Throughout human history the leading causes of death have been infection and trauma. Modern medicine has scored significant victories against both, and the major causes of ill health and death are now the chronic degenerative diseases, such as coronary artery disease, arthritis, osteoporosis, Alzheimer’s, macular degeneration, cataract and cancer. These have a long latency period before symptoms appear and a diagnosis is made. It follows that the majority of apparently healthy people are pre-ill.
But are these conditions inevitably degenerative? A truly preventive medicine that focused on the pre-ill, analysing the metabolic errors which lead to clinical illness, might be able to correct them before the first symptom. Genetic risk factors are known for all the chronic degenerative diseases, and are important to the individuals who possess them. At the population level, however, migration studies confirm that these illnesses are linked for the most part to lifestyle factors—exercise, smoking and nutrition. Nutrition is the easiest of these to change, and the most versatile tool for affecting the metabolic changes needed to tilt the balance away from disease.
Many national surveys reveal that malnutrition is common in developed countries. This is not the calorie and/or micronutrient deficiency associated with developing nations (Type A malnutrition); but multiple micronutrient depletion, usually combined with calorific balance or excess (Type B malnutrition). The incidence and severity of Type B malnutrition will be shown to be worse if newer micronutrient groups such as the essential fatty acids, xanthophylls and flavonoids are included in the surveys. Commonly ingested levels of these micronutrients seem to be far too low in many developed countries. There is now considerable evidence that Type B malnutrition is a major cause of chronic degenerative diseases. If this is the case, then it is logical to treat such diseases not with drugs but with multiple micronutrient repletion, or ‘pharmaco-nutrition’. This can take the form of pills and capsules-‘nutraceuticals’, or food formats known as ‘functional foods’. This approach has been neglected hitherto because it is relatively unprofitable for drug companies-the products are hard to patent-and it is a strategy which does not sit easily with modern medical interventionism. Over the last 100 years, the drug industry has invested huge sums in developing a range of subtle and powerful drugs to treat the many diseases we are subject to. Medical training is couched in pharmaceutical terms and this approach has provided us with an exceptional range of therapeutic tools in the treatment of disease and in acute medical emergencies. However, the pharmaceutical model has also created an unhealthy dependency culture, in which relatively few of us accept responsibility for maintaining our own health. Instead, we have handed over this responsibility to health professionals who know very little about health maintenance, or disease prevention. One problem for supporters of this argument is lack of the right kind of hard evidence. We have a wealth of epidemiological data linking dietary factors to health profiles / disease risks, and a great deal of information on mechanism: how food factors interact with our biochemistry. But almost all intervention studies with micronutrients, with the notable exception of the omega 3 fatty acids, have so far produced conflicting or negative results. In other words, our science appears to have no predictive value. Does this invalidate the science? Or are we simply asking the wrong questions?
Based on pharmaceutical thinking, most intervention studies have attempted to measure the tiny single micronutrient in the incidence of disease. The classical approach says that if you give a compound formula to test subjects and obtain positive results, you cannot know which ingredient is exerting the benefit, so you must test each ingredient individually. But in this approach, this does not work. Each intervention on its own will hardly make enough difference to be measurable, especially when you are dealing with chronic diseases where the metabolic errors happen over long periods.
The only explanation for this is anthropological. Once established in calcified organizations, humans do two things: sabotage changes that might render people dispensable, and ensure industry-wide emulation.
In the 1960s, German auto companies developed plans to scrap the entire combustion engine for an electrical design. (The same existed in the 1970s in Japan, and in the 1980s in France.) So for 40 years we might have been free of the wasteful and ludicrous dependence on fossil fuels. Why didn’t it go anywhere? Because auto executives understood pistons and carburettors, and would loath to cannibalize their expertise, along with most of their factories.


