Saturday, October 06, 2007

The Life Sciences

I received an e-mail from my daughter's Biology II teacher, indicating that she will give my daughter an A in Biology for the six week period. The fact that my daughter is in Biology II at all is a minor miracle. No Porter in her direct line,and this goes back all the way to 17th century Ulster, has ever taken this advanced a course in a science. It is true that her father took Biology twice in high school, but that was the same course. I just enjoyed it so much my sophomore year that I took it again the next year !

I am reminded of this because of the startling news today, that surgeons and immunologists at Duke Medical School are reporting that they have found a purpose for the appendix. If there is one thing I retained from high school biology, it is that the appendix has no use. That was my North Star, the one point I could rely upon as invariable in the study of human anatomy, that the appendix was as useless to the body as the Pill is to the Pope. It did nothing except get inflamed to the point of bursting, whereby it could kill you. I liked to think of it as God's little time bomb.I can reliably report that 321,000 people in this country went to the hospital with appendecitis last year.How many left the hospital without thier appendix, or left the hospital at all, is unreported. The state of American health care being what it is, we can probably guess that a good many of them left without a kidney (or two).

But back to the use of the Appendix. It turns out that the appendix has a function, just not in a "modern industrial society". The appendix acts as "a good safehouse for bacteria", as well as a "bacteria factory". Apparently, and I recall hearing this from a doctor once who told me to eat a lot of yogurt after I took a lot of anti-biotics, there is a massive amount of bacteria populating the human digestive system. Some of that bacteria is not such a good thing, but most of it is helpful to the digestive process. Well, lo and behold, it turns out that there is actually more bacteria in the body that there are cells in the human body. Where do the extraneous bacteria hang out when not in use ? The good old appendix. The appendix is, in the words of Duke Medical School "a cultivator of bacteria". Dr. Bill Parker goes so far as to say that is a "gut cul-de-sac". At this point, the biological metaphors went beyond my capacity to understand, so I can not tell you why it is important that our guts have a "cul de sac" rather than a through street. You will have to do that research yourself.

O.K, so why is the appendix not needed in the good old USA, but possibly needed in remote parts of the world. Here it is, according to Parker, if your "gut flora" (his term not mine) dies, you can easily pick up more from other people. People pass along germs to each other constantly. However, when there are few humans,and say ,cholera came along and wiped most of them out, it was not as easy for the remainder to grow back the needed bacteria. So it was important to have the old appendix acting as sort of a "gut dugout" (my term, not theirs) to send in the replacement bacteria when needed. Now get this. In the underdevloped countries, where the appendix still has a purpose, rates of appendecitis are much lower ! So if the 300-400 Americans who die of apedecitis each year lived in say, equatorial Africa and lived as hunter gatheres, they would probably not die that. Of course in equatorial Africa, their chances of dying os something else are much greater. So saving your appendix is probably not a good reason to move there.

But this is a great day, mystery solved. Only a jealous , bitter malcontent, like Dr Gary Huffnagle of the University of Michigan, would ruin such a day by saying, "Oh yeah, well what about the tonsils ? " One mystery at a time Doc. One mystery at a time.

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