The Rise and Fall of Modern Medicine

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Authors: James Le Fanu

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James Le Fanu contributes a twice-weekly column on medicine, science and social policy to the
Sunday
and
Daily Telegraph
. His articles and reviews have also appeared in the
New Statesman
,
Spectator
,
GQ
, the
British Medical Journal
and the
Journal of the Royal Society of Medicine
. He has also made original contributions to controversies concerning experiments on human embryos, environmentalism and the causes of disease.
The Rise and Fall of Modern Medicine
won the
Los Angeles Times
Book Prize in 2001. His most recent book
Why Us? How Science Rediscovered the Mystery of Ourselves
was published jointly by HarperCollins in the UK and Random House in the United States in 2009. He is married to the publisher Juliet Annan and they live with their two children in South London.

Praise for
The Rise and Fall of Modern Medicine

âExcellent . . . As Le Fanu explains in a telling phrase, the human hip joint is more slippery than a skate sliding on ice. How could such a thing be made artificially? This is one of the fascinating “twelve definitive moments” that make up the first part of the book. Le Fanu describes them â from penicillin to heart surgery and the treatment of infertility â with just the right mixture of science, history and anecdote. The struggles, disappointments and fatal errors of these early pioneers are described with zest, authority and a special brand of wry humour . . . An endlessly fascinating read'

M
AX
W
ILKINSON
in the
Financial Times

âLe Fanu [is] one of today's leading writers on medicine to the informed public.
The Rise and Fall of Modern Medicine
is a substantial work (and very good value) for those with a fairly serious interest in health matters'

H
UGH
F
REEMAN
in the
Daily Telegraph

âStand by for a brilliant read. James Le Fanu's massive book, bulging with juicy medical history and anecdotes, will set your heart palpitating and your blood pressure rising from the start. It is an absolute must-read for all people interested in medical matters, and particularly for those (like me) whom Le Fanu dubs The Worried Well, i.e. the ones who are “well” but “worried” we might not be . . . By reading Le Fanu's book we will be made aware of the thrilling power of the scientific method and the manner in which it pushes the boundaries of knowledge, to thank our lucky stars for the leaps forward in medicine and to acknowledge the enormous limitations imposed by the inscrutable mysteries of biology'

V
AL
H
ENNESSY
in the
Daily Mail

âRecently writing a history of medicine from the Stone Age to New Age, I deeply regretted that there was no up-to-the-minute account of modern medicine which I could pillage. That book has now arrived . . . Its author, the distinguished medical journalist Dr James Le Fanu, writes with clarity and authority, and has the great knack of making even the most complex technical developments in immunology or embryology exciting and intelligible . . . You'll find nowhere
a better crafted and more expert account of how modern medicine helps ensure that the great majority of us live to a ripe old age . . . Erudite [and] absorbing'

R
OY
P
ORTER
in the
Observer

â[A] well written, fascinating and informative book, which should be read by anyone with an interest in contemporary medicine . . . Everyone will finish the book knowing much that he did not know before, and stimulated into thought about the future of medicine. At the very least, the reader will have a more realistic appreciation of the powers and limitations of medicine; and in an age of hysteria about the subject, that is no mean achievement'

A
NTHONY
D
ANIELS
in the
Sunday Telegraph

âThis book is a major achievement. It will be a test of the state of modern medicine to see whether that achievement is acknowledged and
The Rise and Fall of Modern Medicine
accorded the widespread discussion it deserves. It is a book that desperately needed to be written. And it is an indictment of the universities and medical schools that the job had to wait for the attentions of one of the country's most gifted freelance intellectuals. The book succeeds at two levels. It is at the same time a thorough, scholarly and well-referenced text, and a clear, vivid and compelling narrative, accessible to the interested lay person'

B
RUCE
C
HARLTON
in
The Tablet

âIn this invaluable amalgam of human drama, vivid history, cutting-edge nous and old-fashioned polemic, Le Fanu issues an appeal to reason and calls for medicine to recover its sense of what it is for . . . The ambition of this, the first historical account of this period, is admirably justified throughout. Le Fanu communicates complex material in a clear and straightforward fashion while taking care, wearing his journalistic cap atop his white coat, never to let the scientific facts stand in the way of what is a rattling good story'

