Casper, S.T.; (2007) The idioms of practice: British neurology, 1880-1960. Doctoral thesis , University of London.

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Abstract

This dissertation analyses the emergence of clinical neurology in Britain between 1880 and 1960. Though it is mainly grounded in archival sources, it also relies upon a prosopography of nineteenth and twentieth century neurologists, a survey of the neurological literature between 1880 and 1960, as well as other primary sources, including: textbooks, newspaper editorials, and articles in the medical press. British neurology emerged in a medical culture philosophically generalist in its values for medical practice and opposed to medical specialisation on these grounds. Rather than contravening that culture, British neurologists initially sought to embrace those values by demonstrating that their practices not only conformed to this culture but were also its highest manifestation. This effort was not without its disadvantages. The result was a paradox of practices. While neurologists located themselves within general medical culture, they also distinguished their practice and knowledge as pre-eminent. On one hand, neurologists produced and reproduced habits and dispositions accenting their specialty's differences. On the other hand, they argued vociferously that they were general physicians of wide knowledge and sound judgement. The outcome was haphazard and contingent. British neurology's practices were marked by fluidity and transience. The specialty was institutionally marginal and the number of practicing neurologists small. Neurology was defined more by events and contexts, such as the formation of neurological societies, the First World War, patronage for neurological research, the Second World War, and the creation of the National Health Service. Thus clinical neurology's emergence was dependent upon its definitions. It was at once the most elite of generalist medicine's many practices at the same time, it was one of its most marginal specialties.

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