Re: Michel Foucault--The Birth of the Clinic

看板EngTalk (全英文聊天)作者fizeau (Gratias ad Opus)時間18年前 (2008/01/09 15:53)推噓0(0推 0噓 0→)

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For Descartes and Malebranche, to see was to perceive (even in the most concrete kinds of experience, such as Descartes's practice of anatomy, or Malebranche's microscopic observations); but, without stripping per- ception of its sensitive body, it was a matter of rendering it transparent for the exercise of the mind: light, anterior to every gaze, was the element of ideality--the assignable place of origin where things were adequate to their essence--and the form by which things reached it through the geometry of bodies; according to them, the act of seeing, having attained perfection, was absorbed back into the unbending, unending figure of light. At the end of the eighteenth century, however, seeing consists in leaving to experience its greatest corporal opacity; the solidity, the obscurity, the density of things closed in upon themselves, have powers of truth that they owe not to light, but to the slowness of the gaze that passes over them, around them, and gradually into them, bringing them nothing more than its own light. The residence of truth in the dark centre of things is linked, paradoxically, to this sovereign power of the empirical gaze that turns their darkness into light. All light has passed over into the thin flame of the eye, which now flickers around solid objects and, in so doing, establishes their place and form. Rational discourse is based less on the geometry of light than on the insistent, impenetrable density of the object, for prior to all knowledge, the source, the domain, and the boundaries of experience can be found in its dark presence. The gaze is passively linked to the pri- mary passivity that dedicates it to the endless task of absorbing experience in its entirety, and of mastering it. The task lay with this language of things, and perhaps with it alone, to authorize a knowledge of the individual that was not simply of a historic or aesthetic order. That the definition of the individual should be an end- less labour was no longer an obstacle to an experience, which, by accepting its own limits, extended its task into the infinite. By acquiring the status of object, its particular quality, its impalpable colour, its unique, tran- sitory form took on weight and solidity. No light could now dissolve them in ideal truths; but the gaze directed upon them would, in turn, awaken them and make them stand out against a background of objectivity. The gaze is no longer reductive, it is, rather, that which establashes the individual in his irreducible quality. And thus it becomes possible to organize a rational language around it. The object of discourse may equally well be a subject, without the figures of objectivity being in any way altered. It is this formal reorganization, in depth, rather than the abandonment of theories and old systems, that made clinical experience possible; it lifted the old Aristotelian prohibition: one could at last hold a scientifically structured discourse about an individual. Our contemporaries see in this accession to the individual the establishment of a 'unique dialogue', the most concentrated formulation of an old medical humanism, as old as man's compassion. The mindless phenomenologies of under- standing mingle the sand of their conceptual desert with this half-baked notion ; the feebly eroticized vocabulary of 'encounter' and of the 'doctor/patient relationship' (le couple medecin-malade) exhausts itself in trying to commu- nicate the pale powers of matrimonial fantasies to so much non-thought. Cli- nical experience--that opening up of the concrete individual, for the first time in Western history, to the language of rationality, that major event in the relationship of man to himself and of language to things--was soon taken as a simple, unconceptualized confrontation of a gaze and a face, or a glance and a silent body; a sort of contact prior to all discourse, free of the bur- dens of alnguage, by which two living individuals are 'trapped' in a common, but non-reciprocal situation. Recently, in the interests of an open market, so-called 'liberal' medicine has revived the old rights of a clinic understood as a special contract, a tacit pact made between one man and another. This patient gaze has even been attributed with the power of assuming--with the calculated addition of reasoning (neither too much nor too little)--the general form of all scientific observation: In order to be able to offer each of our patients a course of treatment per- fectly adapted to his illness and to himself, we try to obtain a complete, objective idea of his case; we gather together in a file of his own all the information we have about him. We 'observe' him in the same way that we ob- serve the stars or a laboratory experiment [4]. Miracles are not so easy to come by: the mutation that made it possible--and which continues to do every day--for the patient's 'bed' to become a field of scientific investigation and discourse is not the sudden explosive mixture of an old practice and an even older logic, or that of a body of knowledge and some strange, sensorial element of 'touch', 'glance', or 'flair'. Medicine made its appearance as a clinical science in conditions which define, together with its historical possibility, the domain of its experience and the structure of its rationality. They form its concrete a priori, which it is now possible to uncover, perhaps because a new experience of disease is coming into being that will make possible a historical and critical understanding of the old experience. A detour is necessary here if we are to lay the foundations of our discourse on the birth of the clinic. It is a strange discourse, I admit, since it will be based neither on the present consciousness of clinicians, nor even on a repetition of what they once might have said. -- ※ 發信站: 批踢踢實業坊(ptt.cc) ◆ From: 163.25.118.131