Medical Hypotheses 77 (2011) 560564

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Medical Hypotheses
journal homepage: www.elsevier.com/locate/mehy

Medicine could be constructing human bodies in the future

Arthur Saniotis, Maciej Henneberg
Biological Anthropology and Comparative Anatomy Research Unit, School of Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
Department of Archaeology, Flinders University, Australia
Center for Evolutionary Medicine, University of Zrich, Switzerland

a r t i c l e

i n f o

Article history:
Received 23 March 2011
Accepted 12 June 2011

a b s t r a c t
In the 21st century human life has been profoundly changed by developments in sanitation, medical
interventions and public health measures. Practically every person born into a developed nation population has a chance to survive throughout entire reproductive life and well beyond. Human body has
evolved in the past adaptations to huntinggathering, and later, agricultural ways of life. In the new situation of practically non-existent premature mortality and technologically developed complex societies
medical practice will devote less attention to saving lives preventing premature deaths and more to
enhancing capacities of our biological organisms and providing for maintenance of the bodies beyond
their biological limits established by evolution. The role of advances in nanotechnology, information
technology, neuroscience and biotechnology is discussed in the context of mind and body enhancements.
2011 Elsevier Ltd. All rights reserved.

History of human body

Humans are mammals. We share with other mammals nearly
all of our physiological processes and biochemical properties. Our
anatomical structure has the basic mammalian plan, but is uniquely modied by the evolutionary experience and development
of erect bipedalism [13]. This development had a number of
structural and functional consequences. It released our upper limbs
from the necessity of locomotion and allowed them freedom for
manipulation of objects. It requires precise balancing of our entire
body over a very small area covered by the feet. It moved our head
far away from the ground so that teeth ceased to be a versatile tool
for manipulation of objects and direct acquisition of foods. Instead,
we use hands to bring food to our mouths. With the need to balance the head over the neck supporting it centrally, reduction of
forward-protruding large dental arcade was necessary. Our teeth
became small and the entire facial skeleton reduced. In consequence, mechanical preparation of food is partly done extraorally.
We can efciently carry large loads in our arms and on our shoulders which requires re-balancing of the body.
All these anatomical changes require complex control of movements by the central nervous system based on voluminous sensory
input, especially the visual one. Our neurohormonal regulation is
adapted to coordination of multiple inputs with a variety of interrelated outputs.
As human behavioural adaptations to omnivorous way of life
developed, we were able to invade climatic zones inappropriate
for survival of large apes. This was possible through the use of re
Corresponding author. Tel.: +61 8 83035479; fax: +61 8 83034398.
E-mail address: Maciej.henneberg@adelaide.edu.au (M. Henneberg).
0306-9877/$ - see front matter 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.mehy.2011.06.031

(since at least 1.5 Ma) for warming our bodies, construction of

shelters to reduce wind chill and production of clothing at least
some 40,000 years ago.
History of human lifespan
For the vast majority of our 5 Ma long history we were subjected to same threats to our lives as other mammals: infectious
and parasitic diseases, accidental trauma, predation. Age distribution of probabilities of dying of our ancestors, the australopithecines was similar to that of other large mammals (Fig. 1). This
situation remained basically unchanged until about eight thousand
years ago food production spread through large sections of humanity. Agricultural way of life brought new threats, but also some
ways of preventing premature deaths. Due to crowding of people
in unhygienic conditions of ancient villages and cities with poor
sanitation, infectious diseases became widespread while unreliable
supplies of poor quality carbohydrate-rich foods lead to nutritional
deciencies (e.g. anaemia). Settled way of life with its xed homebases allowed better care for sick and injured people while development of technologies allowed more complex intervention into
the human body. In Classical Antiquity a number of surgical instruments, including catheters, specula uteri, effective scalpels were
used [4], while a repertoire of medicines based on plant extracts
and minerals (e.g. mercurial ointments, Pliny 80) [5] became available. All this lead to prevention of premature deaths of adults producing in effect prolongation of average duration of human life (Fig
2). Effective treatment of common diseases occurring in childhood
was, however, problematic since there was no knowledge of the
causality of infectious diseases, nor of nutritional problems resulting from iron or iodine deciencies. More children could be born in

A. Saniotis, M. Henneberg / Medical Hypotheses 77 (2011) 560564

561

Fig. 1. Comparison of mortality (probability of dying during a year of life) for Australopithecines, Mountain Sheep, Gorillas and Modern Australians. More information on
australopithecine mortality in McKinley (1971) [6], wild mammals in Deevey (1947) [7] and gorillas in Robbins and Robbins (2004) [8]. Australian mortality as reported by
Australian Bureau of Statistics.

