old questions.
The presentation is small being replaced by the new puritanism of the
format and pleasant, but several of the
drawings would benefit from some labelling.
Although the book is aimed at non-scientists,
many (most?) of its readers will be scientists
delighted to find an intelligible summary of a
daunting topic: it is a pity, therefore, that no
references are given. Finally, there should be
a cheaper paperback edition, so that the
students who hold the future of medicine
can be inspired with an interest in modern
embryology.
The Triumph of the Embryo. L Wolpert.
(Pp 21 1; £14.95.) Oxford: Oxford University
Press, 1991. ISBN 019-854243-7.
Counterblasts to
cultural imperialism
Alex Paton
The theme of Health, Lifestyle and Environ-
ment, an entertaining and often maddening
tirade, is that our way oflife is being subverted
by a "sinister conspiracy" of elite middle
class health activists, epidemiologists, con-
sumer interests, and governments, intent on
cultural imperialism and social engineering.
Fear and ignorance among the public are
exploited by health scares; as a result regu-
latory agencies are set up with the enthusiastic
support of the people and individual freedom
is eroded. In short, the swinging '60s are
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BMJ VOLUME 304 2 MAY 1992
Other authors attack the experts: Skra-
nanny '90s.
As befits the single issue fanatic, most of
the authors are highly selective in their views
and are thrown back on the defensive by
contrary opinions. A case in point is their
condemnation of the antismoking lobby.
Berger kicks off rather shakily by claiming
that he cannot understand the "complex"
evidence on cigarette smoking and ill health
-thus absolving himselffrom producing any
data-and in the next breath declaring that
evidence implicating passive smoking *is
"dubious." Later Johnstone does a con-
vincing hatchet job on the statistics of two
of the many papers purporting to show a
deleterious effect of passive smoking. But
neither he nor Finch, in criticising the historic
judgment in the Australian courts, quotes the
view of Justice Morling, who had carefully
considered all the data, that the scientific
evidence relating passive smoking to lung
cancer, respiratory disease in young children,
and asthma was "compelling and in some
cases overwhelming."
Similar distortions apply to their paranoid
attitude towards the anti-alcohol (sic) lobby
-"the fascinating and full blown revival of
the temperance movement," Berger calls it.
It is, of course, no such thing but a campaign
against alcohol misuse, the biggest cause of
premature death after cigarettes. Anderson is
quite right in saying that most people drink
sensibly, but a minority means at least six
million in Britain who do not, and it is just
not good enough to dismiss the widespread
harm done to individuals and families by
woolly comments like "economists cannot
agree" on the costs to society.
banek has a field day blaming the epidemio-
logists (in passing it is surely the media
that seize on their findings for eye catching
headlines), while Finch deplores the "creative
statistics" of medicine; true statisticians are
much more humble. Indeed a hatred of
research is a recurring theme, neatly summed
up by Johnstone: "Medical and scientific
vandals have hijacked the tools and results of
science and prostituted them to their own
ends." The only convincing arguments are
those of Le Fanu, who objects strongly to the
imposition of dietary changes on a population
healthier and longer lived than ever before;
and of Mills and Wildavsky, who highlight
the enormous gap between public and expert
perception of environmental hazards-
nuclear radiation, asbestos, pesticides, etc-
and the public panic that forces governments
to spend millions in combating often minimal
risks.
Several lessons emerge: scientists-and
that includes social scientists-must be
honest in presenting the data and present
them in a way that can be understood by
lay people; the media need 'to be more
responsible in reporting the findings of
science;. and powerful corporations and the
advertising industry have a greater vested
interest in manipulating our lifestyle than
any of the Aunt Sallies put up by the authors.
Health, Lifestyle and Environment:
Countering the Panic. P Berger, I Kristol,
M Mills, A Wildavsky, D Anderson, J Le
Fanu, P Skrabanek, R Browning, P Finch,
R Johnstone. (Pp 152; £9.95; paperback.)
London: Social Affairs Unit, 1991. ISBN
0-907631-44-4.
Sleepwalkers to..
bloodsuckers:
Brian Hurwitz
-Of all the gothic novels that.appeared at the
end.of the eighteenth and during thefirst half
of the nineteenth centurie; 'The Vampyre
fashioned one of the ,ost potent literary
monsters of modem 'imes. Oily Mary
Shelley's nameless: monster in Frankenstein
rivals, and perhaps surpasses in imaginative,,
literary, and philosq'hical import'ance, that
of John Polidori's creation in The vmre.
Since the bookappeared in 18198 the fire
of the vampire has drawn its power from the
haunting spectre of the dead controlling,
depleting, and consuming the living.It was
for precisely the:s qualities that later in the
century Karl Marx used it in. his political
-philosophy-,a .fvourite image was that of
capital, vampire-like, sucking the blood
of living labour. Part of the vampire's meta-
phorical power derives from the organic
1189
 ...:':Xi
.

