Science and Medicine 207Despite such reservations at home, the French infl uence spread rapidly
to the major medical centers of Europe and across the Atlantic to North
America. Laboratories, institutes, societies, and journals dedicated to exper-
imental medicine, especially physiology, appeared in its wake. In Germany
in 1842 several physicians launched the Archiv für physiolo gische Heilkunde
to help build a scientifi c basis for medicine, declaring that “now is the time
to establish a positive science from the existing material of experience, [a
science] that does not seek to ground itself in the authorities but rather
in the empirical evidence which allows phenomena to be understood,
and which also avoids the illusions of praxis and will lead to a deliberate,
certain therapy.”^27 By promoting the experimental method, such activi-
ties, in the words of one German, “fi rst raised medicine to a science.”^28
British physicians, in contrast to their French and German brethren,
initially displayed little affection for making medicine scientifi c. Even
though the fl edgling British Association for the Advancement of Science
created a section on “medical science” in the 1830s, it failed to thrive,
largely because leading medical men declined to participate.^29 As the his-
torian Gerald L. Geison observed, it was not until the early 1870s, when
the Royal College of Surgeons began requiring familiarity with laboratory
physiology of all candidates for membership and the University of London
began requiring it for medical students, that the tide began to turn.^30
Among historians of medicine Geison took the lead in stressing “the
separation between medical science and medical practice before about
1870” and, consequently, the practical vacuity of all the talk about sci-
ence. In his view, experimental science left virtually no imprint on medical
practice before Joseph Lister used Louis Pasteur’s insights to develop anti-
septic surgery in the late 1860s, and even then elite physicians promoted
science more for professional than practical reasons.^31 Arleen Tuchman,
however, has challenged this view. While not denying that science did
little to improve therapy before the last third of the century, she points to
the many important developments in diagnostic technique before then.
Even prior to the appearance of the germ theory, nineteenth- century phy-
sicians could diagnose specifi c diseases such as Bright disease and Addison
disease; demonstrate that the “fevers” of the eighteenth century were ac-
tually distinct diseases such as malaria, typhus, and typhoid; see and often
remove internal tumors in their early stages; and identify in general early
warning signs of oncoming illnesses. To a large extent, they had acquired
this knowledge through the techniques of auscultation, percussion, mi-
croscopy, and chemical analysis, aided by the use of such instruments as
the ophthalmoscope, kymograph, laryngoscope, urometer, thermometer,
and pleximeter.^32