Article

Knowledge of Shadows: The Introduction of X‐ray images in Medicine

Authors:
To read the full-text of this research, you can request a copy directly from the author.

Abstract

Abstract Ever since the discovery of X-rays in 1895, X-ray imaging has played a large role in the cognitive and practical organization of medicine. This article analyses the way X-ray images were introduced and made sense of in medical thinking and acting around the turn of the century. The implicit assumption in many histories of radiology is that the specific (diagnostic) message of the X-ray images resided inside them from the beginning, and that it is obscured either by technological or epistemological problems. These being solved, it would then be no problem to see directly what information the image contains. In this article this assumption is contested. It is argued that the specific content of the images was shaped by the activities of X-ray workers within the context of medical developments of the time. This shaping, as it is historically reconstructed here, consisted of four methods. X-ray workers (be they physicians, technicians or scientists) experimented with the technology, the images, the photographic materials and the objects that were X-rayed. They used X-ray images of dead bodies to compare them with radiographs of living patients. Radiologists tried to‘translate’diagnostic information acquired with other methods into the shadows of the X-ray images. And finally they compared images with images. The process of shaping the content and use of X-ray images, of making them represent reality, took place within specific institutions, and it took a different form in different countries, but also for different parts of the body. Developments of institutionalisation and professionalisation of radiology in England and the Netherlands are presented to provide a small part of the background of this shaping of knowledge of shadows.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the author.

... Thus, paradoxically, the more science and technology succeed, the more opaque and obscure they become (Latour, 1999: 304). Pasveer (1989) in an historical overview of medical imaging, identified the term being used to illustrate the change in content of publications about imaging. At first, the technology was given similar weighting in publications to the product of the technology, the images. ...
... Without intuition or previous study the one is almost as incomprehensible as the other, but as we gaze the wealth of detail rises before our vision until finally we are able to interpret the meaning of streaks and shadows that to the untrained eye are meaningless. (Dally 1903: 1806, in Pasveer, 1989. ...
... The first is that, as radiographers may feel the equipment is an extension of themselves, in a cyborgian fashion, where machine and human become as one in Freund's (2004) 'technological habitus'. Secondly a phenomenon called 'black boxing', first used with respect to medical imaging in the early twentieth century may be occurring (Latour, 2005;Pasveer, 1989 ...
Thesis
Full-text available
Context As a diagnostic radiographer, educator, and researcher, the focus of my study is research pedagogy in radiography and the importance of research for our profession. I explored how current practice in one educational setting endeavours to realise the aims of The Society and College of Radiographers Research Strategy 2016-2021 around embedding research in the curriculum, from the perspective of educators and radiography students. Method Searching for a research method in harmony with my position within the interpretivist paradigm, while acknowledging my entanglement within the research as a co-constructor with my participants and also mindful of the voices of individuals, I developed Co-Constructed Depiction as an innovative use of imagery in both data collection, analysis and presentation of results. This new method is symbolic of, and congruent with, the practices of the radiography profession since it maintains the importance of images, their interpretation, and use in my research. Participants, who were radiography staff, post-graduate radiography and ultrasound students and 3rd year radiography undergraduate students, took part in individual semi-structured interviews that included participant image making. Information gathered was reported as a pictorial and written depiction and analysis, in an echo of our professional work of image making and reporting. Using a Bourdieusian lens, I looked at the concept of habitus for radiographers and explored replacing the concept of ‘profession’ with that of ‘field’, looking through the data for patterns and noted the puncta- that which struck me as important. Results I developed Bourdieu’s work on symbolic capital to propose a new concept of ‘symbolic research capital’ to explain the importance of a spectrum of research activity for a profession. The results show that radiography students and educators do see the importance of research for individuals and the profession, but they identify many constraints to teaching and learning. There are however many suggestions for improvements, some of which have already had an impact on my teaching. While students were able to identify places where research was embedded in the curriculum, staff did not feel embedding was done well, if at all. Conclusion and Recommendations The findings will inform future research pedagogy and curriculum development in radiography around embedding research in the curriculum in a way that educators and students recognise. A greater awareness of the importance of research and ‘symbolic research capital’ for radiographers will lead to them being better prepared to take on advanced practice roles for the benefit of patients. My ongoing aim is to make clear to students how important research is for them, their profession and most importantly, for our patients rather than, as one participant described it, ‘a hoop to jump through’ on the way to qualification.
... He and other microbiologists quickly recognized that the Gram stain also conveniently divided the microbial world essentially into two halves, with bacteria containing lipopolysaccharide in their cell walls staining pink (gram-negative bacteria) and those without lipopolysaccharide staining dark blue (gram-positive bacteria). German physicist and Nobel Prize laureate Wilhem Conrad Röntgen (1845-1923) first reported the discovery and potential clinical applications of what he called X-rays in 1896 (2). Surprisingly, the initial diagnostic approach to identifying bacterial pneumonia has not improved appreciably in the 21st century from what it was back in the 19th century. ...
... The Evidence for Long-Term Benefits of Restoration of CFTR Function Continues to Grow In 1989, it was first reported that mutations in the CFTR gene on chromosome 7 result in dysfunction of the CFTR protein and cause the multisystem disorder we know as cystic fibrosis (CF) (1). Although that initial discovery offered hope of treating the underlying cause of CF by restoring CFTR protein function, it was not until 2012, when Ramsey and coworkers reported the effect of the CFTR potentiator ivacaftor in a subset of patients with CF and the G551D mutation, that this hope was realized (2). In that study, restoring CFTR function with ivacaftor resulted in significant improvement in lung function, reduction in pulmonary exacerbations, and improvement in body mass during a 48-week study period. ...
... Both screens were used for comparative purposes -a cross-referential approach which draws relation between the anatomies in the PowerPoint radiograph and schematic diagrams/radiographs of anatomies available online. This observation connects with the findings of other research studies on the radiological interpretive process and learning to see (Pasveer 1989 As across all the four classes, the looking and touching of computer screens was central to their vision of learning pattern recognition, particularly what appeared to be significant locations, cavities and surface features of bones. The accounts that I offer in the two labelling activities below shows the process of the student's perception of parts and the beginning of a holistic vision of patterns; accounts that stress the interdependencies between different kinds of subtle and micro anatomical forms. ...
Chapter
Full-text available
Leading historians, anthropologists, educators and designers explore the role of materiality in medical education. With a broad focus, international scope and experimental format, this is the first book to seriously reflect on the material relationship between the medical school and reproduction of medical knowledge.
... Since Roentgen discovered X-ray, radiation has played an important role in diagnosis and treatment 28 in the medical field [1,2]. The digital radiography system (DR system), which has been used for 29 general radiography since the mid-1990s, not only provides convenience to users, but also enables Kyoto, Japan) was used for upper and lower extremities radiography. of about 62 million. ...
Article
Background: The International Electrotechnical Commission established the concept of the exposure index (EI), target exposure index (EIT) and deviation index (DI). Some studies have conducted to utilize the EI as a patient dose monitoring tool in the digital radiography (DR) system. Objective: To establish the appropriate clinical EIT, this study aims to introduce the diagnostic reference level (DRL) for general radiography and confirm the usefulness of clinical EI and DI. Methods: The relationship between entrance surface dose (ESD) and clinical EI is obtained by exposure under the national radiography conditions of Korea for 7 extremity examinations. The EI value when the ESD is the DRL is set as the clinical EIT, and the change of DI is then checked. Results: The clinical EI has proportional relationship with ESD and is affected by the beam quality. When the clinical EIT is not adjusted according to the revision of DRLs, there is a difference of up to 2.03 in the DI value and may cause an evaluation error of up to 1.6 time for patient dose. Conclusions: If the clinical EIT is periodically managed according to the environment of medical institution, the appropriate patient dose and image exposure can be managed based on the clinical EI, EIT, and DI.
