ArgumentIt is well known that the development of a diphtheria anti-toxin serum evolved in a competitive race between two groups of researchers, one affiliated with Emil Behring in Berlin and Marburg, and another affiliated with Émile Roux in Paris. Proceeding on the basis of different theoretical assumptions and experimental practices, the two groups developed a therapeutic serum almost simultaneously. But the standardized substance they developed took on very different forms in the two countries. In Germany the new serum was marketed (...) in the private sphere and subjected to state regulations, becoming a kind of prototype of industrial medications. In France, however, the same substance was marketed as a gift of science to humanity and distributed through the communal health care system. This article demonstrates how a new medication emerged from the efforts to produce, market, regulate, distribute, and apply it in the two respective countries. It attributes the difference to the negotiations between the respective actors (scientists, industrialists, politicians, officers, and the public) and institutions (firms, academies, private and public institutes, legislative bodies, professional corporations). I develop this argument on three different levels: First, I stress the importance of the institutional foundations of serum production; second, I illustrate the decisive role played by existing “ways of regulating” in the rapid development of new legal statutes; and third, I describe the consequences that flowed from the respective administrative organization of marketing and dissemination. In sum, I explore how an experimental object was transformed into an object of the public health system and stabilized by administrative means. (shrink)

In this paper, I enquire whether there are Kuhnian paradigms in medicine, by way of analysing a case study from the history of medicine—the discovery of the germ theory of disease in the nineteenth century. I investigate the Kuhnian aspects of this event by comparing the work of the famous school of microbiology founded by Robert Koch with a rival school, powerful in the nineteenth century, but now almost forgotten, founded by Carl Nageli. Through my case study, I show that (...) medical science possesses some Kuhnian features. Within each school, scientists used similar exemplars and shared the same assumptions. Moreover, their research was resistant to novelty, and the results of one party were disregarded by the other. In other words, in a moderate sense, the Koch and Nageli groups worked within distinct paradigms. However, I reject the stronger Kuhnian claim that the terms used within the two paradigms were mutually unintelligible. Focusing on the semantic aspects, I argue that no account of incommensurability of reference can be given in this case, although, for sociological reasons, the two parties talked past each other. I suggest in addition that the rival scientists could have understood each other more easily if their theoretical commitments had not been so deeply ingrained, and I use the example of Pasteur to indicate that the causal account of meaning might have avoided the communication breakdown. (shrink)