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The Normal and the Pathological
The Normal and the Pathological is one of the crucial contributions to the history of science in the last half century. It takes as its starting point the sudden appearance of biology as a science in the nineteenth century and examines the conditions determining its particular makeup.
Canguilhem analyzes the radically new way in which health and disease were defined in the early nineteenth century, showing that the emerging categories of the normal and the pathological were far from objective scientific concepts. He demonstrates how the epistemological foundations of modern biology and medicine were intertwined with political, economic, and technological imperatives.
Canguilhem was an important influence on the thought of Michel Foucault and Louis Althusser, among others, in particular for the way in which he poses the problem of how new domains of knowledge come into being and how they are part of a discontinuous history of human thought.
Canguilhem analyzes the radically new way in which health and disease were defined in the early nineteenth century, showing that the emerging categories of the normal and the pathological were far from objective scientific concepts. He demonstrates how the epistemological foundations of modern biology and medicine were intertwined with political, economic, and technological imperatives.
Canguilhem was an important influence on the thought of Michel Foucault and Louis Althusser, among others, in particular for the way in which he poses the problem of how new domains of knowledge come into being and how they are part of a discontinuous history of human thought.
336 pages, Paperback
First published January 1, 1966
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About the author
Georges Canguilhem
47 books34 followersGeorges Canguilhem was a French philosopher and physician who specialized in epistemology and the philosophy of science.
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August 18, 2021
برای یک دانشجوی پزشکی، مواجه با لابراتوار فیزیولوژی و ابزارهای اندازه گیری دقیق این حس را ایجاد می کند که در نهایت فیزیولوژی به مثابه یک علم توانسته از قوانین و ویژگی حاکم بر حیاتِ سالم و نرمال پرده بردارد. اما شاید در اثر یک توافق ضمنی، شاید ناشی از جوِ دانشگاه، این پرسش مطرح نمی شود که فیزیولوژی به عنوان یک علمی که موضوعش وضعیت نرمال یک ارگانیسم است دقیقا قصد شناختن چه چیز را دارد؟ به عبارتی موجزتر، نرمال اصلا چیست؟
ژرژ کانگیم، پزشک و فیلسوف فرانسوی، در کتابِ "درباره هنجارمند و بیمارگون" که در اصل رساله دکتری اوست در سال ۱۹۴۳ و تحت تجدید نظری در ۱۹۶۶ قرار گرفته، تلاش کرده تا با بررسی تاریخ مفهومی مفاهیمی همچون نرمال، بیماری، سلامتی، آنومالی، ابنرمالی و بررسی انتقادی رشته های فیزیولوژی و پاتولوژی که داعیه‌ی عینی بودن دارند، این نکته را نشان دهد که این مفاهیم و رشته ها، برخلاف آنچه در نگاه نخست به نظر می رسد، تضادها و ابهامات بسیاری را در خود حمل می کنند.
در آموزش پزشکی، همانطور که کانگیم به درستی اشاره می کند، پاتولوژی چیزی است متاخر از فیزیولوژی. برای یک دانشجوی پزشکی در ابتدا این تصور ایجاد می شود که بیماری صرفا مانعی است بر کرد و کار های فیزیولوژیک بدن. دانشجو با مطالعه فیزیولوژی به این نتیجه می رسد که می توان پاتولوژی را از فیزیولوژی به راحتی استنتاج کرد. با شناختن فیزیولوژی گردش خون، و یا سیستم انعقادی می توان فهمید که چه بیماری هایی امکان ایجاد شدن دارند. در این نگاه، بیماری همچون سنگی است که بر سر راه ساز و کار فیزیولوژیک قرار گرفته. سنگی که با برداشتن آن همه چی به حالت قبل باز می‌گردد.
اما حقیقت چیز دیگری است. کانگیم با بررسی تاریخ پزشکی این نکته را ثابت می کند که فیزیولوژی نسبت به پاتولوژی تاخر دارد. ما اولین بار در مواجه با بیماری است که نسبت به وضعیت نرمال شناخت پیدا می کنیم. سلامتی مفهومی بی معناست برای کسی که هیچ گاه بیمار نشده باشد. سلامتی و نرمال را نمی توان به صورت مستقیم مطالعه کرد و از چهارچوب مشخص و عینی ای در این علم که نسبت به قضاوت های هنجاری انسان بی تفاوت است سراغ گرفت. انسان بیماری را به مثابه کیفیتی در تضاد با سلامتی ادراک می کند و نمی‌توان این ادراک را به کمیت هایی بی روح فروکاست.
کانگیم نتیجه می گیرد که حیات و سلامتی چیزهایی نیستند که با خودشان این همان باشند. حیات و آنچه که تحت عنوان سلامتی می شناسیم دائما در حال تغییر اند و همچنین از آنجا که با ارگانیسم ها در ارتباطند، موجوداتی که خیر خود را در جهان دنبال می کنند، نمی توانند خالی از قضاوت های هنجاری (normative) و صرفا مجموعه از امور واقع (fact) باشند. انسان را نمی توان جدا از محیطش و تاریخی که در آن می زید مورد مطالعه قرار داد. برای کانگیم، بیمار کسی نیست که از محدوده آنچه آمارِحیاتی تحت عنوان سلامتی می شناسد جای نگیرد، بلکه او بیماری را چنین تعریف می کند: ناتوانی یک فرد انطباق و تحمل محیط اطرافش.
ژرژ کانگیم، پزشک و فیلسوف فرانسوی، در کتابِ "درباره هنجارمند و بیمارگون" که در اصل رساله دکتری اوست در سال ۱۹۴۳ و تحت تجدید نظری در ۱۹۶۶ قرار گرفته، تلاش کرده تا با بررسی تاریخ مفهومی مفاهیمی همچون نرمال، بیماری، سلامتی، آنومالی، ابنرمالی و بررسی انتقادی رشته های فیزیولوژی و پاتولوژی که داعیه‌ی عینی بودن دارند، این نکته را نشان دهد که این مفاهیم و رشته ها، برخلاف آنچه در نگاه نخست به نظر می رسد، تضادها و ابهامات بسیاری را در خود حمل می کنند.
