Family Practice Vol. 18, No. 6, 647-648
© Oxford University Press 2001
Book Review |
Great feuds in medicine: ten of the liveliest disputes ever.
Hal Hellman. (250 pages, £17.95.) John Wiley & Sons Ltd, 2001. ISBN 0-471-34757-5.
Senior Lecturer and Director of the SWARM Research Network, Department of Primary Health Care and General Practice, University of Plymouth
One of the essential components of the scientific method is peer review and critical discussion. In practice, this is not always constructive however and can seriously damage the lives of researchers and the progress of scientific endeavour if it becomes negative and confrontational. This book looks at 10 important rivalries in the development of medical science. There is particular discussion of the factors which sparked off the controversy and which contributed positively and negatively to advancement of the research area involved. The writing style is light and colloquial in places, but clear and thoughtful overall. It is a good read.
The 10 chapters each cover one feud, moving in historical order from William Harvey and his problems with getting the idea of circulation of blood accepted, to the French– US saga of the ‘AIDS War’ of Robert Gallo versus Luc Montagnier. All the examples provide lessons for us still today—human nature has not changed through the years.
Being a biochemist before I went into medicine, the story I liked best was that of Claude Bernard, the pioneer of physiology. His careful experiments and analyses established the basis on which our understanding of the chemistry of the body is founded. He was the first person successfully to carry out cardiac catheterization and maintain structures alive outside the body by organ perfusion. But in his day, the anti-vivisection campaigners had a very similar approach to that of the animal rights movement of the present. The culture of the 19th century was in favour of experimentation on chemical and physical matters, but opposed to experimentation on living things and particularly anything related to human life.
His work was opposed by the medical establishment who believed that it was beneath their dignity to dirty their hands with contact with the tissues that they sought to heal. The chemistry research community was also vehemently against the findings of his analyses. They would not believe living things could be chemically based, because they thought that body materials should therefore be synthesizable outside the body.
This book is very well researched and lists references for all material used. My only regret is that the examples are mainly laboratory research based. The story of Semmelweiss and childbed fever is the only clinical controversy covered. The lessons apparent from this treatise are that feuds often cannot be settled with a purely rational, scientific approach. There may not be sufficient understanding of the field of research. External factors such as religion, nationality and social status may be involved. Personal factors such as pride, greed and ambition may be playing a role. Awareness of all these influences is important if we are not to share the fate which befell most of this sample of subjects, of dying bitter and broken, often after suffering from emotional illness for many years.
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