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There's no such thing as pure seeing...
on January 17, 2013
This is a hard book to summarize, so I am not even going to try. I am simply going to point out some themes from the book. The book is, ultimately, a history of medicine, or the medical gaze, that covers, I believe, the period from the end of the eighteenth to the beginning of the nineteenth century. There were some pretty major transitions in medical perception, and in the theory of disease, during that period. Foucault uses that period in medical transformation to illustrate some more general philosophical and epistemological points.
The main point, I think, of the book is that there is no such thing as "pure seeing". The medical professionals who were responsible for the shift in medicine that took place in the time period Foucault is covering conceived the transformation in terms of an abandonment of the distortions of theory in favor of a pure seeing. The myth is of a science that abandoned its stock of traditional and metaphysical theories in order to make itself into a genuine empirical science. Foucault argues that the transformation was actually a transformation in medical perception itself. There was a kind of gestalt switch which produced a different form of visibility. However, the new vision was still mediated by its own concrete, historical a priori.
The major transformation was from what Foucault called a nosological theory of disease, in which diseases were treated as species, and in which symptoms served as signs for determining the species of disease, to a theory of disease where disease was located in the body, and where visible lesions were no longer signs, but were the disease itself. Disease is no longer the invasion of some foreign essence, but is, instead, a breakdown in the body itself. The disease itself became visible in the body and not just its signs. This is what Foucault means when he says that the form of visibility changes. Formerly, all the visible symptoms were merely signs that allowed the doctor to place the disease in an already constructed taxonomy of the species of disease. After the change, the disease itself becomes visible in the full light of day. Strangely, bringing disease into the full light of day required a new relation to death, since it was only through dissection that doctors were able to make the internal lesions, that were the disease itself, visible.
The point here, I think, is that doctors from both periods were "seeing" things. The transformation was not, therefore, a transformation from a metaphysical to an empirical science. The change was in the form of visibility, or a change in the distribution of the visible and the invisible, and in the conceptual spaces, or historical a prioris, informing vision.
The book also tries to connect the changes in medical perception to institutional reforms around the French revolution. This is a very interesting part of the book. Foucault describes debates that took place during the French revolution about how to organize medicine. However, I did not think that Foucault did enough to connect those institutional debates and changes with the changes in medical perception. Either that, or I just did not follow the connections.
Ultimately, the book deals with some really important epistemological problems, and problems relating to the philosophy of science. I think one of the major take aways of the book is that perception is always mediated by theory. That is, obviously, an overly simplistic summary of the thesis of the book. Foucault's thesis is, I think, more complex than that. Foucault, I think, might take issue with my use of the term "theory". I think Foucault would argue that there is something deeper at work, something below the level of any specific theory, that is shaping the form perception takes in an epoch. Perhaps it would be better to just use Foucault's own terms: perception is always based on an historical a priori (what Foucault eventually calls an episteme). Foucault supports that claim with a wealth of empirical detail that it is not really possible to summarize in an amazon review. The empirical detail can make the book a little slow going in places, especially for those who are not familiar with eighteenth century medical terminology. I found my mind wandering at times, and often had to read sections over and over, because I was getting a bit bored with all the medical terminology. However, there were parts of the book that I thought were extremely exciting as well, so it is definitely worth sticking with it.
Addendum: I rarely do this kind of thing, but I have quickly browsed through the other reviews of this book, and I feel I have to warn readers somewhat. I think a lot of the reviews of this book are somewhat misleading. It seems to me that most of the reviews of this book are reading this book through Foucault's later work, and his analysis of power in particular. That is not really what this book is about. There is actually very little discussion of the clinic as an institution, and Foucault nowhere argues, that I can remember, that physicians were utilizing supposedly objective knowledge to incarcerate their patients, or define people as deviant. There is just nothing like that in this book. People should take the subtitle seriously, it is an "archaeology of medical perception."
It is a book about epistemological formations, and transformations in medical perception. It is a about a shift in historical a prioris that gave rise to a new organization of medical perception and knowledge. Foucault does argue that these changes in medical perception and knowledge were tied to institutional shifts in medicine around the French revolution, although, as I mentioned in the main body of my review, I do not think that Foucault does enough to tie the shifts in medical perception that he sees to those institutional shifts. The only reason I am adding this addendum is that I do not want people to be misled about the contents of this book. If you are looking for a book about power hungry doctors using their supposedly objective knowledge to define people as deviant and incarcerate them then you are going to be disappointed with this book. That just is not what it is about.