Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics

by Lundy Braun

How race became embedded in a medical instrument

In the antebellum South, plantation physicians used a new medical device—the spirometer—to show that lung volume and therefore vital capacity were supposedly less in black slaves than in white citizens. At the end of the Civil War, a large study of racial difference employing the spirometer appeared to confirm the finding, which was then applied to argue that slaves were unfit for freedom. What is astonishing is that this example of racial thinking is anything but a historical relic. In Breathing Race into the Machine , science studies scholar Lundy Braun traces the little-known history of the spirometer to reveal the social and scientific processes by which medical instruments have worked to naturalize racial and ethnic differences, from Victorian Britain to today. Routinely a factor in clinical diagnoses, preemployment physicals, and disability estimates, spirometers are often “race corrected,” typically reducing normal values for African Americans by 15 percent. An unsettling account of the pernicious effects of racial thinking that divides people along genetic lines, Breathing Race into the Machine helps us understand how race enters into science and shapes medical research and practice.

Honorable Mention, 2017 Rachel Carson Prize, Society for the Social Studies of Science

Winner of the 2018 Ludwik Fleck Prize from the Society for Social Studies of Science

Genres: History, Medicine, Nonfiction, Race, Health Care, Health, Medical

304 pages, Paperback

First published January 1, 2014

Reviews

[Tula or KathyPotter · Rating 5 out of 5]

Subject matter is important to know but once the point is made one can loose interest.

[Corey Wynn · Rating 3 out of 5]

One of the challenges of this book is that its central thesis isn't supported by that much of the content. Most of the chapter on silicosis constantly points out how only white miners in South Africa were evaluated for decades, and doesn't get to later data that showed less racial difference until much later. The content on how researchers measured racial differences is interesting and important, but does not make up enough of the narrative to really justify the title. It's more a history of how medical study changes over time through the lens of a medical instrument, focusing on not just race, but class, occupation, gender, and medical intransigence.

Another challenge is that the timeline is very muddied - chapters have overlapping time periods that aren't often explicitly acknowledged, making the progress of the spirometer hard to track as it fell in and out of use in different parts of the world.

The book still makes its argument that it's likely inappropriate to have racial corrections without better analysis, but could have done so in a quarter of the pages.

[McKenzie Andrews · Rating 3 out of 5]

Important topic, didn’t love the writing style, a bit dry for me! Basically the spirometer used to be race corrected which doesn’t make sense to have different standards for different groups of people!

[Chelsea · Rating 3 out of 5]

This book was my Black History Month themed book for my Fight the Power year. I anticipated my year focusing on politics, but apparently medical science is another aspect of our society that needs a good side eye.

Perhaps naively, I believed that scientists of all people should be able to see through blatant social injustices and logically examine data. The lesson I learned here is to have a healthy level of skepticism and to ask where data comes from.

The book is full of illuminating information in the form of medical jargon. It's tough to get through and too often felt like I was still doing my anatomy and physiology homework. An article could have condensed this book into something mkre readable.

[Annie · Rating 4 out of 5]

Extremely important information, but difficult to read.

[Zuster · Rating 5 out of 5]

As a healthcare worker that works with spirometers, this was essential for me to read. I understand more of the complex and troubled history involving race and how we even haven't got a good alternative for this. I hate that it's built in the software we use, and I have to confront patients with this discriminatory bias we use. I really don't know how we could change this, expect with more research that's not biased. But this was really worth the read.

[Ship · Rating 3 out of 5]

While an interesting and needed premise this book failed to thorough address race and breathing tests. The article version of this book and even the newer ATS guidelines cover much of what is needed to be known. This book is very circular in its writing and chapters about physical education did not seem to be relevant to the discussion. It was a good starting point but I think this topic needs a book that is not this one.

[Soc Page]

Inova Fairfax hospital library
academic review of the history and usage of a spirometer to determine fitness and determine workmen's comp.