I find this weirdly amazing, as to this day I was reading some medical news and documentaries where it was said that entire human bodies were sliced by millimetre slices. So, somehow I always imagined that each part of body and tissue is 100% known and that only left is to find out what are inner workings on the nano-meter scale, deep molecular levels or genetic level.
We know there's stuff there, but we don't necessarily know what all of it does. In this case the tissue in question was probably thought to be part of a known larger structure, but now it turns out it has a distinct function. Slices aren't going to tell you that.
On top of that, not every one has the same tissues in the same places, or the same tissues at all. Most famous is the palmaris longus muscle in the arm.
Still easy to miss if you don't know what you're looking for, which, by definition, we didn't, because in attentional terms, What You Know Is All There Is.
> I for one would be deeply ashamed if I suddenly found that bytes had a ninth bit we never suspected was there in the first place.
If anything, this shows that biology and medicine are incomprehensibly more complex than computer science, and that their practitioners are true hackers!
The thing with bytes, and everything else pertaining to computing, is that it's wholly invented by humans, so of course it's possible to obtain a complete enough mental image of things like CPUs given enough documentation. Human body, on the other hand, is literally alien technology because humans themselves didn't take any part in engineering it.
Actually, you’d be surprised how plausible it is to diagram the human electrophysiology using electromechanical circuit analogs. Everything in the body signals electrically, and biological matter being piezoelectric has been known (probably not popularly) since the late 60’s.
Indeed, I am finishing up my dissertation applying electrical engineering theory to model cellular evolutionary biology predicated on digital signal processing theory to demonstrate natural selection progressively evolves adaptations with faster sampling rates of environmental radiation for greatest BIBO system stability.
It's not that. Yes it's all electrical and chemical and electrochemical and so on. The problem is not with finding a good visual/logical representation.
You usually don't see connections between different things when you aren't actively looking for them, or when you haven't seen/thought those things to be related in the past. Since CPUs were designed by humans, your logical reasoning would usually work well when reverse engineering one, especially if you know the general ideas of how integrated circuits are constructed and what functional blocks a CPU is made of. Nature, on the other hand, has no logic. Your reasoning doesn't work with natural phenomena, and that's exactly what we're seeing in areas where experimentation and direct observation is hard, infeasible, or impossible.
As a matter of fact, Nature does have logic. It’s motion is principally geometrical and affords us the ability to recursively structure electrical signals harmonically, eg feedback amplification.
Feedback circuits are vital to biological systems and prove my point.
> Feedback circuits are vital to biological systems and prove my point.
Yes they are. Consciousness is a result of an electric feedback loop, and aging is apparently a result of a chemical feedback loop but that wasn't proven completely yet (that's the feedback loop I'd very much like disrupted).
But again, that's not what I'm talking about. You're missing my point entirely. I'm talking about connections that aren't obvious so no one looks for them in the first place and performs no experiments to reveal them. Example: sleep-deprived fruit flies accumulate active oxygen in their gut[1] and eventually die because of it. Is this an obvious connection to look for? Hell no. And there are many more examples of such unexpected and perplexing connections in the inner workings of living things. Nature doesn't always choose the most optimal implementations either. Life is a fascinatingly complex Rube Goldberg machine.
I see what you are saying. Sorry for missing the point. Of course I have to agree that what you describe is the enterprise of scientific discovery altogether! My point on that end is all these “mysteries” in the biological domain are easier to spot with the proper framework. Right now the biological sciences do not emphasize any mathematically rigorous understanding of electricity which is keeping their blinders on. It is intuitive to understand the oxidation reactions, per your example, dielectrically, but the researchers certainly lack the cohesive understanding.
Frankly speaking, how could you judge? I am coming from a biomedical engineering advanced education from a top 10 institution, mind you. And I can tell you the lack of mathematical completeness in medicine is very alarming. It is too pharmacologically driven without a fundamental appreciation of the electrical sciences being applied, well, anywhere in their disciplines.
Well, almost every field that's "lacking mathematical completeness" is generally more complex than those that are not lacking it.
Real life is extremely fuzzy and ill-defined. Almost everything mathematical is a model and models are almost by definition, simpler than the thing they model.
I'd be glad to be proven wrong within my lifetime and have someone come up with the Fundamental Laws of History, for example, fully defined from a mathematical point of view.
I would claim that the mathematical models of the electrical engineering sciences which permit frequency domain convolutions empirically demonstrate “real life” is fuzzy because our sensible perceptions are bandlimited, and not because of Nature herself. We arrive at approximations because things are always in motion!
And I’m in the process of writing a scientific work of human history in an evolutionary biological paradigm, justified by the linear time-invariant mechanics of dipole oscillations which are elemental to all natural phenomena.
Even if Nature were perfectly defined, which it might well be, I'd venture to say, without any proof, of course, that its mathematical definition could still be beyond our current or even future power of comprehension.
Fortunately, it’s mathematical definition, were we to equate a science of Nature with a science of motion, is not. Euler’s Formula characterizes all universal phenomena in time. The important judgment to make is in understanding our observation is an effect of our brain processing, with everything reducible to discrete units of simple harmonic motion, ie quanta, in time.
I'm sure, but in the case of medical practitioners, that arrogance may be borne by confidence rather than ignorance. You certainly need to be confident in your abilities if you're going to take the responsibility of someone's health in your hands.
I don't disagree that they need to be confident in dealing with people's health. In the end arrogance born from confidence is still arrogance and I would argue (understandably unsubstantiated and difficult to quantify) that it is pervasive in the medical community.
