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The medical achievements of the post-war years rank as one of the supreme epochs of human endeavour. Advances in surgical technique, new ideas about the nature of disease and huge innovations in drug manufacture vanquished most common causes of early death, But, since the mid-1970s the rate of development has slowed, and the future of medicine is uncertain. How has this happened? James Le Fanu's hugely acclaimed survey of the 'twelve definitive moments' of modern medicine and the intellectual vacuum which followed them has been fully revised and updated for this edition. The Rise and Fall of Modern Medicine is both riveting drama and a clarion call for change.
- Sales Rank: #1759580 in Books
- Published on: 2011-11-01
- Original language: English
- Number of items: 1
- Dimensions: 7.76" h x 1.46" w x 5.04" l, 1.10 pounds
- Binding: Paperback
- 608 pages
From Publishers Weekly
"Much current medical advice is quackery," cautions Le Fanu in this remarkably engrossing scholarly study of medical progressAand the recent lack thereofAin the 20th century. Le Fanu (a medical columnist for London's Daily and Sunday Telegraph) contemplates what he sees as the unhappy situation of contemporary health care. The decades from the 1940s to the 1980s saw some of the most critically important advances Western medicine has seen, from penicillin to the heart pump that made open-heart surgery possible. Yet doctors are disillusioned, and patients are turning in droves to alternative forms of medicine. How has this dilemma come about? Le Fanu first details the astonishing breakthroughs of the earlier part of the 20th century (he describes, for instance, the progress made by the first patient ever administered penicillin). But, more controversially, he argues that since the 1980s medical progress has been crippled by two developments, which he terms "Social Theory" and "New Genetics," respectively: according to the author, misguided epidemiologists promote a lifestyle changes (low-cholesterol diet, etc.) as a means of preventing heart disease; and geneticists have misled us into thinking that their research breakthroughs can eliminate genetic diseases. Both cases have been overstated, Le Fanu contends, drawing on a wealth of scientific data to attempt to show that dietary changes have done little to prevent heart disease and that genetic experiments, despite "millions of hours of research," have had "scarcely detectable" practical results. He concludes with a plea to return to the traditional in the practice of medicineAthe relationship between doctor and patientAand to a renewal of faith in the diagnostic skill and judgment of one's personal physician. B&w photos. Agent, Caroline Dawnay. (July)
Copyright 2000 Reed Business Information, Inc.
From Kirkus Reviews
English physician and Daily Telegraph columnist Le Fanu writes a thoughtful history of the only 20th-century revolution that turned out brilliantly.During the century before 1940, people grew healthier and lived longer through improved hygiene, housing, and nutrition. Once they got sick, however, doctors weren't that much help: except for a few treatments (such as thyroid hormone, insulin, and vitamins) a patient got better pretty much on his own--or he didn't. WWII marked the beginning of a torrent of miraculous advances. To label these miracles is no hype. Dreadfully sick people received penicillin, cortisone, or lithium--and suddenly they weren't sick. Every single child who contracted leukemia in 1950 died; today almost all live. Victims of congenital heart disease or kidney failure lived as pitiful invalids if they lived at all; now they live normally. This was a wonderful period full of heroes, and Le Fanu describes it superbly in the first half of his story. Then he grows sober, thoughtful, and pessimistic. Medicine's golden age peaked in the 1960s, he writes. Important discoveries trailed off after 1970, introduction of genuinely new drugs dropped sharply, and two disturbing trends appeared. He calls one the Social Theory. Misled by triumphs of the golden age (proof that smoking causes cancer and treating hypertension prevents strokes), doctors embraced a utopian theory of prevention with enthusiasm unaccompanied by proof. Readers will be jolted by the author's claim that diet, lifestyle, and pollution contribute only marginally to ill health. Obsessive efforts to fine-tune our diet and environment (medical correctness) have, in Le Fanu's view, produced little beside anxiety. The author also takes a dim view of the New Genetics: science's fascination with DNA, genetic engineering, and genetic therapy. He points out that 20 years of expensive research, media obsession, and wildly optimistic claims have produced only minor benefits to patients. Le Fanu's doubts about prevention and genetic engineering place him in the minority among laymen as well as doctors, but he makes a convincing case in this readable and informative account. -- Copyright © 2000 Kirkus Associates, LP. All rights reserved.
