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Summary: Would have made a nice essay
Review: Actually, that's pretty much all this book is. There was a cover article in "Atlantic Monthly" a few years back that contained all the important ideas in this book and then some. This book merely fluffs out those ideas a bit, prints them with large type and big margins, and adds a few irrelevant tangents to (barely) get the book up to an acceptable length to market.The main idea, that many diseases beleived to have genetic and environmental causes may actually be linked to infectious agents, is interesting, challenging, and worth more investigation. But the book is ultimately unconvincing on this central thesis, and doesn't explore it in the depth I expected from a book-length treatment. Ewald is a true believer, and his main reason for his belief is theoretical. If diseases were genetic, then they should be selected against. Ergo, heart disease (to take an example) can't be a genetic problem, it must be something else. A suggestive argument, but, despite Ewald's zeal, theory proves nothing without some experimental verification. Unfortunately, there is limited experimental support for his thesis. Ewald is reduced to repeatedly bringing up the two cases for which his thesis has been proven: cervical cancer and peptic ulcers. He must mention both of these at least 10 times through the course of the short book. Beyond that, he's got a few somewhat suggestive results and a lot of hectoring and arguing by analogy. His ideas may be true, but it's far from clear just yet. Beyond that, he adds in a long historical digression on the emergence of AIDS, which was mildly interesting but almost completely unrelated to any other part of the book. But they needed that extra 35 pages to push up the length. I'd say it's worth checking out from the library, but if you've read any (however brief) explication of Ewald's ideas before, you're not going to find anything new in this book to make it worth getting.
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Summary: Credibly incredible!
Review: Dr. Ewald makes some outstanding points and raises questions that should have been raised 50 years ago. The idea that all (or most) cancers are microbes is old news, however. There was a group of doctors during the 1920's that isolated the virus in a microscope and were able to destroy the microbe using a radio frequency. People with cancer were being cured because these doctors were destroying the microbes with their radio frequency machine. These doctors' findings and the invention of their microscope were common knowledge and their success against the cancer microbe was published. But the growing medical establishment prevented its treatment from becoming mainstream and eventually destroyed their work. I recommend reading "The Cancer Cure That Worked: 50 Years of Suppression" by Barry Lynes to learn the story. The world needs more insightful doctors like Paul Ewald. I highly recommend this book to learn about how viruses and other pathogens are causing so many of our health problems!
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Summary: A very important book
Review: Ewald sets out to show that medicine has made so little progress over the past 50 years in tackling chronic diseases like heart disease and cancer because it has been looking in the wrong places - at genetic defects and environmental factors. The medical authorities have virtually ignored infectious causes of chronic diseases. The case for infectious causation of ulcers met with hostility and dismissal from the medical profession. The doctors who proved that heliobacter pylori caused ulcers had to struggle for years before their work was recognised. Ewald provides good evidence that many other chronic diseases are likely to have infectious causes. The reviews here seem to divide into two camps: those who believe that Ewald has got hold of a vitally important idea that will transform the way we tackle chronic disease, and those who dismiss the book. I am firmly in the first camp. I found it clear, balanced, and full of fascinating insights.
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Summary: Plague time
Review: Excellent book- stirs up controversy on chronic illnesses and thier possible viral et.al. causes. A must read.Dr. Ewald's ideas need a wide readership. I urge others to read his book and research his ideas.
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Summary: Provocative Ideas -- Speculative Execution Thus Far
Review: I was initially very excited to read this book; and it does identify some serious problems with current perspectives on the origins of disease. If anything, the best thing about the book is that it identifies how much we don't know. His method of filling in the gaps, however, is unsatisfying. "May, might, could, if" are the words that characterize the intellectual rigor of this book. It is a popularized, speculative foray, that uses conditionals and anecdotes to fill the void of substance. His work is a worthy pursuit. I won't belittle the importance of exploring all the possiblities of this idea of microbial origins for many diseases. This gives us a new realm of exploration in an area that has been intent on unravelling genetic predispositions. Any serious work in this area, however, needs to transcend an inter-disciplinary argument of genes v. environment/microbes and understand the complex interrelationships of all of these factors. This book does not contribute to that. It is the interaction of predispositions and external conditions (toxins, microbes, what have you) that is important to understand. There is much in the book that is interesting. It is wasted, however, with the author's attempt at flair. His attempts to analyse terrorist motivations and science fiction literature are digressions from the supposed point of the book. The attempt was to be another, "Guns, Germs, and Steel" meets, "The Lexus and the Olive Tree." The effect, however, wastes time and and leads one to wonder at the insubstantiality of his work in general. It's an important area, but not that great of a book.