Of course it would be embarrassing to discover a ninth bit; humans invented, created, and placed the other 8 bits, along with the entire computing infrastructure around them.
Humans did not invent the human body, so it's not embarrassing to discover something new--it's exciting. That's the whole point of science. Medical researchers certainly know that they still have a ton to learn about the human body.
The point is that these days we're supposedly past finding 'large' physical chunks of the body—given a century's worth of diagnostics, x-rays, MRIs, etc.—and onto much more complicated matters such as how proteins are synthesized in human cells and how gut bacteria affects mental function and the like.
This one is a bit like not realizing the wheels are missing off your car. Right, it ought to have been damn obvious ages ago.
It's more like suddenly realizing there is a spare tire under the carpet in the trunk. Or that 5 is indeed divisible by 2, even though everyone said it wasn't and doctors never bothered to check.
Yeah... and hearing some of those being related to the gut. I’ve been diagnosed with a condition this year without real, solid evidence for cause. Seeing some of the brightest doctors try and write off health matters to alcoholism in non-alcoholics was concerning. After even cursory, high-level reading of what those terms mean elf me to believe it’s the favoured diagnosis when they’re unsure of the diagnosis and hesitate at all costs to give the label “idiopathic” if possible because then it really means “we don’t know”.
There are a number of "bucket" diagnoses that you can get thrown into once other things are ruled out, because there simply is no way to test to confirm that is what they are.
Most mental illnesses, but also physical ones like fibromyalgia and psoriatic arthritis have no definitive test.
The concerning factor for me re: alcoholic diagnosis is that there is typically a baseline for minimum consumption that has been tested and "proven". And that even said baseline isn't necessarily adhered to, and that bucket is used in preference over more accurate, but less resolute, buckets (like idiopathy).
I've been reasonably critical of medicos and medical science in posts to this article, but in all fairness I think this sort of thing happens in almost all professions.
Everything from time constraints to lack of knowledge to incompetence and or a combination of these is often found in most walks of life.
With medicine, we've a terribly complicated field, and like any profession, there is a range of competencies. I recall decades ago knowing a state director of health (the state's top doctor) and he said to me 'if you ever get really sick come to me and I'll put you in contact with the best advice available, as there are too many in this profession that I wouldn't give you a quarter for'.
As I said, this is a problem with all professions, finding the best advice available, can, at times, be a daunting experience.
That sucks. The thing to understand is that the vast majority of doctors don't have the mindset of scientists or even engineers. They're more like plumbers who have to triage/fix 400 houses a day.
I get that. What I find disturbing is that even when some doctors dedicate their lives to study anatomy, we still find a pair of salivary glands nobody has ever documented.
It's not a rare malformation. It's something that's more or less behind each and every human nose on Earth and has been there for thousands of years.
I do seem to recall a very large cohort of programmers (LOCALE=en_us) finding themselves dumped through a rabbithole of wonder which turned the black-and-white scenery of the Land of ASCII to the kaliedoscopic technicolor of Unicode. We did, in fact, discover that there were extra bits on those characters that we had been pretending weren't there all along :)
You assume all bytes are eight bits, but that hasn’t always been the case. Machines with variable byte sizes were relatively common in the 70s and early 80s. This is why so many RFCs use the word octet instead of byte.
Yeah, and I also remember when real parity checking was replaced with a special pseudo parity-pretend chip on many SIM modules. It was so designed to especially fool motherboards into thinking that parity was actually enabled and working when it was not.
Yes, even the memory business had its sleazy carpetbaggers.
There's something to the parent comment, even though it's getting downvoted to oblivion. I'm a computer engineer turned biophysicist, so I've hit up against the "holy shit biology is so much more complicated than I could have imagined" realization. That said, should medical researchers be looking at their processes, incentives, etc. to figure out why such things have been missed, and how to find more "low-hanging fruit"
This is why I invest to earn karma. So it can burn.
> how to find more "low-hanging fruit"
That we still have low hanging fruit (or fruit hiding behind our noses) after so many years of study is a bit concerning.
It's like discovering you can turn the lamp to remove it from the socket instead of keeping your hand still and hiring two people to rotate the ladder.
Why would it be troubling that there is more to learn? There is always more to learn. If you were under the misconception that we knew everything about the human body, then I’m glad you’re now enlightened
It's about expectations. We obviously will never know everything about anything. Some things seem easier to discover than others. This seems like something easy to discover that has long since gone undiscovered.
In this case it's a little like finding someone's house in a town you've never been in before. You expect the town's map to be accurate and to have all relevant streets listed - not having some of them missing.
This report suggests that we do have 'streets' missing. Researchers are now delving into finely nuanced areas of research at a level the equivalent of the house before the preliminaries are resolved - before all streets are found. Bypassing prerequisites always has serious consequences, things go wrong, errors occur, time is wasted, work is duplicated by others, etc. Even patients may die.
I'd suggest that no one yet knows how this will impact research that's already been completed and which now has to be reinvestigated.
Bytes aren't real. Bodies are, and also have people living in them a lot of the time. It shouldn't come as a surprise or a concern, I think, that the imaginary and trivially simple thing is much easier to comprehend than the category of real and vastly complex things.
(Anyway, some obsolete architectures actually did use nine-bit bytes.)
Putting aside your insult to medical researchers, it's not that they couldn't account for 20% of body weight. They knew there was fluid around cells, but the tissue sampling method would not preserve it so they couldn't inspect it. With the new sampling method they could see the structure, and realized these are more like connected spaces filled with fluid rather than small individual pockets.
