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Posts Tagged ‘medicine’

Take Two Skulls And Call Me In The Morning

There is a common and ancient opinion that certain prophetic women who are popularly called ‘screech-owls’ suck the blood of infants as a means, insofar as they can, of growing young again. Why shouldn’t our old people, namely those who have no [other] recourse, likewise suck the blood of a youth? — a youth, I say who is willing, healthy, happy and temperate, whose blood is of the best but perhaps too abundant. They will suck, therefore, like leeches, an ounce or two from a scarcely- opened vein of the left arm; they will immediately take an equal amount of sugar and wine; they will do this when hungry and thirsty and when the moon is waxing. If they have difficulty digesting raw blood, let it first be cooked together with sugar; or let it be mixed with sugar and moderately distilled over hot water and then drunk.

Marsilio Ficino, De Vita II (1489), 11: 196-199. Translated by Sergius Kodera

If your world-building has a medieval flavor and you’re looking to add some period-authentic medicine, you need look no further than cannibalism. For more than 200 years, cannibalism was a routine part of medicine. Walk in to the shop of any apothecary (the equivalent of today’s pharmacist), and you would find, among other things, the skull of a man killed by violent death, human blood (which could include menstrual blood), human urine (separated by sex, and if the urine came from a woman, by whether she was a virgin or not), human fat, and mummia.

Skulls

Perhaps the simplest form of this type of medicine was the skull and the moss of the skull. But not just any skull would do. It was widely believed that the skulls used should be from those who suffered violent death. There were disagreements of which type of violent death was best. The German professor Rudolf Goclenius (fl. c.1618) held that skulls should come from those who had been hanged. Flemish chemist, physiologist, and physician Jan (or Jean) Baptist van Helmont disagreed, claiming that a body broken on the wheel would do just as well. He also explained the skull was the most efficacious of all the human bones because, after death, “…all the brain is consumed and dissolved in the skull… by the continual… imbibing of [this] precious liquor” of dissolved brains “the skull acquires such virtues.”

One of the most important sources of skulls in England was Ireland. Sir Humphrey Gilbert slaughtered thousands of Irish men, women, and children during the late 1560′s, severing the heads of those he captured and place them in long rows, like a wall, leading to his tent. The skulls rotted and moss grew on them, and he began exporting the skulls to England, where they ended up being used as medicine by the English aristocracy. So much money was made by exporting the skulls that the English introduced an import tax of one shilling for each one. As late as 1778, the skulls were still liable for duty and were also listed amongst goods which were imported into England before being exported elsewhere.

One of the earliest descriptions of using human skull is from the 1651 book by John French, The Art of Distillation. One of the methods described in the book for turning human skull into spirit involved braking the skull up into small pieces, placing them a glass retort. Heat them in a “strong fire” which will eventually yield “a yellowish spirit, a red oil, and a volatile salt.” The salt and spirit are then further distilled for an additional 2-3 months. This spirit of the skull was said to be good for falling-sickness, gout, dropsy, and as a general panacea for all illnesses.

A different recipe for turning human skull into spirit was developed by Jonathon Goddard, Professor of Physic at London’s Gresham College, and was purchased by King Charles II for £6,000 (and enormous sum of money), which became know as “the King’s Drops.” This concoction was used against epilepsy, convulsions, diseases of the head, and often as an emergency treatment for the dying. Charles even manufactured and sold himself. Unfortunately they didn’t do Charles much good, as he died on February 6, 1685, after being treated with high doses of the distillation after falling ill four days earlier. The drops failed again in December of 1694, when despite having taken some of the King’s Drops, Queen Mary II died.

The moss of the skull, called usnea, was also important. Francis Bacon (d.1626), the father of scientific inquiry, probably started the trend in consuming fresher skulls with moss growing on them. Chemist and physicist Robert Boyle (d.1691) then found another use. One summer Boyle was badly afflicted by nosebleeds. During a violent bleed, Boyle decided to use “some true moss of a dead man’s skull” which had been sent from Ireland. The usual method was to insert the moss, often powdered, directly into one’s nostrils. But Boyle said he found that he was able to completely halt the bleeding merely by holding the moss in his hand, thus confirming that the moss could work at a distance.

