heartbeat irregularities 227–8
pacemakers 248
transplants 103, 119
workings of 102
see also cardiac surgery; heart disease
heart disease 2, 336, 361–82
angina 153, 284
cholesterol 362–4, 381, 403
clots (thrombus) 361, 367–8, 370, 379–81
coronary thrombosis 361–3, 367–8
and diet 364–6, 368–74, 376, 381–2
Keys on 362–9
McKeown on 355
modern epidemic 361–2, 366–7, 370, 373
resembles infectious disease 373, 379, 381
risk factors 363
trials 370–2, 401
heart-lung machines (pumps) 96–8, 102, 108–12
heartburn 470
helicobacter 202, 210, 211, 212, 411
Hench, Philip Showalter 28, 29, 32, 33, 38, 216
hepatitis 225
Herceptin 487
heritability, missing 459–61, 491
herpes virus 412
Herrick, Richard 139–40
Herrick, Ronald 139, 140
High Molecular Weight Polyethylene (HMWP) 127–8
Hill, Sir Leonard 42
Himsworth, Sir Harold 64–5
hip replacements 121–30
Hirschowitz, Basil 257, 258
Hitchings, George 133, 141, 144, 167, 241, 284
HIV (human immunodeficiency virus) 413
Holman, Arthur 228
Hopewell, John 144
Hopkins, Harold 255–7, 259, 260, 262, 447
Hopkins, Mary 110
Horder, Lord ‘Tommy’ 226–7, 428
hormones 12, 31, 32, 189–92
see also cortisone; insulin
Horton, Richard 2
hospitals, specialists 275–7
Hu, Howard 390
human chorionic gonadatrophin (HCG) 191, 200
Human Genome Project 312, 441, 454–7, 458–9, 462
human immunodeficiency virus (HIV) 413
human menopausal gonadatrophine (HMG) 191
Huntington’s chorea 316, 334
hydrazine 509
hydroxychloroquine 501
hypertension 147–55
Ibsen, Bjorn 88–90, 93, 221, 296
ibuprofen 501
illness, definition of 441, 470–1
imipramine 282, 507–8
immune system
immunisation 11
immunological tolerance 134–6
immunosuppressant drugs 133, 142, 144, 145, 146, 242
transplants 131–6
immunology 498
immunosuppressant drugs 133, 142, 144, 145, 146
in vitro fertilisation (IVF) 179–81, 182–9, 194–201, 221
indomethacin 500
infectious diseases 2
infertility 2, 181, 182–4, 191, 201
inflammation
anti-inflammatory proteins 269
cortisone 27, 37, 39, 269–70
heart disease 381
steroids 220
insulin
animal source 325
diabetes 31
gene 321, 322, 328
genetic engineering 327–8, 330
psychiatric illnesses 79
insulin coma 79
intensive care units 84, 93–5, 96, 248, 297–8
iron-lung respirators 86–7, 89, 90
Isberg, Ann 85
isoniazid 56
IVF (in vitro fertilisation) 179–81, 182–9, 194–201, 221
Jabon, Marcel 243
jaundice 29, 30, 225, 231
Johnson, Enid 92
Jones, Steve 459, 461
Judet, Jean and Robert 123
Judet prosthesis 123, 124
Kan, Yuet Wei 333
Keller, Evelyn Fox 462
Kempner, Walter 150
Kendall, Edward 28, 31, 33, 38
Kennaway, Edwards 61
Kennedy, Ian 357
Kettering, Charles 164
keyhole surgery 261, 440, 447–50
Keys, Ancel 362–9, 370
Keys, Margaret 364, 365
kidneys 131, 136–41, 224–5, 452
Kinlen, Leo 410
Kirklin, John 99, 114, 116, 117–18
Kirsch, Irving 480
Klarer, Josef 239
knowledge, forms of 432
Koch, Robert 49, 499
Kolff, Wilhelm 137, 231
Kuhn, Roland 507–8
Kuo, Chochuo 381
Kurtzke, John F. 409
Kuss, René 145
Laborit, Henri 80, 81, 220
laparoscopes 181, 221, 255, 260–1
laparoscopy 192–4
surgery 261, 448–50
Lassen, H. C. A. 88, 89, 90
LaTouche, C. J. 16
Lehmann, Jorgen 52