... X-rays are a form of energy (electromagnetic waves) such as light and radio waves but the difference between the X-ray and against light is the ability of X-ray to penetrate the human body so, because of this nature of X-rays used in the medical field for viewing and diagnosing the internal organs in the human body. We can say that the use of radiation in the medical field has a major impact in improving the general health of the human being, and it also has a major role in helping doctors make decisions in treating their patients better [2]. So, one from the biggest Radiation advantage has been exploited in the medical field. ...
Conference Paper
Radiation is a form of energy that can produce acute effects such as skin redness, hair loss, radiation burns, depending on radiation doses and radiation dose rates. Despite of all these risks from radiation, X-ray diagnostics is greatly increased by people especially, at the present time, after the appearance of the Corona virus (COVID 19), and it has been proven that one of the most important diagnostic tests for corona disease. So, in this research, we evaluated the extent of awareness, understanding and knowledge of radiation hazards through radiological examinations, by focusing on the healthcare personnel who use ionizing radiation as a part of their work (persons who’s radiation-related occupations). So, the questionnaire was applied to staff working, technicians and any one that use radiation in his work for a different X-ray clinics in Al-Amiriya in Baghdad, to evaluate their awareness level and knowledge about the effect of ionizing radiation and the appropriate amount of radiation dose that resulting from radiological examinations. The results show that In spite of commitment of radiography clinics by safety and security procedures but, there is a problem for the people who run radiology clinics (they are not specialists). I.e. requires a person with knowledge of the effects of radiation, its risks and effects in addition to giving him the correct medical diagnosis which has a direct relationship with the patient’s life. And the most X-ray device in the clinics are considered old and the defect of old devices compared with modern devices is that they give a high dose of radiation at examination of X-ray.
... Some even argue that practices such as auscultation changed the very perceptive abilities and focus of the medical profession (Lachmund 1999). Most of the discussions about such measuring objects in medicine are often around the introduction of what is seen as a radically new technology (e.g., stethoscopes and X-rays ;Lachmund 1999;Pasveer 1989)--innovative tools that are viewed as having changed the face of medicine. As in other domains of STS (Oudshoorn 2020), there is less focus on practices concerning humble everyday materials that seem to seep into medical practice, such as the measuring tape. ...
Article
Full-text available
Medicine is often criticized in science and technology studies (STS) for its dominating measuring practices. To date, the focus has been on two areas of “metric work”: health-care workers and metric infrastructures. In this article, I step back into the training of clinicians, which is important for understanding more about how practices of measurement are developed. I draw on ethnographic fieldwork in a Dutch medical school to look at how a ubiquitous and mundane tool––measuring tapes––is embodied by medical students as they learn to coordinate their sensory knowledge. In doing so, they create their own bodies as the standard or measure of things. Unpacking educational practices concerning this object, I suggest that tracing the making of measuring bodies offers new insights into medical metric work. This also speaks to the growing interest in STS in sensory science, where the body is fashioned as a measuring instrument. Specifically, two interrelated contributions build on and deepen STS scholarship: first, the article shows that learning is an embodied process of inner-scaffold making; second, it suggests that the numerical objectification of sensory knowing is not a calibration to “objectivity machines” but rather to oscillations between bodies and objects that involve sensory-numerical work.
... Scintillant materials emitting radioluminescence (RL) under ionizing irradiation have garnered increasing attention due to the urgent need for reliable and affordable ionizing radiation detectors in the fields of medical diagnostics, nuclear industry, and high-energy particle physics. [1][2][3][4][5][6] The brightness of the RL of a qualified scintillant materials usually depends on two key features including heavy elements (high Z) and high-efficiency bulk radioluminescence (BRL). 7,8 Compared with a high Z property, high BRL efficiency has been obtained by conventional bulk-form scintillators such as Bi 4 Ge 3 O 12 , CdWO 4 , and activator-doped alkali halide crystals (CsI(Tl)) by exciton migration and trap-assisted down-conversation emission. ...
Article
Full-text available
Scintillators with color-tunable radioluminescence have attracted great attention due to the advantage of satisfying needs required by different radiation detection applications. However, while most traditional scintillators achieve efficient radioluminescence through exciton migration or activator-assisted recombination mechanism, the challenges relating to spectral modulation remain. Here, a composite scintillator consisting of a eco-friendly metal halide heterostructure demonstrates color-tunable radioluminescence with color temperature ranging from 2,505.6 K to 14,215.9 K. Under X-ray irradiation, the composite scintillator emits bright white light with a color rendering index of 92.6 set and a luminescent yield of 21,400 photons/MeV, which originates from self-assembled metal halide heterostructure and efficient energy transfer. The performance exhibited by the composite heterostructure material provides and proves a feasible strategy for realizing color-tunable scintillators in ionizing radiation detection.
... Once again, the composition of theteaching staffreflected Shimadzu'sclosecooperation ties with universitiesand private practitioners (see table 3). Thecenter,run by Fukuda,alsoemployed four other engineers.Asfor the three external lecturers,they were Professor Aoyagi and Doctor Urano,both of whom also 74 Thep rofessionalizationo fX -rayt echnicians was nots olely due to ap rocess of defining commonworking methods and cognitive referents by workersthemselves,asemphasizedby Pasveer 1989. 75 Shimadzu 1967 attendedthe one-weekcourseorganised in 1921, as wellasanotherdoctor, Saito Taiga, Presidentofthe Japanese RoentgenSociety (Nihon rentogen gakkai) 76 .The centre wasopen to students who graduated from ajunior high school.The course lasted six months,and wassubsequently extendedtonine months in 1933 and twelve months in 1936.Thefirst year,40students entered the school, of whom half were sent by public institutions (army, navy,national railways,etc.) ...
Article
Full-text available
This contribution focuses on the role of the firm Shimadzu in the marketing of X-ray machines in Japan during the first part of the 20th century, viewed from a business history perspective. It attempts to further understanding of the process of technology diffusion in medicine. In a global market controlled by American and German multinational enterprises, Japan appears to have been a particular country, where a domestic independent firm, Shimadzu, succeeded in establishing itself as a competitive company. This success is the result of a strategy based on both the internalisation of technological capabilities (recruitment of university graduate engineers, subcontracting of research and development activities) and an original communication policy towards the medical world. Finally, the specific structure of the Japanese medical market, composed of numerous and largely privatised small healthcare centres, facilitated the rapid diffusion of X-ray machines, a new technology which conferred a comparative advantage on its holders.
... and quite another to be able to apply those criteria in common with other practitioners in the production of appropriate categories and attributions" (Atkinson, 1995: 84). For a historical account of the shaping of radiography and the reconstruction of its images, see Pasveer (1989). 124 This is further complicated by the fact that the choice of which ranking's or rating's measures one gives priority to may vary, depending on whether they are assessed jointly or separately (Sunstein, 2018). ...
... 81 Radiologists, medical specialists defined through the use of a specific technology, unsurprisingly gave strong support to a widespread diffusion of mammographic (that is, radiological) screening. 82 At the same time, radiologists stressed that the efficacy of mammographic screening depended on the quality of radiological exams. It was therefore crucial to train high-level specialists in this area. ...