در آموزش پزشکی، همانطور که کانگیم به درستی اشاره می کند، پاتولوژی چیزی است متاخر از فیزیولوژی. برای یک دانشجوی پزشکی در ابتدا این تصور ایجاد می شود که بیماری صرفا مانعی است بر کرد و کار های فیزیولوژیک بدن. دانشجو با مطالعه فیزیولوژی به این نتیجه می رسد که می توان پاتولوژی را از فیزیولوژی به راحتی استنتاج کرد. با شناختن فیزیولوژی گردش خون، و یا سیستم انعقادی می توان فهمید که چه بیماری هایی امکان ایجاد شدن دارند. در این نگاه، بیماری همچون سنگی است که بر سر راه ساز و کار فیزیولوژیک قرار گرفته. سنگی که با برداشتن آن همه چی به حالت قبل باز می‌گردد.
اما حقیقت چیز دیگری است. کانگیم با بررسی تاریخ پزشکی این نکته را ثابت می کند که فیزیولوژی نسبت به پاتولوژی تاخر دارد. ما اولین بار در مواجه با بیماری است که نسبت به وضعیت نرمال شناخت پیدا می کنیم. سلامتی مفهومی بی معناست برای کسی که هیچ گاه بیمار نشده باشد. سلامتی و نرمال را نمی توان به صورت مستقیم مطالعه کرد و از چهارچوب مشخص و عینی ای در این علم که نسبت به قضاوت های هنجاری انسان بی تفاوت است سراغ گرفت. انسان بیماری را به مثابه کیفیتی در تضاد با سلامتی ادراک می کند و نمی‌توان این ادراک را به کمیت هایی بی روح فروکاست.
کانگیم نتیجه می گیرد که حیات و سلامتی چیزهایی نیستند که با خودشان این همان باشند. حیات و آنچه که تحت عنوان سلامتی می شناسیم دائما در حال تغییر اند و همچنین از آنجا که با ارگانیسم ها در ارتباطند، موجوداتی که خیر خود را در جهان دنبال می کنند، نمی توانند خالی از قضاوت های هنجاری (normative) و صرفا مجموعه از امور واقع (fact) باشند. انسان را نمی توان جدا از محیطش و تاریخی که در آن می زید مورد مطالعه قرار داد. برای کانگیم، بیمار کسی نیست که از محدوده آنچه آمارِحیاتی تحت عنوان سلامتی می شناسد جای نگیرد، بلکه او بیماری را چنین تعریف می کند: ناتوانی یک فرد انطباق و تحمل محیط اطرافش.
February 28, 2014
Can a book change your life? I read it at the high school on the advices of my professor of philosophy. At this time, I hesitated between medicine and philosophy. The little red book.
Canguilhem, resistant to the Nazi, physician and philosopher. In short a model, a hero. He has given the aggregation of philosophy to Foucault. It was a completed time or France had great thinkers. Philosopher and physician, he made the synthesis in this work which takes again its thesis of 1943.
Canguilhem fights positivism very present in medicine as in Claude Bernard for example. For him, the pathological status is defined like a quantitative variation compared to the normality. For Canguilhem, the disease is perceived qualitatively by the patient. Pathological status must be defined both quanttatively and qualiatively.
Questioning on the concept of normality, he gives the patient to the center of the medical approach :
“The physician must take account of the individual and subjective dimension of the disease, the conscience and the feeling of the patient “
That appears normal and obvious to you but it was very new.
Thank you Georges.
Canguilhem, resistant to the Nazi, physician and philosopher. In short a model, a hero. He has given the aggregation of philosophy to Foucault. It was a completed time or France had great thinkers. Philosopher and physician, he made the synthesis in this work which takes again its thesis of 1943.
Canguilhem fights positivism very present in medicine as in Claude Bernard for example. For him, the pathological status is defined like a quantitative variation compared to the normality. For Canguilhem, the disease is perceived qualitatively by the patient. Pathological status must be defined both quanttatively and qualiatively.
Questioning on the concept of normality, he gives the patient to the center of the medical approach :
“The physician must take account of the individual and subjective dimension of the disease, the conscience and the feeling of the patient “
That appears normal and obvious to you but it was very new.
Thank you Georges.
November 10, 2011
I am totally obsessed with this book, I keep reading it over and over again.
October 31, 2024
This is a lovely and humane book which takes as its starting point the advent of something new in the empire of nature: the presence of pathology among the living. For if neither the hurricane nor the waterfall can fall sick or recover, strictly speaking, then the arrival of life-which-falls-ill marks a break in the continuity of things, the eruption of an interruption in the cosmic order. While what counts as the ‘living’ has been the subject of much healthy debate (the inclination to ‘finality’, the work of the gene, the capacity for reproduction, to list a random few), Canguilhem’s wager is to look for the singularity of life in the presence of exactly what threatens it: illness and disease. Accompanying life as its ever-present shadow, it’s just in plumbing the recesses of pathology that the living itself comes into relief.
Trained as both a physician and a philosopher, it was likely this unique paring that allowed Canguilhem to occupy the perspective of pathology, all the better to serve as an aperture upon the living. For the attention to health - the fact that the living being tends or strives toward a state of well being - marks life out at that which establishes itself not merely as a fact, but more importantly and more profoundly, as a norm. In other words, life is not indifferent to itself: it works upon itself and its milieu so as to lend itself powers of action, security from catastrophe, and the luxury of error. To this degree, life is a set of values, or better, that which can establish values (Canguilhem: “valerie, in Latin, means ‘to be well’”). Nietzsche was maybe more correct than anyone suspected!
