Medical Quantification in Historical and Sociological Perspectives (review)

This collection contains sixteen essays on various aspects of medical quantification broadly considered, in addition to a brief introduction and a concluding overview. The papers are drawn from a 2002 conference which brought together a number of medical and social historians from England, France, Germany, Canada and the United States, many of them very well known. The instances studied are mostly European, deal with the period from about 1750 until the present, and some of the chapters reprise work that the authors have published in the monograph literature. The considerable variety of substantive topics covered means that the general sociological reader will find something of interest in the volume, but some contributions are likely to appeal primarily to subject specialists.

One difficulty with the book is that quantification seems to have formed a pretext for conference discussion rather than an object of direct investigation. The "sociological perspectives" are equally diffuse. Quantification includes counting, as in attempts to determine infant mortality, the effects of inoculation, and conditions of public health; standardization and measurement, as in the attempts by agencies of the League of Nations to develop indices of national health, or in the development of the thermometer; but also matters of method and of research logic, as in papers on the lung cancer debates, on controlled trials, on selection bias, and on evidence-based medicine. The disciplinary history of epidemiology interests several contributors, and several others refer to or revisit the well-known 1830s French Academy of Medicine debates over the status of the knowledge generated by large scale observation, on which, nonetheless, Ann F. La Berge manages to cast some new light. Occasionally, the direct links between the development of sociological thought and systematic medical observation are drawn out, but most contributors appeal to varieties of social studies of scientific knowledge and of the sociology of official statistics to guide their analysis. As well, Ilana Löwy presents a fascinating account of the biography and sociological-educational-medical interests of the Polish intellectual and scientist Jozefa Joteyko — among other things, the first woman to lecture at the Collège de France — about whom, and about the Belgian sociological milieu in which she worked, Canadian sociologists could stand to learn more.

The analytic purchase of the sociology of science is particularly evident in Volker Hess's essay on the standardization of body temperature in mid-nineteenth century hospitals. Hess shows that standardization demanded first a displacement of qualitative thought and practice with respect to body temperature, then the calibration of measurement instruments and the "configuration of the user" through the adoption by the latter of a set of bodily techniques. The widespread use of the minute thermometer also reconfigured the relations of doctors and patients to one another and to forms of medical knowledge by making it possible for patients to measure themselves.

In Lion Muard's elegantly written essay on attempts by the Rockefeller Foundation in the 1920s to have its sponsored instrument for appraising American municipal public health administration adopted internationally through the League of Nations, we see a fascinating instance of a private/public initiative to make information production and quantified norms of practice into forces of transformation in the domain of public health. While Muard's work points to a longer history of political practices better known today as "benchmarking," both Ulrich Tröhler's examination of eighteenth century British attempts to control selection bias in clinical medicine, and George Weisz's probing of the contemporary furor for "evidence based medicine," inject healthy doses of scepticism about steady progress towards an objectified, quantitative medicine. Keating and Cambrosio point us to three areas of cancer investigation in which quantification proves to be of limited utility.

On the whole, the collection succeeds in demonstrating the common interest that historians of medicine and sociologists share in systematic observation and in the logics of...