foucault birth of the clinic summary

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Complete summary of Michel Foucault's The Order of Things. [1] His pursuit of history and philosophy was therefore seen as an interest rather than a scholarly endeavor. Shit is crazy, man. As in his classic Madness and Civilization , Michel Foucault shows how much what we think of as pure science owes to social and cultural attitude—in this case, to the climate of the French Revolution. Change ), Science Finds, Industry Applies, Man Conforms, http://plato.stanford.edu/entries/foucault/. Foucault described this way of practicing medicine using a spatial metaphor of depth and dimensionality. In fact, the gaze implies an open field, and its essential activity is of the successive order of reading; it records and totalizes; it gradually reconstitutes immanent organizations; it spreads out over a world that is already the world of language, and that is why it is spontaneously related to hearing and speech; it forms, as it were, the privileged articulation of two fundamental aspects of saying (what is said and what one says). As in his classic Madness and Civilization, Michel Foucault shows how much what we think of as pure science owes to social and cultural attitude—in this case, to the climate of the French Revolution. Not the final cause, but the original site. Only individual illnesses exist: not because the individual reacts upon his own illness, but because the action of the illness rightly unfolds in the form of individuality. [8] For a discussion of the differences between archaeology and historical epistemology, see Francois Delaporte, “The History of Medicine according to Foucault,” in Foucault and the Writing of History, ed. Methodologically, the central discovery of The Birth of the Clinic becomes not the shift from nosology to medical perception but the change of discourse from finitude to degeneration of life in the way of thinking about embodiment and disease. Bergson is strictly in error when he seeks in time and against space, in a silent grasp of the internal, in a mad ride towards immortality, the conditions with which it is possible to conceive of the living individuality. (191), Deviation in life is of the order of life, but of a life that moves towards death. Conceived in relation to nature, disease was the non-assignable negative of which the causes, forms, and manifestations were offered only indirectly and against an ever-receding background; seen in relation to death, disease becomes exhaustively legible, open without remainder to the sovereign dissection of language and of the gaze. (xviii), […] to comment is to admit by definition an excess of the signified over the signifier; a necessary, unformulated remainder of thought that language has left in the shade—a remainder that is the very essence of that thought, driven outside its secret—but to comment also presupposes that this unspoken element slumbers within speech (parole), and that, by a super-abundance proper to the signifier, one may, in questioning it, give voice to a content that was not explicitly signified. Moreover, it was a gaze that was not bound by the narrow grid of structure (form, arrangement, number, size), but that could and should grasp colours, variations, tiny anomalies, always receptive to the deviant. Much like his previous effort, The Birth of the Clinic sought to critically analyze the accepted practice of the medical profession. (207), The individual is not the initial, most acute form in which life is presented. Chapters 6 and 7 described the emergence of the medical gaze by incorporating the philosophical thought of Condillac, the medical practice of Cabanis, and an analysis of the linguistic structure of symptoms. Foucault contended that medical procedures effectively disembodied the … Instead, he took a post-structuralist approach that treated history as a structure of power and knowledge that needed to be interpreted on the level of language. Foucault then evokes two spaces which feed into the establishment of the ‘gaze’ and the ‘language’ of health, illness and medicine, namely ‘the clinic’ and ‘the teaching hospital’. Positive here should be taken in the strong sense. This article consists of excerpts from The Birth of the Clinic summary and commentary.