While it’s very well to say this, the philosophical significance of life-as-norm lies in everything that follows. Subject to particular criticism by Canguilhem are efforts to establish health as a matter of measurements and thresholds: as if one could read disease off a barometer, and health by a gauge. Far from being immutable and given, to say that life establishes norms is to say that the normal itself is a relative matter: the normal, as anything but a statistical measure, is only ever normal with respect to the living being’s own capacities for action, its affordances of movement and desire. Anticipating, by nearly half a century, the findings of developmental systems theory (c.f. the work of Susan Oyama), for Canguilhem, only life-in-an-envrionment can be considered normal or not, and never a living being taken in abstraction.
And what follows for ‘the normal’ follows too for ‘the pathological’. If health is a matter of capacity and function rather than a game of numbers, then the pathological is not a deviant health, but a different kind of living altogether. Or, in Canguilhem’s succinct phrasing: “the abnormal is not what is not normal, but what constitutes another normal”. It’s here that one can hear the notes of Canguilhem’s humanism ring loudly, a humanism extrapolated in the second half of this book, which extends his reflection on life to its uses and abuses with respect to social questions (eugenics, with its passion for biological measurement, is given particularly short shrift). Originally published in 1966, this is a book which has lost none of its animating power, and still calls for a readership interested in the most vital questions of all.
Trained as both a physician and a philosopher, it was likely this unique paring that allowed Canguilhem to occupy the perspective of pathology, all the better to serve as an aperture upon the living. For the attention to health - the fact that the living being tends or strives toward a state of well being - marks life out at that which establishes itself not merely as a fact, but more importantly and more profoundly, as a norm. In other words, life is not indifferent to itself: it works upon itself and its milieu so as to lend itself powers of action, security from catastrophe, and the luxury of error. To this degree, life is a set of values, or better, that which can establish values (Canguilhem: “valerie, in Latin, means ‘to be well’”). Nietzsche was maybe more correct than anyone suspected!
While it’s very well to say this, the philosophical significance of life-as-norm lies in everything that follows. Subject to particular criticism by Canguilhem are efforts to establish health as a matter of measurements and thresholds: as if one could read disease off a barometer, and health by a gauge. Far from being immutable and given, to say that life establishes norms is to say that the normal itself is a relative matter: the normal, as anything but a statistical measure, is only ever normal with respect to the living being’s own capacities for action, its affordances of movement and desire. Anticipating, by nearly half a century, the findings of developmental systems theory (c.f. the work of Susan Oyama), for Canguilhem, only life-in-an-envrionment can be considered normal or not, and never a living being taken in abstraction.
And what follows for ‘the normal’ follows too for ‘the pathological’. If health is a matter of capacity and function rather than a game of numbers, then the pathological is not a deviant health, but a different kind of living altogether. Or, in Canguilhem’s succinct phrasing: “the abnormal is not what is not normal, but what constitutes another normal”. It’s here that one can hear the notes of Canguilhem’s humanism ring loudly, a humanism extrapolated in the second half of this book, which extends his reflection on life to its uses and abuses with respect to social questions (eugenics, with its passion for biological measurement, is given particularly short shrift). Originally published in 1966, this is a book which has lost none of its animating power, and still calls for a readership interested in the most vital questions of all.
April 9, 2016
A wise, provocative book.
Some quotes:
"Health is organic innocence. It must be lost, like all innocence, so that knowledge may be possible."
"The laws of physics and chemistry do not vary according to health or disease. But to fail to admit from a biological point of view, life differentiates between its states means condemning oneself to be even unable to distinguish food from excrement. Certainly a living being's excrement can be food for another living being but not for him. What distinguishes food from excrement is not a physicochemical reality but a biological value. Likewise, what distinguishes the physiological from the pathological is not a physicochemical objective reality but a biological value."
"No one innocently knows that he is innocent since being aware of adequation to the rule means being aware of the reasons for the rule which amounts to the need for the rule. It is appropriate to contrast to the overly exploited Socratic maxim no knowing man is evil, the opposite maxim that no one is good who is aware of being so. Similarly no one is healthy who is aware of being so... But it is in the rage of guilt as in the clamor of suffering that innocence and health arise as the terms of a regression as impossible as it is sought after."
Comment would be superfluous.
Some quotes:
"Health is organic innocence. It must be lost, like all innocence, so that knowledge may be possible."
"The laws of physics and chemistry do not vary according to health or disease. But to fail to admit from a biological point of view, life differentiates between its states means condemning oneself to be even unable to distinguish food from excrement. Certainly a living being's excrement can be food for another living being but not for him. What distinguishes food from excrement is not a physicochemical reality but a biological value. Likewise, what distinguishes the physiological from the pathological is not a physicochemical objective reality but a biological value."
"No one innocently knows that he is innocent since being aware of adequation to the rule means being aware of the reasons for the rule which amounts to the need for the rule. It is appropriate to contrast to the overly exploited Socratic maxim no knowing man is evil, the opposite maxim that no one is good who is aware of being so. Similarly no one is healthy who is aware of being so... But it is in the rage of guilt as in the clamor of suffering that innocence and health arise as the terms of a regression as impossible as it is sought after."
Comment would be superfluous.
March 3, 2010
A very important book, profound, but occasionally difficult to get through. Canguilhem, for his renown as a philosopher, originally trained as a physician and wrote his thesis, which forms the first section of this volume, at the completion of his medical doctorate from the University of Strasbourg. Point being, there are long passages of medical detail that are impenetrable and uninteresting to someone coming at this from a philosophical or history of science angle.
What is most interesting is the assault on the perception of life sciences, the investigation of how they are framed and frame themselves, teasing their conclusions into various threads - the normal, norms, normativity, error, health, disease, physiology - and using this analysis to challenge the self-conception. Biological sciences, far from being statistical / rigorous / neutral, are woven from politically / economically / technologically / culturally / religiously influenced interpretations of "fact".
Beyond his writing, Canguilhem was incredibly influential in the second half of the 20th century in France through his institutional positions as Inspector General and, later, President of the Jury d'Agregation in Philosophy. His impact on thinkers such as Derrida, Althusser, Lacan, and particularly Foucault, are easy to trace and to "feel." As Foucault writes in his introduction, "[...:] it is easy to find the place of those who, from near or from afar, had been trained by Canguilhem." Trace back to his antecedent, and you find Bachelard. A fine set of poles to connect.
