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The Rise and Fall of Modern Medicine Paperback – 6 Nov 2012

4.5 out of 5 stars 38 customer reviews

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Product details

  • Paperback: 590 pages
  • Publisher: Basic Books (AZ); Revised ed. edition (6 Nov. 2012)
  • Language: English
  • ISBN-10: 0465058957
  • ISBN-13: 978-0465058952
  • Product Dimensions: 14 x 3.9 x 21 cm
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (38 customer reviews)
  • Amazon Bestsellers Rank: 672,218 in Books (See Top 100 in Books)

Product Description

About the Author

James Le Fanu, M.D., is a medical columnist for the "Daily Telegraph" and "Sunday Telegraph" as well as a writer for the "Times," the "Spectator," and "GQ."

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Customer Reviews

4.5 out of 5 stars
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Top Customer Reviews

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.
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By F Henwood TOP 1000 REVIEWER on 29 May 2012
Format: Paperback
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 which lasted roughly from the end of the Second World War until the 1970s/1980s when innovations started to peter out, a decline that neither the breakthroughs in mapping the human genome nor the enormous research outlays of pharmaceutical corporations have done anything to reverse.

Before the 1930s, doctors were all but powerless: they could diagnose what was wrong but the cupboard of specific remedies was all but bare. This was to change dramatically over the next few decades. As Le Fanu writes:

`The newly qualified doctor setting up practice in the 1930s had a dozen or so proven remedies ... to treat the multiplicity of different diseases he encountered every day ... Thirty years later, when the same doctor would have been approaching retirement, these dozen remedies had grown to over 2000 ... (p. 234).

In forty years medicine banished a range of maladies that had afflicted humankind for millennia. The victories were not just against the perennial killers of the body such as polio and TB but also of the mind, like schizophrenia. These advances were reinforced and complemented by technological innovations, leading to the wonders of open-heart surgery, organ transplants and hip replacement operations. The alleviation of suffering and distress these advances entailed was truly phenomenal.

What was the basis of this success? Le Fanu confesses that he doesn't know: these discoveries were fortuitous, serendipitous, and accidental. Had Alexander Fleming not been at the right place, at the right time, we might never have discovered penicillin.
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Format: Paperback Verified Purchase
This book factually destroys many myths about medicine and health care peddled by interest groups and financially interested parties. It raises big questions about priorities for public sector expenditure and charitable expenditure in the next few decades, as the rate of new discoveries slows down and treatments become more routine. It should be read by everyone who thinks about health care priorities.
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Format: Paperback
The first 186 pages of Le Fanu's book are a brilliant history of the twelve major moments of post-war medicine. In a gripping narrative Le Fanu manages to present a well-researched, thorough and insightful journey from Penicillin to Heliobacteria - the reader never loses track of where they are thanks to the author's ability to seamlessly weave context and science together.

After page 186 things radically change. Le Fanu now argues for a certain interpretation of modern day medicine - one where statistics and clinical medicine have slowed medical breakthroughs to a halt and are strangling the spontaneity and freedom which (he argues) were the hallmark of the 1940's to 1970's which produced almost all twelve major moments. From here the diatribe begins - whilst he pulls out major themes and changes there is a distinct lack of counter arguments. In fact his evidence is so one-sided that the reader starts to wonder what is not being shown to them.

However it is a convincing argument in places, but not uniformly so. One might question whether the style of argument Le Fanu deploys is little different to the style of argument that the clinical scientists use in reaching their (by now) ridiculed conclusions - the conclusion comes first the evidence second, and counter arguments are ignored in order to present seemingly clear correlations.

Overall, an interesting read. The long 'prologue' is excellent, but the next few hundred pages are frustrating. More balance is required in order to give weight to Le Fanu's arguments.
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