"Seeing and Knowing"

May 7, 2025

BC, Ch. 7 “Seeing and Knowing”

And the group began with questions…

1. Relation between logic/syntax and values (p. 113)? 

2. Getting clear on three loci (meeting place of doctor and patient): perception/observation; (2) gaze/language; (3) ideal of an exhaustive description (pp. 111-115)? 

3. Nothing known; at most recognition (p. 113)? 

4. Is Foucault here not critiquing the same thing as Sellars in The Myth of the Given? (p. 107-111). Is this also a proto-anatomo-politics? (p. 111)

5. Relationship between the gaze and the four epistemological myths? (pp. 111-117) 

6. At what level is something an epistemological myth vs. savoir? 

Discussions: 

Begin with Q6: 

—Myth is what historians/practitioners, etc., believe but savoir is a way of revealing the myth as a myth. 

—Structural feature of knowledge is what makes myths possible (since practitioners cannot excavate savoir from their own present). He states this in The Order of Things and also in Archaeology of Knowledge. Philosophically can you get sufficient critical distance to excavate savoir? 

Next Q4

—Good example M.F's description of "the myth of the given": "Over all these endeavors on the part of clinical thought to define its methods and scientific norms hovers the great myth of a pure Gaze that would be pure Language: a speaking eye" (114). 

[The myth of the given is the myth of the pure gaze, which is isomorphic with pure language.]

What is mythical is that constitution of a savoir is actually tracking things as they really are: "This speaking eye would be the servant of things and the master of truth" (115). 

    —An awareness that is not elicited by inference and it comes to us in a way that carries conceptual implications.  

    —The subject adds nothing, but is a vessel for that which is given to it (a notion of purity operating here). 

    —Ideal of a exhaustive description: "A precarious balance, for it rests on a formidable postulate: that all that is visible is expressible and that it is wholly visible because it is wholly expressible" (115). 

#5 Epistemological Myths 

—Myths mask an underlying savoir of the myth of the given? 

—Myth of immediacy and myth of transparency is used to masked the savoir.

—Underlying positivist empiricism and the myths mask that it is self-constituted as a way of knowing, viz. other possible ways of knowing; it is an episteme just like others.)

—Gaze introduces opacity and transparency—opacity becomes a problem when transparency is seen as a possibility? 

Michel Foucault Birth of the Clinic Chapter 6

 Questions:

§ 90: When he distinguishes codes of knowledge; interested in the distinction between the linguistic structure of the sign and the aleatory structure of the case.

a.        Interested in why he can think this distinction because it is categorically weird, feels like a category mistake.

§ 93: Also getting clearer on distinction in first question. Relationship between sign/signifier and symptom.

b.        What is the French translation for ‘codes of knowledge,’ what is the code? (90)

§ 93: relationship between signs and symptoms; “In its material reality, the sign is identified with the symptom…”

c.        Taking the symptom and elevating it to the level of the sign and on another part, seems like the symptoms are separate, getting sign off symptom.

§ Tracking signs and symptoms with regards to nosological and anatomo-clinical view of sign and symptom?

d.        Chapters 1-3 Nosological view

e.        Chapters 4-7 Transition period of clinic, no anatomy

f.           Chapters 8-10 Anatomo-clinical view

g.         What is the threshold (in our reading, chapter 6) and how to characterize?

§ 97-98: The transition to what we later know MF will discuss in terms of disciplinary power “This conceptual transformation was decisive…Medicine no longer tried to see the essential truth beneath the sensible individuality…”

h.        Disciplinary power and MF:  its individualizing, or normalizing because it individualizes; can we read it as the opposite? Is there an anonymization happening in this reduction? What is the role of anonymity and individuation in this new structure of the medical gaze?

§ 104-105: Relationship between the two codes; similar first question but referencing pages.

i.            Classical archaeology: have two seemingly different things and part of the argument there is this depth knowledge such that you learn that they are both doing the same thing even though they look different.

Discussion:

(89) Distinction between aleatory gaze and linguistic structure. Take this linguistic structure to be an account of how signs come to be structured and how cases come to be structured.

The case comes to assigned a probability and the sign comes to be assigned.

Aleatory: probabilistic, more up to chance; reference to the taming of chance that is happening at this time. Going from chance = randomness, to chance = structured probability.

