Caughey AB, et al. Nonpharmacologic approaches to management of labor pain. https://www.uptodate.com/contents/search. Accessed Oct. 28, 2021. The Birth of the Clinic: An Archaeology of Medical Perception ( Naissance de la clinique: une archéologie du regard médical, 1963), by Michel Foucault, presents the development of la clinique, the teaching hospital, as a medical institution, identifies and describes the concept of Le regard médical ("the medical gaze"), and the epistemic re-organisation of the research structures of medicine in the production of medical knowledge, at the end of the eighteenth century. Although originally limited to the academic discourses of post-modernism and post-structuralism, the medical gaze term is used in graduate medicine and social work. [1] The medical gaze [ edit ] 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 Review There's some very sharp reminders in here of why Foucault is considered a descendent of Nietzsche. The one most important for me is that, unlike most philosophers, he's a damn good writer. His love of language shines almost as brightly. The clinic—constantly praised for its empiricism, the modesty of its attention, and the care with which it silently lets things surface to the observing [medical] gaze without disturbing them with discourse—owes its real importance to the fact that it is a reorganization-in-depth, not only of medical discourse, but of the very possibility of a discourse about disease. [5] The Doctor by Sir Luke Fildes (1891)

By what right can one transform into an object of clinical observation a pacient whose poverty has compelled him to seek assistance at the hospital? When it's time to push, you may experiment with different positions until you find one that feels best. You can push while squatting, sitting, kneeling — even on your hands and knees.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?

T]he 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” (xiii-xiv). At the beginning of the nineteenth century, doctors described what for centuries had remained below the threshold of the visible and the expressible, but this did not mean that, after over-indulging in speculation, they had begun to perceive once again, or that they listened to reason rather than to imagination; it meant that the relation between the visible and invisible—which is necessary to all concrete knowledge—changed its structure, revealing through gaze and language what had previously been below and beyond their domain. A new alliance was forged between words and things, enabling one to see and to say. Sometimes, indeed, the discourse was so completely ‘naive’ that it seems to belong to a more archaic level of rationality, as if it involved a return to the clear, innocent gaze of some earlier, golden age” (p.xii).Tip voor de lezer die net als ik geen filosofische achtergrond heeft: na de inleiding wordt het boek een stuk beter te begrijpen! (De inleiding is volstrekt logisch nadat je het boek uit hebt) . Modern medicine has fixed its own date of birth as being in the last years of the eighteenth century. Reflecting on its situation, it identifies the origin of its positivity with a return—over and above all theory—to the modest but effecting level of the perceived. In fact, this supposed empiricism is not based on a rediscovery of the absolute values of the visible, nor on the predetermined rejection of systems and all their chimeras, but on a reorganization of that manifest and secret space that opened up when a millennial gaze paused over men’s sufferings. Nonetheless the rejuvenation of medical perception, the way colours and things came to life under the illuminating gaze of the first clinicians is no mere myth. 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)