In the past, when attempting to read really difficult continental philosophy, I've reading found guidebooks and SEP entries to be quite profitable. (6-7) In the rational space of disease, doctors and patients do not occupy a place as of right; they are tolerated as disturbances that can hardly be avoided: the paradoxical role of medicine consists, above all, in neutralizing them, in maintaining the maximum difference between them, so that, in the void that appears between them, the ideal configuration of the disease becomes a concrete, free form, totalized at last in a motionless, simultaneous picture, lacking both density and secrecy, where recognition opens of itself onto the order of essences. (161), 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 successions; 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.  Michel Foucault, “Questions of Method,” in The Foucault Effect: Studies in Governmentality with Two Lectures and an Interview with Michel Foucault, ed.  Foucault, The Birth of the Clinic, 9. The Birth of the Clinic, his second major book-length work, was published in 1963. But the medical gaze was also organized in a new way.  His pursuit of history and philosophy was therefore seen as an interest rather than a scholarly endeavor. Chapter 10 provided an example of how the clinical gaze affected medical knowledge through a study of fevers, looking specifically at the differences in practice between Bichat and Broussais.  For more on the shift to new cultural history and intellectual history in the 1980s, see Neubauer, Cultural History After Foucault and Hollinger, “American Intellectual History.” See also Lynn Hunt, ed. Change ), You are commenting using your Twitter account. Larry Shiner, a professor of philosophy and history, wrote: “One must read his genealogies… as a political act rather than merely a history of their development or a philosophy of their foundations.” Similarly, Mark Poster, a professor of history and media studies, noted: “Foucault unmasks the epistemological innocence of the historian.  Chapter 5 focused on the political legislature that contributed to the restructuring of the hospital and university systems in the 1790s: “what occurred was the restructuring, in a precise historical context, of the theme of ‘medicine in liberty.’” Viewing the hospital as the institutionalization of poverty, a government funded space that served only to house those who could not support themselves, Foucault argued that revolutionary era politics renounced the old system: “The clinic figures, then, as a structure that is essential to the scientific coherence and also to the social utility and political purity of the new medical organization.  Historians often dismiss Foucault as a philosopher; philosophers tend to relegate Foucault’s historical work to the social and human sciences. It was given at last to knowledge only at the end of a long movement of spatialization whose decisive instruments were a certain use of language and a difficult conceptualization of death. And, quite naturally, Bichat recognized in his discovery an event symmetrical with Lavoisier’s: ‘Chemistry has its simple bodies which form by the various combinations of which they are susceptible composite bodies…. If the science of man appeared as an extension of the science of life, it is because it was medically, as well as biologically, based: by transference, importation, and, often, metaphor, the science of man no doubt used concepts formed by biologists; but the very subjects that it devoted itself to (man, his behaviour, his individual and social realizations) therefore opened up a field that was divided up according to the principles of the normal and the pathological. Nineteenth-century medicine was haunted by that absolute eye that cadaverizes life and rediscovers in the corpse the frail, broken nervure of life.  In his assessment of the state of history as a discipline in the early 1980s, David Hollinger noted a general shift away from intellectual history and toward “histories of meaning”.  Larry Shiner describes Foucault’s shift from archaeology to genealogy in the context of his larger political project. The descriptive act is, by right, a ‘seizure of being’ (une prise d’e• tre), and, inversely, being does not appear in symptomatic and therefore essential manifestations without offering itself to the mastery of a language that is the very speech of things. The fine two-dimensional space of the portrait is both the origin and the final result: that which makes possible, at the outset, a rational, well-founded body of medical knowledge, and that towards which it must constantly proceed through that which conceals it. Hence the importance of the Morbid. As far as the work of Michel Foucault exemplifies a post-structuralist approach to historiography, we can characterize it as embracing discontinuity, fragmentation, and historical relativity. It is no longer a pathological species inserting itself into the body wherever possible; it is the body itself that has become ill. (167), What is modified in giving place to anatomo-clinical medicine is not, therefore, the mere surface of contact between the knowing subject and the known object; it is the more general arrangement of knowledge that determines the reciprocal positions and the connexion between the one who must know and that which is to be known. The Birth of the Clinic cannot be understood without first understanding the history of medicine and its ties to Shamanism, etc. Hence his paradoxical position. The privilege of its intemporality, which is no doubt as old as the consciousness of its imminence, is turned for the first time into a technical instrument that provides a grasp on the truth of life and the nature of its illness. File history. Analysis, the philosophy of elements and their laws, meets its death in what it had vainly sought in mathematics, chemistry, and even language: an unsupersedable model, prescribed by nature; it is on this great example that the medical gaze will now rest.  The privilege of the consumptive: in earlier times, one contracted leprosy against a background of great waves of collective punishment; in the nineteenth century, a man, in becoming tubercular, in the fever that hastens things and betrays them, fulfills his incommunicable secret. (116), As an isomorph of ideology, clinical experience offers it an immediate domain of application. The founding of the SRM was the result of a disease that broke out in southern France which forced the Controller General of Finance to order the killing off of suspect animals, which in turn led to economic instability. Disease exists only in that space, since that space constitutes it as nature; and yet it always appears rather out of phase in relation to that space, because it is manifested in a real patient, beneath the observing eye of a forearmed doctor. Hospital foundations represented an immobilization of wealth, and, by their very inertia, created poverty; these must disappear, but they must be replaced by a national, constantly available fund capable of providing help when and where required. And the hospital played this dual role: for the doctor’s gaze it was the locus of systematic truths; for the knowledge formulated by the teacher it was the locus of free experiment. As in his classic Madness and Civilization , Michel Foucault shows how much what we think of as pure science owes to social and cultural attitudeâin this case, to the climate of the French Revolution. And to the advantage of a historical view that relates the fecundity of the clinic to a scientific, political, and economic liberalism, one forgets that for years it was the ideological theme that prevented the organization of clinical medicine. J. (xviii), […] to comment is to admit by definition an excess of the signified over the signifier; a necessary, unformulated remainder of thought that language has left in the shade—a remainder that is the very essence of that thought, driven outside its secret—but to comment also presupposes that this unspoken element slumbers within speech (parole), and that, by a super-abundance proper to the signifier, one may, in questioning it, give voice to a content that was not explicitly signified.  The Stanford Encyclopedia of Philosophy entry expresses some hesitancy in referring to Foucault as a philosopher. 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. For Michel Foucault the clinic is a mode of perception and enunciation that allows us to see and name disease and to place statements about illness among statements about birth and death. It is no longer that of a living eye, but the gaze of an eye that has seen death—a great white eye that unties the knot of life. First, it was no longer the gaze of any observer, but that of a doctor supported and justified by an institution, that of a doctor endowed with the power of decision and intervention. The morbid authorizes a subtle perception of the way in which life finds in death its most differentiated figure. 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