The voluntary impulse: philanthropy in modern Britain

physiologist's adherence to Pestalozzi's educational theories of "hands-on" experience, and his practical application of those concepts to higher scientific education. The University ofHeidelberg and the efforts there of Carl Pfeufer and Jacob Henle are placed by Tuchman against the background of liberal reforms initiated by the government of Baden, its utilitarian demands of the new educational system being exemplified by Henle's "rational" medicine with its emphasis on the acquisition of scientific knowledge and practical experience. In Leipzig, the similar belief, that a commanding lead in scientific knowledge was an essential component of state political and economic strength, was influential in allowing Carl Ludwig to establish his world-famous Institute. Equally important, according to Lenoir's assessment, was Ludwig's perception of the experimental laboratory as a vital constituent of clinical experience. This connection between physiology and medical practice, as indicated in the book's sub-title, is addressed more explicitly by Lesch in his essay on the Paris Academy of Medicine and Experimental Science from 1820 to 1848. He provides a detailed case-study of the debates about the fatality of accidentally introduced air in the pleural cavity and in venous blood, in which physiological experiments were performed to resolve clinical disputes about surgical procedures. A different experimental departure, the active encouragement of collaboration between practitioners with different skills and outlooks, is detailed in Holmes's analysis of the Munich School of Metabolism. This group, although based in the Institute of Physiology, was not conterminous with it and here there is another shift in scale, as the technical and conceptual developments of the research school that grew around Justus Liebig, Theodor Bischoff, and Carl Voit are assessed. These papers emphasize in different degrees the increasing reliance on specialized instrumentation, whether it be the kymograph, the microscope, or Pettenkofer's purpose-built metabolic chamber in Munich. This aspect is more specifically developed in Frank's chapter on cardiovascular physiology and recording techniques in the laboratory and in the clinic. Starting with Marey's sphygmograph and ending with Einthoven's string galvanometer, this paper cuts across the institutional framework chosen by the other contributors, and offers a broad view of the synergism between basic research and clinical diagnosis in the use and development of investigative techniques. It also charts the rise of the new breed of clinical scientist, represented by Thomas Lewis, thus neatly encapsulating the two main themes of the book-the rise of experimental physiology in the nineteenth century and its applicability to medical practice.