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Reading group: Canguilhem, The Normal and the Pathological

Claire Dubois Fellow
· 4 replies
Medicine & healthContinentalModern EuropeanGeorges CanguilhemMichel Foucault#canguilhem#normal-and-pathological#normativity#reading-group
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Its coordinates: 6.13 Philosophy of Medicine

Georges Canguilhem's essay began as his medical thesis in 1943, written while he was also active in the Resistance, and was reissued in 1966 with a second part, "New Reflections". It is one of the founding texts of the philosophy of medicine, and in France it shaped a whole generation of historians of science.

His target is an assumption he finds in Comte and in the physiology of Claude Bernard: that the pathological is only a quantitative variation of the normal, too much or too little of the same thing. Canguilhem argues that disease is a different way of living, and that health is not an average but a capacity: the ability of an organism to set new norms when its environment changes.

Plan (three weeks; the English translation by Carolyn Fawcett is good, the French is better):

  1. Part One. The history of the "quantitative" thesis, from Broussais and Comte to Bernard and Leriche.
  2. Part Two. The chapters on the normal and the average, and on disease, cure and health. This is the heart of the book.
  3. New Reflections (1963–66). The move from organic norms to social ones.

As a translator I'll be watching how the word normal behaves in French. It is slipperier than it looks.

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4 replies

  1. Martín Iriarte

    Fellow

    Week 1. The quote from the surgeon René Leriche, that health is life lived in the silence of the organs, is the hinge of Part One, and Canguilhem both admires it and turns it. Silence is not the same as health: you can be ill without symptoms. For anyone who reads psychoanalysis there is another resonance. Canguilhem was later the examiner who reported on Foucault's thesis on madness, and you can feel the family resemblance in how both refuse to treat the abnormal as a mere deficit.

    Helpful · 1
  2. Alistair Gow

    Fellow

    Week 2. The idea that hit me hardest: the patient defines illness before the doctor does. Medicine exists because people feel ill and ask for help; the science of the pathological comes after. In thirty years at a surgery I saw people whose tests were normal and who were plainly not well, and others with abnormal tests who were living perfectly good lives. Canguilhem gives both groups a place.

    Helpful · 2
  3. Dima Nasser

    Fellow

    Week 2, from a disability advocate, with mixed feelings. I love that he makes health individual: a person can be healthy within a narrower range of environments. But he describes illness as a reduced normativity, a shrinking of the capacity to tolerate change. Many disabled people would accept "different norms" and reject "reduced". Whether the shrinking is in the body or in the environment we built is exactly what the social model asks.

    Helpful · 3
    1. Claire Dubois

      Fellow

      Dima, I think that's the sharpest reading in the group. And the New Reflections almost invite it: once he turns to social norms, the environment that the organism must "tolerate" is partly made by us. On the French: normal slides between "usual", "healthy" and "as it ought to be", and Canguilhem exploits the slide deliberately. The English can't quite follow him.