Medical Innovations: Historiography, Heterogeneity and `The Mangle of Practice'

Abstract

A notable feature of much recent historiography of medicine has been the extent to which it has embraced the agendas of other fields of enquiry. Medical Innovations in Historical Perspective is a good example of this process.' The volume is presented to us by John Pickstone (both editor and series editor) as medical history which has been enlightened by input from the sociology of technology, the sociology of scientific knowledge and the theory of economic history, to mention only three. The explicit intention is 'to present ... medicine as [an] aspect of modem culture, analysing [its] economic, social and political aspects' (ix) and 'to investigate the uses and consequences of technical knowledge, and how it was shaped within particular economic, social and political structures' (ix). There can be no doubt that the quality and sophistication of the debate in medical history has been raised by such encompassing agendas. But, one might still ask, has the incorporation of sociological emphases been done in such a manner as brings optimum benefit to the historiography? Despite much recent cross-fertilization and professional hybridization, sociology of science and the history of science (and medicine) retain distinctive professional characteristics. This was demonstrated, not so long ago, by the differing responses of the two camps to John Law's essay on Portuguese Imperial expansion.2 Arguing that due weight had not been previously given to interaction with the physical environment in accounts of social change, Law emphasized the importance of agencies such as wind, tide and current, and the partial control painfully and gradually achieved