and more uncommon. They have to be done if the coroner orders it but he will only do so if the death is unexpected or foul play is suspected or if no medical attendant is willing to say that death was from natural causes. Again a cynic might say that the pathologist gets no extra financial reward for doing an autopsy but if the coroner orders one he gets a fee.
When I was a young doctor, we eagerly attended the mortuary every day to witness the post-mortem examinations. The pathologist had flair. Like a magician he would gradually lay out the salient facts and the offending organs until, like Poirot in the drawing room, he would reveal the dénouement. In the last year that I was at Bournemouth there were only eleven autopsies that were not ordered by the coroner. Diagnostic imaging has so improved that patients die without mystery. Physicians imagine that they have solved the puzzle. Yet I doubt this is so, and what is written on death certificates may seldom tell the whole truth.
Recently I saw a death certificate for a woman who died in her seventies. The cause of death was given as 1a Myocardial ischemia 1b Coronary artery thrombosis and coronary artery atherosclerosis. 2 Hodgkin’s disease – treated.
This gives the impression that this was a woman who was successfully treated for her Hodgkin’s disease who eventually succumbed to heart disease, and when you hear that she smoked for 50 years, you might justifiably call it a medical success. Here was a woman who developed a form of cancer that was treated by the doctors; but nobody lives for ever and if you abuse yourself with tobacco for 50 years then you’re bound to get hardening of the arteries.
Nothing could be further from the truth. In fact this was a woman with chronic lymphocytic leukemia whose disease progressed after a couple of years watch and wait and who was quite reasonably treated with fludarabine and cyclophosphamide. She had a complete remission though this was punctuated by chest infections. Two and a half years out she developed enlarging lymph nodes in her neck accompanied by night sweats, weight loss and fatigue, although her blood remained free of leukemia. CT scan showed that the lymph nodes were extending into her chest and fine needle aspirate showed small and medium sized lymphocytes ‘consistent with recurrence of her CLL’.
On this basis her doctor diagnosed recurrence of her CLL and treated her with Campath. She didn’t really get better so the doctor switched to CHOP. After deteriorating further she was referred to a tertiary referral center where they did what should have been done when she first relapsed – a lymph node biopsy. This showed Hodgkin’s disease and she was started on appropriate Hodgkin’s disease therapy. Unfortunately, she died midway through the first course, probably because she had become anemic, was transfused and then started on an anthracycline – all too much for her heart to bear. The coronary thrombosis was the terminal event, but the true cause of death was CLL – not treated, but mistreated.
Fine needle aspirate is a useless means of diagnosing lymph node enlargement. Even normal lymph nodes will show a mixture of small and medium lymphocytes. The clinical picture of enlarging lymph nodes with systemic symptoms and no blood relapse is characteristic of Richter’s syndrome, and we know that it is becoming commoner in patients who have been treated with fludarabine. Although in the past Richter’s syndrome has been a form of diffuse large B cell lymphoma, more recently it has taken the form of Hodgkin’s disease, possibly because of the release from T-cell control of the EB virus.
Campath is a good drug for treating fludarabine refractory CLL, but its strengths are in treating blood and bone marrow disease; it is poor at treating disease in lymph nodes.
There was no mention of CLL on the death certificate.
Is it ignorance? Is it laziness? Is it understaffing? Is it a systems failure? Probably a bit of all four. So when the headlines scream CANCER SCARE STORY there may be something in it, but almost certainly not what the article is about.
My first response is that someone is riding a hobby horse. I suspect it is the College of Radiologists who are trying to get the Government to buy more radiotherapy machines. Now that may well be a good thing, but it certainly lowers morale for cancer sufferers if they think that they are not getting the best that is available.
I strongly suspect that cancer statistics are inaccurate. I once asked a famous epidemiologist about this and he replied that he thought the figures about right as around 30% of people who are supposed to have cancer don't have it while around 30% of those who are supposed not to have cancer do have it. I hope he was joking.
A statistic that I often quote concerns prostate cancer which became ten times commoner in the USA during the 1990s as a result of the availability of the PSA test. The NHS restricted access to this test and as a result it became only two and a half times more common in the UK. There was much mockery traveling East across the Atlantic. Britain lags behind. Urologists in America became very busy. Cures multiplied but despite this the numbers of deaths from prostate cancer barely altered. Extra operations in the NHS bring no financial reward. We did not see a great burgeoning of prostate surgery, although more people had prostatic biopsies (a cynic might say that if you badger your doctor for a PSA you deserve to have a prostatic biopsy). In the UK the number of deaths from prostate cancer also stayed the same. In fact pro-rata it stayed the same as it was in America. What did become commoner in America was post-operative impotence and incontinence. But then this just produces more work for urologists.
Cancer statistics in the UK are obtained from death certificates and hospital admission diagnoses. They are bolstered by histopathology reports. Of course, not everybody with cancer gets admitted to hospital and even if they do the diagnosis may be wrong. Autopsies are getting more and more uncommon. They have to be done if the coroner orders it but he will only do so if the death is unexpected or foul play is suspected or if no medical attendant is willing to say that death was from natural causes. Again a cynic might say that the pathologist gets no extra financial reward for doing an autopsy but if the coroner orders one he gets a fee.
When I was a young doctor, we eagerly attended the mortuary every day to witness the post-mortem examinations. The pathologist had flair. Like a magician he would gradually lay out the salient facts and the offending organs until, like Poirot in the drawing room, he would reveal the dénouement. In the last year that I was at Bournemouth there were only eleven autopsies that were not ordered by the coroner. Diagnostic imaging has so improved that patients die without mystery. Physicians imagine that they have solved the puzzle. Yet I doubt this is so, and what is written on death certificates may seldom tell the whole truth.
Recently I saw a death certificate for a woman who died in her seventies. The cause of death was given as 1a Myocardial ischemia 1b Coronary artery thrombosis and coronary artery atherosclerosis. 2 Hodgkin’s disease – treated.
This gives the impression that this was a woman who was successfully treated for her Hodgkin’s disease who eventually succumbed to heart disease, and when you hear that she smoked for 50 years, you might justifiably call it a medical success. Here was a woman who developed a form of cancer that was treated by the doctors; but nobody lives for ever and if you abuse yourself with tobacco for 50 years then you’re bound to get hardening of the arteries.
Nothing could be further from the truth. In fact this was a woman with chronic lymphocytic leukemia whose disease progressed after a couple of years watch and wait and who was quite reasonably treated with fludarabine and cyclophosphamide. She had a complete remission though this was punctuated by chest infections. Two and a half years out she developed enlarging lymph nodes in her neck accompanied by night sweats, weight loss and fatigue, although her blood remained free of leukemia. CT scan showed that the lymph nodes were extending into her chest and fine needle aspirate showed small and medium sized lymphocytes ‘consistent with recurrence of her CLL’.
