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Mirage of Health: Utopias, Progress, and Biological Change
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Top Customer Reviews
1) Dubos has some of the best illustrations of the cyclic/repetitive nature of social thought. He offers a very clear interpretation of meta-medicine since the early Greeks in the Western world, with some decent insights about non-Western cultures as well. (Remember that this book was written in 1959; here's some salt, take a grain of it.)
2) He has a great overall critique of our philosophy of causation in the medical sciences, with a specific focus on the relation between microbial parasites and disease. We know that bronchitis, for example, is caused by certain bacilli, but we also discover that, killing off those bacilli, the patient won't necessarily get better; another infection can take hold. Conversely, and I didn't realize this before reading Mirage of Health, essentially every European urbanite in the 19th century was infected with tuberculosis - but only "were consumptive", became ill. He points out that obliterating bacterial competition is neither possible, desirable, nor necessary, which is on the one hand, so very interesting in its ivory tower way, and on the other hand, so very important. Drug-resistant TB is worsening the world over, from Russia to South Africa to Haiti, and the only thing that consistently works are comprehensive programs that don't just drug the patient, don't just treat the whole patient, but treat the community and environment as a whole. I'm not really interested in being alarmist - "we'll find ourselves in a whole heap of trouble if we don't listen!! zomg" - but the possibility to prevent human suffering is enormous.
Despite being written in 1959, the book is surprisingly fresh and almost timeless. This is mostly because Dubos writes primarily about events and trends that occurred in the decades and centuries before it was written and doesn't spend a long time focusing on the contemporary state of medical science. One interesting exception to this is when Dubos mentions that cancer's cause--which is now known to be genetic mutation--was unknown at the time of writing.
Dubos makes it clear that the doctrine of specific etiology (that is the notion that all medical problems can be traced to a certain, physical cause) has contributed more to medicine in the last century than probably any other idea. Yet Dubos also stresses the limitations of this mindset. He emphasizes that with physical ailments, there are many causes at work and it is difficult or impossible to determine the most significant among these. By emphasizing the multitude of factors that determine our health, Dubos makes it clear that balance with our environment is of utmost importance to maintenance of health.
Dubos illustrates this point historically in a most vivid fashion. In the presence of a new pathogen, for example, a population can be decimated. Dubos uses the example of the introduction of smallpox to America as an example of such devastation. Another way that Dubos illustrates humans' relationship with their environment is the story of a Zulu tribe in Africa.Read more ›
Four stars only because it might be a little dated by now, but no one has attempted to surpass what Dubos accomplished.
Most Recent Customer Reviews
Really insightful. A must read for any Public Health student, and a highly encouraged read for all people who care about health and societal well-being.Published 5 months ago by Vinton
A classic, necessary read for all health professionals & folks interacting with such.
- Will Taylor, MD