Archives
Understanding ulcers: Medical knowledge social construction constructionism and Helicobacter Pylori
Fran Collyer
Department of Sociology & Social Policy, University of Sydney, NSW
Abstract
The study of historical change in the content of medical knowledge in regard to specific illnesses or diseases provides sociologists with the opportunity to investigate both social processes and social theory. In this study of medical knowledge, propositions from the social constructionist school of sociology are utilised to highlight the way new knowledge about ulcers is generated, and to identify the cultural and social factors which inhibit the dissemination of new knowledge. The paper then explores recent challenges to this school of thought, using the case study of ulcers to suggest that there are limits to social constructionism and its capacity to explain change in medical knowledge and practice.
References
Alper, J. with Spalding, BJ. (1985) 'A Bacterium That May Cause Ulcers' Chemical
Week 136 (4) Jan. 23. pp. 17-8.
Andersen, LP. & Nielsen, H. (1993) 'Peptic Ulcer - An Infectious Disease' Annals of
Medicine 25 (6) Dec. pp. 563-68.
Baume, P. (1991) A Question of Balance: Report on the Future of Drug Evaluation in
Australia Australian Government Printing Service, Australia.
Bijker, WE. (1995) 'Sociohistorical Technology Studies' in Jasanoff, S; Markle, GE;
Petersen, JC. & Pinch, T. (eds) Handbook of Science and Technology Studies London,
The Society for Social Studies of Science and Sage.
Bishop, JE. (1995) 'Lasker Award Goes To The Man Who Found Peptic Ulcer's Cause'
Wall Street journal (eastern edition) Sept. 26, p B6.
Bliss, M. (1982) The Discovery of Insulin Faber and Faber, London and Boston.
Bode, G; Malfertheiner, P. & Ditshuneit, H. (1987) 'Invasion of Campylobacter-Like
Organisms in the Duodenal Mucosa in Patients With Active Duodenal Ulcer' Klin
Wochenschr Feb. 2, 65 (3), pp. 144-6.
Boyd, EJS; Wilson, JA; Wormsley, KG. (1984) 'Recurrent Ulcer Disease' in Misiesicz, JJ.
& Wood, JR. (eds). Ranitidine: Therapeutic Advances Amsterdam, Excerpta Medica,
pp. 14-42.
Bowden, G. (1995) 'Coming of Age in STS' in Jasanoff, S; Markle, GE; Petersen, JC. &
Pinch, T. (eds). Handbook of Science and Technology Studies London, Sage, pp. 64-
79.
Bradford Hill, A. (1965) 'Environment and Disease: Association or Causation' Proc R
Soc Med 58, pp. 295-300.
Braithwaite, J. (1984) Corporate Crime in the Pharmaceutical Industry Routledge and
Kegan Paul, London and Boston.
Brody, H. (1980) Placebos and the Philosophy of Medicine: Clinical, Conceptual and
Ethical Issues Chicago, Chicago University Press.
Business Week (1982) 'A Rival That May Give SmithKline A Pain' 2766-97, Nov. 22,
pp.31.
Bury, MR. (1986) 'Social Constructionism and the Development of Medical Sociology'
Sociology of Health and Illness 8 (2) pp. 137-69.
Callon, M. (1986) 'Some Elements of a Sociology of Translation' in Law, J. (ed). Power,
Action and Belief: A New Sociology of Knowledge? Sociology Review Monograph
London, Routledge and Kegan Paul. pp.196-229.
Callon, M. (1995) 'Four Models For The Dynamics of Science' in Jasanoff, S; Markle,
GE; Petersen, JC. & Pinch, T. (eds) Handbook of Science and Technology Studies
London, The Society for Social Studies of Science and Sage.
Castiglione, F; Daniele, B; Pignata, S. et al (1993) 'Treatment of Duodenal Ulcers - An
Update' European Journal of Gastroenterology and Hepatology 5 (suppl. 2) Oct. pp.
S89-91.