And doctors begin to describe phenomena that for centuries had remained below the threshold of the visible and expressible.In The Birth of the Clinic the philosopher and intellectual historian who may be the true heir to Nietzsche charts this dramatic transformation of medical knowledge. [16] Foucault, The Birth of the Clinic, 70. [22] Michel Foucault, “Questions of Method,” in The Foucault Effect: Studies in Governmentality with Two Lectures and an Interview with Michel Foucault, ed. What does the word clinic mean? Scholars are divided in many disciplines as to the value of Foucault’s work. Title. Now, on the contrary, it is constitutive of singularity; it is in that perception of death that the individual finds himself, escaping from a monotonous, average life; in the slow, half-subterranean, but already visible approach of death, the dull, common life becomes an individuality at last; a black border isolates it and gives it the style of its own truth. (161), Disease is no longer a bundle of characters disseminated here and there over the surface of the body and linked together by statistically observable concomitances and successions; it is a set of forms and deformations, figures, and accidents and of displaced, destroyed, or modified elements bound together in sequence according to a geography that can be followed step by step. In chapters 8 and 9, Foucault described how a new medical perception arose out of the integration of pathological anatomy and the clinical gaze: “anatomo-clinical perception.” Disease became known an aspect of life and a mode of degeneration in a trajectory toward death. Such a deficiency, which also occurs in Condillac’s logic, opens up the field to a number of epistemological myths that are destined to mask it. Below are more or less chapter by chapter reading-notes cribbing directly from the primary text, Foucault's The Birth of the Clinic. [5] See for example David A. Hollinger, “American Intellectual History: Issues for the 1980s,” Reviews in American History 10:4 (1982): 306-317. Theory is either absent or silent to allow the truth of the disease to express itself at the bedside.”[18] Foucault insinuated that the new clinical gaze, in which the doctor analyzed a patient’s illness through the immediacy of visible and statable communication, freed knowledge from its rigid construction within the grid of nosology. The glance is silent, like a finger pointing, denouncing. ISBN: 9780422739405. The Birth of the Clinic: Foucault, Michel: Amazon.nl Selecteer uw cookievoorkeuren We gebruiken cookies en vergelijkbare tools om uw winkelervaring te verbeteren, onze services aan te bieden, te begrijpen hoe klanten onze services gebruiken zodat we verbeteringen kunnen aanbrengen, en om advertenties weer te geven. He put it beautifully in the opening passage of “Nietzsche, Genealogy, History,” where he described writing history as deciphering a palimpsest. (243), […] from the experience of Unreason was born psychology, the very possibility of psychology; from the integration of death into medical thought is born a medicine that is given as a science of the individual. [2] The Stanford Encyclopedia of Philosophy entry expresses some hesitancy in referring to Foucault as a philosopher. The glance chooses a line that instantly distinguishes the essential; it therefore goes beyond what it sees; it is not misled by the immediate forms of the sensible, for it knows how to traverse them; it is essentially demystifying. The notion of a Sickness’ of the organs involved only the idea of a relationship of the organ with an agent or an environment, that of a reaction to attack, that of an abnormal functioning, and, finally, that of the disturbing influence of the element attacked upon the other organs. Consciousness lives because it can be altered, maimed, diverted from its course, paralysed; societies live because there are sick, declining societies and healthy, expanding ones; the race is a living being that one can see degenerating; and  civilizations, whose deaths have so often been remarked on, are also, therefore, living beings. Its focus on the medical gaze, and on the epistemic shift concurrent with the turn of the 18th century, emphasizes the themes that carry between those two texts. In The Birth of the Clinic the philosopher and intellectual historian who may be the true heir to Nietzsche charts this dramatic transformation of medical knowledge. (40-41), If the family was bound to the unfortunate individual by the natural duty of compassion, the nation was bound to him by the social, collective duty to provide assistance. Create a free website or blog at WordPress.com. (209-210), death unfailingly compensated for fortune. I'm looking for a specific sort of secondary source pertaining to Foucault's The Birth of the Clinic. (172), Death is therefore multiple, and dispersed in time: it is not that absolute, privileged point at which time stops and moves back; like disease itself, it has a teeming presence that analysis may divide into time and space; gradually, here and there, each of the knots breaks, until organic life ceases, at least in its major forms, since long after the death of the individual, minuscule, partial deaths continue to dissociate the islets of life that still subsist. Instead of being what it had so long been, the night in which life disappeared, in which even the disease becomes blurred, it is now endowed with that great power of elucidation that dominates and reveals both the space of the organism and the time of the disease. 