A Brief History of Disease, Science and Medicine

Rating:
Summary: The product of a three year research project
Review: A Brief History Of Disease, Science & Medicine is the product of Dr. Michael Kennedy's three year research project to write a book that would fill the unfortunate gaps in most medical student's educational curriculums, and also be of considerable value for the non-specialist general reader seeking a clearer understanding of the long history behind what we commonly recognize as the history of medical development from superstition to science. The first eight chapters aptly cover the history of early medicine and science described in more detail than typical medical history. Then Dr. Kennedy goes on to cover the discovery of anesthesia and antisepsis, the development of modern medicine and surgery, and concludes with a history of medical economics (including the origin of medical malpractice litigation). A Brief History Of Disease, Science & Medicine is enthusiastically recommended any and all for personal, professional, academic, and community library History of Medicine reference collections.

Rating:
Summary: The product of a three year research project
Review: A Brief History Of Disease, Science & Medicine is the product of Dr. Michael Kennedy's three year research project to write a book that would fill the unfortunate gaps in most medical student's educational curriculums, and also be of considerable value for the non-specialist general reader seeking a clearer understanding of the long history behind what we commonly recognize as the history of medical development from superstition to science. The first eight chapters aptly cover the history of early medicine and science described in more detail than typical medical history. Then Dr. Kennedy goes on to cover the discovery of anesthesia and antisepsis, the development of modern medicine and surgery, and concludes with a history of medical economics (including the origin of medical malpractice litigation). A Brief History Of Disease, Science & Medicine is enthusiastically recommended any and all for personal, professional, academic, and community library History of Medicine reference collections.

Rating:
Summary: A side of medicine that you don't often read about
Review: At some point in the nineteenth century, the practice of medicine was transformed into medical science. Before that time, while there were some people who critically examined techniques of treatment, most medical practitioners did more harm than good. At best, the treatment did no harm and there was tremendous resistance by the medical profession to change, even when the benefit was clearly demonstrated. Many women died in childbirth due to infections caused by doctors going directly from dissecting cadavers to delivering babies without washing their hands. It was not until sometime in the twentieth century before it could be said that the medical profession had alleviated more suffering than it caused.
This book chronicles all of this and is one of best written histories that I have encountered, independent of subject. It all starts in the first few pages, where you learn that early humans who were hunter-gatherers did not suffer from many acute diseases. After populations spent generations in the same general area, most diseases had adapted to being chronic in nature. Few people died from those diseases and new ones were rarely introduced into the population.
Three things, leading to the rise of civilization, changed that. The first was the domestication of animals, which allowed for the trans-species migration of diseases. This was a bit of a surprise to me, although it should not have been. The modern and deadly diseases of AIDS and Ebola are both caused by viruses that have migrated from other primates. As I write this, countries in Asia are killing enormous numbers of chickens in an attempt to prevent a disease virus from moving from chickens to humans.
The second event was the development of agriculture, which required stationary populations, and allowed the numbers to grow dramatically. This led to the profession of civil engineering and how to provide potable water and dispose of waste. Until recently, this has been a chronic problem and many epidemics have been due to contaminated water.
The third event is the increased mobility of populations, which is a more recent event. Strains of diseases that are chronic and mild in one population due to generations of acquired immunity become plagues when introduced to new populations. So much of the history of the world has been shaped by disease, which is one of the primary themes explained in detail. The Europeans gave the Americas smallpox and the Americans gave the Europeans syphilis. Asia gave Europe the bubonic plague, and Africa gave the world AIDS. I was very impressed with how Kennedy describes these events and explains how they changed the world.
Some of the most fascinating historical accounts dealt with individuals. The Russian Czar known as Ivan the Terrible was not always so terrible. In the early years of his reign, he was very enlightened, establishing schools and a legal code. However, in his later years, he earned his historical moniker, even killing his own son. His body was exhumed in the years of Soviet rule and it showed clear evidence of tertiary syphilis. Therefore, the insanity of his last years and the devastating consequences for Russian history were most likely due to his suffering from advanced syphilis. Although not proven, there are strong indications that Henry VIII of England also suffered from tertiary syphilis, which can explain some of the erratic behavior in his later years. One cannot help but be astonished at the rates of syphilitic infection in Europe a short time after it was brought back by the early explorers of the Americas. In 1599, one-third of the inhabitants of Paris were infected with syphilis. Given that it is transmitted primarily by sexual contact, this figure is incredible. It also indicates how sexually promiscuous the Parisians had to be and points out that there were times in history where people were more sexually promiscuous than they are now.
One cannot help but be astonished by the resistance to change that has pervaded the medical profession throughout its existence. It would be hard to find any other group of people who have exhibited such a conservative mindset for so long. In some ways, the only place where similar mindsets can be found is in religion. On the personal side, Kennedy occasionally refers to events in his life. There are not many, but they are expressed in a very matter of fact manner. It is unusual to read something like, "I was there when we tried . . . ., the patient died."
This book is a real riveting page-turner. Once I started reading it, it was the only book that I read until I finished it and now I have to catch up on all my other projects.