Article
Full-text available
Mammographic screening for breast cancer is a widely used public health approach, but is constantly a subject of controversy. Medical and historical research on this topic has been mainly conducted in Western Europe and North America. In Brazil, screening mammography has been an open topic of discussion and a challenge for health care and public health since the 1970s. Effectively, Brazilian public health agencies never implemented a nationwide population-based screening programme for breast cancer, despite the pressures of many specific groups such as advocacy associations and the implementation of local programmes. This article examines the complex process of incorporating mammography as a diagnostic tool and the debates towards implementing screening programmes in Brazil. We argue that debates about screening for breast malignancies, especially those conducted in the late twentieth and early twenty-first centuries, took place in a context of change and uncertainty in the Brazilian health field. These discussions were strongly affected both by tensions between the public and the private health care sectors during the formative period of a new Brazilian health system, and by the growing role of civil society actors. Our study investigates these tensions and their consequences. We use several medical sources that discussed the topic in Brazil, mainly specialised leading oncology journals published between 1950 and 2017, medical congress reports for the same period, books and theses, institutional documents and oral testimonies of health professionals, patients and associations collected in the framework of the ‘The History of Cancer’ project from the Oswaldo Cruz Foundation and Brazilian National Cancer Institute.
... Such a mode of reference contributes also to the perception of the condition as if it was a separate entity that can be eradicated from the body as opposed to some malfunction of the way the body performs (cf. Pasveer 1989). For Blois (1984), this mode of reference can be called nominalist as opposed to the psychological one, where the disease is presented as a condition experienced by a www.journal.tertium.edu.pl ...
Article
Full-text available
Ample research on written professional medical discourse across genres and modalities generally points to the impersonal and dehumanising character of the communication in this particular context. On the other hand, there have been numerous attempts at incorporating the human element into medical texts, be it through different models, sets of guidelines, generic varieties, but also, more holistically, models of medical practice. The objective of the present paper is to study the discourse of case reporting in contemporary medical case reports with respect to patient’s presence. To this aim, a sample of regular case reports derived from a prestigious medical journal has been examined with particular attention to textual references to the treated. It will be shown that regardless of the current trend in medical practice in the direction to patient-centredness, regular medical reports, i.e. not special varieties, still bear the features of the biomedical discourse.
... The research of Jet Propulsion Laboratory (JPL) adopted geometric correction, gray transform, suppression of noise, Fourier transform and two-dimensional linear filtering to deal with the thousands of moon pictures from the space probe Prowler 7 in 1964, and repainted the image of the lunar surface [35]. In the end of 1960s and the early 1970s, the researchers started to combine image processing with remote sensing techniques, medical imaging and astronomy, and in 1895 X-ray which is used widely in medical image nowadays, was discovered by Wilhelm Roentgen [36]. With the development of electronic devices toward excellent performance, small size and high reliability [37], in 1990s, the technology of image enhancement had embedded in every aspect of human life and social development. ...
Article
Full-text available
In this era of artificial intelligence (AI), the Internet of things (IoT) with the capability of connecting a great number of heterogeneous terminals and the popularity of mobile devices, which makes more devices available as another pair of eyes for people, such as video surveillance and smart navigation. As image enhancement is assisting people to better work together and helping people live a smarter life, it is therefore becoming increasingly important. Nevertheless, many vision systems are sensitive to factors like the scattering of light or motion which may cause blur. This paper promotes an image enhancement method and is dedicated to reduce the adverse effects of blurred images on vision systems. We first researched the theory of indented frame over fusion (IFOF) and presented an automatic screening function. Then subtly combined color reversal, registration and transformation. Lastly, we tested two examples with this method and gained good results. Image processed by this method, facing strong scattering of light environment, has improved its quality and visual effects. With the development of this kind of technology, there will be more practical and intelligent applications in our lives, such as license plate numbers recognition in bad weather and important items search on fire scenes.
... Die Prominenz des Sehsinns für die Diagnose in der Medizin ist bis heute ungebrochen. Vielzählige Studien befassen sich mit dem Wandel von alten körpernahen zu neueren bildgebenden Verfahren, etwa vom unmittelbaren Beobachten der körperlichen Verfasstheit, der Inspektion der Augen und der Hautröte, des Abtastens der Organe und des Fühlens von Puls und Atmung bis hin zur Messung von Fieber-und Blutdruck, Aufzeichnung von Fieberkurven und der technischen Repräsentation des Körpers durch Röntgen-und Ultraschallbilder (Pasveer 1989;Yoxen 1987). Dabei rückt vor allem die zunehmende technische Vermittlung ärztlicher Diagnosepraktiken ins Zentrum der Analyse, wenn die sensorischen Mittel des Körpers durch die technische Sensorik der Instrumente ersetzt werden. ...
Chapter
Seit dem „practice turn“ und dem „material turn“ rücken menschliche Körper und technische Artefakte vermehrt in den Fokus soziologischer Aufmerksamkeit. Diese (Wieder-)Entdeckung von Körper und Technik kann einerseits auf etablierte Theorieangebote und eine Anzahl klassischer Studien zurückgreifen, andererseits sind die Verhältnisse von Körpern und Technik soziologisch noch nicht hinreichend geklärt. Wir suchen daher nach theoretischen und empirischen Verschränkungen von Körpern und Techniken und ihrer Relevanz für ein Verständnis sozio-technischer Konstellationen in modernen Gesellschaften. Damit wollen wir einen systematischen Beitrag zu den Verhältnissen von Körpern und Technik aus soziologischer Perspektive leisten. Insbesondere beziehen wir uns auf Ansätze aus der Techniksoziologie, um den Stand der Forschung sowie mögliche Entwicklungsperspektiven zu skizzieren. Unsere Ausgangsthese dabei ist, dass sowohl menschliche Körper als auch gegenständliche Technik als spezifische Verkörperungen des Sozialen gedacht werden können, die jedoch nicht als passive Träger, sondern als eigenständige Agenturen und konstitutive Elemente gesellschaftlicher Dynamiken und Strukturen gelten.
... By 1910, various medical societies had begun to call for regulation and professionalization of the field as the ill effects of X-ray photography were exposed by iatrogenic illnesses and deaths. As early as 1898 Röntgen noted the ill effects of X-ray photography, yet it would be decades before medical practitioners would protect themselves and the public from X-ray photography (Pasveer, 1989). ...
Article
Full-text available
Innovations in communication technologies have had a profound impact on health. Over the decades, new communication tools have sometimes prompted fears that they will produce sociological and psychological distress, and have a negative impact on various aspects of health. Critics claim that innovation may disrupt the social order and degrade the health of communities due to anxiety. On the other hand, advocates of new technologies have pointed out that innovation supports progress in society, saves time and money, and improves health. This paper reviews responses to new communication technologies over the centuries, and how resistance to them, or cultural lag, has sometimes delayed their impact on health. As evidence accumulates that the benefits of a new technology outweigh the harms, innovations in health communication become part of standard practice. To ensure that emerging communication technologies provide the most benefit to the most people we recommend that purveyors of health information on any channel or platform be held accountable to standards that are ethical, scientific, and evidence-based.
... By 1910, various medical societies had begun to call for regulation and professionalization of the field as the ill effects of X-ray photography were exposed by iatrogenic illnesses and deaths. As early as 1898 Röntgen noted the ill effects of X-ray photography, yet it would be decades before medical practitioners would protect themselves and the public from X-ray photography (Pasveer, 1989). ...
