In the original dustsheet. Black board binding with gilt title on the spine.

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The achievements of medicine in the postwar period rank as one of the most sustained epochs of human endeavour since the Renaissance. So dramatic and profound has been the assault on disease that it is now almost impossible to imagine the world of just fifty years ago when there were no drugs for most killer diseases. These achievements have had a profoundly beneficial effect on people’s lives as well as being a liberating force, freeing them from the fear of illness or untimely death, permitting them for the first time in human history to live out their natural lifespans, whilst significantly ameliorating the chronic disabilities associated with aging. The scope of medicine is immeasurably greater than it was fifty years ago, but the optimism generated by those achievements seems to have evaporated. Medicine is doing better but feeling worse.

THE RISE AND FALL OF MODERN MEDICINE presents for the first time a comprehensive and searching reappraisal of the science, philosophy and politics of modern medicine.

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 affect 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 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

‘For every problem there is a solution: neat, plausible and wrong’. H.L.MENCKEN

James Le Fanu (born 1950) is a British retired General Practitioner, journalist and author, best known for his weekly columns in the Daily and Sunday Telegraph. He is married to publisher Juliet Annan.