Skills through History

Abstract

Few historians would deny that skills are at the heart of modern medicine.Yet skill can prove troublesome to define.The content of what counts as a medical skill ranges widely across different dimensions of the body and self, as through places, disciplines and phases of history.From the physician's touch in physical examination to the discriminating eye of the histologist, from empathy in nursing to precision in surgery: all suppose and reproduce a skilled practitioner.Despite or perhaps because of their abundance, skills have appeared too easily as a self-evident feature of medical history.Their ubiquity and the wide spectrum of concepts they assimilate have obstructed efforts to historicise them, or to explore the wider implications of their transience.Impossible to deny and yet notoriously hard to define, skills in medical history are everywhere and nowhere at once, persistent through its sources and yet rare as organising principles of its scholarship. 1 The object of this volume is to address that asymmetry, and begin unsettling the self-evidence of skills by drawing them into critical focus.This brief introduction sets out to foreground existing work in the history of medical and scientific skill, and to emphasise the richness of the topic.Our claim, however, is not that skills have been absent in medical historiography.On the contrary, they arise again and again, and often in ways that are consistent with the perspective advocated here.Historians have asked how the evaluation of skills was closely bound up with professional aims, for instance, or how new diagnostic methods invented and relied on new skills. 2They have described how skills were transmitted through pedagogical practices 3 and how medical specialisation was connected (or not) to the proliferation of medical skillsets. 4Despite these efforts, the category of skill itself is still easily taken for granted.A closer examination promises to cast light on the varied and refined practices that skills include, and to strengthen the connections of medical history to other fields, such as the history of observation, objectivity, emotions and the senses.Although the focus of this special issue will be on the last two centuries, work on skill is of course not restricted to this period.Obvious fields for examining its history are surgery and anatomy, both of which underwent regime changes in the Middle Ages and 1 Lorraine Daston, 'On Scientific Observation ', Isis, 99, 1 (2008), 97-110. 2 Malcolm Nicolson, 'The introduction of percussion and stethoscopy to early nineteenth-century Edinburgh', in William F.

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