A
NDREW
M
ACKENZIE
in
Scotland on Sunday

â[Le Fanu's] book, in many ways a history of medicine since 1935, is as lucid as it is comprehensive. In it, he comments that few doctors are intellectuals. He is an exception, but, even so, it is an easy and fascinating read, studded with little-known facts . . . His arguments develop
slowly and clearly . . . I would recommend
The Rise and Fall of Modern Medicine.
I found it informative and intriguing'

T
HOMAS
S
TUTTAFORD
in the
Literary Review

âThe skill [of medical journalism] is to write with humanity and objectivity, a dual responsibility brilliantly fulfilled by the author . . . This book is well worth reading just for the brilliant pen portraits of Le Fanu's twelve definitive moments of medical advance. Some, like the discovery of penicillin, are well known, but even here the author has a way of encapsulation that is full of insights and unusual detail . . . It would be possible to close the book here, just over halfway through, and still feel you had had your money's worth. But the challenge is in the second half, where three much hyped hopes for the future are brought down to earth . . . This excellent book has challenged many of my views'

D
AVID
O
WEN
in the
Spectator

â[The first] part of the book makes a jolly good yarn. The tales are well told, and should be read by all [junior doctors] to give them some feeling of the excitement felt by their grandparents as major diseases that had seemed totally untreatable came under control. Seniors should read it too: they will be reminded of the great men who taught them . . . The second half of the book, concerning the fall of medicine, is more contentious though no less enjoyable for that'

J. R. H
AMPTON
in the
Journal of the Royal Society of Medicine

âLe Fanu's dozen vignettes [of the definitive moments of modern medicine] are excellently done . . . Le Fanu, a part-time practitioner, sounds just the sort of physician we would like to consult'

D
AVID
S
HARP
in the
New Statesman

âClose on 500 pages of passionate criticism . . . Le Fanu's accounts of the success stories of medical care are lively and well worth reading'

D. J. W
EATHERALL
in the
Times Higher Education Supplement

âThis well written, extremely readable, and thought-provoking book deserves to be widely read, especially by those in the establishment who would say he is wrong'

R
OB
H
ENDRY
in the
British Journal of Medical Practice

âLe Fanu's
The Rise and Fall of Modern Medicine
is the best book on the history of medicine I have ever read. Thoroughly fascinating, immensely readable. Deserves wide public attention'

N
ORMAN
F. C
ANTOR
, Emeritus Professor of History, New York University

âA compelling insider account that tries to determine, from the vantage point of the United Kingdom, why so few people are happy with the institution of medicine'

I
AIN
B
AMFORTH
in the
Times Literary Supplement

âI enjoyed
The Rise and Fall of Modern Medicine
, and I expect most doctors will also, possibly dipping into it (topics are well indexed), rather than reading from start to finish. Le Fanu's “twelve definitive moments” are a particular pleasure to read. Having practised through most of the years he covers, and having participated in or observed first-hand many of the events he recounts, his accounts of the serendipity, imagination, and luck that led to each are intriguing and informative . . . Le Fanu is a keen observer of the changing medical scene. He presents a wealth of interesting material and offers interpretations that, whether or not they agree, readers will find thought-provoking and well worth reading'

J
OHN
B
UNKER
in the
British Medical Journal

THE
R
ISE AND
F
ALL
OF
M
ODERN
M
EDICINE
James Le Fanu
BASIC BOOKS
A Member of the Perseus Books Group
New York

Published by Basic Books,
A Member of the Perseus Books Group
First edition published in Great Britain in 1999 by Abacus, an imprint of Little, Brown

All rights reserved. No part of this book may be reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews. For information, address Basic Books, 250 West 57th Street, 15th Floor, New York, NY 10107.

Books published by Basic Books are available at special discounts for bulk purchases in the United States by corporations, institutions, and other organizations. For more information, please contact the Special Markets Department at the Perseus Books Group, 2300 Chestnut Street, Suite 200, Philadelphia, PA 19103, or call (800) 810-4145, ext. 5000, or e-mail
[email protected]
.

Diagrams by Linda Payne
Typeset in Bembo by M Rules

A CIP catalog record for this book is available from the Library of Congress.

LCCN: 2012946998

ISBN: 978-0-465-05889-1 (e-book)

10 9 8 7 6 5 4 3 2 1

For Frederick and Allegra

C
ONTENTS

Acknowledgements

Preface to the Revised Edition

Introduction

A L
ENGTHY
P
ROLOGUE
: T
WELVE
D
EFINITIVE
M
OMENTS

1 1941: Penicillin