Canguilhem, "Diseases" and "Health" from Writings on Medicine

The group began with questions.

[1] What is the thesis in these pieces? PP. 48: health becoming an object of calculation. The body as given. What should we make of this?

[2] PP. 39: “We would nevertheless….social facts”. In what sense are patients not social facts? Is there a distinction between social factors in medicine and psycho-somatic qualities that he discusses below?

[3] PP. 38: “Should the introduction….” Discussion of the “in vogue” paradigm. What other sources (other than immunology) are there for thinking about disease? Where else does GC look for an account of disease?

Is the reading of health and the history of philosophy performing an account of disease and human experience?

[4] PP. 37-8 How is the discussion for living conditions integrated into an understanding of disease? How does this relate to inequality?

PP. 50 does GC contrast his own account with the phenomenological account?

[5] Could we apply Delaporte’s ‘epistemographic’ framework to make sense of the disease chapter? What does GC mean in claiming that health is the truth of the body?

 Discussion ensued.

The Normal and the Pathological : is disease merely a quantitative variation of the normal state? GC: no.

Do sciences of the normal and the pathological exist? Are these discrete? CG: 228. only a science of what is called normal. He is critical of the idea that physiology comes before pathology. We actually start with pathology (the way that knowledge actually develops): ‘the patient calls the doctor’. Eventually that gives rise to questions about normality.

GC is criticizing the ideas that there is no self-standing “ontology” of disease. It is always a quantitative distance from the health.

Three problems with this view: (i) rationalist optimism: evil has no reality. (ii) the view is too deterministic (Laplace). (iii) the reduction of quality to quantity.

CG is doing historical epistemology. But is he also doing epistemocritical work too? He is not only charting the discursive shift, but wants to make a positive argument for why conception of health is better than another.

At the end, GC seems to suggest that Merleau-Ponty was paving the way for his own view. On pp. 48, he refers to the body as having different qualities—then this is taken up in relation to health. He also does not want to embrace a kind of anti-medicine.

CG wants to see the body as both given and constructed. But does not seem to want to take the phenomenological route to make this point. He seems to want to preserve a space for experience viz a viz the body (or health and disease?).

Perhaps what CG is rejecting is a kind of reductionism of health to either the first or third personal perspective.

37-8: The treatment of disease in the hospitals systematically erase or decontextualize them from their social conditions. There is an interesting connection between production and medicine.

GC seems like he is interested in different registers: social, biological, etc.. and wants to leave room for a kind of phenomenological point of view within each.

Is GC just rejecting the idea that ophthalmology patients are purely social facts?

He wants to affirm both the sociological and the medical.