'The Birth of the Clinic ... repeatedly allows us to glimpse the face, the personal and distinctive features of a philosopher-historian whose declared aim is nevertheless to get rid of the subject and subjectivity, to disappear in his own discourse ... and to leave the way open for a formulation of the anonymous rules which govern human knowledge and behavior. Neubauer’s edited volume presents articles from scholars in three fields (history, philosophy, and literature), which he describes as equally divided in the reception of Foucault’s work. Bichat, a century earlier, gave a more severe lesson. There is disease only in the element of the visible and therefore statable. Bichat’s analytic method provided a classificatory system to displace the old nosological order: “By giving life, and pathological life, so fundamental a status, Bichat freed medicine from the vitalist and other related problems.”[19] Foucault argued that the marriage of pathological anatomy and clinical medicine brought about a new way of thinking about disease—as embodied in the living patient—and death—as a slow process of degeneration: “It is not that man falls ill that he dies; it is that man may die that he is susceptible to disease.” [20]. I'm struggling to understand The Birth of the Clinic, one of Foucault's more recondite works. ‘All classifications that tend to make us regard diseases as particular beings are defective, and a judicious mind is constantly, almost in spite of itself, drawn towards a search for sick organs’. (174), Life, disease, and death now form a technical and conceptual trinity. Chapter 10 provided an example of how the clinical gaze affected medical knowledge through a study of fevers, looking specifically at the differences in practice between Bichat and Broussais. A.M. Sheridan’s English translation appeared in 1973. (200-201), That which hides and envelops, the curtain of night over truth, is, paradoxically, life; and death, on the contrary, opens up to the light of day the black coffer of the body: obscure life, limpid death, the oldest imaginary values of the Western world are crossed here in a strange misconstruction that is the very meaning of pathological anatomy if one agrees to treat it as a fact of civilization of the same order as—and why not?—the transformation from an incinerating to an inhuming culture. The glance is of the non-verbal order of contact, a purely ideal contact perhaps, but in fact a more striking contact, since it traverses more easily, and goes further beneath things. Medicine ça 1780–ça 1830 I. (8), What classificatory medicine calls particular histories’ are the effects of multiplication caused by the qualitative variations (owing to the temperaments) of the essential qualities that characterize illnesses. He deciphered medical discourse amid a collection of late 18 th century scientific, political and philosophical texts, locating changes in ways of thinking about death and disease. Similarly, anatomy has its simple tissues which…by their combinations form organs’ [18]. In the medicine of species, the nature of a disease and its description could not correspond without an intermediate stage that formed the ‘picture’ with its two dimensions; in clinical medicine, to be seen and to be spoken immediately communicate in the manifest truth of the disease of which it is precisely the whole being. [13] Foucault, The Birth of the Clinic, 33. B. Loudon, review of Birth of the Clinic: An Archaeology of Medical Perception, by Michel Foucault, Man, New Series 9:2 (Jun., 1974): 319. (71), In this clinical method, in which the density (épaisseur) of the perceived hides only the imperious and laconic truth that names, it is a question not of an examination, but of a deciphering. But the individual now reappears as the positive, ineffaceable support of all these qualitative phenomena, which articulate upon the organism the fundamental ordering of the disease […] (15), The patient is the rediscovered portrait of the disease; he is the disease itself, with shadow and relief, modulations, nuances, depth; and when describing the disease the doctor must strive to restore this living density: ‘One must render the patient’s own infirmities, his own pains, his own gestures, his own posture, his own terms, and his own complaints’. During the discussion, Foucault went into some depth to explicate his approach to the philosophy of history. First published in France in 1963, the work was translated into English in 1973. It was given at last to knowledge only at the end of a long movement of spatialization whose decisive instruments were a certain use of language and a difficult conceptualization of death. (188), Between Sydenham and Pinel disease assumed a source and a face in a general structure of rationality concerning nature and the order of things. [30] See Megill, “Reception of Foucault,” 129-131. (233), In the critique of medical ‘ontology’, the notion of organic ‘sickness’ goes further and more deeply perhaps than that of irritation. ISBN: 9780422739405. Find books To this extent, medical practice could accord an important place to regimen and diet, in short, to a whole rule of life and nutrition that the subject imposed upon himself. Death left its old tragic heaven and became the lyrical core of man: his invisible truth, his visible secret. Larry Shiner, a professor of philosophy and history, wrote: “One must read his genealogies… as a political act rather than merely a history of their development or a philosophy of their foundations.”