This volume is functionally contradictive in its methodological manifestations and its objects of inquiry. The editors acknowledge this immediately, and these disagreements are to the reader's benefit because in differently defining their objects each chapter attempts to tease out a new facet of interaction between people and technology. Divided into three different broadly conceived sections regarding epochs and transitions, laboratories and clinics, and finally technology and bodies, the different scales of inquiry allow their chapters to overlap, intersect and contradict one another.
The first section takes as its object the construction of nature and culture dichotomies, and engages with the deployment of time as a unit of analysis. Rheinberger begins by discussing the change in molecular biological practice since the introduction of recombinant DNA, which allows the reading, writing and replication of DNA. This technology ushers in a transition in practice and understanding and, he argues, collapses the traditional ontological distinction between nature and culture because what we consider the natural order of our genetic structure can be rewritten into a literal social construct. Juxtaposed, Rabinow takes issue with the entire notion of an epoch or transition and the similarly absolutizing categories of culture, events and civilization. His argument is for a more refined nominalism to understand emergent forms and generate new understandings.
Material culture is extremely important to any anthropological endeavour and the second section attends to this. Mol's discussion – the best in the section – in particular describes how one disease, atherosclerosis, is performed differently by clinicians and laboratories resulting in multiple linked understandings. For the clinician and patient articulate it together through description and location of symptoms, whereas the pathologist sees it – under a microscope – as the thickened intima, calcification and loss of lumen in the vascular wall. For Löwy, the technology is randomized control trials and the influence of AIDS activists in getting desperate patients into AZT trials, arguing that they exposed the social relations of power inherent in a specific biomedical technology. Keating and Cambrosio turn their combined attention to the constantly active creation of diagnostic technologies and the politics of pathologists and clinicians in trying to establish universal diagnostic criteria for lymphomas and leukaemia. Finally, a plethora of biomedically unauthorized conditions like Gulf War Syndrome, Chronic Fatigue Syndrome and Satanic Ritual Abuse have been described as psychogenic manifestations of hysteria and Young disagrees, positing that they merely resemble one another, especially in aetiological origins.
The last section attempts to understand bodily intersections. Lock discusses her well known work with the historical and social contingencies of organ transplantation in Japan, where acceptance is extremely contentious and only partially recognized. Das then elaborates by analysing the networks and practices of the ‘transplant world’ using a Foucauldian genealogical approach to get at the creation of this world and the highly specialized fields of medicine, law and technology that articulate to create it. Kaufert, deriving some analysis from Foucault as well, examines the screening of women's bodies through pap smear and mammogram and how the benevolent reasoning behind the monitoring does not engender the proposed benefits in women, instead creating uncertainty in their bodies located in the dynamically symbolic generative areas of breasts and vaginas. Dumit's task is the circulation of explanations and brain imaging science as temporary and local for explaining socio-medical disorders. Young's chapter critiquing Showalter engaged with many of the same disorders providing another intersection. Finally one of the standout chapters is Rapp's study of the intersection of medicalization, race science, technological sampling, doubled discourses and imagined communities surrounding Down Syndrome. She pays particular attention to the interpretations of this condition as they are enacted, altered, refuted and passed on between the medical domain and the lived world of parents with Down Syndrome children. Earlier ideas of these individuals as being closer to animals or inferior races dominate the literature her informants were given.
This volume's strength lies in its multiple understandings of scientific objects and practices. The authors often disagree, but all provide detailed and nuanced accounts of how new medical technologies are not always those just derived, but those now forced, incorporated and present in people's lives. It is interrogatory of the different styles of reasoning embedded in technological practice and knowledge production and as such has use for interested readers of philosophy and medicine, medical anthropology and science studies. It is still, a decade after publication, relevant to continuing concerns, reflecting the continuing lack of agreement in epistemology, but approaches that nonetheless, articulate new knowledge.
