J. Lachmund, BETWEEN SCRUTINY AND TREATMENT - PHYSICAL DIAGNOSIS AND THE RESTRUCTURING OF 19TH-CENTURY MEDICAL-PRACTICE, Sociology of health & illness, 20(6), 1998, pp. 779-801
This article is a historical-sociological account of the rise of physi
cal diagnosis (auscultation and percussion) in 19th century medicine.
It focuses on the spread of physical diagnosis, from the near exclusiv
e confines of the hospital to the broader realm of medical practice. I
n particular, it sheds light on the relationship between diagnosis and
treatment which turned out to play a most crucial role in the eventua
l success of physical diagnosis. On the one hand, critics argued that
physical diagnosis lacked any practical value and that its introductio
n into medical practice would not contribute to the treatment of the p
atient. 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 diagno
stic scrutiny. The article also sheds light on the negotiation between
physicians and patients which took place during the introduction of p
hysical diagnosis into private practice. In the last part of the artic
le, it will be argued that the success of physical diagnosis was close
ly related to the coproduction of a new form of professional expertise
in 19th century medicine.