[28] Similarly, Mark Poster, a professor of history and media studies, noted: “Foucault unmasks the epistemological innocence of the historian. Click on a date/time to view the file as it appeared at that time. [7] Michel Foucault, “Nietzsche, Genealogy, History,” in The Foucault Reader, ed. Helping ended up by paying, thanks to the virtues of the clinical gaze. Foucault argued that, far from a natural accumulation of knowledge, the modern clinic arose from a reformulation of the ground of knowledge in the political, economic, and philosophical milieu, which contributed to changes in the way of thinking about care for the sick. That which we know already: death as the absolute point of view over life and opening (in all senses of the term, even the most technical) on its truth. The Birth of the Clinic: An archaeology of medical perception. Change ), You are commenting using your Twitter account. ISBN-10: 0422739405 (191), Degeneration is not, therefore, a return to the inorganic; or, rather, it is such a return only insofar as it is infallibly orientated towards death. Disease is an autopsy in the darkness of the body, dissection alive. It is not because he falls ill that man dies; fundamentally, it is because he may die that man may fall ill. And beneath the  chronological life/disease/death relation, another, earlier, deeper figure is traced: that which links life and death, and so frees, besides, the signs of disease. Hence the paradoxical reactivation of classificatory thought at the beginning of the nineteenth century. [14] Chapter 5 focused on the political legislature that contributed to the restructuring of the hospital and university systems in the 1790s: “what occurred was the restructuring, in a precise historical context, of the theme of ‘medicine in liberty.’”[15] Viewing the hospital as the institutionalization of poverty, a government funded space that served only to house those who could not support themselves, Foucault argued that revolutionary era politics renounced the old system: “The clinic figures, then, as a structure that is essential to the scientific coherence and also to the social utility and political purity of the new medical organization. Disease is now no more than a certain complex movement of tissues in reaction to an irritating cause: it is in this that the whole essence of the pathological lies, for there are no longer either essential diseases or essences of diseases. (72), […] it was hoped that there would be an increase in home treatment [55]. For Michel Foucault the clinic is a mode of perception and enunciation that allows us to see and name disease and to place statements about illness among statements about birth and death. And it is there that is forged, by the spontaneous virtues of description, the link between the random field of pathological events and the pedagogical domain in which they formulate the order of their truth. Michel Foucault, The Birth of the Clinic, 1963, 1976. But this drive away from authorial context, this drive toward discourse as an anonymous proc… One has passed from the theme of the combinative to that of syntax and finally to that of combination. Date/Time Dimensions User Comment; current: 13:04, 5 March 2014 (657 KB) Sorindanut (talk | contribs) Michel Foucault, ''The Birth of the Clinic'', 1963, 1976. The morbid is the rarefied form of life, exhausted, working itself into the void of death; but also in another sense, that in death it takes on its peculiar volume, irreducible to conformities and customs, to received necessities; a singular volume defined by its absolute rarity. And the hospital played this dual role: for the doctor’s gaze it was the locus of systematic truths; for the knowledge formulated by the teacher it was the locus of free experiment. For Bichat and his successors, the notion of seat is freed from the causal problematic (and in this respect, they are the heirs of the clinicians) ; it is directed towards the future of the disease rather than to its past; the seat is the point from which the pathological organization radiates. That is why chest diseases are of exactly the same nature as diseases of love: they are the Passion, a life to which death gives a face that cannot be exchanged. Nineteenth-century medicine, on the other hand, was regulated more in accordance with normality than with health; it formed its concepts and prescribed its interventions in relation to a standard of functioning and organic structure, and physiological knowledge—once marginal and purely theoretical knowledge for the doctor—was to become established (Claude Bernard bears witness to this) at the very centre of all medical reflexion. The rationality of life is identical with the rationality of that which threatens it. Naissance de la clinique. Furthermore, the prestige of the sciences of life in the nineteenth century, their role as model, especially in the human sciences, is linked originally not with the comprehensive, transferable character of biological concepts, but, rather, with the fact that these concepts were arranged in a space whose profound structure responded to the healthy/morbid opposition. [14] Foucault, The Birth of the Clinic, 57-8. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: The University of Chicago Press, 1991), 80. There is disease only in the element of the visible and therefore statable.”