Amazon.com: Customer Reviews: The Birth of the Clinic: An Archaeology of Medical Perception
Your Garage Summer Reading Amazon Fashion Learn more nav_sap_plcc_ascpsc Recess Monkey Fire TV Stick Sun Care Patriotic Picks Shop-by-Room Amazon Cash Back Offer roadies roadies roadies  Amazon Echo  Echo Dot  Amazon Tap  Echo Dot  Amazon Tap  Amazon Echo Introducing new colors All-New Kindle Oasis UniOrlando Best Camping & Hiking Gear in Outdoors

Customer Reviews

4.5 out of 5 stars21
Format: Paperback|Change
Price:$11.35+ Free shipping with Amazon Prime
Your rating(Clear)Rate this item


There was a problem filtering reviews right now. Please try again later.

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.
22 comments|16 people found this helpful. Was this review helpful to you?YesNoReport abuse
on May 10, 2002
Foucault has been interpreted in the US as a pretentious standard-bearer of postmodernism - as an almost "evil" figure who threatens to undermine the foundations of Western knowledge with his problematisation of conceptual categories. It doesn't help that his work has been taken up to justify just about any subversive perspective, whether well-conceived or not. This is only a pitifully small perspective on the man and his work. Foucault should be seen first as a historian, not a philosopher; second, his work should be lauded for the contribution it makes to Western knowledge rather than the superficial "threats" it makes to perspectives whose time has come in any event. Every revolution of perception has been accompanied by vociferous resistance, yet a great many of those sounding their disapproval loudly probably don't really understand what the late Michel was really on to.

The Birth of the Clinic, MF's most accessible work, is a well-researched, brilliantly interpreted account of the development of the clinical "gaze" in the wake of modern medical knowledge and practice. Foucault problematises the institution of the clinic, showing how clinical perception is the result of a historically specific constellation of knowledge and power. His ultimately emancipatory analysis is substantiated every step of the way with textual and historical examples. No metaphysics here, just a radical questioning of the nature of knowledge within institutional practice.

So, sorry (Objectivists!) if this is too much to handle. It's good research, plain and simple. Don't dismiss Foucault as a lightweight postmodernist - try to see him where he would situate himself, in the tradition of reflexive historical sociology.
11 comment|43 people found this helpful. Was this review helpful to you?YesNoReport abuse
on July 21, 1998
In this short book that forms a worthy companion to his classic "Madness and Civilisation," Michel Foucault first traces the history of medical care from the days when people were usually treated at home by their families, to the early nineteenth century, when public health became a political issue. The outcome of this process was the "clinic," which Foucault defines a field of confinement where those labelled ill, the Other, were monitored and treated to further the reciprocally-linked goals of the health of society and the furtherance of medical knowledge.
Foucault's well-documented narrative concerning the evolving socio-political perception of health and medicine, however, pales in erudition and philosophical significance when compared to the primary thrust of the book ; namely, in detailing how the medical profession ordered and analyzed not only disease, but later the human experience itself. Both seeming to have pushed back the finality ! of death through conjoining to it to the experience of life, and isolating disease not as a phenomenon in itself, but like life and death, simply as a discursive manifestation of visible and invisible symptoms, the medical profession acquired for itself the mantle of positivism that is still basically unquestioned by the public even today.
0Comment|11 people found this helpful. Was this review helpful to you?YesNoReport abuse
on May 17, 1998
This book examines our cultural tendency to elevate the authority of the physician. It introduces the concept of the clinical gaze and describes the way the myth of this gaze was developed in the early Enlightenment atmosphere and fostered the birth of the clinic. A detailed online summary by Lois Shawver, with excerpts and page numbers, can be found through some of the standard search engines.
0Comment|8 people found this helpful. Was this review helpful to you?YesNoReport abuse
TOP 100 REVIEWERon December 30, 2014
Michel Foucault (1926-1984) was a French philosopher, historian of ideas, and social theorist and activist; he wrote many books, such as Madness and Civilization: A History of Insanity in the Age of Reason,Discipline & Punish: The Birth of the Prison,The History of Sexuality, Vol. 1: An Introduction,The History of Sexuality, Vol. 2: The Use of Pleasure,The History of Sexuality, Vol. 3: The Care of the Self, etc. Openly gay [see the James Miller biography, The Passion of Michel Foucault], he died of AIDS---the first "public figure" in France to die of the virus.

