Review Essay The Technology of Medicine*
J. T. H. CONNOR
The history of medical technology is a subject that is more broad than deep (see J. T. H. Connor, The Artifacts and Technology of the Health Sciences: A Bibliographic Guide to Historical Sources [London, Ontario, 19871). Works such as Stanley Reiser's Medicine and the Reign of Technology (Cambridge, 1978) and Audrey Davis' Medicine and its Technology: A n Introduction to the History of Medical Instrumentation (Westport, 1981) stand out as seminal studies which provide a framework for the historical interpretation of medical technology. More typical of the field is the annotated catalogue, a publication which consists of numerous listings of medical instruments usually accompanied by a brief technical description and perhaps an illustration of the object in question.
* Antique Dental Instruments, by Elisabeth Bennion. London: Sotheby's Publications, 1986. 192 p., ill., $45.00 (US). The Finest Instruments Ever Made: A Bibliography of Medical, Dental, Optical and Pharmaceutical Company Trade Literature: 1700-1939, by Audrey B. Davis and Mark S. Dreyfuss. Arlington, MA: Medical History Publishing Associates I, 1986.448 p., ill.,
$45.00 (US). Nineteenth Centuy Surgical Instruments: A Catalogueof the Gustav Weber Colllectionat the Howard Dittrick Museum of Historical Medicine, by James M. Edmonson. Cleveland, OH: Cleveland Health Sciences Library, 1986. 69 p., ill., $20.00 (US). No Laughing Matter: Historical Aspects of Anaesthesia, by Christopher Lawrence and Ghislaine Lawrence. London: Wellcome Institute for the History of MedicinelScience Museum, 1987. 84 p., ill., £4.75. The Mechanics of Surgey (1899), by Charles Truax. San Francisco: Norman Publishing, 1988. 1024 p., ill., $145.00 (US). Antique Medical Instruments, by C. Keith Wilbur. West Chester, PA: Schiffer Publishing, 1987. 149 p., ill., $16.99.
J. T. H. Connor, Medical Museum and Archives, University Hospital, Department of History of Medicine and Science, The University of Western Ontario, London, Ontario. CBMH 1 BCHM / Volume 6: 1989 / p. 67-70
J. T. H. CONNOR
Catalogues may be encyclopedic in nature and cover a range of instruments and devices, or conversely may focus on a specificinstrument or specialty. Generally speaking, the six books of this review essay may be classifiedin the genre of the catalogue, although they vary considerably in their plan. Perhaps the most intriguing is C. Keith Wilbur's Antique Medical Instruments, which consists of hundreds of accurately drawn annotated illustrations of all manner of medical equipment including microscopes, stethoscopes, blood pressure instruments, electrocardiographs, specula, thermometers, forceps, bloodletting instruments, and surgical equipment. One example of an instrument should serve to capture the book's overall approach. Under the heading of nasal specula, Wilbur traces the development of this device from 1800 to 1961 and includes sketches of no fewer than 79 examples arranged and identified chronologically. From this array the reader not only becomes acquainted with the development of the nasal speculum, but also is provided with a first-class identification chart. Complementing the body of Antique Medical Instruments is a fairly current price guide (in US dollars) of historical medical equipment. This book also includes a list of major American medical, dental, and apoothecary museums. Although Antique Medical Instruments is useful and satisfactory, too frequently the accompanying discussion is marred by folksy writing and many, many spelling errors (the text is a product of the author's calligraphic hand, and is not typeset). Much more lavish is Elisabeth Bennion's Antique Dental Instruments, one of the few comprehensive treatises about the history of dentistry. With its numerous halftone and color illustrations, accompanied by informative, copious, and readable discussion, this work is indeed less a catalogue and more a monograph. After providing some background on the "place of the tooth in life and folklore," Bennion devotes individual chapters to extracting instruments, excavating instruments and filling materials, artificial teeth, anaesthesia equipment, dental mirrors and scalers, and items associated with oral hygiene. As in her earlier work (Antique Medical Instruments [London, 1979]), this book concludes with a directory of British, European, and American instrument makers, as well as a chronology of some of the main contributors to dentistry during the period 936 to the later nineteenth century. For those readers who wish to learn of the development of dentistry through the theme of its technology, this work is second to none. Discussion of medical technology and catalogues naturally raises the issue of the role of medical museums; not surprisingly therefore, the remaining four monographs all have connections with major museological institutions. Christopher and Ghislaine Lawrence's No Laughing Matter: Historical Aspects of Anaesthesia is the exhibition catalogue of a series of exhibits
