The political economy of scientific medicine: science, education and the transformation of medical practice in Sheffield, 1890-1922.

INTRODUCTION One of the most striking developments in twentieth-century medicine has been the growing involvement of laboratory science in day-to-day medical practice. Not only are scientific laboratories employed extensively in the diagnosis and investigation of illness, but it is now commonplace to regard doctors as, in many ways, applied scientists. This is a far cry from the situation at the end of the nineteenth century, when few hospitals had more than rudimentary laboratory facilities, and few clinicians made more than cursory use of them. At that time, laboratories were just starting to play a part in the practice ofmedicine. Microscopic techniques had begun to be incorporated into post-mortem examinations from the mid-nineteenth century. And with the proliferation ofnew bacteriological techniques from the 1 880s, diagnostic laboratories came to be used routinely, first in public health work, and subsequently in hospitals. ' Gradually, a minority of clinicians also began to undertake their own research in hospital laboratories, and by the 1920s a few university teaching hospitals were providing full-time scientists with clinical facilities for the purposes of research, teaching and healing.2 From these beginnings, medical practice came increasingly to revolve around the work of laboratories, both as technical resources for the routine