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: #122684 in Books
• Published on: 2004-02-03
• Original language: English
• Binding: Paperback
• 501 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 '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

Customer Reviews

Fascinating read, interesting hypothesis
A must read for anyone blinded by medicine's apparent glory and victories over human disease. This book exposes the past in which medicine's landmark discoveries/ events are shown to be mostly a combination of chance, persistance, mindless trial and error or even freak accident. From modern medicines illustrious history '10 definitive moments' have been selected by the author to illustrate the events that have led to the glorified status that medicine holds in our western society. Beginning with Penicillin in 1941 and ending with the discovery of Helicobacter, the cause of peptic ulcers, in 1984. These accounts make any reader wide-eyed at the simplicity of some of the research designs and truck loads of luck involved in the discoveries. This portion of the novel is full of interesting facts concerning the '10 definitive moments' written in rich narrative rather than a more conventional dry historical account to keep any reader glued to his lazy chair.

The next portion of the book is an elaborate argument for his hypothesis; that medicine has long ago reached it epiphany and is currently in the decent phase, "The Fall". He gives convincing arguments for his opinion which makes a reader think about it even if one isn't totally convinced.

The Title, "The Rise and Fall of Modern Medicine" caught my attention and once I opened the book the words trapped me until the last page was turned. Even after closing the book I considered his hypothesis and reflected on it, which has spawned me to follow up on some of his references and read some of them. In my opinion any book that causes such a fury of reading, thought, and reference checking and further reading is worth a look by any casually interested reader.

The rise and fall of modern medicine
This is a brilliant book and I am amazed that this is the first review. It is a 'tour de force'. It brings together many threads of the great advances of modern medicine post war and chronicles how the golden age petered out eg the pharmacological revolution slowed rapidly particularly post thalidimide. It explores the fallacies and cheating which gave us the Social Theory ie ill health is all our own fault because of what we eat - we shouldn't eat so many lamb chops or choccie bikkies - and the unfulfilled expectations of genetics and its possible limited application in medicine. It is both scholarly and readable as well as becoming quite compelling. Even if the bloke is a journalist this is stunning stuff. I am still searching for an effective contrary view.

Provocative and infuriating survey
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.