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Page 83
With these processes of convergence, the site of the medical work itself has gained in importance. The classification of tuberculosis, canonically difficult to diagnose accurately (see chapter 5; and compare Latour, forthcoming) retains the story of what has been done in the laboratory as well as what has occurred in the body. (In chapter 4 we discuss the intersection of these different forms of time.)
A15Respiratory tuberculosis, bacteriologically and histologically confirmed
A15.0Tuberculosis of lung, confirmed by sputum microscopy with or without culture
Tuberculous,
bronchiectasis}
fibrosis of lung}
pneumonia}confirmed by sputum microscopy with or
}without culture
pneumothorax}
A15.1Tuberculosis of lung, confirmed by culture only
Conditions listed in A15.0, confirmed by culture only
A15.2Tuberculosis of lung, confirmed histologically
Conditions listed in A15.0, confirmed histologically
A15.3Tuberculosis of lung, confirmed by unspecified means
Conditions listed in A15.0, confirmed but unspecified whether bacteriologically or histologically
(ICD-10, 1: 113)

In this case, the disease itself is always classified in terms of the work that has been done in the medical laboratory. Again, as new technologies are invented, historical shifts occur, as seen with the relationship between epilepsy and the EEG machine as diagnostic many decades ago.
The doctors themselves enter the story at the moment of classification, while the patient rarely does. This comes out clearly if we compare migraine and epilepsy in ICD-9. Epilepsy is a condition that is defined by the doctor in the context of laboratory and so is a real condition:
345Epilepsy
The following fifth-digit subclassification is for use with categories 345.0, .1, .4.9:
0without mention of intractable epilepsy
1with intractable epilepsy
(ICD-9CM, 80)

 
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