Michel Foucault “The Politics of Health in the 18th Century”

Foucault, Michel 2000. The Politics of Health in the Eighteenth Century. – Foucault, Michel. Power. Essential Works of Foucault, Volume 3. New York: The New Press: 90-105.

An analysis of idleness—and its conditions and effects—tends to replace the somewhat global charitable sacralization of “the poor.” This anal-ysis has as its practical objective at best to make poverty useful by fixing it to the apparatus of production, at worst to lighten as much as possible the burden it imposes on the rest of society. The prob-lem is to set the “able-bodied” poor to work and transform them into a useful labor force; but it is also to assure the self-financing by the poor themselves of the cost of their sickness and temporary or permanent incapacitation, and further to make profitable in the short or long term the education of orphans and foundlings. Thus, a complete utilitarian decomposition of poverty is marked out, and the specific problem of the sickness of the poor begins to figure in the relationship of the imperatives of labor to the needs of produc-tion. (93)

Down to the end of the ancien regime, the term “police” does not signify (at least not exclusively) the institution of police in the modern sense; “police” is the ensemble of mechanisms serving to ensure order, the properly channeled growth of wealth, and the conditions of preservation of health “in general.” (94)

The medical politics outlined in the eighteenth century in all Eu-ropean countries has as its first effect the organization of the family or, rather, the family-children complex, as the first and most im-portant instance for the medicalization of individuals. The family is assigned a linking role between general objectives regarding the good health of the social body and individuals’ desire or need for care. This enables a “private” ethic of good health as the reciprocal duty of parents and children to be articulated onto a collective sys-tem of hygiene and scientific technics of cure made available to individual and family demand by a professional corps of doctors qualified and, as it were , recommended by the state. (98)

The city with its principal spatial var-iables appears as a medicalizable object. Whereas the medical to-pographies of regions analyze climatic and geological conditions outside human control, and can only recommend measures of cor-rection and compensation, the urban topographies outline, in neg-ative at least, the general principles of a concerted urban policy. During the eighteenth century the idea of the pathogenic city in-spires a whole mythology and very real states of popular panic (the Charnel House of the Innocents in Paris was one of these high places of fear); it also gave rise to a medical discourse on urban morbidity and the placing under surveillance of a whole range of urban developments, constructions, and institutions. (99)

A “medico-administrative” knowledge begins to develop concerning society, its health and sickness, its conditions of life, housing and habits; this serves as the basic core for the “social economy” and sociology of the nineteenth century. And there is likewise constituted a politico-medical hold on a population hedged in by a whole series of prescriptions relating not only to disease but to general forms of existence and behavior (food and drink, sexuality and fecundity, clothing and the layout of living space). (100)

The point is that, in relation to these new problems, the hospital appears as an obsolete structure in many respects. A fragment of space closed in on itself, a place of internment of men and diseases, its ceremonious but inept architecture multiplying the ills in its in-terior without preventing their outward diffusion, the hospital is more the seat of death for the cities where it is sited than a thera-peutic agent for the population as a whole. (101)

However, the disappearance of the hospital was never more than the vanish-ing point of a Utopian perspective. The real work lay in the effort to elaborate a complex system of functions in which the hospital comes to have a specialized role relative to the family (now con-sidered as the primary instance of health), to the extensive and continuous network of medical personnel, and to the administrative control of the population. It is within this complex framework of policies that the reform of the hospitals is attempted. (103)

It is also necessary to organize the internal space of the hospital so as to make it medically efficacious, a place no longer of assis-tance but of therapeutic action. The hospital must function as a “curing machine.” First, in a negative way: all the factors that make the hospital dangerous for its occupants must be suppressed, solv-ing the problem of the circulation of air (which must be constantly renewed without its miasmas or mephitic qualities being carried from one patient to another), and solving as well the problem of the changing, transport, and laundering of bed linen. Second, in a positive way, the space of the hospital must be organized according to a concerted therapeutic strategy, through the uninterrupted pres-ence and hierarchical prerogatives of doctors, through systems of observation, notation, and record-taking. […]The hospital tends toward becoming an essen-tial element in medical technology, not simply as a place for curing, but as an instrument which, for a certain number of serious cases, makes curing possible. (103-104)

