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Ideal Places: Laboratory and Clinic in the History of Medicine
| A recurring concern among British and North American historians of medicine over the past thirty years or so has been to document and explain tensions between laboratory scientists and clinicians over the role of science in medical practice. Continental European historians often profess themselves baffled by this preoccupation. In this paper, I will explore some of the reasons for this Anglo-American emphasis on inter-professional conflict. I will look, first, at the persistence among doctors and philosophers of medicine of rhetorical appeals to “art” and “science” as different but often complementary ways of reinforcing medical authority. Secondly, I will discuss the growth of a sociologically-informed historiography of science that stresses the specificity and distinctness of local cultures of knowledge and practice and the conflicts and controversies that often arise between the inhabitants of different cultures. I will argue that much Anglo-American writing on laboratory-clinic relations has tended to take the rhetoric of art and science too much at face value, seeing it as a guide to the realities of scientific and medical culture rather than a resource used flexibly in particular situations for particular purposes. In consequence, I will suggest, historians have tended to adopt idealised accounts of laboratory and clinical culture, and to reinforce these idealisations by dwelling excessively on such instances of conflict as did sometimes arise between the proponents of particular scientific and clinical cultures.
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