Georges Canguilhem presented his thesis in 1943 on the difference between the normal and the pathological.
In matters of pathology, the first word, historically speaking, and the last word, logically speaking, belongs to the clinic. However, the clinic is not a science and will never be a science, even though it will use means whose effectiveness is increasingly scientifically guaranteed. The clinic is not separate from therapy and therapy is a technique of establishing or restoring normality, the end of which, namely the questionive satisfaction that a norm is established, escapes the jurisdiction of objective knowledge. One does not scientifically dictate norms to life. But life is this polarized activity of debate with the environment that feels normal or not, depending on whether it feels in a normative position or not. The doctor has taken the side of life. Science serves him in the fulfillment of the duties that arise from this choice. The call to the doctor comes from the patient. It is the echo of this pathetic call that makes all the sciences used to help life by the medical technique be qualified as pathological. Thus there is a pathological anatomy, a pathological physiology, a pathological histology, a pathological embryology. But their quality of pathological is an import of technical origin and therefore subjective. There is no objective pathology. Structures or behaviors can be described objectively, but they cannot be said to be “pathological” on the basis of any purely objective criteria. Objectively, one can only define varieties or differences without positive or negative vital value. (…)
In short, the distinction between physiology and pathology has and can only have a clinical significance. This is the reason why we propose, contrary to all current medical habits, that it is medically incorrect to speak of diseased organs, diseased tissue, diseased cells.
Georges CANGUILHEM, The Normal and the Pathological, 1943
Canguilhem is focused on medicine. “Health” is a vulgar concept, since it covers several themes; we are no longer in the conception of psychiatry. The WHO has defined health is not as the absence of disease, but as total physical, psychological and social well-being. In the name of well-being, everyone could be controlled, normalized: this is a problem.
Medicine uses science, but it is not a science. Doctors find themselves prolitarized because they are alienated from protocols.