On this basis her doctor diagnosed recurrence of her CLL and treated her with Campath. She didn’t really get better so the doctor switched to CHOP. After deteriorating further she was referred to a tertiary referral center where they did what should have been done when she first relapsed – a lymph node biopsy. This showed Hodgkin’s disease and she was started on appropriate Hodgkin’s disease therapy. Unfortunately, she died midway through the first course, probably because she had become anemic, was transfused and then started on an anthracycline – all too much for her heart to bear. The coronary thrombosis was the terminal event, but the true cause of death was CLL – not treated, but mistreated.
Fine needle aspirate is a useless means of diagnosing lymph node enlargement. Even normal lymph nodes will show a mixture of small and medium lymphocytes. The clinical picture of enlarging lymph nodes with systemic symptoms and no blood relapse is characteristic of Richter’s syndrome, and we know that it is becoming commoner in patients who have been treated with fludarabine. Although in the past Richter’s syndrome has been a form of diffuse large B cell lymphoma, more recently it has taken the form of Hodgkin’s disease, possibly because of the release from T-cell control of the EB virus.
Campath is a good drug for treating fludarabine refractory CLL, but its strengths are in treating blood and bone marrow disease; it is poor at treating disease in lymph nodes.
There was no mention of CLL on the death certificate.
Is it ignorance? Is it laziness? Is it understaffing? Is it a systems failure? Probably a bit of all four. So when the headlines scream CANCER SCARE STORY there may be something in it, but almost certainly not what the article is about.
Tuesday, November 27, 2007
Parallels
The Peter Principle: in any organisation people are promoted to their point of incompetence.
They got rid of Sven Goran Erickson. He had taken the England soccer team to three tournaments in a row, but hadn't won anything. A large pay off was needed to terminate his contract early and he soon found another job coaching Manchester City, who are enjoying their best season for more than 20 years. They found it hard to find a replacement for Sven; nobody really wanted the job and eventually they gave it to his number 2, Steve McClaren. He started well, but when confronted by Macedonia, Croatia and Russia he couldn't cope. Now Steve has gone too; he wasn't up to the task, the Peter Principle applied.
They got rid of Tony Blair. He had taken the Labor Party to three election victories in a row, but the Iraq war was unpopular and he had to go. He quickly found another job and is now busily employed in the Middle East. They didn't find it hard to replace Tony; someone wanted the job and they gave it to Tony's number 2, Gordon Brown. He started well and opened up a big lead in the Opinion Polls, but when confronted by David Cameron at the Dispatch Box he couldn't cope. Successively he has presided over purloining Conservative policies on inheritance tax, a run on a British bank, the loss of the confidential financial details of half the population on a computer disc and now undeclared but disguised donations to Party Funds by a property developer who has mysteriously appears to have reversed unfavorable planning decisions. It looks as though the Peter Principle is applying again.
They got rid of Sven Goran Erickson. He had taken the England soccer team to three tournaments in a row, but hadn't won anything. A large pay off was needed to terminate his contract early and he soon found another job coaching Manchester City, who are enjoying their best season for more than 20 years. They found it hard to find a replacement for Sven; nobody really wanted the job and eventually they gave it to his number 2, Steve McClaren. He started well, but when confronted by Macedonia, Croatia and Russia he couldn't cope. Now Steve has gone too; he wasn't up to the task, the Peter Principle applied.
They got rid of Tony Blair. He had taken the Labor Party to three election victories in a row, but the Iraq war was unpopular and he had to go. He quickly found another job and is now busily employed in the Middle East. They didn't find it hard to replace Tony; someone wanted the job and they gave it to Tony's number 2, Gordon Brown. He started well and opened up a big lead in the Opinion Polls, but when confronted by David Cameron at the Dispatch Box he couldn't cope. Successively he has presided over purloining Conservative policies on inheritance tax, a run on a British bank, the loss of the confidential financial details of half the population on a computer disc and now undeclared but disguised donations to Party Funds by a property developer who has mysteriously appears to have reversed unfavorable planning decisions. It looks as though the Peter Principle is applying again.
Sunday, November 25, 2007
Scandalous disciples
Listen to Mahalia Jackson singing ‘Just a closer walk with thee’.
I am weak, but Thou art strong;
Jesus, keep me from all wrong;
I’ll be satisfied as long
As I walk, let me walk close to Thee.
Just a closer walk with Thee,
Grant it, Jesus, is my plea,
Daily walking close to Thee,
Let it be, dear Lord, let it be.
Through this world of toil and snares,
If I falter, Lord, who cares?
Who with me my burden shares?
None but Thee, dear Lord, none but Thee.
When my feeble life is o’er,
Time for me will be no more;
Guide me gently, safely o’er
To Thy kingdom shore, to Thy shore.
“You will all fall away,” Jesus told them.
The word translated ‘fall away’ is from skandalon in the Greek, from which we have scandal in English. It originally described part of a trap. Imagine a bear trap, a cubical construction with one side propped open by a log. The bear enters and the log is pulled away, slamming shut the entry. The log that held the gate open would be a skandalon. Or supposing you were being chased by enemies in a forest; after you had passed them your friends raised a trip wire that bought your enemies down. The trip wire would be a skandalon.
In Hellenistic Greek the word was only used in a figurative sense. Something that brings someone down – but there is always a moralistic overtone. So here, there is not just a sense of the bubble being pricked for the self-important disciples, but also the sense that it is a scandal. They should be ashamed that they would be brought down. Not only are they deflated, they are shamed.
Jesus quotes from Zechariah 13:7, “Strike the shepherd and the sheep will be scattered.” Jesus tells us who will strike the shepherd; not the chief priests, not the crowd crying crucify, not Pilate, not the Roman soldiers; I will strike the shepherd and from the context in Zechariah it is God the Creator and Father who is doing the striking.
We forget sometimes that Jesus is Prophet as well as Priest and King. Here Jesus is prophesying exactly what will happen in a few hours.
Peter, poor puffed up Peter, denies it. “Even if all fall away, I will not.”
How many of us have such a high opinion of ourselves? When God created Man he saw that it was good. Adam was created perfect – but guess what? Adam fell. David was a man after God’s own heart. David fell. Abraham believed God and it was counted to him as righteousness. Abraham fell. So did Moses. So did Samuel. So did Elijah. And Peter, brave impetuous Peter; he fell too.
Does anyone think they could do better? Yet we have such high opinions of ourselves and our churches. The most famous pastors have fallen, the bravest missionaries, the most zealous evangelists. It is a scandal.
Peter was not alone among the disciples – verse 31 – “all the others said the same.” Peter, at least, was close enough to demonstrate his disloyalty; the others had fled.
“Before the cock crows twice, thou shalt deny me thrice.” The old English has ingrained it in our memories.
What led to the betrayal? Why, because the sheep were scattered. It is a warning to us. This is why I cited Mahalia Jackson’s ‘Just a close walk with thee’. If we stray from Him we become scattered; we become a scandal. We really are weak. It is only when we know that we are weak that we are strong. It is then that we lean on Him. When we stop holding His hand, like little children on a crowded beach we get lost and wander.
The most optimistic verse comes in the middle, “After I have risen, I will go ahead of you into Galilee.”