After quoting an 18th century doctor treating a hysteric, he comments in the Preface, "How can we be sure that an eighteenth century doctor did not see what he saw, but that it needed several decades before the fantastic figures were dissipated to reveal, in the space they vacated, the shapes of things as they really are? What occurred was not a `psychoanalysis' of medical knowledge... `positive' medicine is not a medicine that has made an `objectal' choice in favor of objectivity itself... What has changed is the silent configuration in which language finds support: the relation of situation and attitude to what is speaking and what is spoken about." (Pg. x-xi)

He adds, "the clinic appears---in terms of the doctor's experience---as a new outline of the perceptible and statable: a new distribution of the discrete elements of corporal space... a reorganization of the elements that make up the pathological phenomenon... a wedding of the disease onto the organism... The appearance of the clinic as a historical fact must be identified with the system of these reorganizations." (Pg. xviii)

He states, "In order to know the truth of the pathological fact, the doctor must abstract the patient: ... Paradoxically, in relation to that which he is suffering from, the patient is only an external fact; the medical reading must take him into account only to place him in parentheses... It is not the pathological that functions, in relation to life, as a counter-nature, but the patient in relation to the disease itself." (Pg. 8)

He observes, "It is often thought that the clinic originated in that free garden where, by common consent, doctor and patient met, where observation took place, innocent of theories, by the unaided brightness of the gaze, where, from master to disciple, experience was transmitted beneath the level of words. And to the advantage of a historical view that relates the fecundity of the clinic to a scientific, political, and economic LIBERALISM, one forgets that for years it was the ideological theme that prevented the organization of clinical medicine." (Pg. 52)

He summarizes, "In the eighteenth century, then, the clinic was already a much more complex form that a mere knowledge of cases... But in a few years... the clinic was to undergo a sudden, radical restructuring: detached from the theoretical context in which it was born, it was to be given a field of application that was no longer confined to that in which knowledge was SAID... in which it was born, put to the test, and fulfilled itself: it was to be identified with the WHOLE of medical experience. For this, it had to be armed with new powers, detached from the language on the basis of which it had been offered as a lesson, and freed for the movement of discovery." (Pg. 62)

He suggests, "The clinic was probably the first attempt to order a science on the exercise and decisions of the gaze... it was no longer the of any observer, but that of a doctor supported and justified by an institution, that of a doctor endowed with the power of decision and intervention. .. it was a gaze that was not content to observe what was self-evident; it must make it possible to outline chances and risks; it was calculating." (Pg. 89)

He argues, "As pathological anatomy becomes more accurate in situating the seat of the disease, it would seem that the disease itself withdraws ever more deeply into the intimacy of an inaccessible process." (Pg. 175)

An excellent companion to Foucault's "Madness and Civilization" and "Discipline and Punish," this is one of his most important books.
0Comment|One person found this helpful. Was this review helpful to you?YesNoReport abuse
TOP 100 REVIEWERon December 30, 2014
Michel Foucault (1926-1984) was a French philosopher, historian of ideas, and social theorist and activist; he wrote many books, such as Madness and Civilization: A History of Insanity in the Age of Reason,Discipline & Punish: The Birth of the Prison,The History of Sexuality, Vol. 1: An Introduction,The History of Sexuality, Vol. 2: The Use of Pleasure,The History of Sexuality, Vol. 3: The Care of the Self, etc. Openly gay [see the James Miller biography, The Passion of Michel Foucault], he died of AIDS---the first "public figure" in France to die of the virus.

