What exactly does Foucault mean by the Clinic?

Actually, you’ve seen it on TV. Think of Dr. Kildare, Dr. Welby, St. Elsewhere, or Doogie Howser (pick the one from your generation). In all of those shows you’ve seen the experienced doctor making the rounds of the wards, along with eager and scared novices.

If you’ve been in a hospital you may have seen the same thing. You probably accept it as a natural part of being sick and in a hospital, part of what helps you. But notice what happens to the patient in these interchanges.

A bunch of people crowd around the bed staring at her, perhaps poking and feeling. She is supposed to be silent unless she is asked a question, and at times she is used as the basis for the ritual humiliation of a student. She becomes a thing, a disease, as the doctors are not interested in anything else about her. (Except, of course, the TV doctor-hero who always sees and understands the real person lying there.)

All of this, the teaching hospital and the notion of clinical medicine as the best method of treating patients and of training doctors, at the same time, is what Foucault refers to by

One big element in its creation was, once again:

There were two great medical dreams of the Revolution:

A nationalized, almost religious order of doctors, who would care for the body as the priests had formerly cared for the soul.

a perfected social order, with no more disease at all!

The diseases of the poor are products of the horrible conditions in which they live, and the diseases of the rich are the result of their dissipation.

But how do you put such policies into place?

In the Revolution, the first move was to get rid of the old ways. The Universities were seen as the bastions of the elite, so they were done away with. The hospitals were seen as a waste of money—people could be cared for more efficiently at home, within the family. So no more hospitals. Hospital funds were seized, and sometimes saved, sometimes used to fund public charity, and sometimes turned into ready cash.

So certainly doctors were needed. Medical officers were needed, and pretty much anyone was accepted and given a little bit of training. These people would return to civilian life as doctors and, unsupervised, could do a lot of damage.

Something had to be done.

University-trained doctors began teaching students in secret.

After the Revolution, the whole system was rebuilt from scratch. Hospitals had to be rebuilt, and they were usually connected to the rebuilt universities.

So what is important about the Clinic?

Teaching is united with practice.

The Clinic becomes a basis for the licensing of doctors, which gradually became much more restricted.

THE PROFESSOR OF MEDICINE becomes a very powerful figure. He examines the patient, and then “examines” the students. At the same time, the professor is always taking a risk. If he makes a blunder, it may be seen by all the students.

Patients accept the clinical rounds as part of their necessary service to the state. Yes, they may die, but nobly, since they will add to human knowledge.

As the place of medical learning, the clinic offers up a series of diseases. All examples of a particular disease may be located in a single ward. The disease is what is important, the individual patient is just an accident. The more unusual the disease, the more interesting the patient. So the diseases are laid out spatially, and the professor walks from one to another, turning his all-powerful eye on each one.

A kind of active vision, what Foucault calls

A desire develops for a complete nosology (a system of classifying all disease) that would be like Linnaeus’ taxonomy of plants and animals.

But not enough is known about disease—too much is hidden from the eye. Suddenly there is a new focus:

Dissecting corpses was not actually so new, but deciding that it was central was very different. Suddenly the eye can see inside the body, and all of disease is visible to the Gaze.

Death and disease change from purely negative ideas to crucial elements in the process of life.

Science focuses on general principles, not on individual circumstances. Newton did not stop his thought at the particular apple that fell on his individual head; he developed a principle that would account for all apples, all objects, falling.

But such science has a great deal of difficulty dealing with human beings. For some reason, we can be very abstract about apples, but when humans are concerned, we tend to care very much about the actual individual.

A round the end of the 18th and the beginning of the 19th centuries, many sciences began to focus on humans, namely the Human Sciences: economics, anthropology, linguistics, psychology and so on.

Medicine is more like HARD SCIENCE than the others, but it has always focused on humans. Opening up the corpses, Foucault maintained, gave medicine the opportunity to subject all of the Body to the scientific Gaze.

and his power came from his way of seeing rather than from his abstract theories.