Here is the promise of forgiveness, the promise of redemption. If I falter, Lord, who cares? None but Thee, dear Lord, none but Thee.
Who struck the shepherd? None but God Himself. Why was the shepherd struck? To take the place of the sheep. There on the cross the price for Adam’s sin, for David’s sin, for Moses’ sin, for Abraham’s sin, for the sins of Elijah, Samuel, Samson, Gideon, and all the Old Testament heroes; for Peter’s sin; for my sin and yours was paid.
That’s why Mahalia could sing, “When my feeble life is o’er, guide me gently, safely o’er to Thy kingdom shore, to Thy shore.”
We, the redeemed, shall be free. He will go ahead of us to Galillee.
I am weak, but Thou art strong;
Jesus, keep me from all wrong;
I’ll be satisfied as long
As I walk, let me walk close to Thee.
Just a closer walk with Thee,
Grant it, Jesus, is my plea,
Daily walking close to Thee,
Let it be, dear Lord, let it be.
Through this world of toil and snares,
If I falter, Lord, who cares?
Who with me my burden shares?
None but Thee, dear Lord, none but Thee.
When my feeble life is o’er,
Time for me will be no more;
Guide me gently, safely o’er
To Thy kingdom shore, to Thy shore.
“You will all fall away,” Jesus told them.
The word translated ‘fall away’ is from skandalon in the Greek, from which we have scandal in English. It originally described part of a trap. Imagine a bear trap, a cubical construction with one side propped open by a log. The bear enters and the log is pulled away, slamming shut the entry. The log that held the gate open would be a skandalon. Or supposing you were being chased by enemies in a forest; after you had passed them your friends raised a trip wire that bought your enemies down. The trip wire would be a skandalon.
In Hellenistic Greek the word was only used in a figurative sense. Something that brings someone down – but there is always a moralistic overtone. So here, there is not just a sense of the bubble being pricked for the self-important disciples, but also the sense that it is a scandal. They should be ashamed that they would be brought down. Not only are they deflated, they are shamed.
Jesus quotes from Zechariah 13:7, “Strike the shepherd and the sheep will be scattered.” Jesus tells us who will strike the shepherd; not the chief priests, not the crowd crying crucify, not Pilate, not the Roman soldiers; I will strike the shepherd and from the context in Zechariah it is God the Creator and Father who is doing the striking.
We forget sometimes that Jesus is Prophet as well as Priest and King. Here Jesus is prophesying exactly what will happen in a few hours.
Peter, poor puffed up Peter, denies it. “Even if all fall away, I will not.”
How many of us have such a high opinion of ourselves? When God created Man he saw that it was good. Adam was created perfect – but guess what? Adam fell. David was a man after God’s own heart. David fell. Abraham believed God and it was counted to him as righteousness. Abraham fell. So did Moses. So did Samuel. So did Elijah. And Peter, brave impetuous Peter; he fell too.
Does anyone think they could do better? Yet we have such high opinions of ourselves and our churches. The most famous pastors have fallen, the bravest missionaries, the most zealous evangelists. It is a scandal.
Peter was not alone among the disciples – verse 31 – “all the others said the same.” Peter, at least, was close enough to demonstrate his disloyalty; the others had fled.
“Before the cock crows twice, thou shalt deny me thrice.” The old English has ingrained it in our memories.
What led to the betrayal? Why, because the sheep were scattered. It is a warning to us. This is why I cited Mahalia Jackson’s ‘Just a close walk with thee’. If we stray from Him we become scattered; we become a scandal. We really are weak. It is only when we know that we are weak that we are strong. It is then that we lean on Him. When we stop holding His hand, like little children on a crowded beach we get lost and wander.
The most optimistic verse comes in the middle, “After I have risen, I will go ahead of you into Galilee.”
Here is the promise of forgiveness, the promise of redemption. If I falter, Lord, who cares? None but Thee, dear Lord, none but Thee.
Who struck the shepherd? None but God Himself. Why was the shepherd struck? To take the place of the sheep. There on the cross the price for Adam’s sin, for David’s sin, for Moses’ sin, for Abraham’s sin, for the sins of Elijah, Samuel, Samson, Gideon, and all the Old Testament heroes; for Peter’s sin; for my sin and yours was paid.
That’s why Mahalia could sing, “When my feeble life is o’er, guide me gently, safely o’er to Thy kingdom shore, to Thy shore.”
We, the redeemed, shall be free. He will go ahead of us to Galillee.
Saturday, November 24, 2007
Cranford
Like many others we have been watching Cranford of BBC TV. Mrs Gaskell's story of life in a northern town with precise manners has been captivating millions as we all play spot the thespian. Dame Judy Dench and Dame Eileen Atkins will be joined tomorrow by Sir Michael Gambon, but we have already been entertained by several actors with plenty of experience of costume drama. Julia Sawalha was in Pride and Prejudice as well as Martin Chuzzlewit (and before that in Inspector Morse). Francesca Annis was in Wives and Daughters, a recent Jane Eyre and Madame Bovary and an early Great Expectations. Imelda Staunton was in David Copperfield and Canterbury Tales. Julia Mackenzie was in The Old Curiosity Shop. Lesley Manville was in North and South and a different David Copperfield to Imelda Staunton. She was also in Topsy Turvey, the Gilbert and Sullivan biopic and is a Mike Leigh regular.
Barbara Flynn was in Wives and Daughters and was Beatrix Potter's mother in Miss Potter, Mary Queen of Scots in Elizabeth 1; she was in Hornblower, the color version of the Forsyte Saga, Lorna Doone, the Barchester Chronicles and like many of the above, she was one of Morse's ladies. Deborah Findley was in Wives and Daughters and Anna Karenina. Jim Carter was in Wind in the Willows, Hornblower, the Madness of King George, Philip Glenister was in Hornblower, the Other Boleyn Girl, Vanity Fair, a Sharpe and, of course, the wonderful Life on Mars. Greg wise also did Hornblower, Madam Bovary, as well as Alice Through The Looking Glass, The Moonstone and Sense and Sensibility. Andrew Buchan did Jane Eyre.
Michael Gambon is of course famous for having done just about everything including Dumbledore, but as far as period pieces are concerned, he is in the new Brideshead to be released next year, and was in Gosford Park, Longitude, Wives and Daughters, the Wings of The Dove, Wind in the Willows (and since it's Thanksgiving I should mentions Squanto). Eileen Atkins was in Vanity Fair, Gosford Park, David Copperfield, Madame Bovary, Cold Comfort Farm, Oliver Twist, Sons and Lovers, The Duchess of Malfi and of course she was one of the creators of Upstairs Downstairs. Judy Dench was in a rather inferior Pride and Prejudice (the one with Keira Knightley), The Importance of Being Earnest, Middlemarch, and of course numerous interpretations of various British Queens.
Most of the actors have appeared in Miss Marples or Poirots or Midsummer Murders or Morse. It's almost as if there is one vast repertory theatre with actors swapping roles very week. Sometimes they are the lead, sometimes it's only a bit part.