Article
Full-text available
Innovations in communication technologies have had a profound impact on health. Over the decades, new communication tools have sometimes prompted fears that they will produce sociological and psychological distress, and have a negative impact on various aspects of health. Critics claim that innovation may disrupt the social order and degrade the health of communities due to anxiety. On the other hand, advocates of new technologies have pointed out that innovation supports progress in society, saves time and money, and improves health. This paper reviews responses to new communication technologies over the centuries, and how resistance to them, or cultural lag, has sometimes delayed their impact on health. As evidence accumulates that the benefits of a new technology outweigh the harms, innovations in health communication become part of standard practice. To ensure that emerging communication technologies provide the most benefit to the most people we recommend that purveyors of health information on any channel or platform be held accountable to standards that are ethical, scientific, and evidence-based.
... Not so much because of its truthfulness, but because, as a mechanical method of visual representation, it was considered "to be free of individual judgment" (Daston and Galison, 1992: 114). Later on this quality was transmitted to radiography -perceived to be a photograph of the inner body -and subsequent medical imaging technologies as part of a new scientific paradigm based on the claim that "seeing is knowing" (Pasveer, 1989). It was from this epistemological ground that arose the widespread belief that medical images were like "transparent windows" through which one could see directly inside the human body (Joyce, 2008: 11). ...
... In der modernen Medizin treten die Verschränkungen von menschlichen Körpern und technischen (Pasveer, 1989;Yoxen, 1987 (Burri, 2008). In der Medizin und den Neurowissenschaften werden nicht zuletzt die techno-korporalen Verschmelzungen der Cyborg-Debatte an die Grenzen des praktisch Machbaren geführt und neu verhandelt (Sahinol, 2016). ...
... There is renewed medical social scientific interest in materialities (Fox, 1997;van Hout et al., 2015). This follows from classical literature on the symbolic role of objects in structuring professional boundaries (Becker, 1961) and examinations of the social history of medical artefacts (Pasveer, 1989). When examining the existing contemporary literature around the role of materialities within hospitals, these tend to focus upon novel, complex or contested medical technologies (Prout, 1996;Timmermans and Berg, 2003) despite explicit calls to examine the mundane within sociology (Latour, 1992) as well as to connect with other social scientific explanations, such as work on material culture (Miller, 2005). ...
Article
Full-text available
This study draws upon interviews of medical staff working in the city of Minamisoma, Japan, following the 2011 Triple Disaster. It investigates staff responses to the disruption of material resources as a consequence of the disaster and its management. The disruption of spaces, and the loss of oxygen supplies, food, and medications impacted upon staff experience and the ability of institutions to care for patients. This resulted in a restructuring of spaces and materials as workers made efforts to reconfigure and reestablish healthcare functions. This is one of the few qualitative studies which draws upon the experience and perspectives of health workers in understanding material disruption following disaster. This is particularly important since this case did not involve the breakdown of lifeline infrastructure, but rather, brought to attention the way everyday material objects shape social experience. In highlighting these effects, the paper makes the case for the social scientific investigation of the impact of disasters on healthcare, shedding light on an area of research currently dominated by disaster medicine.
... One might even argue for medicine that it has be come doubly opaque with the broad introduction of medical technologies. First, medicine is itself inherently uncertain (Parsons 1951: 428-479;Fox 1957;Wag ner 1995;Schubert 2007b) and second, especially diagnostic tools may produce new uncertainties (Pasveer 1989;Yoxen 1989). From this perspective, safety i n such settings cannot be understood as a permanent organizational feature, but must be considered the continuous accomplishment of the people involved. ...
... & Berg 1995;Star 1995;Elston 1997;Heath et al. 2003;Timmermans & Berg 2003). Auch dort herrschen Studien zur Einführung neuer Instrumente, etwa zu bildgebenden Verfahren wie Rçntgen (Pasveer 1989), Ultraschall (Yoxen 1987) (Latour 1994), deren Wirkweise undurchsichtig und verschleiert ist. ...
Article
Full-text available
Zusammenfassung Der Beitrag untersucht die Beteiligung von Technik an medizinischen Handlungsvollzügen in der täglichen Praxis. Wie Studien zur medizinischen Alltagspraxis zeigen, ist die routinierte Nutzung von Technik im Alltag von Ungewissheit und Unbestimmtheit durchzogen. Der Beitrag schließt an diese Studien an und bezieht sich auf die aktuelle Diskussion um die Handlungsträgerschaft von Technik, um die spezifische Mitwirkung von Technik in der medizinischen Praxis aufzuzeigen. Insbesondere wird die Frage nach der Handlungsträgerschaft von Technik kritisch reflektiert und für eine Analyse der technisierten Medizin angepasst. Anhand ethnografischer Beobachtungen in chirurgischen Operationssälen wird nachgezeichnet, wie medizinische Zwecktätigkeiten auf Ensembles von Menschen und Maschinen verteilt und die alltäglichen Ungewissheiten im Umgang mit Technik praktisch aufgelöst werden.
... Probably the best known practical application of X-ray radiation is in medicine. Examples are diagnostic examinations, radiotherapy treatments and surgery [1,2]. Other applications are for analytics in material science, geosciences or mining [3]. ...
Article
Common textile materials as cotton or polyester do not possess reliable X-ray absorption properties. This is due to their morphology and chemical composition in particular. Common fibers are built up from organic polymers containing mainly the elements carbon, hydrogen, oxygen and nitrogen. These “light” elements only have low X-ray absorption coefficients. In contrast, inorganic materials composed of “heavy” elements with high atomic numbers, e.g. barium or bismuth, exhibit X-ray absorption co- efficients higher by up to two orders of magnitude. To obtain a flexible yarn with high X-ray absorption properties both these materials, the organic polymer and the inorganic X-ray absorber, are combined to an inorganic/organic composite fiber material. Hence, as the organic component cellulose from modified Lyocell-process is used as carrier fiber and blended with inorganic absorber particles of low toxicity and high absorption coefficients, as bariumsulphate, bariumtitanate or bismuthoxide. A content of inorganic absorber particles equally distributed in the whole fiber of up to 20% is achieved. The composite fibers are produced as staple or filament fibers and processed to multifilament or staple fiber yarns. The staple fiber yarns are rotor-spinned to increase the comfort of the subsequent textile material. Several woven fabrics, considering multilayer structure and different warp/weft density, are developed. The energy dependent X-ray shielding properties are determined in dependence on the different yarn compositions, yarn types and structural parameters of the woven fabrics. As a result, a production process of textile materials with comfortable and dedicated X-ray absorption properties is established. It offers a promising opportunity for manufacturing of specialized textiles, working clothes or uniforms applicable for med- icine, air craft and security personal, mining as well as for innovative composite materials.
Article
Contemporarily, significant progress has been made in the development and application of image fusion technology in the field of diagnostic imaging. Image fusion is a fully automated image alignment and interpretation system that not only allows images with different characteristics to be displayed, interpreted, compared, and analyzed on the same platform, but also provides a fast and seamless pathway to clinical diagnosis and treatment. The purpose of this study was to explore the imaging theory, clinical advantages and limitations of CT. At the beginning of the study, the definition and development history of CT will be explained. Subsequently, in addition to imaging theory and key parameters, one can also understand the individual advantages and clinical application of CT. Afterwards, the limitations of CT will be mentioned, and the new technology of PET/CT will be introduced. As the most advanced medical imaging technology, PET/CT has improved the way of single PET and CT scanning, making them more widely used, making it the best combination of medical imaging and diagnostic technology. Overall, these results shed light on guiding further exploration of CT.