Looking at the patient and the patient’s chart, and the patient is a case, looking at in terms of their probabilities; probabilities of getting a certain disease, etc. Seeing the symptoms in terms of probability.

Before, it has a pure observing and tracking of the essence of before, why this was an ideal space, and now we are viewing in terms of not having an essence.

(90): “New objects were to present themselves to the medical gaze in the sense that…”

(96-104): Linguistic structure of the sign

Medicine reorganizing itself as signs—symptoms as a sign for what? The doctors questioning shifts and the two codes of knowledge, domains of knowledge are what allow us to understand a depth condition of knowledge. MF wants to better understand what appears initially and what kind of conditions allow for that.

Disease-gaze relationship tracking as a from of knowledge and savior allowing for these aspects to be known. The symptom starts functioning as a sign. (93)

Here it almost looks like we’re bringing the symptom itself into some kind of relationship where it becomes a sign. MF doesn’t want to necessarily equate them but the sign says the same thing which is the symptom.

 

(91) Is he describing a different kind of recognition? It’s not one that has anything to offer knowledge.

At this moment not super critical of visibility/invisibility but there is a reference this shift.

Invisibility as a deterrent to knowledge, and a different kind of obfuscation from before, has a deceitful quality to it. The gaze is now contending with what is hidden or masked. Less of this tension playing between visibility and invisibility.

Seems like they are intentionally opposed.

(90-91) You do not see the disease; you see its symptoms. These are available to reason only, never exposed to the senses. This would be a problem for the empiricist structure of medicine at this point. When you would look at measles, for example, you would think that was the disease which isn’t how we view it now.

Focus on what show through a symptom, and a symptom becomes a sign for something else.

Deduction vs induction and step towards induction, this is what something is essentially, this is its idealized space, type of view. You can have a cough but that can be many different things.

(92) “By this simple opposition to the forms of help…”

Both totality and difference in relation to disease. You know something is not disease X because it doesn’t have the right symptoms.

(93) “Every symptom as a sign and every sign is a symptom.”

Every sign as a symptom makes sense; you wouldn’t look at a patient and assume they are the disease itself.

How is every sign a symptom?

Calculating the age or other demographics as the sign? Reference to earlier mention of regional training for medical doctors. How is that still not able to exhaust reality of a sign?

The fact that you live near a river…is a sign, not a symptom, but still has a specific relation to a disease. Ex: You’re by the chemical plant, that’s a sign of exposure.

There is a particular relationship between the doctor and the disease MF referencing here. Also thinking there might be something here in the exhausting of reality, where the symptom is taken up as a sign, but the sign, combined with probabilistic language, changes.

More of in a falsifying than verifying language. Example of Kuhn: paradigm shifts as happening because of solving puzzles that appear to scientist. MF giving an account of the shift in medical gaze but is there a logic to that? Kuhn would reference the structure of revolutions; view of the medical gaze as changing due to the attempt to solve problems.

Archaeology: what’s the form?

Genealogy: how the formation?

In archaeology, Foucault is not asking the same questions as Kuhn. Not trying to account for its formation yet. Genealogy shows there is all this—including Kuhn puzzle solving—going on.

(94-95) isn’t this the dream of all doctors, total transparency and an ability to see any and all things ailing a patient who comes in.

Still here prior to germ theory; they’re noticing something beneath the skin, that is “invisible,” is the real disease whereas we wouldn’t say it is invisible now. We can see it under a microscope.

(68) use of spontaneous in relation to the form

Morphology vs formation? What is the shape vs how did it form, what was the process?

Signification of symptom makes sense with the aleatorization of the case. Thinking certainly in relation to signs would be problematic; but is certainty still a regulative ideal? The dream of the serene, accomplished form of scientific knowledge seems it would be exhaustive. Certainty, in terms of absolute certainty, you have to give up as soon as you allow probabilistic thinking.

