Normierung der Gesundheit: Messende Verfahren der Medizin als kulturelle Praktik um 1900

The history of statistical thinking has been the subject of a number of excellent recent studies, from Ian Hacking’s initial monograph on the Emergence of Probability (1975) and Theodore M. Porter’s The Rise of Statistical Thinking 1820–1900 (1988) to Porter’s recent study of “objectivity,” Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (1995). Now there are a number of new studies on the specifics of how the very notion of statistical thinking has created norms and values, many of them assumed to be “natural,” in a wide variety of fields, from high-energy physics to medicine. In 1996 the German historians of science held a workshop on norms in medicine. The results of that workshop, or at least the major papers held there, are published in this volume.

For historians of medicine, the history of the establishment of norms is an important one. The authors in this volume attempt to examine a number of the problems in the history of medicine that established normative functions through statistical reasoning. Johannes Büttner begins with a general overview of quantitative diagnosis and the establishment of norms; Sybilla Nikolow, a trained mathematician and certainly one of the best of the younger historians of statistical thought, follows with a commentary containing a detailed examination of the establishment of norms in the analysis of blood and urine. Heinz-Peter Schmiedebach presents a study of psychiatric norms in the nineteenth and twentieth centuries, focusing on the work of German phenomenological psychiatry; Eric Engstrom’s commentary points out the unraveling of theses concepts within the psychiatric practice of the time. Cornelius Borck’s paper discusses the studies of the electrical capacity of heart muscles, upon which Jakob Tanner notes how the very notion of the “heart” is constructed. In two complementary essays, Mariacarla Gadebusch Bondio and Volker Roelcke use the statistical evaluation of the image of the patient as the basis for a critique of the phenomenology of “evil” and “crime” during this period. Gunnar Stollberg presents a perceptive analysis of how statistical reasoning has infiltrated patients’ self-awareness, at least as mirrored in their autobiographies; Eberhard Wolff follows this with a paper on the “common” understanding of statistical practices in daily life. The penultimate paper and commentary, by Michael Martin and Jens Lachmund, look at the effects of statistical reasoning and representation in the setting of the tubercular sanitarium. Closing the volume is a paper on the measurement of fever and the role of the thermometer as instrument.

This must have been a wonderful conference. The papers are all of spectacular quality. Each serves in complicated ways as a commentary on the others and on the overall question of the role that statistical measurement, instruments, and reasoning have come to play in medicine. What was missing, however, and should have been present, is the history of statistics in eugenics and modern genetics: no field of medicine today (or in the nineteenth century) rested more on statistical reasoning. Indeed, all of Karl Pearson’s early work rested on such models; this is clear even in his work on the philosophy of science. Today, one cannot pick up a newspaper without finding the statistics of genetics being used to explain disease, disease process, and cure. The dangers of such reasoning, its spectacular semiotic imprecision in the light of its ever-increasing mathematical precision, is a feature of “modern life.” This is elegantly and precisely highlighted in this book.