Spurred on by Cranford, we have also watched the other Mrs Gaskell productions, North and South and Wives and Daughters. Excellent! And if you haven't seen them get the DVDs. Ladies, I guarantee that Richard Armitage as John Thornton will send teh same shivers of pleasure down your spine as Colin Firth did in Pride and Prejudice.
Barbara Flynn was in Wives and Daughters and was Beatrix Potter's mother in Miss Potter, Mary Queen of Scots in Elizabeth 1; she was in Hornblower, the color version of the Forsyte Saga, Lorna Doone, the Barchester Chronicles and like many of the above, she was one of Morse's ladies. Deborah Findley was in Wives and Daughters and Anna Karenina. Jim Carter was in Wind in the Willows, Hornblower, the Madness of King George, Philip Glenister was in Hornblower, the Other Boleyn Girl, Vanity Fair, a Sharpe and, of course, the wonderful Life on Mars. Greg wise also did Hornblower, Madam Bovary, as well as Alice Through The Looking Glass, The Moonstone and Sense and Sensibility. Andrew Buchan did Jane Eyre.
Michael Gambon is of course famous for having done just about everything including Dumbledore, but as far as period pieces are concerned, he is in the new Brideshead to be released next year, and was in Gosford Park, Longitude, Wives and Daughters, the Wings of The Dove, Wind in the Willows (and since it's Thanksgiving I should mentions Squanto). Eileen Atkins was in Vanity Fair, Gosford Park, David Copperfield, Madame Bovary, Cold Comfort Farm, Oliver Twist, Sons and Lovers, The Duchess of Malfi and of course she was one of the creators of Upstairs Downstairs. Judy Dench was in a rather inferior Pride and Prejudice (the one with Keira Knightley), The Importance of Being Earnest, Middlemarch, and of course numerous interpretations of various British Queens.
Most of the actors have appeared in Miss Marples or Poirots or Midsummer Murders or Morse. It's almost as if there is one vast repertory theatre with actors swapping roles very week. Sometimes they are the lead, sometimes it's only a bit part.
Spurred on by Cranford, we have also watched the other Mrs Gaskell productions, North and South and Wives and Daughters. Excellent! And if you haven't seen them get the DVDs. Ladies, I guarantee that Richard Armitage as John Thornton will send teh same shivers of pleasure down your spine as Colin Firth did in Pride and Prejudice.
Monday, November 19, 2007
Vaccination against pneumonia
People keep asking about vaccination against pneumonia and although I have been able to give some advice, it hasn't been very encouraging advice. In general people with CLL don't respond well to vaccination and vaccination against polysaccharide antigens such as are present on the pneumococcus bacterium is particularly hopeless, especially in patients who have advanced, treated or longstanding disease. I have been advocating the use of the conjugated vaccine, Prevenar®, but only on theoretical grounds that it ought to be better, and with no documented evidence that proves that it is better. Now at last there is a paper that gives some facts and figures. Marjatta Sinisalo and colleagues from Finland have vaccinated 52 patients with CLL and 25 age- and sex-matched controls with Prevenar® pneumococcal conjugate vaccine (published today on-line in the journal, Vaccine. Serum samples were taken for antibody determinations before and four weeks after vaccination.
In the case of pneumococcal polysaccharide vaccine, in previous studies no antibody response has been detected (Hartkamp et al, Antibody responses to pneumococcal and haemophilus vaccinations in patients with B-cell chronic lymphocytic leukaemia, Vaccine 2001; 19:1671–1677; Sinisalo et al, Response to vaccination against different types of antigens in patients with chronic lymphocytic leukaemia, Br J Haematol 2001; 114:107–110.)
Here is a quote from an editorial in Clinical and Experimental Immunology about conjugate vaccines by David Goldblatt of the Institute of Child Health in London:
Polysaccharide antigens are large molecules consisting of repeating epitopes which are not processed by antigen-presenting cells (APC) but interact directly with B cells, inducing antibody synthesis in the absence of T cells (thus designated T-independent antigens). T cells can influence the antibody response to certain polysaccharides, such as the capsular polysaccharide of S. pneumoniae type 3, (S. pneumoniae is the microbiologists’ name for pneumococus) but an absolute requirement for T cells has not been demonstrated. T-independent responses are restricted in a number of ways. Most importantly, they fail to induce significant and sustained amounts of antibody in young children below the age of 18 months. While polysaccharides are immunogenic in older children and adults, the characteristics of the antibody responses are rather restricted. They are dominated by IgM and IgG2, are relatively short lived and a booster response cannot be elicited on repeated exposure. This failure to induce immunological memory is also reflected in the absence of demonstrable affinity maturation. In contrast to polysaccharides, antibody responses to protein antigens have an absolute requirement for T cells. The consequence of this T cell help are that antibody responses to protein antigens can be elicited in the very young and immunity is long lived due the generation of immunological memory. Antibody responses to protein antigens are dominated by the IgG1 and IgG3 subclasses and affinity maturation can be demonstrated over time.
As a result conjugate vaccines have been introduced for vacinating infants against both haemophilus influenzae and pneumococus. Studies have already shown that CLL patients do respond better to conjugate Hib vaccines but hitherto there are no data for Prevenar. Readers should note that haemophilus influenzae is nothing to do with influenza, and that it is not a significant pathogen in CLL. Pneumococcus is by far the most important pathogen in CLL pneumonia and one for which a decent vaccine is urgently needed.
So what did they find? As expected the immune response to Prevenar in CLL patients was significantly worse than for normal controls. However, if the vaccine had been administered at an early stage in the disease, before commencement of chemotherapy and the development of hypogammaglobulinemia, almost 40% of the patients developed a significant response to at least six antigens.
There is one further caveat, the serotype coverage of the 7-valent conjugate vaccine against invasive pneumococcal infections in patients ≥65 years was only 56% compared to that of 86% in 23-valent polysaccharide vaccine. So even in patients with early stage disease who have never had treatment and have not developed hypogammaglobulinemia, only about a quarter of patients will be protected against pneumonia by this vaccine, which is, I suppose better than nothing, but there is a lot more yet to do.
In the case of pneumococcal polysaccharide vaccine, in previous studies no antibody response has been detected (Hartkamp et al, Antibody responses to pneumococcal and haemophilus vaccinations in patients with B-cell chronic lymphocytic leukaemia, Vaccine 2001; 19:1671–1677; Sinisalo et al, Response to vaccination against different types of antigens in patients with chronic lymphocytic leukaemia, Br J Haematol 2001; 114:107–110.)