Fig. 2. Comparison of mortality (probabilities of dying during a year) for australopithecines, Pompeians [9] and modern Australians.

settled societies where mothers were not obliged to carry their infants and toddlers on long walks of nomads. This greater fertility
producing more children raised in unhygienic conditions and exposed to numerous sources of pathologies, increased early mortality. The overall effect was low life expectancy at birth (about
25 years).
Only since the 19th century when better medical knowledge and
more effective methods of sanitation became available, that humans
could signicantly reduce premature mortality. Of special importance was the understanding of the causes of infectious diseases that
nearly immediately produced antiseptic approaches in surgery and
obstetrics and sparked a series of attempts at vaccination against
common diseases. The search for effective cures of infectious
diseases, based on elimination of causative micro-organisms from

patient bodies, took longer. It occurred only in the 20th century.

After initial attempts at using laboratory-manufactured chemicals
(e.g. salvarsan, sulphonamides) the discovery of antibiotics produced by various organisms resulted in the effective reduction of
infectious diseases to the extent that an epidemiological transition
occurred. This transition removed massive amounts of premature
deaths due to infections and lead to the primacy of degenerative
diseases amongst causes of deaths. The transition occurred in
developed nations at different years during the 20th century, but
is still to occur in some developing nations.
The dramatic difference between the historical and modern life
expectancy can be best summarised using the Biological State Index [10,11]. This index measures the probability that a neonate
will be able to survive to the end of her/his reproductive life span,

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A. Saniotis, M. Henneberg / Medical Hypotheses 77 (2011) 560564

Fig. 3. Changes in the Biological state index calculated as a probability of fully participating in reproduction per a neonate. Data from Henneberg (1976) [10] and Stephan and
Henneberg (2001) [11].

that is the probability this person has to pass on genes to the next
generation. Throughout the entire human history, from 4 Ma to the
Middle Ages, values of this index oscillated around 0.200.30. In
early modern times they slowly rose to 0.5, but it was only towards
the very end of the 20th century that they became close to 0.99
Fig. 3. Now, at least in developed nations, practically any newborn
person will survive to the post-reproductive age.
Since natural selection can only operate through differential
reproductive success, it was powerless in adapting traits of human
organisms older than 70+ years when even as grandparents, individuals have practically no inuence over production and survival
of their offspring.
In the late 20th century, as the need for saving lives decreased,
the focus of medical practice started shifting from removing causes
of premature death and of abnormalities to improving structure and
function of the human body beyond its natural state. Some techniques for doing this have been developed long time ago as a response to the curative needs. For instance, repair of body
disgurement following injuries can be used to alter innate appearance of a body. A surgeon who was able to reconstruct a persons
nose damaged in an accident, can use the same techniques to alter
the shape of an intact nose of another person who simply does not
like its appearance. Many substances used to correct brain function
in psychiatric disorders, or to prevent sensation of pain in wounded
people are now used to alter workings of perfectly normal brains and
bodies. Old human ability to alter the body is now coming to the fore
as both health practitioners (in the broad sense) and patients have
more opportunities to devote their time and energy to concerns
other than straightforward cure restoration of ailing body to its
healthy balance.

The modied body in medical discourse

Medical attitudes of the body must be understood according to
social categories which present the body as uid and non-static-a
continuing work in progress. The anthropologist Mary Douglas is
insightful here. For Douglas [12], human beings are creatures who
live according to social categories. Human societies use an array of

complex social categories in order to maintain social order. Social

categories are also important for delineating between socially sanctioned and prescribed behaviours. What is important here is that a
taboo indicates a deviation from the natural order of things which
must be retrieved. In this way, a taboo is intrinsically tied to human
ontology. According to Douglas, the body is a universal symbol for
understanding culture and society. Douglas elegantly explains that
the body is central to a litany of social constructions relating to social
boundaries and pollution. In short, body margins may threaten society, and therefore, need to be controlled via prescribed body rituals.
In this way, bodily integrity reects the social status quo. A case in
point is Douglas thesis on dirt as matter out of place. Dirt is constructed as being morally ambiguous and demands immediate
attention. Take for instance, the dirty body and how it is invariably
linked to a persons lack of moral character. In Judeo-Christian societies the onus on clean bodies is paramount to ideas of success,
wealth and beauty. To illustrate the point further between dirt as
matter out of place, lets us use the example of shoes. In human societies the natural place of shoes is on the feet. Shoes on feet are not
categorised as being dirty. However, if the same pair of shoes is
placed on a dining table, such an act is socially proscribed since
the shoes are out of their place. The plethora of hygiene rules and
norms in many societies which are integral to grooming rituals reect the importance of bodily maintenance. Take for instance, how
menstrual blood is conceived of as morally polluting in Judeo-Christian societies. The onus is for women to be attuned to their menstrual cycles so as to keep it hidden. Moreover, various television
commercials showing menstrual tampons or pads often show women dressed in white garments, symbolising both ritual purity
and being in control of their menstrual cycle. In some recent Australian television commercials on menstrual pads there was an evident
omission of the colour red and the use of the colour blue.
In western societies the onus of bodily control has been exacerbated in the recent decades by the body culture which has been
privileged by health and fashion media. Here, the body is constructed as a vehicle of self creation, or in Foucaults terminology
technique du corps [13]. This involves the body undergoing various bodily regimes including dieting, fasting, and forms of exercise
in order to develop a socially sanctioned type of body which is