Rating:
Summary: Splendid piece of work, authoritative and readable
Review: Brief this is not, but compared to some dry academic tomes it seems brief. University of Southern California professor Dr. Michael T. Kennedy has the all too rare gift of writing well which he combines with a passion for detail so that this history is packed with the bizarre, the fascinating, the arcane, and the all too often revolting facts of medical delusion, malpractice, and triumph that have characterized the long and tortured history of the healing arts.

Note well that this is a history not only of medicine and disease, but of science as well. The emphasis is on twentieth century developments, which is as it should be since so much has happened in recent times. This is not to say that the more distant past is neglected. Kennedy starts with the pre-history and follows the quest for health through Greek and Roman times to "The Rise of Islam and Arabic Medicine" (Chapter 5) with excursions into ayurvedic medicine (from India) and the traditional Chinese practices from antiquity. He even looks at European health, or the lack thereof, during the Dark and Middle Ages before the rise of science. When he gets to the modern or nearly modern era, Kennedy organizes less by chronology and more by subject matter. Some of the later chapters are about "Cardiac Surgery," "Transplantation," "Psychiatry," etc. I particularly liked the crisp way he dealt with psychoanalytic theory and the inefficacy of psychoanalysis.

Frankly, I don't know if there is anything else quite like this available. The recognized authority on the subject of the history of medicine in English, University College London's late Roy Porter wrote both a popular account, Blood and Guts: A Short History of Medicine (2002), and a full blown treatment, The Greatest Benefit to Mankind (1997) which Kennedy cites. I have read the former and it is to Kennedy's book as Mary Poppins is to Hamlet. There are other histories, but most are either not current or too voluminous or too restricted in content.

Dr. Kennedy shows how various ideas and methods were developed, how they stemmed from, or were in contrast to, earlier methods; and he highlights the personalities of the practitioners as he describes what they did or discovered. He also focuses on patients and their stories. His style is sharp and uncluttered. Sometimes he employs a dry, cynical wit. At other times his report takes on extra-medical aspects that lend depth and familiarity to his portraits, as when, for example, he reports on the tragic death of transplant pioneer, Dr. David Hume. (p. 388)

Here are some examples of the kind of detail that I found fascinating:

"The early Middle Ages saw little consumption of animal protein by the peasants, but legume production, which increased with the agricultural revolution, reduced the dependence on carbohydrates and led to rapid population growth again." (p. 69)

And on the following page: "Women lived shorter lives than men in the Middle Ages...This is attributed to the hazards of childbirth, but also to an iron deficient diet...[because] animal protein was not available."

"...[A]lthough opium offered some relief of pain...until the anesthesia era, speed was the sign of the good surgeon." (p. 85)

"Infectious diseases were uncommon in primitive societies because the available pool of susceptible individuals was too small and the contact with other groups was not common." (p. 87) Indeed, infectious disease is part of the price we pay for agriculture and civilization.

Quoting Freud: "I often console myself with the idea that, even though we achieve so little therapeutically, at least we understand why more cannot be achieved." (p. 401) This is doubly ironic since Freud was even deceived in what he thought he understood. A few pages later Kennedy drily remarks that psychotherapy "is useful in helping adults to deal with life stress. It has little or no role in treating psychosis. The serious mental illnesses are increasingly seen as biological disorders." (p. 424)

The only weakness of this book is that it could have used a more meticulous editor. (The proofreading is excellent.) Kennedy's writing style is fast-forward, actually suggesting to me how medical history might be written had somebody like, say, novelist James M. Cain taken his hand to it. The words just rush down the page. Kennedy has so much to say and he wants to get it all said. Sometimes one has to read a sentence twice since sometimes his tenses are a little eccentric, and parallel construction is not always strictly observed.

