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)

That there was a ‘Bacteriological Revolution’ in medicine in the late nineteenth-century, associated with the development of germ theories of disease, is widely assumed by historians; however, the notion has not been defined, discussed or defended. In this article a characterisation is offered in terms of four linked rapid and radical changes: a series of discoveries of the specific causal agents of infectious diseases and the introduction of Koch’s Postulates; a reductionist and contagionist turn in medical knowledge and practice; greater (...) authority for experimental laboratory methods in medicine; the introduction and success of immunological products. These features are then tested against developments in four important but previously neglected diseases: syphilis, leprosy, gonorrhoea and rabies. From these case-studies I conclude that the case for a Bacteriological Revolution in late nineteenth-century medicine in Britain remains unproven. I suggest that historians have read into the 1880s changes that occurred over a much longer period, and that while there were significant shifts in ideas and practices over the decade, the balance of continuities and changes was quite uneven across medicine. My argument is only for Britain; in other countries the rate and extent of change may have been different. (shrink)