Leiden, Jeffrey 343
Leitz cystoscopes 259–60
Lepley, Derward 100, 101
leprosy 243
leukaemia 157, 158, 384
Acute Lymphoblastic Leukaemia (ALL) 157, 158, 159–60, 174
anti-cancer drugs 157–8, 159, 166, 169, 171, 173, 242
Sellafield cluster 394, 409, 410
Lewis, Sir Thomas 226, 227, 229
Lewontin, Richard 348
life-sustaining technology 248–9, 296
lifestyle (as cause of disease) 61, 396–7, 398, 404–5
see also Social Theory (of disease) lifestyle drugs 286
Lillehei, Walton 99–101, 114, 115–16
limbs, replantation 252
Lind, James 53
lithium 504–7
litigation, obstetrics 294–5
liver, transplants 146
lobotomies 79–80
Longmore, Donald 118
Louis, Pierre Charles 53
lovastatin 481
lungs 109, 146
cancer 41, 59, 60, 71, 176
see also heart-lung machine
luteinising hormone (LH) 190, 191
lysozymes 18
malaria 243
Malpas, J. S. 178
Manhattan Project 215, 218
Maniatis, Thomas 320
Marimastat 332
Marshall, Barry
peptic ulcers 202, 208–10, 212, 217, 411
self-experimentation 204, 205
Marsilid 509
McCallum, F. V. 243
McElwain, Tim 177
McIndoe, Sir Archie 253
McIntire, Ross 149
McKee, Kenneth 123
McKeown, Thomas 353–5, 359
McMichael, John 224, 225, 229, 231, 301
measles 134
Medawar, Peter 132, 133, 289, 419
Medical Annual, The 279
medical expansionism 440–1, 470–1
‘medical vampirism’ 289–90
medicine
definitive moments 2, 3, 7, 180, 216–17, 244
future 428–35, 490–5
methods of practising 228
paradoxes 4–7, 417, 423–7
post-war achievement 1, 437
Rise and Fall (theme) 7, 417–23, 497
task of 430–1, 434
workforce 439
see also clinical science; diseases; doctors; research; therapeutic revolution
melphalan 164
Melrose, Donald 119
Melzer, Andreas 448
Menkin, Miriam 183, 187
menstrual cycle 190, 192
mental illness see psychiatric illness
mepacrine 501
6-mercaptopurine (6-mp) 142, 159, 167, 171, 173
messenger RNA (mRNA) 315, 321
methotrexate 502
methotrexate (MTX) 159, 166, 171, 173
Meyers, Morton 492
microscopes, operating 249, 250–4
microsurgery 250–4
middle life, diseases of 203, 306
milieu intérieur, physiological functions 358, 363, 382, 397
minimally invasive surgery see keyhole surgery
missing heritability 459–61, 491
molecular biology 311–12
see also genes
Moniz, Egas 80
monoamine oxidase inhibitors (MAOIs) 508–9
Moynihan, Roy 467
Multiple Risk Factor Intervention Trial (MRFIT) 370–1, 372
multiple sclerosis (MS) 408–9
Murakami, Shingo 412
Murray, Joseph 132, 133, 136–40, 144, 145
muscular dystrophy 334, 342–3
mustard gas 162
National Cancer Institute (NCI) 168, 170, 175, 218
National Health Service, costs 6, 439
National Institute of Cancer 340
National Institute of Health 218, 342
natural chemicals 392–3
neurosurgery 252
new chemical entities (NCEs) 278–9, 281
New Genetics 345–50, 454–63
constraints 347
and disease 347
future 429–30
gene therapy 324, 339–44, 345
genetic engineering 324, 325–32, 345
genetic screening 333–6, 345
genetic testing 336–8
Human Genome Project 312, 441, 454–7, 458–9, 462
medicine’s status 323
missing heritability 459–61, 491
molecular biology 311–12
possibilities 346, 406
term 312, 322
see also genes; genetic diseases
Newton, Isaac 323
