NONFICTION : THE SECOND MEDICAL REVOLUTION: FROM BIOMEDICINE TO INFOMEDICINE by Laurence Foss and Kenneth Rothenberg (New Science Library/Shambhala: $22.50; 336 pp.).

The stated purpose of this ambitious, complex, and often exasperatingly opaque treatise is nothing less than the construction of a new paradigm for the “medical enterprise.� The authors (a philosopher of science and an economist) are either sufficiently brazen or brave to suggest that their infomedical model--an “interaction-of-levels ideal�--will succeed in supplanting the current biomedical model that serves, de facto, as the basis for all clinical practice, as well as most clinical and basic research.

The many flaws of the latter paradigm are documented; the need for a successor system is outlined, and the infomedical concept--one based broadly on cybernetic, ‘interactionist’ and biofeedback principles--is presented in detail. The respective arguments are adduced with the assistance of charts and pseudo-mathematical equations that serve to clarify but often dangerously oversimplify the authors’ otherwise carefully argued stance. As well, the text is peppered with neologisms--�geopsychosociobiofeedback� stands out--the use and comprehension of which appear to be prerequisites to embracing this new conceptual framework. Yet the heart of the argument, that “ . . . organic disease . . . is a manifestation of underlying messages that may be generated by various genetic, health-history, personality, sociocultural, and other programs . . . (that) disease is a function of maladaptation (pathogenic message-program mix) . . . “ is quite simple, beyond dispute, and integrated by most physicians into their daily practices.

The authors effectively raise several issues that key players in the traditional biomedical disciplines, ones that almost by definition are skeptical of radical change, would be wise to address and perhaps re-evaluate. Whether this book will have the impact to generate a major departure in our examination of disease processes remains quite another matter.