>Although researchers already knew that there is fluid between individual cells, the idea of a larger, connected interstitium — in which there are fluid-filled spaces within tissues — had been described only vaguely in the literature, Theise said. The new study, he said, expands the concept of the interstitium by showing these structured, fluid-filled spaces within tissues, and is the first to define the interstitium as an organ in and of itself.
I remember the cadaver labs during the school days. Really hard to spot certain (save for the really large organs which are obvious) unless you know what it is you’re looking for. Sometimes an illustration tells you it should be there but the actual structure is... underwhelming or barely visible/damaged from years of specimen abuse. Can see how things like this can be missed.
For some reason this reminds me of the joke: “If the surgeon cuts a vessel and knows the name of that vessel, the situation is serious; if the anaesthetist knows the name of the vessel the situation is irretrievable”
Strangely enough, I find the anesthesiologist sometimes knows the name of the vessels as well as the surgeon, especially for the run of the mill surgeries. Because it usually turns a 20 minute operation to 60-90 minutes (the added time to fix the mistake and find the bleeder, and go to plan B), and they miss their coffee break as a result!
>Dr. Alvand Hassankhani, a radiologist at the University of Pennsylvania, said he was hesitant to label the structures “new organs.” In addition to the three pairs of known large salivary glands, some 1,000 minor salivary glands are sprinkled across the lining of the mouth and throat. They are more petite and tougher to find through imaging or scanning than their heftier cousins. It’s possible that the Dutch researchers just happened upon a better way to image a set of underappreciated minor glands, Dr. Hassankhani said.
"Doctors identify new salivary organ".... maybe? Then I wouldn't have to open their article and I can go on my merry way. Big ups for science, thumbs down for click bait.
Right, it'll be interesting to see if this turns out to be another medical research news beat-up. As I keep repeating, hyped up medical and science stories are very counterproductive, they end up turning people away from science, as they are repeatedly disappointed when the promised 'goods aren't delivered.
Over many decades, we've seen this all too often with news releases about cancer research. It's done great harm.
Preliminary data – based on a retrospective analysis of 723 patients who underwent radiation treatment – seem to support the conclusion radiation delivered to the tubarial glands region results in greater complications for patients afterwards: a result that not only could benefit future oncology, but also seems to strengthen the case that these mysterious, overlooked structures really are salivary glands.
So we already have existing data we can kind of "retrofit" to this new mental model and get meaningful feedback that this new conclusion seems to fit with verifiable experience. That's actually pretty darn cool for a variety of reasons.
And if we do understand it, that doesn't mean a doctor knows about it.
My father was in the hospital for two days with vertigo. He was so frustrated waiting for specialists to show up that he checked himself out.
I was pissed - he's notoriously awful at listening to medical advice. I said, "Did you even wait for them to try the Epley maneuver?"[1] Turns out they didn't even suggest it. I only know about it because my grandmother has it done regularly for her vertigo. And it seems to have solved his problem.
I'm sure it's already in the threads, but that recalls the old joke, "What do you call a medical student with a D average?"
Question for those medical HN ppl:
What is definition of organ?
I mean before when people were doing surgeries and slicing through interstitium, mesentery or different glands, were surgeon thinking "i will just slice through this slimy thing that does not do anything" or there was more thought about it?
Before people were removing on regular bases appendix or tonsil, now understanding about the role has changed... so
How does something becomes an organ after 100 years of modern technology?
Just to clarify I meant would it be possible in future that part of let say heart could become an organ?
Not a medical person, but I think this is much like asking "what's a species?". Nature is clearly clumpy, your body has one heart & two lungs & they have obviously different tissues & purposes. But precisely how many organs, and precisely where you draw the divides, is something we don't have sharp answers to. We adjust as we go along.
> ...the discovery gives us another target to avoid during radiation treatments for patients with cancer, as salivary glands are highly susceptible to damage from the therapy.
> Mysterious Organ Lurking in the Centre of the Head
... The brain?
:P
In all seriousness, this is really cool. It's incredible how we still keep finding out new things about our body. You'd've thought that there wouldn't be much left to find at the macroscopic level, and yet...
I've read a little about the complexity of the gut and it's nervous system connections, but was just thinking of a rough comparison of the two sites.
I mean, if you include the anatomy of brain, the head is conclusively more complicated.
But if you consider the brain, and perhaps the nervous network to be a single, extremely complex part, then I suppose you'd still have to believe the head is the more complicated of the two, because of the eyes, and the array of muscles around the face...
Going up a meta-level, for different types of research/analysis, its also important to ask "when is it important to look at gut/contents of gut as separate" and "when should we use a systems understanding".
My personal opinion is that modern medicine doesn't really like to think about the systems, because it's easier to look at something in isolation. Sometimes this is helpful - simply the problem space and you can simplify the solution - but much of the time it is inappropriate.
In tribal cultures, "medicine men" are both doctors and spiritual leaders. Historically in the Western world, doctors were some of the best educated people in town and some of the wisest people in town and everybody knew each other in a small town. The doctor made house calls with his little black bag.
Now doctors mostly don't make house calls because we use so much tech for diagnostics that you can't carry it with you. Star Trek's Dr. McCoy and his tricorder was modeled on the "little black bag" pattern of medicine and it married the idea of tech to that model and he could diagnose anything with the super advanced gadget in his hand while going to where the patient was. This is not how it has gone in real life.
