50

The success obtained by biomedicine in the treatment of infectious disease (vaccinations, antibiotics) enhances its legitimacy and public acceptance of its continued expansionist thrust. It is in this buoyant context that an extension of medical practices to ??chronic diseases' takes place, one amounting to a real revolution in phthisiology and intensive care. In the 1950's the first was a recognized specialty that had benefited from the development of the campaign against tuberculosis. At the same time the second was just emerging in the form of artificial lungs for polio victims. But both are called into question by the development of new treatments (anti-tubercular, vaccinations). Phthisiology then becomes pulmonology by a gradual process in which pulmonology gradually became dominant in the general public, the authorities, general practitioners, the paramedical professionals, and patients. On the side of intensive care, the recruiting ground is enlarged to cover, among others, chronic bronchopulmonary diseases. And these parallel developments converge towards a homecare equipping of the patients concerned. This process may be seen as a very general transformation of practices, infrastructure and mode of organization. Quickened and pushed to the limit in the sector in crisis considered, it also makes it possible to measure the capacity of the biomedical project to define and impose its fields of operation.