nitrogen mustard 162, 164
Nixon, Richard 175
non-steroidal anti-inflammatory drugs (NSAIDs) 500–1
nucleotides (nucleic acids) 313, 315, 319, 322, 347–8
obstetrics 291–5
oestrogen 190, 393
Ogilvie, Sir William Heneage 232
olanzapine 472–3
oncology 176–8
open-heart surgery 96–102, 108–12, 113–19, 450–1
operating microscopes 249, 250–4
ophthalmic surgery 251–2
optics 221, 249–62
endoscopes 249, 254–62, 448
laparoscopes 181, 221, 255, 260–1
operating microscopes 249, 250–4
orthopaedics 448
Orwell, George 57–8
Osheroff, Rafael 512
Osler, Sir William 235–6, 431
overinvestigation 289
oxygen, ventilation 84
pacemakers 248
Page, Francis 501
Pappworth, Maurice 232
para-amino salicylic acid (PAS) 41, 49, 52–3, 56
paradoxes 4–7, 417, 423–7
Parry, Vince 470
Parsons, Frank 139
patients 230, 232–3, 434
Paul, Richard 292, 293
Pearson, Karl 44
penicillamine 501
penicillin 13–21, 242
peptic ulcers 203–12, 217, 290, 411
personalised genomics 457, 461
personality, and peptic ulcers 206–7
pesticides 390, 392–3
Pettenkoffer, Max von 204
pharmaceutical industry 465–75
as Big Pharma 466, 493–4
and doctors 433, 473–4
medicinal chemistry 221, 244
mergers 286–7
prospects 485–6
redefining illness 441
research 286, 287
revenues 155, 439, 440
shift in purpose 421, 465–6
see also drugs
phenylbutazone 500
physiological functions, milieu intérieur 358, 363, 382, 397
Pickering, Sir George 154, 368
Pincus, Gregory 183, 185
Pinkel, Donald 160–1, 171, 173–4, 175, 220, 384
plastic surgery 252–3
platinum 167–8
Platt, Lord Robert 154
pneumonia 236, 241
polio 84–90
pollution 356, 389–95, 397
polymerase chain reaction (PCR) 411–12
polypharmacy 474–5
population strategy (‘Big Idea’), public health 401, 402
population-mixing studies 410
Porter, Roy 426–7
Postgraduate Medical School 223, 231, 277, 301, 305
poverty 355
pregnancy 30
see also IVF
prescriptions 441, 465, 474–5, 476
prevention 356–7, 422
see also public health
preventive screening see screening
primary metabolites 265
Primolut 197, 198, 200
prions 413
progesterone 190, 191, 197, 198
progress, ideology of 430–2, 434
proguanil 243
promethazine 80–1
prontosil 239
propranolol 151–3, 155, 284
proteins 315–16, 325, 332, 413
Prozac 475–80
Prusiner, Stanley 413
psychiatric illnesses 2, 74–83, 477–8, 503–11
psychiatry 503–13
psychoanalysis 503, 504, 511–13
public health 351, 357, 401, 402
see also prevention
publications 473–4
puerperal fever 240
pumps (heart-lung machines) 96–8, 102, 108–12
Purdy, Jean 195, 196
Quilligan, Edward 292, 293
radiation 394
radiation treatment, leukaemia 159, 173
radioimmunoassay 221
Randomised Controlled Trial (RCT) 58, 59, 61, 70–1
Reeder, Earl 510
Rees, Jonathan 492
regulatory genes 463
replantation, limbs 252
research 439–40
Big Science 491, 492–3
clinical science 300, 301–2
dominant paradigm 491–2
funding 458
Human Genome Project 441
interconnectedness 219, 220–1
state investment 218
retinitis pigmentosa 349
retrovirus 413
reverse transcriptase 321, 322, 328, 413
rheumatic fever 241, 498–9
rheumatoid arthritis
cause of 411
cortisone 28, 34, 497
inflammation 37
jaundice 29, 30
rheumatoid factor 498, 501
