Looking back on it, human health would have materially improved if every physician and surgeon in 1800 had walked behind a horse and vanished. The next question is how that would have influenced health in later years, say in 1900. Medical traditions would have been interrupted, and presumably other people would have drifted into the medical niche. If those vanished medicos had been replaced by astronomers and physicists, progress would likely have been faster – since they were practitioners of the scientific method, which was not often the case for physicians.
What disciplines today would benefit from firing everyone and starting over?
The disability-adjusted life year (DALY) is a measure of overall disease burden – the number of years lost. I’m wondering just much harm premodern medicine did, per doctor. How many healthy years of life did a typical doctor destroy (net) in past times?
Consider Semmelweis. Between 1839 and 1847, the First Clinic at the Vienna General Hospital had 20,204 births and 1,989 maternal deaths. The Second Clinic, attended by midwives, had 17,791 birth and 691 maternal deaths. An MD’s care conferred an extra 6% chance of death. Births at home were even safer, with maternal mortality averaging about 0.5%
In that period, MDs caused about 1200 extra deaths. Today ob-gyns deliver about 12-15 babies per month; assuming that caseloads were similar back then, there would have been something like 14 doctors working there ( a very rough guess: 2500 births a year, 180 births per doctor). So each MD was responsible for something like 85 extra deaths over that period. Since some were students, who surely didn’t spend the whole 8 years there, probably the per-doctor fatality rate was less that that. Maybe only 50 deaths per doc. Of course a doctor’s career was longer than 8 years…
Assuming 30 years of life lost per mom, 1500 DALYs per Victorian ob-gyn sounds like a minimum.
Ob-Gyn was especially bad, but most doctors, over most of history, must have had significantly negative effects. We know that wounded men in the Civil War had a better chance of surviving when they managed to hide from Army surgeons. Think how many people succumbed to bloodletting, over the centuries.
It looks as if the average doctor (in Western medicine) killed a bunch of people over his career ( when contrasted with doing nothing). In the Charles Manson class.
Eventually the market saw through this illusion. Only took a couple of thousand years.
Luzia woman is an 11,500-year-old funny-looking skeleton found in a cave in Brazil. According to Wiki, “Her facial features include a narrow, oval cranium, projecting face and pronounced chin, strikingly dissimilar to most Native Americans and their indigenous Siberian forebears. Anthropologists have variously described Luzia’s features as resembling those of Negroids, Indigenous Australians, Melanesians and the Negritos of Southeast Asia. Walter Neves, an anthropologist at the University of São Paulo, suggests that Luzia’s features most strongly resemble those of Australian Aboriginal peoples.
There are a large number (81) of similar skeletons at this site, ranging from around 11,500 to 7,000 years old.
from the PNAS article: “The results obtained from all multivariate analyses confirm a close morphological affinity between SouthAmerican Paleoindians and extant Australo-Melanesians groups, supporting the hypothesis that two distinct biological populations could have colonized the New World in the Pleistocene/Holocene transition.”
This is right in the area where we find the pseudo-Andamanese, Australo-Melanesian genetic signal.
If those skeletons really do look like Australo-Melanesians, it’s not because they carry a 2% admixture. They would have to be mostly Australo-Melanesian. Which means that they got there first.
Since there are so many skeletons of this kind, there should a fair chance that at least one will have useable DNA, particularly since we’re getting better aDNA recovery.
I wonder if this isn’t already underway.
Every society selects for something: generally it looks as if the direction of selection pressure is more or less an accident. Although nations and empires in the past could have decided to select men for bravery or intelligence, there’s not much sign that anyone actually did this. I mean, they would have known how, if they’d wanted to, just as they knew how to select for destriers, coursers, and palfreys. It was still possible to know such things in the Middle Ages, because Harvard did not yet exist.
A rising empire needs quality human capital, which implies that at minimum that budding imperial society must not have been strongly dysgenic. At least not in the beginning. But winning changes many things, possibly including selective pressures. Imagine an empire with substantial urbanization, one in which talented guys routinely ended up living in cities – cities that were demographic sinks. That might change things. Or try to imagine an empire in which survival challenges were greatly reduced, at least for elites, so that people had nothing to keep their minds off their minds and up worshiping Magna Mater. Imagine that an empire conquered a rival with interesting local pathogens and brought some of them home. Or one that used up a lot of its manpower conquering less-talented subjects and then importing masses of those losers into the imperial heartland.
If any of those scenarios occurred, they might eventually result in imperial decline – decline due to decreased biological capital.
Right now this is speculation. If we knew enough about the GWAS hits for intelligence, and had enough ancient DNA, we might be able to observe that rise and fall, just as we see dysgenic trends in contemporary populations. But that won’t happen for a long time. Say, a year.
IN a recent conversation, Steven Pinker suggests that some students become radicalized when they find that there truths that are unsayable on campus. He gave some examples.
!. Capitalism is just plain better than communism
2. Men and women do not have identical life priorities, tastes and interests, or exactly the same sexuality.
3. Different ethnic groups have different crime rates
4. The great majority of suicidal terrorists are Islamic.
Seems to that this is an incomplete list. I call for suggestions from the audience: more such truths, more details, etc. With a little work we’ll provide one-stop shopping.
When the Amerindians got past the glaciers, it was as if they had died and gone to heaven. They’d lived in Beringia for thousands of years, so obviously it was possible to make a living there, but it was a harsh and unforgiving environment. Things were way better south of the ice: more game, game that had never seen humans, never co-evolved with humans, had no hereditary fear of humans. Likely a brave could close to atlatl range of a giant ground sloth without any reaction.
On the other hand… there were a lot of predators around, and they didn’t have any baked-in fear of humans either. Dire wolves, sabertooth tigers, scimitar cats, the American lion, short-faced-bears. Today, big predators in Africa and Eurasia know in their genes that Man is dangerous. In America, they probably thought that he was the weakest and most defenseless of all living things, and acted according. The life of those early Amerinds was thus full of interest.