Michel Foucault - Birth of the Clinic Chapters 4 and 5

 
CGC Notes
Week 4, 4/23/2025
Birth of the Clinic: Chapters 4 and 5
Questions:
§  Pg 57: On the constant reappearance of medical experience and his analytics of truth, what does it mean for “medicine to be on a level with its truth?” What does this mean at a descriptive level
§  Pg 54: Also, there seem to be multiple histories being tracked and reconstructed by Foucault, what are the histories being tracked and are these histories on multiple levels? Do they involve different objects and or discourse, archives? MF seems to be doing a lot at once, so how are we to understand these levels? For example, ideal (double account), and his own history.
§  What is the role that speech is playing in chapter 4? (pg. 55): MF discusses the idea that writing privatizes speech, “before it became a corpus of knowledge…what was known was no longer communicated to others and put to practical use once it had passed through the esotericism of knowledge, and again on (pg. 62): un language un jeu
§  On the “Conception of immediacy” or the “mythical/idealized account,” what is the role of immediacy in the formation of knowledge? Is this like Sellars’s account of givenness? Or Tiisala’s? perception “without mediation”
§  Pg 83: “The most important moral problem…assistance at the hospital?” What might have been the implications for a notion of medical insurance, or an insurance industry?
Discussion:
·  It seems that MF is tracking at least two narratives. Consider pg. 58, where MF locates a “proto clinic,” or clinic as corpus of knowledge. As such, the clinic was yet to become open or specialized. Against the mythical or idealized account that seeing and knowing offer a continuity that can be tracked (progressively) in time, Foucault is locating a certain “hinge” between paradigms that tells a different story.
·  Rather than folding institutions into the history of progressive accumulation of knowledge, we must question what has been imperceptibly folded in: institutional form. And we need to consider how the institutional form itself has been instrumental as a vector of medical/ scientific epistemology. (Applies to first few pages of Chapter 4
·  This is like an Aristotelian idea that knowing is natural, or that, in other words, seeing and knowing are superimposable.
·  MF will offer a different story of emergence (or existence?) that can be read as a social constructionist account of medical knowledge (as a product of social configurations).
·  A more complicated account would be to give a social configuration account that does not in itself undermine (invalidate) the idealized account but rather reveals its historical possibility.
·  At least two different levels or registers of undermining here: either directed at the medical knowledge or the historical narrative of the progression of it.
·  Consider too a different account (through the phenomenon of the clinical institution), of the French revolution as a hinge that is not a pure progression (or reaction). This narrative of the revolution, given through the clinic as a paradigm site, as liberatory or reactionary misses the complexity or “questions posed” to it as a political event.
·  Yet, even if MF isn’t questioning the epistemological status of the clinic, isn’t he still questioning the idealized account?
·  His questioning could be geared toward a philosophy of knowledge or toward a history of medicine. We seem to agree that his “attack” is geared toward the latter, although certainly the epistemological and historical claims are related, and the epistemological claims can of course gain legitimacy from elsewhere than the idealized account (which takes the institutional form of the clinic as examination of the patient par excellence to be the meaning and structure of clinical experience).
·  MF seems to be intervening in the understanding of savoir of the clinic, which was previously understood in terms of a difference between the theoretical and the clinical. The idealized account if premised on an unquestionability of continuity from theoretical to clinical. Where the theoretical is displaced by clinical immediacy in the idealized account, there is a deeper savoir (including institutional vectors and organizations) that is left unaccounted for beneath the surface, which thematizes differently the metaphysical assumptions that the idealized account presupposes.
·  Maybe a double critique of the positivist origin and idealism of the history.·  As we continue to move through this book, can we track a reading that is more open to an interpretation of genealogy or critique that moves beyond archaeology, despite this being a book that precedes Order of Things?

Michel Foucault – Birth of the Clinic, Chapter 3

 Questions

1. How are we to understand the hospital as a "duplication" of the family that reproduces as a "microcosm, the specific configuration of the pathological world" (42)? Is this similar to the role of "exchanger" or "hinge" that the family operates in his genealogical period?

2. What kind of account of the French Revolution is this? It seems to be broader than an archaeology, but is it? Is it closer to a genealogy? What kind of "deeply rooted convergence between the requirements of political ideology and those of medical technology" (38) is Foucault tracking?

3. How is the medical gaze connected to the Enlightenment? What does Foucault means when he writes that the medical gaze "was only one segment of the dialectic of the Lumières transported into the doctor's eye" (52)?

4. "A free state that wishes to maintain its citizens free from error and from the ills that it entails cannot authorize the free practice of medicine" (46). What does he mean by free here? Are there two contesting conceptions of freedom at play? Liberty versus freedom?

