• The internalization of scientific concepts of health and normality
• Which are administered by professional groups on the basis of their claim to scientific knowledge (biopolitics)
• Linking the human body to organized knowledge
• To achieve social control – the link between the individual and social structures (the body)

• Power “the multiplicity of force relations immanent in the sphere in which they operate and which constitute their own organization”
• “power is everywhere, not because it embraces everything, but because it comes from everywhere.”
• Biopower “numerous and diverse techniques for achieving the subjugation of bodies and the control of populations.”

• “institutions of power” [the family, the army, the schools, medicine/public health, the police, etc]
– “and the adjustment of the phenomena of population to economic processes.”
• Biopower – “an indispensible element in the development of capitalism.”
• Biopower “what brought life and its mechanisms into the realm of explicit calculations and made knowledge-power an agent of transformation of human life.”

• The body is a target of and is constituted by power relations focused on it which render it obedient and docile
• Power relations are not external forces but internalized self-control
– Power – all embracing – flows like an electrical field
• Medical power that shapes and forms the body is relational
– Bodies that are shaped react back on medicine

• The shaping of perception
• Discursive practices in the absence of active practitioners
• The gaze in the absence of the perceiving subject
• a world in which the gaze, free of all obstacle, is no longer subjected to the immediate law of truth: the gaze is not faithful to truth, nor subject to it, without asserting, at the same time, a supreme mastery

• a form of power that circulates in the social field and can attach to strategies of domination as well as those of resistance
• the 'discursive field‘ -- the relationship between language, social institutions, subjectivity and power
• 'disciplinary power'

• power : ability to bring about results
– power may be informal and based on force
– coercive power versus persuasive power
– Symbolic power based on positive expectations of those who accede to it
• authority is the socially recognized right to exert power
• legitimacy - the socially recognized right to hold, use, and allocate power

• Potency, capability, charisma (individual)
• Ability of person to impose its will in social action upon another
• Tactical or organizational power -- The instrumentalities through which individuals or groups direct or circumscribe the actions of others
• Structural power – power that organizes and orchestrates the settings themselves & that specifies the direction & distribution of energy flows

• Medicine is a manifestation of an administered society
• Centralization of information about citizens is essential for social planning
• Marx focuses on economy
• Parsons on social system
• Foucault on bureaucratic state
– Interaction between social structure & development of
“the person”
• Medicine is a record of cultural, political, social changes in European society

• Development of concerns with health & hygiene
– Reflect increased “delicacy of feeling” (Elias) between individuals
• A symbol of correct social relationships
– Democratization of society
– Individualization of “the person”
– Health practice now open to “all”
• Concern with bodies & their presentation to others marks long-term progressive history
– Not administrative coup
• critique of Foucault

• 18 & 19 th cent.
– Infant mortality decreases
– Life expectancy increases
– Economic developments & large scale growth or urban life
• Cities developed & capitalism matured
• New forms of knowledge about people developed
• Disciplines of knowledge – knowledge/power

• More to modern societies than economics
• The development of bureaucratic surveillance of the population as dominant feature of modern societies
• Development of professional groups who:
– Claim to understand human beings (knowledge)
– Prescribe to them how to act (power)
• Medicine is a case study of this process

• From bedside medicine
– Patronage and patient driven
– Disease happened to the whole person: holistic orientation
• “modern” medicine is alternative medicine
– Classical medical paradigm formed during Greek &
Roman times dominant until late 19 th cent.
– Medical traditions elsewhere – Chinese, Unani,
Ayurvedic, indigenous

• Classical
– Individual person
– Body & soul
– Container of humors & energies
– Ecological physiology
– Equilibrium
– Multiple disease causes
– Describe the event
– Prognosis important
• Modern
– Universal body
– Materialistic body reducible
– Complex machinery
– Physiology focused on interior of universal body
– Normal structures & deviation
– Disease & the cause

• To the Hospital
– Patient becomes dependent on professional doctor
– Disease a problem of pathology distinct from the individual
– Medical practitioner wants & elicits specific information
– For the laboratory
– Both patient and doctor displaces by the tests – the examination & experiement
– Statistical tests of biological normality vs charasmatic ability of the practitioner

• Descartes suggested that the body works like a machine
– the material properties of extension and motion
– follows the laws of physics
• The mind (or soul)
– a nonmaterial entity that lacks extension and motion
– does not follow the laws of physics
• only humans have minds, and that the mind interacts with the body at the pineal gland
• form of dualism or duality proposes that the mind controls the body, but that the body can also influence the otherwise rational mind, such as when people act out of passion
• Cogito ergo sum (I think, therefore I am; OR I am thinking, therefore I exist)

• “The most fundamental values in a culture will be coherent with the metaphorical structure of the most fundamental concepts in the culture.” (Lakoff and Johnson 1980:22)
• Dualism – The view that the world consists of or is explicable as two fundamental entities, such as mind and matter
• The machine
• By the numbers