Under The Microscope

FOLLIES AND FALLACIES IN MEDICINE, by Petr Skrabanek and James McCormick; Prometheus Books, 1990; 147 pages; cloth $24.95

This book hopes to dispel myths, or limit misconceptions, about medical issues. The authors, from the Community Health Department of Trinity College, Dublin, write in a direct, easy-to-read and, at times, compelling fashion. They include a wide selection of examples to illustrate their major thesis -- that there is a need for a more sceptical approach to diagnosis, treatment and care of diseases.

If increased medical costs mean that we are visiting the doctor less, then that may be a good thing. Apparently, about 40% of today's prescriptions have no specific effect on target diseases. These "placebos" include antibiotics, cough syrups and tranquilizers. Although they may have no effect on the disease itself, they have a powerful one on the people who use them. The discussion includes how the effects of a drug may depend on our expectations, how placebo reactions can override pharmacological responses, and how a doctor's bedside manner often has a greater effect than his/her pills.

The authors have described 26 different fallacies. That spinach is a rich source of iron is an example of the "bellman's fallacy" -- what you are told often enough must be true. That vitamin C benefits cancer sufferers is a "fallacy of authority", after statements made by Nobel Prize Laureate Linus Pauling.

It is my practice, when reading a book, to underscore sentences or phrases I find particularly edifying, If I had done it for this book, virtually every word on every page would have been highlighted.

Russell Dear