Notes on the work of Canguilhem, Georges

On the occasion of the publication of: ‘A Vital Rationalist. Selected Writings from Georges Canguilhem’, edited by François Delaporte, with an introduction by Paul Rabinow and a critical bibliography by Camille Limoges. Translated by Arthur Goldhammer. MIT Press, 1994.

*The worst bit is the self assuredness. Canguilhem’s writing is severe and calm. Sharp and authoritative. He’s a doctor. One story follows the next. A case is unravelled, then another. Get into the details. And then there’s his diagnosis, each of his words a final word. The sentences sound as if they seek to incorporate history. And to transcend it. This is a breathtaking rationality - but, and this is exceptional, not one that denies pain. Even pain is included.

*An essay review? I am to write an essay review of A Vital Rationalist. Selected Writings from Georges Canguilhem, a volume with translations of fifteen of Canguilhem’s texts from French into English. But I can’t. I do not want to. How ever to judge this work - which is about the very act of judging, about handling norms. It tells that pointing out error in what went before, is what finding truth is all about. But escaping from that place can hardly be done by calling it error, can it?

*Canguilhem knows what a science is. “If medicine has attained the status of a science, it did so in the era of bacteriology. A practice is scientific if it provides a model for the solution of problems and if that model gives rise to effective therapies. Such was the case with the development of serums and vaccines. A second creation of scientificity is the ability of one theory to give rise to another capable of explaining why its predecessor possessed only limited validity.” (p.146) So. That’s how it is. And he knows so much more.

*Is writing down questions a sin? Must writing be affirmative, ordering a chaos that will retreat to the fringes of what is articulated?

*The attractive side is that there’s so much about objects. The big guys of the Vienna-Cambridge philosophy of science tradition were obsessed with method. They wanted guarantees for the trustworthiness of science. And therefore transformed the characteristics of a nineteenth century gentleman into something that had to be as impersonal as possible. Method. The obsession was so strong that even their enemies got caught up in it. The enemies denied that method can ever distinguish real science, because (1) all methods can be productive in their time - which implies we do not need to hold on to a single method (2) that methods do not guarantee or demarcate anything at all since they leak and (3) that methods are not used anyway but reconstructed afterwards.

Method doesn’t keep the social world out of the scientific domain - science is social. Good. All right. Take your constructivism and run. But then. What about the world that’s made? What about the quarks and the genes and the pain? It is at this point that a moderate dose of Canguilhem may help.

*Be careful. Especially those in crisis (and who isn’t after having lost so many of the certainties they were raised with?) might be in danger of succumbing to his voice. A father? A schoolteacher? Philosopher, doctor. Man.

*About objects. The Comptian pyramid holds the promise that knowledge of the smallest particles at its base may - once - help to explain events in the higher, more complicated layers. (Some in STS turn this around. They dream that the most complicated layer, which they call society, helps to explain small particles - or at least the non-methodological production of scientific knowledge about them.)

Canguilhem shows that there are cleavages in the pyramid. And loops.

Cleavages: biochemistry may talk about macro-molecules, but it cannot understand disease. Some mutations are adaptive, others lethal. Since survival, illness and death happen to a living organism in its surroundings, biochemistry can never understand that. Loops: the physicist may dream of explaining life. But at some point, inevitably, he, the physicist, as a person, a body, will suffer illness. Death.

*Canguilhem writes history. With judgements. He hands out credit, takes it away. Meanwhile concentrating on the way objects are framed. On the concepts delineating them. No, Descartes didn’t come up with the concept ‘reflex’. For in the body Descartes described, the sense that ascends from senses to brain was different in nature to the instructions that descend from brain to muscles. This makes the analogy with a mirror that reflects a light beam inconceivable. It only became conceivable at the moment Willis described anima spiritualis that do ascend, reflect and descend again. Willis: a vitalist, who talked about anima spiritualis. Thus, Canguilhem writes, an ideology, vitalism, may produce science. But the theory of the reflex only became scientific a long time after Willis, when the spirits were chased away while the reflex remained.

*That’s his desire. To be subtle in his judgements. To redistribute credits. To look for the good in the bad and vice versa. But then there’s the verdict. And that’s the end of it.

*Social scientists talk endlessly about the boundaries between ‘machines’ and ‘people’. They forget about bodies. They forget they have bodies. And if they mention the body, it is usually in some psychoanalytic erotic version. No beating hearts, bleeding wounds, coding genes.

*Canguilhem puts bodies in the center. He writes about life. About life and the life sciences. Their specificity. “At all levels, biologists have identified ordering structures that, while generally reliable, sometimes fail. The concept of normality is intended to refer to these ordering structures. No such concept is needed in the epistemology of physics.” (p. 215)

Canguilhem doesn’t believe that after Kant a philosopher could ever hope to write about objects directly. He makes the detour into the sciences. It isn’t Canguilhem who knows what life is. The life sciences do. Canguilhem writes their history as a history of the shifting delineations of their objects.

*And Canguilhem writes the history of the norms by which to judge the sciences, too. Even norms don’t fall under the jurisdiction of philosophers. A science creates its own normativity. Objects, methods and norms are intertwined. (They can be pointed out. By Canguilhem, the historian, the epistemologist. This is the object, not that. This the method to study it and the norm that distinguishes good from bad science at that time. No doubt about it.) Writing the history of science is, according to Canguilhem, different from writing other histories precisely because of the normativity of the scientific project. Because science is about breaking with error, and establishing norms, its history cannot be neutral.

