How Personalized Medicine Became Genetic, and Racial: Werner Kalow and the Formations of Pharmacogenetics

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2012-12-25 20:44Z by Steven

How Personalized Medicine Became Genetic, and Racial: Werner Kalow and the Formations of Pharmacogenetics

Journal of the History of Medicine and Allied Sciences
Volume 68, Number 1, January 2013
pages 1-48
DOI: 10.1093/jhmas/jrr046

David S. Jones, A. Bernard Ackerman Professor of the Culture of Medicine
Harvard University

Physicians have long puzzled over a well-known phenomenon: different patients respond differently to the same treatment. Although many explanations exist, pharmacogenetics has now captured the medical imagination. While this might seem part of the broader interest in all things genetic, the early history of pharmacogenetics reveals the specific factors that contributed to the emergence of genetics within pharmacology. This paper examines the work of one pioneering pharmacologist, Werner Kalow, to trace the evolving intellectual formations of pharmacogenetics and, in particular, the focus on race. Working in the 1950s and 1960s, Kalow made three arguments to demonstrate the relevance of genetics to pharmacology, based on laboratory techniques, analogies to differences between other animal species, and appeals to the logic of natural selection. After contributing to the emergence of the field, Kalow maintained his advocacy for pharmacogenetics for four decades, collecting more evidence for its relevance, navigating controversies about race and science, and balancing genetics against other possible explanations of patient variability. Kalow’s work demonstrates the deep roots of the genetic and racial preoccupations in pharmacology. Understanding this history can restore attention to other explanations of individuality in medical practice, something of increasing importance given the current interest in personalized medicine.

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Spirometry, Measurement, and Race in the Nineteenth Century

Posted in Articles, Health/Medicine/Genetics, History, Media Archive on 2012-10-27 21:43Z by Steven

Spirometry, Measurement, and Race in the Nineteenth Century

Journal of the History of Medicine and Allied Sciences
Volume 60, Number 2, April 2005
pages 135-169

Lundy Braun, Royce Family Professor in Teaching Excellence and Professor of Medical Science and Africana Studies
Brown University

Race correction is a common practice in contemporary pulmonary medicine that involves mathematical adjustment of lung capacity measurements in populations designated as “black” using standards derived largely from populations designated as “white.” This article traces the history of the racialization and gendering of spirometry through an examination of the ideas and practices related to lung capacity measurements that circulated between Britain and the United States in the nineteenth century. Lung capacity was first conceptualized as a discrete entity of potential use in the diagnosis of pulmonary disease and monitoring of the vitality of the armed forces and other public servants in spirometric studies conducted in mid-nineteenth-century Britain. The spirometer was then imported to the United States and used to measure the capacity of the lungs in a large study of black and white soldiers in the Union Army sponsored by the U.S. Sanitary Commission at the end of the Civil War. Despite contrary findings and contestation by leading black intellectuals, the notion of mean differences between racial groups in the capacity of the lungs became deeply entrenched in the popular and scientific imagination in the nineteenth century, leaving unexamined both the racial categories deployed to organize data and the conditions of life that shape lung function.

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A Question of Blood, Race, and Politics

Posted in Anthropology, Articles, Health/Medicine/Genetics, Media Archive, Politics/Public Policy, United States on 2010-03-05 01:50Z by Steven

A Question of Blood, Race, and Politics

Journal of the History of Medicine and Allied Sciences
Volume 61, Number 4 (2006)
pages 456-491
DOI: 10.1093/jhmas/jrl003

Michael G. Kenny, Professor of Sociology and Anthropology
Simon Fraser University, Burnaby, British Columbia

This article explores the political and intellectual context of a controversy arising from a proposal made at the 1959 meetings of the American Society of Blood Banks to divide the blood supply by race. The authors, a group of blood-bankers and surgeons in New York, outlined difficulties in finding compatible blood for transfusion during open-heart surgery, which they attributed to prior sensitization of their patient, a Caucasian, by a previous transfusion from an African American donor. Examining the statistical distribution of blood-group antigens among the various races, they concluded that risk of adverse hemolytic reactions and the cost of testing could be reduced by establishing separate donor pools. The media reported the suggestion, which, given the political climate of the day, rapidly became a public issue involving geneticists, blood-bankers, physical anthropologists, and the African American medical community. Liberals condemned it, whereas eugenically inclined segregationists used the finding to support their views concerning evolutionary distance between the races and the dangers of miscegenation. Here we examine the contribution of comparative racial serology to this affair, the arguments and background of the main players, and the relevance of the debate to discussions about the role of “race” in post-genomic medicine.

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