Here is a quote from an editorial in Clinical and Experimental Immunology about conjugate vaccines by David Goldblatt of the Institute of Child Health in London:
Polysaccharide antigens are large molecules consisting of repeating epitopes which are not processed by antigen-presenting cells (APC) but interact directly with B cells, inducing antibody synthesis in the absence of T cells (thus designated T-independent antigens). T cells can influence the antibody response to certain polysaccharides, such as the capsular polysaccharide of S. pneumoniae type 3, (S. pneumoniae is the microbiologists’ name for pneumococus) but an absolute requirement for T cells has not been demonstrated. T-independent responses are restricted in a number of ways. Most importantly, they fail to induce significant and sustained amounts of antibody in young children below the age of 18 months. While polysaccharides are immunogenic in older children and adults, the characteristics of the antibody responses are rather restricted. They are dominated by IgM and IgG2, are relatively short lived and a booster response cannot be elicited on repeated exposure. This failure to induce immunological memory is also reflected in the absence of demonstrable affinity maturation. In contrast to polysaccharides, antibody responses to protein antigens have an absolute requirement for T cells. The consequence of this T cell help are that antibody responses to protein antigens can be elicited in the very young and immunity is long lived due the generation of immunological memory. Antibody responses to protein antigens are dominated by the IgG1 and IgG3 subclasses and affinity maturation can be demonstrated over time.
As a result conjugate vaccines have been introduced for vacinating infants against both haemophilus influenzae and pneumococus. Studies have already shown that CLL patients do respond better to conjugate Hib vaccines but hitherto there are no data for Prevenar. Readers should note that haemophilus influenzae is nothing to do with influenza, and that it is not a significant pathogen in CLL. Pneumococcus is by far the most important pathogen in CLL pneumonia and one for which a decent vaccine is urgently needed.
So what did they find? As expected the immune response to Prevenar in CLL patients was significantly worse than for normal controls. However, if the vaccine had been administered at an early stage in the disease, before commencement of chemotherapy and the development of hypogammaglobulinemia, almost 40% of the patients developed a significant response to at least six antigens.
There is one further caveat, the serotype coverage of the 7-valent conjugate vaccine against invasive pneumococcal infections in patients ≥65 years was only 56% compared to that of 86% in 23-valent polysaccharide vaccine. So even in patients with early stage disease who have never had treatment and have not developed hypogammaglobulinemia, only about a quarter of patients will be protected against pneumonia by this vaccine, which is, I suppose better than nothing, but there is a lot more yet to do.
Sunday, November 18, 2007
The purpose of life.
What is the meaning of life? In the Hitch Hiker's Guide to the Galaxy the answer was famously 42, which is an oblique way of agreeing with the atheist's answer: there is no purpose to life, but as someone once said, "I do not have enough faith to be an atheist" (Write to me if you know who, but I am not ashamed at my ignorance, even St Paul was wont to write, "Somewhere it is written...").
A Christian should not be left in ignorance for in Paul's letter to the Ephesians we are told in chapter 1 and verses 9-10 << He made known to us the mystery of his will according to his good pleasure, which he purposed in Christ, to put into effect when the times will have reached their fulfillment - to bring all things in heaven and on earth together under one head, even Christ."
This is a difficult bit of Greek to translate and I can't do Greek letters on the blog (let me know if you know how). Transliterated it says anakephalaivsathai. The NIV translates it 'to head up' but it is used elsewhere in the Bible to mean 'sum' as in Acts 22:28 (For a large sum of money I acquired this citizenship) or summary, main point as in Hebrews 8:1 (Now the main point of what we are saying...) or to sum up as in Romans 13:9 (...commandment, is summed up in this word) so the ARV has "to sum up all things in Christ" (whatever that means). A popular rendering is the concept of unity, just as the a king brings unity to his subjects who have many diverse origins. Thus the KJV has "gather together in one all things in Christ", the RSV "to unite all things in him", the NEB "brought into a unity in Christ". the word has "cephalo" from which we get our English 'cephalic', a medical term referring to the head, so I suspect the meaning has something to do with the headship of Christ, but what do I know?
I think these language traps distract us from the message of the passage which tells us that the purpose of life is to bring everything together in Christ.
So if you have any other ambition or none you are missing the point.
Life may be tough and things might be going wrong and we may think life is futile, but don't despair. It all comes out right in the end. I know. I sneaked a look at the last page.
A Christian should not be left in ignorance for in Paul's letter to the Ephesians we are told in chapter 1 and verses 9-10 << He made known to us the mystery of his will according to his good pleasure, which he purposed in Christ, to put into effect when the times will have reached their fulfillment - to bring all things in heaven and on earth together under one head, even Christ."
This is a difficult bit of Greek to translate and I can't do Greek letters on the blog (let me know if you know how). Transliterated it says anakephalaivsathai. The NIV translates it 'to head up' but it is used elsewhere in the Bible to mean 'sum' as in Acts 22:28 (For a large sum of money I acquired this citizenship) or summary, main point as in Hebrews 8:1 (Now the main point of what we are saying...) or to sum up as in Romans 13:9 (...commandment, is summed up in this word) so the ARV has "to sum up all things in Christ" (whatever that means). A popular rendering is the concept of unity, just as the a king brings unity to his subjects who have many diverse origins. Thus the KJV has "gather together in one all things in Christ", the RSV "to unite all things in him", the NEB "brought into a unity in Christ". the word has "cephalo" from which we get our English 'cephalic', a medical term referring to the head, so I suspect the meaning has something to do with the headship of Christ, but what do I know?
I think these language traps distract us from the message of the passage which tells us that the purpose of life is to bring everything together in Christ.
So if you have any other ambition or none you are missing the point.
Life may be tough and things might be going wrong and we may think life is futile, but don't despair. It all comes out right in the end. I know. I sneaked a look at the last page.
Saturday, November 17, 2007
Frogs
An old man was walking down the street when a frog hopped up to him and said, "If you kiss me, I will turn into a beautiful princess."
The old man took no notice and walked on. Astonished the frog hopped after him. "I said, if you kiss me I will turn into a beautiful princess and I'm all yours."
The old man walked on and took no notice. In desperation the frog hopped after him and screamed at the top of its voice, "If you kiss me, I will turn into a beautiful princess, and I'm all yours and you can do what you like with me."
The old man reached down, picked up the frog and put it in his jacket pocket. Then he continued on his way.
Frustrated, there came a muffled cry from his pocket, "You've got to kiss me!"
The old man took the frog from his pocket and spoke to it, "Listen, at my age a talking frog is worth more."
The old man took no notice and walked on. Astonished the frog hopped after him. "I said, if you kiss me I will turn into a beautiful princess and I'm all yours."
The old man walked on and took no notice. In desperation the frog hopped after him and screamed at the top of its voice, "If you kiss me, I will turn into a beautiful princess, and I'm all yours and you can do what you like with me."
The old man reached down, picked up the frog and put it in his jacket pocket. Then he continued on his way.
Frustrated, there came a muffled cry from his pocket, "You've got to kiss me!"
The old man took the frog from his pocket and spoke to it, "Listen, at my age a talking frog is worth more."
Wednesday, November 14, 2007
The complexity of cancer
Today I went to a lecture by Nick Cross on tyrosine kinase inhibitors in chronic leukemias. The lecture was a tour-de-force, but I came away profoundly depressed. Nick runs an excellent genetics unit and is extremely erudite. He has managed to identify 43 chromosomal translocations in the chronic leukemias in which conjoined genes result in a constitutively activated tyrosine kinase that has the effect of causing the leukemic cell to continue to divide even when it is not receiving an appropriate signal from its environment.