When people who are talking don’t share the same culture, knowledge, values, and assumptions, mutual understanding can be especially difficult. Such understanding is possible through the negotiation of meaning. To negotiate meaning with someone, you have to become aware of and respect both the differences in your backgrounds and when these differences are important. You need enough diversity of cultural and personal experience to be aware that divergent world views exist and what they might be like. You also need the flexibility in world view, and a generous tolerance for mistakes, as well as a talent for finding the right metaphor to communicate the relevant parts of unshared experiences or to highlight the shared experiences while demphasizing the others. Metaphorical imagination is a crucial skill in creating rapport and in communicating the nature of unshared experience. This skill consists, in large measure, of the ability to bend your world view and adjust the way you categorize your experiences. Problems of mutual understanding are not exotic; they arise in all extended conversations where understanding is important.
When it really counts, meaning is almost never communicated according to the CONDUIT metaphor, that is, where one person transmits a fixed, clear proposition to another by means of expressions in a common language, where both parties have all the relevant common knowledge, assumptions, values, etc. When the chips are down, meaning is negotiated: you slowly figure out what you have in common, what it is safe to talk about, how you can communicate unshared experience or create a shared vision. With enough flexibility in bending your world view and with luck and charity, you may achieve some mutual understanding.
Communication theories based on the CONDUIT metaphor turn from the pathetic to the evil when they are applied indiscriminately on a large scale, say, in government surveillance or computerized files. There, what is most crucial for real understanding is almost never included, and it is assumed that the words in the file have meaning in themselves—disembodied, objective, understandable meaning. When a society lives by the CONDUITmetaphor on a large scale, misunderstanding, persecution, and much worse are the likely products.
Later, I realized that reviewing the history of nuclear physics served another purpose as well: It gave the lie to the naive belief that the physicists could have come together when nuclear fission was discovered (in Nazi Germany!) and agreed to keep the discovery a secret, thereby sparing humanity such a burden. No. Given the development of nuclear physics up to 1938, development that physicists throughout the world pursued in all innocence of any intention of finding the engine of a new weapon of mass destruction—only one of them, the remarkable Hungarian physicist Leo Szilard, took that possibility seriously—the discovery of nuclear fission was inevitable. To stop it, you would have had to stop physics. If German scientists hadn’t made the discovery when they did, French, American, Russian, Italian, or Danish scientists would have done so, almost certainly within days or weeks. They were all working at the same cutting edge, trying to understand the strange results of a simple experiment bombarding uranium with neutrons. Here was no Faustian bargain, as movie directors and other naifs still find it intellectually challenging to imagine. Here was no evil machinery that the noble scientists might hide from the problems and the generals. To the contrary, there was a high insight into how the world works, an energetic reaction, older than the earth, that science had finally devised the instruments and arrangements to coart forth. “Make it seem inevitable,” Louis Pasteur used to advise his students when they prepared to write up their discoveries. But it was. To wish that it might have been ignored or suppressed is barbarous. “Knowledge,” Niels Bohr once noted, “is itself the basis for civilization.” You cannot have the one without the other; the one depends upon the other. Nor can you have only benevolent knowledge; the scientific method doesn’t filter for benevolence. Knowledge has consequences, not always intended, not always comfortable, but always welcome. The earth revolves around the sun, not the sun around the earth. “It is a profound and necessary truth,” Robert Oppenheimer would say, “that the deep things in science are not found because they are useful; they are found because it was possible to find them.”
...Bohr proposed once that the goal of science is not universal truth. Rather, he argued, the modest but relentless goal of science is “the gradual removal of prejudices.” The discovery that the earth revolves around the sun has gradually removed the prejudice that the earth is the center of the universe. The discovery of microbes is gradually removing the prejudice that disease is a punishment from God. The discovery of evolution is gradually removing the prejudice that Homo sapiens is a separate and special creation.
For any natural number $k$, let $a_k = 3^k$. The smallest natural number $m$ for which \[ (a_1)^1 \times (a_2)^2 \times \dots \times (a_{20})^{20} \;<\; a_{21} \times a_{22} \times \dots \times a_{20+m} \] is: