This was first published to considerable acclaim in 1999. It neatly divided modern medical achievements into "12 definitive moments": from the discoveries of penicillin and cortisone through to the birth of intensive care, hip replacements and test-tube babies. Central to its historical narrative is Le Fanu's argument that the most significant modern medical advances are clustered between the post-war period and the 1970s, a time when innovations in our understanding of disease, surgical technique and drug manufacture reached their zenith. Since then, he claims, medical advances have dwindled. For him this is due to a number of "false strategies" that have tried to "pole-vault over medical progress": namely, an obsession with minor ailments; corporate drug-profiteering; an emphasis on social context; and the unrealised promise of the new genetics. This updated edition also includes fascinating work on how Big Science is producing mega-projects with generic results because of its finance-driven emphasis on "outcomes".