Dwyer-Hemmings Louis
Med Hist. 2018 Apr;62(2):217-241. doi: 10.1017/mdh.2018.5.
Histories of twentieth-century surgery have focused on surgical 'firsts' - dramatic tales of revolutionary procedures. The history of tonsillectomy is less glamorous, but more widespread, representing the experience and understanding of medicine for hundreds of children, parents and surgeons daily. At the start of the twentieth century, tonsillectomy was routine - performed on at least 80 000 schoolchildren each year in Britain. However, by the 1980s, public and professional discourse condemned the operation as a 'dangerous fad'. This profound shift in the medical, political and social position of tonsillectomy rested upon several factors: changes in the organisation of medical institutions and national health care; changes in medical technologies and the criteria by which they are judged; the political, cultural and economic context of Britain; and the social role of the patient. Tonsillectomy was not a mere passive subject of external influences, but became a potent concept in medical, political, and social discourse. Therefore, it reciprocally influenced these discourses and subsequently the development of twentieth-century British medicine. These complex interactions between 'medical' and 'non-medical' spheres question the possibility of demarcating what is internal from what is external to medicine.
二十世纪外科手术史聚焦于外科手术的“首例”——那些革命性手术的传奇故事。扁桃体切除术的历史虽不那么引人注目，却更为普遍，它代表着数百名儿童、家长以及外科医生每天的医疗经历与认知。在二十世纪初，扁桃体切除术是常规手术——在英国，每年至少有8万名学童接受该手术。然而，到了二十世纪八十年代，公众和专业人士的讨论将该手术谴责为一种“危险的时尚”。扁桃体切除术在医学、政治和社会地位上的这一深刻转变基于多个因素：医疗机构和国家医疗保健组织的变化；医疗技术及其评判标准的变化；英国的政治、文化和经济背景；以及患者的社会角色。扁桃体切除术并非仅仅是外部影响的被动接受者，而是在医学、政治和社会讨论中成为了一个有力的概念。因此，它反过来影响了这些讨论，进而影响了二十世纪英国医学的发展。“医学”与“非医学”领域之间的这些复杂互动对区分医学内部和外部事物的可能性提出了质疑。