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Discussion

His objects of study are "decrees" (an archive of the French Revolution) and he is trying to understand them in the context of the changes in the discourse, practices, and institutions of medicine.

In some sense, his history of "the birth of the clinic" is also not a linear history but a very complex web of issues that intersect, move back and forth (dialectically)? It is significant in this context his interesting discussion between the push for revolutionary abolition ("the abolition of state help demanded by the Girondists", p. 43) but also the requirement of protecting from disease (p. 42). This tension is predominant throughout the chapter. It seems that a "free practice" of medicine (revolutionary) does not entail a "healthy citizenry" (see p. 46).

We can see this is a history of the French Revolution that shows, through a microscopic focus on medicine, that it is not one of "progress" or mere transformation but of tensions, rifts, dissent, messiness, and that is also a history of how the revolutionary government handled or met "demands" and practical problems of health. The challenges to revolution and/or reformism? Revolutionary thinking versus "reformist thinking" (48)?

Perhaps we can think of Foucault as working through or archivally dealing with the problem of "transition" that is a constant debate among revolutionary theorists or Marxists. What happens once revolution is achieved? How does transition happen? How can we assess it functionally? What does this kind of assessment (i.e, non-moral, non-ideologically driven) tell us about political practice?

It is interesting that, without using the language (or an analytic) of power, we can see some seeds or preliminary gesture towards biopower. For example, he talks about a "corpus of knowledge about the health of the population" (38) and mentions the challenges to manage health of people (42). At the same time, he mentions a differentiation of the space of the hospital according to "two principles": 'training' and 'distribution', which refer to the disciplinary dispositif developed in Discipline and Punish. 

In this chapter, we see a lot of discussion about the university and the role of medicine faculties not only in terms of knowledge production/dissemination, but also as institutions of social organization themselves (later, sites of power-knowledge). If we think of Foucault as a Kantian, is this his way of address the conditions for the possibility of medical concepts, discourses, and practices? Maybe there is an underlying relation between The Birth of the Clinic and Kant's The Contest of Faculties.

Foucault ends by noting that his history is, in some sense, a counter-history that challenges "a historical view that relates the fecundity of the clinic to a scientific, political, and economic liberalism" (52) and that conveniently "forgets" that it was liberalism what "prevented the organization of clinical medicine" (52). It seems the Foucault equates here liberalism and revolution...

Michel Foucault - Birth of the Clinic, Ch. 2

 

Questions

Q1 - What does Foucault mean by the "two great myths"? (pp. 31-32)

Q2 - What is the relevance of the 2nd myth and "war against bad government"? (p. 33)

Q3 - In relation to the"medicine of species, what are the "systemic intersection of two series of information"? (p. 30)

Q4 - What is the distinction between medical gaze and medical consciousness?

Q5 - What is the "true sense" of epidemics within the medicine of epidemics? (p. 24)

Q6 - What is the relationship of the medicine of epidemics to sovereignty (esp. the police)? (p. 25)

