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Anatomy of an Illness as Perceived by the Patient

Joseph S. Alpert, MD
JAMA. 1996;275(15):1209. doi:10.1001/jama.1996.03530390077045.
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Norman Cousins' concise book, Anatomy of an Illness, has recently been re-released in an attractive gift edition. First published in 1979, the book expands on Cousins' experience of an acute exacerbation of ankylosing spondylitis after a stressful trip to the Soviet Union. Cousins failed to respond to standard medical therapy but experienced a remarkable "cure" following high-dose ascorbic acid infusions and laughter induced by various films and books.

This unusual experience led Cousins to reflect on the nature of the patient-physician relationship, the placebo effect, ascorbic acid as a therapeutic agent, and the holistic medicine movement, which was just gaining a considerable following at that time. His style is clear and refreshing, as expected from an editor of the Saturday Review.

Much of what Cousins said in 1979 is still of interest more than 15 years later. Interest in ascorbic acid for therapy and prevention is even greater today than


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