4.05.2006
The Birth of the Clinic (History and Theory of the Body)
Title
Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books, 1975.
Field
History and Theory of the Body
Summary
"This book is about space, about language, and about death; it is about the act of seeing, the gaze." (ix) Indeed. Foucault charts the changes in the medical experience that in turn, changed the way the body was understood medically over the course of the mid-18th to 19th Centuries. He begins by discussing the spatialization of disease in the mid-18th C that coincided with the spatialization of the proper venue for care for disease - the home. However, this began to change: "What now constituted the unity of the medical gaze was not the circle of knowledge in which it was achieved but that open, infinite, moving totality, ceaselessly displaced and enriched by time, whose course it began but would never be able to stop - by this time a clinical recording of the infinite, variable series of events. But its support was not the perception of the patient in his singularity, but a collective consciousness, with all the information that intersects in it, growing in a complex, ever-proliferating way until it finally achieves the dimensions of a history, a geography, a state."(29) "Medicine must no longer be confined to a body of techniques for curing ills and of the knowledge that they require; it will also embrace a knowledge of healthy man, that is, a study of non-sick man and a definition of the model man." (34) This is all discussed in the context of post-Revolutionary negotiations of medicine. On one hand, they had wanted the poor to be taken care of at home and subsidized by the government, rather than placed in a hospital which was seen to breed poverty and sap money from the state. This didn't really work out. The field of medicine was opened up, it was taught everywhere. This is the birth of the clinic, where every part of the body is opened to the medical gaze (I think). "Clinical medicine is not, therefore, a medicine concerned only with the first degree of empiricism, seeking to reduce, by some kind of methodical scepticism, all its knowledge and teaching to observation of the visible alone. At this first stage, medicine is not defined as clinical unless it is also defined as encyclopaedic knowledge of nature and knowledge of man in society." (72) Further, the clinic became the site of the spectacle of pain: "But to look in order to know, to show in order to teach, is not this a tacit form of violence, all the more abusive for its silence, upon a sick body that demands to be comforted, not displayed? Can pain be spectacle? Not only can it be, it must be, by virtue of a subtle right that resides in the fact that no one is alone, the poor man less so than others, since he can obtain assistance only through the mediation of the rich." (84) Next Foucault looks at symptoms and signs, the way the gaze interpreted through language the signifieds of the signs it was confronted with. "The clinic is a filed made philosophically 'visible' by the introduction into the pathological domain of grammatical and probabilistic structures...They freed medical perception from the play or essence and symptoms, and from the no less ambiguous play of species and individuals: the figur disappeared by which visible and invisible were pivoted in accordance with the principle that the patient both conceals and reveals the specificity of his disease. A domain of clear visibility was opened up to the gaze."(105) But this medicine of symptoms (of signs) will subside with the rise of pathology, when the doctor can cut right to the signified, the linguistic aspect of the clinic will recede. "The medical gaze must therefore travel along a path that had not so far been opened to it: vertically from the symptomatic surface to the tissual surface; in depth, plunging from the manifest to the hidden; and in both directions, as it must continuously travel if one wishes to define, from one end to the other, the network of essential necessities."(135) Finally, when it is clear that disease is a reaction to an irritating agent (in the early 19th century), when the medicine of diseases (nosology) comes to an end and the medicine of pathology finds its full blossoming. Foucault devotes the final chapters to talk of death: "Life, disease, and death no form a technical and conceptual trinity."(144) "It is not because he falls ill that man dies; fundamentally, it is because he may die that man may fall ill. And beneath the chronological life/disease/death relation, another, deeper figure is traced: that which links life and death, and so frees, besides, the signs of disease."(155) "It is when death became the concrete a priori of medical experience that death could detach itself from counter-nature and become embodied in the living bodies of individuals."(196)
Keywords
Clinic, Knowledge, Gaze, Language, Permeability, Body, Death, Symptom.
Other Thoughts
"Disease is no longer a bundle of characters disseminated here and there over the surface of the body and linked together by statistically observable concomitances and succesions, it is a set of forms and deformations, figures and accidents and of displaced, destroyed, or modified elements bound together in sequence according to a geography that can be followed step by step. It is no longer a pathological species inserting itself into the body wherever possible; it is the body itself that has become ill."(136)
Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books, 1975.