Q7 - Implicit reference to Canguilhem's The Normal and the Pathological 

Discussion 

• Medicine of epidemics now actual spaces, not abstract spaces [Q5; Q6]
• Movement away from "general form" of disease
• Specific disease in a historical-physical location (Paris, 1785)
• "Historical individuality" (p. 24)
• "collective perception" of an epidemic as opposed to individual perception of the medicine of species (p. 26)
• Observation moved from doctor to the police 
• Broader state bureaucracy of reporting versus doctor
• Socialization of the disease 
• "botanical model," nosology, framing as species (Ch. 1, p. 7)
• Now, framing as social-political model (Ch. 2)
• "The specific disease is always more or less repeated, the epidemic is never quite repeated." (p. 24) - medicine of series which becomes the clinical model
• Population appears as a concept - something you manage 
• Hospital, family (Ch. 1)
• Police/inspectors, university (Ch. 2) 
• Is this sovereign power or disciplinary power? [Q6]
• It is the state apparatus - but its not about killing, it's about saving/producing
• Not yet a formation of disciplinary power (some examples below)
• "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." (p. 29) 
• "And yet they played an important role: by linking medicine with the destinies of states, they revealed in it a positive significance. Instead of remaining what it was, ‘the dry, sorry analysis of millions of infirmities’, the dubious negation of the negative, it was given the splendid task of establishing in men’s lives the positive role of health, virtue, and happiness; it fell to medicine to punctuate work with festivals, to exalt calm emotions, to watch over what was read in books and seen in theatres, to see that marriages were made not out of self-interest or because of a passing infatuation, but were based on the only lasting condition of happiness, namely, their benefit to the state." (p. 34)
• Still assumption is the state - in Discipline and Punish, this change in power will not be told in terms of institutions but rather techniques/technologies (sovereign power vs. disciplinary power)
• BUT detach connotations of sovereignty from "police"
• Two series of information [Q3] 
• Earlier account - map - "In the eighteenth century, the fundamental act of medical knowledge was the drawing up of a ‘map’ (repérage): a symptom was situated within a disease, a disease in a specific ensemble, and this ensemble in a general plan of the pathological world." (p. 29)
• But now: "What defines the act of medical knowledge in its concrete form is not, therefore, the encounter between doctor and patient, nor is it the confrontation of a body of knowledge and a perception; it is the systematic intersection of two series of information, each homogeneous but alien to each other—two series that embrace an infinite set of separate events, but whose intersection reveals, in its isolable dependence, the individual fact." (p. 30)
• What are two series of information? 
• Series of information about diseases & series of information about demographic information (of populations) (?)
• One example: 
• Judiciary - court determines professional abuses
• Executive - function of policing 
• System of communication between doctors - state now concerned with medical knowledge 
• There does not seem to be a top-down organization, but a structure which emerges from struggle
•  Two great myths 
• "the myth of a nationalized medical profession, organized like the clergy" and "the myth of a total disappearance of disease in an untroubled, dispassionate society restored to its original state of health" (pp. 31-32)
• Myth as ideal - this is what they told themselves they were doing
• By getting a nationalized medical profession, we eliminate disease
• Do we care about other nations? 
• How cohesive is this? - Foucault points out that its all struggle
• Tracks the two myths in p. 32
• Linked health and state (p. 34)
• Sets up norm or model of health - healthy man, non-sick man, model man (p. 34)
• What is actually produced is a society of normality? 
• "Nineteenth century medicine, on the other hand, was regulated more in accordance with normality than with health." (p. 35)

Michel Foucault – Birth of the Clinic, Preface & Chapter 1

 

Questions

Preface

Q1. How does one look at ‘things’ and ‘words’ through an archeological method? (p. xi) How should we relate these given the idea of conceptuality discussed by Tiisala?

Q2. In relation to Tiisala’s “making explicit” and savoir, is the study of systematization this “making explicit,” and is that the historical a priori? (p. xix)

Q3. What happens to the patient’s confession as a site/technique/experience of truth-telling/saying/speech within the historical and formal reorganization of medicine? (p. xiv)

Q4. Is Foucault engaging in a meta-critique of the Critique of Pure Reason? Is he asking about the conditions of possibility for the constitution of the Kantian subject? (p. xix)

Q5. How does Foucault think that the signifier can exist without the signified? (p. xvi)

Chapter 1

Q6. To what extend does the medical truth of classificatory thought/the medical gaze depend upon what is visible, and so what remains hidden? (p. 9) 

Q7. What are primary, secondary, and tertiary spatialization? (pp. 10, 15, 16)

