The experience of sickness, its diagnosis and treatment has been dramatically transformed over the last century. Many, if not all, of these changes involve technological developments that have enabled the body of the sick to be evaluated in new and different ways and that have permitted the caregiver to intervene in the illness experience in an unprecedented manner, with not always predictable outcomes. In their thoughtful introduction to this excellent new collection of essays on the history of medicine and its technologies, editors Carsten Timmerman and Julie Anderson concede that the significant role of technology in medical care has not exactly been neglected by historians of medicine, science and technology. Nonetheless, the field, as evidenced by the contributors to this book, has expanded and developed; it has become more international and more methodologically diverse.

Devices and Designs includes essays that focus on a broad spectrum of medical technologies and associated topics, including orthopaedic techniques, the X-ray, the laboratory analysis of body fluids, the artificial eye and the prosthetic hip, the medical linear accelerator, the cardiac pacemaker, the social organization of medical research (especially the clinical trial), and the pharmaceutical industry and its impact on germs, patients and providers in the treatment of infection and the control of hypertension. In addition, several authors concentrate on the conceptual features of the careers of certain medical technologies: evaluations of efficacy, assessments of risk and benefit and the understanding and deployment of evidence in making recommendations about the use of such controversial technologies as hormone replacement therapy, breast cancer screening and cochlear implants.

In an especially illuminating essay, Neil Handley, the curator of the British Optical Association Museum and College of Optometrists in London, analyses what he calls the ‘artificialization’ of the human face by the use of ‘false eyes’. These eyes, unlike false teeth, did not initially serve a physical function; they were used to conceal a defect and to normalize the appearance of someone who had lost an eye through disease or injury. Given their cosmetic function, it is perhaps unsurprising that physicians and surgeons left the provision and sale of these devices to opticians, even though the placement and care of artificial eyes had health implications for the recipients.

In his trenchant essay on the post-Second World War career of a drug for the treatment of hypertension, Carsten Timmerman looks at how technologies shaped the diagnosis of high blood pressure and its treatment with a new class of drugs in post-war Britain. Timmerman emphasizes how the Medical Research Council successfully recruited pharmaceutical companies to a more active role in drug development for the management of hypertension, and how the careers of these drugs continued to coexist with extra-drug management, including the hospital beds used to compensate for the sudden lowering of the blood pressure produced by the drug. Julie Anderson offers a superb essay on hip replacement, drawing on her research with John Pickstone on the history of disability and its treatment. (Pickstone also has a provocative essay here on the long history of a medical technology.) Anderson explores some of the challenges in the larger environment in which a medical technology must adapt in order to succeed as a viable treatment option for patients and practitioners. In the case of hip replacement, one of the challenges to the efficacy of the device was the condition of the operating theatre and the quality of air flow, which had major implications for the rates of post-operative infection after the replacement surgery. Adaptations, as Anderson illustrates, can take many different forms – further evidence of the role of historical contingency in the success and failure of medical technologies.

In all, this volume is an excellent introduction to current historical approaches and subjects in the continuing interaction of medicine and technology.