This has nothing to do with CLL, by the way, the pardigmic disease is chronic myeloid leukemia in which the BCR/ABL tyrosine kinase is always in the switched on mode. Nick has looked at a variety of atypical chronic myeloid leukemias and has sorted out the molecular mechanisms.
Excellent though the science was there were several depressing features. First, in one case they had identified a Gleevec-like inhibitor which switched the tyrosine kinase off and would have had the effect of controling the leukemia, but so few patients suffered from this particular variant that no pharmaceutical company would spend the money to manufacture the product. Second, although he had identified 43 molecular mechanisms these represented less than 10% of all cases of atypical chronic myeloid leukemia. This is a rare variant of a rare disease; there are only 750 new cases of chronic myeloid leukemia in the UK every year.
The chronic myeloproliferative diseases are single gene disorders - there is usually only one molecular mistake. The common cancers, on the other hand, have 6, 7 or 8 molecular mistakes. If single gene diseases are so complex, how much more complex must the common cancers be?
When Gleevec was discovered I was very excited. The age of molecular therapies was dawning. That was 9 years ago. All we have done since then is produce one failed drug - Iressa - for common cancers. It is still the case that the most effective treatment for cancer is surgery, a treatment 150 years old.
The third depressing feature came from a meeting I went to the day before. WE were proposing a trial of mini-dose Revlimid for maintenance therapy in CLL. This was being opposed on the grounds that as the drug was so expensive, no matter how effective it might be, it would never pass NICE, and therefore there was no point in doing the trial. If Revlimid (a relatively easy to make molecule) is too expensive, what hope is there for new drugs in cancer.
The fourth thing that depressed me was seeing a doctor smoking. I have always refused to work on lung cancer on the grounds that the problem is already largely solved. Just stop tobacco smoking. As we unravel these molecular mechanisms at huge expense, society as a whole is unwilling to give up the thing that causes the commonest type of cancer. Why should we bother?
This has nothing to do with CLL, by the way, the pardigmic disease is chronic myeloid leukemia in which the BCR/ABL tyrosine kinase is always in the switched on mode. Nick has looked at a variety of atypical chronic myeloid leukemias and has sorted out the molecular mechanisms.
Excellent though the science was there were several depressing features. First, in one case they had identified a Gleevec-like inhibitor which switched the tyrosine kinase off and would have had the effect of controling the leukemia, but so few patients suffered from this particular variant that no pharmaceutical company would spend the money to manufacture the product. Second, although he had identified 43 molecular mechanisms these represented less than 10% of all cases of atypical chronic myeloid leukemia. This is a rare variant of a rare disease; there are only 750 new cases of chronic myeloid leukemia in the UK every year.
The chronic myeloproliferative diseases are single gene disorders - there is usually only one molecular mistake. The common cancers, on the other hand, have 6, 7 or 8 molecular mistakes. If single gene diseases are so complex, how much more complex must the common cancers be?
When Gleevec was discovered I was very excited. The age of molecular therapies was dawning. That was 9 years ago. All we have done since then is produce one failed drug - Iressa - for common cancers. It is still the case that the most effective treatment for cancer is surgery, a treatment 150 years old.
The third depressing feature came from a meeting I went to the day before. WE were proposing a trial of mini-dose Revlimid for maintenance therapy in CLL. This was being opposed on the grounds that as the drug was so expensive, no matter how effective it might be, it would never pass NICE, and therefore there was no point in doing the trial. If Revlimid (a relatively easy to make molecule) is too expensive, what hope is there for new drugs in cancer.
The fourth thing that depressed me was seeing a doctor smoking. I have always refused to work on lung cancer on the grounds that the problem is already largely solved. Just stop tobacco smoking. As we unravel these molecular mechanisms at huge expense, society as a whole is unwilling to give up the thing that causes the commonest type of cancer. Why should we bother?
Monday, November 12, 2007
The cost of gene therapy
There is something of a controversy at the moment over the decision of the FDA not to recognise Oblimersen (BCL2 antisense) for the treatment of CLL. Spare a moment for Zheng Xiaoyu, once head of the Chinese FDA.
On July 10th this year Zheng was executed for taking bribes worth $840,000 from eight Chinese pharmaceutical companies in return for illegally approving their products. (There were 1010 recorded executions in China in 2002 according to Amnesty International).
Among the drugs approved by Zheng's regime were Gendicine, a recombinant human adenovirus type 5 which aims to introduce wild type p53 gene into cells with mutant p53. It was an immune reaction to adenovirus that killed Jesse Gelsinger the first person in the world to die from gene therapy.
This is not to say that the Chinese virus killed Jesse, but it suggests that the Chinese FDA might have been cavalier in licensing their product. Gendicine is analogous to the US drug Advexin, which is still in clinical trials and is not yet licensed. It may be that China, by applying less stringent criteria for licensing than the US, has leap-frogged America in the field of gene therapy. I suppose the lesson is if you are going to take risks with people's health don't take bribes for doing it.
On July 10th this year Zheng was executed for taking bribes worth $840,000 from eight Chinese pharmaceutical companies in return for illegally approving their products. (There were 1010 recorded executions in China in 2002 according to Amnesty International).
Among the drugs approved by Zheng's regime were Gendicine, a recombinant human adenovirus type 5 which aims to introduce wild type p53 gene into cells with mutant p53. It was an immune reaction to adenovirus that killed Jesse Gelsinger the first person in the world to die from gene therapy.
This is not to say that the Chinese virus killed Jesse, but it suggests that the Chinese FDA might have been cavalier in licensing their product. Gendicine is analogous to the US drug Advexin, which is still in clinical trials and is not yet licensed. It may be that China, by applying less stringent criteria for licensing than the US, has leap-frogged America in the field of gene therapy. I suppose the lesson is if you are going to take risks with people's health don't take bribes for doing it.
Sunday, November 11, 2007
Cenotaph Sunday
We who have missed our wars, being either too young or too old to fight, are often perplexed by the heroism of those who died.
I was two when WW2 ended and still too young for Korea and Suez. In Britain, Harold Wilson kept us out of Viet Nam and by the time of the Falklands we had a professional army that did not require aging amateurs. The First Gulf War would have been my children's war, but my oldest were still at University and my youngest still at school. I have a nephew who was there and close to a friendly fire incident where American bombers demonstrated their effectiveness but not their efficiency.
My youngest toyed with a career in the air force, but eventually ended up designing racing cars instead. Had he joined he would now be in Iraq or Afghanistan.
My father was deferred military service because of TB, but my grandfather was in the trenches in world war one, surviving, no doubt, by the luck of having charge of the horses. My wife had an uncle who was a fighter pilot in the Battle of Britain, but he too survived.
As a family, therefore, we have escaped the warmongering of the twentieth century.