Mummia

Mummia, or mummy, was a powder made from ground mummies. There were broadly four type of mummy – the mineral pitch (also known as “natural mummy”, “transmarine mummy”, or bitumen), matter derived from embalmed Egyptian corpses (“true mummy” or “mumia sincere”), the relatively recent bodies of travelers “drowned” in sandstorms in the Arabian desert (“Arabian mummy”), and flesh taken from fresh corpses, preferably those of felons who had died no more than three days prior to the flash being collected, then treated and dried.

Mummy was thought to cure everything from headaches to stomach ulcers. For example, in 1747, successful London physician Robert James, in his book Pharmacopeia Universalis: or A New Universal English Dispensatory, wrote

Mummy resolves coagulated Blood, and is said to be effectual in purging the Head, against pungent Pains of the Spleen, a Cough, Inflation of the body, Obstruction of the Menses and other uterine Affections: Outwardly it is of Service for consolidating Wounds. The Skin is recommended in difficult Labours, and hysteric Affections, and for a Withering and Contraction of the Joints. The Fat strengthens, discusses, eases pains, cures Contractions, mollifies the Hardness of Cicatrices, and fills up the pits left by the Measles. The Bones dried, discuss, astringe, stop all Sorts of Fluxes, and are therefore useful in a Catarrh, Flux of the Menses, Dysentery, and Lientery, and mitigate Pains in the Joints. The Marrow is highly commended for Contractions of the Limbs. The Cranium is found by Experience to be good for Diseases of the Head, and particularly for the Epilepsy; for which Reason, it is an Ingredient in several anti-epileptic Compositions. The Os triquerum, or triangular Bone of the Temple, is commended as a specific Remedy for the Epilepsy. The Heart also cures the same Distemper.

But the use of mummy as a medicine goes back much further. Thomas Willis, a 17th-century pioneer of brain science, brewed a drink for apoplexy, or bleeding, that mingled powdered human skull and chocolate.

In 1575, John Banister, Queen Elizabeth’s surgeon, describes a mummy plaster for a tumerous ulcer and a drink made of mummy and water of rhubarb for ulcers of the breast. In 1562, physician William Bullein published Bullein’s Bulwark of Defence Against all Sickness, which recommended mummy mixed with wild fennel, juice of black poppy, gentian, honey, and wild yellow carrots to make “Therica Galeni”, a treatment for ”the falling sickness… and convulsions”, headaches (including migraines), stomach pains, the “spitting of blood”, and “yellow jaundice”.

Earlier, anatomist and medical writer Berengario da Carpi (d.1530) made frequent use of mummy in medical plasters using a family secret recipe going back decades. His family insured they had sufficient amounts of mummy by keeping mummified heads in their house.

Blood

It is said that in July of 1492, the physician to dying Pope Innocent VIII bribed three healthy youths to help him save the pope. The youths were then bled, and the pope drank their blood, still fresh and hot. But the blood did not save the pope, and all three youths died of the bloodletting.

The belief that blood could cure disease goes back at least to Roman times. Between the first and the sixth century a single theological and several medical authors reported on the consumption of gladiator’s blood or liver to cure epileptics. The origins of this belief are thought to lie in Etruscan funeral rites. After the prohibition of gladiatorial combat in about 400 AD, an executed individual (particularly had he been beheaded) became the “legitimate” successor to the gladiator. Pliny the Elder (AD 23-79), one of the great historians of the Roman Empire, described the mad rush of spectators into arenas to drink the blood of fallen gladiators:

Epileptic patients are in the habit of drinking the blood even of gladiators, draughts teeming with life, as it were; a thing that, when we see it done by the wild beasts even, upon the same arena, inspires us with horror at the spectacle! And yet these persons, forsooth, consider it a most effectual cure for their disease, to quaff the warm, breathing, blood from man himself, and, as they apply their mouth to the wound, to draw forth his very life; and this, though it is regarded as an act of impiety to apply the human lips to the wound even of a wild beast! Others there are, again, who make the marrow of the leg-bones, and the brains of infants, the objects of their research!

