In 1761 German physician Leopold Auenbrugger remarked, "It has always been the fate of those who have illustrated or improved the arts and sciences by their discoveries to be beset by envy, malice, hatred, destruction and calumny." Following Great Feuds in Science, Hellman (Beyond Your Senses) now documents 10 dramatic medical disputes. British anatomist William Harvey's 1628 discovery of blood circulation challenged anatomical theory and caused his ostracism by the scientific community. In the late 18th-century, electrical disputes raged between Galvani whose "animal electricity" theory, to modern sensibilities, borders on the occult, though it garnered immediate support and prefigured current studies of electricity and paralysis and Volta, who worked to disprove Galvani. Claude Bernard's experiments on animals, in his studies of the nervous system, caused outrage among antivivisectionists and led to his being disowned by his family. Hungarian obstetrician Ignaz Semmelweis was committed to a mental hospital after the Viennese medical establishment rejected his hypothesis that unsanitary conditions in his workplace (doctors went from an autopsy to a birth without washing their hands) caused the high infection and death rate among patients. Other chapters address "Freud bashing," Sabin vs. Salk (polio vaccine) and Gallo vs. Montagnier (AIDS). Hellman eschews comprehensiveness for pith and entertainment, neglecting no unusual "twist," "strange coincidence," "cloud of suspicion" or "lucky break" to heighten the drama of these medical milestones. (Mar. 9)Forecast: Hellman's well-received books and articles (in the New York Times, Omni, Reader's Digest, etc.), and the success of popular science writing ensure his continuing appeal to serious science buffs, history fans, and casual readers alike.
Copyright 2001 Cahners Business Information, Inc.
--This text refers to the
Hardcover
edition.
Inundated by medical journals, surrounded by news media with health and science reporters, bombarded with invitations to conferences, and ensnared in the World Wide Web, physicians and the public have come to expect medical discoveries and breakthroughs to appear constantly and to be incorporated instantly into clinical practice or further research. Hal Hellman, a writer of popular science, has provided a valuable service in his new book, Great Feuds in Medicine, revealing how difficult it can be to create and disseminate innovative medical information. Hellman has assembled 10 chapters in medical history, a series of contentious cases with ``some special drama or scientific interest'' to highlight the ``human enterprise'' of medical discovery. His stories cover a broad span of time, from the work of Harvey in the early 1600s to research on the human immunodeficiency virus in the 1980s, and an equally wide range of disciplines, including physiology, microbiology, neuroscience, psychiatry, and molecular biology. Most chapters tackle pivotal moments in medical thinking, when dramatic ideas or experiments transformed the field. After each such moment followed a time of discontent and upheaval, when challenges arose and information was dispersed, before the paradigm shifts and discoveries were accepted with broad consensus.
Collectively, the vignettes illustrate the personal perils of being an explorer; medical researchers who aspire to greatness ought to have a thick skin. Before ascending to the pantheon of medicine, most of these heroes had to suffer through bitter attacks on their work and their character. Pasteur, Freud, Harvey, Bernard, Salk, Semmelweis -- each was prey to criticism, envy, competition, resistance, and dismissal before, with the passage of time, their contributions were accepted and acknowledged. The scientific process is revealed to be less pure and pristine than many imagine. Nationalist bias, professional entrenchment, institutional bureaucracy, religious sentiments, and cultural tradition all influence the development and adoption of medical knowledge, and thus have an impact at least as important as the scientific method itself.
This is medical history as personal rivalry; hence, the feuds. Hellman relishes the anecdote, the off-hand comment, and the individual foible that make real people of these legendary heroes. Vanity, competitiveness, self-doubt, jealousy -- all these human frailties appear in great abundance. In some instances, this approach clearly enriches our understanding of seminal physicians, yielding insight into their ambition and brilliance. It is enlightening to be reminded that the acceptance or rejection of medical ideas frequently hinges on the personality of the individual researcher and on that of his or her competitors. The showmanship of medical discovery -- the ability to illustrate a point dramatically in public ceremony -- emerges as a lost art. Certain figures, such as Pasteur and Freud, prove so compelling that the controversy surrounding their discoveries extends into the historical assessment of their lives. Hellman notes how the feuds ignited by these men turned into battles among their various biographers and historians.
How do differing opinions, conflicting data, disparate observations, contrasting philosophies, personal rivalries, and pointed conjecture influence the growth of medical knowledge? This is the unspoken question underlying Hellman's book, and it is a critical one for understanding the way in which science and clinical practice evolve. The resolution of medical disputes is a fascinating and important process, and as Hellman shows, it is often governed by much more than cold, hard facts or data. Hellman provides interesting anecdotes that will capture the attention of a lay audience and build appreciation for human interaction in medical discovery. However, his method falls short of explaining how medicine changes over time, and his reliance on secondary sources means that there is little new information. The narration lacks the richness and depth favored by professional historians of medicine. Those seeking an introduction to the history of medicine will find the chapters readable and free of technical jargon. Yet the disputes Hellman chooses seem oddly petty -- personal but not intellectual -- and surprisingly devoid of the compelling drama created by real tensions in the scientific community. In relying on short case studies, Hellman misses an opportunity for tackling the broader meaning of dispute and debate as part of the scientific and medical process.
The word ``feud'' connotes a bitter, festering, long-standing, and somewhat irrational quarrel -- an argument for the sake of an argument. In the long and colorful history of medicine, there have undoubtedly been many feuds. Some persist to this day. Great Feuds in Medicine serves up some of the most exciting disputes. These stories make for fascinating, if not entirely satisfying, reading.
Harold J. Burstein, M.D., Ph.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
--This text refers to the
Hardcover
edition.
