Diagnosis, Therapy, And Evidence: Conundrums In Modern American Medicine (critical Issues In Health And Medicine)

Diagnosis, Therapy, and Evidence Critical Issues in Health and Medicine Edited by Rima D. Apple, University of Wisconsin–Madison, and Janet Golden, Rutgers University, Camden Growing criticism of the U.S. health care system is coming from consumers, politicians, the media, activists, and health care professionals. Critical Issues in Health and Medicine is a collection of books that explores these contemporary dilemmas from a variety of perspectives, among them political, legal, historical, sociological, and comparative, and with attention to crucial dimensions such as race, gender, ethnicity, sexuality, and culture. For a list of titles in the series, see the last page of the book. Diagnosis, Therapy, and Evidence Conundrums in Modern American Medicine Gerald N. Grob and Allan V. Horwitz Rutgers University Press New Brunswick, New Jersey, and London Librar y of C ongr e s s C a t aloging - in - Public a tion Da t a Grob, Gerald N., 1931– Diagnosis, therapy, and evidence : conundrums in modern American medicine / Gerald N. Grob and Allan V. Horwitz. p. ; cm. — (Critical issues in health and medicine) Includes bibliographical references and index. ISBN 978-0-8135-4671-1 (hardcover : alk. paper) — ISBN 978-0-8135-4672-8 (pbk. : alk. paper) 1. Social medicine—United States. 2. Diseases and history—United States. 3. Diagnosis. I. Horwitz, Allan V. II. Title. III. Series: Critical issues in health and medicine. [DNLM: 1. Medicine—trends—United States. 2. Diagnosis—United States. 3. Disease— etiology—United States. 4. Therapeutics—trends—United States. WB 100 G8728d 2010] RA418.3.U6G76 2010 362.1—dc22 2009008097 A British Cataloging-in-Publication record for this book is available from the British Library Copyright © 2010 by Gerald N. Grob and Allan V. Horwitz All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 100 Joyce Kilmer Avenue, Piscataway, NJ 08854–8099. The only exception to this prohibition is “fair use” as defi ned by U.S. copyright law. Visit our Web site: http://rutgerspress.rutgers.edu Manufactured in the United States of America To the memory of our fathers Contents Preface ix List of Abbreviations xi Chapter 1 Rhetoric and Reality in Modern American Medicine Chapter 2 Medical Rivalry and Etiological Speculation: The Case of Peptic Ulcer 33 How Theory Makes Bad Practice: The Case of Tonsillectomy 57 How Science Tries to Explain Deadly Diseases: Coronary Heart Disease and Cancer 84 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Epilogue 1 Transforming Amorphous Stress into Discrete Disorders: The Case of Anxiety 111 Depression: Creating Consensus from Diagnostic Confusion 141 Post-Traumatic Stress Disorder: The Result of Abnormal Environments or Abnormal Individuals? 164 Where Do We Go from Here? 192 Notes 199 Index 243 vii Preface Americans are besieged by advice about the efficacy of medical therapies and drugs as well as behavioral and dietary modifications that will presumably prevent disease, promote health, and extend longevity. Scarcely a day passes without revelation