Collyer, FM. (1993) The Fabrication of Sex, Sound and Sleep: A Sociological Study of
the Development of Technology in Australian Health Care PhD thesis, Department of
Sociology, The Flinders University of South Australia.
Collyer, FM. (1995) Medical Invention: Actors, Networks and Social Structure Paper
presented at the Australian Sociological Association Annual Conference, 4-8th
December, University of Newcastle, NSW, pp. 1-8.
Collyer, FM. (1996) 'Medical Technology' in Grbich, C. (ed). Health In Australia:
Sociological Concepts and Issues Sydney, Prentice Hall.
Cozzens, S. & Woodhouse, E. (1995) 'Science, Government, and the Politics of
Knowledge' in Jasanoff, S; Markle, GE; Petersen, JC. & Pinch, T. (eds). Handbook of
Science and Technology Studies London, Sage, pp. 533-53.
Daily Telegraph Mirror 'Ulcer Victims Denied Cure' Sept. 18, 1995.
Decross, AJ. & Marshall, BJ. (1993) 'The Role of Helicobacter-Pylori In Acid-Peptic
Disease' American Journal of the Medical Sciences 306 (6) Dec. pp. 381-92.
Doyal, L. & Pennell, I. (1983) The Political Economy of Health Pluto Press, London.
Dunbar, HF. (1938) Emotions and Bodily Changes New York, Columbia University
Press.
The Economist 'Zantac Threatens To Give Tagamet Ulcers' 288, Aug. 27, 1983,
pp.61-2.
The Economist 'Do Bugs Cause Ulcers?' 300, Sept. 20, 1986, pp. 100.
The Economist 'Glaxo: Ulcers On The Brain' 304, Aug. 1, 1987, pp. 80-1.
The Economist 'Glaxo's New Drugs: Not a Panacea' 317, Dec. 15, 1990, pp. 69-70.
The Economist 'Glaxo's Migraine Drug: Mystifying Headaches' 318, Mar. 2, 1991, pp.
88-89.
The Economist 'The Ethics of Marketing Drugs: The World According to Ernest' 319,
April 6, 1991, pp. 70.
The Economist 'Rumpus At Glaxo' 326, Mar. 13, 1993, pp. 75.
The Economist 'Ulcer Freedom Fighters' 330, Mar. 5, 1994, pp. 91-2.
Edwards, J. (1992) 'Metaphor in Medical Theories About Cancer' paper presented at
the Australian Sociological Association Annual Conference, 10-13 Dec. Adelaide.
Figlio, K. (1982) 'How Does Illness Mediate Social Relations?' in Wright, P. &
Treacher, A. (eds). The Problem of Medical Knowledge: Examining The Social
Construction of Medicine Edinburgh, Edinburgh University Press, pp. 174-224.
Forman, D; Debacker, G; Elder, J. et al. (1993) 'Epidemiology of, and Risk Factors for,
Helicobacter Pylori Infection Among 3194 Asymptomatic Subjects in 17 Populations'
Gut 34 (12) Dec. pp. 1672-76.
Freud, S. (1924) Collected Papers London, Hogarth Press.
Freidson, E. 0970) Profession of Medicine: A Study of the Sociology of Applied
Knowledge Chicago, University of Chicago Press.
Goldberg, EM. with Kanter, V. (1958) Family Influences and Psychosomatic Illness: An
Inquiry Into The Social and Psychological Background of Duodenal Ulcer London,
Tavistock Publications.
Goldberg, J. (1988) Anatomy of a Scientific Discovery: The Race to Discover The
Secret of Human Pain and Pleasure Transworld Publishers, Toronto & Sydney.
Grace, WJ. & Graham, DT. (1952) 'Relationships of Specific Attitudes and Emotions To
Certain Bodily Diseases' Psychosom. Med. 14, pp. 243-51.
