Medicine and Technology in Canada, 1900-1950 (review)

This fluidly written and much-needed synthetic study is number 16 in the Canada Science and Technology Museum's Transformation Series, which derives from work conducted for the museum's Research and Collection Division. Authors Allison Kirk-Montgomery and Shelley McKellar were commissioned to survey current scholarship in the history of medical technology in order to create both a reference resource for students and scholars and a guide for the museum's acquisitions.

The history of medicine in Canada from 1900 to 1950 is not radically distinct from that of the United States and Western Europe. For example, the authors note that Canadian doctors bought their instruments from the same medical supply companies as their counterparts elsewhere. Nevertheless, there are important Canadian milestones, and the authors deftly keep those homegrown achievements in the foreground, especially when they are hallmarks in the broader story of Western medicine. These include Frederick Banting and Charles Best's discovery of insulin, the rise of university-based medical research in Montreal, and Norman Bethune's work on tuberculosis treatments. Indeed, in each chapter there is a museological emphasis on identifying firsts, eminent practitioners, and significant discoveries. Still, the authors are also attentive to the cultural entanglements of Canadian history, such as the importance of regional variations, the idiosyncrasies of French-speaking Quebec, and the distinct cultures of aboriginal peoples.

Kirk-Montgomery and McKellar organize the book thematically. Each of the eight chapters examines how technology figures in the issues and practices surrounding a particular medical topic: public health, cancer, tuberculosis, the discovery of insulin, alternative practices, poliomyelitis, artificial body parts, and heart disease. This division allows a remarkably broad survey of medical history. The chapter on cancer discusses both radium therapy and operating-room hygiene, while that on tuberculosis broaches architecture, X-rays, and vaccines, as well as surgical instruments, chemotherapy, and anesthesia. Methodologically, the study looks at technology the way social historians look at material culture. For instance, each chapter discusses carefully selected photographs as historical evidence, such as a pair taken in 1912 showing the transformation of Toronto's City Laboratory from an overcrowded ad hoc office to a glimmering, purpose-built facility. Even though discrete artifacts are foregrounded, the authors do not neglect the idea of technology as system—discussing, for instance, the way educators and governments joined with medical workers to wage the "war on polio."

Overall, the focus is more on medicine than on technology. That is, Kirk-Montgomery and McKellar are specifically interested in devices and drugs developed for research and clinical practice. This is already a large and diverse topic, but the focus does mean that the discussion has little to offer the historiography of technology. The study underemphasizes the dramatic roles played by technologies not explicitly conceived as medical in forming twentieth-century medicine: electricity, telephone networks, and the automobile, to name but three. Moreover, at points the authors implicitly posit a physiological reality, known to biomedical science, on which sits human experience of medicine and disease. This conception leads them to a vocabulary of "improvements" and "saving lives" that is sometimes at odds with their avowed interest in rejecting both technological determinism and technological optimism.

Kirk-Montgomery and McKellar rely on secondary literature. Well-known historians of medicine and technology such as Michael Bliss, Audrey Davis, Jacalyn Duffin, Joel Howell, Stanley Joel Reiser, and Charles Roland provide the main theoretical and narrative frameworks, into which Kirk-Montgomery and McKellar nimbly integrate work on specifically Canadian topics by scholars including Annmarie Adams, Jacques Bernier, J. T. H. Connor, and Wendy Mitchinson. The breadth of the bibliography, then, is one factor that makes the volume such a useful resource for scholars of all levels. (I did note one distressing error—they left out my name as a coauthor on one publication and did not note that the paper has been published in a revised version.) There is, unfortunately, no other book on the history of Canadian medical technology...