Having read and enjoyed The Birth of the Clinic, History of Madness, and more general philosophical writings on the nature of scientific inquiry & progress, such as Kuhn's Structure of Scientific Revolutions, it's surprising to me that I skipped this for so long. Happy to have corrected that omission.
What is most interesting is the assault on the perception of life sciences, the investigation of how they are framed and frame themselves, teasing their conclusions into various threads - the normal, norms, normativity, error, health, disease, physiology - and using this analysis to challenge the self-conception. Biological sciences, far from being statistical / rigorous / neutral, are woven from politically / economically / technologically / culturally / religiously influenced interpretations of "fact".
Beyond his writing, Canguilhem was incredibly influential in the second half of the 20th century in France through his institutional positions as Inspector General and, later, President of the Jury d'Agregation in Philosophy. His impact on thinkers such as Derrida, Althusser, Lacan, and particularly Foucault, are easy to trace and to "feel." As Foucault writes in his introduction, "[...:] it is easy to find the place of those who, from near or from afar, had been trained by Canguilhem." Trace back to his antecedent, and you find Bachelard. A fine set of poles to connect.
Having read and enjoyed The Birth of the Clinic, History of Madness, and more general philosophical writings on the nature of scientific inquiry & progress, such as Kuhn's Structure of Scientific Revolutions, it's surprising to me that I skipped this for so long. Happy to have corrected that omission.
Currently reading
May 25, 2024Indicação do psicanalista Pedro Ambra, em conversa com Tati Bernardi (podcast 7/3/23). Autor foi orientador de Foucault e médico; a escrita poética de uma tese em medicina, tenta entender a normalidade de fato. O normal não é uma adequação a uma norma pré estabelecida, é ter a capacidade de instaurar uma nova normatividade, inventar a vida.
This entire review has been hidden because of spoilers.
September 30, 2018
muito repetitivo, jesus amado
January 19, 2021
İyi baya
June 21, 2019
«La vita, anche per un'ameba, è preferire ed escludere»
La lettura di un classico della filosofia della vita come Il normale e il patologico dovrebbe essere un punto di partenza imprescindibile per chi vuole avere uno sguardo più profondo sul significato stesso di vita organica.
La prima opera fondamentale di Georges Canguilhemnon è altro che una rielaborazione della sua tesi dottorato in medicina. Uscito nel 1943, Il normale e il patologico rappresenta un lavoro pionieristico sia dal punto di vista metodico che per il contenuto. Il lavoro dei Canguilhem oscilla tra una storia della scienza epistemologica e un'epistemologia della storia della scienza. La prima sezione del testo si concentra sui predecessori che si sono concentrati sulla definizione del concetto di normalità, principalmente Comte e Bernard. Non è un caso che gli autori con cui si vuole confrontare siano un filosofo e un medico, rispettivamente il padre del positivismo e il fondatore della medicina sperimentale. Il lavoro di Canguilhem è un'opera dove medicina e filosofia si intrecciano come la famosa doppia elica.
Definire la normalità non è solo una questione medica: è assieme una questione morale, filosofica, terapeutica e metodica. Canguilhem è estremamente critico nei confronti di chi pensa di poter definire la normalità (e, di riflesso la patologia) sulla base di una variazione meramente quantitativa; leggasi rispetto a una media statistica che definisca ciò che è normale e ciò che non lo è. Questo approccio "oggettivo" si dimostra paradossalmente privo dell'oggetto fondante la medicina, ovvero il soggetto malato. Se non ci fossero malati non ci sarebbe nemmeno la medicina. Assumere il punto di vista del malato implica lasciare a lui il dovere di decidere cosa è patologico e cosa no, e di conseguenza anche cosa significa guarire. Un uomo a cui è stato amputato un braccio è malato? Se l'intervento terapeutico gli ha consentito di svolgere comunque la sua vita si può dire che in qualche modo c'è stata una guarigione, nonostante l'irreversibilità della menomazione. E' l'uomo, in ultima istanza, a definire quali sono le norme della propria vita.
Ma Canguilhem non si limita alla sfera antropocentrica, dato che secondo lui ogni vita organica svolge un'attività normativa. Una tale attività, chiaramente, non può prescindere dall'ambiente in cui si svolge, per cui è possibile definire lo stato patologico una mancanza di "tolleranza" nei confronti delle sfide che l'ambiente pone alla vita. In questo senso la vita è anche polarità: oscilla tra lo stato del proprio organismo e il feedback che l'ambiente fornisce.
Lo studio di Canguilhem, a quasi un secolo di distanza, si dimostra estremamente attuale e ricco di spunti di riflessione. Il concetto di normalità, come il suo successore e allievo Michel Foucault ha poi dimostrato, cambia ripetutamente nel corso degli anni. Spesso si tratta di un processo influenzato non solo dall'ambiente propriamente detto, ma anche da quella sfera ambientale tipicamente umana che è la cultura dell'epoca. La medicina di oggi riflette senza dubbio questo cambio di paradigma, con le sfide della nuova frontiera medica, quali l'EBM (evidence-based medicine) e la medicina personalizzata. Si tratta di nient'altro che nuove istanze del problema della normalità in relazione al soggetto: quanto può dirci una previsione della malattia sulla base della lettura del genoma? la conoscenza di evidenza medica statistica può aiutarci nel caso concreto della cura del paziente? L'importanza di questi aspetti non è solo medica o filosofica (e non sarebbe poco), ma ha anche chiare implicazioni sociali, dato che si è sempre malati all'alterno di un contesto socioeconomico. Solo l'uomo nello stato di natura si ammala da solo, e proprio per questo non lo si potrebbe nemmeno definire malato.
La lettura di un classico della filosofia della vita come Il normale e il patologico dovrebbe essere un punto di partenza imprescindibile per chi vuole avere uno sguardo più profondo sul significato stesso di vita organica.
