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Ten years ago, in papers on medical sympathectomy and the clinical use of methonium compounds, early experience in this unit with ganglion-blocking drugs was recorded (Turner, 1950, 1951). Recently the indications for treatment, method of administration, and the problems of tolerance and side-effects were reviewed (Turner, 1959). At an early stage it was decided that to initiate life long treatment with potent and potentially dangerous drugs was a major decision and that it was best first to make a detailed and standardized assessment of each patient in hospital. If treatment was indicated we tried to achieve a steady state with the appropriate drug, and then further treatment was supervised on a long-term basis in a special clinic organized for the purpose. This procedure has helped to ensure the proper and uniform selection of patients suitable for treatment, has facili tated the maintenance of good control over the blood pressure as well as the collection and correlation of data, and has made possible comparative assessments of different drugs. Numerous ganglion-blocking agents have been investigated, all potent in lowering the blood pressure, but none free from difficulties of administra tion, particularly as regards tolerance and side-effects. None, in fact, has been satisfactory. Although the blood-pressure can be reduced to almost any desired level this can rarely be achieved without troublesome side-effects from concomitant parasympa thetic blockade. Some improvement results from combining the ganglion-blocking drug with chloro thiazide or rauwolfia, but in some degree most patients complain of constipation, dryness of the mouth, diffi culty with accommodation, delay in micturition, or impotence. In many individuals these effects are asso ciated with a feeling of general malaise. Because of all this, physicians have looked forward to the day when research workers would be rewarded by the finding of a compound with selective blocking action on the sympathetic nervous system. Recently, in the laboratories of the Wellcome Founda tion in England and the Ciba Foundation in Switzer land, compounds have been isolated which do selectively block the peripheral sympathetic nervous system by accumulating in sympathetic ganglia and post-ganglionic fibres. The first of these has been given the name of bretylium tosylate (" darenthin "), and has the formula N-o-bromobenzyl-N-ethyl : N : N-dimethylammonium p toluenesulphonate. The second substance has been given the name of guanethidine (" ismelin ") and has the formula 2-(octahydro-L-azocinyl-ethyl) guanidine sulphate. This paper is principally concerned with a clinical trial of bretylium, which we have used for 15 months in the treatment of 43 patients with hypertension.

In March 2020, the ‘Everyone In’ initiative was introduced by the UK government as a public health response to COVID-19. This initiative sought to temporarily accommodate people experiencing rough sleeping in hotels in all local authority areas throughout England. In London, ‘Everyone In’ involved the procurement of vacant accommodation in over 100 hotels and temporarily re-housed approximately 2000 individuals. A rapid qualitative study was undertaken within two hotels to explore experiences of the initiative from the perspective of people accommodated in the hotels. This article describes how standard qualitative methods were adapted and implemented to complete the study whilst meeting COVID-19 social distancing guidelines. The research involved a longitudinal design of a two-stage qualitative interview that sought to capture residents’ experience of ‘Everyone In’ at two points in time (while in the hotel and when residents had left the hotel). Adapted qualitative methods were employed by a team of 13 researchers. These adaptations included socially distanced leaflet dropping, telephone-based participant recruitment, a remote, multistage, longitudinal qualitative telephone interviewing and rapid framework analysis. 35 hotel residents were recruited into the study (two subsequently withdrew participation). A total of 299 (of a possible 330) short interviews were completed by 33 participants (26 male and 7 female) as part of the multi-stage, longitudinal design of the study. This study indicates that adapted qualitative research methods employed during a pandemic can be successfully applied to obtain insights and experiences (of individuals and groups) otherwise difficult to reach and/or complex to understand.