In the process of making house calls, a doctor casually picked up a lot of information by observation that didn't require him to ask questions. He saw how clean your house was. He saw if you lived alone or with family. Etc.
Medicine has moved to a place where we treat people like specimens in a petri dish and as if their physical health is a separate question from the rest of their life. The reality is these are deeply intertwined and cannot be neatly separated.
The systems we need to be looking at are not just systems within the body but how the systems those bodies exist within impact the human body. And we aren't even really thinking in that direction yet.
It amazes me that we are still discovering new features in our anatomy. I studied biological sciences in undergrad, and studying anatomy was like studying history because almost all of it was discovered by the 1950's.
I’m a little surprised they went to a press release but didn’t say they identified a structure in a cadaver. So, at the moment, this is sort of like a geological feature that’s only ever been seen using a satellite.
"These tubarial glands were seen to exist in the PSMA PET/CT scans of all the 100 patients examined in the study, and physical investigations of two cadavers – one male and one female – also showed the mysterious bilateral structure, revealing macroscopically visible draining duct openings towards the nasopharyngeal wall."
What does that mean? (Zero medical cadaver background, with regard tk the distance of validity between one or the other). Satellites are a lot more powerful (hehe) than our eyes, so my understanding Of your point failed.
Some vestigial structures are missing on some people.
For example the little muscles at the point of the ears (Darwin's tubercle). It has been documented to be present in about 10.5% of the Spanish adult population, 40% of Indian adults, and 58% of Swedish school children.
It's worth noting, for the sake of everyone here in the comments on a tl;dr tanget, that the organ is absolutely not new or 'mysterious' in the least. There are a pair of salivary glands at the back of the nose in a place no-one thought to look at them. They were discovered because they accumulated radioactive glucose, like the other salivary glands, to an extent that was visible when a fairly new and sophisticated scanning technique was used. They revealed macroscopic structure upon examination in two cadavers.
It was probably a joke. You know we're looking for the soul, right? Some say it's a part of the body. If this was the soul this would have made a lot of philosophers unhappy. Unfortunately it's just saliva. Maybe next time.
It seems almost unbelievable that in this day and age we could have missed something like this. In my opinion, it put modern medicine into perspective. I've suspected for some time that medicine is actually closer to the dark ages than we like to think it is, and this report seems like a good validation of that notion.
> medicine is actually closer to the dark ages than we like to think it is
I'm not sure it's entirely on point, but ever since my mother was almost murdered by medical malpractice, and then learning about exactly how bad (frequent and severe) medical malpractice is, it's extremely hard for me to not see it this way.
Somewhere close to 300,000 people die a year from medical malpractice, give or take ~50k! Even adjusting for the elderly and comorbidities the number is still huge. I don't know why I never did, but it keep thinking I need to go buy and read Bruce Schneiers book about outliers[1]... it seems crazy how much we ignore much more concrete and repeated issues that cause death and love to focus on outliers that will probably never happen to us.
This common factoid isn't actually true. The real number is almost certainly less than 10,000 people even with a generous definition, and probably closer to a few hundred annually.
> (1) [Adverse Effects of Medical Treatment] are not uncommon; (2) the vast majority of AEMTs that occur in patients who die aren’t the primary cause of death; (3) only a relatively small fraction of AEMTs are due to misadventure or medical error; and (4) population-adjusted AEMT rates have been slowly decreasing
Well thank you for giving me a different view, now I'm going to have to dig deeper on this. I would say at first glance I already see some methodological cracks, but thanks for the rabbit hole anyway.
Agreed, though it also makes me think of the numerous cases of drugs developed with a specific purpose, but then afterwards found to have a completely different effect to what was originally intended.
Medical science is an incredible thing, but science, by definition, does not have all the answers.
A small part of me is actually somewhat surprised, that people (both lay, and professional) are surprised.
Though I am not the best placed commentator to champion this view.
> drugs developed with a specific purpose, but then afterwards found to have a completely different effect to what was originally intended
I don't find that surprising. You have to do the early phases of drug development in model systems like cell cultures for practical reasons: It makes evidence obtained more reproducible and has less ethical concerns than experimenting on humans immediately. It's like how software components usually get implemented and tested in simplified environments (e.g. unit tests use doubles), and just like with drugs, sometimes we find that software components interact with each other in unexpected ways when combined into a whole.
What seems weird about this is that the process for deciding that an approved drug is useful for a certain condition (not the one it was intended for) is really informal, it seems to rely on common knowledge circulating in the guild.
For the initial approval, we have this very formal process, the FDA wants this kind of data from trials of this size to show this statistical level, etc. All very scientific-looking.
But once it's on the market, random doctors try it out for other conditions. If it seems to work they tell their buddies, tweak the mixtures, share anecdotes. If it becomes widespread, some industry club records this for the purpose of arguing with insurance companies. I am told this off-label use now constitutes the majority of drug prescriptions. All based on (as far as I can tell) no statistically driven testing at all, just stories.
(To be clear, I'm not at all surprised that drugs have "off-target" effects, and may be very useful for things their inventor never imagines. I'm just a bit shocked how pre-modern our system for collecting this knowledge appears to be. But not an expert, and would love to know more.)
> I'm just a bit shocked how pre-modern our system for collecting this knowledge appears to be.
I'm not an expert, but I imagine any more advanced system would be extremely problematic from a data protection point of view (think HIPAA etc.). In a study, patients sign multiple pages of legalese to allow the researchers to collect all the required data. You don't have that with regular patients in a GP's office.