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Summary: Being at the point of the spear is not easy...
Review: If you categorize your self as an early adopter, I think you will appreciate the words written by Paul W. Ewald concerning the strong possibility of infectious agents (germs) causing the medical conditions of heart disease, cancers, HIV and Alzheimer's. He suggests many other diseases as well may be caused by germs.
There was a time not long ago (1980's) when the cause of peptic ulcers were clearly and almost universally accepted to include stress, genetic disposition and emotional anguish. Today, as a result of the acceptance that ulcers of this type are caused by germs, are successfully treated with antibiotics.
To my knowledge, the author is one of the early advocates of this theory that germs are the cause of many of the diseases not presently associated with being caused by them. As a result, he is often subject to harsh critical review from the present generation of medical experts.
I especially appreciated his suggestion for the creation of a data base made up of anecdotal reports of unexpected positive results of the application of vaccines on chronic diseases. The data base could supply direction for future research studies to explore.
Although I have no medical expertise, I found reading the book manageable but not an especially easy read. Even so, I found the time spent was very rewarding and left me feeling as though I was getting a pretty clear view of where the future of medicine is headed.
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Summary: The most important theory in medicine
Review: Not genes but germs cause most chronic diseases. So argues evolutionary biologist Paul Ewald in his new book, "Plague Time: How Stealth Infections Cause Cancers, Heart Disease, and Other Deadly Ailments," (Free Press, 282 pp, ...). The Amherst professor is trying to drag the medical establishment into the Darwinian age. While modern research often aims to uncover genetic factors in major diseases, Ewald contends that "human genome mania" often violates the fundamental principle of biology, Charles Darwin's theory of natural selection. Darwin argued that families with harmful hereditary traits will die out over time, asserts Ewald, and would be replaced by lineages whose hereditary constitution better enables them to survive and reproduce. Ultimate goals aside, Ewald has made sure that lay readers will find his book interesting and intelligible. He believes that patients are often more open-minded than their doctors. In an interview, Ewald claimed that the health benefits of the Human Genome Project are over hyped because "most diseases aren't genetic." He said research funds dedicated to improve antibiotics would bring greater payoffs than those spent on the glamour field of genetic research. Ewald, who is not a medical doctor, said, "My goal is to bring into medicine all of biology, especially evolution." So far, he has had more success persuading other biologists than the medical establishment. The late William D. Hamilton of Oxford University, England -- considered by the likes of Edward O. Wilson and Richard Dawkins to be the most important evolutionary thinker of recent decades -- commented on Ewald's theory, "It opens our eyes to many quite weird possibilities about disease that most medical scientists, tending to be unaware of current evolutionary thought, don't think of." Ewald contends there are only three fundamental causes of disease: -- First, nonliving environmental agents like radiation, poisons, and nutrition. Too many cigarettes cause lung cancer; too little Vitamin D causes rickets. -- Second, infections. Long ago, people figured out that smallpox, measles, and chicken pox passed from one person to another. Since then, an ever-growing number of diseases have been shown to be induced by bacteria, viruses, or protozoa. Historically, infectious agents have been harder to identify than nonliving poisons as the cause of diseases because germs can evolve ways to hide. Simple chemicals cannot. -- Third, hereditary causes. The Human Genome Project has been widely advertised as eventually leading to cures for many diseases, such as breast cancer. Ewald observed, however, "If one identical twin gets breast cancer, the other's likelihood of contracting it is only around 10 to 20 percent. This suggests that genes are not the whole story." But the more basic logical problem with what he dubs Human Genome Mania, argued Ewald, is natural selection theory. Such reasoning was forcefully introduced to Ewald in the early 1990s by a letter from a physicist named Gregory Cochran. After America won the Cold War, this New Mexico rocket scientist had turned to developing formulas for estimating which diseases are hereditary and which are infectious. The key number proved to be the ailment's "reproductive fitness burden." In other words: Compared to a healthy person, how many fewer descendents will a sufferer procreate? The tendency of people with healthy genes to reproduce more than people with sick genes, Cochran and Ewald determined, makes it unlikely that there are many hereditary syndromes that are both widespread and significantly damaging to their victims ability to reproduce successfully. We can evolve new defenses against both bad genes and bad germs. What makes infections more dangerous than genes, however, is that germs can fight back, said Ewald. They can relatively quickly counter our new resistance strategies by evolving news methods of attack -- thus antibiotic resistence, for example. Ewald admits there are numerous hereditary diseases. But the ones produced by spontaneous mutations tend to be quite rare since the bad genes quickly get weeded out of the gene pool, he said, citing