A. Saniotis, M. Henneberg / Medical Hypotheses 77 (2011) 560564

deemed to be beautiful. Moreover, such bodies exemplify a type of

corporeal integrity which is the antithesis of fat or obese bodies. In
the latter, such bodies personify a lack of self discipline, ugliness
and a awed self [14]. Vertinsky contends that many western nations during social and cultural change have inclined towards a
pre-occupation with the body in order to afrm constructions of
national identity [15]. This analogy is not surprising. As the corporeal borders are susceptible to pathogens which threaten bodily
integrity, so are national borders vulnerable to attack or invasion
by enemies or undesirables.
The range of technologies and regimes available to modify the
body are integral to western style consumer cultures which view
the body as an object willing to be transformed according to societal aesthetics. Furthermore, body modication is a growing part of
bio-medicine such as cosmetic surgery and its promise of a renewed body and self [14]. The enormous growth of cosmetic surgery in many countries across the globe highlights the relationship
between medicine and consumerism. It could be argued that cosmetic surgery proffers the new face of western bio-medicine with
a promise to use corrective techniques in order to achieve an ideal
look. What corrective surgery offers is a transformation of both
body and self. This foregrounding of transformation, as Featherstone notes is central to western modernity [14]. In the West, the
ideal of transformation can be traced back to early Christianity
where the body is viewed as a bi-morphic plenum composed of
matter and spirit. Only through vigorous body techniques can the
body be sublimated as a true vessel of the Divine. Thus inner transformation of the spirit is believed to leave its indelible mark on the
body. In the Abrahamic traditions, the body of holiness is invariably depicted as being thin and gaunt, indicating moderation in
eating and other carnal instincts. In India, where one of us (AS)
conducted eldwork in the 1990s on Su mystics, their bodies
were considered as conduits of sacred power.

The future of the body and medicine

We contend that the notion of transformation is integral to the
current medicalised body. Bio-medicines movement from preventative to corrective techniques during the second half of the
20th century exemplies the notion of transformation. Never in
human history has the body undergone such modication; a phenomenon which will increase in the 21st century. The use of gene
therapy, stem cell therapy and nanotechnology, or a combination
of these will herald incredible medical advances. Consequently,
the body as we know it will be different by the end of this century. However, it is medicine that will re-dene the human body.
These afore-mentioned technologies will be mainly corrective in
their theory and practice. For example, gene therapy may hopefully correct various congenital diseases such as phenylketonuria,
Down syndrome, cystic brosis and haemophilia. Gene therapy
may also diminish the onset of age related diseases and possibly
increase human longevity. The current anti-aging revolution in
the western world bears testament to the probable future uses
of gene therapy. This is being fuelled mainly by the obsession towards keeping youthful among westerners. One problem with
gene therapy and hopeful anti-aging treatments is the pleiotropic
nature of genes. For instance, the gene which assists in the calcication of bones during youth is the same gene which may lead
to atherosclerosis in later age. Current research on telomeres and
anti-aging is a case in point. Telomeres are located at the ends of
chromosomes and are related to aging in organisms. As organisms
age telomeres become shorter leading to chromosomal instability [16]. Defects in telomere length have been linked to various
age-related diseases and premature aging syndromes [16]. Animal research has so far revealed how telomerase may regulate

