The Birth of the Clinic: An Archaeology of Medical Perception. by Michel Foucault; A. M.

Sheridan Smith Review by: Roger Hahn American Journal of Sociology, Vol. 80, No. 6 (May, 1975), pp. 1503-1504 Published by: The University of Chicago Press Stable URL: http://www.jstor.org/stable/2777325 . Accessed: 05/11/2013 17:17
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Book Reviews in thinking seriously about deviance.Let us hope that otherswill follow Selby'slead. The Birth of the Clinic: An Archaeology of Medical Perception.By Michel Foucault. Translated by A. M. Sheridan Smith. New York: Pantheon Books,1973.Pp. xix+215. $8.95. RogerHahn University of California, Berkeley Michel Foucault'sNaissance de la clinique (1963) is a terrible book. It is terribly annoying because of the impressionistic style,the faultyconstruction, thewillful effort to createnew concepts by manipulating traditionallanguage, and the forced desirecontinually to transcend the banal. It is also terribly perceptive and suggestive, in ways that are hard to In reading express. it again,I had the senseof participating in a momentous act of creationfullof flashes of beauty but capable of totallydifferent, noncontradictory interpretations. The book is closer to a work of modernart than to a sociologicaltreatiseabout the development of the art of healingin France fromabout 1780 to 1820. To grasp it in all the fullness of its meaning would requirea long analysisof all Foucault's works,especiallyMadness and Civilizationand The Order of Things. The book functions simultaneously on threelevels.The mostconcrete, and mosteasy to criticize, is the narrative level. Foucault tells the story of the emergence of a new medical gaze (regard) fromthe traditional medicine of the 17thand 18thcenturies. Traditionalmedicine reliedon classifying illnessesand curingthe category(to the point of preferring an understanding and controlof the evolutionof epidemicsbased on statisticaldata about the incidenceand spread of particular"fevers") rather than examiningthe patients and dealing with them as individuals. In contrast, the "clinical" style developedby French doctors in the closingyears of the 18th century shiftedattentionaway from nosological considerations and governmental committees and towardhospitals, wherepatientswere treatedfor specificpathologicalsymptoms. Foucault advancesthe plausiblebut unproven idea that this transformation owed much to the sociopolitical climateof the FrenchRevolution, of the through the reorganization of medicaleducation,the revaluation for professions of the healingarts, and the creationof new institutions and treating examining the sick. Yet because of his impressionistic style, in eitherthe one neverknowsforsure what Foucault considers primary, ontological or the historical sense. One has no idea of how representative his data are fora period(or indeedhow he periodizes his data) or which is his key variable.Foucault takesrefuge from makingcausal statements by relying on a narrative-evocative stylewhichis sprinkled withlearned quotations,oftenfromobscureworks,that are meant to reassurethe 1503

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of Sociology Journal American but remain skepI am fascinated As a historian, readerof his erudition. tical and unconvinced. Here,I pitythe translator, The secondlevelis verbaland structuralist. plays with the French Foucault consciously whose task was impossible. popular tiedto current he reliedon connotations, In theoriginal, language. setting. in another thathave no equivalent languageor to Frenchculture, Much of whatis alreadyvague (or poetic,if one is charitable)in French seemed opaque, I becomesnonsensein English. When the translation of thelanguage and moreoftengraspedthe melody to the original turned the Englishwas than its meaning.But while the Frenchwas hypnotic, as muchas the editor the translator One can criticize soporific. generally the translation. who commissioned What emerges at thissecondlevel is theextentto whichthe revolution of the place of illnessin the in medicalstyleinvolveda new perception social and of a corresponding and the necessity life cycle of individuals, "anatomo-clinvocabularyto encompassthis revolutionary professional to The new methodreliedon the abilityof the physician ical" method. of a patientinto a languageof recogsymptoms pathological translate nizable signs and into a pictureof illness drawn in a new perceptual archistatic, "geometrical space. Abandonedwas the two dimensional, in favorof a visionof diseaseas possessof nosological tecture" concepts, hospitaloffered What the teaching and symptoms. ing its own evolution to a patternof signs made evidentby new was morea new sensibility than the abilityto examinstruments and professional mentalconstructs nexuses. and occupational theirfamily of cases isolatedfrom ine a variety by Laennec Foucault explainsthis best when he evokes the rediscovery applied in clinwhichwas successively of Auenbrugger's "pectoriloquy," ics to healthyand diseased patients,as well as to those who had succumbed. The third-and forme the mostsuggestive-levelof Foucault's work of to the new conception is the cultural.He linksthe medicalrevolution To illustratethis, Westerncivilization. in 19th-century death emerging and to offer the potentialreadera taste of Foucault's complexthought his concluon death takenfrom and heavyprose,I end witha selection sion: it has been of evil,to which themetaphysics awayfrom Diseasebreaks of deaththefullform in thevisibility forcenturies; and it finds related Conceived in relation terms. to in positive its content in which appears thecauses, ofwhich negative disease wasthenon-assignable forms, nature, and againstan everonly indirectly and manifestations were offered diseasebecomes exhausto death, seenin relation background; receding dissection of to the sovereign remainder open without tivelylegible, becametheconcrete a priori and of thegaze.It is whendeath language itself from counter-nature thatdeathcoulddetach of medical experience embodied in theliving bodiesof individuals. [P. 196] and become 1504

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