La prima opera fondamentale di Georges Canguilhemnon è altro che una rielaborazione della sua tesi dottorato in medicina. Uscito nel 1943, Il normale e il patologico rappresenta un lavoro pionieristico sia dal punto di vista metodico che per il contenuto. Il lavoro dei Canguilhem oscilla tra una storia della scienza epistemologica e un'epistemologia della storia della scienza. La prima sezione del testo si concentra sui predecessori che si sono concentrati sulla definizione del concetto di normalità, principalmente Comte e Bernard. Non è un caso che gli autori con cui si vuole confrontare siano un filosofo e un medico, rispettivamente il padre del positivismo e il fondatore della medicina sperimentale. Il lavoro di Canguilhem è un'opera dove medicina e filosofia si intrecciano come la famosa doppia elica.
Definire la normalità non è solo una questione medica: è assieme una questione morale, filosofica, terapeutica e metodica. Canguilhem è estremamente critico nei confronti di chi pensa di poter definire la normalità (e, di riflesso la patologia) sulla base di una variazione meramente quantitativa; leggasi rispetto a una media statistica che definisca ciò che è normale e ciò che non lo è. Questo approccio "oggettivo" si dimostra paradossalmente privo dell'oggetto fondante la medicina, ovvero il soggetto malato. Se non ci fossero malati non ci sarebbe nemmeno la medicina. Assumere il punto di vista del malato implica lasciare a lui il dovere di decidere cosa è patologico e cosa no, e di conseguenza anche cosa significa guarire. Un uomo a cui è stato amputato un braccio è malato? Se l'intervento terapeutico gli ha consentito di svolgere comunque la sua vita si può dire che in qualche modo c'è stata una guarigione, nonostante l'irreversibilità della menomazione. E' l'uomo, in ultima istanza, a definire quali sono le norme della propria vita.
Ma Canguilhem non si limita alla sfera antropocentrica, dato che secondo lui ogni vita organica svolge un'attività normativa. Una tale attività, chiaramente, non può prescindere dall'ambiente in cui si svolge, per cui è possibile definire lo stato patologico una mancanza di "tolleranza" nei confronti delle sfide che l'ambiente pone alla vita. In questo senso la vita è anche polarità: oscilla tra lo stato del proprio organismo e il feedback che l'ambiente fornisce.
Lo studio di Canguilhem, a quasi un secolo di distanza, si dimostra estremamente attuale e ricco di spunti di riflessione. Il concetto di normalità, come il suo successore e allievo Michel Foucault ha poi dimostrato, cambia ripetutamente nel corso degli anni. Spesso si tratta di un processo influenzato non solo dall'ambiente propriamente detto, ma anche da quella sfera ambientale tipicamente umana che è la cultura dell'epoca. La medicina di oggi riflette senza dubbio questo cambio di paradigma, con le sfide della nuova frontiera medica, quali l'EBM (evidence-based medicine) e la medicina personalizzata. Si tratta di nient'altro che nuove istanze del problema della normalità in relazione al soggetto: quanto può dirci una previsione della malattia sulla base della lettura del genoma? la conoscenza di evidenza medica statistica può aiutarci nel caso concreto della cura del paziente? L'importanza di questi aspetti non è solo medica o filosofica (e non sarebbe poco), ma ha anche chiare implicazioni sociali, dato che si è sempre malati all'alterno di un contesto socioeconomico. Solo l'uomo nello stato di natura si ammala da solo, e proprio per questo non lo si potrebbe nemmeno definire malato.
October 30, 2019
Génie incontestable. Je n'en dors plus de la nuit.
November 3, 2014
Quando il sapere filosofico si unisce alla pratica medica... the magic happens!
March 26, 2022
« Il en est de la médecine comme de toutes les techniques. Elle est une activité qui s’enracine dans l’effort spontané du vivant pour dominer le milieu et l’organiser selon ses valeurs de vivant. »
Georges Canguilhem (1904-1995) est un penseur singulier, brassant dans un même geste le langage du philosophe et celui du médecin. À rebours d’une pensée réductionniste ou déterministe, l’effort théorique de Canguilhem consiste à restituer toute sa singularité au phénomène du vivant, à en souligner l’incroyable plasticité et liberté dans l’agencement de ses formes.
Il est des lectures vécues comme des rencontres-charnière : Le Normal et le Pathologique, thèse de doctorat en médecine soutenue en 1943, en fait partie. Ce livre est venu toucher, à un moment précis de mon existence, un noeud d’interrogations quant à l’essence de ce qui est vécu comme anormal ou pathologique.
Car la pensée de Canguilhem, outre sa justesse philosophique et scientifique, est émancipatrice : nulle fatalité dans la maladie ou la crise organique, tout est potentialité, tout est normativité vitale. « La vie est polarité, et par là même position inconsciente de valeur » … et la normativité biologique est cette « capacité biologique de mettre en question les normes usuelles à l’occasion de situations critiques », « d’instaurer un nouvel ordre physiologique ». Car en effet, « ce qui caractérise la santé, c’est la possibilité de dépasser la norme qui définit le normal momentané, la possibilité de tolérer des infections à la norme habituelle et d’instituer des normes nouvelles dans des situations nouvelles ». S’appuyer sur l’épreuve de la maladie (et non l’éviter ou la supprimer) pour manifester un nouvel agencement normatif, persévérer dans son être pour donner forme à l’existence : telle est l’essence première de la santé, définie non pas comme une série statistique de constantes moyennes, mais comme une disposition existentielle à la (re)création de normes.
La vie est éternel débat avec un milieu d’existence, débat apaisé ou douloureux : car nos corps sont en prise constante avec un milieu biologique, chimique, mais aussi social ou politique qui a une incidence sur notre normativité biologique. Les rythmes fonctionnels qu’une certaine architecture socio-politique nous impose, la détermination culturelle de nos modes d’alimentation, ou encore la structure même de notre langage ont des effets épigénétiques que notre corps assimile, absorbe, transforme. Le milieu dans lequel nous baignons (qui n’a rien à voir avec le concept d’environnement ou de nature) nous façonne autant que nous le façonnons : c’est là le propre de l’activité animale, et plus spécifiquement de l’activité humaine.
