Melling Joseph
Centre for Medical History, University of Exeter.
Bull Hist Med. 2010 Fall;84(3):424-66. doi: 10.1353/bhm.2010.0006.
The history of silicosis provides an important chapter in the history of occupational and environmental health. Recent historical scholarship has drawn attention to the importance of patient attitudes, popular protests, and compensation claims in the formation of a "lay epidemiology" of such a disease, frequently challenging the scientific orthodoxies devised by large corporations and medical specialists. Surprisingly little research has been undertaken on the United Kingdom, which provided much of the early expertise and medical research in respiratory diseases among industrial workers. This article examines the introduction of a particular technique, x-radiography, and its use by radiologists and others in debates on the causes and consequences of silica inhalation by the laboring population in Britain during the early decades of the twentieth century. In contrast to some recent interpretations, and also to the narrative of progress that practitioner historians have developed since the 1940s, this article suggests that the use of this technology was contested for much of this period and the interpretation of X-rays remained disputed and uncertain into the 1950s. The article also questions recent accounts of lay epidemiology as an adequate model for understanding the progress of such innovations in medical history.
矽肺病的历史在职业与环境卫生史上占据着重要篇章。近期的历史学术研究已使人们注意到患者态度、民众抗议以及赔偿诉求在形成此类疾病“外行流行病学”过程中的重要性，这常常对大公司和医学专家所制定的科学正统观念构成挑战。令人惊讶的是，针对英国的相关研究极少，而英国在早期为产业工人的呼吸系统疾病提供了大量专业知识和医学研究。本文考察了一种特定技术——X射线照相术的引入，以及20世纪初几十年间放射科医生和其他人在关于英国劳动人口吸入二氧化硅的原因及后果的辩论中对该技术的使用。与一些近期的解读以及自20世纪40年代以来从业历史学家所构建的进步叙事不同，本文表明在这一时期的大部分时间里，这项技术的使用存在争议，并且对X射线的解读在20世纪50年代之前仍存在争议且不确定。本文还对近期将外行流行病学视为理解医学史上此类创新进展的充分模式的观点提出质疑。