I heard on a news item this morning that a large proportion of British soldiers killed in Iraq and Afghanistan were victims of friendly fire, road accidents or logistic errors, like the soldier killed by a roadside bomb when the defence against it, radio-jamming equipment, had been delivered to his base but not fitted to the vehicle because someone had forgotten to sign the requisite chitty.
Watching an old movie on TV last night, 'D-Day, 6th of June', it was galling to see the Richard Todd character, having survived the battle with only the sort of scratch that war heroes dismiss with heaps of aplomb and modesty, carelessly step on a landmine so as to leave the beautiful Dana Wynter for Robert Taylor.
I suppose things like happen in the fog of war, but were I the parent of a soldier who had put his life on the line to preserve our land, our liberty, our lives, and then found that he had died because someone left the handbrake off, or left early for lunch, of hadn't memorized the call sign or for some other trivial error I should be dismayed. Our soldiers deserve more.
This morning watching the great and the good leaving their wreathes around the Cenotaph in London, I was moved to write this poem.
Poppies on every coat,
Wreathes of regret;
Was it for this they wrote,
"Lest we forget"?
Ploughshares and pruning hooks,
Wolves with the lamb;
Splendid the pageant looks;
All just a sham?
Reverent with pomp and show,
The dead they adore,
Then as they bend quite low,
Plan the next war.
I was two when WW2 ended and still too young for Korea and Suez. In Britain, Harold Wilson kept us out of Viet Nam and by the time of the Falklands we had a professional army that did not require aging amateurs. The First Gulf War would have been my children's war, but my oldest were still at University and my youngest still at school. I have a nephew who was there and close to a friendly fire incident where American bombers demonstrated their effectiveness but not their efficiency.
My youngest toyed with a career in the air force, but eventually ended up designing racing cars instead. Had he joined he would now be in Iraq or Afghanistan.
My father was deferred military service because of TB, but my grandfather was in the trenches in world war one, surviving, no doubt, by the luck of having charge of the horses. My wife had an uncle who was a fighter pilot in the Battle of Britain, but he too survived.
As a family, therefore, we have escaped the warmongering of the twentieth century.
I heard on a news item this morning that a large proportion of British soldiers killed in Iraq and Afghanistan were victims of friendly fire, road accidents or logistic errors, like the soldier killed by a roadside bomb when the defence against it, radio-jamming equipment, had been delivered to his base but not fitted to the vehicle because someone had forgotten to sign the requisite chitty.
Watching an old movie on TV last night, 'D-Day, 6th of June', it was galling to see the Richard Todd character, having survived the battle with only the sort of scratch that war heroes dismiss with heaps of aplomb and modesty, carelessly step on a landmine so as to leave the beautiful Dana Wynter for Robert Taylor.
I suppose things like happen in the fog of war, but were I the parent of a soldier who had put his life on the line to preserve our land, our liberty, our lives, and then found that he had died because someone left the handbrake off, or left early for lunch, of hadn't memorized the call sign or for some other trivial error I should be dismayed. Our soldiers deserve more.
This morning watching the great and the good leaving their wreathes around the Cenotaph in London, I was moved to write this poem.
Poppies on every coat,
Wreathes of regret;
Was it for this they wrote,
"Lest we forget"?
Ploughshares and pruning hooks,
Wolves with the lamb;
Splendid the pageant looks;
All just a sham?
Reverent with pomp and show,
The dead they adore,
Then as they bend quite low,
Plan the next war.
Friday, November 09, 2007
Zebras, Pandas, Pelicans and Puffins
In the UK we have strange ways of crossing the road. We once had zebra crossings, so called because of the back and white stripes painted on the road. They were marked by black and white poles on which sat orange globes - Belisha Beacons - which were named after Leslie Hore-Belisha, the Minister of Transport who introduced them in 1934.
In 1962, concerned that pedestrians were disrupting the traffic flow by jumping on to 'their territory' the zebra crossing and occupying it (one retired colonel in Highcliff smashed the windscreen of an encroaching Rover with his walking stick), Ernest Marples the great innovator (he introduced Premium Bonds and Motorways) introduced Panda crossings which were controlled by pedestrian-operated light buttons and had black and white triangles rather than stripes on the road.
By 1967 the Panda experiment was deemed a failure. The flashing and pulsating lights were too confusing and the triangles were unpopular, so in 1969 the simpler Pelicon crossing was introduced. Note that strictly speaking they are Pelicon crossings (not Pelican) which stands for Pedestrian Light Con trolled crossings. You can watch this amusing government information film about them on You Tube
The pedestrian lights are situated on the far side of the road to the pedestrian. A Puffin crossing has the lights on the same side as the pedestrian; a toucan (Two can)crossing is a crossing for pedestrians and bicycles and a Pegasus crossing allows horse-riders to cross as well.
Someone at the Ministry of Transport spends their time thinking up these silly names.
Tuesday, November 06, 2007
Stem cell transplant - a lifelong committment
Some people think I am against transplants. Not at all, I regularly attend a ward round at the biggest transplant center in Britain. There are certainly situations where I recommend it unequivocally. I just want people to be realistic about the likely outcomes.
Everyone is aware that there is a certain mortality to stem cell transplants (SCT), especially in CLL, where at one time we were talking about a 40% risk of death in the first 100 days. Since the introduction or reduced intensity conditioning (RIC) that has been reduced so that in the best centers more than 80% are alive at a year post transplant. It is what happens afterwards that I want to write about today. In next week's Blood an article by Bhatia et al deals with the late consequences of SCT. Th is a report from very reputable centers including City of Hope, University of Minnesota, Ann Arbor, Michican and St Jude's, Memphis.
The paper deals with the long term consequences of transplants in leukemia and lymphoma excluding CLL and these were full intensity transplants not RICs.
By June 30, 2003, 21.6% (n = 320) of the patients who had undergone SCT between 1974 and 1998, and survived at least 2 years, had died. Median age at death was 33.4 years. Most of the deaths (69%) occurred in the 2- to 5-year period after allogeneic SCT, although 43 deaths (13%) did occur after 10 years from SCT.
The graph shows a survival curve comparing patients who had survived for 2 years after SCT with the normal US population of the same age.
For CLL patients it is important to realise that this is a young population. For most of the time covered by the study, the upper age for transplants was 40. CLL patients are generally older, and mostly would have RIC SCT. CLL patients have a more damaged immune system than other leukemic patients and would be more susceptible to infection.
Overall, premature death occurred 10 times more often than expected both in males (8-fold) and females (13-fold). Relative mortality was elevated across all age groups, but was highest in subjects undergoing SCT when younger than 18 years (17-fold). Relative mortality was highest in the 2- to 5-year period after allogeneic SCT (78-fold), and declined dramatically in the 6- to 10-year period (8-fold). Relative mortality remained elevated (2-fold above that of the general population) in patients followed for more than 15 years after SCT.
