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