Et, près de 90 ans après la publication de l’ouvrage, lire ces lignes : on peut traiter la mort « comme un phénomène social, en estimant que l’âge où elle survient résulte en grande partie des conditions de travail et d’hygiène, de l’attention à la fatigue et aux maladies, bref de conditions sociales autant que physiologiques. Tout se passe comme si une société avait « la mortalité qui lui convient », le nombre des morts et leur répartition aux différents âges traduisant l’importance que donne ou non une société à la prolongation de la vie. En somme les techniques d’hygiène collective qui tendent à prolonger la vie humaine ou les habitudes de négligence qui ont pour résultat de l’abréger dépendant du prix attaché à la vie dans une société donnée, c’est finalement un jugement de valeur qui s’exprime dans ce nombre abstrait qu’est la durée de vie humaine moyenne. La durée de vie moyenne n’est pas la durée de vie biologiquement normale, mais elle est en un sens la durée de vie socialement normative. »
Preuve s’il en est que le néolibéralisme, en attaquant systématiquement les filets de sécurité les plus existentiels (retraite, RSA, écosystèmes, régimes salariaux), a pour principe normatif même de dépouiller la vie de toute valeur.
(Nul besoin de préciser ici que je recommande chaleureusement la lecture de ce merveilleux ouvrage)
Georges Canguilhem (1904-1995) est un penseur singulier, brassant dans un même geste le langage du philosophe et celui du médecin. À rebours d’une pensée réductionniste ou déterministe, l’effort théorique de Canguilhem consiste à restituer toute sa singularité au phénomène du vivant, à en souligner l’incroyable plasticité et liberté dans l’agencement de ses formes.
Il est des lectures vécues comme des rencontres-charnière : Le Normal et le Pathologique, thèse de doctorat en médecine soutenue en 1943, en fait partie. Ce livre est venu toucher, à un moment précis de mon existence, un noeud d’interrogations quant à l’essence de ce qui est vécu comme anormal ou pathologique.
Car la pensée de Canguilhem, outre sa justesse philosophique et scientifique, est émancipatrice : nulle fatalité dans la maladie ou la crise organique, tout est potentialité, tout est normativité vitale. « La vie est polarité, et par là même position inconsciente de valeur » … et la normativité biologique est cette « capacité biologique de mettre en question les normes usuelles à l’occasion de situations critiques », « d’instaurer un nouvel ordre physiologique ». Car en effet, « ce qui caractérise la santé, c’est la possibilité de dépasser la norme qui définit le normal momentané, la possibilité de tolérer des infections à la norme habituelle et d’instituer des normes nouvelles dans des situations nouvelles ». S’appuyer sur l’épreuve de la maladie (et non l’éviter ou la supprimer) pour manifester un nouvel agencement normatif, persévérer dans son être pour donner forme à l’existence : telle est l’essence première de la santé, définie non pas comme une série statistique de constantes moyennes, mais comme une disposition existentielle à la (re)création de normes.
La vie est éternel débat avec un milieu d’existence, débat apaisé ou douloureux : car nos corps sont en prise constante avec un milieu biologique, chimique, mais aussi social ou politique qui a une incidence sur notre normativité biologique. Les rythmes fonctionnels qu’une certaine architecture socio-politique nous impose, la détermination culturelle de nos modes d’alimentation, ou encore la structure même de notre langage ont des effets épigénétiques que notre corps assimile, absorbe, transforme. Le milieu dans lequel nous baignons (qui n’a rien à voir avec le concept d’environnement ou de nature) nous façonne autant que nous le façonnons : c’est là le propre de l’activité animale, et plus spécifiquement de l’activité humaine.
Et, près de 90 ans après la publication de l’ouvrage, lire ces lignes : on peut traiter la mort « comme un phénomène social, en estimant que l’âge où elle survient résulte en grande partie des conditions de travail et d’hygiène, de l’attention à la fatigue et aux maladies, bref de conditions sociales autant que physiologiques. Tout se passe comme si une société avait « la mortalité qui lui convient », le nombre des morts et leur répartition aux différents âges traduisant l’importance que donne ou non une société à la prolongation de la vie. En somme les techniques d’hygiène collective qui tendent à prolonger la vie humaine ou les habitudes de négligence qui ont pour résultat de l’abréger dépendant du prix attaché à la vie dans une société donnée, c’est finalement un jugement de valeur qui s’exprime dans ce nombre abstrait qu’est la durée de vie humaine moyenne. La durée de vie moyenne n’est pas la durée de vie biologiquement normale, mais elle est en un sens la durée de vie socialement normative. »
Preuve s’il en est que le néolibéralisme, en attaquant systématiquement les filets de sécurité les plus existentiels (retraite, RSA, écosystèmes, régimes salariaux), a pour principe normatif même de dépouiller la vie de toute valeur.
(Nul besoin de préciser ici que je recommande chaleureusement la lecture de ce merveilleux ouvrage)
July 21, 2021
Δυστυχώς δεν μπορώ να περιγράψω πόσο βαθιά ανατρεπτική είναι η συλλογιστική του Κανγκιλέμ γύρω από τις έννοιες της κανονικότητας, της μη-κανονικότητας και της ανωμαλίας. Διερευνά μέσα από το πρίσμα της ιατρικής και της βιολογίας την αξία του κανόνα, αλλά και της παρέκκλισης από αυτόν, για τα έμβια όντα αυτά κάθ’ αυτά, αναδεικνύοντας το «σφάλμα» σαν τον μείζονα πυλώνα γύρω από τον οποίο διαρθρώνεται η εμπειρία και η ιστορία της ζωής.