Article
The narrative of the rise and fall of the stethoscope is partly written. Medical historians agree on the rise in its use; however, on the decline, they are less certain. This article explores the previously unexamined and surprisingly long history of predictions of the stethoscope’s demise. It also provides evidence to show that it is not yet extinct, although its applications are changing as it adapts to newer technology and recent public health measures. Primary sources include medical school curricula, books, medical journals, and popular literature. Trends and projections in patent applications for stethoscope modifications and sales of the instrument provide additional evidence for the robust position of the stethoscope in current American practice.
Book
Full-text available
Die in der vorliegenden Studie vorgestellte postphänomenologische Soziologie untersucht die komplexen Weltzugänge und Wirklichkeitskonstruktionen einer technologisierten Spätmoderne. Grundlage bildet das Konzept der Postphänomenologie von Don Ihde und die darin beschriebene Vielfalt an Technologien, die den Körper erweitern (embodiment relation), ihn um Messtechnologien ergänzen (hermeneutic relation), ein ernstzunehmendes Gegenüber bilden (alterity relation), im Hintergrund arbeiten (background relation) oder sich Peter-Paul Verbeek zufolge sogar mit dem Körper (cyborg relation) oder der Welt (immersion relation) verbinden. Erweitert wird dieses Konzept um eine soziologische Perspektive, vor allem orientiert an der phänomenologischen Soziologie und der Wissenssoziologie. Analysiert werden damit schrittweise die körperliche Erfahrung des Subjekts, ihre technisch bedingte Veränderung, ihre Verbindung mit den Erfahrungen anderer Subjekte und schließlich, wie Subjekte auf Basis dieser Erfahrungen ein geteiltes Verständnis von Wirklichkeit aushandeln. Die dergestalt entwickelte postphänomenologischen Soziologie wird empirisch, unter Einbezug der Methoden der qualitativen Sozialforschung, weiter expliziert, und zwar anhand der Rolle der Assistenzsysteme beim Autofahren, des Umgangs von Diabetiker:innen mit Blutzuckermessgeräten und Insulinpumpen sowie anhand der dokumentarfilmischen Darstellung zum Umgang mit sozialen Robotern. Es zeigt sich: Durch die Vielfalt an Technologien und entsprechenden Erfahrungsweisen gewinnen jene Kompetenzen an Bedeutung, mit denen zwischen ihnen übersetzt und vermittelt werden kann. ›Common Sense‹ gründet sich dann nicht mehr in der Annahme einer Ähnlichkeit aller Weltzugänge, sondern in gelungenen Abstimmungsprozessen.
Chapter
Although deep learning-based AI systems for diagnostic imaging tasks have virtually showed superhuman accuracy, their use in medical settings has been questioned due to their “black box”, not interpretable nature. To address this shortcoming, several methods have been proposed to make AI eXplainable (XAI), including Pixel Attribution Methods; however, it is still unclear whether these methods are actually effective in “opening” the black-box and improving diagnosis, particularly in tasks where pathological conditions are difficult to detect. In this study, we focus on the detection of thoraco-lumbar fractures from X-rays with the goal of assessing the impact of PAMs on diagnostic decision making by addressing two separate research questions: first, whether activation maps (as an instance of PAM) were perceived as useful in the aforementioned task; and, second, whether maps were also capable to reduce the diagnostic error rate. We show that, even though AMs were not considered significantly useful by physicians, the image readers found high value in the maps in relation to other perceptual dimensions (i.e., pertinency, coherence) and, most importantly, their accuracy significantly improved when given XAI support in a pilot study involving 7 doctors in the interpretation of a small, but carefully chosen, set of images.KeywordseXplainable AIMedical machine learningActivation mapsThoracolumbar fracturesX-rays
Article
The proposed X-ray spatial light modulator (SLM) concept is based on the difference of X-ray scattering from amorphous and crystalline regions of phase change materials (PCMs) such as Ge 2 Sb 2 Te 5 (GST). In our X-ray SLM design, the “ on” and “ off” states correspond to a patterned and homogeneous state of a GST thin film, respectively. The patterned state is obtained by exposing the homogeneous film to laser pulses. In this paper, we present patterning results in GST thin films characterized by microwave impedance microscopy and X-ray small-angle scattering at the Stanford Synchrotron Radiation Lightsource.
Chapter
This chapter gives a review for both conventional X-ray and computed tomography (CT) scan imaging modalities and their medical applications. The chapter presents a brief history on the discovery of X-ray, X-ray imaging, and computed tomography scan. The linear projection for the generation of the sinogram (the detector’s signals versus the rotational angle) and the filtered backprojection for image reconstruction are discussed. Computer simulations for linear and fan beams X -ray are also presented. The chapter discusses some medical applications of both the conventional X-ray and CT scan imaging.
Presentation
Full-text available
Ementa da disciplina Estudos Sociais da Ciência e da Tecnologia, ofertada no 2º semestre de 2021 no Programa de Pós-Graduação em História das Ciências e da Saúde, Fiocruz / Syllabus of the course Science and Technology Studies offered to graduate students of the History of Science and Health program at Fiocruz (Brazil)
Article
Full-text available
This article discusses the process of medical specialization on cancer in Brazil between the 1930s and the 1970s, specifically the project to develop a specialty that would bring together knowledge and practices to fight against the disease, named cancerology. Initially part of the movement for the national campaign against cancer, cancerology gradually became a specialty, with proposals for the titling and inclusion of disciplines in medical curricula. Conceived as a unifying specialty, cancerology ended up with a fragmented practice within several specialties. We argue that this fragmentation process occurred due to the specialization of other medical specialties, mainly regarding technological incorporation, making the unifying project of cancerology unfeasible.
Article
Full-text available
Este escrito es una aproximación a las Imágenes por Resonancia Magnética (IRM, que al igual que los rayos x, la ecografía, o la mamografía, hacen parte del grupo de imágenes diagnósticas. Dichas imágenes parecen resultarnos cada vez más familiares como forma de visualizar el interior del cuerpo, no obstante, es necesario precisar que no siempre ha sido así. Por esta razón, este artículo se pregunta cómo estas imágenes diagnósticas se han incorporado en nuestra vida cotidiana, se han naturalizado al grado de hacer posible otras formas de imaginar el cuerpo. Teniendo en mente lo anterior, este artículo se estructura de la siguiente manera: comienza ilustrando el lugar que ocupan las imágenes diagnósticas en la construcción de imaginarios sobre el cuerpo, especialmente en el campo de la salud. Luego a manera de contraste, presenta una recopilación de momentos que logran caracterizar la extrañeza y consternación que despertaron en un inicio las primeras imágenes diagnósticas (los rayos x). Continúa exponiendo porqué estas imágenes no son tan neutrales o fidedignas como parecen, sino que son más bien, un artificio producido por manipulaciones técnicas e interacciones humanas. Por último, se observa que, a pesar de su ‘artificiosidad’, estas imágenes tienen cada vez más poder en las formas en la cual se imagina, siente, entiende e, interviene el cuerpo. No siendo más, este escrito está pensado como un intento por desestabilizar la mirada familiar que recae en estas imágenes, desmantelando así sus sentidos cotidianos.
