In the Image of Science? Negotiating the Development of Diagnostic Ultrasound in the Cultures of Surgery and Radiology

Abstract

In the Image of Science f Negotiating the Development of Diagnostic Ultrasound in the Cultures of Surgery and Radiology ELLEN B. KOCH Between 1948 and 1952, two physicians working in the United States independently developed a method of producing cross-sectional images of soft tissues, using ultrasound, or sound waves at a frequency above the range of human hearing. One was Douglass Howry, who graduated from the University of Colorado Medical School in 1947 and began an internship in radiology at the Denver General Hospital. The other was John Julian Wild, a British surgeon who had trained at Cambridge University; Wild began a U.S. Public Health Service surgical research fellowship at the University of Minnesota Medical School in 1946. Both Howry and Wild, who were unaware of each other’s work for several years, pursued their ideas for using ultrasound for clinical diagnosis by borrowing—and subsequently modifying—pieces of military equipment. Both also sought funding from various sources in order to pursue their research. By 1957 both men had been working on improved instrumentation under grants from the National Cancer Institute (NCI), one of the National Institutes of Health; Wild began receiving NCI funds in 1949, and NCI began support of Howry in 1954. Combined, the two projects were costing NCI about $50,000 a year.1 Officials at the institute were understandably concerned that the projects were duplicative, especially as they had overcommitted their annual budget in that particular year.2 A specially convened Dr. Koch is an independent scholar working on the dynamics of the invention and use of medical technologies. This article is based on her Ph.D. dissertation “The Process of Innovation in Medical Technology: American Research on Ultrasound, 1947-1962” (University of Pennsylvania, 1990), supported in part by a University Fellowship from the University of Pennsylvania. She extends her thanks to Ruth Schwartz Cowan and the Technology' and Culture reviewers for their valuable comments on an earlier version of the article. 'The majority of NCI extramural projects in this period were funded at about SI0,000 or less per year. "Stephen Strickland notes that 1957 was a year in which the budget for the NIH was not increased, as it had been quite predictably in previous years. The NIH may have© 1993 by the Society for the History of Technology. All rights reserved. 0040-165X/93/3404-0005S01.00 858 Negotiating the Development of Diagnostic Ultrasound 859 group of scientific reviewers, familiar with ultrasound, was asked to assess the scientific merit of the two grant applications. They concluded, What Dr. Wild wishes to do is in effect to adopt the techniques of Dr. Douglass Howry in the application of transducers to this type of work. Dr. Howry has been working in this field for a number of years and has developed equipment which probably is superior to Dr. Wild’s. ... It was suggested that instead of supporting the transducer development proposed by Dr. Wild, he be provided with the necessary funds, probably in the neighborhood of $50,000, to purchase a machine from Dr. Howry. This would enable Dr. Wild to concentrate on the detection and diagnostic aspects of the work with the latest equipment. Future efforts of Dr. Wild’s group, on equipment development, could then be directed toward modifications of the Howry apparatus for spe­ cific applications instead of duplicating the work already accom­ plished by Dr. Howry’s group? Why did the experts think that Howry’s instrument was probably superior to Wild’s and that Wild was merely duplicating Howry’s work on instrumentation? The answer to this question necessitates under­ standing not only the history of both research projects but also the historical context of American academic biomedical research in general and medical technology in particular in 1957. Howry’s and Wild’s research projects on ultrasound were both harbingers of a new style of collaborative, cross-disciplinary clinical research that did not match existing institutional settings and funding sources. This new style of research, incorporating physics and engi­ neering into clinical medicine, only slowly gained acceptance as a legitimate partnership in American medical research. But Howry’s research gained acceptance more readily than did Wild’s because...