There are two indices, one for names, but I notice that the aforementioned Roy Porter, for example, does not appear in either of them. Probably the names in the footnotes were left out. Also the references (545 of them) are collected at the end of each chapter, which is fine, but there is no overall alphabetized bibliography. This is a pet peeve of mine since one has to chase through chapter after chapter to see if a particular work is cited.

However Kennedy more than makes up for this deficiency with what he calls a "Postscript" which is a lightly annotated bibliography organized into the categories, "Recommended Reading," "General Sources," and sources by individual chapters.

Bottom line: the best history of medicine that I have found and a delight to read.

Rating:
Summary: master storyteller tells, with love, how medicine grew up
Review: I couldn't put it down, because it hit so many of my buttons: history, medical sciences, and just plain storytelling. While I'm most known in network engineering, clinical medicine has always been an intellectual love. While I often tell people "I'm not a doctor but I simulate them on computers," I learned a great deal from this book -- above all, the connections and less-than-obvious relationships between concepts. Kennedy chronicles both the major insights and the terribly wrong blind alleys that characterize what many call the "youngest science".
It's too easy to forget, looking at modern medicine, how recent most developments are -- and yet how many ancient insights were correct. Kennedy literally goes back to the dawn of history, explaining original ideas, how they were expanded upon, how they were confused, and how they finally converged into a scientific discipline -- that remains an art.
While the author occasionally does drop to the molecular level, it isn't necessary to have a detailed background to understand the map he reveals. There are enough very specific insights to give a medical expert a few pleasant doubletakes, as well as to introduce the layman to how we reached our current views.
There were times that I wanted more detail on a technical topic, but isn't it traditional for the great storytellers to leave you hanging, wanting more?
The author doesn't ignore that medicine always exists in a social and technical context. Religion has both suppressed and enhanced medical knowledge, and he presents both ends of the spectrum. Anyone who gets into the real world of hospitals, to say nothing of academic research, learns very quickly of the profusion of enormous egos -- and the politics resulting from them. While people may be pictured smiling as they receive Nobel Prizes, quite a number were suppressing rage at their co-awardees, or feeling terrible because their collaborator wasn't up there as well.
In modern times, more general financial and political interests have a great deal to do with the practice of medicine. Kennedy has definite opinions on where managed care and outcomes research improved care, and also where they've gone horribly wrong.

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Summary: The Return of Humanism in Medicine: Hope for the Future!
Review: In this litigious time when physicians and all medical care workers tend to live under an umbrella of suspect brought on by the intervention of the media, vast lawsuits, big business (pharmaceutical companies) intervention, and computer access to data, there has occurred a response in the medical facilities to promote 'defensive medicine' to instruct the nascent students how to cope with the antagonistic world outside the halls of the teaching hospitals. This has resulted in less emphasis on the learning of the skills of the time honored Doctor-Patient relationship and in creating the aura that physicians dwell in glass dome sanctuaries of science: the quiet moments of sharing personal fears and concerns and relieving the pain in the souls of the patient and patients' families seem relics of the past house-call/caring-physician image. Michael Kennedy in his book A BRIEF HISTORY OF DISEASE, SCIENCE & MEDICINE has done more to rectify this widening gap between physician and patient than any volume I have read. This meticulously written, dignified yet very warm and honest look at medicine from the Ice Age to the era of molecular and genetic concepts for the present and the future reads more like a fascinating novel than an academic treatise. There are facts and histories discussed here which will enlighten not only the general public but also the men and women of medicine - from premed student to retired doctor. It is simply an amazing source of knowledge while simultaneously being an honest, no-holds-barred review of how we came to this point in healthcare. And if ever there were a time when this book was needed, it is certainly now. Read this fascinating tome and learn not only the extraordinary progress made in the mystery of disease and physical meanderings away from the 'normal', but at the same time see just how vulnerable is the scientist and physician in dealing with new aspects of the art of practicing medicine through time. Kennedy and his colleagues have added an important adjunct to the re-entry of humanism in the teaching of medicine at his alma mater: this book demonstrates that journey of commitment to resurrect the precious healing relationship between the doctor and those who approach him for succor. Read this book for a highly dignified history of medicine, for some amazing insights into disease process, and for reassurance the perhaps the return of the sanctity of healthcare delivery is a possibility. A fine and very important achievement, Dr. Kennedy!


