Jens Lachmund

Making Sense of Sound: Auscultation and Lung Sound Codification in Nineteenth-Century French and German Medicine

With the introduction of the technique of auscultation in nineteenth-century medicine, the auditory became a most important means of producing diagnostic knowledge. The correct classification and interpretation of the sounds revealed by auscultation, however, remained an issue of negotiation and often controversy throughout the mid-nineteenth century. This article examines the codification of lung sounds within two cultural and geographic contexts: first, the original approach as it was developed by Laennec and his followers in Paris that came to be dominant in French medicine, and second, the alternative approach that grew out of Joseph Skoda’s reception of Laennec’s method in Vienna and became widely adopted in the German-speaking world. On one hand, it will be argued that lung sound classifications attempted a standardization of the perception and the interpretation of auscultation sounds. On the other hand, it will be shown that the development of auscultation sounds was shaped by the local context in which it took place. This article seeks to shed light on the way in which auditory experiences were instrumentalized for epistemic purposes in medicine. Furthermore, it discusses the role of standardization both as a mechanism for the universalization of knowledge and as a contextually bounded practice.

Introduction: Toward an Urban History of Science

This essay calls for an urban history of science that unites the history of science and urban history. Focusing on the nineteenth and twentieth centuries, it emphasizes the active role cities play in shaping both scientific practice and scientific knowledge. Furthermore, the essay argues that cities themselves have to be viewed-at least partially-as mediated by science. Four interconnections of science and the city are discussed: the relationship between scientific expertise and urban politics, sciences role in the cultural representation of the city, the embedment of scientific activity in the social and material infrastructure of the city, and the interaction between science and urban everyday life.

Between scrutiny and treatment : physical diagnosis and the restructuring of 19th century medical practice

This article is a historical-sociological account of the rise of physical diagnosis (auscultation and percussion) in 19th century medicine. It focuses on the spread of physical diagnosis, from the near exclusive confines of the hospital to the broader realm of medical practice. In particular, it sheds light on the relationship between diagnosis and treatment which turned out to play a most crucial role in the eventual success of physical diagnosis. On the one hand, critics argued that physical diagnosis lacked any practical value and that its introduction into medical practice would not contribute to the treatment of the patient. On the other hand, proponents of physical diagnosis maintained that medical treatment would benefit from better diagnostic knowledge and that the physician’s actions should be based on systematic diagnostic scrutiny. The article also sheds light on the negotiation between physicians and patients which took place during the introduction of physical diagnosis into private practice. In the last part of the article, it will be argued that the success of physical diagnosis was closely related to the co-production of a new form of professional expertise in 19th century medicine.

Wiebe Bijker and Trevor Pinch: Der sozialkonstruktivistische Ansatz in der Technikforschung

Der unter dem Namen Social Construction of Technology oder kurz „SCOT“ bekannt gewordene Ansatz wurde in den 1980er und fruhen 1990er Jahren gemeinsam von dem britischen Soziologien Trevor Pinch und dem niederlandischen Technikforscher Wiebe Bijker entwickelt. In Absetzung von den bis dahin dominierenden internalistisch-technikhistorischen oder innovationsokonomisch orientierten Arbeiten zur Technikentwicklung, pladierten die beiden Autoren fur eine kontextualistische Betrachtungsweise, die technische Artefakte sowohl als Erzeugnisse wie als Erzeuger kontingenter sozialer Handlungs- und Deutungszusammenhange interpretiert. Kennzeichnend fur diesen Ansatz war ein Analysestil der detaillierte, meist historische, Fallstudien exemplarischer technischer Artefakte, mit der Entwicklung allgemeiner theoretischer Kategorien verband. Durch die Kumulation und vergleichende Kontrastierung solcher Fallstudien sollten nicht nur Einsichten in die soziale und politische Dynamik technischer Innovationsprozesse gewinnon werden, sondern ein auch angemesseneres Verstandnis entwickelter Gesellschaften als „technologischer Kulturen“ (Bijker 1995: 288). Das Kapitel beschreibt und diskutiert die Entwicklung des SCOT-Ansatzes von seiner ersten Formulierung durch Bijker und Pinch im Jahre 1987 bis hin zu seiner Weiterentwicklung in einer Reihe technikspezifischer Fallstudien.