The Laboratory Revolution in Medicine ed. by Andrew Cunningham, Perry Williams

Abstract

924 Book Reviews TECHNOLOGY AND CULTURE Roger Cooter’s essay on the development of specialty clinics during the interwar period devoted to the treatment of fractures is a sophisticated assessment of an innovation that was organizational rather than technical. The effort by British orthopedists to create a specialized institutional setting did not rely on any new medical practice. Instead, these physicians sought to create a need for fracture clinics by mobilizing support from disparate social groups: industry (both labor and management), insurance companies, the military, and provincial hospitals. Cooter highlights how the development of frac­ ture clinics was contingent on the intersection of specific social, economic, and intellectual circumstances. Perhaps the most original essay is David Cantor’s “Cortisone and the Politics of Drama, 1949-55.” The discovery that cortisone appar­ ently cured patients with crippling arthritis received extraordinary popular and professional attention. British rheumatologists used this to strengthen their status within the National Health Service. They soon grew wary, however, of the spectacle surrounding the introduc­ tion of cortisone. Cantor perceptively analyzes the bases of this discomfort, discussing both the philosophical roots of modern scien­ tific medicine and the problem of alternative medicine and its use of the dramatic. The remaining articles concern the reception of antisepsis, tuber­ culosis sanatoria, diphtheria antitoxin, oxygen therapy, and obstetric X-rays, and the organization of psychiatric services after World War II. They remain squarely focused on the social, cultural, and eco­ nomic forces that influence medical innovations. Ironically, it is the technical that receives the least attention in the book. Indeed, my principal criticism of this fine collection is that greater technical detail could have reinforced the presentation. One of the great strengths of history of technology is its ability to make a case for social construction by demonstrating how seemingly arcane technical decisions are actually shaped. This collection of essays begins this process, but much remains to be done before we have a clear understanding of the historical roots of our modern reliance on medical technology. Steven C. Martin Dr. Martin is an assistant professor in the Departments of Epidemiology and Social Medicine and Medicine at the Albert Einstein College of Medicine. He is working on a history of chiropractic. The Laboratory Revolution in Medicine. Edited by Andrew Cunningham and Perry Williams. New York: Cambridge University Press, 1992. Pp. xi + 347; illustrations, notes, index. $69.95. “Modern medicine is based on the laboratory.” So claim the first few words of this book. This collection is derived from a conference held TECHNOLOGY AND CULTURE Book Reviews 925 at the Wellcome Unit for the History of Medicine at the University of Cambridge. Following a useful introduction, the eight primary essays cover a wide range of perspectives on the history of the medical laboratory. Mainly focused on 19th- and 20th-century laboratories in Western Europe and the United States, the collection will be of interest to historians of technology both for its attention to the mechanical artifacts used within the laboratory and for its elucidation of the social space within which those artifacts were applied. The essays cover a wide range of topics. Paul Weindling compares the architectural layout of the Pasteur Institute and Robert Koch’s Institute for Infectious Diseases. Andrew Cunningham examines the role of the laboratory in constructing the disease now known as plague. Timothy Lenoir considers how laboratories for experimental physiology were institutionalized in mid-19th-century Germany and characterizes the primary change as a shift in the definitions of the kinds of knowledge that were valued, particularly physiology. Richard Kremer addresses the process by which entrepreneurs were able to create physiological laboratories in Prussia from 1836 to 1846. Other essays address resistance to laboratory-generated information. John Harley Warner considers how knowledge about the laboratory was different in the United States from that in Europe and traces the gradual process by which laboratory-generated knowledge became accepted in the late 19th century. Michael Osborne looks at a mid-19th-century French surgeon’s ideas about bacteriology and disease causation. Stewart Richards explores the use of animals in English laboratories and the objection to such use by the antivivisec­ tion movement. Wai Chen suggests that the Inoculation Unit at St...