Rating:
Summary: Interesting look into the history of medicine - good and bad
Review: Personally I always enjoy a historical book that actually discusses history and not some surgically altered history that only reports the things that went right. That is what you get with "A Brief History of Disease, Science & Medicine". Not only do you read about the great advances in medicine but also about the mistakes that were made along the way. Although the book was written with the first year medical student in mind it is easy enough to read and understand by those with only a passing knowledge of basic first aid. Perhaps one sentence from the Forward best describes the writing style - "...it has been written to be read, rather than studied."

Dr. Kennedy states that this book was not widely accepted by the academic presses and so was published independently. It is fairly obvious that one of the reasons this might be the case is his candid examination of the history of medicine. In an age when most practitioners of the medical profession seem to feel that they have perfect knowledge, Dr. Kennedy's book shows that they have often been wrong with tragic results. Take for instance the case of Ignaz Semmelweiss who worked in a hospital where there was a twenty-nine percent mortality rate for women giving birth. Through experimentation and deduction he came to believe that washing your hands between patients and after autopsies would cause this rate to drop. He ordered that hand washing would be done between patients and the rate of death dropped drastically. However, since he had not reason why it worked it was resisted, he eventually resigned (other historians have noted that he was forced to resign) and the doctors returned to their old habits and the old mortality rate. After all it made no sense to them that something they could not see could make any difference. Many people will immediately see the similarities between things like this and modern attitude of medical science as related to alternative therapies - if we don't yet understand how it works then it must not work. Most medical history texts are severely sanitized to keep such historical errors out. So, it is really no surprise that this book, which portrays history as it was, from many primary sources, is not the most popular one among the medical establishment.

Personally, I enjoyed the book but I am one of those who enjoys history from a viewpoint of accuracy - warts and all. Still you should be prepared to have some of your history that you learned in high school discredited. I remember learning that Louis Pasteur invented innoculations to prevent disease in the later 1800's, but the fact is that Charles Maitland and others were doing it in the 1700's. "A Brief History of Disease, Science and Medicine" is a recommended read for anyone interested in the history and progression of medicine.

Rating:
Summary: Interesting look into the history of medicine - good and bad
Review: Personally I always enjoy a historical book that actually discusses history and not some surgically altered history that only reports the things that went right. That is what you get with "A Brief History of Disease, Science & Medicine". Not only do you read about the great advances in medicine but also about the mistakes that were made along the way. Although the book was written with the first year medical student in mind it is easy enough to read and understand by those with only a passing knowledge of basic first aid. Perhaps one sentence from the Forward best describes the writing style - "...it has been written to be read, rather than studied."

Dr. Kennedy states that this book was not widely accepted by the academic presses and so was published independently. It is fairly obvious that one of the reasons this might be the case is his candid examination of the history of medicine. In an age when most practitioners of the medical profession seem to feel that they have perfect knowledge, Dr. Kennedy's book shows that they have often been wrong with tragic results. Take for instance the case of Ignaz Semmelweiss who worked in a hospital where there was a twenty-nine percent mortality rate for women giving birth. Through experimentation and deduction he came to believe that washing your hands between patients and after autopsies would cause this rate to drop. He ordered that hand washing would be done between patients and the rate of death dropped drastically. However, since he had not reason why it worked it was resisted, he eventually resigned (other historians have noted that he was forced to resign) and the doctors returned to their old habits and the old mortality rate. After all it made no sense to them that something they could not see could make any difference. Many people will immediately see the similarities between things like this and modern attitude of medical science as related to alternative therapies - if we don't yet understand how it works then it must not work. Most medical history texts are severely sanitized to keep such historical errors out. So, it is really no surprise that this book, which portrays history as it was, from many primary sources, is not the most popular one among the medical establishment.

Personally, I enjoyed the book but I am one of those who enjoys history from a viewpoint of accuracy - warts and all. Still you should be prepared to have some of your history that you learned in high school discredited. I remember learning that Louis Pasteur invented innoculations to prevent disease in the later 1800's, but the fact is that Charles Maitland and others were doing it in the 1700's. "A Brief History of Disease, Science and Medicine" is a recommended read for anyone interested in the history and progression of medicine.

