But we are concerned here not simply with medicine and the way in which, in a few years, the particular knowledge of the individual patient was structured. For clinical experience to become possible as a form of knowledge, a reorganization of the hospital field, a new definition of the status of the patient in society, and the establishment of a certain relationship between public assistance and medical experience, between help and knowledge, became necessary; the patient has to be enveloped in a collective, homogeneous space. It was also necessary to open up language to a whole new domain: that of a perpetual and objectively based correlation of the visible and the expressible. An absolutely new use of scientific discourse was then defined: a use involving fidelity and unconditional subservience to the coloured content of experience—to say what one sees; but also a use involving the foundation and constitution of experience—showing by saying what one sees.” (p.196)

Ik miste wel de laatste vertaalslag naar de hedendaagse geneeskunde, de geneeskunde van de microbiologie, genetica, farmacologie. We eindigen op een punt waar de geneeskunde de chemie nog afwees - wat veranderde er eigenlijk zodat de geneeskunde echt een soort van verlengstuk van de biologie werd? Disease is perceived fundamentally in a space of projection without depth, of coincidence without development. There is only one plane and one moment. The form in which truth is originally shown is the surface in which relief is both manifested and abolished—the portrait: ‘He who writes the history of diseases must… observe attentively the clear and natural phenomena of diseases, however uninteresting they may seem. In this he must imitate the painters who when they paint a portrait are careful to mark the smallest signs and natural things that are to be found on the face of the person they are painting.' Prior to this time, diseases were viewed in a rather Aristotelean sense: they were viewed as beings (substances) themselves, to be classified according to their accidental properties. The physician’s task was to discover the disease, to classify it and to let it develop along a natural course. There is an almost exact analogy to be drawn with the botanist, who studies, classifies and cultivates plants. Within this structure of knowledge, the patient is a negative factor – his body distorts the way the disease manifests himself. The physician has to negate the patient, and himself as well (as observer), and view the disease in its pure manifestation. In many ways this book is a structuralist analysis of the kinds of discourses that go on in medicine. There is some incredibly interesting stuff at the start where the disadvantages of putting people into hospitals prior to the French Revolution is discussed by doctors at the time because they understood illness as something needing to be explained in relation to the patient’s entire life as lived and in the hospital a person stops being a person and becomes merely an example of an illness. This shifting relationship between what one is and what one becomes due to where one is, how one is being observed, is really interesting and still relevant today. I think it is also interesting in relation to more than just medicine – also education, workplaces, the courts and so on.

NIPT

the development of clinical medicine, of pathology (this part is quite tenuous to read especially if you are a doctor and know the actual state of the arts. because those whole "ancient" theories about tissues and diseases are nowadays outdated, you can read them and think of them as medical dystopies (HAHAHA). Nevertheless, the reasons for inventing the stethoscope are quite funny (as the doctor was not allowed to put his ear on the woman's chest)

St. Godard, E. E. (2005). "A better Reading". Canadian Medical Association Journal. 173 (9): 1072–1073. doi: 10.1503/cmaj.051067. PMC 1266341. Access-restricted-item true Addeddate 2023-01-23 15:27:59 Autocrop_version 0.0.14_books-20220331-0.2 Boxid IA40821218 Camera Sony Alpha-A6300 (Control) Collection_set printdisabled External-identifier According to Foucault, during the eighteenth century this way of viewing diseases was transformed on a structural level. This development heralded the birth of the clinic, which itself is the birth of modern medicine. Learned [and] rewarding... The Birth of the Clinic continues [Focault's] brilliant history, not of ideas as such, but of the structures of perception."-- The New York Times Book ReviewThis period saw the attempt to model medicine on the chemical approach. In chemistry there had occurred huge breakthroughs through the method of analysis: breaking up substances in their elements and describe their relations and proportions through observation. Similarly, doctors started breaking down diseases into elements and their relations, trying to quantify these through the observation of huge amounts of patients. Medicine became statistics and observation – fitting neatly into the current trend of transforming almost everything into mathematical models. If this is a structuralist account we can expect some talk about signs, signifiers and the signified. And, being medicine, some talk of symptoms also seems inevitable. But what is the difference between a sign and a symptom? The problem is that we have a fairly limited vocabulary of signs – ‘my stomach hurts, I’ve a sore head, it’s a kind of stabbing pain here” – and putting these signs together so as they add up to symptoms defining a disease can be anything but obvious. Particularly given a disease is generally temporal in nature and therefore changes over time.