Devices and Designs: Medical Technologies in Historical Perspective (review)

This volume is a collection of fourteen essays dealing with various aspects of the history of medical technologies. Derived from papers first presented at a 2003 conference, the chapters’ authors use a diverse range of theoretical approaches (sometimes within a single chapter). Many share an explicit or implicit emphasis on the utility of historical analysis for shaping contemporary policy. Some include international comparisons, usually involving Europe and North America. As is often the case in such collections, many of the essays read as though they might be detailed outlines for future book-length analysis.

The editors have grouped the chapters into three sections. The first section considers relationships between technical innovations and medical practice from the nineteenth and twentieth centuries. John Pickstone presents an insightful analysis of the many ways that experts in bones—from bonesetters to orthopedic surgeons—lived and worked and interrelated in Lancashire. Jonathan Reinarz helps us to think more carefully about how nineteenth-century voluntary hospitals in Britain saw the role of charitable donations. While many of the essays focus on the use of technology in the hospital setting, Christopher Crenner takes a particularly interesting look at how free-standing, private laboratories offered to sell laboratory tests, particularly urine analysis, in Boston at the turn of the twentieth century. The book’s second section focuses more on specific innovations, especially relationships between industry and medical practice. Some chapters address the interrelationships between state sponsors of research, such as Carsten Timmermann’s essay on the role of the British Medical Research Council in working with an early drug found useful for lowering blood pressure. Julie Anderson offers an astute look at the complexities of moving to an especially clean operating room environment when implanting artificial hips.

The final section of the book addresses controversies surrounding medical technology. More than other essays, some of these chapters bring public attitudes and responses into the frame, as Robert Bud does for changing responses to antibiotic resistance and Sally Wyatt and Flis Henwood do for risks associated with the use of hormone replacement therapy in post-menopausal women. Gerald Kutcher offers an astute look at measurement issues associated with conducting cancer clinical trials. Finally, Stuart Blume argues that policymakers ought to take account of national differences while making decisions about the use of technologies such as cochlear implants and polio vaccines.

All in all, these fourteen essays offer a wide-ranging introduction to topics in the history of medical technology. Selected essays could be useful in the classroom, and those who write the history of medicine are likely to find useful insights.