563

the biological clock. While telomerase is implicated in telomere

regulation, the theory that by increasing telomerase to human
chromosomes we will increase longevity is facile. The reason for
this is that cancer cells which are potentially immortal are maintained by telomerase activity [17]. Consequently, any future
tweaking of human telomeres must take into account the potential risk of triggering cancer cells. While it has been established
that telomerase deciency is implicated in loss of telomeric replication in mice, it is still early days in transposing such results
to human ageing syndromes [16].
Current research in human brain augmentation such as brainmachine interfaces (BMIs) and cosmetic neurology indicate that
the brain will be a future site for medical corrective transformation. Recent advances in nanotechnology, information technology,
neuroscience and biotechnology are leading towards the development of BMIs which promise cognitive and sensory enhancements.
Recent animal research on BMIs supports the contention that humans are at the threshold of a technological revolution where
articial devices are integrated into the primate brain [18]. Current
work on BMIs investigates improvements in signals from the
brain and carrying sensory inputs to the brain [19]. Present research is based on the need to better understand neural coding,
sensory and memory information. A second aim is to assist paralysed patients and those individuals suffering from peripheral sensory impairments [19]. A third motivation for BMI research is to
be able to ascertain cognitive advantages of having neural prostheses within a military arena where split second decision making is
vital [20]. Considerable research has been done in BMIs in the last
twenty years. However, most BMIs are currently in their developmental stage, with applications for humans in the not too distant
future [21].
The thrust towards brain and body augmentation has been the
topic of much debate by futurist thinkers such as Ray Kurzweil
[22,23], Nick Bostrom [24], Gregory Stock [25], Hans Moravec
[26] and Ramez Naam [27]. In his seminal work The Age of Spiritual Machines [22], the futurist Ray Kurzweil states that the human
brain needs improvement. While a marvel in parallel processing
(100 billion neurons and 100 trillion synaptic connections), it is
slow of its computing medium (only 200 calculations per second),
a limitation not shared with computers. He even calls for an abandonment of DNA based evolution. Why this rejection one may ask?
Firstly, he believes that nanotech designed brains will be exponentially more efcient with greater memory and recall capacity. As he
notes, By probing the brains circuits, we can copy and imitate a
proven design, one that took its designer several billion years to
develop [22]. Any fundamental re-design of the human brain will
have to take into account its lengthy evolution, as well as, genetic
and environmental factors that have shaped it. Of course, this does
not even take into account mind and to what extent any future redesign will transform it.
Kurzweil also poses a future in which neural implants are so
widespread in the human species to the point that they become
necessary to future humans to function normally in a high tech
world. Kurzweil discusses how the human brain will be comfortably tethered to computational devices to the point that it will become a normalized part of human existence. Brain enhancement
will occur gradually but inexorably via direct interface with
sophisticated machines until the architecture of human thinking
becomes contingent on them. Kurzweil predicts by 2029 that neural pathways with high bandwidth connections would be perfected
[22]. This would allow the bypassing of neural regions and augmenting or supplanting these regions with neural implants or
externally [22]. In Kurzweils thinking visual, auditory and tactile
implants will become so widespread in the 21st century that BMIs
will alter human evolution and lead humans at that period to become post-humans.

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A. Saniotis, M. Henneberg / Medical Hypotheses 77 (2011) 560564

If we can provide the brain with speedy access to unlimited memory,

unlimited calculation ability, and instant wireless communication
ability we will produce a human with unsurpassable intelligence.
We fully expect to demonstrate this kind of link between brain and
machine [28].
Similarly, Andy Clark believes that the human brain is suitable
for various novel mergers with prosthetic devices with an onus
of improving human health [29]. Neural implants, for example
could probe the level of neurotransmitters and stimulate the secretion or retention of neurotransmitters at neural synapses. In this
way, the neuro-hormonal system could work in an optimal manner, offsetting the onset of serious psychotic and depressive illnesses. In Clarks vision neural implants will have an impact on
the way in which humans will interact with their environments
or global positioning systems (GPS) [29]. The combination of GPS
with various neural implants would have numerous everyday
applications including driving, ying aircraft and nding ones
direction. Clark also argues that the neuroplasticity of the brain
will enable a comfortable accommodation of neural implants
[29]. To what extent BMIs will affect the neuro-hormonal system,
as well as, higher order brain functions and affectivity is still unknown. We would argue that any long term implementation of
BMIs needs to take into account neuronal and neuro-hormonal
complexity.
A major inspiration for futurist thinking of the body derives
from medical discourse which has traditionally viewed the body
as a sophisticated machine comprised of interacting body parts.
In addition, current medical discourse approaches the body as a
compilation of detachable things (organs, blood, faces, bone marrow, ova, sperm, ova, hands, etc.) [30,31]. The zenith of such
detachable thinking involves the idea of downloading the human
mind into a computer as a simulation. From there copies of the detached mind can be made ensuring the individuals immortality
[32]. While such an idea inclines towards science ction, it does
showcase how medical discourse on the body is being used by
futurists.
Conict of interest statement
No conicts nancial or otherwise are related to this work.
Sources of support
None.
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