Bodies 5: Physiology and

function

History of Medicine 1, lecture 18, 23 October 2014 Steve Sturdy

The growth of laboratories
• Before the mid-C19, medical knowledge was mostly
produced by medical practitioners working:
• at “the bedside”, in the course of their observation and
treatment of patients
• in the dissecting room – studying the dead body in order
to understand how it works in life, in health and illness
• Over the course of the C19, we see the emergence of a
separate occupation of medical scientist
• paid to teach and conduct research
• working in laboratories
• conducting experimental research – usually on animals,
understood to models of humans
Physiology: the queen of the nineteenth-
century medical sciences
• Physiology displaces anatomy as the science of how living bodies function
• Applying approaches and technologies from the physical and chemical sciences
• approaching the living body as if it were a machine
• vivisection as a way of dismantling the body and analysing its working parts
• e.g. 1849 Hermann von Helmholtz uses a galvanometer to measure the speed of
electrical conduction in isolated frog nerves
The physiology laboratory as a site of
technological control
• Experimental physiology employs increasingly
sophisticated technologies to investigate animal
function
A university physiology laboratory c. 1912

Ludwig kymograph
William Bayliss in his home laboratory c. 1890
Experimental physiology applied to humans
• Research in experimental physiology also yields new
techniques and instruments for examining patients

Sphygmograph c. 1860
Étienne-Jules Marey (1830-1904)
Ergograph, 1884
Angelo Mosso (1846–1910)
Electrocardiogram 1908
Augustus Waller (1856-1922)
Physiology and medicine
• Initially, it is unclear that this approach to the human
body has anything to offer to medicine
• a source of interesting research
• but adds little to the techniques that doctors
already have for investigating and treating their
patients
Physiology and the human machine
• This approach starts to find applications with the
study of industrial fatigue
• First World War: efficient use of labour power in
munitions factories is crucial to the war effort
• study of fatigue provides a basis for regulating
working hours for maximum efficiency – 8 hr day
• study of energy
expenditure as a basis
for determining what
constitutes an adequate
diet and a living wage
• i.e. treating the body as
part of the industrial
machinery
Physiology and the industrial body
• This link between physiology and industry is not an accident
• it reflects an underlying commonality in thinking about
the human body and industrial society
• cf. earlier periods – the humoral body, the religious body
• Experimental physiology applies engineering technologies
to the body – and conceives of the body using technological
metaphors
• muscles as engines turning fuel into movement
• nerves as telephone system connecting the parts – brain
as exchange, more recently computer
• “physiological division of labour”
The laboratory as knowledge factory
• The physiology laboratory itself increasingly
resembles an industrial workplace

The Harvard physiology

laboratory c. 1884
The chemical body
• Meanwhile, physiology is undergoing further division of labour
into new disciplines
• biochemistry
• endocrinology
• molecular biology
• Similarly, pathology likewise spawns bacteriology and
immunology
• Several of these subdisciplines seek to understand the body as
a chemical system
• leading to new active medical products
• many of which lend themselves to industrial production
• industrial and academic laboratories converge
The Wellcome Physiological
Research Laboratories c. 1920
Organotherapy
• Research in experimental physiology in the mid-19th
century suggest that various organs produce “internal
secretions” that mediate normal function
• Speculation that some illnesses may be due to
insufficiency of secretions provokes an interest in
“organotherapy”
• Edouard Brown-Séquard promoting testicular extract
1889
• George Murray treating myxoedema with thyroid
extract 1891
• Pharma companies also develop and sell organ extracts
Hormones
• Further research leads to purification of a growing number of
hormones from the early 20th century
• 1901 Jokichi Takamine purifies adrenalin from the adrenal
glands of sheep and oxen – manufactured by Parke, Davis & Co.
• Frederick Banting and Charles Best isolate insulin 1922 –
manufactured by Eli Lilley
• administration involves monitoring blood sugar
• Cortisone, an adrenal hormone, first identified as an effective anti-
inflammatory hormone in 1929
• development and patenting of semi-synthetic production
methods in 1950s leads to wide range of steroid drugs
• Sex hormones and birth control pill 1960s
Vaccines and anti-toxins
• Early bacteriological research includes development of prophylactic and
therapeutic vaccines
• Pasteur: anthrax vaccine for livestock 1881
• Roux and Pasteur: rabies vaccine 1883
• Behring and Kitasato: diphtheria antitoxin 1892 – produced by
infecting horses and bleeding them for serum – successfully
commercialised
• Industry develops new vaccines sporadically through the first half of the
20th century
• e.g. inactivated polio vaccine 1955, oral vaccine 1961
• Recombinant DNA technology from the 1970s provides new means of
creating vaccines
• e.g. HPV, the first “blockbuster” vaccine
The search for magic bullets
• Paul Ehrlich, bacteriologist and microscopist who had
worked with Koch in Berlin
• Interested in the use of synthetic dyes to selectively stain
bacteria
• reasons that other, more toxic chemicals might also
selectively target bacteria, killing disease germs without
killing their hosts – “magic bullets”
• Screens hundreds of newly-synthesised chemicals for
selective toxicity against syphilis
• discovers Salvarsan (compound 606) in 1909
• patented and produced by Hoechst, a dye manufacturer
moving into medicines (now part of Sanofi)
The growth of chemotherapeutics
• Ehrlich’s screening methods become standard in
pharmaceutical innovation
• Sulfonamides identified and developed in 1930s
• like Salvarsan, starts from work on dyes that
selectively stain bacteria
• first sulfa drug developed and patented by Bayer –
followed by many similar compounds
• Penicillin first produced in Britain 1941
• effective against wound infections and syphilis – i.e.
particularly valuable in wartime
• quickly followed by search for other antibiotics
The chemotherapeutic revolution
• Post-war period sees massive growth in the
pharmaceutical industry
• Large research investment, both public and private,
leads to a rapidly expanding range of new chemical
products
• psychopharmaceuticals from the 1950s
• cancer chemotherapies from 1960s
Adopting the sphygmomanometer
• No obvious clinical value in the late C19
• Early C20: limited clinical use to monitor blood
pressure during brain surgery
• i.e. in a context of technical control of the body,
similar to a vivisection laboratory
• From the 1920s, growing recognition that high blood
pressure correlates with risk of early death
• begins to be adopted into life
insurance examinations as a
means to identify bad risks
• from there, moves into healthcare
• from 1960s, blood pressure drugs
become available – now a huge
market
Science and mass healthcare
• Sphygmomanometric surveillance of blood pressure is
about identifying statistical risk
• observed and managed in populations, not individuals
• Research into new medicines is expensive
• but worthwhile if the products reach a large market
• especially if the costs of expensive medicines are
shared through public or private insurance
• i.e. laboratory approaches to the body and its medical
management have developed in ways that are intimately
aligned with the development of industrialised mass
healthcare