Most fans of modern medicine do not realize how similar in appearance was ancient medicine: While the Greeks left a vast legacy of medical texts in a familiar language, we know of only 12 from the time of the pharaohs – written on papyrus in a vanished language that scholars are still grappling with. From their descriptions of diseases and treatments, the texts have left little doubt that the ancient Egyptians had considerable medical skills, but weighing up their pharmaceutical knowledge has proved trickier: although the papyri include some 2000 prescriptions, doubts surround the identity of many of the ingredients listed. ….
Even most physicians have little concept of marginal benefit and "number needed to treat" when considering an intervention. It was stated above "survive a heart attck"...So lets look at the numbers. Angiography and thrombolysis for MI were big interventions developed in the 1990's. Both saved about 2 lives/1000 when compared with "standard treatment"(O2, meds, hospitalization). So, is that the marginal benefit you expect for this level of intervention? This cost? When I share this well-done data with physicians they are mute. I(an MD) would still recommend the intervention, but awareness of our limited marginal benefit is critical for good advice, care...I'm not sure it's how I'd want to spend my last $100K.Most increases in longevity in human populations can be attributed to public health measures(water, sewer, dwellings). Most of modern medicine is heroism...
I see a few comments pointing out some of the ways that modern medicine is clearly much better than ancient Egyptian medicine, but everyone else seems to be blowing them off.
Think of it this way: If modern medicine has an effective treatment for something that ancient Egypt had no treatment for, where does that show up in the percentages quoted above?
It doesn't.
The percentages are all percentages of ancient treatments, not modern ones. If the figure were 100%, it would mean that we kept their treatments, or some equivalent, and went on to develop new treatments for other things.
Considering our bodies haven't really changed, improving on 36% of what was already shown to work isn't bad -- but the real improvement is all the additional things we can treat.
When I googled define:bias, I got the following definition:
"A bias is a prejudice in a general or specific sense..."
Now I look at your statement:
"As long as he was arrogant, wore a white coat, put his drugs in capsules, and spoke the local language, I doubt most people today could tell the difference if they were treated by an ancient Egyptian doctor."
So if you're saying he would have to be arrogant in order for most people to be unable to tell the difference, aren't you implying that most doctors are arrogant? Isn't that a bias? Isn't this blog called "overcoming bias"?
Now I look up arrogant in the OED:
"... aggressively assertive or presumptuous..."
Now for a definition of presumption:
"the act of presuming a thing to be true"
So unless you've somehow reliably ascertained that most doctors are arrogant, you're being presumtpuous, that is, arrogant..
So you're being biased on a blog called 'overcoming bias', by arrogantly calling doctors arrogant...I'll leave you with one last definition:
hypocrisy: "the assumption or postulation of moral standards to which one's own behaviour does not conform"
so the modern medicine undoes natural selection? It would be interesting to ponder on the consequences. I know I avoided being voted off this island due to the ulcerative colitis. Bleeding to death ain't fun.
I feel that I have definitely gotten my money's worth from Western medicine. Why? Because I'm still alive. If I lived 2,000 years ago I would be dead now (type I diabetes). So would: my mother and my brother (major childbirth complications), one aunt (like 10 different things), an uncle (alcohol withdrawl resulting in grand mall siezures). My grandmother would have died earlier from skin cancer, and her sister from complications of type II diabetes. My dad had the Hepatitis that can be cured - not sure if that's lethal if untreated. And I'm sure I'm forgetting stuff.
Think about it - how many people you know would be dead by now without the modern western medicine you pretend to have so much disdain for? And how many of these things would have been fixable in ancient Egypt? If you pray, give thanks every night for not living 2,000 years ago.
The attack on modern medicine is not a claim that it's the same, it's a claim that, at the margin, the difference is a lot less than we're paying for.
