Making Sense of Illness: Science, Society and Disease / Edition 1

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Overview

Making Sense of Illness is a fascinating investigation into the social and clinical factors that determine what constitutes a "legitimate" illness in the twentieth century. By examining six case studies of diseases that have emerged within the past fifty years—from what we now consider to be "straightforward" diseases such as coronary heart disease, to the currently widely-debated Chronic Fatigue Syndrome—Aronowitz examines the historical and cultural factors that influence how doctors think about illness; how illnesses are recognized, named, classified, and finally, what they "mean" in an individual and social context. The choices that are available to the investigators, clinicians, patients and the processes by which change occurs are factors that all play a great role in "legitimizing" an illness, and these are the roles that are seldom examined. By juxtaposing the histories of each disease, Aronowitz shows how cultural and historical precedents have determined research programs, public health activities, clinical decisions, and even the patient's experience of illness. This is a must-read for anyone interested in public health and the history of medicine in the United States.

The book contains no figures.

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Editorial Reviews

Christopher Crenner
This original and thought-provoking book charts the history of several new diseases that have emerged during the twentieth century. The author invites his readers to consider how modern medicine defines and gives meaning to disease. The author argues that the recognition of a new disease results from complex negotiations among physicians, scientists, and patients. People who are concerned about medical diagnoses, either because they make them, have them, or use them, will gain from this book. The author links six case studies of new diseases into a subtle and convincing analysis of the process of acknowledging and defining illness. He examines Lyme disease, chronic fatigue syndrome, psychosomatic ulcerative colitis, coronary heart disease, coronary risk factors, and type-A personality. The history of a contentious condition like chronic fatigue syndrome, or type-A personality, highlights the importance of successful negotiations among social groups in creating diseases. The author extends this insight to his analysis of other conditions, like coronary heart disease, that have developed a more durable, empirical grounding. There are limitations to the social analysis of disease concepts. Such an analysis may seem an embellishment to our understanding of a disease with accepted empirical grounding. Alternately, it may serve to undermine the legitimacy of a disease that lacks such grounding. The author does an unrivaled job of identifying and overcoming these limitations. His arguments work to wonderful effect in the case of Lyme disease. He shows that the boundary between Lyme disease and the contentious diagnosis of chronic Lyme disease is itself negotiated, and is contingentupon agreements among different groups about such things as the interpretation of empirical evidence. The author does not tackle directly the problem of reckoning with the stigmatized, subjective elements in all illness. He makes a bold attempt to diagram the implications of medicine's avoidance of subjectivity and idiosyncrasy in explaining disease. He successfully pursues a line of analysis suggested by several authors in Framing Disease: Studies in Cultural History (Rutgers Univ Pr 1992) edited by Charles Rosenberg and Janet Golden. Comparable historical analysis of changing disease categories appears in Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton Univ Pr 1996), and Mark Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton Univ Pr 1995).
From The Critics
Reviewer: Christopher Crenner, MD, PhD (University of Kansas Medical Center)
Description: This original and thought-provoking book charts the history of several new diseases that have emerged during the twentieth century. The author invites his readers to consider how modern medicine defines and gives meaning to disease.
Purpose: The author argues that the recognition of a new disease results from complex negotiations among physicians, scientists, and patients.
Audience: People who are concerned about medical diagnoses, either because they make them, have them, or use them, will gain from this book.
Features: The author links six case studies of new diseases into a subtle and convincing analysis of the process of acknowledging and defining illness. He examines Lyme disease, chronic fatigue syndrome, psychosomatic ulcerative colitis, coronary heart disease, coronary risk factors, and type-A personality. The history of a contentious condition like chronic fatigue syndrome, or type-A personality, highlights the importance of successful negotiations among social groups in creating diseases. The author extends this insight to his analysis of other conditions, like coronary heart disease, that have developed a more durable, empirical grounding. There are limitations to the social analysis of disease concepts. Such an analysis may seem an embellishment to our understanding of a disease with accepted empirical grounding. Alternately, it may serve to undermine the legitimacy of a disease that lacks such grounding. The author does an unrivaled job of identifying and overcoming these limitations. His arguments work to wonderful effect in the case of Lyme disease. He shows that the boundary between Lyme disease and the contentious diagnosis of chronic Lyme disease is itself negotiated, and is contingent upon agreements among different groups about such things as the interpretation of empirical evidence.
Assessment: The author does not tackle directly the problem of reckoning with the stigmatized, subjective elements in all illness. He makes a bold attempt to diagram the implications of medicine's avoidance of subjectivity and idiosyncrasy in explaining disease. He successfully pursues a line of analysis suggested by several authors in Framing Disease: Studies in Cultural History (Rutgers Univ Pr 1992) edited by Charles Rosenberg and Janet Golden. Comparable historical analysis of changing disease categories appears in Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton Univ Pr 1996), and Mark Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton Univ Pr 1995).

3 Stars from Doody
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Product Details

  • ISBN-13: 9780521558259
  • Publisher: Cambridge University Press
  • Publication date: 5/28/2011
  • Series: Cambridge Studies in the History of Medicine Series
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 284
  • Sales rank: 1,188,449
  • Product dimensions: 5.98 (w) x 8.98 (h) x 0.63 (d)

Table of Contents

1. Introduction; 2. The rise and fall of the psychosomatic hypothesis in ulcerative colitis; 3. From myalgic encephalitis to yuppie flu: a history of chronic fatigue syndrome; 4. Lyme disease: the social construction of a new disease and its social consequences; 5. From the patient's angina pectoris to the cardiologist's coronary heart disease; 6. The social construction of coronary heart disease risk factors; 7. The rise and fall of the type A hypothesis; 8. Conclusion.

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