Yes that's a hurdle. But even without that, it seems hard to design a good system. If most of the doctors treat the very sick cases (among those diagnosed with X) with drugs Y+Z currently rumoured to work, how do you disentangle the causes of their poor outcomes?
More generally, how do we know it isn't mostly garbage? That seems to be the consensus about most pre-20th-C medicine, and those guys weren't idiots, they were just trying things out and sharing ideas...
Medical research is devoted to diseases, particularly where there's confidence something can be done about it. It's easy to imagine science being weak on something if it doesn't cause life-threatening problems.
There are many people who espouse a bright and endless increase of medical power, combined with a utopia-lite for our current state of medical knowledge.
There is a lot in the dark and we should not hesistate to point it out. It would be a lie to paper over the cracks with yet another affirmation about it all being figured out and we can go back to sleep.
Honestly, I think cytotoxic chemotherapy will be more shocking. Radiation oncology has made great strides in targeting the dose (cyberknife and other stereotactic approaches). Cytotoxic therapy is still basically poisoning everything and hoping the cancer dies first.
Or, in the case of cancers like multiple myeloma, killing all immune cells and replacing the stem cells.
The future of cancer therapy is likely to be heavily reliant on customization and precise drug delivery, to give an overwhelming dose of poison to the cancer without harming the patient.
Yes there are some diseases that can be treated very reliably but a large share of commonly occurring issues can't. Also given that modern medicine is largely based on statistics, I have doubts that the sophistication of statistics in use is really appropriate. I think Physics or Psychology do a lot better in that regard. That said, I think many diseases can be treated or prevented with a high success rate without any invasive procedure. For instance the risk of coronary heart disease can be lowered a lot with good diet and mild exercise. It surprises me that doctors never pro-actively mention how to prevent such lifestyle diseases until it's too late. Probably the subject of medicine needs to be broadened a bit.
> I've suspected for some time that medicine is actually closer to the dark ages than we like to think it is
What does that even mean?
Nobody's claiming that modern medicine is anywhere close to perfect but the "dark ages" medicine was Humorism, blood letting and faith healing. Surgeons didn't start washing their hands before childbirth until the 19th century. It's really weird to look back at the mind-boggling progress we achieved in the past 200 years and conclude "we're basically still in the dark ages!"
In this scenario it seems like what you're saying and what your parent said are both true (it is true both that medicine is much closer to the dark ages than we'd like to think, and also that we know a great deal more than we knew in the dark ages).
I'm reminded of the scene in Mad Men where Roger says something to the effect of "I did everything they said for my ulcer, I drank the buttermilk. and now I have a coronary!"
Also, in the book "The King of Hearts" which describes the history of open heart surgery, the first open heart surgeries were done by sewing the circulatory system of two people together (usually mother and child). that was in the recent past.
You might find the book The Butchering Art: Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine interesting. Crazy to think that the training to become a surgeon led to a lot of people dying from cutting into infected cadavers during training.
I didn't read the book, but the Joe Rogan interview with the author was a favorite episode. She was the right mix of smart, enthusiastic, craz.... eccentric.
We have advanced incredibly far in both treatment of CAD and ulcers. And in CAD, still making tremendous improvements within the last ten years. You don’t really know what you’re talking about at all, citing a TV show.
Ha, the show was making a joke and it was relevant.
The point I was making was that in our short lifetimes common medical practices have change directions 180 degrees. The guy who drank h pylori was in our lifetime.
I wonder what common problems and solutions we have today will be changed in the coming 30 years? Maybe there will be a cancer or fat pill and we can eat what we want. Maybe sugar will be banned. Maybe longevity might be conquered? Maybe covid-19 will be viewed like the black plague, which is well understood now.
I could think of other examples. I mean, we know for sure that electrical motors are not going to be hugely more efficient, because then they will break conservation of energy and bunch of other laws of physics. So, by that measure we are not in dark ages
Life would be pretty boring if it were different don't you think? If almost everything were already figured out after just a few centuries of the scientific method and we wouldn't expect any substantial improvements to be made ever.
No, one's life would not be boring because of that. There's a difference between things being known to sience and _you_ knowing those things. Even now, you can live your full lifespan without getting bored just learning in depth what is already known to science.
I have to agree with this. Before I have to exhaust all the medical resources, in my mind, when people get sick, they go see a doctor, the doctor prescribes medicine, and medicine fixes problems. But in reality we're still largely relying on our own defense, e.g. COVID. We rarely have a drug that directly fixes our problem.
I started having really bad insomnia more than a year ago. I went to see a bunch of doctors. Initially, I was given low dosage sleeping pills, which didn't help much. I went to a hospital to get a CT scan because I was having mad headaches, which my family doctor wouldn't refer me. The scan was normal. Finally, I found a doctor who's willing to refer me MRI scan. After waiting for couple of months, the result didn't turn up anything again. Keep in mind I've been suffering 2 - 3 hours sleep a day all these time. I also did sleep study, and sleep study mostly care about sleep apnea, so they couldn't identify any causes again. Then I went to see a psychiatrist, more sleeping pills, which are really antidepressants. Eventually, after a long wait, I was referred to a neurologist and sleep specialist. I've done so much research on sleep medicine at this point, I already knew what he's gonna prescribe me - sleep restriction therapy. That didn't really help altho I gave up after trying for two weeks. I intend to try it again but I can't attempt it now that I'm back to work. So one year later, I'm still messed up with no known cause.
I know insomnia in my case is not a traditional disease, but it goes to show you that if you're not having one of the common diseases then you're shit out of luck.