mounted by London's Wellcome Institute during the summer of 1987. Owing to its origins, this work is highly thematic and its structure parallels the 15 cases or exhibits on which it was based. However, the inclusion of annotated illustrations of most of the major artifacts or graphics enables readers to "attend" this significant exhibition. Moreover, each catalogue section (corresponding to a specific exhibit case) is introduced with a fairly comprehensive historical overview of the particular theme or era, thereby adequately conveying the evolu: tion of anesthetic methodology and technology. In adopting this approach the authors have produced a hybrid document that is muselogically sound, aesthetically pleasing, and informative. Of equally high quality and value is James M. Edmonson's Nineteenth Centuy Surgical Instruments, which is a catalogue that documents a specific collection, rather than an exhibition. Based on the instruments owned and used by Dr. Gustav Weber, who is described as the "single most powerful figure in Cleveland medicine" during the latter half of the nineteenth century, this monograph not only documents the range of surgical and some medical devices available to practitioners, but also is testimony to their craftsmanship. Like the Lawrences' work, this book successfully brings together museology and historical scholarship in its detailed artifactual descriptions and background contextual information. Also of note is Edmonson's useful bibliography of primary sources, which is arranged thematically according to specific instruments. Edmonson, who is Curator of Cleveland's Howard Dittrick Museum of Historical Medicine, was also instrumental in making available a valuable work long out of print: Charles Truax's The Mechanics of Surgey , first published in 1899. This remarkable 1,000-page volume was actually a comprehensive trade catalogue produced by the major Chicago-based medical and surgical supply house founded and operated by Charles Truax. As such it discusses almost every instrument, device, article of furniture, and accessory that was available to clinicians during the late nineteenth century. Augmenting these many descriptions are beautifully clear engravings depicting most of the items identified. The net result of this fascinating work therefore is a reference text of immense worth to historians of medicine, medical museologists, and amateur collectors alike; its crisp prose also makes it a readable book. Special mention should be made of Edmonson's introduction to this facsimile reprint, for in addition to putting Truax and his company in historical context, it also places study of surgical instruments on a level not previously attained. The final work to be discussed will also prove to be of tremendous value to historians and amateur and professional collectors. In The Finest Instruments Ever Made, Audrey Davis (of the Smithsonian Institution) and Mark Dreyfuss (a former colleague of Davis) have managed
J. T. H. CONNOR
to compile a reference tour de force that has been fifteen years in the making. Essentially this work is a catalogue of catalogues in which the great majority of medical and related trade literature produced during the nineteenth century and up to 1939 has been classified, and its various locations identified. The compilers have emphasized American repositories, but Australian, British, Canadian, and private holdings have also been surveyed, resulting in a truly comprehensive reference guide to English-language instrument catalogues. In addition to its breadth, this work is of great use owing to its arrangement, for entries are alphabeticallygrouped first, according to manufacturer, and second by institutions and their catalogue holdings. Users of this bibliography will find the first category of particular worth because of its informative citation format which includes pertinent historical material concerning the development and evolution of individual instrument companies. Similarly, the introductory remarks of Davis and Dreyfuss orient readers to the field of medical trade literature and offer additional information on the history of the major companies, as well as discussing selected examples of medical technology. Clearly, these recent works on aspects of medical technology support the view that the subject of medical and related instruments is worthy of study. Together they illustrate the scope of the field as well as helping scholars to understand it, but collectively they do not probe to its heart. The real isue, therefore, is not whether this aspect of material culture should be studied; rather it is perhaps how should we study it? As noted, few comprehensive, historical analyses of the role, function, and impact of medical technology exist-more such synthetic works are needed. It seems reasonable to suggest that active clinicians, probably in collaboration with professional historians, might be the best equipped to undertake such a task. As it is a blend of art and science, medicine is therefore a craft; thus its craftspeople may most understand the operational requirements, mechanisms, drawbacks and advantages of medical technology.