But Canguilhem doesn’t write Whiggish history - the present wasn’t what the past was aiming at from its very beginning. History could have taken a different course. And yet for Canguilhem writing history begins in the present. It is not just anything in the past that is of interest to the epistemological historian, but only those things that are steps - errors, findings - towards the present.

*Not Whiggish but starting from the present all the same. Canguilhem’s writing is bereft of many of the dichotomies familiar to those whose education largely consisted of reading books in English.

As a Dutch student of philosophy at the end of the seventies, I was taught Popper-Lakatos-Kuhn. But being Dutch (and a student of medicine, too) allowed me to read Canguilhem in French. What a relief it was. How subtle. How many words that opened up the body of medicine and made it analysable.

Disillusion came in the early eighties when I went to study in France. There this rebellious author appeared to be severe. He wasn’t undermining the foundations of science, but laying foundations. They were merely different ones. What will be the reading experience of others (Scandinavian, Japanese, American) whose language skills only allow them to read Canguilhem in this English translation, now, years later, after so much iconoclastic work has been done? I cannot tell. Try, if you want to.

*Canguilhem even attends to materialities, to the very experimental set ups of the life sciences he studies. And he relates these to the societal content of the questions they must solve. “Did the technique of in vitro culture of explanted cells (…) offer experimental proof that the structure of the organism is an analogue of liberal society?” (p. 300) The answer is negative. For while Canguilhem carefully explains how analogy was used as a method in the life sciences of the nineteenth century, he also shows the limits of this method. Society and bodies are different objects.

In vitro cultures do not tell us what organisms have been all along, they create something new. They make ‘organic elements’ that didn’t exist before. “An organic element can be called an element only in its undissociated sate.” (p.300) In its associated state, an organism isn’t a set of separate elements, linked up. It’s an organised whole.

*The body and society are different. “For an organism, organization is a fact; for a society, organization is a goal.” (p. 302)

It comes back again and again. A body isn’t a physico-chemical assemblage of elements because it is organised. And the organisation of a body isn’t like the organisation of a society. Both organisations are characterised by norms. But the body lives its own normality. Each organism may deviate from all others, but as long as it maintains some norm or other, there is organisation, and the organism lives. When no norms are maintained there is chaos and chaos is death. In a society norms aren’t given, they are actively set. They may be altered, too.

Normalisation: making order by setting norms. Everyone and everything that doesn’t live up to the norms, ends up at the fringes. The chaotic unconcious that is constantly created and respressed. Norms are concomitant with order.

*You’ve read Foucault? Then you knew this story.

*Canguilhem, as a philosopher of medicine, defends the lived suffering of patients against objective data. He defends clinical medicine against the outcomes of laboratory measurement. It is not because a number is deviant, that the patient suffers. It is because there are patients who suffer, that we built laboratories. And call them in.

“The abnormal, being the a-normal, logically follows the definition of the normal. It is a logical negation. But it is the priority of the abnormal that attracts the attention of the normative, that calls forth a normative decision and provides an opportunity to establish normality through the application of a norm. A norm that has nothing to regulate is nothing because it regulates nothing. The essence of a norm is its role. Thus practically and functionally the normal is the operational negation of a state which thereby becomes the logical negation of that state; the abnormal, though logically posterior to the normal, is functionally first.” (p. 383)

*The question is this. Reader. Canguilhem follows biology and medicine judgementally. Finding errors makes him come up with norms. But if one leaves the judgements out, what happens? We might try. For after so many years that we, in STS, have anthropologised method, have looked into the way facts are produced, we might try this. To anthropologise objects. Life. Bodies. To look at what’s produced in practive. What is sustained, what altered. To look not into mechanisms (associations, translations) but into products. What is made. Objects.

Canguilhem defends the clinical assesment of disease against that of the lab. Anthropologising disease, would imply suspending judgements about clinic and lab in order to study how they work and relate in practice. In detail. When and where do doctors currently take complaints as their lead? What precise role do they give to laboratory numbers? Where do pain and numbers clash? That is: where does the way pain and numbers are handled clash? And what is the interdependence between them? Links, gaps, resonances, analogies, shifts, struggles.

*To judge is not an error. It is no mistake. It can be done, and in current medicine a defence of the clinic against the lab isn’t such a bad move, either. But what does postponing judgement yield? What is there to learn? The reality, not of the body as it should be known, but that of the body as it is practiced.

What are bodies made to be in the hospital around the corner? Go and take a look. Beating hearts make graphs and graphs make heartbeats. Wounds bleed, are closed, covered with cloth. Genetic codes are read from long printouts. Diseases attributed to the codes. Patients scream. They tell a story. Series of blood sugar values are scribled down in files. Doses of insulin are increased, decreased, adapted. Vessels opened up, stripped clean. All this. And a lot more.

*All criticism is partial: “theoretical themes survive even after critics are pleased to think that the theories associated with them have been refuted.” (p. 177) No doubt some of Canguilhem’s theoretical themes are still alive. In different guises. They might even go through a revival in the work of those who do not know what science is. Non-doctors. Non-philosophers. Non-teachers. Non-fathers. Non-men.

(Thanks to Marianne de Laet for the immediacy of her reactions. Thanks to John Law for his help with the language.)