The human body's extremely complex, but instead of using proper debugging tools, doctors are mostly relying on "console logs" or "print statements". Even if a root cause is identified, often time we don't have the necessary tools to fix the problems.
I'd say "medical knowledge" is too broad of a term to define a finite full spectrum in reasonable terms, as it effectively includes every possible interaction of each part of the human body with every type of physical or chemical condition. More reasonable would be to talk about "anatomical knowledge", which is finitely bound to understanding the expected structure/distribution, function of and communication between each part of the human body to a sub-cell level. We're most of the way there on the first facet, but our models of the latter two are still hilariously incomplete at this point.
Chuck Klosterman's book "But What If We're Wrong: Thinking About the Present As If It Were the Past" examines this phenomenon, and while its difficult to make predictions (that's one of the takeaways) it's a terrific lens to look at both the present and the past.
(One of my favorite chapters is imagining 1000 years into the future, where rock and roll is basically only remembered for one artist, who might that be? And why it won't be Elvis or the Beatles.)
Along these lines I've heard it said that "Doctors don't heal anyone. The get them to the point where their bodies can heal themselves." Sure, there are some exceptions where the body literally can't heal itself, like reattaching something, but the sentiment holds true most of the time.
In another discussion bred from boredom where some friends and I were trying to define entire fields of study in a single sentence (Economics is the allocation of scarcity) one doctor said, "Medicine is about controlling swelling." His response (he was a surgeon) kind of made your point that we imagine that doctors are fixing things and he is saying that he spent most of his time trying to get the body to make it better and not worse.
Since that axis really cannot be constructed, I think a better way to present your sentiment is the following:
Is it possible that we still miss a large discovery in medicine, akin to the introduction of evidence-based treatment, hygiene, inoculations or the discovery of DNA?
Absolutely, without question. Dozens, maybe hundreds of things that big.
The arrogant assumption of an infinite wisdom of the present is one of the strongest there is.
Ptolemaic astronomy looked right until Galileo came along. It matched observational measurements, just with an unhelpful set of assumptions. We're Ptolemy on countless things whose Galileos haven't been born yet.
It's unsettling to think we're all stupid in ways we'll never know, I know. Sorry about that.
Yes, we've made some great leaps and they shouldn't be discounted, but neural-science is still in its infancy. We still don't know the exact mechanism of action of many commonly prescribed psychoactive medications. We know they work because, unlike in the past, we conduct rigorous studies, but we can only theorise as to why the work and why they don't have the same effect in all patients. This has real implications for how medicine is practiced, which will undoubtedly make our methods look quite primitive to future generations. For instance, physiatrists are still forced into a 'trial and error' approach when finding the correct antidepressant and dosage for each patient.
I feel the placebo effect characterizes the true power of the mind, of which we’ve only scratched the surface. I think the newfound interest in researching psychedelics also shows some real promise in understanding consciousness.
I think we know their mechanism of action, but the grim reality is that they don't work that well at low doses, plus there are a lot of side effects even at low doses. (Because their mechanism is so general. Inhibit this, promote that. But those are all over our body. Plus eventually there are tolerance issues - so doctors switch from time to time. But then they have to fiddle with the dose.)
You would be quite wrong. We do know some bits about the effects of serotonin in the body, though I would be amazed if we really understood the whole story.
But more than that, we have no idea what depression actually is, and that goes for any other psychiatric disease unrelated to direct brain damage. It would probably be more correct to call these syndromes rather than diseases, as we do not know the mechanisms causing the disease enough to even be sure if 'depression' is a meaningful diagnosis (in the sense that coughing is not a diagnosis).
We also don't have proper neurological studies of emotional illnesses - there are basically no comparative neurological studies of people diagnosed with depression versus people showing similar symptoms who are expected to quickly recover (for example, people grieving for a lost one). We don't know whether the brain chemistry changes we see in depression are the cause of the disease, or just the way 'sadness'/'lack of motivation' looks like neuro-chemically.
I think we're in agreement, but perhaps I wasn't precise enough in my phrasing.
I mean we know what they do chemically, but as you said we have no idea what serotonin does. (Which is not true, but it's so complicated that what we know just makes us exhausted thinking about how truly complicated it is.)
> We don't know whether the brain chemistry changes we see in depression are the cause of the disease, or just the way 'sadness'/'lack of motivation' looks like neuro-chemically.
Indeed. Though it's always both. And probably asking whether we could, let's say take a pill every day as prevention seems unfathomable, because so far - again, just as you said - we don't really know what is depression. It's basically too much of feeling down. Feeling down when you shouldn't really be feeling that down, at least somehow "compared" to other people. So it's hard to know when prevention should start and when it's just normal case of the mondays.
However, just as with the nurture-nature conundrum it seems natural to treat it as one thing very tightly coupled with the other. Which makes it likely that any kind of treatment and understanding has to always handle both in a lockstep. (Even if there are a lot of subgroups, some are more susceptible on the chemistry side, some more on the cognitive side, some are simply resilient enough to deal with it with some light touch counseling, some got a very bad ticket in life and need a whole support network to keep the darkness at bay, etc.)
You don't have to look far in health policy to see the lunacy of modern medicine.
Using nuclear radiation to "cure" cancer. Giving patients highly addictive narcotics for pain relief. Giving patients broad-spectrum antibiotics. And don't get me started on the insanity of current events, with mass over-use of disinfectants, conflicting and dubious public health guidelines (Covid 19 spreads 3M in Europe but only 6ft. in the USA, N95 masks don't prevent infection but surgical masks work great, viruses don't spread while sitting but spread while standing in a restaurant). Dark ages? No. But I can see the parallels.
