The Worst of Evils: The Fight Against Pain

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9780300113228: The Worst of Evils: The Fight Against Pain

This riveting book takes the reader around the globe and through the centuries to discover how different cultures have sought to combat and treat physical pain. With colorful stories and sometimes frightening anecdotes, Dr. Thomas Dormandy describes a checkered progression of breakthroughs, haphazard experiments, ignorant attitudes, and surprising developments in human efforts to control pain. Attitudes toward pain and its perception have changed, as have the means of pain relief and scientific understanding. Dr. Dormandy offers a thoroughly fascinating, multi-cultural history that culminates with a discussion of today’s successes and failures in the struggle against pain. 
The book’s exploration is fused with accounts of the development of specific methods of pain relief, including the use of alcohol, plants, hypnosis, religious faith, stoic attitudes, local anesthesia, general anesthesia, and modern analgesics. Dr. Dormandy also looks at the most recent advances in pain clinics and palliative care for patients with terminal disease as well as the prospects for loosening pain’s grip in the future.

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About the Author:

Thomas Dormandy, M.D., is consultant chemical pathologist and retired professor of chemical pathology, Whittington Hospital, University of London, and Brunel University, London. He is the author of the prizewinning book The White Death: A History of Tuberculosis.

From Scientific American:

A 560-page history of anesthesia sounds like perfect operating-room reading—you would fall asleep before page two. The Worst of Evils, however, is a chatty book, sprinkled with anecdotes and Thomas Dormandy’s opinions—some very interesting though apropos of nothing—on everything from the French Revolution to the Iraq War. The tome is also a history of pain itself, beginning with the ideas of the ancient Greeks and Romans and ending with contemporary medical pain management. But more than anything else, Dormandy tells the story of the men (very few women appear) who were important to the fi ght against pain, from Galen in Rome (who compiled medical knowledge around A.D. 200) and early Islamic thinkers to the founders of the modern hospice movement. Dormandy, a retired pathologist in London, is fascinated by the lives of the chemists, physicians and researchers who advanced our understanding of pain and the means to dull or abolish it. He tells good stories, especially when dealing with 18th- and 19th-century Europe, when science came into its own. One chapter is devoted to three generations of Renoirs—Pierre-Auguste Renoir, the impressionist painter, suffered from rheumatoid arthritis—whereas another discusses Rasputin, the evil holy man whose hypnotic powers helped to ease the pain suffered by Russian Tsar Nicholas II’s hemophiliac son. In addition to lively, clever writing, Dormandy makes several good points. He provides vivid descriptions of just how awful surgery was for doctor and patient before anesthesia. He reminds us that many religious and medical fi gures initially denounced anesthetics because they believed suffering ennobled patients and that pain was endorsed by the Bible. The Worst of Evils also has a cynical history of the rise of pharmaceuticals as big business, with aspirin leading the way. What is missing, however, is the science. Given Dormandy’s own background, how could a book with detailed histories of the introduction of ether and chloroform, the fi rst effective anesthetics for surgery, fail to say a single word about how either chemical works? Only very late in the book does he provide an outline of the nervous system and pain perception, and except for aspirin and a few other modern medicines there is little about the chemical composition of pain drugs. Furthermore, he devotes only three paragraphs to China and India, which for centuries have had compounds to control pain. Overall, the limitations of Dormandy’s approach leave the reader disappointed, especially given the number of pages into which some of the omissions could have been painlessly woven.

Jonathan Beard

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