- Hardcover: 512 pages
- Publisher: Little, Brown (3 Jun 1999)
- Language English
- ISBN-10: 0316648361
- ISBN-13: 978-0316648363
- Product Dimensions: 23.6 x 14.8 x 4.8 cm
- Average Customer Review: 4.5 out of 5 stars See all reviews (11 customer reviews)
- Amazon Bestsellers Rank: 385,420 in Books (See Top 100 in Books)
The Rise And Fall Of Modern Medicine
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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 )
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 )
Inside This Book
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First Sentence
The discovery of penicillin is, predictably, both the first of the twelve definitive moments of the modern therapeutic revolution and the most important. Read the first page
Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
The discovery of penicillin is, predictably, both the first of the twelve definitive moments of the modern therapeutic revolution and the most important. Read the first page
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Concordance
Browse Sample PagesConcordance
Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
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Customer Reviews
Most Helpful Customer Reviews
19 of 19 people found the following review helpful
Format:Paperback
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.
7 of 7 people found the following review helpful
Format:Paperback
The first section (the twelve most important medical breakthroughs) is the best medical history I've read. His critique of social medicine and genetics is sound - too much is made of too little by 'epidemiologists' and genetics has promised much but delivered little despite huge claims being made for it (not what happened in heart surgery etc.)However, both genetics and epidemiology may prove more beneficial in the future. However this is not certain (which is not what you here from geneticists!
10 of 11 people found the following review helpful
Format:Paperback
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.
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Most Recent Customer Reviews
Nothing fails like success?
As you have probably already guessed by its title, this is a book of two halves.
The first half is the uplifting bit, the history of modern medicine's stunning advances... Read more
The first half is the uplifting bit, the history of modern medicine's stunning advances... Read more
Published 5 days ago by F Henwood
The Rise and Fall of Modern Medicine
Most of us take modern health care for granted without any thought as to how it developed in the latter half of the twentieth century. Read more
Published 4 months ago by Sue Jones
An Excellent History Then An Infuriating Diatribe
The first 186 pages of Le Fanu's book are a brilliant history of the twelve major moments of post-war medicine. Read more
Published 10 months ago by jamespiggott5
Medicine and how both the sick and well are treated.
Given that we are all potential patients; this is a book that everyone should read. With painstaking research 'The Rise & Fall of Modern Medicine" describes both the beauty and... Read more
Published 18 months ago by Mrs. Deborah J. Nash
A lucky generation
James le Fanu is a good sensible journalist and this book is just that; reminding us how much has happened in medicine and surgery since 1945 to remove a vast range of illnesses... Read more
Published on 11 Nov 2009 by J. B. Swingler
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... Read more
Published on 5 Aug 2001 by William Podmore
excellent and evocative history, rather weak arguments about the...
Excellent in parts - mainly the first part, in which Le Fanu evocatively lays out some of the most exciting discoveries made by the pioneers of medicine in the twentieth century;... Read more
Published on 10 Oct 2000 by Dr. James A. Mchugh
Great overview of medicine, past and future
I'm working as a health economist and this book has helped me a lot in understanding the history of medicine.
Published on 11 Feb 2000
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