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How Did Ancient Medics Determine the Medicinal Properties of Substances?

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Drew Smith:

For the most part, they didn’t. At the dawn of the age of scientific medicine (the mid-19th century) there were only a handful of remedies that we would recognize today as safe and effective.

But why? Our ancestors were not dummies, and did not require scientific methods to create sophisticated and effective technologies. The Romans built what is still the largest unsupported dome structure in the world 1800 years ago. Gunpowder, in concert with metallurgical advances, steadily developed from a Taoist elixir to a city-destroying technology by the 1600s. Sailing technology created worldwide trade networks even earlier. Scientific methods would have sped the development of these technologies, but were not required. Trial and error—plus lots of time—sufficed.

Yet traditional medicines largely suck. Hundreds have now been tested in clinical trials. Few show any benefit at all, and even fewer show a benefit comparable to modern scientific medicines. There is little evidence that the remedies of 1800 CE were any more effective than the remedies of 1800 BCE. Moliere’s quip in 1673 that “More men die of their medicines than of their diseases” was very much on the mark.

This is a mystery, at least to me. Unlike other sophisticated modern technologies, such as jet aircraft or telecommunications, medicines are largely discovered rather than invented. They don’t rely on an entire edifice of previous scientific discoveries.

In fact, effective medicines sometimes come and find us. The ancient Nubians drank a beer (more like a gruel, really) fermented by Streptomyces bacteria. It was so loaded with tetracycline that their bones fluoresce under UV light. Tetracycline is a very effective broad spectrum antibiotic that can be used to treat plague, TB, diarrheal diseases, and respiratory, skin, and urinary tract infections. Tetracycline beer, used judiciously, could well have slashed infant mortality, leading to a Demographic Transition in Central Africa in 400 CE.

But it didn’t.

The ancients were also capable of creating, not just finding, sophisticated medicines. Bard’s Salve, resurrected from a 10th century Saxon text, is an effective remedy for wound infection in mouse models.

More surprisingly, every component—and the precise process for producing it—is required in order for it to work. This is a clear example of an effective ancient medicine that answered a critical medical need. Its formulation was written down, allowing it to spread and be improved upon. Instead it was forgotten.

Why?

I’m sure there is no single answer, but I will posit this: In a Malthusian world, effective medicines were a liability, not an asset.

Up until about 1800, everyone in the world, to a first approximation, was a poor subsistence farmer. Despite substantial technological advances, like the ones I described above and many others, the standard of living of the world’s population advanced not at all. Any improvement in agricultural technology, such as the horse collar and improved plow designs, led to increased food production but subsequent population increases ate up any gains in living standards.

We think of historical plagues as disasters, but they were in fact a great benefit—at least to the survivors. Life expectancy increased after the Black Death of 1350:

So did wages:

Fewer mouths to feed and a scarcity of labor leading to increased bargaining power led to more resources per person and a more equitable distribution of those resources.

In our modern innovation-driven economy, we consider more people to be a good thing.

We fret that declining birth rates will cause economic growth to stagnate. But prior to 1850, a growing population meant growing poverty.

Saving lives—particularly the lives of economic sinks like small children—did not make societies stronger. This is not to say that parents did not mourn the loss of their children. They did. But societies operated under what was a reverse Tragedy of the Commons, where what was bad for the individual was good for everyone else.

I think our ancestors were perfectly capable of making effective medicines. They chose not to, not out of perversity or ignorance, but because those medicines would have caused more suffering than they prevented. Medicine was not intended to cure; its role was to provide comfort. It was a form of social support, not unlike religion. Looked at from that perspective, traditional medicines are very effective. They did exactly what their creators intended them to do. I’m not sure that we can always say the same today.

This post originally appeared on Quora. Click here to view.

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Why Are Mugshots Made Public Before a Suspect is Convicted by the Court?
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Jennifer Ellis:

Several reasons.

1. Mugshots can help find people when they have absconded, or warn people when someone is out and dangerous. So there is a good reason to share some mugshots.

2. Our legal system requires openness as per the federal constitution, and I imagine most if not all state constitutions. As such, this sort of information is not considered private and can be shared. Any effort to keep mugshots private would result in lawsuits by the press and lay people. This would be under the First and Sixth Amendments as well as the various Freedom of Information Acts. However, in 2016 a federal court ruled [PDF] that federal mugshots are no longer routinely available under the federal FOIA.

This is partially in recognition of the damage that mugshots can do online. In its opinion, the court noted that “[a] disclosed booking photo casts a long, damaging shadow over the depicted individual.” The court specifically mentions websites that put mugshots online, in its analysis. “In fact, mugshot websites collect and display booking photos from decades-old arrests: BustedMugshots and JustMugshots, to name a couple.” Some states have passed or are looking to pass laws to prevent release of mugshots prior to conviction. New Jersey is one example.

a) As the federal court recognizes, and as we all know, the reality is that if your picture in a mugshot is out there, regardless of whether you were convicted, it can have an unfortunate impact on your life. In the old days, this wasn’t too much of a problem because it really wasn’t easy to find mugshots. Now, with companies allegedly seeking to extort people into paying to get their images off the web, it has become a serious problem. Those companies may get in trouble if it can be proved that they are working in concert, getting paid to take the picture off one site and then putting it on another. But that is rare. In most cases, the picture is just public data to which there is no right of privacy under the law.

b) The underlying purpose of publicity is to avoid the government charging people and abusing the authority to do so. It was believed that the publicity would help protect people. And it does when you have a country that likes to hide what it is up to. But, it also can cause harm in a modern society like ours, where such things end up on the web and can cause permanent damage. Unfortunately, it is a bit of a catch-22. We have the right to know issues and free speech rights smack up against privacy rights and serious damage of reputation for people who have not been convicted of a crime. The law will no doubt continue to shake out over the next few years as it struggles to catch up with the technology.

This post originally appeared on Quora. Click here to view.

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What Happens When You Flush an Airplane Toilet?
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For millions of people, summer means an opportunity to hop on a plane and experience new and exciting sights, cultures, and food. It also means getting packed into a giant commercial aircraft and then wondering if you can make it to your next layover without submitting to the anxiety of using the onboard bathroom.

Roughly the size of an apartment pantry, these narrow facilities barely accommodate your outstretched knees; turbulence can make expelling waste a harrowing nightmare. Once you’ve successfully managed to complete the task and flush, what happens next?

Unlike our home toilets, planes can’t rely on water tanks to create passive suction to draw waste from the bowl. In addition to the expense of hauling hundreds of gallons of water, it’s impractical to leave standing water in an environment that shakes its contents like a snow globe. Originally, planes used an electronic pump system that moved waste along with a deodorizing liquid called Anotec. That method worked, but carrying the Anotec was undesirable for the same reasons as storing water: It raised fuel costs and added weight to the aircraft that could have been allocated for passengers. (Not surprisingly, airlines prefer to transport paying customers over blobs of poop.)

Beginning in the 1980s, planes used a pneumatic vacuum to suck liquids and solids down and away from the fixture. Once you hit the flush button, a valve at the bottom of the toilet opens, allowing the vacuum to siphon the contents out. (A nonstick coating similar to Teflon reduces the odds of any residue.) It travels to a storage tank near the back of the plane at high speeds, ready for ground crews to drain it once the airplane lands. The tank is then flushed out using a disinfectant.

If you’re also curious about timing your bathroom visit to avoid people waiting in line while you void, flight attendants say the best time to go is right after the captain turns off the seat belt sign and before drink service begins.

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