Article
Full-text available
Este escrito es una aproximación a las Imágenes por Resonancia Magnética (IRM, que al igual que los rayos x, la ecografía, o la mamografía, hacen parte del grupo de imágenes diagnósticas. Dichas imágenes parecen resultarnos cada vez más familiares como forma de visualizar el interior del cuerpo, no obstante, es necesario precisar que no siempre ha sido así. Por esta razón, este artículo se pregunta cómo estas imágenes diagnósticas se han incorporado en nuestra vida cotidiana, se han naturalizado al grado de hacer posible otras formas de imaginar el cuerpo. Teniendo en mente lo anterior, este artículo se estructura de la siguiente manera: comienza ilustrando el lugar que ocupan las imágenes diagnósticas en la construcción de imaginarios sobre el cuerpo, especialmente en el campo de la salud. Luego a manera de contraste, presenta una recopilación de momentos que logran caracterizar la extrañeza y consternación que despertaron en un inicio las primeras imágenes diagnósticas (los rayos x). Continúa exponiendo porqué estas imágenes no son tan neutrales o fidedignas como parecen, sino que son más bien, un artificio producido por manipulaciones técnicas e interacciones humanas. Por último, se observa que, a pesar de su ‘artificiosidad’, estas imágenes tienen cada vez más poder en las formas en la cual se imagina, siente, entiende e, interviene el cuerpo. No siendo más, este escrito está pensado como un intento por desestabilizar la mirada familiar que recae en estas imágenes, desmantelando así sus sentidos cotidianos.
Chapter
In this introductory part, I present the book’s goals. The issues of neuroimaging, neuroimaging software, computer programming, and open source, are initially presented. After a brief description of the methods employed, I give an outline of the book’s structure.
Article
This article extends new materialist theorizing on the constructive role played by the physical stuff of the world. Specifically, it draws on Kenneth Burke’s writings on recalcitrance to theorize the materialities of rhetorical invention. It takes X-rays as a case study in recalcitrance-driven invention, focusing on two particular applications, traditional medical X-rays, a pervasive category of contemporary technical communication, and backscatter x-ray airport security scans, a controversial and short-lived one. Its analysis shows how recalcitrance (1) is harnessed as means of technical invention and (2) is key to invention’s bidirectionality, by which our material interventions, in turn, work upon us.
Chapter
We tend to associate the sciences with seeing—but scientists, engineers, and physicians also use their ears as a means for acquiring knowledge. This chapter introduces this essay’s key questions about the role of sound and practices of listening in the sciences, and explicates their relevance for understanding the dynamics of science more generally. It defines the notion of sonic skills, situating it in the wider literature on the auditory dimensions of making knowledge. It presents the case studies on which the essay draws, explaining their geographical, temporal, and methodological scope and the researchers behind them.
Chapter
How do individuals make sense of their biosensor data? Focusing on two different health biosensors—an ovulationmonitor and the consumer gene test—we discuss how individuals interpret their biosensor data by engaging in exchanges on online forums. Participants share and discuss ovulation patterns and genetic susceptibilities by drawing on a range of materials. We argue that it is through these biosensing networks that genetic and ovulation data become meaningful, and that it is through this process that the biosensing body is acquired. We show how discussion and speculation, artefacts and body sensations, anticipations and corporeal imaginaries are part of what constitute and hold together the biosensing body.
Chapter
The chapter introduces the theoretical foundations of the book, drawing on literature from medical sociology, STS, and innovation studies. It begins by describing the innovation-as-an-emergent process conceptualisation of innovation, contrasting this with the linear model, and it provides an overview of social science literature on the problem of technology adoption within healthcare settings. In the process of bringing these two areas together, the chapter introduces and describes the notion of proto-platforms, drawing on Keating and Cambrosio’s notion of biomedical platforms. This book can thus be seen as a study of a patient-centred proto-platform, constituted by various socio-technical elements that reflect the ideals of patient-centred care, which has emerged to deliver DBS in a paediatric context.
Chapter
The last two decades have witnessed a revival of interest in sociology’s broad heritage of research methodologies and in the use of techniques and data sources which have, for too long, been on the margins of research practice in the discipline. The cause of the life history method was taken up by Ken Plummer (1983) in the early 1980s, and we are now witnessing the growth of a range of auto/biographical approaches. It now seems timely to consider a neglected history within the social sciences of using visual methods and data, building on important recent texts (notably, Fyfe and Law 1988; Ball and Smith 1992). It is my contention that the value of visual imagery and visual methods to the sociological enterprise is such as to warrant a more central location in research training and research practice. In doing so we will inevitably draw on, and benefit from, an increasing multidisciplinarity in research methodologies available for our use.
Article
Phantom limb pain is one of the most intractable and merciless pains ever known-a pain that haunts appendages that do not physically exist, often persisting with uncanny realness long after fleshy limbs have been traumatically, surgically, or congenitally lost. The very existence and “naturalness” of this pain has been instrumental in modern science's ability to create prosthetic technologies that many feel have transformative, self-actualizing, and even transcendent power. In Phantom Limb, Cassandra S. Crawford critically examines phantom limb pain and its relationship to prosthetic innovation, tracing the major shifts in knowledge of the causes and characteristics of the phenomenon. Crawford exposes how the meanings of phantom limb pain have been influenced by developments in prosthetic science and ideas about the extraordinary power of these technologies to liberate and fundamentally alter the human body, mind, and spirit. Through intensive observation at a prosthetic clinic, interviews with key researchers and clinicians, and an analysis of historical and contemporary psychological and medical literature, she examines the modernization of amputation and exposes how medical understanding about phantom limbs has changed from the late-19th to the early-21st century. Crawford interrogates the impact of advances in technology, medicine, psychology and neuroscience, as well as changes in the meaning of limb loss, popular representations of amputees, and corporeal ideology. Phantom Limb questions our most deeply held ideas of what is normal, natural, and even moral about the physical human body.
Article
To its proponents, the ultrasound scanner is a safe, reliable, and indispensable aid to diagnosis. Its detractors, on the other hand, argue that its development and use are driven by the technological enthusiasms of doctors and engineers (and the commercial interests of manufacturers) and not by concern to improve the clinical care of women. In some U.S. states, an ultrasound scan is now required by legislation before a woman can obtain an abortion, adding a new dimension to an already controversial practice. Imaging and Imagining the Fetus engages both the development of a modern medical technology and the concerted critique of that technology. Malcolm Nicolson and John Fleming relate the technical and social history of ultrasound imaging-from early experiments in Glasgow in 1956 through wide deployment in the British hospital system by 1975 to its ubiquitous use in maternity clinics throughout the developed world by the end of the twentieth century. Obstetrician Ian Donald and engineer Tom Brown created ultrasound technology in Glasgow, where their prototypes were based on the industrial flaw detector, an instrument readily available to them in the shipbuilding city. As a physician, Donald supported the use of ultrasound for clinical purposes, and as a devout High Anglican he imbued the images with moral significance. He opposed abortion-decisions about which were increasingly guided by the ultrasound technology he pioneered-and he occasionally used ultrasound images to convince pregnant women not to abort the fetuses they could now see. Imaging and Imagining the Fetus explores why earlier innovators failed where Donald and Brown succeeded. It also shows how ultrasound developed into a "black box" technology whose users can fully appreciate the images they produce but do not, and have no need to, understand the technology, any more than do users of computers. These "images of the fetus may be produced by machines," the authors write, "but they live vividly in the human imagination." © 2013 The Johns Hopkins University Press. All rights reserved.