How do you decide to attribute something to "modern medicine" versus "The Game of Telephone, Medical Style"?
For example,
>Giving patients highly addictive narcotics for pain relief.
Is the opioid epidemic modern medicine's fault? Or is it more the fault of doctors who over-prescribe coupled with the lack of a sane healthcare system?
Also, are there viable (read: equally effective) alternatives to opioids for pain relief?
>Giving patients broad-spectrum antibiotics
Is the rise of antibiotic-resistant bacteria modern medicine's fault? Or is it more the fault of patients who do not finish out their full regimen?
And again, are there viable alternatives to broad-spectrum antibiotics?
>Covid 19 spreads 3M in Europe but only 6ft. in the USA
Distancing guidelines were meant to provide a general reference point, not magical thresholds at which COVID is incapable of passing over... They're going for a distance that is easily visualized, is situated well up on the "diminishing returns" curve, and (when combined with other measures like wearing a mask) provides an "acceptable" risk of exposure.
Sneezing, for one example, will throw respiratory droplets much further than the recommendation for social distancing.
>N95 masks don't prevent infection but surgical masks work great
I'd like to see a source for this claim if you don't mind, as a quick perusal of the FDA[0] and CDC[1][2] do not show this statement anywhere. Everything I've found states they're fairly equally effective. Everything I've found also says that N95 and surgical masks are not recommended for use outside a profession which requires them:
Q: Should I purchase personal protective equipment such as facemasks or N95 respirators for me and my family?
A: No. Surgical masks and N95s need to be reserved for use by health care workers, first responders, and other frontline workers whose jobs put them at much greater risk of acquiring COVID-19. The cloth face coverings recommended by CDC are not surgical masks or N95 respirators. Surgical masks and N95s are critical supplies that must continue to be reserved for health care workers and other medical first responders, as recommended by CDC.
--
CDC does not recommend using masks for source control if they have an exhalation valve or vent.
Masks are not surgical masks or respirators. Currently, those are critical supplies that should continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance. Masks also are not appropriate substitutes for them in workplaces where surgical masks or respirators are recommended or required and available.
--
CDC also links to a study[3] that found "Surgical and N95 masks were equally effective in preventing the spread of PCR-detectable influenza". There are plenty of related studies which come to the same conclusion.
>viruses don't spread while sitting but spread while standing in a restaurant
Again, how is this a "modern medicine" issue, or a "conflicting and dubious public health guideline"? They're not saying "the virus won't spread as long as you're sitting down!", they're saying "if you fucks have to go out, at least try to stay apart for everyone else's sake".
If by modern medicine you mean only "the best conclusions derived from the best meta-analyses based on the best evidence" then very little of what any doctor does is grounded in that.
I wouldn't call that medicine. I'd call that, maybe, "research biomedical science".
I think OP's comment is precisely that the practice of medicine has very little to do with what top-quality research would prescribe, and is more like medieval reasoning (like causes like, etc.).
Of course the reason behind this is that we dont have much top-quality research; and what "research" we often have is poorly executed and ambiguous (if honest).
What we "need" is 10k "disposable humans" manufactured on-demand, for 100k RCT experiments. What we have is often much closer to astrology.
Thank you for the more thorough take on that perspective.
Yes, there are "parallels to the Dark Ages" in the sense that "medical practitioners prescribe treatment based on the best information available at the time".
That doesn't mean medical knowledge, practice, research, and equipment has been stagnant or that medical practitioners should not be trusted with their advice.
Statements like "the lunacy of modern medicine" are not truthful and not productive, especially when the minimal supporting evidence for the statements are misleading at best.
Leaches produce enzyme that prevents blood cloth from forming. It also improves oxygenation. For some wounds, leaches would protect leg or arm from amputation.
Leaching is a process in which you percolate a liquid (like water) through something, and it picks up chemicals and carries them out. Brewing coffee, for instance.
Right but only because we know the mechanism of action and it's efficacy. It's also performed in a different manner to blood letting as a historical treatment.
Humorism probably produced observable benefits just by encouraging people to eat a balanced diet. Its basic notion that you have different things in your body that need to be balanced is not wrong.
On the other hand, just keeping to the observation, we can at least say that countless pathologists and others over a very long period have failed to identify this anatomical entity. In the main it seems that experts see what they expect to see and if it's not in the anatomy book then it doesn't exist. That's not necessarily perjorative. It's how we humans tend to be when observing the world (including ourselves) around us.
For one thing, it feels like we're still very much not confident with anything at all because everything has to be tested in real humans, in real time, before it's considered a valid treatment (clinical trials). I understand why clinical trials are needed — because otherwise we'd still be using mysterious compounds and procedures without having a clue if they actually work — but I believe that at some point we'd become so advanced with knowing how the human body works that we won't have to do that, and so could progress much, much faster, while knowing that our treatments work, and theoretically, instead of experimentally, proving that they should work.
I think you're being a little mean to the dark ages.
Galen was a pretty accomplished medical researcher, and Roman-era medical implements were quite sophisticated, and were well-established by the time of the dark ages. By the late dark ages, we also saw a lot of modern medical techniques coming in from the Middle East.
There's this stereotype of people being filthy, ignorant, and dumb, but it's not really true. And for many of the bad practices from then do persist in poorer parts of the world today affecting likely around a billion people (and some, like homeopathy, even in wealthy parts).
