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The Birth of the Clinic: An Archaeology of Medical Perception by Michel Foucault (1963)



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My knowledge of the history of medical theory is practically non-existent, and I'm embarrassed to say that I know next to nothing about the French Revolution, so large sections of this book didn't really register with me. It seems like Foucault is using a slightly more direct style than is his wont, but this effect is largely eliminated by the obscurity of his historical references. As with much of his writing, I felt that I understood the beginning and end of the narrative arc pretty well without being entirely clear on what happened in the middle. I was, in fact, all set to give this a mediocre rating; what changed my mind was the clear and fantastic ending. It really is a great statement of Foucault's (early?) philosophy as a whole, and an unusually elegant formulation. ( )
  breadhat | Jul 23, 2013 |

(Source: http://www.flickr.com/photos/patrick-costello/6186206079/sizes/m/in/photostream/)

Beneath the outstretched arms of the statue, Christus Consolatur, at the illustrious Johns Hopkins Hospital in Baltimore, there is a simple inscription: €ûCome unto me all ye that are weary and heavy laden and I will give you rest.û€û This simple phrase reflects the hopes and aspirations of many who turn to the medical profession.

Foucault here attempts an 'archaeology' of the medical field - he reconstructs a history of ideas of how medicine was perceived - through a study of French medicine in the late 18th and early 19th century, and brushes away the sediment which obscure the origins of the field. He discards the old narratives as myths and offers his own metanarrative.

Several main points about his analysis stuck with me. First, his history of the clinique, which is translated here as 'clinic' but might instead mean something more like 'teaching hospital'. He uses the phrase 'birth' of the clinic because it did not gradually form, it suddenly instantly became a new institution.

Second, his episteme history of medicine, comparing past analysis of how physicians looked at the body, the soul, humors, parts of the body vs. the whole, and so forth. He cites Morgagni, the founder of anatomical pathology, and Bichat, who differentiates tissues from organs. His history of pathology also expands into experimentation and prodding of the dead or dying, with the dissection of corpses.

Third, because he is Foucault, after all, he ties this into power dynamics. Outbreaks of illness as a sign of poor governmentality or God's displeasure. The role of physicians, after the 19th century, began to take over that of churchmen and pre-modern physicians, offering physical healing whereas the church could offer only spiritual healing instead of blessings and prayers, or arbitrary procedures which are at best a placebo.

Most interesting to me was his description of the 'medical gaze' in Chapter 6. Separating the physical symptoms of the illness from the person, and comparing it with an ideal terminology-'textbook' version of said disease. This is more of an analysis of the physical symptoms, even to the extent of disregarding the person.

For example. Imagine you are at the dentist. I know it's uncomfortable, but please try. They place the curved pick in your mouth and ask if you have been flossing. You mum ( )
  HadriantheBlind | Mar 30, 2013 |
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Michel Foucaultprimary authorall editionscalculated
Smith, A.M. SheridanTranslatorsecondary authorsome editionsconfirmed
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This book is about space, about language, and about death; it is about the act of seeing, the gaze.
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Amazon.com Product Description (ISBN 0679753346, Paperback)

In the eighteenth century, medicine underwent a mutation. For the first time, medical knowledge took on a precision that had formerly belonged only to mathematics. The body became something that could be mapped. Disease became subject to new rules of classification. And doctors begin to describe phenomena that for centuries had remained below the threshold of the visible and expressible.

In The Birth of the Clinic the philosopher and intellectual historian who may be the true heir to Nietzsche charts this dramatic transformation of medical knowledge. As in his classic Madness and Civilization, Michel Foucault shows how much what we think of as pure science owes to social and cultural attitudes -- in this case, to the climate of the French Revolution. Brilliant, provocative, and omnivorously learned, his book sheds new light on the origins of our current notions of health and sickness, life and death.

(retrieved from Amazon Thu, 12 Mar 2015 18:13:00 -0400)

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