Gérald Jorland, Annick Opinel, George Weisz (eds), Body counts: medical quantification in historical and sociological perspectives/ La Quantification médicale, perspectives historiques et sociologiques, Montreal and London, published for Fondation Mérieux by McGill-Queen's University Press, 2005, pp. x, 417, £64.00 (hardback 0-7735-2829-6).

The seventeen essays (plus Introduction) in this book complicate and deepen the narrative about the use of quantification in medicine over the longue duree. I say “complicate”, because in their Introduction, Gerald Jorland and George Weisz make the point that there is much more to the history of medical numbering than the received wisdom of persistent rejection until the acceptance of mathematics as a research tool in medicine after the Second World War. The chapters take the reader from the early eighteenth through to the early twenty-first century and cover a lot of international ground (though with recurring attention to Great Britain and France in particular). Written in either English or French (a paragraph abstract in French of the English chapters and vice versa would help non-bilingual readers), the chapters are organized into four broad themes, namely: ‘Medical Arithmetic’; ‘Quantification and Instrumentation’; ‘Statistics and the Underdetermination of Theories’; and ‘Reducing Uncertainty and the Politics of Health’. Of course, many individual chapters overlap these categorizations and it strikes me that three themes should be emphasized further as contributions to the debate about quantification. The first is the two-way link between quantification and policy. I was impressed with Andrea Rusnock's essay on eighteenth-century attempts to use Bills of Mortality and parish registers to quantify and explain infant mortality in England and France. Not only does Rusnock's chapter serve as an important corrective to the assertion that infant mortality was “invented” in the nineteenth century, but it also teases out the possibility that by drawing distinctions between ages, places and social classes in the overall picture, infant mortality calculations in fact influenced “reform” for the care of foundlings and the timing of smallpox inoculation. On an altogether different note, in tracing epidemiology and statistics in post-Second World War France, Luc Berlivet observes that ministerial desire for data and analysis during the HIV crisis furthered the development of applied epidemiology. A second topic is the relationship between the numeric method and the state, notably as a tool of governance and administration. One is now used to reading about this issue from particular national contexts and especially in relation to public health. In his essay on the mid-eighteenth-century debate between Daniel Bernoulli and Jean D'Alembert about the “value” of smallpox inoculation, Harry Marks encourages us to think not only about what such quarrels tell us of “moral expectation”, but also about what the State actually is and means. Lion Murard takes us one step further by considering the supranational context, specifically the massively diverse measures of quality of life and health reported on by the League of Nations in the inter-war period. The unwieldy range of survey tools used by individual countries defied distillation and provides us with an informative historical backdrop to the more recent preoccupations of international public health with rural under-development and global health indicators. The third issue concerns statistical and/or epidemiological methodology. It hardly goes without saying that forms of quantification are crucial to the practice of modern medicine and public health. One of the most enjoyable aspects of this book is the compelling treatment of otherwise dry methodological-statistical debates. The chapters by Mark Parascandola on tobacco and cancer epidemiology in the mid-twentieth century, by Iain Chalmers on the disputed reasons for the use of randomization in the Medical Research Council's clinical trial of streptomycin in 1948, and by Nicolas Dodier on the politicization of randomized control trials in AIDS research in the final decades of the twentieth century, all weave together discussions about disciplinary advances across statistics and medicine, the role of institutional priorities, biographical trajectories of key protagonists and wider social contexts. Achieving such complexity in such a short space is a tall order, but extremely satisfying when done well, as it is here. By selecting these three themes I do not seek to criticize the editors' choice of structure; rather, I am trying to suggest that there is much in this volume that can and should be taken up in the future but can barely be covered in a short review such as this. I could expand on even more analytic frameworks, such as Canguilhemian standardization (Christiane Sinding's chapter on diabetes; Weisz's reflections on evidence based medicine); the transformation of qualitative information into biomedical quantitative “platforms” in cancer pathology (Peter Keating and Alberto Cambrosio); or the fascinating chapters on instruments of quantification such as the thermometer (Volker Hess) and physiological measurement (Ilana Lowy). Many of these essays show that such frameworks could profitably be developed for other diseases, medical specialties and devices.