'Identities ascertained': British ophthalmology in the first half of the nineteenth century.

Abstract

The paper takes its cue from the work on specialization and American ophthalmology by George Rosen (1944). Where Rosen's account was inspired by sociology, this paper gives a non-teleological account of medical specialization through a cultural history of ophthalmology. The cultural nature of the ophthalmic epidemics motivated practitioners to study the eye in earnest. These practitioners had to surmount obstacles intrinsic to the medical culture: the division between physicians and surgeons, hostility to specialisms, and the association with quackery. Practitioners justified their interests through the management of history, the association with philanthropy, and the construction of a father-figure. New interest in the eye was partly legitimated by the use of existing discourses, both philosophical and religious, that offered practitioners motivating languages to describe their practice. Specialization was effected through varying combinations of elements: emotional and intellectual investment in the eye, the advocacy of further research, and the explicit prosecution of specialties. The process depended upon generalist enthusiasm for the eye, and specialists' championing of generalist medicine. Specialization is a continual cultural process in a constant balancing act with the generalist tendency in medicine.