«Ο Νίτσε είπε πως η αλήθεια είναι το βαθύτερο ψέμα. Ο Κανγκιλέμ, όντας κοντά στον Νίτσε, αλλά ταυτόχρονα και μακριά του, θα έλεγε ίσως πως στο τεράστιο ημερολόγιο της ζωής είναι το πιο πρόσφατο σφάλμα. Θα έλεγε ότι η διαίρεση αληθούς/ψεύδους και η αξία που προσδίδεται στην αλήθεια συνιστούν τον πιο μοναδικό τρόπο ζωής που θα μπορούσε να έχει ανακαλύψει μια ζωή η οποία, από την παλαιότερη απαρχή της, κουβαλάει μέσα της το ενδεχόμενο του σφάλματος. Το σφάλμα για τον Κανγκιλέμ είναι η μόνιμη τύχη γύρω από την οποία αναπτύσσεται η ιστορία της ζωής καθώς και η ιστορία του ανθρώπου.» {Εισαγωγή: Μ. Φουκό}
Το παθολογικό δεν ταυτίζεται με το μη-κανονικό αλλά διακρίνεται από τη δίκη του, πρωτότυπη και ανέκδοτη κανονικότητα. «Εάν αναγνωρίσουμε ότι η ασθένεια παραμένει ένα είδος βιολογικού κανόνα, αυτό συνεπάγεται ότι η παθολογική κατάσταση δεν μπορεί να θεωρηθεί κατ’ απόλυτο τρόπο μη-κανονική, αλλά μη-κανονική σε σχέση με μια προσδιορισμένη κατάσταση. Αντιστρόφως, το να είναι κανεις υγιής και το να είναι κανονικός δεν είναι ισοδύναμα, αφού το παθολογικό είναι ένα είδος κανονικού.» {σ. 141}
Ιδιαίτερα ρηξικέλευθα συμπεράσματα τα οποία καθόρισαν την πορεία της δυτικής διανόησης μέσα από πλήθος προεκτάσεων αφού η ίδια η ιστορία της επιστήμης, της γνώσης και της φιλοσοφίας, φαίνεται να αποτελείται από μια σειρά ασύμμετρων κανονικοτήτων, που η αναγνώριση ενός προβλήματος οδηγεί σε ρήξη και την εγκαθίδρυση μιας νέας επιστημονικής κανονικότητας.
«Ο Νίτσε είπε πως η αλήθεια είναι το βαθύτερο ψέμα. Ο Κανγκιλέμ, όντας κοντά στον Νίτσε, αλλά ταυτόχρονα και μακριά του, θα έλεγε ίσως πως στο τεράστιο ημερολόγιο της ζωής είναι το πιο πρόσφατο σφάλμα. Θα έλεγε ότι η διαίρεση αληθούς/ψεύδους και η αξία που προσδίδεται στην αλήθεια συνιστούν τον πιο μοναδικό τρόπο ζωής που θα μπορούσε να έχει ανακαλύψει μια ζωή η οποία, από την παλαιότερη απαρχή της, κουβαλάει μέσα της το ενδεχόμενο του σφάλματος. Το σφάλμα για τον Κανγκιλέμ είναι η μόνιμη τύχη γύρω από την οποία αναπτύσσεται η ιστορία της ζωής καθώς και η ιστορία του ανθρώπου.» {Εισαγωγή: Μ. Φουκό}
Το παθολογικό δεν ταυτίζεται με το μη-κανονικό αλλά διακρίνεται από τη δίκη του, πρωτότυπη και ανέκδοτη κανονικότητα. «Εάν αναγνωρίσουμε ότι η ασθένεια παραμένει ένα είδος βιολογικού κανόνα, αυτό συνεπάγεται ότι η παθολογική κατάσταση δεν μπορεί να θεωρηθεί κατ’ απόλυτο τρόπο μη-κανονική, αλλά μη-κανονική σε σχέση με μια προσδιορισμένη κατάσταση. Αντιστρόφως, το να είναι κανεις υγιής και το να είναι κανονικός δεν είναι ισοδύναμα, αφού το παθολογικό είναι ένα είδος κανονικού.» {σ. 141}
Ιδιαίτερα ρηξικέλευθα συμπεράσματα τα οποία καθόρισαν την πορεία της δυτικής διανόησης μέσα από πλήθος προεκτάσεων αφού η ίδια η ιστορία της επιστήμης, της γνώσης και της φιλοσοφίας, φαίνεται να αποτελείται από μια σειρά ασύμμετρων κανονικοτήτων, που η αναγνώριση ενός προβλήματος οδηγεί σε ρήξη και την εγκαθίδρυση μιας νέας επιστημονικής κανονικότητας.
August 26, 2022
Istota żywa i środowisko nie są normalne w oderwaniu od siebie, ale jedynie dzięki swym wzajemnym stosunkom. Dla danej istoty żywej środowisko jest normalne o tyle, o ile umożliwia ono takie bogactwo i, odpowiednio, taką różnorodność form, tak że w wypadku zmian środowiska w jednej z tych form życie mogłoby znaleźć rozwiązanie problemu przystosowania.
