Pioneers and early years. A history of British radiology

E. H. BURROWS, Pioneers and early years. A history ofBritish radiology, Alderney, Colophon, 1986, 4to, pp. viii, 264, illus., £32.50. E. H. Burrows sets out to describe the history of diagnostic radiology from its birth in the late-nineteenth century to 1930. He begins by documenting the discovery of X-rays and its British reception. Outlining the early history of British experimentation on X-rays, Burrows goes on to chronicle the establishment of hospital X-ray departments and the professional structure of radiology-journals, diplomas, and so on. He concludes with descriptions of the use of X-rays in war, and a history of radiation injury and protection. The text is pitted with short biographies of major radiologists and others associated with X-rays, which unhappily interrupt the narrative. (It would have been easier to read if they had been marshalled together as an appendix.) However, Burrows has uncovered a wealth of useful information on the early history of British radiology. Unfortunately, Burrows' discussion is flawed by the lack of an explanatory framework. He is unfamiliar with the literature on the medical division of labour. His story flows onward, seemingly interrupted only by technical difficulties easily or quickly resolved. But even his own narrative later hints that the difficulties might have been more than technical. For instance, he quotes the Liverpool radiologist, Thurstan Holland, who stated that deplorably few teaching hospitals accepted radiologists as full members of staff. However, the preceding discussion on the formation of radiological departments in teaching hospitals provides no indication of this. Again, Burrows quotes Holland to show that radiologists wanted to exclude other doctors and radiographers from the interpretation of X-ray images. However, the earlier narrative gives no hint of any local discussion on the matter. Burrows never makes his criteria clear for deciding what contributes to the birth and growth of clinical radiology. What forces moulded the discipline? Central to his discussion is the emergence of a self-styled specialist elite of medical radiologists, but Burrows largely accepts their own account. Sadly, a number of other voices are lost. Burrows generally echoes the radiologists' own claims that they provided the best interpretation of X-ray images. This was a common claim, but is largely unsubstantiated. There is ample evidence to show that other medical practitioners were happy enough to interpret their own plates, films, or screens, or even rely on the lay radiographer's interpretation. Were these practitioners wrong? How do we decide where the legitimate claims of radiologists ended and their professional aspirations began? How do we determine who should have been excluded from interpretation of radiographic images when what counted as expertise in this field was defined by radiologists as an incommunicable "art"? These are not questions of determining the sincerity of radiologists, but are ones of historical methodology. What significance should be attached to texts? Of course radiologists claimed to be better than their competitors, but how are we to assess this claim? Disappointingly, Burrows does not escape the mire of contemporary rhetoric, and the mud sticks.