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?