If an ancient Egyptian doctor came to our time an took a high school class to learn about sanitation, he could do many functions (though obviously not all) as well as a modern doctor with a twenty-five year long education. This supports the claim is that doctors do a lot of work where they do not provide much added value given their expense.
As such, the claims about vaccinations and antibiotics are not terribly relevant. These do not encompass a large portion of our medical expenditures (to my knowledge). Hanson's point seems to be that doctors are overpaid or we use doctors for work that does not require their expertise, and that a lot of the advances in medicine have been fairly simple and inexpensive and should not translate into our current costs. This post certainly supports that.
Though "Someone drilled a hole in someone else's skull, and he didn't die for at least a few months" doesn't really count as brain surgery. And the motivation was probably to let out demons or evil spirits or some such, so I'd hardly tout that as the efficacy of ancient medicine.
While this article is quite interesting, I think it is using the wrong metric. A straight percentage of remedies does not reflect the incidence of these conditions. Most big pharma R&D is focused on a few very common conditions, since that is where the most profit and benefit are to be found.
So this could just be indicating that there is a "long tail" of conditions & remedies where we still use the old treatments because it is not yet cost-effective to find new ones. Yet we may be getting most of the benefit at the head of the condition distribution. The biotech revolution seems quite promising for better addressing this long tail.
Sam the people who contribute to this blog are well aware that vaccinations and antibiotics save lives but in the context that they speak those considered to be more along the line of food, clean water, sanitation and vitamins all of which are not for this discussion considered healthcare though they are necessary for health.
The claim is not that 36% of Egyptian drugs didn't work but rather that to the best of our knowledge 36% didn't work. This probably implies that almost 36% more of their drugs didn't work than of our drugs, and maybe also that they knew a few useful things that we don't.
Sam, that's a pretty skewed reading of posts here. Nobody said Egyptian medicine was superior, just that it has some remarkable similarities to modern medicine.
Futhermore, I wouldn't attribute longer lifespans to antibiotics and vaccines, or medicine alone, though of course I am happy to have these things and I have certainly taken advantage of them. Don't discount nutrition, improved sewage and sanitation systems, mechanization to enhance human labor, and other forms of capital formation and accumulation that make longer life possible.
No one would be surprised to learn that medical doctors and the field that they are experts in are not perfect. The suprising thing to me is that the rest of society views them and treats them so differently from other experts in other fields.
People go to Drs. all the time and more than 36% of what they do has no discernable effect at all, some have negative effects.
That's shifting the terms. Campbell (or whoever; I don't trust New Scientist's assignment of credit, because they chronically play games with it) did not conclude that 64% of ancient Egyptian treatments worked, which is what it would have to be for that comparison to make sense. She said that 64% were on a par with drugs used sometime in the last 50 years. She's giving herself plenty of room to make a favorable choice of comparisons. One also has to suspect that her standard of equivalence was pretty loose.
She said:
Campbell was impressed. "Sixty-four per cent of the prescriptions had therapeutic value on a par with drugs used in the past 50 years. In many cases even the dosing was right."
Ancient medicine is something I've taken an interest in, as a student of archaeology. There's actually a lot of interesting medical practices from the ancient world as well as those mentioned here. Trauma surgery, for one, has been around a good while - records of Alexander the Great's campaigns note that he was treated by his personal surgeon for several wounds; the surgeon was famed for having successfully removed an arrow from the eye of Alexander's father, Philip of Macedon - this involved the use of a specially designed surgical tool for the job.
Whilst many commenters are right about the lack of good anaesthesia and sterility in ancient medicine, it's worth remembering that open injuries, if they could be kept submerged in a pool of the patient's blood, could be surgically closed with a much reduced risk of infection. But that's pretty touch and go - trauma victims tend not to lie still, plus there's little evidence that much effort was made to address shock or pain. Still, there are plenty of good examples from records of the Napoleonic era that describe this practice still in use, so there must (I assume) have been positive observable results.
