This book presents the proceedings of an interdisciplinary international conference, held at Ulm University in 2010, which aimed to reflect philosophically on the multifaceted origins of medical images of the human body and their role in diagnosis. It is divided into four parts. In Part I, two papers elaborate on technical descriptions of the main technologies used to visualize the human body internalities, such as X-rays, magnetic resonance imaging (MRI), ultrasound and many others. They also set the tone for what is coming in the rest of the book by including some reflections on the role that images play as thinking tools and on their accuracy in representing the ‘reality’ of the body despite their virtual origins, a list of many putative pitfalls when interpreting images, and a call to radiologists and physicians for philosophical reflection on the worth of images in diagnosis. Critical in Part I are Chhem's reflection on whether medical imaging is an ‘“imaging” or an “imagining” process’ (p. 17), and Wang's remarks on the risks of easily falling prey to ‘virtualisation’, by failing to question the accuracy and veracity of its products (pp. 30–31).

In Part II, five chapters consider the status of images for ontology and scientific truth; the role of metaphors in this process; and, a key aspect of visual studies, the construction of representational chains of meaning. In Chapter 1, by comparing Leeuwenhoek's and Harvey's drawings, which were based on direct microscopical observations, with those from Ehrlich, which were based instead on pictorial (indirect) representations, Müller and Fangerau invite us to reflect on the key relationship between the explanatory function of the image (the image ‘as if’) and the image as empirical proof (the image ‘as it’) (p. 58). In Chapter 2, James A. Overton and Cesare Romagnoli introduce the reader to the concept of ‘domain ontologies’ (p. 61), a system of terminology used for the conceptualization and communication of images by the radiologist. In their view this is a concept that should serve to solve the three main problems facing modern radiology, namely the global scale at which images are displayed, ‘the sheer amount of information’ that they produce (p. 62), and the electronically based form of communication that takes place between patient and specialists and among specialists involved in diagnosis. In Chapter 3, Kirsten Brukamp starts by pondering whether the concept of consciousness can be captured by a scientific image. Although inclined to answer yes to the question, she argues, by presenting a case study of MRI data that highlights the complexities of the procedure, and especially its statistics, in support of the necessity of using philosophy to avoid drawing glib conclusions about a very complex and multifaceted theme.

In Chapter 4, Frédéric Gilbert, Lawrence Burns and Timothy M. Krahn explore the use and unintended significations of the ‘brain-reading metaphor’ (p. 83). They argue that the image-as-text metaphor is not a consequence of new technologies, but rather a long-standing theme in the history of medicine, with clear antecedents in the sixteenth-century anatomical work of Vesalius. On the question whether neuro-imaging is ‘seeing’ or ‘reading’ the brain, the authors favour the latter option because reading rather than seeing, they argue, relies on instrumentally derived data and requires interpretation. The authors' conclusion is that the metaphor possesses both positive and negative consequences. In the last chapter of Part II, by using Latour's concept of ‘circulatory references’ to explain the epistemological status and application of medical images, Fangerau and Robert Lindenberg ask us to visualize neuroscientists as active creators and not mere receptors of medical imagery. By transforming Bruno Latour's concept into several ‘reference steps diagrams’, they expose the fragilities of conceiving of digitally produced images as ‘real’.

In the opening chapter of Part III, Fabio Zampieri, Alberto Zanatta and Maurizio Rippa Bonati reveal the centrality of the iconography of wax models of smallpox as used by Luigi Sacco, an Italian physician and surgeon from the early nineteenth century, to support his medical epistemology, one that favoured empirical observation, experimentation and therapeutic intervention over theory (pp. 141–142). In the second chapter, Katsiaryna Laryionava discusses the reappropriation by artists of medical imagery, a reappropriation that, in her view, discloses the body as a transient and fluid entity which is constantly constructed and reconstructed by the viewer (p. 150). Richard Hoppe-Sailer, Rainer-M.E. Jacobi and Sarah Sandfort, in Chapter 3, call for a critical appraisal of medical images – this not only because the relation between image and object is highly problematic (uncertain iconicity), but also because ‘images, rather than the object (e.g., the human body), become sources for the concept of normativity’ (p. 158). Kathrin Friedrich in the last chapter of Part III explores the individual and the collective dimensions of image creation in medicine for diagnosis by using Ludwig Fleck's concept of ‘thought collective’ and Karl Polanyi's concept of tacit knowledge, respectively rebranded by the author as ‘seeing collective’ and as ‘visual tacit knowledge’. She concludes that ‘a sight style is not only constituted by collective aspects such as education or training, but also by individual skills’ (p. 175).

Part IV, just a single chapter, focuses on the ethical issues of medical imaging. Santiago Sia argues that it is necessary for the radiologist to view the patient as a subject rather than an object and espouses the need for an ethical education ‘to expose underlying theoretical assumptions and subject them to a critical evaluation to provide a warning system to potential problems in urgent cases’ (p. 190).

Taken as a whole, this is a compelling book. My compliments to the authors for achieving the difficult task of placing under a unifying narrative the diversity of themes (technical, scientific, cultural, historical and philosophical) involved in the production of medical images. Medical Imaging and Philosophy is recommended reading for radiologists, medical doctors and historians, as well as the general reader with an interest in the complex process of making medical imagery.