After quoting an 18th century doctor treating a hysteric, he comments in the Preface, "How can we be sure that an eighteenth century doctor did not see what he saw, but that it needed several decades before the fantastic figures were dissipated to reveal, in the space they vacated, the shapes of things as they really are? What occurred was not a `psychoanalysis' of medical knowledge... `positive' medicine is not a medicine that has made an `objectal' choice in favor of objectivity itself... What has changed is the silent configuration in which language finds support: the relation of situation and attitude to what is speaking and what is spoken about." (Pg. x-xi)

He adds, "the clinic appears---in terms of the doctor's experience---as a new outline of the perceptible and statable: a new distribution of the discrete elements of corporal space... a reorganization of the elements that make up the pathological phenomenon... a wedding of the disease onto the organism... The appearance of the clinic as a historical fact must be identified with the system of these reorganizations." (Pg. xviii)

He states, "In order to know the truth of the pathological fact, the doctor must abstract the patient: ... Paradoxically, in relation to that which he is suffering from, the patient is only an external fact; the medical reading must take him into account only to place him in parentheses... It is not the pathological that functions, in relation to life, as a counter-nature, but the patient in relation to the disease itself." (Pg. 8)

He observes, "It is often thought that the clinic originated in that free garden where, by common consent, doctor and patient met, where observation took place, innocent of theories, by the unaided brightness of the gaze, where, from master to disciple, experience was transmitted beneath the level of words. And to the advantage of a historical view that relates the fecundity of the clinic to a scientific, political, and economic LIBERALISM, one forgets that for years it was the ideological theme that prevented the organization of clinical medicine." (Pg. 52)

He summarizes, "In the eighteenth century, then, the clinic was already a much more complex form that a mere knowledge of cases... But in a few years... the clinic was to undergo a sudden, radical restructuring: detached from the theoretical context in which it was born, it was to be given a field of application that was no longer confined to that in which knowledge was SAID... in which it was born, put to the test, and fulfilled itself: it was to be identified with the WHOLE of medical experience. For this, it had to be armed with new powers, detached from the language on the basis of which it had been offered as a lesson, and freed for the movement of discovery." (Pg. 62)

He suggests, "The clinic was probably the first attempt to order a science on the exercise and decisions of the gaze... it was no longer the of any observer, but that of a doctor supported and justified by an institution, that of a doctor endowed with the power of decision and intervention. .. it was a gaze that was not content to observe what was self-evident; it must make it possible to outline chances and risks; it was calculating." (Pg. 89)

He argues, "As pathological anatomy becomes more accurate in situating the seat of the disease, it would seem that the disease itself withdraws ever more deeply into the intimacy of an inaccessible process." (Pg. 175)