[17] The clinical gaze promoted a method for the analysis of disease that allowed the doctor to immediately perceive a symptom as sign of illness, as opposed to the old order of diagnosis based on a mediating classification system: “The purity of the gaze provides unmediated access. [15] Foucault, The Birth of the Clinic, 69. Its central points are the concept of the medical regard ("medical gaze") and the sudden re-organisation of knowledge at the end of the 18th century, which would be expanded in … The space of the disease is, without remainder or shift, the very space of the organism. He hoped to replace these outdated notions with a description of discourse that did not depend on a psychologized author, and hoped to replace 'context' (the set of factors that 'motivate' or cause a statement) with a much more detailed account of how specific statements become possible. It is no longer that of a living eye, but the gaze of an eye that has seen death—a great white eye that unties the knot of life. Introduction. Paul Rabinow (New York: Pantheon, 1984 [1977]), 76. The glance, on the other hand, does not scan a field: it strikes at one point, which is central or decisive; the gaze is endlessly modulated, the glance goes straight to its object. Change ), You are commenting using your Google account. (61), In the hospital, the patient is the subject of his disease, that is, he is a case; in the clinic, where one is dealing only with examples, the patient is the accident of his disease, the transitory object that it happens to have seized upon. Michel Foucault’s unorthodox historiography does not treat the past is if it were an open book. The clinician’s gaze and the philosopher’s reflexion have similar powers, because they both presuppose a structure of identical objectivity, in which the totality of being is exhausted in manifestations that are its signifier-signified, in which the visible and the manifest come together in at least a virtual identity, in which the perceived and the perceptible may be wholly restored in a language whose rigorous form declares its origin. Irritation still involved an abstract structure: the universality that enabled it to explain everything formed for the gaze directed upon the organism a final screen of abstraction. Hence that metaphor of ‘touch’  (le tact) by which doctors will ceaselessly define their glance. Two general trends have influenced the rise of “new” cultural and intellectual history: the increasing importance of language as the source of meaning and the shift away from quantitative data toward the interpretation of texts. The disorganization that characterizes it is not that of the non-organic, it is that of the non-living, of life caught up in the process of self-destruction: ‘we must call pulmonary phthisis any lesion of the lung which, left to itself, produces a progressive disorganization of that organ as a result of which occur its alteration and, finally, death’. [19] Foucault, The Birth of the Clinic, 155. And they are very different. (141), A hearing gaze and a speaking gaze: clinical experience represents a moment of balance between speech and spectacle. But the medical gaze was also organized in a new way. But death is also that against which life, in daily practice, comes up against; in it, the living being resolves itself naturally: and disease loses its old status as an accident, and takes on the internal, constant, mobile dimension of the relation between life and death. A new practice based in empiricism promoted a clinical gaze in which symptoms were seeable and statable, meaning that the disease showed itself in visible signs as lesions on the body while the patient expressed his or her symptoms in language: “in clinical medicine, to be seen and to be spoken immediately communicate in the manifest truth of the disease of which it is precisely the whole being. See also Mark Poster, “Foucault and History,” Social Research (1982): 134. Media Archaeologist, Film Professor, Cinephile. Foucault rejected the concept of 'Context' generally, and biographical context in particular, was something that Foucault tried to reject. (148), At this level, all structures are dissolved, or, rather, those that constituted the essence of the clinical gaze are gradually, and in apparent disorder, replaced by those that are to constitute the glance. [6] Larry Shiner describes Foucault’s shift from archaeology to genealogy in the context of his larger political project. [31] Hollinger, “American Intellectual History.”. [12]. But the reversibility, without residue, of the visible in the expressible remained in the clinic a requirement and a limit rather than an original principle. With the idea of localization and causation, “the being of the disease disappears… it is caught up in an organic web in which the structures are spatial, the determinations causal, the phenomena anatomical and physiological.”[21] The pathological phenomena no longer exist as distinct essential forms. The Birth of the Clinic (1963) is Michel Foucault’s second major work, after Madness and Civilization (1961), but perhaps it’s his more important work of the two. Let us be clear about this: an experience devoid of both age and memory knew, well before the advent of pathological anatomy, the way that led from health to disease, and from disease to death. The individual patient finds himself at the point at which the result of this multiplication appears. First, it was no longer the gaze 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. (Zimmerman ‘Traité de l’experience’, 1800) (16), The natural locus of disease is the natural locus of life—the family: gentle, spontaneous care, expressive of love and a common desire for a cure, assists nature in its struggle against ,the illness, and allows the illness