A glance at the birth of the clinic
The Birth of the Clinic is composed of scraps of Madness and Unreason. For Foucault, The Birth of the Clinic was a research, the project of which was his-toricocritical and the aim of which was to determine “the conditions of possibility of medical experience in modern times” (Foucault 1976: xxii). At that time, medicine was born as a clinical science, and Foucault supported the importance of the medical gaze in the constitution of medicine as a science:
it was this constant gaze upon the patient, this age-old, yet ever renewed attention that enabled medicine not to disappear entirely with each new speculation, but to preserve itself, to assume little by little the figure of a truth that is definitive, if not completed, in short, to develop, below the level of the noisy episodes of its history, in a continuous historicity. In the non-variable of the clinic, medicine, it was thought, had bound truth and time together.
(Foucault 1976: 65)
In other words, “the clinic gives medicine its true historical movement,” and the advent of medical clinics was an essential moment in supporting its scientific consistency, where the medical gaze played a central role.
In another register, Foucault recalled that the simple fact of hospitalizing someone was criticized, even before the French Revolution, for moral and economic reasons: An illness treated in hospital would be a cost for society, the patient becoming chronic, he and his family losing money, which accentuated financial and moral distress. Foucault saw another moral problem here: that of the patient asking for help, finding himself obliged to be the object of a gaze - because it is through the clinic that we see the symptoms that are the telltale signs of an illness.
In his last chapter, he returned to the conditions of the possibility of medicine and especially the anatomo-clinical method.
For clinical experience to become possible as a form of knowledge, a reorganization of the hospital field, a new definition of the status of the patient in society, and the establishment of a certain relationship between public assistance and medical experience, between help and knowledge, became necessary; the patient has to be enveloped in a collective, homogeneous space (Foucault 1976: 242).
It is, moreover, only at the end of the volume that Foucault mentioned the “Freudian man” and “the importance of Bichat, of Jackson, of Freud in European culture” (Foucault 1976: 245). No doubt. The Birth of the Clinic, which gives so much room to the gaze, could not integrate Freud, who is remembered as the doctor who suppressed the gaze in the clinic by inventing psychoanalysis. Psychoanalysis as an “eyes wide shut clinic,” if I may say, is the couch depriving the analyst and analysand of the other’s gaze. This is part of the development of the clinic in the 20th century, a clinic without a gaze, heterogeneous to the Foucauldian theory exposed in The Birth of the Clinic.