Product Description

The achievements of medicine in the post-war period rank as one of the most sustained epochs of human endeavour since the Renaissance. So dramatic and profound has been the assault on disease that it is now almost impossible to imagine the world of just fifty years ago when there were no drugs for most killer diseases. These achievements have had a profoundly beneficial effect on people's lives as well as being a liberating force, freeing them from the fear of illness or untimely death, permitting them for the first time in human history to live out their natural lifespans, while significantly ameliorating the chronic disabilities associated with ageing. The scope of medicine is immeasurably greater than it was fifty years ago, but the optimism generated by those achievements seems to have evaporated. Medicine is doing better but feeling worse. THE RISE AND FALL OF MODERN MEDICINE presents for the first time a comprehensive and searching appraisal of the science, philosophy and politics of modern medicine.

Product Details

• Amazon Sales Rank: #28249 in Books
• Published on: 2000-08-03
• Original language: English
• Binding: Paperback
• 501 pages

Amazon.co.uk Review
Take this book on holiday--it's a gripping story full of drama and suspense, heroes and villains and, despite charting dark periods when evil triumphed over virtue, has an optimistic message at the end. James Le Fanu has an enviable talent for making medical history fascinating and has produced a story about medicine's rise and fall since the Second World War that will surprise, intrigue and shock you. He claims that in a period of intense innovation between 1940 and 1970 medicine conquered all the major chronic diseases affecting the very young and the very old. With only the much rarer conditions that effect very small numbers of the population in middle life left to address, the revolution dramatically slowed down and innovation almost came to a halt.

Medicine looked subsequently for new frontiers but went up blind alleys, "The New Genetics" and "The Social Theory" of disease. Neither of these new "paradigms" have produced the same level of innovation and are responsible in part for bringing medicine into disrepute.

Despite enormous levels of funding, understanding the "code of life" has not produced any major therapeutic pay-offs, because genetically caused diseases--with only a few exceptions--are rare; genetic engineering and screening proved largely fruitless and genetic therapy made little impact. Theories that social behaviour causes disease, however, has not just been shown to be invalid but has also caused an epidemic itself of health hysteria amongst the well and resulted in blaming the sick for contracting their disease. He regards social theories such as the false idea that high- fat diets cause heart attacks as intellectual scandals that should be apologised for.

Perhaps his most controversial suggestion is that all university epidemiological departments should be closed down in order to prevent any further misinformation from being produced. But Fanu offers criticism of as well as praise for clinical practitioners, and scientists too. He suggests that doctors need to start listening to patients again and interpreting histories instead of ordering barrages of tests if they want medicine to regain respect. And clinical science needs to start trying to discover the biological transmissible agents of the diseases of middle-life if it is to awaken to a new dawn of innovation in the future. --Dorothy Porter

