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drill operated by rotary motion" (1985, 76). A topological approach would ideally preserve this multiplicity of meanings. |
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To record information properly about a given disease at a given time, everything about the social, economic, personal, and physical conditions of the patient can be relevant (some will recognize this as a version of Spinoza's problem). The encyclopedic vision so common in information sciences envisions a preemptive, or open-ended capture of the information attributes of any object. For epidemiology, this would ideally mean that patient information would be captured at the lowest descriptive level (atomic units). In future years, the data so collected could be remined as advances in medical knowledge reconfigure the attributes. For example, the discovery of a new disease could be read backwards into existing data, and entities unknown at the time of data collection could be read out of the data. In practice, as the above examples show, the infinite possible ontologies of objects is limited by the pragmatics of data collection and by the inescapable inertia of categories already in use. |
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The expanding wave of information gathering practices is a defining characteristic of the modern state, as Foucault (1991) observes. To produce and maintain standardized medical records, state bureaucrats needed to create a uniform set of data-gathering and encoding practices. Without these practices, standardization could not be achieved. These standards entailed a range of governmental activities, including accustoming citizens to the regular collection of information about ever more detailed aspects of their personal lives. Standards also meant enforcing a standardized set of procedures. |
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These practices, and the standardized information thus generated, meant that information could be rendered comparable across situations. In turn, the development of a professional class that could use the information garnered was fostered (see Abbott 1988 for the medical profession as archetypal modern profession). This process appeared indefinitely expansive. |
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As the general level of sanitation improved during the nineteenth century in industrializing countries, doctors needed ever finer classification systems to discriminate these infrastructural effects from other disease agents. At least in the western world, more people were living to an age when they died more complex deaths. Infant mortality, appendicitis, or malnutrition no longer killed them in such great numbers at earlier ages. This is the story from within the history of medicine. But by the same token, as the modern state developed its |
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