138 General Discussion 



in two to three months, ninety-five in four months, and staying at that 

 level for the fifth month — an increase of about 04 per cent. It may be 

 that this group was a select group of very well-preserved men, and with 

 a less well-preserved group you might get more on the psychological 

 side. I don't know. 



Tunbridge: There is some work, I believe, to suggest that when old 

 people are kept immobile there is a difference in excretory values from 

 when they are mobile and active. You've not done any studies on 

 people in bed, have you? 



Rubin: Most of our subjects do live in an old people's home, but they 

 are not bedridden. 



Tunbridge: There is evidence from fracture cases, for what it's worth, 

 that the level when they are outside living in the country, for example 

 farmers, is not so low. When we bring them in after a fracture the level 

 drops lower than in your cases. 



Rubin: But with fracture cases you are running into the stress factor. 



Olbrich: How do you exclude the increase in muscle strength by daily 

 exercise? 



Freeman: The strength test is only run once a month, so there is no 

 practice effect at all. There was one session at the beginning of the 

 placebo period, and one at the end, and the mean of each of the two 

 tests was within a second of the other. 



Olbrich: And what was the interval for the memory test? 



Freeman: That was done in a control period and three and five months 

 after the initial level. 



Comfort: Did they have subjective effects, either during the placebo 

 period or during the medication? 



Freeman: I believe the placebo period was too short. During the 

 medication period some said they felt better and there were varying 

 reports of increased or decreased urination. The general report by the 

 majority was of not feeling so tired. I wouldn't trust this unless I ran a 

 group on placebos where the investigator didn't know which was which. 

 There have been an increasing number of reports on the effect of placebos 

 on pain and headache — ^I believe that in arthritis it has been shown that 

 25 per cent of cases show some improvement on placebos. 



Miescher: We spoke yesterday about the vitality factor. Do you think 

 that by giving testosterone there is improvement of the physical vitality, 

 but not of the psychological one — ^that the two don't run parallel? 



Freeman: Apparently not for this short period of time. I don't know 

 whether a longer period might show anything, but certainly over a 

 five-month period in which the hormone output was increased four to 

 five times on an average, nothing happened psychologically. It was just 

 an effect on their physical well-being, but that's all. 



Lewis: I think it is rash to assume that this is a test of muscular 

 strength. It could ecjually be regarded as a test of endurance. Gordon, 

 O'Connor and Tizard found, for example, in defectives, that if you give 

 a test of this tyi)e, people may change in their endurance, and conse- 

 ((uently in their achievement. They carry out the performance more and 

 more effectively as their standard rises, or as they learn what they 



