nancylebov (nancylebov) wrote,
nancylebov
nancylebov

Medicine is hard

From Less Wrong, an article about losing track of the cure for scurvy for fifty years because of inadequate theory.

This article points in so many interesting directions that I had been putting off posting about it until I could do it justice. Then I saw it show up twice on my flist, so I don't have credit for posting it first. On the other hand, sometimes I don't get around to following links till I see them more than once, and it's not as though everyone on my flist sees all same the posts I do.

Anyway, when lemons were discovered as a cure for scurvy, no one knew what was important about them, nor that there was enough vitamin C in fresh meat to keep people healthy, nor that vitamin C is very fragile. They didn't know that there's a lot less vitamin C in limes than lemons, either.

People died on ships and Antarctic expeditions as result of this ignorance, and so did some upper class babies who'd been put on what was assumed to be the best possible diet of cooked food.

I've heard elsewhere that the Chinese prevented scurvy on ships by growing sprouts-- this is echoed in the story when the Scott expeditions grew watercress under glass on Antarctic, which I think of as charming as well as effective.

Also from elsewhere, the Amundsen expedition was less dramatic (more successful and didn't kill as many people)-- I wonder if they had a better guess about nutrition, and if so, what it was. More googling: Amundsen may just have been luckier, combined with a little less ambition.

Being right is not enough:
Lind tends to get the credit for discovering the citrus cure since he performed something approaching a controlled experiment. But it took an additional forty years of experiments, analysis, and political lobbying for his result to become institutionalized in the Royal Navy.

Being right really isn't enough:
Scurvy had been the leading killer of sailors on long ocean voyages; some ships experienced losses as high as 90% of their men. With the introduction of lemon juice, the British suddenly held a massive strategic advantage over their rivals, one they put to good use in the Napoleonic wars. British ships could now stay out on blockade duty for two years at a time, strangling French ports even as the merchantmen who ferried citrus to the blockading ships continued to die of scurvy, prohibited from touching the curative themselves.

The success of lemon juice was so total that much of Sicily was soon transformed into a lemon orchard for the British fleet. Scurvy continued to be a vexing problem in other navies, who were slow to adopt citrus as a cure, as well as in the Merchant Marine, but for the Royal Navy it had become a disease of the past.

Any further anecdotes about militaries failing to pick up on obvious useful things that their rivals were doing will be gratefully received.

It was a matter of luck that vitamin C as a cure for scurvy was rediscovered as soon as it was-- guinea pigs are the only non-primates which are knows to need vitamin C and get scurvy as a deficiency disease. This in itself might be a reason to be kind of nervous about animal study results.

Finally, that one of the simplest of diseases managed to utterly confound us for so long, at the cost of millions of lives, even after we had stumbled across an unequivocal cure. It makes you wonder how many incurable ailments of the modern world - depression, autism, hypertension, obesity - will turn out to have equally simple solutions, once we are able to see them in the correct light. What will we be slapping our foreheads about sixty years from now, wondering how we missed something so obvious?

We may not just be missing things that were obvious, we may well have forgotten things we already knew.

Sf about a cold trek: The Left Hand of Darkness by Ursula Le Guin

Sf about scurvy: Bedlam Planet by John Brunner

More cold: Norse Code by Greg Van Eekhout (packaged as urban fantasy/paranormal romance, but is actually about an effort to deal with Ragnarok-- pretty good and more like standard fantasy)

The Making of the Representative for Planet 8 by Doris Lessing (a planet freezes slowly, be warned that this is make up as you go science fiction from a non-science fiction author, I found it fascinating anyway)

The Winter of the World by Michael Scott Rohan, in which the big magical threat is malevolent glaciation (from memory, so I might be a little off).

More Lessing: The Good Terrorist. Just a nicely put together book that I enjoyed--it was interesting to track how much havoc the viewpoint character caused as a result of very moderate impulsiveness, how her fucked-upness had clear roots in her childhood, and possibly a hint as to why you shouldn't stock a terrorist cell with British people. As Ellison said (probably about Laffery's Past Master), humor so dark it's ultraviolet.

More free association: Past Master is really excellent. It's about Thomas More getting pulled out of the past to solve the problem of people on a planet based on his Utopia voluntarily forming slums. Lafferty is the only science fiction author I know of whose style is strongly influenced by tall tales.

There's a rain forest that goes down and down, there's killing a cyclops and eating its brains, there are programmed mechanical killers, there are the ansels that go on two legs or four or none and play fan tan, and there are snakes in the brain.

It's set in a temperate climate, in case you want a relief from all that cold.

A little wiseass about scurvy and incentive programs from wikkit42 at another link to the scurvy article

I probably still haven't done the scurvy article justice-- you'll need to read the article to find out how all the mistakes seemed entirely reasonable at the time. People have not gotten smarter.
Subscribe
  • Post a new comment

    Error

    Anonymous comments are disabled in this journal

    default userpic

    Your reply will be screened

    Your IP address will be recorded 

  • 12 comments