An excellent companion to Foucault's "Madness and Civilization" and "Discipline and Punish," this is one of his most important books.
0Comment|Was this review helpful to you?YesNoReport abuse
on June 15, 2016
Pretentious, dated treatise on the origin of "modern" clinical practices. The language is hopelessly convoluted and seemingly choosen to impress other philosophers rather than communicate useful insights or ideas. A major problem is that Foucault makes his observations and inferences as a complete outsider, lacking much of the comprehension needed to interpret the events and records he describes. The result is a book that is at least as much fiction as fact, despite the ample reference listings that follow each chapter. While the subject matter itself is interesting enough you are better off finding other resources to learn about it.
0Comment|Was this review helpful to you?YesNoReport abuse
on September 1, 1999
" The birth of the Clinic " is an attempt by the philosopher and the learned historian to decipher the secret of medical perception. Only when the chaotic and subjective clinical experience is transcended to the objective language, we have the medicine as a scientific subject as today. As a physician myself , I think understanding " clinical gaze " helps me to define the place of modern medicine, of doctors and patients and of medical organisation in this fast changing world.
0Comment|8 people found this helpful. Was this review helpful to you?YesNoReport abuse
on September 8, 2006
Birth of the Clinic is a partner to Discipline and Punish: Birth of the Prison. They are both about political economy and the irony of how the modern 'free' world is as confining as previous historical eras just in an opposite way. This is kind of Foucault's whole mission, to show us just how confined we really are and wake us up to reality. But he is always subtle about it. In a way his 'philosophy' and 'methodology' and the wild theoretical tangents the academies have taken it to, are a mask for his very powerful and even dangerous political indictments. In Discipline and Punish (Surveil in French) Foucault shows historically how individual time and space have been controlled by the ever evolving, profit-driven, techno-efficiency of the panopticon-state and the distracted aquiescence of its subjects. In Birth of the Clinic he will show historically how the individual person and their body have become property of the state via consensus (law) and the same somnambulent aquiescence. In many ways Foucault is a major conservative showing us empirically, through historical evidence, how the power-play of today is an interiorization of past power-relationships, interiorized to the point of invisibility and largely unacknowledged by the manipulated masses.
0Comment|5 people found this helpful. Was this review helpful to you?YesNoReport abuse
on May 5, 2011
Michel Foucault's determination to trace the historical growth and impact of institutionalized incarceration on those on the outer periphery of power began with Madness and Civilization (1961) and continued two years later with The Birth of the Clinic. In the former, Foucault sees an inverse relation between the construction of hospitals and the ability of the insane to retain their freedom to walk about without fear of enforced incarceration by doctors who are less interested in the mental health of their patients than in accumulating raw power. As the former increases, the latter decreases. The clinic as we generally think of it today is, according to Foucault, a direct result of a rapid change in the way that doctors prior to the 18th century practiced medicine. Before the Age of Reason, doctors tended to treat diseases rather than patients, who were of interest only insofar as the patients gave doctors an opportunity to expand the vistas of knowledge by zeroing in on how disease affected a patient rather than how a patient overcame a disease. Advances in medicine and science combined with a concomitant surge in the primacy of reason to convince doctors that the patient should be placed on a higher level than his disease. In order to accommodate an upsurge in dissection and vivisection, new buildings called "clinics" were constructed that were later used to forcibly house those patients diagnosed as mentally incompetent. Foucault considered this early concept of the clinic as an unfortunate marker of patient degradation. As soon as doctors discovered that they could require incarceration of patients merely by certifying them as in dire need of immediate medical care, they could scarcely resist the god-like power to do so. It is precisely here that one of Foucault's major theses appears: power and knowledge are inextricably intertwined in a legal and philosophical bear hug that requires the one with the power to exercise it against the one without it.

One problem with this thesis is that power, to Foucault, is an end unto itself. Doctors must then accumulate power to use in ways that they make up as they go along. And since Foucault had an abiding interest in the fate of the marginalized--gays, the mad, criminals, etc--it seemed natural to him to assume that anyone who uses power must use it to gain dominion over those who cannot resist. It is this sole focus that made Foucault such a darling of the academic left. Yet, if history has taught us anything it is that those who seek power do not do so solely to emulate O'Brien's torturing of Winston Smith in 1984 just to control others; power must have a measurable payoff, most often in wealth, lust, territory, and personal aggrandizement. Foucault's power has nothing to do with any of these basic drives. Power leads to control leads to repression, and so on in a dreary world that is made drearier if the entire structure of society is modeled after the paradigm of the clinic. And this is the true point of The Birth of the Clinic. Foucault envisions the root cause of repression of the entire spectrum of western society--schools, prisons, hospitals, and the like--are no more than repressive variations of the basic clinic model. Once people have been conditioned en masse to submit themselves to the control of others in such rigidly controlled environments, then the cost of control declines even as the power to control increases. This book is indeed a dreary interpretation of society that can easily accommodate competing theories. But for those who are entranced by the misguided precepts of Michel Foucault, none other will do.
0Comment|6 people found this helpful. Was this review helpful to you?YesNoReport abuse