Abstract
The Aschheim–Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the ‘heroic age’ of reproductive endocrinology. Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim–Zondek test launched a ‘modern era’ of obstetric knowledge, which asserted its superiority over that of pregnant women. This article reconsiders Oakley’s claim by examining how pregnancy testing worked in practice. It explains the British adoption of the test in terms less of the medicalisation of pregnancy than of clinicians’ increasing general reliance on laboratory services for differential diagnosis. Crucially, the Aschheim–Zondek reaction was a test not directly for the fetus, but for placental tissue. It was used, less as a yes-or-no test for ordinary pregnancy, than as a versatile diagnostic tool for the early detection of malignant tumours and hormonal deficiencies believed to cause miscarriage. This test was as much a product of oncology and the little-explored world of laboratory services as of reproductive medicine.
Highlights
The Aschheim–Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the ‘heroic age’ of reproductive endocrinology
Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim–Zondek test launched a ‘modern era’ of obstetric knowledge, which asserted its superiority over that of pregnant women
Beyond the fact that the test was invented in Berlin and implemented on a large scale in Edinburgh, surprisingly little is known about how it worked in practice or the purposes for which it was used
Summary
A case study in use-based history of medical technology, my account will focus less on the novelties of scientific research than on the establishment and maintenance of routine practices.5 It will situate pregnancy testing within the little-studied world of commercial laboratory services (Chen, 1992; Close-Koening, 2011; Crenner, 2006; Rosenberg, 1990; Worboys, 2004). Steve Sturdy and Roger Cooter’s account of statist efforts to rationalise health care remains an influential explanation of the rise of the laboratory in modern medicine (Kohler, 2008; Sturdy & Cooter, 1998) Their analysis is good at explaining the role of the diagnostic laboratory in public health campaigns, for example, in mass screening programmes for syphilis or cervical cancer.. Though Fleck only mentioned the Aschheim–Zondek test in passing (to distance laboratory diagnosis from medieval uroscopy), in this article I want to take up his central sociological concerns with the significance of routine laboratory work and the sustained process of collective invention in the making of modern medicine and, in this case, modern pregnancy.
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