Chapter nine Opening Up the Body to the Empirical Medical Gaze PDF

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This is a summary on the Opening Up the Body to the Empirical Medical Gaze from the "Pratices of Looking" for the HUMI 16 class, Spring 2021. It is useful for photographs from the prehistory of medicine to appreciate the place of images in biomedicine and research. The use of photographs and the loo...

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chapter nine: Opening Up the Body to the Empirical Medical Gaze Class: HUMI16 Spring 2021 - Summary Book: Practices of Looking 3rd ed., Marita Sturken Chapter: chapter nine: Scientific Looking, Looking at Science Date: 09/9/2021 Short Description: This is a summary on the Opening Up the Body to the Empirical Medical Gaze from the "Pratices of Looking" for the HUMI 16 class, Spring 2021. It is useful for photographs from the prehistory of medicine to appreciate the place of images in biomedicine and research. The use of photographs and the look both for a better understanding of the body and for medical attention goes back to old times. In illuminated manuscripts the Greeks reproduced different treatments by doctors.

Opening Up the Body to the Empirical Medical Gaze To understand the place of images in biomedicine and science, it is helpful to consider images from the pre-history of medicine. The use of images and looking, both to know the body and to improve medical treatment, dates back to antiquity. The Greeks depicted various interventions by physicians in illuminated manuscripts. Greek medical practitioners were unified in the view that illness was caused not by divine powers but by natural forces. The ancient Hippocratic Corpus, a collection of sixty medical works, in the section titled The Art, argues that medicine is a special set of skills involving techne-that is, art or craft. Drawing held a special place as a technical practice. Throughout history, the human body has been subject to brutal injury in war, and this has been a site for the construction of medical knowledge. The "Wound man" is a rather startling type of illustration used in fifteenth- and sixteenth-century manuscripts to map typical locations of battle wounds. The "Wound man" is iconic in the sense that as a symbol it has been widely reproduced and recognized in different versions. It is also iconic in Peirce's sense, in

that the image looks like a body. It is a violently wounded body depicting all manner of injuries-though with their weapons, impossibly, still in place. Although we may see this as a pictorial image, and indeed an iconographic one, this particular "Wound man" is in fact also a spatial index, providing a diagram of common locations of physical battle injuries. What do we make of the cut-open body? "Looking within" is a common trope for getting at hidden truths, whether we identify truth with an abstraction such as "The soul" or a hidden physical structure that is symbolic, such as the brain or the heart. The concept of bodily truth was a topic of particular interest to French philosopher Michel Foucault. In The Birth of the Clinic, he discusses the emergence of the concept of looking inside the body as a privileged form of medical knowledge in the late eighteenth century. This was the time of the Enlightenment, when the Declaration of the Rights of Man and of the Citizen was introduced, and along with it humanistic hospital-based medical teaching, research, and clinical practice. Foucault explains that traditional methods of diagnosis before this time involved reading the body's surface for illness symptoms and observing the body by hand and by eye, empirically-through sight and touch. With the rise of anatomical dissection during this time, as practiced by researchers such as the descriptive anatomist Marie-François Xavier Bichat, a change took place in processes of inquiry and interpretation. Whereas previously physicians palpated or touched the body to gain knowledge of its interior, or listened with scopes, now physicians sought empirical evidence by looking inside the body, not only cutting it open to see but also using tools to seek out aspects that could not be discerned directly by hand or by eye. Bichat, who did not trust microscopes, opened up cadavers and studied their interior structures, proposing on the basis of his observations that tissues and membranes, and not organs, were the basic units of life. By opening up and looking inside dead bodies, he found a new way of under- standing and classifying the body as a system. A new way of looking and knowing came to prominence-one that involved not just seeing directly but also defining seeing itself as something that required instruments. Medical visuality from this period forward began to involve the use of more and more instruments to measure and to enhance, mediate, and correct human observation. In Chapter 3 we discussed Foucault's interpretation of the panopticon prison as a structure that introduced the surveillant gaze. What was important was not the actual activity of seeing, but the distribution of the power of vision across different agents, including the inmate, who internalized the gaze of the guard, and the prison structure itself, which orchestrated the distribution of power. In Enlightenment medicine, Foucault saw a different kind of gaze than this panoptic one-a

"Medical gaze" that elicits hidden truths about life by looking inside dead bodies, through which one could discern, paradoxically, the structure of the living system. Whereas the visualization of the body in the wound maps offered a diagram for pedagogical purposes, Bichat, according to Foucault, aimed to reveal the true organization of things: he "Rediscovers not the geography of the body, but the order of classifications."5 A classification system, Foucault notes, is not a reflection of objective truth about the order of nature, but a social system that both creates and reinforces systems of knowledge and power in its given episteme. In the rise of the natural sciences in the nineteenth century and in biomedicine today, vision is understood as the primary avenue to knowledge, and sight is privileged over the other senses. Foucault identifies the introduction of a new regime of knowledge in which vision plays a distinctive role in the regard to the living body as a system. Vision can play different roles in contem- poraneous regimes of truth, and in privileging vision, instruments and technologies of seeing become even more important. The looking Foucault describes is crucially linked to other activities that give meaning to what vision uncovers: experimenting, measuring, analyzing, and ordering, for example. The paradox of the clinical gaze and its legacy is that vision may predominate, but it is nonetheless dependent on other sensory and cognitive processes, as well as upon tools and instruments designed to regulate, check, correct, and augment our visual capacities. Foucault's contribution was the linking of seeing to a broader set of systems of seeing as knowing, including imaging devices and tools of measurement. The seen body was understood to be in motion, an interrelationship of physiological systems and not a set of discrete, fixed anatomical parts. Knowledge through seeing was a modality that required technologies to implement and correct sight, and this demand for visual technologies became more pronounced as we moved into the digital age....