John V. Pickstone

Ways of knowing: towards a historical sociology of science, technology and medicine

Among the many groups of scholars whose work now illuminates science, technology and medicine (STM), historians, it seems to me, have a key responsibility not just to elucidate change but to establish and explain variety. One of the big pictures we need is a model of the varieties of STM over time; one which does not presume the timeless existence of disciplines, or the distinctions between science, technology and medicine; a model which is both synchronic and diachronic, and both cognitive and social. To that end, this brief paper presents a historical typology of STM from about 1700 to the present by focusing on four ‘ideal’ socio-cognitive types – four knowledge structures which correspond to four sets of social relations. To some extent these are period specific, but they do not have to be – hence, one may hope, the flexibility and usefulness of the model.

A Brief Introduction to Ways of Knowing and Ways of Working

The five invited papers in this collection both use and test the Ways of Knowing approach for a range of topics which spans from chemistry around 1800 to molecular biology now, and from classical bacteriology to classifications used in cancer hospitals. I have added two sections. At the end of the volume, I reflect on the papers, and then extend the discussion to further aspects of the WoK method and its potential uses. But additionally, in this Introduction, I have tried to summarize my general approach in the hope that the volume can be used more easily by readers who are new to the WoK project. To a first approximation, I here summarize material presented in my book of 2000/1 and my Isis paper of 2007; I have tried to simplify as much as possible, leaving the elaborations and qualifications to the Afterwords. The basic idea of the WoK approach is that the multiple configurations of knowledge and working practices seen in the general area of science, technology and medicine (STM), both now and across time, can be analysed as ‘compounds’ — as made up of ‘elementary’ ways of knowing and working. I have tried to characterize several ‘elementary’ types of ways of knowing (WoK) and of ways of working (WoW). I have further suggested, in 2007, that each WoK is associated with a WoW, and that each of the pairs might be also be seen as constituting a type of ‘working knowledge’; but in most of this presentation I will use WoKs and WoWs separately. These WoKs and WoWs are seen as developing, cumulating, and ‘nesting’, over time; the later ones involve the earlier, but the earlier may continue independently, as we shall see. To avoid a common misunderstanding, I stress here that WoKs and WoWs are used like elements in modern chemistry and not as taxonomic boxes into which instances of STM are to be placed, or forced. In that respect my approach differs notably (though not completely) from the listings of styles as given by Alistair Crombie and Ian Hacking — which are usually read as taxonomic. Hacking, it is true suggests that his styles can be combined, though he did not pursue this aspect. But if, by contrast, one looks for types of knowing and working which are interwoven in various ways, then the combinatorial possibilities are enormous. And since the analysis of complex cognitive and social configurations can be pursued to any level of detail, the method is not reductive in the usual objectionable senses. Hopefully indeed, the subtleties evident in the best recent historical and sociological analyses of STM can be modelled in ways which do justice to the cases, but which are also sufficiently systematic to facilitate multiple comparisons — including the transfer of historiographical findings between different fields of HSTM. Since these elements are ideal types and, like Weber’s ‘bureaucracy’, are more-or-less scale

The Manchester heritage

The wider historical and scientific context of the development of computing at the University of Manchester, focusing on the relationship between the University and industry, is described. The role of the National Archive for the History of Computing in preserving this heritage is discussed.<<ETX>>

The rule of ignorance: a polemic on medicine, English health service policy, and history

A good health service needs evidence based policy making as well as evidence based medicine, says John Pickstone

On knowing, acting, and the location of technoscience: A response to Barry Barnes

