Cancer is that “loathsome beast, which seized upon the breast, drove its long claws into the surrounding tissues, derived its sustenance by sucking out the juices of its victims, and never even relaxed its hold in death,” a turn-of-the-century physician recorded. Even today cancer affects the popular imagination with dread. In a subtle and penetrating cultural history, James Patterson examines reactions to the disease through a century of American life.

The modern American preoccupation with cancer was apparent during the widely publicized illness and death from that ailment of Ulysses S. Grant in 1885. Awareness of the disease soon figured heavily in the public consciousness, and individual reactions to it continue to reveal broader tensions within American society. Patterson examines responses to cancer by researchers and physicians, quacks and faith healers, by the multitude who have heard sensational media reports of “cures,” as well as by many who have had firsthand experiences with the disease.

Optimistic attitudes of many experts contrast sharply with the skepticism of large segments of the population—often the less wealthy and the less educated—that reject the claims of medical science and resist the advice or, some argue, the paternalistic dictates of the government-supported cancer research establishment.

Expanding expectations of a cure from a confident medical profession; the rise of a government-supported Cancer Establishment managing a large research empire; the emergence of a “cancer counterculture”; a new emphasis on prevention through control of the environment and the self; and the private fears and pessimism of millions of Americans form a telling history of American social patterns. Whether the issue is smoking, pollution, or regular checkups, attitudes toward cancer reflect more general views on medicine, public policy, and illness, as well as on death and dying. This century has witnessed both a biomedical revolution and a vastly increased role of the state in the private lives of citizens; but not everyone has bought the medical package, and many have little faith in government intervention.

Readers interested in the cultural dimensions of science and medicine as well as historians, sociologists, and political scientists will be enlightened and challenged by The Dread Disease.

In 1927 the first bill to secure government support in the search for a cure for cancer was introduced to Congress. In 1971 Congress passed the Conquest of Cancer Act, which initiated a new and enlarged effort in the fight against cancer, including possible annual expenditures of up to one billion dollars. The forty-four years between these two dates have witnessed the evolution of medical research from a limited, private endeavor to a major national enterprise commanding substantial support from the federal government.

In this first historical analysis of national policy in biomedical research, Stephen Strickland examines the rise of the National Institutes for Health, tells of the recurrent struggle between elected public officials and science administrators over the pace and direction of cancer and heart disease research; analyzes the roles that key members of Congress have played in the development of medical research; and discusses the medical research lobby and its founder, Mrs. Albert D. Lasker. What emerges is a clear picture of how government officials actually formulate national policy, not only in medical research but in other areas as well.

This is a historical review of the development of our knowledge of the clinical picture, etiology, pathogenesis, and prevention of rheumatic fever and rheumatic heart disease over the past four centuries. Benedict Massell examines the major contributions of both clinicians and investigators to our current understanding of rheumatic fever as a separate disease form.

Elucidating many facts about this dread disease, Massell examines the frequent epidemics in training camps during World War II, discusses our growing understanding of the pathogenesis and mechanisms by which streptococcal infections cause the disease, and shows the important progress made in prevention through the use of penicillin and other antibiotics. He includes a discussion of the many problems which can hinder our understanding and control of this disease, as well as recent promising developments in the clarification of the molecular structure of the streptococcal protein and the possible application of this information to the development of a safe and effective vaccine for the prevention of streptococcal infection.