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 'Dr Le Fanu writes with clarity and authority... you'll nowhere find a better crafted and more expert account of how modern medicine helps ensure that the great jaority of us live to a ripe old age...erudite and absorbing.' Professor Roy Porter, OBSERVER 'The struggles, disappointments and fatal errors of these early pioneers are described with zest, authority and a special brand of wry humour...it is an endlessly fascinating read.' FINANCIAL TIMES 'Well written, a fascinating and informative book, which should be read by anyone with an interest in contemporary medicine.' SUNDAY TELEGRAPH 'A masterly history of these revolutionary years.' THE TIMES 'The ambition of this, the first historical account of this period, is admirably justified throughout. Le Fanu communicates complex material in a clear and straightforward fashion while taking care, wearing his journalistic cap atop his white coat, never to let the abundant scientific facts stand in the way of what is a rattlingly good story.' SCOTLAND ON SUNDAY 'A fascinating overview.' DAILY EXPRESS 'This well-written, extremely readable, and thought-provoking book deserves to be widely read, especially by those in the establishment who would say he is wrong.' BRITISH JOURNAL OF GENERAL PRACTICE 'This book is well worth reading just for the brilliant pen portraits of Le Fanu's 12 definitive moments of medical advance...the author has a way of encapsulation that is full of insights and unusual detail.' SPECTATOR 'The tales are well told, and should be read by all juniors to give them some feeling of the excitement felt by their grandparents as major diseases that had seemed totally untreatable come under control.' JOURNAL OF THE ROYAL SOCIEETY OF MEDICINE 'Take this book on holiday--it's a gripping story full of drama and suspense, heroes and villains and, despite charting dark periods when evil triumphed over virtue, has an optimistic message at the end. James Le Fanu has an enviable talent for making medical history fascinating and has produced a story about medicine's rise and fall since the Second World War that will surprise, intrigue and shock you. He claims that in a period of intense innovation between 1940 and 1970 medicine conquered all the major chronic diseases affecting the very young and the very old. With only the much rarer conditions that effect very small numbers of the population in middle life left to address, the revolution dramatically slowed down and innovation almost came to a halt. Medicine looked subsequently for new frontiers but went up blind alleys, "The New Genetics" and "The Social Theory" of disease. Neither of these new "paradigms" have produced the same level of innovation and are responsible in part for bringing medicine into disrepute. Despite enormous levels of funding, understanding the "code of life" has not produced any major therapeutic pay-offs, because genetically caused diseases--with only a few exceptions--are rare; genetic engineering and screening proved largely fruitless and genetic therapy made little impact. Theories that social behaviour causes disease, however, has not just been shown to be invalid but has also caused an epidemic itself of health hysteria amongst the well and resulted in blaming the sick for contracting their disease. He regards social theories such as the false idea that high- fat diets cause heart attacks as intellectual scandals that should be apologised for. Perhaps his most controversial suggestion is that all university epidemiological departments should be closed down in order to prevent any further misinformation from being produced. But Fanu offers criticism of as well as praise for clinical practitioners, and scientists too. He suggests that doctors need to start listening to patients again and interpreting histories instead of ordering barrages of tests if they want medicine to regain respect. And clinical science needs to start trying to discover the biological transmissible agents of the diseases of middle-life if it is to awaken to a new dawn of innovation in the future.' - Dorothy Porter, Amazon.co.uk

Daily Mail
'Stand by for a brilliant read ... will send your heart palpitating and your blood pressure rising from the start'

Customer Reviews

Lively provocative account of medicine
Other pundits have proposed the misanthropic ideas of the end of history, of politics, of industry and of class. Now James Le Fanu, the Daily Telegraph's medical columnist, pronounces the end of medicine.

He claims that medicine's golden age from 1945 to 1980 was due to the chance discovery of drugs, advances in clinical science and innovative technology. He believes that medical progress 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.

However, it is perhaps bad timing to write off genetics when the Human Genome Project offers such exciting possibilities, and when epidemiology and social medicine have proven the social determinants of so many diseases. He rejects all social and economic explanations of illness. But lifestyle changes - losing weight, improving diet and exercising more - do, for instance, prevent diabetes and promote health and well being (British Medical Journal, 14 July 2001, page 63.)

But he usefully calls for more research into the causes of disease, and rightly rejects idealist explanations. He recounts how doctors used to blame peptic ulcers on 'stress' or 'personality factors', but in 1984, Barry Marshall, a young Australian doctor, identified the bacterium that triggered them. A seven-day course of antibiotics could cure them. The same organism caused two-thirds of stomach cancer cases. In 1986, Thomas Grayston discovered that the bacterium chlamydia caused heart disease. Le Fanu speculates that bacteria as yet undiscovered may cause arthritis, schizophrenia, leukaemia, MS, diabetes and ME.

Le Fanu shows that doctors' seclusion of tuberculosis patients in sanatoria dramatically reduced the infection's incidence, proving that the influential historian of medicine, Thomas McKeown, was wrong to deny doctors the credit for its decline.

He has a brilliant chapter on how the use of new drugs refuted Freudianism and psychoanalysis, as chlorpromazine effectively relieved schizophrenia's symptoms, lithium mania's, prozac depression's and Valium anxiety's.

This is a provocative and infuriating book, full of ideas and prejudices. All who work on improving people's health will naturally make their own judgements about the continuing value of their work.

A refreshingly truthful and gripping book.
This is the best book I have read in ages- it manages to present the truth about medicine and science of yesterday and of today with a sometimes brutal but refreshing frankness. Le Fanu is not blinded by science nor is he scornful of it. He is a faithful reporter with a sprinkling of imagination thrown in for fun. What a wonderful read.

Infuriating and provocative account of medicine today
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.