Doctors and patients alike trust the medical profession and its therapeutic powers; yet this trust has often been misplaced. Whether prescribing opium or thalidomide, aspirin or antidepressants, doctors have persistently failed to test their favourite ideas - often with catastrophic results. From revolutionary America to Nazi Germany and modern big-pharmaceuticals, this is the unexpected story of just how bad medicine has been, and of its remarkably recent effort to improve. It is the history of well-meaning doctors misled by intuition, of the startling human cost of their mistakes and of the exceptional individuals who have helped make things better. Alarming and optimistic, Taking the Medicine is essential reading for anyone interested in how and why to trust the pills they swallow.
A bestselling history of medicine, enriched with a new foreword, concluding essay, and bibliographic essay. Erwin H. Ackerknecht’s A Short History of Medicine is a concise narrative, long appreciated by students in the history of medicine, medical students, historians, and medical professionals as well as all those seeking to understand the history of medicine. Covering the broad sweep of discoveries from parasitic worms to bacilli and x-rays, and highlighting physicians and scientists from Hippocrates and Galen to Pasteur, Koch, and Roentgen, Ackerknecht narrates Western and Eastern civilization’s work at identifying and curing disease. He follows these discoveries from the library to the bedside, hospital, and laboratory, illuminating how basic biological sciences interacted with clinical practice over time. But his story is more than one of laudable scientific and therapeutic achievement. Ackerknecht also points toward the social, ecological, economic, and political conditions that shape the incidence of disease. Improvements in health, Ackerknecht argues, depend on more than laboratory knowledge: they also require that we improve the lives of ordinary men and women by altering social conditions such as poverty and hunger. This revised and expanded edition includes a new foreword and concluding biographical essay by Charles E. Rosenberg, Ackerknecht’s former student and a distinguished historian of medicine. A new bibliographic essay by Lisa Haushofer explores recent scholarship in the history of medicine.
If you believe that the latest blockbuster medication is worth a premium price over your generic brand, or that doctors have access to all the information they need about a drug’s safety and effectiveness each time they write a prescription, Dr. Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced. This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans. In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls? Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible. This is a passionate and provocative call for action as well as a compelling work of clear-headed science.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
The number of prescriptions issued by family doctors has soared threefold in just fifteen years with millions now committed to taking a cocktail of half a dozen (or more) different pills to lower the blood pressure and sugar levels, statins, bone strengthening and cardio protective drugs. In Too Many Pills, doctor and writer James Le Fanu examines how this progressive medicalisation of people's lives now poses a major threat to their health and wellbeing, responsible for a hidden epidemic of drug induced illness (muscular aches and pains, lethargy, insomnia, impaired memory and general decrepitude), a sharp increase in the number of emergency hospital admissions for serious side effects and implicated in the recently noted decline in life expectancy. The paradoxically harmful, if increasingly well recognised, consequences of too much medicine are illustrated by the remarkable personal testimony of the readers of James Le Fanu's weekly medical column, coerced into taking drugs they do not need, debilitated by their adverse effects - and their almost miraculous recovery on discontinuing them. The only solution, he argues, is for the public to take the initiative. His review of the relevant evidence for the efficacy, or otherwise, of commonly prescribed drugs should allow readers of Too Many Pills to ask much more searching questions about the benefits and risks of the medicines they are taking.
Circadian rhythms, the biological oscillations based around our 24-hour clock, have a profound effect on human physiology and healthy cellular function. Circadian Rhythms: Health and Disease is a wide-ranging foundational text that provides students and researchers with valuable information on the molecular and genetic underpinnings of circadian rhythms and looks at the impacts of disruption in our biological clocks in health and disease. Circadian Rhythms opens with chapters that lay the fundamental groundwork on circadian rhythm biology. Section II looks at the impact of circadian rhythms on major organ systems. Section III then turns its focus to the central nervous system. The book then closes with a look at the role of biological rhythms in aging and neurodegeneration. Written in an accessible and informative style, Circadian Rhythms: Health and Disease,will be an invaluable resource and entry point into this fascinating interdisciplinary field that brings together aspects of neuroscience, cell and molecular biology, and physiology.
Unpleasant, uncomfortable, and unexplained side effects? Drug Muggers is your side effect solution. Prescription and over-the-counter drugs help millions of people with devastat-ing diseases and chronic conditions. But in the process, these medications can also deplete the body's natural stores of vitamins, minerals, and hormones—the very nutrients you need to keep energy levels high, fend off infections, and be healthy. Pharmacist Suzy Cohen calls these medications "drug muggers," and she says it's essential to replenish what a drug mugger steals from your body in order to feel your best and avoid side effects. Not understanding the drug-mugging effect may lead to new "diseases" and possibly catastrophic health con-sequences. You'll discover: • How to relieve uncomfortable or potentially serious side effects • How to remain compliant with your medication and still feel well • Which foods and drinks to avoid if you take certain medications • How to install a nutrient security system with vitamins, minerals, and food choices Plus! • Improve your energy levels • Learn which minerals you need if you take heartburn medicine • Improve digestion and relieve constipation with a simple nutrient • Discover the antioxidant you must have to save your heart • Get your hair and nails to grow faster by replenishing nutrients • Find out which vitamins and minerals are the purest and highest quality • Learn which vitamins outperform medications in some cases Drug Muggers is an eye-opener! It reveals why you may be feeling so poorly and how to improve your well-being with affordable nutrients that are sold over the counter. You can (and will) improve the way you feel—whether or not you take medicine!