Discussion

• Preface – change between Pomme and Bayle is “both tiny and total” (p. x)
• French Revolution demarcates the two periods
• Signifier-signified passage is a criticism of a mode of analysis of language. (p. xvi). Foucault’s voice comes back at “To speak about the thought of others” (Q5) 
• Discussion of sovereignty? (p. 4)
• Is there a Heideggerian notion of disclosure? OR Question of empiricism and its relation to language (pp. x-xi)
• How does language turn into rational discourse? – Two different “metaphorical descriptions” of        the brain.
• Question of the relation of linguistic shift as more rational as a result of being more                                     empirical 
• What gives modern empiricism its epistemological foothold? 
• OR it isn’t empiricism – it’s some kind of positive science (?)
• Modern science doesn’t see the act of seeing – doesn’t see how it constitutes subjects
• “Experience” or “appearance” as phenomenological issue – how experience has been reduced to a rational discourse
• What is the order before the order of the subject? (Q4)
• Progression of the disease being separate from the individual to them being brought together
• “What made clinical experience possible” (p. xiv) is tied to the “sovereign power of the empirical gaze” (p. xiii) (Q2)
• Discourse is the conditions of possibility for experience
• New distinction – “What is the matter with you?’, with which the eighteenth-century dialogue between doctor and patient began (a dialogue possessing its own grammar and style), was replaced by that other question: ‘Where does it hurt?’, in which we recognize the operation of the clinic and the principle of its entire discourse.” (p. xviii)
• Some non-linguistic structure – “the non-verbal conditions on the basis of which it can speak” (p. xix) (Q1 & Q2)
• How does the structure relate to power? Is there underlying pouvoir operating?
• Are there vectors of power that we can track such that this is genealogical even though Foucault is doing archaeology, here? 
• The tactical battle of hysteric and doctor in Psychiatric Power more genealogy rather than archeology (he uses the word power there)
• So, can we retroactively describe these as instances of power?
• “Play” rather than “struggle” (p. 15)
• Chapter 1 begins with criticism of perception as self-evident (epistemological foundationalism)
• “The exact superposition of the ‘body’ of the disease and the body of the sick man is no more than a historical, temporary datum. Their encounter is self-evident only for us, or, rather, we are only just beginning to detach ourselves from it.” (p. 3)
• Nosological, classification of species
• Analogies define diseases – for instance, a resemblance of symptoms 
• Before anatomical pathological, sexuality is abstracted from bodily sex – bodily sex constructed within the moment of the anatomical regime 
• Resemblances define essences, it supposedly uncovers the rational order of things, both natural and             ideal 
• Disease exists in space of essences (p. 9) 
• Disease is understood independently of the body, the body distorts the essence of disease (probably, psychological thought is like this today – we look how well you fix the essence of OCD, ADHD, etc.)
• Concrete space of perception (p. 9) 
• Primary, secondary, tertiary spatializations (pp. 15-16) 
• Primary – “the medicine of species situated the disease in an area of homologies in which the individual could receive no positive status”
• Essence of disease separated from the individual
• Secondary – “in secondary spatialization, on the other hand, it required an acute perception of the individual, freed from collective medical structures, free of any group gaze and of hospital experience itself.” 
•  “Doctor and patient are caught up in an ever-greater proximity, bound together, the doctor by an ever-more attentive, more insistent, more penetrating gaze, the patient by all the silent, irreplaceable qualities that, in him, betray—that is, reveal and conceal—the clearly ordered forms of the disease.” (p. 14)
• Cannot perceive the disease unless in the “spatial synthesis” or “density” of the patient,
• Tertiary – “Let us call tertiary spatialization all the gestures by which, in a given society, a disease is circumscribed, medically invested, isolated, divided up into closed, privileged regions, or distributed throughout cure centres, arranged in the most favorable way.” 
• “But to a greater extent than the other forms of spatialization, it is the locus of various dialectics: heterogeneous figures, time lags, political struggles, demands and utopias, economic constraints, social confrontations. In it, a whole corpus of medical practices and institutions confronts the primary and secondary spatializations with forms of a social space whose genesis, structure, and laws are of a different nature.” (p. 16)
• Are secondary and tertiary spatialization at different times or within the same discourse
• Three aspects occurring at the same time – doctors essentializing, doctors treating, and the distributed medicine of tertiary
• Different spaces of the same discursive period

 

Tiisala, PFSR - Chapter 5 and conclusion

Notes for CGC March 11, 2025

1. Can archaelogical critique actually give us a history of the present (or some present region of practices)? How can we do critique from our standpoint through archaeology? And, then, what is left for genealogy to do?

2. How does inferentialism present an alternative to social engineering? (Haslanger)

3. Can we identify conditions under which a space of reasons is devoid of power vs a space of reasons where power operates covertly?

4. Disclosing (archaeology) vs depriving (genealogy) formation? (101)

5. Is there any place for institutional/structural critique in this account of critique?

6. Rational control---goal? Is it possible?

Discussion:

Rational control as the aim of the critique, rational material as the content of critique. One does not imply the other. Does T have an overly strong conception of rational control?  

Is the broader notion of the conceptual still theoretical in some Brandomian sense after all? 

The challenge is the elements of practice that are not reducible to language. 

There is no account of pouvoir, but we do need that for elements of practice that are not conceptual.