Two hundred forty-one deaths were observed in patients who had survived disease free for 2 years after SCT. Relapse of primary disease was the leading cause of death(29% of all deaths) mostly between the second and fifth year of follow-up. Chronic graft-versus host disease (cGVHD) was the second most common cause of late mortality accounting for 22% of deaths, while late infection in the absence of cGVHD was the cause of 11% of deaths. Late mortality was attributed to treatment-related causes in (25%), including 7% due to subsequent malignancy, 5% due to pulmonary complications, 3% due to cardiac toxicity, and 8.4% due to miscellaneous treatment-related complications.
The risk of late mortality due to any cause was 2.6-fold increased among individuals older than 45 years at the time of SCT, compared with those who were younger than 18 years; 2.3-fold increased among patients with cGVHD compared with those without cGVHD; and 1.7-fold increased among patients at high risk of relapse at the time of SCT, compared with those at standard risk. Patients undergoing SCT after 1980 were less likely to suffer from relapse-related mortality, compared with those who underwent transplantation before 1980.
In order to look at morbidity the investigators produced a questionnaire which looked at whether the patient had married or stayed married, was employment or not, could obtain health insurance and life insurance, and compared them with their siblings who had mot had a transplant.
Marital rate (proportion currently married) for the survivors was significantly lower compared with siblings (55% vs 69%, P < .001).
SCT survivors were 14-fold more likely to report a health problem preventing them from holding a job compared with siblings (19% vs 2%). Presence of cGVHD (OR = 3.2; 95% CI, 1.9-5.4), and female sex (OR-1.7; 95% CI, 1.1-2.7) were associated with difficulty in holding a job.
SCT survivors were 7-fold more likely to report difficulty in obtaining or retaining health insurance (26% vs 5%, P < .001), and low annual household income (< $20 000) was associated with difficulty in obtaining health insurance (OR = 2.7; 95% CI, 1.4-5.0). However, 90% of the survivors did report health insurance coverage at the time of study participation, although the rate in siblings was 95% (p = 0.01).
A significantly greater proportion of SCT survivors reported difficulty in obtaining or retaining life insurance compared with siblings (30% vs 5%, P < .001) and the survivors were 10-fold more likely to report difficulty in obtaining or retaining life health insurance. Only 56% of the survivors had life insurance at study participation, compared with 76% of the siblings (P < .001).
Tough though it is to have a transplant, it is better than being dead. When it is appropriate a transplant is the right course to take, but it should not be entered into unadvisedly.
Monday, November 05, 2007
Hope for p53 mutants
The worst cases of CLL are those with reduced or absent p53 function. There are two reasons for this. p53 is known as ‘the guardian of the genome’. I like to think of it as a sort of bumble bee buzzing up and down the DNA seeking out mistakes. When it finds them, it puts the cell into stasis and instructs the DNA repair enzymes to put the matter right. If they cannot do so, it instructs the cell to commit suicide – apoptosis, or programmed cell death. If this doesn’t happen and the cell continues to multiply the mistake is perpetuated and more accumulate. Characteristically, cells with a defunct p53 molecule develop a complex karyotype with many mistakes. Without p53 the cell gets progressively more malignant.
In addition p53 is needed by most cytotoxic drugs to kill the cells. They don’t work by committing murder, but by inducing p53 to tell the cell to commit suicide. Thus cells with aberrant p53 tend to be drug resistant.
CLL cells can be defective in p53 either by losing the part of chromosome 17 on which it is located, or by a molecular mistake so that the DNA sequence that codes for p53 has an error in it (ie a mutation). There is a third way that diminishes the effectiveness of p53. The ATM gene of chromosome 11q23 codes for an enzyme that adds a phosphate group to p53 which makes it much more active, so no ATM and your p53 is a bit effete, weak and watery. That’s not as bad as having no p53, but it will do for you in the end.
A poster at the IWCLL from the Royal Marsden confirmed what most of us had suspected. 85% of those with deleted p53 on one chromosome had a mutated p53 on the other one. Since they did not look at the complete length of the gene it is likely that the true figure is 100%. Interestingly, this was only true for those with >20% cells with the del 17p, lesion. In those with <20% the mutation rate was only 7%. This confirms the finding of the LRF CLL4 trial that only those with >20% del 17p had a very poor prognosis.
I have already written about Nutlin-3, a molecule that antagonises MDM-2, a natural inhibitor of p53 and about PARP-1 inhibitors, chemicals that enhance the effect of ATM, but here I want to introduce you to two other ways of putting right defective p53.
RITA (2.5-bis (5-hydroxymethyl-2-thienyl) furan) binds to the p53 N-terminal domain and preventing the p53-HDM2 interaction which leads to the accumulation of p53 in tumour cells lines, increasing its half-life. Of course there must be some normal p53 present for it to work, but it may have a use in del 11q CLLs where the p53 is there but not very strong.
PRIMA-1 (2,2-bis(hydroxymethyl)-1-azabicyclo[2,2,2]octan-3-one)is a low-molecular-weight compound that can restore wild-type conformation of mutant p53 and specific DNA binding, consequently triggering apoptosis in tumor cells carrying mutant p53.
Look forward to seeing papers reporting the use of these two molecules in early clinical trials.
In addition p53 is needed by most cytotoxic drugs to kill the cells. They don’t work by committing murder, but by inducing p53 to tell the cell to commit suicide. Thus cells with aberrant p53 tend to be drug resistant.
CLL cells can be defective in p53 either by losing the part of chromosome 17 on which it is located, or by a molecular mistake so that the DNA sequence that codes for p53 has an error in it (ie a mutation). There is a third way that diminishes the effectiveness of p53. The ATM gene of chromosome 11q23 codes for an enzyme that adds a phosphate group to p53 which makes it much more active, so no ATM and your p53 is a bit effete, weak and watery. That’s not as bad as having no p53, but it will do for you in the end.
A poster at the IWCLL from the Royal Marsden confirmed what most of us had suspected. 85% of those with deleted p53 on one chromosome had a mutated p53 on the other one. Since they did not look at the complete length of the gene it is likely that the true figure is 100%. Interestingly, this was only true for those with >20% cells with the del 17p, lesion. In those with <20% the mutation rate was only 7%. This confirms the finding of the LRF CLL4 trial that only those with >20% del 17p had a very poor prognosis.
I have already written about Nutlin-3, a molecule that antagonises MDM-2, a natural inhibitor of p53 and about PARP-1 inhibitors, chemicals that enhance the effect of ATM, but here I want to introduce you to two other ways of putting right defective p53.
RITA (2.5-bis (5-hydroxymethyl-2-thienyl) furan) binds to the p53 N-terminal domain and preventing the p53-HDM2 interaction which leads to the accumulation of p53 in tumour cells lines, increasing its half-life. Of course there must be some normal p53 present for it to work, but it may have a use in del 11q CLLs where the p53 is there but not very strong.
PRIMA-1 (2,2-bis(hydroxymethyl)-1-azabicyclo[2,2,2]octan-3-one)is a low-molecular-weight compound that can restore wild-type conformation of mutant p53 and specific DNA binding, consequently triggering apoptosis in tumor cells carrying mutant p53.
Look forward to seeing papers reporting the use of these two molecules in early clinical trials.
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