Article
Medical work is deeply mediated by technology. In line with constructivist studies of medicine and technology, this paper conceptualizes routine medical work as being fundamentally marked by uncertainty and indeterminate situations. To account for the agency of the means of medical practice in such situations, current discussions about the agency of technology are critically reflected and adapted to the analysis of medical technologies. Drawing on ethnographic observations in operating theaters this paper traces the empirical distribution of medical work between ensembles of humans and machines as well as the handling of uncertainties in daily practice.
Article
'This work is a magesterial introduction to the sociology of science. With science being imbricated in the very tissue of our political lives - with climate change, energy policy, biodiversity conservation and so forth - it is increasingly important that the rich lessons of the field of science studies be brought to a wider readership. This book achieves that goal with great style: it is both highly accessible and rigorously researched.' © Dominique Vinck 2010. First published in French as Sciences et société. Sociologie du travail scientifi que.
Article
Attending to the material discursive constructions of the patient body within cone beam computed tomography (CBCT) imaging in radiotherapy treatments, in this paper I describe how bodies and machines co-create images. Using an analytical framework inspired by Science and Technology Studies and Feminist Technoscience, I describe the interplay between machines and bodies and the implications of materialities and agency. I argue that patients' bodies play a part in producing scans within acceptable limits of machines as set out through organisational arrangements. In doing so I argue that bodies are fabricated into the order of work prescribed and embedded within and around the CBCT system, becoming, not only the subject of resulting images, but part of that image. The scan is not therefore a representation of a passive subject (a body) but co-produced by the work of practitioners and patients who actively control (and contort) and discipline their body according to protocols and instructions and the CBCT system. In this way I suggest they are 'con-forming' the CBCT image. A Virtual Abstract of this paper can be found at: https://youtu.be/qysCcBGuNSM.
Article
As an abstraction that identifies the inner thinking self, the mind is a powerful resource for rhetorical invention, enabling both the generation of discourse and epistemic sense-making. This dissertation provides insight into the discursive life of "the mind," examining how different instantiations of the concept were put to rhetorical use in three specific historical cases. In each case study, I examine a conception of the mind that originated in the realm of institutional science and that made its way into public culture, often circuitously, and frequently transformed in the process. The first case study analyzes a nineteenth-century phrenology handbook, which reveals how the phrenological mind enabled pre-existing cultural beliefs to be resourced, or respoken as if the objective results of science. The second case study examines Benjamin Spock's use of Freudian ideas to generate child-rearing advice in his classic Baby and Child Care manual. My analysis of Spock's Freudianism leads me to propose that beliefs about the mind constitute a uniquely generative class of doxa that I label "psychodoxa." The final case study focuses on the contemporary cerebral self, which asserts the isomorphism of mind, brain, and self. This conception of mind generated considerable interest in Terri Schiavo's brain in the end-of-life case that dominated news media in the early 2000s, and I suggest that much of the discourse concerning Schiavo's brain relied on recalcitrance to channel invention. The dissertation concludes by considering the mind's utility as an inventional resource for rhetoric itself.
Article
The past three decades have seen enormous changes in the organisation of health care. This book explores the role of knowledge production and technology on these transformations, focusing on the market (attempts to embed principles of economic rationality and efficient use of resources in the shaping and delivery of health care), the laboratory (science, experiments and 'evidence' in the management of research, practice and policy) and the forum (the application of deliberative procedures and other forms of public consultation to health care decision making).
Article
Full-text available
This is not an article on the latest means available for the diagnosis of chest diseases, but simply a consideration of history taking and of signs and symptoms. Medicine is without meaning unless we think in terms of patients. It is by developing our powers of observation and interpretation while we are in contact with our patients that we learn medicine, rather than from books and articles. Hippocrates is our great master of the art of inspection-he stands for the fundamental importance of seeing clearly. To-day if we read his reports of 2,400 years ago we can often make an almost instantaneous diagnosis. Descriptions which cannot be bettered are the squeaking of leather for a pleural friction rub, or the boiling inside the chest of pulmonary oedema. In the time of Hippocrates as much as now thoroughness in examination produces more correct diagnoses than sudden flashes of brilliance.
Article
In this paper a new schema for the analysis of scientific observation is proposed. The concepts of `externality' and `evidential' context of observational reports are introduced. The degree of externality of reports is shown to be related to the specificity of the evidential context. Attention is drawn to how the new concepts differ from traditional issues raised by the problem of the theory-ladenness of observations. The analysis is illustrated by reference to the detection of solar neutrinos and measurements of solar oblateness. Detailed studies of these cases reveal how the externality and evidential context shifts during the course of observational disputes. Some of the consequences of the new schema for the analysis of scientific language, access to experimental data, and black-box instrumentation are developed.
Article
This paper is about how natural objects are made visible and analyzable in scientific research. It is argued that the objects scientists actually work upon are highly artificial, in that their visibility depends upon complex instruments and careful preparatory procedures. Instruments and laboratory procedures do more than provide a window to the world; they lay the groundwork for specific analytic operations which utilize literary resources to represent phenomena graphically. Two specific cases from biology are discussed. The first is from a popular field manual, and is used to introduce themes for analyzing a more complex case, a neuroscience project using electron microscopy of brain tissue. The discussion of both cases concerns how specimens are modified into `docile objects' for purposes of investigation. These modifications are summarized under the headings of `marking', `constituting graphic space', and `normalizing observations'. Finally, it is claimed that these practices make up an `externalized retina' for scientific perception — a `retina' that depends upon disciplined conduct within the laboratory setting.
Article
If one pays a visit to one of the great London hospitals, and still more to one of the great provincial hospitals, one is struck with the enormous progress which has been made of late years in the provision of adequate space for the X-ray department. The apparatus is there, and the buildings are there, but where are the men? The department is usually very inadequately staffed, and we see none of the students whom we would expect to crowd into this, the most interesting corner of the whole hospital. It is still worse with the electrical department. Muscle and nerve-testing is becoming a lost art, and if one wishes to study electro-therapeutics one must go to France for training as well as for inspiration. Meantime the lot of the qualified radiographer is not altogether a happy one. It is true he is watching the evolution of the most interesting and rapidly growing branches of medical science; and if he is made of true stuff, that alone will repay him for much unrecognised and unrewarded labour. But the radiographic work of a large hospital is increasing by leaps and bounds. The bismuth meal examination alone has thrown an enormous increase of work on the already overtasked radiographer, and it is work, moreover, that cannot be relegated to a lay assistant—there is a lack of clinical assistants and nurses and students in the electrical department.
Article
L'A. distingue deux formes de realisme: le realisme des entites, le realisme des theories. Des deux, seul le realisme des entites peut etre considere comme une condition necessaire de l'experimentation dans les sciences de la nature. Apres un rappel de ce qu'il doit a Putnam, l'A. prend l'exemple de l'electron "PEGGY II" dont il reconstitue la genese, rappelant a ce sujet la theorie des courants neutres faibles. Il en tire une reflexion generale sur la "realisation" des "entites hypothetiques" et conclut en montrant que la preuve de la necessite du realisme des entites n'est pas la theorie mais l'ingenierie.
