The Birth of the Clinic: An Archaeology of Medical Perception

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But this experience [of the epidemic –ZJB] could achieve full significance only if it was supplemented by constant, constricting intervention. A medicine of epidemics could exist only if supplemented by a police: to supervise the location of mines and cemeteries, to get as many corpses as possible cremated instead of buried, to control the sale of bread, wine, and meat, to supervise the running of abattoirs and dye works, and to prohibit unhealthy housing; after a detailed study of the whole country, a set of health regulations would have to be drawn up that would be read ‘at service or mass, every Sunday and holy day’, and which would explain how one should feed and dress oneself, how to avoid illness, and how to prevent or cure prevailing diseases: These precepts would become like prayers that even the most ignorant, even children, would learn to recite.’ Lastly, a body of health inspectors would have to be set up that could be ‘sent out to the provinces, placing each one in charge of a particular department’; there he would collect information about the various domains related to medicine, as well as about physics, chemistry, natural history, topography, and astronomy, would prescribe the measures to be taken, and would supervise the work of the doctor. ‘It is to be hoped that the state would provide for these physicians and spare them the expense that an inclination to make useful discoveries entails’” (25-6). After you deliver the placenta, your uterus will continue to contract to help it return to its normal size.

This clinical medicine is more open than classificatory medicine and offers a “concrete sensibility.” Doctors no longer decided whether a patient’s condition fit into this or that class; they instead assessed the probabilities of a condition fitting into this or that disease. They no longer had to “simply read the visible; [they had] to discover its secrets” (p. 120). To Foucault, this was the clinic, a place of analysis. During this period, hospitals were deemed to be economic and medicinal hindrances. They would distort the natural flow of capital through a society as well as distort the natural flow of a disease. The hospitals confounded disease. Reforms were introduced which closed the hospitals, limited the freedom of doctors, and send patients to their families. Medicine would now become family medicine.Foucault's thesis about the birth of the clinic (teaching hospital) contradicts the histories of medicine that present the late 18th century as the beginning of a new empirical system "based on the rediscovery of the absolute values of the visible" material reality. [4] The birth of modern medicine was not a common-sense move towards seeing what already existed, but actually was a paradigm shift in the intellectual structures for the production of knowledge, which made clinical medicine a new way of thinking about the body and illness, disease and medicine: The history of illness to which he is reduced is necessary to his fellow men because it teaches them by what ills they are threatened. Your health care provider will examine the placenta to make sure it's intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. If you're interested, ask to see the placenta. A member of your health care team may massage your abdomen. This may help the uterus contract to decrease bleeding.

This was a very challenging book to read. Foucault's narrative is very meandering and tortuous, sometimes I had the feeling that the phrases made no sense at all, but they looked well altogether through the type of used words. 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)

Gutting, Gary (1989). Michel Foucault's Archaeology of Scientific Reason. Cambridge: CUP. ISBN 9780521366984. Satin AJ. Labor: Diagnosis and management of the latent phase. https://www.uptodate.com/contents/search. Accessed Oct. 28, 2021.