Graham, DY; Adam, E; Klein, PD. et al. (1989) 'Comparison of the Prevalence of
Asymptomatic C.Pylori Infection in the United States: Effects of Age, Gender and Race'
Gastroenterology 96, A180.
Hemminki, E. (1986) 'Review of the Literature on the Factors Affecting Drug
Prescribing' in Gabe, J. & Williams, P. (ed). Tranquillisers: Social, Psychological, and
Clinical Aspects London, Tavistock. pp. 78-89.
Hirschl, A; Potzi, R; Stanek, G. et al. (1986) 'Occurrence of Campylobacter Pyloridis in
Patients From Vienna with Gastritis and Peptic Ulcers' Infection Nov-Dec, 14 (6) pp.
275-8.
Hopkins, A. (1989) 'The Dangers of Social Constructionism in Medical Sociology'
Paper presented at the plenary session The Utility of Social Constructionism at The
Australian Sociological Association, annual conference, December, La Trobe
University, Melbourne.
Hopkins, RJ. & Morris, JG. (1994) 'Helicobacter Pylori: The Missing Link in
Perspective' The American Journal of Medicine 97, Sept. pp. 265-77.
Hughes, T. (1983) Networks of Power: Electrification in Western Society, 1880-1930
Baltimore, Johns Hopkins University Press.
Jones, DM; Lessels, AM; Eldridge, J. (1984) 'Campylobacter Like Organisms on the
Gastric Mucosa: Culture, Histological and Serological Studies' Journal Clinical
Pathology 37, pp. 1002-06.
Kleinman, D. & Cohen, L. (1991) 'The Decontextualization of Mental Illness: The
Portrayal of Work in Psychiatric Drug Advertisements' Social Science and Medicine 32
(8) pp. 867-74.
Knorr-Cetina, KD. (1995) 'Laboratory Studies: The Cultural Approach To The Study of
Science' in Jasanoff, S; Markle, GE; Petersen, JC. & Pinch, T. (eds). Handbook of
Science and Technology Studies London, Sage, pp. 115-39.
Kuhn, TS. (1972) 'Scientific Paradigms' in Barnes, B. (ed.) Sociology of Science:
Selected Readings Penguin Books, pp. 80-104.
Lachman, S. (1972) Psychosomatic Disorders: A Behaviourist Interpretation New York,
John Wiley and Sons.
Lambert, JR; Lin, SK; Sievert, W. et al (1995) 'High Prevalence of Helicobacter Pylori
Antibodies In An Institutionalised Population' American Journal of Gastroenterology 90
(12) Dec. pp. 2167-2171.
Langenberg, ML; Tytgat, GNJ; Schipper, MEI. (1984) 'Campylobacter Organisams In
the Stomach of Patients and Healthy Individuals' Lancet 2, pp. 1348.
Larson, M. (1977) The Rise of Professionalism: A Sociological Analysis Berkeley,
University of California Press.
Latour, B. (1987) Science in Action: How to Follow Scientists and Engineers Through
Society Cambridge, MA, Harvard University Press.
Latour, B. (1991) 'Technology is Society Made Durable' in Law, J. (ed) A Sociology of
Monsters: Essays on Power, Technology and Domination Sociological Review
Monograph 38, London, Routledge, pp.103-31.
Lazzaroni, M. & Porro, GB. (1993) 'The Relationship Between Duodenal Ulcer Disease
and Helicobacter Pylori' European Journal of Gastroenterology and Hepatology 5
(supp. 2) pp. S 70-72.
McKinlay, JB. (1981) "From 'Promising Report' to 'Standard Procedure': Seven Stages
in the Career of a Medical Innovation" Milbank Memorial Fund Quarterly Volume
59, Number 3, pp. 374-411.
Marshall, BJ. (1983) 'Unidentified Curved Bacilli On Gastric Epithelium In Active
Chronic Gastritis' Lancet 1, pp. 1273-75.
Marshall, BJ; Armstrong, JA; McGechie, DB. & Glancy, RJ. (1985) 'Attempt to Fulfil
Koch's Postulates For Pyloric Campylobacter' The Medical Journal of Australia 142 (8)
April 15, pp. 436-39.
