Anderson, W. and Mackay, I.R.Intolerant Bodies: A Short History of Autoimmunity. 2014. 264pp £16.50 (pbk) ISBN 978‐1421415338

Autoimmune disorders, while increasingly common, are notoriously misconstrued. Essentially occurring when the body's immune system attacks and destroys its own healthy tissues by mistake, health researchers often overlook the impacts of such a medical paradox beyond the physiological ones. In Intolerant Bodies: A Short History of Autoimmunity, Warwick Anderson, a leading biomedical historian, along with Ian R. Mackay, a renowned immunologist best known for his work on autoimmune diseases, have explored the intricate crux of clinical and social experiences of autoimmune diseases. The monograph provides a detailed account of the laboratory and social history of autoimmune disorders, paying particular attention to four well-known medical diagnoses: multiple sclerosis (MS), lupus, rheumatoid arthritis and type I diabetes. The book's unique contribution lies in its intricate look at the psychosocial and historical relevance of autoimmune pathogenesis in a way that can be read as empowering to patients. By focusing on four specific diseases, Intolerant Bodies gives nuance to the daily lived experiences of patients living with these illnesses. This draws attention to the fact that living with MS, lupus, rheumatoid arthritis or type I diabetes is much more complex and debilitating than one might expect based on the widespread and oft-invisible nature of these chronic illnesses. Of particular interest to the medical sociology community are chapters 4 through 6, which deal with the self and otherness, and the reframing of identity when living with a paradoxical diagnosis which is ultimately centred around the body turning on itself. Animated with the warfare metaphors that have become characteristic analytical tools of medical sociological inquiry, the authors managed to write an original, clear, and thoughtful monograph that simultaneously informs and provokes thought. The detailed empirical context provided by Intolerant Bodies is supplemented with several brief excerpts from classical literature, including the works of Edgar Allen Poe and Charles Dickens, providing a rich historical and cultural frame of reference for the reader. In addition, Anderson and Mackay provide numerous examples of individuals who have struggled with autoimmune disorders throughout recent history, including several of Mackay's own patients, many of whom have had to grapple with ambiguous diagnoses and treatments as this new concept of pathogenesis became accepted. The one word of caution I have for readers is that this book is quite ambitious in including such a nuanced history of the subject matter. While fascinating, the authors included a considerable amount of detail in a very short monograph, and this could be construed by some as a shortcoming because despite being concise, the narrative is inevitably riddled with complexity. While the purpose of the monograph – as claimed explicitly in the book's title – is to be a short history of autoimmunity, the quick pace of the book, along with its comprehensiveness, made some chapters a bit more monotonous than others. While it was certainly no insurmountable feat to include such an immense amount of history in such a short monograph (and there is undoubtedly a great deal of detail that was excluded for this very reason), at times the writing felt a bit rushed, and in my opinion, the authors could still have accomplished a succinct yet detailed history had they written a more lengthy book.

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