First, many thanks to Barry for his comments and for the critical questions, which I found helpful in explaining and reaning the arguments launched in my book. I also beneated from other papers and discussion at the conference, and refer to some of the points in this revised version of my response to Barry. With the main thrust of Barry’s argument, I agree: the current interest in the history of technoscience, variously deaned, is to be explained in part by the present positions and perspectives of historians and sociologists of science, technology and medicine (of STM, for short). My own approach, exempliaed in my Ways of Knowing book (Pickstone 2000), is certainly conditioned by my having worked from the mid 70s as a historian of medicine, interested in medical practice (which could be called technology, though it wasn’t) as well as “medical science” (which is an actor’s term—with many meanings). It also derives from my historical research on the STM of the industrial revolution, especially on Manchester, where actors’ science-technology distinctions were historically weak, and where our historical research interests usually ran across S T and M; and from my current interests in recent medicine, including its industrialisation. To these historical interests and orientations, one might add a long-standing interest in historical sociology of STM, and an informal political concern with the governance and ideologies of recent medicine and of the academe. With this background, and having run a Centre of the History of Science, Technology and Medicine (CHSTM) in Manchester University, I wanted to explore, on a grand scale, whether it was possible to write the histories of non-medical sciences and technologies in ways which undoubtedly work for the history of medicine, past and present.

Natural History, Analysis and Experimentation: Three Afterwords

My fellow authors in the present volume are colleagues who have long taken an interest in the WoK project and have helped in various ways. They have here explored the utility of the WoK approach for the topics and themes on which they are expert. In the three Afterwords which follow I first comment on the five essays — not to cover all the points raised, but rather to reflect on the main messages for the common concerns of this volume. In the second Afterword I take up some questions of nomenclature which relate to the essays and more generally to the use of the WoK approach, focusing on the meanings of ‘natural history’, ‘analysis’ and ‘experiment’, as terms used by actors and also as I have used them in my work on WoKs. I am particularly concerned with ‘experimental’ and with its antonyms, especially in the nineteenth century. In the third Afterword I focus on the ways in which my modes of analysis are related to other forms of analysis in the historiography of STM; and I end by discussing how analytical categories may be related to actors’ categories — so that analytical schemes such as mine can also represent the multiple perceptions of different actors.

What is Past is Present

Writing this book has been an adventure in many ways, from the initial proposal conceived with David Cantor on the basis of his research on arthritis, to the work with Francis and the extension into museum projects at the Royal College of Surgeons, London, and at Wrightington Hospital. We did not expect to include as much as we have on patients — that came largely from Julie’s interests in disability and cultural history; nor that we would look so much to America, which came from our shared realisation that the UK story only made sense in a transatlantic context. We have ventured into many new areas, and we have lots of questions still outstanding. But in this conclusion we first quickly survey the histories in the UK and the US, and we then draw together some of the lessons we have learned so far.

The Changing Nature of Patients: Expectations and Information

Throughout the day there were more preliminaries. Sister Holmes came and gave me a knowledgeable, motherly talk about the operation. She was followed by one of the nurses I’d seen in the morning, a nice girl who talked to me animatedly. She said something about the prosthesis — ‘Haven’t you seen one?’ she asked. ‘Haven’t they ever shown you one?’ ‘No,’ I said. I didn’t know that I should have been able to look at it, if they had shown me one. ‘It looks like a pork chop,’ she said…From what I’d imagined, I could see that was what it might well look like. Like a pork chop.1

Hips, Health Services and Quality

So far in this book we have discussed surgeons, engineers and companies, and in the next chapter we will discuss patients. Much of this present chapter will be about governments. We will look at the health services of the UK and the US, and the different ways in which THRs existed in those systems. We then turn to discuss issues of quality regulations, from the industrial standards which applied to the materials of hips, through questions of professional assessments, to national registers of hips inserted, or the lack thereof.

Total Hip Replacement: Introduction, Sources and Outline

On May 9 1933, an article in The Times headed ‘Railway Engineer’s Suicide’, reported that a 57-year old man had shot himself ‘while of unsound mind.’ As the Coroner explained, (He was) Suffering from profound depression caused by physical disability arising from a chronic disease of the hip-joint, which disabled him, which was getting worse, and of which there was no hope of a cure.1