(…) Żaden nazwany normalnym, gdyż już zaistniały, fakt nie może pełnić roli normy, której jest wyrazem, skoro warunki, do których był odnoszony, już zanikły. Nie ma faktów normalnych i patologicznych samych w sobie. Anomalia bądź mutacja nie są same w sobie patologiczne. Wyrażają jedynie inne możliwe normy życiowe. Jeśli normy te są - w odniesieniu do stabilności, płodności, zmienności życia - gorsze od wcześniejszych norm gatunkowych, to zostają uznane za patologiczne. Natomiast jeśli w tym samym środowisku okazują się równoważne, a w innym lepsze, to uznaje się je za normalne. Ich normalność bierze się z ich normatywności. Patologiczne nie oznacza bynajmniej braku normy biologicznej, ale normę inną, tyle że - w porównaniu z pozostałymi - odrzuconą przez życie. (s. 112-114)
(…) Żaden nazwany normalnym, gdyż już zaistniały, fakt nie może pełnić roli normy, której jest wyrazem, skoro warunki, do których był odnoszony, już zanikły. Nie ma faktów normalnych i patologicznych samych w sobie. Anomalia bądź mutacja nie są same w sobie patologiczne. Wyrażają jedynie inne możliwe normy życiowe. Jeśli normy te są - w odniesieniu do stabilności, płodności, zmienności życia - gorsze od wcześniejszych norm gatunkowych, to zostają uznane za patologiczne. Natomiast jeśli w tym samym środowisku okazują się równoważne, a w innym lepsze, to uznaje się je za normalne. Ich normalność bierze się z ich normatywności. Patologiczne nie oznacza bynajmniej braku normy biologicznej, ale normę inną, tyle że - w porównaniu z pozostałymi - odrzuconą przez życie. (s. 112-114)
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May 14, 2024"O Normal e o Patológico" de Georges Canguilhem é uma obra fundamental que aborda de forma profunda e provocativa questões essenciais sobre a filosofia da ciência, a epistemologia e a história das ciências. Canguilhem explora a relação entre o normal e o patológico, destacando a importância da reflexão crítica sobre o conhecimento científico e a necessidade de integrar a história das ciências com a epistemologia para uma compreensão mais ampla. Com uma abordagem dinâmica e histórica, o autor discute a polivalência teórica dos conceitos, a evolução do pensamento científico e a relação entre ciência e filosofia, oferecendo uma visão complexa e enriquecedora sobre a construção do conhecimento científico e suas bases epistemológicas. Uma leitura sensacional para quem gosta de ir além da superficialidade dos temas, buscando o real sentido daquilo que se considera "normal".
May 8, 2018
Creo que va a pasar mucho tiempo hasta que termine de masticar el contenido se este libro, pero algo sí se puede concluir: la salud es relativa, pero objetiva y normal y normativa mientras que la enfermedad es subjetiva pero anterior a la salud. Y lo anormal no es sinónimo de lo patológico ni de lo anómalo. Su argumentación para demostrarlo es imbrincada y satisfactoria.
Ahora entiendo porque Canguilhem es una autoridad en filosofía de la medicina y la biología. Su lucidez e imaginación es ejemplar, pero su estilo es pesado y trabajoso. Recomiendo leerlo con cuidado y sin muchas distracciones, es todo un reto.
Ahora entiendo porque Canguilhem es una autoridad en filosofía de la medicina y la biología. Su lucidez e imaginación es ejemplar, pero su estilo es pesado y trabajoso. Recomiendo leerlo con cuidado y sin muchas distracciones, es todo un reto.
Want to read
July 10, 2023A book I'm really interested in now. I tried to read it a few years back, but to no luck because it's prose was as dense as an boreal forest. From the secondary sources, Canguilhem sounds quite like a thinker who resonates with my ambitions (although I doubt I should limit my reading palate to simply thinkers who resonate with my ambitions).
Far from being dry or scientific (even though engaging with the scientific community is part of his goal), I really find his concepts infused with life and creativity. Important for disability studies, even.
I've been kind of losing my passion for books, so this might be the one I get back into after a long time.
Far from being dry or scientific (even though engaging with the scientific community is part of his goal), I really find his concepts infused with life and creativity. Important for disability studies, even.
I've been kind of losing my passion for books, so this might be the one I get back into after a long time.
April 16, 2020
"A rigore, si può vivere con molte malformazioni o affezioni, Ma non si può non fare nulla della propria vita, o quantomeno si può sempre farne qualcosa, ed è in questo senso che ogni stato dell'organismo, se è adattamento circostanza in poste, finisce, in quanto esso è compatibile con la vita, per essere in fondo normale."
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May 18, 2025Bela reflexão entre estados qualitativos e quantitativos, entre limiares e continuidades, entre anomalia e norma, e as implicações que derivam dessa ciência que se dá na encruzilhada de diversas outras, que é a medicina. Excelente leitura para todo aquele que se interessa por patologia, excessos, faltas, desmedidas, experimentações e epistemologia.
July 2, 2025
Texto construido alrededor de la intuición fundamental de que el uso del concepto de "normal" en el saber medico moderno es de un carácter profundamente ideológico. El organismo vivo humano al estudiarse a si mismo, crea valores éticos, existenciales, estéticos que no remiten a ninguna objetividad universal, sino que se confunden con el despliegue de una práctica concreta que es a la vez un pensar de sí.
Fue la tesis de doctorado de Canguilhem. Libro de partícular influencia para la arqueología planteada por Foucault.
Fue la tesis de doctorado de Canguilhem. Libro de partícular influencia para la arqueología planteada por Foucault.
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June 27, 2019Complex view of normal rationale.
November 26, 2020
Normal ve Patolojik, Georges Canguilhem’in biyoloji, bilim felsefesi, tıp ve psikoloji alanlarının kurucu ismi olarak anılmasını sağladı ve şimdi Perge Akgün’ün çevirisiyle MonoKL'da.
March 8, 2021
One of my favorite books. Wise and provocative.
July 25, 2023
A brilliant classic. It is surprisingly fresh despite having been written in the 1940s (and parts in the 1960s). It contains insights relevant to disability scholars even today.
November 12, 2024
Molt bó
June 5, 2011
"Health is a set of securities and assurances...securities in the present, assurances for the future. As there is a psychological assurance which is not presumption, there is a biological assurance which is not excess, which is health. Health is a regulatory fly-wheel of the possibilities of reaction. Life is usually just this side of its possibilities, but when necessary is shows itself above its anticipated capacity...To be in good health means being able to fall sick and recover, it is a biological luxury."
January 19, 2024
Lecture très difficile mais une vision fondamentale de la question de la norme notamment dans le champ du handicap. Une vision extrêmement vivante et humaine de la maladie, loin de nos imaginaires froids, médicaux et bureaucratiques.
March 9, 2024
de obligada lectura bajo mi punto de vista
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