In the previous two posts in this series I outlined how some of the key theories which are used in my Biosocieties module including Martin Heidegger’s analysis of modern technology’s instrumentalist approach to the world, Michel Foucault’s critique of the role of “technologies of the self” in constructing how we understand our bodies and minds and Actor-Network-Theory’s approach to interpreting our relationship with technologies, objects and other “non-human actors”.
In this third post I consider the way in which medical knowledge and devices are used as “technologies” which “enframe” our bodies and “reveal” the truth about ourselves particular ways.
The great medical historian Roy Porter once said that
“High amongst medicine’s priorities lies identifying the trouble” (Porter, 1999: 89)
This may seem like a fairly obvious point. But it is of course vital to medicine to identify the cause of an illness. This establishes perception as being of central significance to medicine. The doctor must perceive where the illness really lies. This process is often not straightforward and indeed medicine has changed its mind over history as to what the aetiologies (causes) of various diseases are and even as to what the body looks like.
“Taking the history” of the patient has consequently been a central part of the activities of the doctor for centuries and today it is still the most commonly experienced interaction which most people will have with a medical professional. This is where a patient is asked about the nature, experience and character of their symptoms. Throughout most of history this interaction is what doctors have based their diagnosis and treatment pop. However, since the age of enlightenment there has been increasing emphasis on the use of technologies to interpret the workings of the body.
What I will suggest here is that such technologies do not simply, transparently and objectively represent the body or its workings but construct a particular vision of it. Also, increasingly the use of specialised “technologies of perception” has enabled a shift of power away from patients towards the medical profession and perhaps increasingly to technical processes.
Probably the most important such technology is the vision of the doctor themselves. In his book The Birth of the Clinic Michel Foucault suggested that there was a “great break in Western medicine” in the 18th century when for the first time anatomy began to play a central role in medical education.
For many years student physicians did not have to attend or practice dissections as they do today. Instead they were expected to learn from the teachings of the Greek physician Galen (and others) who lived between 129 and 216AD. For 1000 years after Galen’s death almost no original anatomical inquiries were performed, mainly because the Church was against the dissection of human bodies.
From the 1200s onwards, some dissections were carried out, but not many – surgeons had to rely on the corpses of executed criminals, and these were in short supply. Also, without refrigeration there was no way to preserve the bodies, so dissections could only be performed during the winter when temperatures were icy. Therefore, only a limited number of students would have had the experience of attending a dissection in person.
According to Foucault, the French anatomist Marie François Xavier Bichat signalled the “great break” when ‘clinical experience became the anatamo-clinical gaze’ (Foucault, 2003: 146).
“for twenty years, from morning to night, you have taken notes at patients’ bedsides on affections of the hear, the lungs, and the gastric viscera, and all is confusion for you in the symptoms which, refusing to yield up their meaning, offer you a succession of incoherent phenomena. Open up a few corpses: you will dissipate at once the darkness that observation alone could not dissipate” Bichat Anatomie Générale 1801 cited in Foucault (2003).
Anatomy was seen as allowing doctors to stop fumbling around in the dark in trying to establish the relations between organs, between organs and tissues, tissues and nerves and so on. Now we can look into the body and see the real meaning. The medical gaze now penetrates the body rather than merely observing the surface manifestations of disease.
The practice of anatomy therefore changed the ways in which the body was interpreted and was part of the move towards an “empirical” approach to medicine consistent with Enlightenment philosophy.
As time progressed various technologies have been produced which help to “reveal” the body in different ways. One of the most significant innovations is the “stethoscope” what might now seem like a fairly simple piece of equipment enabled medics to listen to the inside of the human body does transforming their section of the inner workings. But like any technology this only reveals the body through a particular lens.Embed from Getty Images
This can be seen even more clearly with examples of medical scans such as x-rays, CT or MRI scans. These all show different elements of the body (and sometimes it’s internal workings and processes). Some scans can reveal bone structures, other tissues and others the electrical impulses. None of these give a complete and holistic picture of the body but simply reveal certain aspects and present partial visualisations.Embed from Getty Images
Such imaging devices are as much aesthetic and artistic achievements as they are technical. They are in this is not so different from the artistic representations of the body produced by Renaissance artists and based on their own first hand assessment of human anatomy.Embed from Getty Images
Such technologies serve a similar function to a more basic seeming technology the “Anatomical Atlas”, a book used by medical students to learn about the workings of the body. Like a map of a terrain it reveals certain aspects and obscures others. As David Armstrong has said
‘The atlas renders the body transparent; it is a means of making the body legible to an observing eye […] In effect, what the students sees is not the atlas as a representation of the body but the body as a representation of the atlas’ (Armstrong, 1983: 2)
This “mapping” of the human body becomes even more sophisticated with the innovation of the Visible Human Project which render the body as a virtual, three dimensional space, fully accessible to the medical gaze.
In the next post I will discuss how public health can be seen as a technology of medical intervention which reveals particular truths about the population but also acts as a tool of governing bodies.
Armstrong, D. (1983) Political Anatomy of the Body: medical knowledge in Britain in the Twentieth Century. Cambridge: Cambridge University Press.
Foucault, M. (2003) The birth of the clinic : an archaeology of medical perception. London: Routledge.
Porter, R. (1999) The greatest benefit to mankind : a medical history of humanity from Antiquity to the present. New York: HarperCollins.Foucault, M. (2003) The birth of the clinic : an archaeology of medical perception. London: Routledge.