rheumatoid factor 498, 501
rheumatological diseases 425, 498
rheumatology 497–501
Rhoads, Cornelius ‘Dusty’ 164, 172
Rhone-Poulenc 81
Ridley, Harold 251
rifampicin 56
Rise and Fall (of medicine) 7, 417–23, 497
RNA, messenger (mRNA) 315, 321
Rock, John 182, 183
Rollin, Henry 78
Roosevelt, Franklin D. 149
Rose, Sir Geoffrey 372, 401, 402
Rose, Molly 186
Rosenberg, Barnett 168
Russell, Ritchie 90, 91, 94
Sabin, Albert 87
Salk, Jonas 87
Sanger, Frederick 322
Santhouse, Alastair 478
Sarett, Lewis 32
Sataba, Richard 450
Savage, Oswald 33–4
Savill, John 312
scarlet fever 240
Schatz, Albert 50–1
schizophrenia 75, 79
chlorpromazine 76–8, 81, 282, 504, 510
Schou, Mogens 507
Schwartz, Robert 142–3
Schwartz, William 152
science 215–16, 218–19, 220, 263
scientific progressivism 431–2
screening 148, 333–6, 345, 421–2
Seascale see Sellafield
secondary metabolites 265–6
selective serotonin reuptake inhibitors (SSRIs) 476, 508
self-experimentation
204, 205, 506
self-healing ability 27, 35, 37
Sellafield 394, 409, 410
Sellors, Holmes 104
Selye, Hans 32
Semm, Kurt 261
Shackman, Ralph 277
Shaw, Laura 444–5
Sheehan, John C. 22
Sherlock, Sheila 224, 225, 231, 301
Shorter, Edward 503, 512
Shumway, Norman 119
sickle cell anaemia 333, 347, 348
side-effects of drugs
cortisone 33–4
hypertension 151
leukaemia 159, 160
lithium 506
statins 483–4
sulphonamides 242
Silva, Ashanthi de 340, 341
single-gene disorders 324, 339, 457, 459
Single Nucleotide Polymorphisms (SNPs) 460
skin grafting 252–3
Skipper, Howard 171–3
Sloan, Alfred 164
Sloan-Kettering Institute 164
Smith-Petersen, Marius 122
smoking 41, 59–69
social engineering see Social Theory (of disease)
Social Theory (of disease) 309, 351–60, 396–405
affluence 355, 402–3
appeal of 351, 356, 402, 406
cancer 355, 356, 383–8
claims 397
environmental pollution 389–95, 397
epidemiology 309, 397, 398–402
evaluated 357–8
and evolution 310, 358
future 429
inconsistencies 403–5
prevention 356–7, 422
rise of 352, 400
statistics 358
tuberculosis 353–5
utopianism 400–1
victim-blaming 404
see also heart disease
soil bacteria 24, 50
solid tumours 176
Souttar, Henry 106
sperm
IVF 184, 185, 187, 188
sperm counts 201, 390, 393–4
Spiers, Alexander 170
Stalin, Josef 149
Stamler, Jeremiah 369, 370
Starling, E. H. 228
Starzl, Thomas 145–6
statins 480–4
statistics 42, 44–6
alcohol consumption distribution 401–2
case-control studies 62–5
cohort studies 66–9
and knowledge 432
Randomised Controlled Trial (RCT) 58, 59, 61, 70–1
Social Theory 358
stents 447
Steptoe, Patrick
and Edwards 181, 194, 196, 197, 200
laparoscopy 192–3, 261
Sternbach, Leo 510–11
steroids
inflammation 220
kidney transplants 146
leukaemia 159, 166, 171, 173
role of 219
see also cortisone
Steward, Fred 278
Stock, Percy 61
stomach, bacteria 205
stomach cancer 211
stomach ulcers see peptic ulcers
strep sore throats 241
streptococcus 239, 240, 498
streptokinase 380
streptomycin
clinical trials 53, 54–6
discovery 24, 25, 50–1
tuberculosis 41, 47–8, 51
stress 207
strokes 147, 148, 153, 155, 355
Subba Row, Y. 165, 166
suicide 479
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