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Intolerant Bodies

, 264 pages
November 2014



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Intolerant Bodies

A Short History of Autoimmunity

Autoimmune diseases, which affect 5 to 10 percent of the population, are as unpredictable in their course as they are paradoxical in their cause. They produce persistent suffering as they follow a drawn-out, often lifelong, pattern of remission and recurrence. Multiple sclerosis, lupus, rheumatoid arthritis, and type 1 diabetes—the diseases considered in this book—are but a handful of the conditions that can develop when the immune system goes awry.

Intolerant Bodies is a unique collaboration between Ian Mackay, one of the prominent founders of clinical immunology, and Warwick Anderson, a leading historian of twentieth-century biomedical science. The authors narrate the changing scientific understanding of the cause of autoimmunity and explore the significance of having a disease in which one’s body turns on itself. The book unfolds as a biography of a relatively new concept of pathogenesis, one that was accepted only in the 1950s.

In their description of the onset, symptoms, and course of autoimmune diseases, Anderson and Mackay quote from the writings of Charles Dickens, Edgar Allan Poe, Joseph Heller, Flannery O’Connor, and other famous people who commented on or grappled with autoimmune disease. The authors also assess the work of the dedicated researchers and physicians who have struggled to understand the mysteries of autoimmunity. Connecting laboratory research, clinical medicine, social theory, and lived experience, Intolerant Bodies reveals how doctors and patients have come to terms, often reluctantly, with this novel and puzzling mechanism of disease causation.

Warwick Anderson is an Australian Research Council laureate fellow and a professor in the Department of History and the Center for Values, Ethics, and the Law in Medicine at the University of Sydney. He is the author of The Collectors of Lost Souls: Turning Kuru Scientists into Whitemen, also published by Johns Hopkins. Ian R. Mackay is a research professor in the Department of Biochemistry and Molecular Biology at Monash University. He is the coauthor of Autoimmune Diseases: Pathogenesis, Chemistry, and Therapy and the coeditor of The Autoimmune Diseases, fifth edition.

"Anderson and Mackay's engaging survey is a studious examination of autoimmune diseases, and a humble admission that their cures remain stubbornly elusive."

"This is a fascinating read... A solid choice for academic science and health sciences collections."

"... This book packs in serious scholarship in both science and its history, adding hefty amounts of philosophy for good measure."

"A magisterial, historically rich biography of autoimmunity... Anderson and Mackay reveal an expert understanding of how to use 'lived experience' to bring a biography of disease to life. Personal accounts demonstrate how, as theories about the causes of inexplicable chronic debilitating diseases abounded, the variety of treatments devised to alleviate or 'cure' them expanded."

"I am thoroughly beguiled by Anderson and Mackay’s book. It describes symptoms in straightforward terms, explains the paradox inherent in a natural defense system gone wrong, looks at the conceptual struggles of doctors trying to understand causation, shows how research changed perceptions gradually from disbelief into puzzled acceptance, and relates how the idea of autoimmunity contains philosophical as well as scientific resonances. All that and an exquisite writing style— Intolerant Bodies is a fine and original work."

" Intolerant Bodies tells a fascinating, thought-provoking story about an important but insufficiently studied subject. Thoroughly researched, well-written, and innovative, the book—which is enriched with thoughts on the clinical aspects of autoimmune disease and patient testimonies—provides a clear and much-needed summary of the history of autoimmunity."

" Intolerant Bodies is an extraordinary journey into the ideas behind today’s notion of autoimmunity. Who knew that we have returned to concepts that held sway before the age of bacteria? This is a riveting story, full of intriguing archival discoveries and original analytical insights, for anyone who loves the history of science and medicine."

"Treatments have steadily improved, but autoimmune diseases like multiple sclerosis continue to diminish too many lives. This readable account by a physician medical writer and a physician pioneer in the field informs us about the history and nature of the chronic, debilitating autoimmune diseases."

"Succinct, well-written, and informed, Intolerant Bodies narrates the history of immunology through the lens of autoimmune disease... the story told here extends far beyond the topic of ‘‘attack against self’’ to provide perhaps the best overview of immunity (normal and pathological) available for the general reader."

"Few topics in contemporary science hold the wide interest commanded by immunology, so this graceful and timely account of the development of this science is a welcomed addition to the literature."

" Intolerant Bodies is beautifully written—an informed, informative, and engaging assessment of the history of autoimmunity. But the small book is far more than the short history it humbly claims to be; for Anderson and Mackay take on a complex subject many of us have struggled to summarize with more words than fewer."

"Anderson and MacKay reward any readers who have dedicated decades to researching a cure for type 1 diabetes, and other equally elusive autoimmune diseases, by illustrating just how far into other scholarly realms the concepts of autoimmunity have reached."

"Highly recommended for any collection strong in health history."

"Well researched, highly readable history of autoimmune disease... The reader will journey in company with the authors on their fascinating tour of autoimmune history, facts, and observations. And what a journey indeed!"

"Within a limited amount of pages, it tells the complicated but intriguing development of immunology and autoimmunity in a clear and consistent narrative that constantly crosses the boundaries between laboratories, hospitals, and patients’ lives."

"The book’s concision, its fluid prose, its courageous (and largely successful) attempt to bring four chronic diseases into a coherent historical relationship, and its bold effort to come at immunology’s history from the margins all conspire to make Intolerant Bodies a valuable and unique contribution to the field."

"[Anderson and Mackay's] work is refreshingly different from some recent best-selling histories of medicine written by scientists and clinicians, and the authors responsibly and soberly juxtapose the exciting science with the problematic clinical reality."

"With clarity, depth, and subtle provocation, Intolerant Bodies covers significant historical, biomedical, and philosophical ground to investigate and explain the aetiological paradox of autoimmune disease...discussions at biomedical science conferences, immunology seminars, and research colloquia will be all the richer if this book is widely circulated."

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