Olszynko-Gryn Jesse
Department of History and Philosophy of Science, University of Cambridge, Free School Lane, Cambridge CB2 3RH, UK.
Stud Hist Philos Biol Biomed Sci. 2014 Sep;47 Pt B:233-47. doi: 10.1016/j.shpsc.2013.12.002. Epub 2014 Jan 1.
The Aschheim-Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the 'heroic age' of reproductive endocrinology. Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim-Zondek test launched a 'modern era' of obstetric knowledge, which asserted its superiority over that of pregnant women. This article reconsiders Oakley's claim by examining how pregnancy testing worked in practice. It explains the British adoption of the test in terms less of the medicalisation of pregnancy than of clinicians' increasing general reliance on laboratory services for differential diagnosis. Crucially, the Aschheim-Zondek reaction was a test not directly for the fetus, but for placental tissue. It was used, less as a yes-or-no test for ordinary pregnancy, than as a versatile diagnostic tool for the early detection of malignant tumours and hormonal deficiencies believed to cause miscarriage. This test was as much a product of oncology and the little-explored world of laboratory services as of reproductive medicine.
阿施海姆-宗德克反应通常被视为首个可靠的妊娠激素检测方法，也是生殖内分泌学“英雄时代”的一项主要成果。该反应于20世纪20年代末在柏林发明，到20世纪30年代中期，爱丁堡的一家诊断实验室每年为英国各地的医生进行数千次检测。社会学家安·奥克利在其关于产前护理的经典历史著作中称，阿施海姆-宗德克检测开启了产科知识的“现代时代”，并宣称其优于孕妇自身的感知。本文通过审视妊娠检测在实际中的运作方式，重新考量了奥克利的这一说法。文章认为，英国采用该检测方法，与其说是将妊娠医学化，不如说是临床医生在鉴别诊断中越来越普遍地依赖实验室服务。至关重要的是，阿施海姆-宗德克反应并非直接检测胎儿，而是检测胎盘组织。它与其说是普通妊娠的“是与否”检测，不如说是一种多功能诊断工具，用于早期发现被认为会导致流产的恶性肿瘤和激素缺乏。这项检测既是生殖医学的产物，也是肿瘤学以及鲜为人知的实验室服务领域的产物。