Review
Stand by for a brilliant read ... will send your heart palpitating and your blood pressure rising from the start Daily Mail Has the great knack of making even the most complex technical developments exciting and intelligible Observer A major achievement The Tablet Epic and entertaining. The Lancet
Most helpful customer reviews
29 of 32 people found the following review helpful.
Everything you know is wrong...
By Adam Rutkowski
Very rarely, I come across a book so enjoyable that I have to put everything else on hold until I finish reading it. This is one of those books. It combines fanscinating information, intriguing analysis, and a thoroughly enjoyable writing style.
The book is divided into two major sections: an extended prologue, and the book proper. The prologue is nearly half of the book, and it describes twelve definitive moments in medicine in the past 50 years. This section is informative and enjoyable, and the book is worth reading for this part alone.
The second section is even better. Le Fanu believes that medicine experienced its Golden Age during the fifties and sixties, and is now in decline. He provides compelling evidence in support of this claim, and his discussions on the false hopes brought about by genetics, and the falsity of the Social Theory (the theory that most of our health problems are caused by environmental factors) are great, and probably largely correct.
This is a book that I would recommend to anyone. It is easy enough for the layman to understand, and I think that those in the medical profession will get a lot out of it, whether they agree with the author or not. READ THIS BOOK!!!
13 of 14 people found the following review helpful.
Good antidote to thoughtless faith in medicine
By J. Lawrence
Le Fanu writes extremely well, as long as he's not ranting. His coverage of the history of western medicine is informative and highly readable, if debatable on small points. His talent is creating a real story out of a collection of facts, and delivering it in a punchy and amusing way.
Le Fanu successfully communicates his main thesis - that the history of medical progress consists mainly of accidental or fortuitous discoveries, and that it is therefore not the rational machine that many people imagine it to be. We know much less about human health than you might think, and even less about how to go about improving it. Since many otherwise intelligent and well-informed people place blind faith in doctors, medicine, and in press stories about health issues, Le Fanu is performing an important public service.
The book is marred by his rants against modern medical research. While this industry undoubtedly deserves criticism, he makes a poor job of it. He ceases to support the points he makes, and since many of them are debatable, it is difficult to take this part of the book seriously. For example, he suggests shutting down all departments of epidemiology in all medical educational and research institutions. While I hold no torch for epidemiology, this strikes me as excessive, and he fails to win me over with any rational explanation as to how this would help.
Despite my reservations about the final chapters, I would highly recommend this book. Anyone who already harbours doubts or concerns about western medicine will find the book interesting. Anyone who does not really needs to read this.
9 of 10 people found the following review helpful.
Provocative and infuriating survey
By William Podmore
The Telegraph's medical columnist claims that medicine's golden age was from 1945 to 1980, due to the chance discovery of drugs, advances in clinical science and innovative technology. He believes that it is now exhausted, and laments that the vacuum is being filled by what he thinks are the dead ends of New Genetics, epidemiology and social medicine. It is untimely to write off genetics when the Human Genome Project offers such exciting possibilities.
He calls for more research into the causes of disease, and rightly rejects idealist explanations. Doctors used to think that peptic ulcers were due to `stress' or `personality', but in 1984, Barry Marshall, a young Australian doctor, identified a type of bacterium that triggered them. A seven-day course of antibiotics was the cure. The same organism caused two-thirds of stomach cancer cases. In 1986, Thomas Grayston discovered that the bacterium chlamydia caused heart disease. Perhaps as yet undiscovered bacteria cause arthritis, schizophrenia, leukaemia, MS, diabetes and ME.
He has a brilliant chapter on how the use of new drugs refuted Freudianism, as chlorpromazine effectively relieved schizophrenia's symptoms, lithium mania's, prozac depression's and valium anxiety's.
Le Fanu shows that the influential historian of medicine Thomas McKeown wrongly denied doctors the credit for tuberculosis's decline. Doctors' seclusion of TB patients in sanatoria dramatically reduced the infection's incidence.
He argues against social medicine, rejecting all social and economic explanations of illness. But lifestyle changes - losing weight, improving diet and exercising more - do prevent diabetes and promote health and well-being (British Medical Journal, 14 July 2001, page 63.)
He claims that medicine has run its course. We have seen the misanthropic idea of the end of history, of politics, of industry and of class. Now Le Fanu pronounces the end of medicine. This is a provocative and infuriating book, full of ideas and prejudices. We need the tests of practice to see what he has got right.
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