fusion of polar opposites, the living dead. Its The epigraph to his MD was from the relation-I would advise his advice-all the
propensity for biting followed by possession sleepwalking scene in Macbeth: "A great patients he had in Ital are dead.
of a human food source, with the merger of perturbation in nature! to receive at once When The Vampyre first appeared it became
feeder and victim, encapsulates a vision of the benefit of sleep, and do the effects of an instant best seller and was reprinted
oral sadism. In its developed Dracula version watching." Lorne MacDonald has translated and translated many times. But although
this restless roaming figure has spawned a the thesis from its original Latin and notes it was acclaimed both in England and on the
film genre; and with the characterisation of the strong influence of de Sauvages's Nosologia Continent, the author remained impover-
vampirism as a clinical entity, more recently Methodica (1761) and the entry on som- ished. Polidori had transformed the hitherto
joined by autovampirism and psychic vam- nambulism in Diderot's Encyclopedie. ghoulish figure of European vampire lore
pirism, we see the metaphor effortlessly MacDonald also provides extensive quotes into an aristocratic gothic villain moving
invading medical territory.'` from Polidori's thesis, unpublished private about freely in English high society. Polidori's
Polidori had been present at the Villa letters to his family, and extracts from his literary revenge on Byron thus emerges as the
Diodati on the shores of Lake Geneva with other works, including On the Punishment novel unfolds.
Byron, Shelley, and Mary Shelley on the of Death (1816), An Essay on the Source MacDonald's book, written with scholar-
evening in 1816 when all gathered to exchange of Positive Pleasure (1818), Ximenes the ship and wit, is part psychological study, part
ghost tales. Mary Shelley later recalled: Wreath, and Other Poems (1819), and Ernestus documentary biography, and part literary
There were four of us.... T he noble author [Byron] Bechtold; or The Modern Oedipus (1819). criticism. A central theme is the young
began a tale, a fragment of which he printed at the Though some of these works may strike the doctor's relationship with Byron, and
end of Mazeppa. Shelley commenced one founded modern reader as meandering and somewhat MacDonald shows how echoes of the doctor's
upon the early experiences of his life. Poor Polidori impenetrable, MacDonald skilfully re- relationship with his father later reappeared
had some terrible idea about a skull-headed awakens their literary and biographical in the tempestuous goings on with the poet.
lady.... I busied myself to think ofa story. value. On hearing of his early death Byron mused,
Polidori's ambitions for literary success Polidori kept a diary of the European tour "Poor Polidori is gone! When he was my
often made him seem ridiculous in the eyes of with Byron. From the edited version that physician, he was always talking of Prussic
his literary companions. He had arrived at survives it is clear that he steadfastly refused Acid, oil of amber, blowing into veins,
the Villa Diodati accompanying Byron as to observe and record the notorious poet's suffocating by charcoal, and compounding
personal physician on the poet's second Euro- personality, preoccupations, and personal poisons.... The book was short listed for
pean tour of 1816. Their journey was made in a behaviour during the trip. This seems es- the Governor-General's award in Canada.
grand carriage (an exact replica of Napoleon's) pecially strange in view of the voracious Though it concerns the short life of a marginal
and took in the battlefield of Waterloo and the appetite of the book buying public for news literary figure, vampires are unlikely to
"crags and castles of the Rhine." PoorPolidori of the noble poet. MacDonald captures its remain quite the same for those who venture
is the first full length biography to appear of eccentricity: rather than being an "account of along this biographical trail.
this hitherto little known doctor. He was born somebody's travels with Byron" the diary
in 1795 in Soho to an English Anglican is an "account of Polidori's travels with I Hemphill RE, Zabow I. Clinical vampirism. S Afr AMcd 7
mother, Anne Maria Pierce, and a Catholic somebody." After the two in had separated 1983:63:278-81
2 I'rins H. Vamrpirism-lcgendarv or clinical phcnomcnon? Med
father, Gaetano Polidori, an Italian literary Byron wrote to his publishers 1817: Sc'iLaw 1984;24:283-93.
3 Hallcvv A, Levi Y, Shnaker A, Orda R. Auto-vampirism -an
figure who had settled in England. Their Talking of Doctors reminds me once more to unusual cause of anaemia.7 R Soc- Mled 1989;82:630-1.
eldest son, John studied medicine at Edin- recommend to you one who will not recommend
burgh, choosing somnambulism as the himself-the Doctor Polidori.-If you can help Poor Polidori: A Critical Biography of the Author
subject for his MD thesis. him to a publisher do-or, if you have any sick of The Vampire. I) L Macdonald. (Pp 333; $60.)
Toronto: University of 'roronto Press, 1991.
Distributed by International Book Distributors,

-|~ ~ ~ ~ ~ ~
66 Wood Lane End, Hemel Hempstead, Hertford-
shire HP2 4RG. ISBN 0-8020-2774-1.

Drawn from life

Peter Cull

Hero worship is a strange phenomenon, for

while your heroes, especially those of the
~~~~~~~~~~~~~~~~~~~~~~~~~~I-
professional variety, engender passionate
Poidr pitue byF Gan or admiration and respect, they also make you
feel inadequate, dissatisfied with your own
achievements, and, frankly, jealous. I have
three professional heroes who stimulate this
mix of conflicting emotions, one of whom
is Leonardo da Vinci. Leonardo has been
described as an unmethodical and wayward
character, but when you think of what he
achieved in a lifetime there is little doubt that
he was a matchless genius. It was he who,
commenting on the understanding of human
anatomy, said: "Don't bother with words-
the more thoroughly you describe, the more

1190 BMJ VOLUME 304 2 MAY 1992