Plin. Nat. 28.2

In the 16th and 17th centuries, various distillations of blood were used to treat consumption, pleurisy, apoplexy, goat, and epilepsy, as well as used for a general tonic for the sick. Moyse (or Moise) Charas, an apothecary in France during the reign of Louis XIV who compendiums of medication formulas, specified blood should be from “healthy young men”. Robert Boyle also had a lot to say about medicine, and was very interested in distillations of human blood. In 1663 he published Some Considerations touching the Usefulness of Experimental Natural Philosophy, in which he advises to

take of the blood of a healthy young man as much as you please, and whilst it is yet warm, add to it twice its weight of good spirit of wine, and incorporating them well together, shut them carefully up in a convenient glass vessel.

Poor people couldn’t afford physicians, and turned to other options for acquiring blood. English traveler Edward Browne reports that, while touring Vienna, he had the good fortune to be present at a number of executions. After one execution, he reports that “while the body was in the chair” he saw “a man run speedily with a pot in his hand, and filling it with the blood, yet spurting out of his neck, he presently drank it off, and ran away… this he did as a remedy against the falling-sickness.” In Germanic countries, the executioner was considered a healer; a social leper but with almost magical powers.

Fat

Human fat was mentioned in European pharmacopoeias as early as the 16th century. It was used to treat ailments on the outside of the body. German doctors, for instance, prescribed bandages soaked in it for wounds, and rubbing fat into the skin was considered a remedy for gout and rheumatism. But it could be used for other diseases as well. Human fat was frequently cited as a powerful treatment for rabies. Robert James, who we met earlier, published a book in 1741 on rabies. In it, he discusses the work of French surgeon J. P. Desault, including the remedy the surgeon had “…tried with constant success, and which I propose to prevent and cure the hydrophobia… the ointment made of one third part of mercury revived from cinnabar, one third part of human fat, and as much of hog’s lard.”

In Scotland, human fat was being sold and used as early as the beginning of the 17th century. An apothecary in Aberdeen, Scotland advertised advertised as part of his available medical ingredients “…human fat at 12s Scots per ounce”. The source of the fat was most likely executed criminals, as it was the most common source of fat available. But sometimes human fat came from much darker actions.

In July 1601, the Spanish began the siege of Ostend, one of the bloodiest battles of the Dutch revolt against the Spanish, and one of the longest sieges in history. An account of the battle tells of how on October 17, 1601, the Spanish ran in to a trap in an attack. Alll the attackers were killed, and afterwards “…the surgeons of the town went thither… and brought away sacks full of man’s grease which they had drawn out of the bodies.” It’s likely that the fat was then used to treat wounds from the battle.

 

Cannibalism as medicine may shock our sensibilities today, but it can be a useful starting point for developing medicinal practices in your world-building.

References

Bostock, John, 1855. The Natural History of Pliny the Elder. London, England: Taylor and Francis

Moog FP, and Karenberg A. Between horror and hope: gladiator’s blood as a cure for epileptics in ancient medicine. J Hist Neurosci. 2003 Jun;12(2):137-43.

Noble, Louise, 2011. Medicinal Cannibalism in Early Modern English Literature and Culture. Basingstoke, Hampshire, England: Palgrave Macmillan

Sugg, Richard, 2011. Mummies, Cannibals and Vampires: The History of Corpse Medicine from the Renaissance to the Victorians. Abingdon, Oxford, England: Routledge

Low-tech Antiseptics, part 2

The importance of keeping wounds clean is something we take for granted now, and we have all the benefits of science and industrial production to provide us with cheap and effective antiseptics. These posts examine some reasonable options for the doctors and healers of a realistic fantasy world to have at hand.

Part 1 discussed salt and sodium bicarbonate.

Alcohol

Your brave character uncorks that vodka bottle with his teeth and pours it over his wound. Problem solved? Check the label first.

Surgical-grade ethanol runs from 60-90% alcohol by volume. In drinking terms, that’s 120-180 proof. Most of the stuff in the liquor cabinet tops out at 100 proof — though you can get brandies that are 120 proof and the infamous Everclear is available in 151 and 190 proof.

