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Techniques & Technologies

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Clinical gaze

Pathological change in the spinal cord, 1829-42.

Pathological change in the spinal cord, 1829-42.

Credits:Wellcome Library, London.

Before the French Revolution of 1789, clinical work in hospitals involved doctors listening to patients’ stories of illness before basing their diagnosis on indirect evidence. With the Revolution came a change in the organisation of French hospitals and an effort to make medicine more rational, less theoretical and more practical. This brought a rise to prominence of new techniques and technologies, including the stethoscope. Such technologies allowed doctors to examine all cases more carefully.

In addition to observing living patients, doctors also occasionally opened dead bodies. More specifically, they did this in order to connect patients’ symptoms with lesions found in their organs. From this point on, doctors began to focus on the diseases themselves, and their impact on the body, as well as listening to their patients.

In the 1960s the French philosopher and historian Michel Foucault questioned the wider implications of the methods developed by French physicians to understand disease. His work focused specifically on the social and political changes brought by the Revolution. He argued that doctors’ new powers of diagnosis relied on their ‘gaze’ - a new type of medical perception and experience. Physicians who observed bodies carefully could potentially penetrate the illusions of outdated theories and see the hidden ‘truth’ of disease. In the process, practitioners gained much power and status, because no-one could challenge their stories of illness. The patient’s own experience or perception became less important than the doctor’s judgment. This trend within biomedicine continued until the second half of the 1900s, when efforts began to be made to look at the patient’s perspective on medical care.

 

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Techniques and Technologies:

Bibliography

M Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (New York: Pantheon Books, 1973)

C Hannaway and A La Berge, Constructing Paris Medicine (Amsterdam: Rodopi, 1998)

Glossary:

Stethoscope

A device which is used to listen to sounds produced by the human body. Ordinarily a stethoscope consists of rubber tubing in the shape of a Y.