Note that I'm not weighing in on the overall debate about where modern medicine is relative to the dark ages. We've made a lot of progress. I'm just refuting the stereotype of the dark ages.
> Galen was a pretty accomplished medical researcher, and Roman-era medical implements were quite sophisticated, and were well-established by the time of the dark ages.
Were those implements actually practiced throughout the dark ages or did they go the way of the Roman road networks?
When people talk of the dark ages they're usually talking of post-Roman Western Europe rather than Asia or the Middle East. I'm not sure if a Bohemian peasant living in 1000 AD would've benefited much from Islamic medicine advancements.
Wikipedia defines the Dark Ages as lasting through the 15th century, by which point, Islamic medical advancements would have made it into Europe. Obviously, in 500AD, they didn't yet exist.
One of the reason for the decline of the term "dark ages" is that there is increasing evidence that people in this period didn't actually crawl under a rock of ignorance. Large-scale armies and infrastructure projects were gone, but at the same time, a lot more knowledge persisted than is given credit for -- the sorts of things which don't require a massive Roman central government administration to maintain.
Right, I used it as an all-embracing term for 'very old', I'm surprised many have taken the term so literally. Perhaps it's characteristic of HN's audience.
"One of the reason for the decline of the term "dark ages" is that there is increasing evidence that people in this period didn't actually crawl under a rock of ignorance."
Despite my use of 'Dark Ages', I cannot agree with you more. Perhaps you might like to look at this image of a shoulder-clasp from Britain's Sutton Hoo Hoard (it's one of many). Considering both its age and the time in which it was created (and the limited tool available then), to me, this is one of the most remarkable and beautiful objects I've ever seen. It sends shivers down my back when I think of the sheer talent that created it. We are so lucky it's survived essentially intact across the last one and half millennia:
Chemotherapy will definitely be on that list, as when you ultimately boil it down you are posioning someone just enough where the tumor dies before the rest of their body also dies.
You should have to because the original comment was seeping in dramatic hyperbole to fish for points. At the end of the day, I'd much rather live with modern medicine than dark age medicine.
BTW, have you ever thought about the fact that cancer deaths are still very prevalent despite all the hyperbole from thousands of researchers say since 1950—yes, hyperbole deliberately spruced up to attract funding and to gain newspaper headlines.
The facts are straightforward: had 0.1% of the promises about improvements in cancer treatments that have appeared in the many tens of thousands of professional research papers on the subject over the past 70 yeas had actually come to fruition, then the disease would have all but been eliminated by now.
You might say this was justified but it's turned out that this type of hyperbole is not befitting of science, and that it's been largely responsible for the enormous drop in the public's approval rating for science over this time. (I'm not saying it's only cancer researchers (although they top the list), essentially it's all researchers these days.)
Don't say this isn't true, do your research. In the 1950s almost everyone believed in and accepted science—even though this was the time of the A-Bomb and bomb development, back then, people could still differentiate science per se* from the bad applications of science.
Now, 60 or 70 years later, I know scientists who, when, say, they go to a party, will disguise their real professions, so bad is Science's PR. (I'm even in that league but I'm less sensitive about it than some.)
Anyway, I'd suggest to you that in comparison with these professionals, my hyperbole pails into insignificance.
Ha, so you reckon my hyperbole is dramatic and done only to fish for points. That implies you actually think about such matters and consider points important (most of my posts never make it even to two). Franky, these post would altogether be much better of without them. For the record, your assertion isn't true (not that I expect you to believe what I've said).
It's quite unnecessary to call people names, and also unwise, people might be tempted to mentally substitute the second person pronoun with a first person one.
"Because no one is looking for tissue that secretes saliva (not very interesting medically), coupled with the fact that this requires special PET/CT to find. You are a buffoon."
et2o: yes—a buffoon—that's very likely true, but at least I admit it!
However, you medicos have a damn lot to answer for. Where would you like me to start? Perhaps with the thalidomide fiasco, or more recently the abysmal lack of preparation for COVID-19 even though we knew it was coming decades ago, or the current opioid epidemic, the policies of which were sorted out nearly a century ago with both government regulation and tightly controlled international treaties, all of which have recently been [conveniently] forgotten by the pharmaceutical industry, the FDA, along with a disreputable mob of doctors who disbanded their Hippocratic Oaths for a few shekels from mafia-like Purdue. Right, the law should bring them all to account.
Perhaps the most tragic aspect of the opioid crisis is that the thousands of 'good' doctors stood knowingly by and effectively did nothing, seemingly ethics flew out the window. In words loosely attributed to Edmund Burke: "The only thing necessary for the triumph of evil is for good men to do nothing".
"(not very interesting medically)"
Whilst many areas of medical science have done wonders, in others research has been almost non-existent. You're right, certain diseases/subjects are not interesting or boring and concomitantly that they fail to attract funding is a problem, and it's always been that way. In this regard, the trouble is (and has always been) that the self-governing medical profession has never been able to prioritize patients above their own interests, not to mention money. In essence, medical researchers do not exercise granularity evenly over the field of medical knowledge (as you implied yourself); and that's aided and abetted by large pharma, et al whose principal interest is money, not medicine.
But in 2018 there was a similar news about Interstitium: https://www.livescience.com/62128-interstitium-organ.html
In 2017 there was mesentery: https://www.livescience.com/57370-mesentery-new-organ-identi...
Now we have this. So, reading this left me with one though "hidden in plain sight" and wondering what else is there.