Traditions of Pathology in Western Europe: Theories, Institutions and Their Cultural Setting (review)

The result of a 1996 conference in Freiburg, this little volume on the history of pathology presents several gratifying aspects. According to the publishing arm of the European Association for the History of Medicine and Health, in whose "EAHMH Network Series" the volume appears, there are now on the order of five such monographs in this series down to 2003. Owing in no small measure to Cay-Rüdiger Prüll's efforts, two of the five deal with pathology. Pathology, for the European historical community, is central to medical history in important ways; the editor correctly identifies it as "a special case within disciplinary history of medicine" (p. 9), spanning a triad of aspects of the subject: studies in disease, expertise, and culture.

That such a big chunk of the EAHMH's output has addressed this topic is remarkable. What is more remarkable is the fact that this volume—like its predecessor, Pathology in the Nineteenth and Twentieth Centuries—manages at least glancingly to cover all three above-listed aspects of the history of pathology. Volker Hess's study on the semiotics of eighteenth-century pathology texts makes up a first section entitled "The Foundation of Morphological Pathology in Cultural Context," relying compellingly on the Aufschreibesystem notion of Friedrich Kittler. The scholars assembled by Prüll rely encouragingly on a wide variety of scholarly genres, typified by this reaching-out to media history. Also part of this outreach is the publication of the entire volume in English; on this point I am of course of two minds: sometimes the English is a bit stilted, but the Germanophone contributors do reach far more potential readers this way.

A second section, "Pathology as a Discipline and Its Cultural Setting," encompasses chapters by Axel Bauer and Boleslav Lichterman. Bauer provides an important brief overview of how pathology became aligned with natural science as the field became institutionalized in the German-speaking world. He helpfully points to the mid-century constitution of clinical prosectorates and other, later, even more secure posts—particularly the eighteen extraordinary professorships established between 1839 and 1866—that led to what he usefully calls "provisional specialization" (p. 49). Bauer notes the transitory quality of pre-Virchovian chairs (sixteen of the first thirty wished to move on to clinical positions), such that Rudolf Virchow's 1856 accession in Berlin was a signal event in locking in the discipline as a foundational one. Once acknowledged as foundational, of course, pathology posts and the institutes surrounding them could accumulate important secondary supports such as assistantships and other posts for young scientists—individuals who could then develop their work and reemerge as leaders in other centers worldwide. Bauer concludes with this intriguing note on the early pathology community's work: "[W]e should not overestimate the role of scientific progress in this case—in spite of the fact that I can placidly remain a hypothetical-realist and anti-constructivist historian of science" (p. 49).

Lichterman segues, still in the Virchovian mold, into a study of the Berlin master's influence in Russia, particularly in the St. Petersburg work of his pupil Sergej Botkin and in the cerebral localizationalist work of Vladimir Bekhterev. Lichterman argues, reasonably, that both the German model's intellectual dimension (cellular pathology) and its institutional dimension (keeping laboratory-based pathology more tightly linked to the bedside fields) were successfully adapted to the Russian milieu.

In a third section, entitled "Pathology and Politics," Christian Bonah and Susanne Hahn examine the interaction of science and politics in case studies of pathology's application in the post-Virchovian world. In the monograph's longest chapter, using in part the correspondence of William H. Welch as a foreign observer, Bonah attempts to demonstrate these interactions through the prism of the work of Friedrich von Recklinghausen in Strasbourg. He concludes, interestingly, that in the...