Cover

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Title, Copyright, Dedication

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pp. ii-vi

Contents

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pp. vii-viii

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Foreword

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pp. ix-xiv

Disease we have always had with us. Our ancestors suffered pains in their joints, debilitating coughs and exhausting diarrheas, sore throats and bloody urine, painful and sometimes mortal swellings. Ancient bones tell us that pathological processes are older than written records...

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Introduction: Thinking Autoimmunity

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pp. 1-6

Soon after waking one morning in winter 1981, a middle-aged writer, recently separated from his wife, fumbled as he tried to open a door in his Manhattan apartment. Later, when eating breakfast alone at a nearby restaurant, he experienced difficulty swallowing. His legs felt rubbery...

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1. Physiology with Obstacles

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pp. 7-25

Fever was the cardinal disorder of the nineteenth century— one might even say it was pathognomonic, or characteristic, of the times. People commonly suffered and died from intermittent or continued fevers; some succumbed to brain fever or puerperal fever; others could be admitted to fever hospitals...

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2. Immunological Thought Styles

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pp. 26-46

In 1896 the eminently antiseptic surgeon Joseph Lister addressed the British Association for the Advancement of Science, assembled in the mercantile city of Liverpool. “The practice of medicine in every department,” he assured delegates, “is becoming more and more based on science...

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3. A Sense of Unlimited Possibilities

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pp. 47-70

“About current scientific speculations there is one characteristic, subtle, perhaps, but profound and far reaching, which distinguishes them from the Victorian age,” wrote J. W. N. Sullivan, an English historian of science, in 1921, conjuring up a “spirit.” “This spirit is chiefly a sense of unlimited possibilities...

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4. The Science of Self

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pp. 71-91

Reflecting on his first visit to the United States, in 1944, the Australian microbiologist F. Macfarlane Burnet experienced a “new realization that an adequate scientific attack on almost any problem will provide a practical solution of it.” Like many Australians during World War II, Burnet had awakened...

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5. Doing Biographical Work

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pp. 92-115

What did it mean for a person to become “autoimmune” in the second half of the twentieth century? For physicians in the 1960s, the novel causal mechanism, while still enigmatic, could sharpen the diagnostic image of a patient’s vague, indefinite illness; often it suggested new treatments...

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6. Reframing Self

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pp. 116-138

Toiling in the laboratories of the Rocke feller Institute in the late 1930s, not far from where Rivers and Schwentker were trying to induce encephalitis in monkeys, Merrill W. Chase wondered how skin could be so exquisitely sensitive to simple chemical substances. For example, a tiny amount of poison...

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Afterword: Becoming Autoimmune, or Being Not

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pp. 139-154

Looking back over the past hundred and fifty years, so much has changed in our knowledge of diseases like systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and type 1 diabetes mellitus— so much that it is tempting to consider them as novel entities...

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Acknowledgments

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pp. 155-158

The origin of this collaboration might be traced back to the early 1980s, when Warwick Anderson was a medical student and then an intern on ward 3E of the Royal Melbourne Hospital, the Clinical Research Unit of the Walter and Eliza Hall Institute, which Ian Mackay directed...

Notes

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pp. 159-196

Bibliography

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pp. 197-242

Index

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pp. 243-250