Simple distillation dates from the first century AD, in Europe, and methods gradually improved during the Renaissance and really took off in the 19th century. So the good news is that it’s not unreasonable for a fantasy world to know how to distill alcohol from fermented mash.

The bad news is that simple distillation (from the most primitive forms up to more complex but still low-tech moonshine stills) will not get you pure enough alcohol to be really effective as an antiseptic. For that, you need a reflux column. (For further information, Google reflex column stills and their use by backyard fuel-alcohol producers.)

Whether this is feasible in your fantasy world (the metallurgy skills, the safety issues) is for you to determine. But once you have that worked out and your healers have access to high-proof alcohol, they can be sterilizing wounds and mixing cocktails at the same time, right? Hopefully the producers didn’t opt for fermenting cheaper stuff like sawdust instead of grain (wood alcohol = methanol = blindness) and hopefully they didn’t build their still out of soft, easy-to-work lead

What about rubbing alcohol? That would be isopropyl alcohol, and it’s a good antiseptic but I haven’t been able to find a way to produce it without industrial chemistry. If you find something, I’d be curious to know.

Terpenes

All of the above — salt, natron, and alcohol — are by no means as effective as modern antibiotics or even the stronger antiseptics like iodine or phenol-based compounds. How you use them in a story is your call, but they are not magic bullets that will realistically bring a character back from death’s door.

If you’re looking for a semi-plausible magic bullet, though: terpenes.

Terpenes are a major component of resin and turpentine (distilled resin) — both important compounds with long, pre-industrial histories. Turpentine itself was used medicinally (and still is, actually) for jobs which included wound-cleansing. (Also de-worming, though I can’t imagine drinking the stuff.) Another natural, low-tech antiseptic containing terpenes is tea tree oil.

Terpenes are compounds synthesized by trees, mostly (some bugs too), particularly conifers (cedar, firs, junipers, etc.). If one wanted a “magic bullet” healing compound in one’s fantasy world, an exotic local tree producing a terpene-packed resin could fit the bill. It can be as scarce and hard to find as the story requires, or common and widely used. Maybe it requires processing — distilling, fermenting, mixing with something else.

 

So: four ways to help your characters survive their adventures without invoking magic, deities, or doing something as nonsensical as boiling wine. (I wrote a little rant that started all this. It seems to have attracted some eyeballs.)

Low-tech Antiseptics, part 1

These posts brought to you by the recurrence of the search term “boiling wine” bringing people to my little rant on the use of same on wounds in GRRM’s A Song of Ice and Fire series.

Magical healing aside, basic sanitation is the one thing that will most increase your characters’ chances of survival when they’re injured. Stitches are helpful. So are herbs. Splints are important for broken bones. But if that cut gets infected, abscesses, and gangrene sets in, all the willow bark tea in the world isn’t going to save you.

In real-world history, the importance of keeping wounds clean was not fully realized until only a few hundred years ago. Why your fantasy world’s physicians know they need to do this is up to you. I’m going to look at how to do it in a world without industrialized chemical analysis and synthesis.

Salt

Gargling saltwater for a sore throat and old recipes for toothpaste made of salt and baking soda (more on that later) work because salt does kill microbes when it’s concentrated enough. This is why pickling and salting work as food preservatives.

Pickled characters

Brine recipes call for anywhere from a half cup to a cup of salt per gallon of water, which would be 3 – 6% salt by volume. Seawater tends to be more like 3 – 4%.

Depending on where your characters are, seawater could be easy to get and a reasonable thing to wash a wound with — if the seawater has been filtered and hopefully boiled as well. It does contain microbes that are acclimated to salty water, after all.

Brine prepared from salt and boiled water is a viable option if your characters have access to economically priced salt. Or maybe it’s a rare and expensive way to treat wounds, reserved only for those who can afford it. Either way, I recommend Mark Kurlansky’s Salt as an excellent overview of salt production over the course of history.

Character jerky

Given a supply of fairly pure salt, why not just pack the wound with salt? Yes, that’s been done in the past. Especially with abscesses, it seems. The packing needs to be changed a few times a day, and after the salt’s done its job the wound will need to be closed by whatever method and given a chance to heal. You don’t actually want to make jerky out of your character.