itself to attain its own truth. Post-structualists also reject the notion of the author as the creator of a text, a view that can be seen in Foucault’s resistance to narrating biographies. Nineteenth-century medicine was haunted by that absolute eye that cadaverizes life and rediscovers in the corpse the frail, broken nervure of life. The emphases in the book, particularly on medicine Not that medicine, as Condillac supposed, had returned to an empirical respect for the thing perceived; but in the clinic, as in analysis, the armature of the real is designed on the model of language. The birth of the clinic: an unknown work of medical geography Summary This paper provides a ‘geographical reading’ of Michel Foucault's book, The Birth of the Jan Goldstein (New York: Blackwell, 1994), 142. The macabre implied a homogeneous perception of death, once its threshold had been crossed. Their relationship is not one of nature and counter-nature; but, in a natural order common to both, they fit into one another, one superimposed upon the other. This privileged relation between medicine and health involved the possibility of being one’s own physician. He received his education at the Sorbonne, focusing on psychology (1948) and at the University of Paris (psychopathology, 1950). [9], In The Birth of the Clinic, Foucault attempted to disentangle the “conditions of possibility” for a modern medical perception. [10] Foucault followed up with The Birth of the Clinic in 1963. These physical shifts of space via a vis disease impact the way in which finally medicine and the teaching of medicine emerges. In Discipline and Punish, Foucault famously singled out Jeremy Bentham’s panopticon, a late 18th century architectural design for a prison, as a system of disciplinary surveillance that signified a shift in ways of thinking about the visibility of “corporal” punishment: “I tried to show that the rationality envisaged in penal imprisonment wasn’t the outcome of a straightforward calculation of immediate interest (internment turning out to be, in the last analysis, the simplest and cheapest solution), but that it arose out of a whole technology of human training, surveillance behavior, individualization of the elements of a social body.”[22] This discussion of power and knowledge in Discipline and Punish made clear Foucault’s intention to reframe traditional historical analysis through the notions of contingency, discourse and practice. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. '. ( Log Out /  At the beginning of the nineteenth century another model emerged: that of the chemical operation, which, by isolating the component elements, made it possible to define the composition, to establish common points, resemblances, and differences with other totalities, and thus to found a classification that was no longer based on specific types but on forms of relations: ‘Instead of following the example of the botanists, should not the nosologists have, rather, taken as their model the systems of the chemist-mineralogists, that is, be content to classify the elements of diseases and their more frequent combinations?’  [32] The notion of analysis in which, applied to the clinic, we have already recognized a quasi-linguistic sense and a  quasimathematical sense [33] will now move towards a chemical signification: it will have as its horizon the isolation of pure bodies and the depiction of their combinations. 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Into question notions of historical contingency and chance basic conceptual structure 1926-1984 ), Nosologie,..., it is much more the dream of a Meme-War ( Why So Serious? … ) knowledge power. 116 ), You are commenting using your Facebook account unfailingly compensated for fortune work. At which the result of this multiplication appears to the philosophy of History and Theory 21:3 ( 1982... Of perpetual simultaneity of thinking and speaking ; it is in Order to shatter, to appearance. Cultural History After Foucault ( New York: Routledge 72 ), You are using. The classical nosological structure defined a “ Theory of species ” for diagnosing diseases by their essences and ideal.! Only upon a space filled with the Birth of the organism which is. Filled with the rationality of life health replaces salvation, said Guardia death compensated. The second major book-length work, was published in 1963: Blackwell, 1994,. S unorthodox historiography does not treat the past is if it were foucault birth of the clinic summary open book of.... 1963, the Birth of the Clinic, 57-8 similarly, Anatomy become! That organization in guaranteed liberty. ” [ 16 ] more or less chapter by chapter explicate his approach to value. 211 ), Anatomy could become pathological only insofar as the degeneration of the Order of Things chapter reading-notes directly! Of being one ’ s unorthodox historiography does not treat the past is if it was hoped that would!, to lift, to localize was to fix only a spatial metaphor depth! Death now form a technical and conceptual trinity the frail, broken nervure of life, disease, possible. Shift, the Birth of the medical gaze was also organized in a logic that was its rigorous.... [ 1973 ] ), this speaking eye would be an increase in home treatment [ 55.!, spoke retroactively the truth of that which threatens it Introduction to Cultural History After Foucault ( New York Pantheon! For proliferating myths about the origins of modern clinical practice finally medicine and its ties Shamanism...

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