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Abstract.
This essay analyses the development of the Carrel-Dakin treatment for infected wounds during the First World War to explore the relationship between industrialized warfare and experimental medicine, the politics of standardization, and the relationship between the theories and practices of physiology and scientific management. It first describes the intellectual and institutional context from which Alexis Carrel's wound research emerged: experimental medicine and the Rockefeller Institute for Medical Research. Next the story moves to the experimental laboratory hospital on the Western Front and the quantification of wounds. Then it considers the propaganda and training campaign in support of the method at the War Demonstration Hospital located on the institute's New York City campus. The de-skilling inherent in the standardization of surgical practice was a response to the incompetence of inexperienced military surgeons, but also an attempt to restructure the medical profession into a hierarchical organization capable of being administered by elite scientist-physicians. Underlying the narrative is the paradox of simultaneous segregation of the biological and the social through laboratory practices and their conflation through the organic analogy.
The human body is placed, on the scale of magnitudes, halfway between the atom and the star.
Alexis Carrel1
At the 'War Session' of the 1917 Clinical Congress of Surgeons of North America, Sir Berkeley Moynihan, chairman of the British Army Medical Advisory Boards, linked the agricultural fecundity of French soil to the problem of infected wounds: 'it is impossible to exaggerate the intimacy of the contact between the soldier and the soil on which he is fighting'. The Journal of the American Medical Association (JAMA) report of Moynihan's paper continued,
Flanders is probably the most highly cultivated region in all of France, the soil having been fertilized and refertilized for many years, with the result that the mud is of a particular bacterial malignancy. All the kinds of infection that occur in gunshot wounds are those which come from the fecal bacteria found in this soil, the streptococcus and bacillus of Welch being the most frequent.2
Embedded in this assessment was much of the tragic irony of the Great War: the technical precision of bacterial identification and the sloppy violence of malignant mud, fertility exploding into death, the horror of war in a civilized land. The...