From the royal houses of Europe the effects became obvious.
Under Salic Law, a monarch could only marry a cousin. The gene pool became smaller with the catholic/protestant divide, and produced either insanity or sterility in all royal houses. Charles II of Spain was probably the height of the Hapsburg inbreeding, and was described as barely recognisable as human.
The Wittelbach's of Bavaria spread their insanity through the Austro-Hungarian empire. Queen Victoria was the carrier of haemophilia through nearly all royal houses.
This 'rule' was only broken when our late Queen Mother married, but even that was only because her husband was not expected to be king. That's several centuries of cousin-cousin marriages. It seems that nature eventually stops the process.
In my own tree, I'm wondering if this is a factor in the many infant deaths in the 19th century.