Crémieux Profile picture
Dec 20, 2024 17 tweets 6 min read Read on X
Psychotic people follow scripts.

Let's talk about the glass delusion, the Middle Ages' bout with a mass psychogenic illness marked by people believing they were made of glass. Image
Glass was a valuable commodity in Europe. It was primarily owned by the noble and well-to-do, and it had a notable purpose in alchemy.

Its perception as the technology of the time was as one that's both fragile and valuable, like the nobility. Image
Glass was the relatively novel technology people knew, and they knew things could be transmuted into glass. Delusional people also thought transmutation could affect them.

Take King Charles VI.

He truly believed his body was made of glass. Image
This delusion was such that Charles felt he had to build his life around it.

He had iron rods fastened into his clothing to hold him up, and he didn't allow his advisors to approach him, lest they accidentally shatter him.

This illness set in during his twenties. Image
The age when his psychotic bouts started is remarkably consistent with when the illness starts today.

Were he alive today, he probably would have been prescribed antipsychotics for his condition. Image
But Charles was alive long before his condition was understood.

He also wasn't its only sufferer. As alchemy's popularity grew, more people started to suffer the glass delusion.

They understood glass as fragile, and themselves as fragile, and they acted out that script. Image
For the well-off, the delusion was treated as legitimate. Many nobles came to wear padded buttocks.

But in one case, in Saint Germain, a doctor took a man who thought his butt was made of glass and beat him until he stopped believing in the delusion.

Apparently that worked. Image
Amusingly, in Rene Descartes' Meditations on First Philosophy, he remarked on the glass delusion and used it as an example of how people can see the world in totally different ways.

Of course, he did say that the perception was insane.Image
Fast forward to the 19th century and factories are beginning to dot the landscape of Europe.

With the change in popular technology, people's delusions followed suit.

With industry, the delusions became industrial. People imagined they were being influenced by vast machines. Image
Patients who presented with this belief in intricate, far off machines that controlled their actions and influenced their lives could never explain how they worked.

Just as people didn't know how they became glass, they didn't get how machines were affecting them. Image
Factories influenced the world, machines could obviously influence us, thus...

Schizophrenics' delusions are tailored to what they vaguely know, and they learn about those half-baked delusions from others, the times, etc.

Consider exorcism. Its modern script came from a movie! Image
People today know about parasites, chronic pain, post-viral conditions, toxic poisoning, and more, and they have an amazing tool for finding and promoting related scripts:

The internet! Image
Thousands of people today believe they have a skin condition called Morgellons.

It's not real.

They just believe they're developing sores and lesions, and hairs are sprouting from them, but they're really picking themselves raw and getting freaked out by cotton fibers. Image
The sufferers from this condition are deeply unwell, and they spread their unwellness to other people through posting about their condition online.

People know about all the requisite concepts, and they see something on themselves and imagine it's a real symptom.

But it's not.
There are no demons, there's no Morgellons, people cannot be made of glass, and there's no big machine out there influencing people and miraculously disappearing the moment those concepts go out of fashion and get replaced by other ones with nary a cure invented.
And this keeps happening!

People are always inventing new conditions or imagining they're afflicted by something real when they're not, by reading into symptoms and gaslighting themselves.

And they sometimes act incredibly mad in these bouts of belief. Image
A subset of people today seem vulnerable to scripts, and some seem to have always been vulnerable to it.

It makes you wonder: must psychotic people always be like this? And what can we do to cure them of their delusions?

I suggest we don't give in with padded buttocks.

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More from @cremieuxrecueil

Nov 20
Why?

I doubt the answer is weight loss. Consider 2 other drugs for diabetes: DPP-4 and SGLT-2 inhibitors

GLP-1RAs are associated with less Alzheimer's vs. DPP-4is:

But not SGLT-2is:

Neither generates much weight loss, but SGLT-2is match GLP-1RAs on glycemic benefitsImage
Image
So, at least in this propensity score- or age-matched data, there's no reason to chalk the benefit up to the weight loss effects.

This is a hint though, not definitive. Another hint is that benefits were observed in short trials, meaning likely before significant weight loss.
We can be doubly certain about that last hint because diabetics tend to lose less weight than non-diabetics, and all of the observed benefit has so far been observed in diabetic cohorts, not non-diabetic ones (though those directionally show benefits).

Anyway, trials needed!
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Nov 20
El Salvador is now a safe country

The reason why should teach us something about commitment

The government there has previously attempted crackdowns twice in the form of mano dura—hard hand—, but they failed because they didn't hit criminals hard enough

Then Bukele really didImage
In fact, previous attempts backfired compared to periods in which the government made truces with the gangs.

The government cracking down a little bit actually appeared to make gangs angrier!

You'd have been in your right to conclude 'tough on crime fails', but you'd be wrong.
You have to *actually* enforce the law or policy won't work. Same story with three-strike laws, or any other measure

Incidentally, when did the gang problems begin for El Salvador? When the U.S. exported gang members to it

This was bad for El Salvador:

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Nov 18
Diets that restrict carbohydrate consumption lead to improved blood sugar and insulin levels, as well as reduced insulin resistance.

Additionally, they're good or neutral for the liver and kidneys, and they don't affect the metabolic rate. Image
Carbohydrate isn't the only thing that affects glycemic parameters.

So does fat!

So, for example, if you replace 5% of dietary calories from saturated fat with PUFA, that somewhat improves fasting glucose levels (shown), and directionally improves fasting insulin: Image
Dietary composition may not be useful for improving the rate of weight loss ceteris paribus, but it can definitely make it easier given what else it changes.

Those non-metabolism details may be why so many people find low-carb diets so easy!

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Nov 18
Property taxes should, in theory, make it so buying a home is more affordable and young people will have increased access to home ownership.

Let's look through the literature to see what really happens🧵

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This reduces the number of people who own multiple homes, increases general ownership, and increases young ownership even more. Image
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Nov 18
There's a popular belief that family wealth is gone in three generations.

The first earns it, the second stewards it, and the third spends it away: from shirtsleeves to shirtsleeves in three generations!

But how true is this belief?

Gregory Clark has new evidence🧵 Image
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It correlates substantially enough to persist for twelve generations at observed rates of decay: Image
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The dominant theory among laypeople is social: that the wealth is directly transmitted.

This is testable, and the Malthusian era provides us with lots of data for testing. Image
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Nov 18
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The origin of this disdain arguably lies with Church Fathers like Justin Martyr, Irenaeus, and Tertullian🧵 Image
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