Field
History and Theory of the Body
Summary
"This book is about space, about language, and about death; it is about the act of seeing, the gaze." (ix) Indeed. Foucault charts the changes in the medical experience that in turn, changed the way the body was understood medically over the course of the mid-18th to 19th Centuries. He begins by discussing the spatialization of disease in the mid-18th C that coincided with the spatialization of the proper venue for care for disease - the home. However, this began to change: "What now constituted the unity of the medical gaze was not the circle of knowledge in which it was achieved but that open, infinite, moving totality, ceaselessly displaced and enriched by time, whose course it began but would never be able to stop - by this time a clinical recording of the infinite, variable series of events. But its support was not the perception of the patient in his singularity, but a collective consciousness, with all the information that intersects in it, growing in a complex, ever-proliferating way until it finally achieves the dimensions of a history, a geography, a state."(29) "Medicine must no longer be confined to a body of techniques for curing ills and of the knowledge that they require; it will also embrace a knowledge of healthy man, that is, a study of non-sick man and a definition of the model man." (34) This is all discussed in the context of post-Revolutionary negotiations of medicine. On one hand, they had wanted the poor to be taken care of at home and subsidized by the government, rather than placed in a hospital which was seen to breed poverty and sap money from the state. This didn't really work out. The field of medicine was opened up, it was taught everywhere. This is the birth of the clinic, where every part of the body is opened to the medical gaze (I think). "Clinical medicine is not, therefore, a medicine concerned only with the first degree of empiricism, seeking to reduce, by some kind of methodical scepticism, all its knowledge and teaching to observation of the visible alone. At this first stage, medicine is not defined as clinical unless it is also defined as encyclopaedic knowledge of nature and knowledge of man in society." (72) Further, the clinic became the site of the spectacle of pain: "But to look in order to know, to show in order to teach, is not this a tacit form of violence, all the more abusive for its silence, upon a sick body that demands to be comforted, not displayed? Can pain be spectacle? Not only can it be, it must be, by virtue of a subtle right that resides in the fact that no one is alone, the poor man less so than others, since he can obtain assistance only through the mediation of the rich." (84) Next Foucault looks at symptoms and signs, the way the gaze interpreted through language the signifieds of the signs it was confronted with. "The clinic is a filed made philosophically 'visible' by the introduction into the pathological domain of grammatical and probabilistic structures...They freed medical perception from the play or essence and symptoms, and from the no less ambiguous play of species and individuals: the figur disappeared by which visible and invisible were pivoted in accordance with the principle that the patient both conceals and reveals the specificity of his disease. A domain of clear visibility was opened up to the gaze."(105) But this medicine of symptoms (of signs) will subside with the rise of pathology, when the doctor can cut right to the signified, the linguistic aspect of the clinic will recede. "The medical gaze must therefore travel along a path that had not so far been opened to it: vertically from the symptomatic surface to the tissual surface; in depth, plunging from the manifest to the hidden; and in both directions, as it must continuously travel if one wishes to define, from one end to the other, the network of essential necessities."(135) Finally, when it is clear that disease is a reaction to an irritating agent (in the early 19th century), when the medicine of diseases (nosology) comes to an end and the medicine of pathology finds its full blossoming. Foucault devotes the final chapters to talk of death: "Life, disease, and death no form a technical and conceptual trinity."(144) "It is not because he falls ill that man dies; fundamentally, it is because he may die that man may fall ill. And beneath the chronological life/disease/death relation, another, deeper figure is traced: that which links life and death, and so frees, besides, the signs of disease."(155) "It is when death became the concrete a priori of medical experience that death could detach itself from counter-nature and become embodied in the living bodies of individuals."(196)
Keywords
Clinic, Knowledge, Gaze, Language, Permeability, Body, Death, Symptom.
Other Thoughts
"Disease is no longer a bundle of characters disseminated here and there over the surface of the body and linked together by statistically observable concomitances and succesions, it is a set of forms and deformations, figures and accidents and of displaced, destroyed, or modified elements bound together in sequence according to a geography that can be followed step by step. It is no longer a pathological species inserting itself into the body wherever possible; it is the body itself that has become ill."(136)
# posted by SMRT : 2:53 PM