Article
TODAY physicians accept machines as a desirable part of medical practice and use them to care for patients throughout the United States. Such was not always the case. Medical technology has been widely used only since the early 20th century.1,2 Many turn-of-the-century machines found their way into the growing number of hospitals.3-5 Perhaps the machines that had the greatest impact were those that revealed parts of the human body previously hidden from view, such as the x-ray machine, or made visible otherwise imperceptible actions of the body, such as the electrocardiograph. This article examines how the x-ray machine became a part of routine patient care at the Pennsylvania Hospital, Philadelphia, between 1897 and 1927, and compares that process with the introduction of the electrocardiograph. It differs from most previous historical analysis of medical technology by focusing on how these instruments were actually used, not on how they were
Book
This book describes some of the technological advances made in the art and practice of medicine during the past four centuries, and shows how those advances altered the methods of diagnosing illness; and how new methods, in turn, have altered the relation between physician and patient and have influenced the systems of providing medical care and treatment. The book concludes that modern medicine has now evolved to a point where diagnostic judgements based on 'subjective' evidence - the patient's sensations and the physician's own observations of the patient - are being supplanted by judgements based on 'objective' evidence, provided by laboratory procedures and by mechanical and electronic devices. The book attempts to trace the historical development of how this happened, and, along with the resulting gains, points out the potential losses to the sick patient, to the physician as clinician, and to society. The development of some of the major technological advances of diagnosis is described - the microscope, the stethoscope, the thermometer, the increasing knowledge of bacteriology and biological chemistry, X-ray devices, electrocardiographs, and the most recent automated devices such as the computer. The reliability of the evidence thus produced is discussed, as well as the hazards involved in its unquestioning acceptance. The growing supremacy of technology in medicine is discussed and how it has led to the rise of the specialist and to the centering of medical care in hospitals; and thus to the decline of the general practitioner and an increasing alienation between doctor and patient. A large number and variety of factors influence medical care and the use of technology, some of them being philosophy and religion, economic and political systems, social and cultural values. This book does not seek to discuss the totality of the factors that are a part of the growth of medicine and technology. It focuses, mainly on the thoughts and actions of doctors and patients as they have responded to the availability of new diagnostic technology, and on the process by which a technical advance is accepted or rejected. The author has not attempted to discuss all the diagnostic methods that are a part of medical history. He examines a selected number of techniques, chosen for their importance in the evolution of diagnosis, and for their illumination of the themes of this book. His analysis is confined principally to developments in Great Britain and the United States, and, from the early twentieth century on, chiefly to those events that shaped American medical care.
Article
"Galison provides excellent histories of three experimental episodes: the measurement of the gyromagnetic ratio of the electron, the discovery of the mu meson, or muon, and the discovery of weak neutral currents. These studies of actual experiments will provide valuable material for both philosophers and historians of science and Galison's own thoughts on the nature of experiment are extremely important. . . . Galison has given both philosophers and historians much to think about. I strongly urge you to read this book."—Allan Franklin, British Journal of the Philosophy of Science "Anyone who is seriously concerned with understanding how research is done should read this. There have been many books on one or another part of its subject matter but few giving such insights into how the research is done and how the consensus of discovery is arrived at."—Frank Close, New Scientist "[Galison] is to be congratulated on producing a masterpiece in the field."—Michael Redhead, Synthese "How Experiments End is a major historical work on an exciting topic."—Andy Pickering, Isis
Article
In Reply.— Dr Dirckx is quite correct that technical developments were critically important in making the electrocardiograph clinically relevant.1-3 His last suggestion is an intriguing one. While the radiographer and the electrocardiographer were not the same person at the Pennsylvania Hospital, studies comparing the organization of radiology and electrocardiography departments in hospitals that did and did not combine the two roles would add a great deal to our understanding of early 20th century American hospitals.The preeminent position of The Johns Hopkins Hospitals has long been recognized by historians of medicine.4I am not surprised to hear that this institution purchased new instruments and adopted new forms before hospitals such as the Pennsylvania Hospital, a well-respected institution, but not one in the same class as Johns Hopkins. However, medical historians of recent decades have tried to move beyond chronicling priorities, a task primarily of interest for those chronicled.
Stereoroentgenography
  • Eijkman
Skiagraph of a Child
  • Rowland
Rowland, S. (1896) Skiagraph of a Child. Archives of Clinical Skiagraphy. I (1), 3-31.
Roentgendiagnosis in miliary tuberculosis
  • Dietz
Dietz, J.J.P. (1918) Roentgendiagnosis in miliary tuberculosis. Nedertands Tijdschrift voor Geneeskunde. I (1), 5 January 1918, 50-64.
Stereoroentgenography: Nederlands Tijdschrift voor Geneeskunde, I (11)
  • P H Eijkman
Eijkman, P.H. (1909) Stereoroentgenography: Nederlands Tijdschrift voor Geneeskunde, I (11), 13 March 1909, 853-8.
Rontgen rays and the diagnosis of internal diseases
  • Harteveld
Harteveld (1897) Rontgen rays and the diagnosis of internal diseases. Nedertands Tijdschrift voor Geneeskunde. I (7), 13 February 1897, 259-61.
The fixation of (visual) evidence Human Studies I. Special Issue on Representations. Archives of the Roentgen Ray Archives of the Roentgen Ray, The X-ray department xviii (7) December 1913, 245. Archives of Radiology and Electrotherapy The old order changes
  • K Amann
  • K Knorr-Cetina
Amann, K., Knorr-Cetina, K. (1988) The fixation of (visual) evidence. In Lynch, M., Woolgar, S. (eds) Human Studies I. Special Issue on Representations. Archives of the Roentgen Ray, iii (4), March 1899, 100. Archives of the Roentgen Ray, The X-ray department xviii (7) December 1913, 245. Archives of Radiology and Electrotherapy, xxiii (7), December 1918, 205. Barclay, A.E. (1949) The old order changes. British Journal of Radiology. 22, 300-8.
Practical Radiography (1896) Roentgen's X-rays
  • H S Ward
  • A W Isenthal
Ward, H.S., Isenthal, A.W. (1898) Practical Radiography, London. Werheim Salomonson, J.K.A. (1896) Roentgen's X-rays. Nederlands Tijdschrift voor Geneeskunde. 1.(7), 15 February 1896, 241-9.
The differences in the appearances of phthisical chests as shown before and after treatment
  • Knobel
Knobel, W.B. (1911) The differences in the appearances of phthisical chests as shown before and after treatment. British Medicat Journat. II, 14 October 1911, 910-3. The Lancet, Editorial 22 January 1859, 89.
Some of the uses of X rays in diagnosis and treatment
  • Metealf
Metealf, J. (1910) Some of the uses of X rays in diagnosis and treatment. British Medicat Journat. I, 19 February 1910, 432-4.
Radioscopy and radiography of the lungs
  • Stumpff
Stumpff, J.Ed. (1899) Radioscopy and radiography of the lungs. Nederlands Tijdschrift voor Geneeskunde. II (20), 11 November 1899, 954-63.
Roentgen treatment by laymen
  • Meyers
Meyers, F.S. (1910) Roentgen treatment by laymen. Nederlands Tijdschrift voor Geneeskunde. I (4), 22 January 1910, 258.
Pioneers and Early Years
  • E H Burrows
Burrows, E.H. (1986) Pioneers and Early Years, Alderney: Colophon Limited.
Les Vues de t'Esprit, Culture Technique
  • B Latour
  • Noblet
Latour, B., Noblet, J.de (eds) (1985) Les Vues de t'Esprit, Culture Technique, 14.
The X-ray department xviii
  • Archives Of The Roentgen
  • Ray
Archives of the Roentgen Ray, The X-ray department xviii (7) December 1913, 245. Archives of Radiology and Electrotherapy, xxiii (7), December 1918, 205.
A Manual of Practical X-ray Work, review. II
  • David British Medical Journal
  • John Arthur
  • Muir
British Medical Journal, David Arthur, John Muir, A Manual of Practical X-ray Work, review. II, 6 October 1917, 455.