Sodium bicarbonate

You know it better as baking soda. Combined with salt and a little water, baking soda makes for a nasty-tasting toothpaste but it’ll kill those germs and even bleach your teeth a little.

Naturally occurring bicarbonate is one of several compounds found in natron, which the Egyptians used for cleaning, an antiseptic, and to preserve mummies. Natron is mined from natural deposits, which can be found in a variety of places — not just deserts. Perhaps this would be a viable industry for your fantasy kingdom on top of its medical uses.

Baking soda mouthwash recipes range up to 25% concentration but tend to fall more around a teaspoon per half pint of water which would be… 4%? As with salt above, your healers could use either a brine to wash wounds or pack the wound directly with natron — bearing in mind that we don’t want to mummify the characters just yet. Natron is a drying agent, which means it draws out moisture from the tissues. This makes the tissues less hospitable to bacteria… and life in general.

Stay tuned for the more accurate use of alcohol (not by boiling wine, for crying out loud) and an antiseptic wild card.

Empty your memory trash can? (This action cannot be undone)

PKMzeta is shaping up to be a single, target-able protein in the brain responsible for reconsolidating memories. Discover ran a three part article on it and there was a recent article in Wired, too — the original scientific papers are behind subscription walls, unfortunately.

In brief, reconsolidation is a maintenance process for long-term memories. We think our memories are firm and unchanging, but plenty of studies have proven that they aren’t. They shift a little each time we remember them, each time we reconsolidate them, and over time those shifts add up. (And they’re often inaccurate to begin with, but that’s another issue.)

PKMzeta is a protien that hangs out in the synapses between neurons and maintains a particular ion channel so that the neuron is able to receive signals from the neighbors. Without PKMzeta, the number of those particular ion channels drops and the neuron becomes less sensitive to nearby activity.

Block the PKMzeta when a memory is undergoing reconsolidation and the memory will fade.We already have one drug (propranolol) that does this, and there are sure to be more.

There are tons of questions still to be answered, of course. And there are tons of possible uses and abuses of such a thing. This is such a gold mine of science fiction possibilities that I’m sure I don’t have to list them. But I would like to bring up one.

“This isn’t Eternal Sunshine of a Spotless Mind-style mindwiping” the article in Wired says. That may be true, but it also does not address an excellent question that movie poses (if you haven’t seen it, I recommend it.) The question being: you can remove the memories associated with a bad relationship with a person, but what about the underlying attraction that drew you to that person in the first place? One of the implications I got from that movie was that the two of them were stuck in a cycle of attraction, falling apart and voluntary mind-wipes.

For “person,” above, substitute anything you like. Kittens. Drugs. Street racing. World domination… like I said, a gold mine of possibilities here.

Science Hacks Our Fiction (And The Feeling Is Mutual)

Science fiction loves robots to pieces, but fortunately for genre writers and fans, the feeling is mutual. Engineers and scientists are working near-miracles in the robotics field, and the fruits of their labor are ripe for fiction’s picking. 2012 is still young by most accounts, yet this year robots have already grown tails and scales, acquired aerial speed limits, and learned to swim like a boss. Next they’ll be popping-up in swarms and colonizing our eaves. Or better yet: We’ll wear them on our hands to reduce the repetitive stress injuries we’re causing ourselves by trying to write ever-cleverer new robots into science fiction faster than actual science can render the bots of our dreams obsolete.

Probably the only way we writers can keep up with – or even hope to outpace – the current rate of robotic development is by imagining new purposes and roles for robots. It’s unlikely that scientists and engineers will ever stop endeavoring to simulate humanity and integrate androids into society, as lofty as that goal is. But if real bots must eventually look like and learn like humans, the least we can do is give readers more interesting robots to read about than the one that sweeps floors and amuses cats, or the android in the kitchen with Dinah. We already use droids for offense and defense, manufacturing, and surgery. Robotic search and rescue is a high priority for research and development, and it looks like construction may soon be crawling with bots. So what frontiers does that leave fiction to explore?