Even most physicians have little concept of marginal benefit and "number needed to treat" when considering an intervention. It was stated above "survive a heart attck"...So lets look at the numbers. Angiography and thrombolysis for MI were big interventions developed in the 1990's. Both saved about 2 lives/1000 when compared with "standard treatment"(O2, meds, hospitalization). So, is that the marginal benefit you expect for this level of intervention? This cost? When I share this well-done data with physicians they are mute. I(an MD) would still recommend the intervention, but awareness of our limited marginal benefit is critical for good advice, care...I'm not sure it's how I'd want to spend my last $100K.Most increases in longevity in human populations can be attributed to public health measures(water, sewer, dwellings). Most of modern medicine is heroism...
For those playing the drinking game at home, we are at three instances of "for a blog called 'Overcoming Bias'" so far in this comment thread.
From Cracked: The 10 Most Insane Medical Practices in History.
I see a few comments pointing out some of the ways that modern medicine is clearly much better than ancient Egyptian medicine, but everyone else seems to be blowing them off.
Think of it this way: If modern medicine has an effective treatment for something that ancient Egypt had no treatment for, where does that show up in the percentages quoted above?
It doesn't.
The percentages are all percentages of ancient treatments, not modern ones. If the figure were 100%, it would mean that we kept their treatments, or some equivalent, and went on to develop new treatments for other things.
Considering our bodies haven't really changed, improving on 36% of what was already shown to work isn't bad -- but the real improvement is all the additional things we can treat.
When I googled define:bias, I got the following definition:
"A bias is a prejudice in a general or specific sense..."
Now I look at your statement:
"As long as he was arrogant, wore a white coat, put his drugs in capsules, and spoke the local language, I doubt most people today could tell the difference if they were treated by an ancient Egyptian doctor."
So if you're saying he would have to be arrogant in order for most people to be unable to tell the difference, aren't you implying that most doctors are arrogant? Isn't that a bias? Isn't this blog called "overcoming bias"?
Now I look up arrogant in the OED:
"... aggressively assertive or presumptuous..."
Now for a definition of presumption:
"the act of presuming a thing to be true"
So unless you've somehow reliably ascertained that most doctors are arrogant, you're being presumtpuous, that is, arrogant..
So you're being biased on a blog called 'overcoming bias', by arrogantly calling doctors arrogant...I'll leave you with one last definition:
hypocrisy: "the assumption or postulation of moral standards to which one's own behaviour does not conform"
Rather than compare ancient Egyptian medicine to today's medicine, let's compare it to the medicine of 1900 or 1850. I'm pretty sure 1850 loses.
Ian,
so the modern medicine undoes natural selection? It would be interesting to ponder on the consequences. I know I avoided being voted off this island due to the ulcerative colitis. Bleeding to death ain't fun.
I feel that I have definitely gotten my money's worth from Western medicine. Why? Because I'm still alive. If I lived 2,000 years ago I would be dead now (type I diabetes). So would: my mother and my brother (major childbirth complications), one aunt (like 10 different things), an uncle (alcohol withdrawl resulting in grand mall siezures). My grandmother would have died earlier from skin cancer, and her sister from complications of type II diabetes. My dad had the Hepatitis that can be cured - not sure if that's lethal if untreated. And I'm sure I'm forgetting stuff.
Think about it - how many people you know would be dead by now without the modern western medicine you pretend to have so much disdain for? And how many of these things would have been fixable in ancient Egypt? If you pray, give thanks every night for not living 2,000 years ago.
The attack on modern medicine is not a claim that it's the same, it's a claim that, at the margin, the difference is a lot less than we're paying for.
If an ancient Egyptian doctor came to our time an took a high school class to learn about sanitation, he could do many functions (though obviously not all) as well as a modern doctor with a twenty-five year long education. This supports the claim is that doctors do a lot of work where they do not provide much added value given their expense.