Marshall, BJ; McGechie, DB; Rogers, PA. & Glancy, RJ. (1985) 'Pyloric Campylobacter
Infection and Gastroduodenal Disease' The Medical Journal of Australia 142 (8) April
15, pp. 439-43.
Marshall, BJ; Royce, H; Annear, DI. et al. (1984) 'Original Isolation of Campylobacter
Pyloridis From Human Gastric Mucosa' Microbios 25, pp. 83-88.
Marshall, BJ; Warren, JR. (1984) 'Unidentified Curved Bacilli In The Stomach of
Patients With Gastritis and Peptic Ulceration' Lancet 1, pp. 1311-15.
Marshall, BJ; Warren, JR; Francis, GJ. et al (1987) 'Rapid Urease Test In the
Management of Campylobacter Pyloridis-Associated Gastritis' American journal of
Gastroenterology 82 (3) Mar. pp. 200-10.
Martin, B. & Richards, E. (1995) 'Scientific Knowledge, Controversy and Public
Decision Making' in Jasanoff, S; Markle, GE; Petersen, JC. & Pinch, T. (eds). Handbook
of Science and Technology Studies London, Sage, pp. 506-26.
Mendall, MA. & Pajaresgarcia, J. (1995) 'Epidemiology and Helicobacter Pylori'
Current Opinion in Gastroenterology 11 (Supp 1) pp. 1 -4.
Merton, R. (1972) 'The Institutional Imperatives of Science1 in Barnes, B. (ed).
Sociology of Science: Selected Readings Penguin, pp. 65-79.
Moerman, DE. (1983) 'General Medical Effectiveness and Human Biology: Placebo
Effects in the Treatment of Ulcer Disease' Medical Anthropology Quarterly 14 (3) pp.
14-6.
Moerman, DE. (1991) 'Physiology and Symbols: The Anthropological Implications of
The Placebo Effect' in Romanucci-Ross, L; Moerman, DE. & Tancredi, LR. (eds) The
Anthropology of Medicine Second edition, New York, Bergin & Garvey.
Moss, GE. (1973) Illness, Immunity, and Social Interaction: The Dynamics of Biosocial
Resonation New York, John Wiley and Sons.
Mulkay, M. (1972) 'Cultural Growth in Science' in Barnes, B. (ed). Sociology of
Science: Selected Readings Penguin, pp. 126-42.
NIH (National Institutes of Health) (1994) Helicobacter Pylori In Peptic Ulcer Disease
NIH Consensus Development Conference Statement Online 12 (1)Jan 7-9.
Navarro, V. (1976) Medicine Under Capitalism London, Croom Helm.
Nicolson, M. & McLaughlin, C. (1987) 'Social Constructionism and Medical Sociology:
A Reply To M.R. Bury' Sociology of Health and Illness 9 (2) pp. 107-26.
Oderda, G. & Cadranel, S. (1995) 'Paediatric Helicobacter Pylori' Current Opinion in
Gastroenterology 11 (Supp. 1) pp. 42-6.
Piper, DW. (1985) 'Bacteria, Gastritis, Acid Hyposecretion and Peptic Ulcer' The
Medical Journal of Australia 142 (8) April 15, pp. 431.
Prather, J. & Fiddell, L. (1986) 'Sex Differences in the Content and Style of Medical
Advertisements' in Gabe, J. & Williams, P. (ed). Tranquillisers: Social, Psychological
and Clinical Aspects London, Tavistock. pp. 90-99.
Prescott, LM. (1991) 'Triple Therapy Recommended For Duodenal Ulcers. (Bismuth
Subcitrate-omeprazole-erythromycin Treatment)' Drug Topics 135, Oct 14. pp. 24.
Rappuoli, R; Bugnoli, M; Ghiara, P; Covacci, A; Olivieri, R; Xiang, ZY. & Telford, JL.
