Mirage of Health: Utopias, Progress, and Biological Change

amazing and wonderful. extremely interesting reading for anyone interested in humanity, disease, science and history. what a brilliant thinker and synthesizer. i can't wait to read his other works. i couldn't put this book down.

I'm so grateful to have happened upon this work. It could stand to be edited a bit - it gets very repetitive and almost circular - but the first couple of chapters are strong, brilliant, enlightening. Two achievements stand out: 1) Dubos has some of the best illustrations of the cyclic/repetitive nature of social thought. He offers a very clear interpretation of meta-medicine since the early Greeks in the Western world, with some decent insights about non-Western cultures as well. (Remember that this book was written in 1959; here's some salt, take a grain of it.) 2) He has a great overall critique of our philosophy of causation in the medical sciences, with a specific focus on the relation between microbial parasites and disease. We know that bronchitis, for example, is caused by certain bacilli, but we also discover that, killing off those bacilli, the patient won't necessarily get better; another infection can take hold. Conversely, and I didn't realize this before reading Mirage of Health, essentially every European urbanite in the 19th century was infected with tuberculosis - but only "were consumptive", became ill. He points out that obliterating bacterial competition is neither possible, desirable, nor necessary, which is on the one hand, so very interesting in its ivory tower way, and on the other hand, so very important. Drug-resistant TB is worsening the world over, from Russia to South Africa to Haiti, and the only thing that consistently works are comprehensive programs that don't just drug the patient, don't just treat the whole patient, but treat the community and environment as a whole. I'm not really interested in being alarmist - "we'll find ourselves in a whole heap of trouble if we don't listen!! zomg" - but the possibility to prevent human suffering is enormous.

Rene Dubos, a doc, was one of the first and most influential environmentalists and also bent medicine. This book established that disease is PART of health---not in some goopy self-awareness way but as an inherent part of a system remaining able to correct itself and restore dynamic homeostasis.Four stars only because it might be a little dated by now, but no one has attempted to surpass what Dubos accomplished.