This is a truly fascinating book, and highly recommended for anyone who wishes to understand modern medicine, why it is so successful, and why a lot of it is baloney. The book begins with Le Fanu surveying the ten seminal moments in the development of modern medicine. This provides extremely important background, and it makes one of the most important arguments of the book: modern medicine is not successful because of a successful explanatory framework for disease. Instead, modern medicine is successful because of its rigorous pragmatism. With the exception of a couple of cases which were solved because of technological development, much of the medical revolution drew on gifts from nature- I'd say God. Antibiotics, for example, are chemical byproducts of a small fraction of bacteria which just so happen to kill a great variety of infectious organisms. Even more curiously, these byproducts provide no real benefit to the bacteria themselves. It is as if they were waiting for us to discover them.
From this starting point, Le Fanu examines the rise of a dispassionate "clinical science" which decentered the doctor-patient relationship and made the patient a test subject. While important discoveries were made in this fashion, its mechanistic presuppositions laid the foundation for problematic developments which constitute the fall of modern medicine. There are two aspects of the fall of modern medicine: the "new genetics" and the "social theory." The former is the idea that we are reducible to our genomes, so that almost all of our diseases are preventable through understanding their genetic causes and correcting for them through genetic engineering or by artificially producing hormones through genetic manipulation. This reductionist view of the genome generated a huge investment into biotechnology companies which promised to patent genes and use them to develop novel medical treatments. Writing immediately before the completion of the Human Genome Project, Le Fanu predicted that this hope would fail and that the reductionist view would turn out to be false. 17 years later, this prediction has turned out to be spot-on. The biotechnology bubble popped, and the epigenetic revolution has swept contemporary biology.
The second aspect of medicine's fall is the "social theory." I noted above how the success of modern medicine was never due to its theoretical understanding. This reality underlies why the social theory has been such a failure. In the 1970s and 1980s, the failure of medicine to develop remedies for diseases of aging led some scientists to conjecture that diseases such as cancer or heart disease were due to the Western diet. This conjecture was spurred on by the proof that lung cancer was most often caused by cigarette smoking, but the evidence turned out to be thin. For one, the correlation between heart disease and the diets of various nations was not rigorous, and admitted to important exceptions in populations, which is a death knell for an inference of direct causation. Moreover, heart disease suddenly skyrocketed in the 1920s and 30s, only to plummet in the 1980s, without any apparent cause. This appears to fit the pattern of an infectious disease, and Le Fanu suggests that the bacterium Chlamydia, found in most heart disease patients, plays a key role. He points to similar statistics in other unexplained diseases, besides the diseases of aging, such as cancer.
For the cancers, Le Fanu says that the hysteria over trace elements of carcinogens is beyond unjustified, as such trace elements are more abundant in fruit and vegetables than they are in the air and water. If you take an enormous amount of any chemical and inject it into mice, it's likely to have some negative consequences. But the fallacy in this plank of the social theory is in assuming that there is no level below which no effect at all is possible. It's like saying that having one glass of wine every twenty years provides only a quantitative, rather than qualitative, difference in the effects of alcohol on one's liver.
This book is absolutely fundamental for anyone who wants to understand why the dietary advice of the medical community changes every six months, and why the officially promoted diet of the government doesn't seem to work. The book is liberating, in that it opens the door to new paths for medical discovery and creative thinking, and frees us from constant fear that the water from the tap is going to give us brain cancer. Highly recommended.
ISBN-13:
978-0786709670
ISBN-10:
0786709677
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