(1993) 'Development of a Vaccine Against Helicobacter-Pylori - A Short Overview'
European Journal of Gastroenterology and Hepatology 5 (suppl. 2) Oct. pp. S76-8.
Reid, R. (1978) Marie Curie London, Paladin Grafton Books.
Richards, E. (1991) Vitamin C and Cancer: Medicine or Politics? Macmillan, London.
Romanucci-Ross, L. & Moerman, DE. (1991) 'The Extraneous Factor in Western
Medicine' in Romanucci-Ross, L; Moerman, DE. & Tancredi, LR. (eds) The
Anthropology of Medicine Second edition, New York, Bergin & Garvey.
Schiller, Z; Siwolop, S; Eklund, S. & Bostic, K. (1987) 'A Bug, Not What's Bugging You,
May Cause Ulcers: Some Scientists Think Drugs Could Kill The Culprit' Business Week
Aug 3, pp. 46.
Short, SD. (1989) 'In Defence of Social Constructionism: A Reply to Bury' Paper
presented at the plenary session The Utility of Social Constructionism at The Australian
Sociological Association, Annual Conference, December, La Trobe University,
Melbourne.
Starr, P. (1982) The Social Transformation of American Medicine Basic Books, New
York.
Stern, B. (1927) Social Factors in Medical Progress Second edition, 1968, AMS Press,
New York.
Stern, B. (1941) Society and Medical Progress Princeton, Princeton University Press.
Talley, NJ. (1995) 'Review Article: Functional Dyspepsia' Alimentary Pharmacology
Therapy 9, pp. 107-115.
Talley, NJ; Zinsmeister, AR; Weaver, A. et al (1991) 'Gastric Adenocarcinoma and
Helicobacter Pylori Infection' Journal National Cancer Institute 83, pp. 1734-9.
Talley, NJ; Zinsmeister, AR; Schleck, CD. & Melton, LJ. (1994) 'Smoking, Alcohol and
Analgesics in Dyspepsia and Among Dyspepsia Subgroups: Lack of an Association in
the Community' Gut 35 (5) pp. 619-24.
Turner, BS. (1987) Medical Power and Social Knowledge London, Sage Publications.
Turner, BS. (1992) Regulating Bodies: Essays in Medical Sociology London, Routledge.
Vines, C. (1994) 'The Enemy Within' New Scientist October 15, pp. 12-4.
Warren, JR. (1983) 'Unidentified Curved Bacilli on Gastric Epithelium In Active
Chronic Gastritis' Lancet 1, pp. 1273.
White, K. (1991) 'The Sociology of Health and Illness' Trend Report. Current Sociology
Autumn, Volume 39, Number 2.
White, K. (1994) 'Social Construction of Medicine and Health' in Spicer, J. & Trlin, A.
(eds) Social Dimensions of Health and Disease Palmerston North, NZ. Dunmore Press.
White, K. (1996) 'The Social Origins of Illness and the Development of the Sociology
of Health' in Grbich, C. (ed.) Health In Australia: Sociological Concepts and Issues
Prentice-Hall, Sydney. pp.37-54.
Whitley, R. (1984) The Intellectual and Social Organisation of the Sciences Oxford,
Oxford University Press.
Williams, RL. (1961) The Relationship of Body-Image to Some Physiological Reactivity
Patterns in Peptic Ulcer and Rheumatoid Arthritic Patients PhD Dissertation
(Psychology/Clinical) Washington University, Ann Arbor, Michigan, University
Microfilms Inc.
Winner, L. (1993) 'Upon Opening The Black Box and Finding It Empty: Social
Constructionism and the Philosophy of Technology1 Science, Technology and Human
Values 18 (3) Summer, pp. 362-78.
Wright, P. & Treacher, A. (ed) (1982) The Problem of Medical Knowledge: Examining
The Social Construction of Medicine Edinburgh, Edinburgh University Press.
eContent Home