Plenty. The world already includes many different kinds of robots with different functions and forms, and the diversity of artificial ‘species’ will only continue to expand (even as natural diversity contracts at an alarming rate). As robots abound, they will inevitably need to interact well with natural species and with each other in order to satisfy human demands. They’ll need to function optimally with a minimum of human guidance, and endure at times in spite of human intervention. Face it: We abuse our tools and hack our toys. Robots need to be resilient just to survive life among humans. There’s enough fodder for stories in those last few sentences alone to keep an author busy for the length of a so-called Golden Age of fiction…

The strange android had stepped from behind an overgrown bougainvillea and disabled their Guardians before they’d even known it was there. “Remain calm, children. I won’t hurt you.” It spoke like a classic film actress, its voice a disarming combination of cultured and flinty that the boys recognized from their seventh grade film history elective but had never heard in person. Read an excerpt from ‘Parent Hack’ by Kay T. Holt

Illness and Medicine: A Google+ worldbuilding hangout report

Note: This article is a report on a live discussion I had with Janet Harriet, Harry Markov, and Glenda Pfeiffer on Google+. Our topic was Illness and medicine.

One of the fundamental underpinnings of any culture of illness and medicine is the idea of cause and effect. The way that we treat people, and the types of medicine we pursue, are based on our understanding of the causes of illness. Thus, when a people believes that illness is caused by evil spirits, the medical approach will typically address this problem directly by providing exorcisms and other spiritual approaches. When a people possesses the idea of germ theory, that fundamentally changes the approach to one of finding medicines to deal with the germs in question. There is also the possibility that medicine may be an empirical/experimental practice, which is to say that a people may have found out through fortuitous circumstance that eating a certain plant will cure headaches, or stop a certain kind of illness. In this case the cause of illness may not be considered particularly relevant. Janet felt that (at least historically) midwives have had an expertise that grows out of this kind of learn-by-experience approach. And Harry mentioned that if you have a magical healing system, the sense of cause might not even be necessary.

On the other hand, a logic of magical healing is necessary. This logic can grow out of the general logic of a magic system, or out of some kind of medically based model, but it needs to feel grounded. I mentioned how I’d worked with Janice Hardy when she was setting up some of the cultural underpinnings of the magical healing system she used in The Healing Wars. In this system, healers are able magically to perceive injury and hurt, and to heal it, but must take the pain of it into their own bodies. Then they have to push the pain out into a magical metal which stores it (and is in short supply). This metal is in turn forged into pain-shooting weapons, creating a pain-based economy. Believe me, this is a fascinating trilogy – but at the start we were looking for answers to questions like these:

Who are physicians?
Why are they chosen as doctors?
What is the role of doctors in the culture?
What are the limitations on doctors?
Is there any alternative to the magical healing system?

In fact, people who use plants and other substances to heal are considered dirty in Janice’s world, and dangerously unreliable…but the system would have seemed incomplete without them.

I believe it was Harry who mentioned that in the Anime series “Bleach” there is a character who can do what looks like healing, but is actually a localized reversal of time that reverts the damage to its previous condition. Harry shared a logistical issue he’s been dealing with in his work in progress, where magic can be used to heal, but at the same time, using magic is a drain on life force. So what happens if you try to heal yourself? It could be complex…

Glenda asked, “How do the magical healers conceptualize healing and illness?” This is an excellent question. Very often we use metaphors to describe illness; this can influence our treatment of it in addition to our general concept of its cause. Magical healers who are aware of physiology will treat people very differently from those who are not. Harry’s system has complex rituals – like recipes – for tissue repair. Thus the healer need not know too much about physiology, only how to follow the rituals, and of course he/she must have the magic ability to activate the process.

It is worth doing research when you’re dealing with illness and medicine in your writing. Don’t just gesture at what is possible. I’ve gone and looked up how to treat bruises, and I’ve looked up the different types of recognized mental illnesses, and a lot of other things as well. It’s also worth considering the scope of what doctors are called on to treat. As Harry noted, homosexuality has sometimes been considered a mental condition that requires “treatment.”