As such, the claims about vaccinations and antibiotics are not terribly relevant. These do not encompass a large portion of our medical expenditures (to my knowledge). Hanson's point seems to be that doctors are overpaid or we use doctors for work that does not require their expertise, and that a lot of the advances in medicine have been fairly simple and inexpensive and should not translate into our current costs. This post certainly supports that.
Though "Someone drilled a hole in someone else's skull, and he didn't die for at least a few months" doesn't really count as brain surgery. And the motivation was probably to let out demons or evil spirits or some such, so I'd hardly tout that as the efficacy of ancient medicine.
While this article is quite interesting, I think it is using the wrong metric. A straight percentage of remedies does not reflect the incidence of these conditions. Most big pharma R&D is focused on a few very common conditions, since that is where the most profit and benefit are to be found.
So this could just be indicating that there is a "long tail" of conditions & remedies where we still use the old treatments because it is not yet cost-effective to find new ones. Yet we may be getting most of the benefit at the head of the condition distribution. The biotech revolution seems quite promising for better addressing this long tail.
Sam the people who contribute to this blog are well aware that vaccinations and antibiotics save lives but in the context that they speak those considered to be more along the line of food, clean water, sanitation and vitamins all of which are not for this discussion considered healthcare though they are necessary for health.
tcpkac,
>> Seriously, who would go to a doctor where 36% of his treatments did not work well or at all?
I guess everybody. Modern doctors are generally known to get either the diagnosis or at least the dosage wrong more than once every three times! :-(
The claim is not that 36% of Egyptian drugs didn't work but rather that to the best of our knowledge 36% didn't work. This probably implies that almost 36% more of their drugs didn't work than of our drugs, and maybe also that they knew a few useful things that we don't.
Sam, that's a pretty skewed reading of posts here. Nobody said Egyptian medicine was superior, just that it has some remarkable similarities to modern medicine.
Futhermore, I wouldn't attribute longer lifespans to antibiotics and vaccines, or medicine alone, though of course I am happy to have these things and I have certainly taken advantage of them. Don't discount nutrition, improved sewage and sanitation systems, mechanization to enhance human labor, and other forms of capital formation and accumulation that make longer life possible.
No one would be surprised to learn that medical doctors and the field that they are experts in are not perfect. The suprising thing to me is that the rest of society views them and treats them so differently from other experts in other fields.
People go to Drs. all the time and more than 36% of what they do has no discernable effect at all, some have negative effects.
That's shifting the terms. Campbell (or whoever; I don't trust New Scientist's assignment of credit, because they chronically play games with it) did not conclude that 64% of ancient Egyptian treatments worked, which is what it would have to be for that comparison to make sense. She said that 64% were on a par with drugs used sometime in the last 50 years. She's giving herself plenty of room to make a favorable choice of comparisons. One also has to suspect that her standard of equivalence was pretty loose.
She said:
Campbell was impressed. "Sixty-four per cent of the prescriptions had therapeutic value on a par with drugs used in the past 50 years. In many cases even the dosing was right."
Ancient medicine is something I've taken an interest in, as a student of archaeology. There's actually a lot of interesting medical practices from the ancient world as well as those mentioned here. Trauma surgery, for one, has been around a good while - records of Alexander the Great's campaigns note that he was treated by his personal surgeon for several wounds; the surgeon was famed for having successfully removed an arrow from the eye of Alexander's father, Philip of Macedon - this involved the use of a specially designed surgical tool for the job.
Whilst many commenters are right about the lack of good anaesthesia and sterility in ancient medicine, it's worth remembering that open injuries, if they could be kept submerged in a pool of the patient's blood, could be surgically closed with a much reduced risk of infection. But that's pretty touch and go - trauma victims tend not to lie still, plus there's little evidence that much effort was made to address shock or pain. Still, there are plenty of good examples from records of the Napoleonic era that describe this practice still in use, so there must (I assume) have been positive observable results.
There's loads of other great info on this subject - this is a nice summary :)http://www.channel4.com/his...