Duchenne's muscular dystrophy. This male-inherited disorder of progressive muscular degeneration may be the most widespread example, yet it only afflicts 0.02 percent of the populace, said Ewald. Still, it's possible for more common hereditary diseases to survive down through the generations if they are a defense against something worse. The best known example is sickle cell anemia, a blood disorder that sickens and can kill those of West African descent who inherit two copies of the sickle cell gene. Those who receive only one copy from their parents, however, have greater resistance to a debilitating form of malaria. A spokesman for the National Human Genome Research Institute, part of the National Institutes of Health, responded diplomatically to Ewald's charges that research dollars invested in genetic research would save more lives if devoted to infectious diseases instead. He suggested, "This shouldn't be a zero sum fight. As promising new areas come along, the government should spend more on health research in general." The Bethesda, Md.-based spokesman also argued that when the Human Genome Project eventually maps the variations found among a large number of individuals, it will help us understand why some people have better resistance to particular germs. For example, he said, certain East African prostitutes appear to be immune to HIV. Understanding their genetic peculiarities might well help researchers uncover the Achilles heel of AIDS. Nonetheless, Ewald's "Plague Time" may someday be remembered as a landmark in the development of more effective treatments for killer diseases.
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Summary: Being at the point of the spear is not easy...
Review: Plague Time provides important and fascinating information about diseases, how they are acquired, their evolution, and their consequences. Professor Ewald contends that many chronic diseases such as several types of cancer, arteriosclerosis, schizophrenia, several types of arthritis, bipolar disease, fibromyalgia, chronic fatigue syndrome, or even many symptoms of aging are the result of infections. The explanations of how these infections are acquired, and situations where the infectious agents are likely to be especially virulent are of great practical value. Dr. Ewald's thesis is that infectious agents quickly evolve to maximize their reproductive success. Their virulence and the nature of the acute or chronic symptoms they cause are a function of how they are transmitted. The discussions of microbe evolution deepened my understanding of biology and evolution. There are many examples presented. Many sections were unnecessarily wordy, with clumsy and overly long sentence constructions and much redundancy. This made parts of the book slow and heavy going. His frequent and often lengthy criticisms of the medical establishment are justified in my view, but sometimes got tiresome. In spite of the effort required, Plague Time is well worth reading.
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Summary: Read the review below
Review: The gentleman below has written a sterling review. I couldn't say it better. I'm only here to point out that many of the items I review feature poignant insights which often are neglected by the mainstream. Click on my name and a cornucopia of underrated gems will open before you like a land of dreams. (Or nightmares.)
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Summary: Insightful
Review: This is a great read. Paul Ewald points out quite convincingly that medical professionals neglect the evolutionary side of disease. His theory is that most diseases including chronic diseases like some cancers and heart disease are caused by infections by micro-organisms. This is not to say that his theory is conclusively demonstrated but rather that it rests on principles that are sensible and possibly correct. Another of the important themes talked about in his book is that the virulancy of an infectious agent will evolve depending on how easily it is transmitted. An organism (bacteria or virus) in the human body is always trying to balance its fitness in reproducing in its host versus its fitness in being able to jump into another host. The outcome is decided by natural selection. Whatever evolutionary path results in the most offstring will win out. An organism which reproduces too quicky and imediately kills its host will not be very capable of being transmitted to another host. Take for example the common cold. If the effects of the common cold were much worse then people would stay home from work and the chance of the germs reaching other hosts would be much less. Ewald in fact advocates that people should stay home from work when they get a cold or the flu. This would probably benefit the employer in the long run because the flu would be less prevalent and less workers would contract it. I won't try to argue his points here but I find them quite convincing. On the other hand there are some down sides to the book. As mentioned in some other reviews the title is a bit overstated. Ewald has a theory and not conclusive evidence that things like cancer and heart disease are caused by infectious agents. Some things like cervical cancer and peptic ulcers have been shown to be caused by infectious agents in just the last few years where as the popular belief in medicine was that these were not infectious diseases. However that is not to say that all cancers and diseases are caused by infectious diseases. Ewalds obviously acknowledges this but nonetheless makes some pretty bold claims. Overall I highly recommend the book to non-specialists like myself who want to learn about infectious diseases and evolutionary biology.
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