What can you alter in your world? There are lots of underlying parameters that are open to change. For example, who is more important, the doctor or the patient? Who has the power, and why? Can you ask questions about the recommended treatments, such as why and how they are to be delivered? Can you refuse treatment?

It’s important to keep in mind also that doctors are knowledge elites, much like priests. They undergo special training, and have knowledge that must be protected and treated with respect. Often they can engage the services of gatekeepers to help them accomplish this. In the case of a system based on evil spirit possession, the roles of doctor and priest can overlap. Even today, Harry told us, people worry about the “evil eye” in Bulgaria: if people look at you and think you’re pretty they will jinx you and make you feel ill; grandmothers will recommend washing your eyes three times at the door and washing the door handle and then you should be fine. Exorcisms still happen, and mental illness can sometimes be labeled as possession.

The metaphors we use to describe our bodies and our health are very resistant to change over time, and they can deeply affect our behavior. If you’re worldbuilding, this is a wonderful area to spend time developing because tiny phrases will speak volumes about the way your people think. Here are some expressions that the discussion participants shared:

“The hamster that runs my brain fell off.”
“One of your boards is loose.”
“Losing your marbles”
“Not playing with a full deck”
“You’ve let go like liver” (in Bulgaria describes lounging around lazily)
“A seagull has eaten your brain”

I wrote a post some time ago called Body Models and Metaphors, which was about how one decides when to seek medical treatment. Some people base their decision on the amount of time one has been sick, while others base their decision on specific types of changes in the health condition.

Some final things we mentioned were terminal illness and palliative care, medical insurance, and issues of public health and vaccination.

In Japan, very often the person who has a terminal illness will not be told, because it is believed that the knowledge would trouble them unnecessarily. Instead, the family will be told, and the patient simply expected to follow doctor’s orders without any knowledge of the reason. I linked to the article called “How Doctors Die” which is also relevant here, about the cultural conditions that lead us to expend so much money on torturous last-ditch treatments when people are near death. The question of medical insurance comes along with the role of government in public health in the society you’re designing. Does this society have a concept of spreading the risk across the population? How might a government respond to issues of public health when it is responsible for safeguarding public health and sponsoring treatment? In Australia, the government puts out pretty stiff advertising against unhealthful behavior that brings significant expense upon the public health system. One would expect vaccinations to be heavily supported in an environment like that, whereas in the US a lot of people have been convinced by fraudulent argumentation that vaccinations cause autism or other disorders… leading directly to public health problems such as the resurgence of diseases like measles and whooping cough. There can also be questions of whether one group in society is disproportionately affected by one health condition or another – such as Tay-Sachs disease affecting Jewish people, or royal families having a tendency to carry hemophilia. In my Varin world the noble caste is heavily inbred and so everybody has some kind of health difficulties (or if they don’t have them currently, they still might have had difficulties at birth).

Obviously there’s far more than can be covered in one hour, but I hope these thoughts have given you some inspiration.

Traumatic Brain Injury

Last spring, I put out a call on my public journal for topic suggestions. A friend of mine and traumatic brain injury [Wikipedia] (TBI) survivor suggested I explore what TBI [Mayo Clinic] has taught us.

Like many of the topics I’ve written about here, I had much to learn before I could begin. Once I researched TBI [Neurologic Rehabilitation Institute at Brookhaven Hospital], I had difficulty breaking the vast topic [Open Directory] back down into a streamlined piece. I have my former editor, Kay Holt, to thank for some of the links I will be including and also for the flow of the piece. As usual, the links will take you to articles that explore the main and related topics more thoroughly. Please have a look beneath the surface.

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Extending Medical Nanotech

A couple weeks ago, Calvin Johnson wrote an interesting post on nanotechnology, discussing some of the proposals, current research, and ways to write about it in a more realistic manner. One application he didn’t touch on, however, was the current work being done in nanomedicine.

Most current medical nanotech takes the form of either microscopic drug vectors tuned to open for certain wavelengths of light, or particles designed to identify cancers by infiltrating cells or locking onto certain proteins. These particles are largely organic and often designed to mimic the actions of antibodies. All these methods are being touted as ways to combat not only cancer and infections, but have also been used to repair tissue damage following heart transplants.
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