Rating:
Summary: Fascinating and highly informative
Review: This fascinating book is an up-to-date history of medicine and medical science. The book begins with a fascinating look at medicine and diseases from prehistoric times to the early nineteenth century, when so little of such things were truly understood. Then, the pace of the book picks up, when the speed of breakthroughs in medical understanding and technology began to simply explode. And then, the final, more modern, chapters spread out, covering everything from DNA and anesthesia to the economics of medicine.

This book was originally designed with medical students and young physicians in mind, but it is no dry textbook. Instead, this book is a fascinating read, covering a whole lot of subjects, without becoming boring. What I especially liked was that the author obviously deeply understands non-Western medicine, and he made sure to include in it in the book. This book is a great read with lots of fascinating information (for example: did you know that King Henry VIII of England probably suffered from syphilis, and that the disease probably had a major role in history?). Overall, I found this to be a fascinating and highly informative book, and I highly recommend it to you!

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Summary: Enormously educational yet thoroughly entertaining and fun
Review: This is both an extremely ambitious and enormously entertaining history of the development of the medical treatment of human beings throughout the ages. It is ambitious in that the author attempts to survey the field from prehistory until the present day, and to do so in less than five hundred pages. The scope means that at times things of necessity have to be left out. For instance, the great story in science as a whole (and in medicine in particular) between classical antiquity and the early 17th century is the growth and eventual downfall of Aristotelianism, which provided the scientific background for nearly every branch of scientific endeavor during that time. Many of the key events of that story are briefly recounted, but many are not (e.g., allied discoveries by Galileo in astronomy that refuted Aristotelian assumptions). Still, given the limitations of space, this is an admirable treatment of the subject. To deal with every issue comprehensibly would have expanded dramatically the size of the book, which would have given the lie to the title. My one serious objection to the book is that the book does not have an overarching narrative structure. I'm not always sure what particular story is being told. Nonetheless, it is impossible to come away from the book without a far deeper appreciation for the remarkable journey medicine has undertaken over the centuries. It also makes me enormously grateful that I am alive today, and not in some previous century.

Above all, this is a fun, engaging, thoroughly entertaining book. Although the book sometimes veers towards the encyclopedic, the style at all times is anecdotal. The author loves his subject, and especially delights in the quirkier side of things. There are mountains of fascinating trivia, and as a lover of great trivia I was constantly saying to myself, "Wow, I didn't know that!" Some of the more fascinating bits of the book are when Kennedy discusses famous individuals and the way in which disease may have affected them, such as Ivan the Terrible or Henry VIII. Even in modern medical discoveries, he has an eye for the unusual.

This is also, however, a very educational book. The amount of information contained in its pages is fairly staggering. One great use for the book is to read through the sections on a particular epoch if one is engaged in historical reading. But the book is more than a collection of interesting facts. The reader gains an appreciation for the way that medical practice has developed over the centuries. For instance, Kennedy discusses how before the invention of anesthesia speed was a highly esteemed virtue in a surgeon. Surgery was performed quickly, and as a result there was less of an emphasis on working carefully and carefully suturing. But with the development of anesthesia, surgery slowed down, and surgeons took more care to operate with great care and to minimize injury to tissue. This is merely one random example out of thousands.

One of the most appealing aspects of the book is the deeply personal style of the author. Closely aligned with his love of the anecdotes and trivia is his eye for the humorous side of things. He also writes with a personal touch. In discussing some medical condition, he will mention that he had had such a case himself at such and such a point, or that someone had devised a form of pediatric surgery, and he later had as a patient the second recipient ever of that treatment. Or he will mention that his mother's uncle had a certain medical condition, or aunt was a nurse for a famous doctor.

This truly is a book suited for a variety of audiences. I have a strong interest in history, and as a result I enjoyed most the first half, in part because I had the background to understand everything there pretty easily. I struggled a bit more in the second half as medicine became more specialized, but I imagine that this half would be of greater interest to medical students or physicians. The main thing that I want to emphasize is that both the medical student and the educated nonspecialist will equally find much to enjoy in the book. Similarly, one could also employ the book merely as a reference work, or read it several chapters at a time. It is rare, however, that a book can be so educational over such a wide-ranging subject, and entertain so thoroughly at the same time.