Consequently, it becomes necessary in the hospital to articulate medical knowledge with therapeutic efficiency. In the eighteenth century, specialized hospitals emerge. (104)

Finally, the hospital must serve as the supporting structure for the permanent staffing of the population by medical personnel. Both for economic and medical reasons, it must be possible to make the passage from treatment at home to a hospital regime. (104)

Bernard Stiegler “Care”

Stiegler, Bernard 2012. Care: Within the Limits of Capitalism, Economizing Means Taking Care. – Cohen, Tom (ed). Telemorphosis. Theory in the Ero of Climate Change, Volume 1. Open Humanities Press. 104-120.

[…] transindividuation is the way psychic individuations are meta-stabilized as collective individuation: transindividuation is the operation of the fully effective socialization of the psychic. With the social networks, the question of technologies of attention becomes manifestly and explicitly the question of technologies of tran-sindividuation. (106)

What Husserl calls primary retention is this operation consisting of re-taining a word in another […] it is the operation consisting in retaining a word which however is no longer present, the beginning of the sentence having been pronounced and in this respect already past, and yet still present in the sense that is thus elaborated as discourse.

We must distinguish the operation we are calling primary retention from secondary retention. The latter is a memory: something that be-longs to a past having passed by (it is thus a former primary retention), whereas the primary retention still belongs to the present, to a passing present: it is the passage itself, per se, and in this respect the direction of the present—its sense in the sense of direction as well. Now, the second-ary memory is also what permits us to select possibilities from the stock of primary retentions: primary retention is a primary selection whose cri-teria are furnished by the secondary retentions. (108)

[…] that which allows such a discourse to be repeated, for example in the form of a recording in MP3 format, is a tertiary retention with the same status as the text I am now reading for you, which allows me to repeat a discourse that I conceived elsewhere, and at another previous time: this is what Plato called a hypomnesic pharmakon. […] Such a device allows, to be more precise, the control of retentional and protentional hook-ups in view of producing attentional effects. (109)

Tertiary retentions are therefore mnemotechnical forms of the exte-riorization of psychic life constituting organized traces into retentional devices […] that character-ize the systems of care, as therapeutic systems whose retentional devices are the pharmacological basis. (109)

[…] where the libido has been destroyed, and where the drives it contained, as Pandora’s box en-closing every evil, henceforth are at the helm of beings devoid of atten-tion, and incapable of taking care of their world. Libidinal energy is essentially sustainable, except when it decomposes into drive-driven energy, which is on the contrary destructive of its ob-jects. The drive is an energy, but an essentially destructive one, for the drive consumes its object, which is to say it consummates it. (113)

If consummation is that which destroys its object, libido is to the con-trary that which, as desire and not as drive, that, as the sublimation in-trinsic to desire,  takes care of its object. This is why the question of the third limit of capitalism is not that of the relinquishment of fossil fuels but rather the relinquishment of a drive-driven economy and the recon-stitution of a libidinal economy, that is, a sustainable one, given that this energy increases with the frequentation of its objects. (114)

An organization based on consumption, and constituted by its oppo-sition to production, is dangerous not only because it produces excess quantities of carbon dioxide, but because it destroys minds. The oppo-sition of production and consumption has as its consequence that both producers and consumers are proletarianized by the loss of their knowl-edge: they are reduced to an economy of subsistence, and deprived of an economy of their existence—they are deprived of libidinal economy, that is, of desire. This is why the fundamental question opened by the combi-nation of the three limits of capitalism is the overcoming of this opposition and of the proletarinarization it engenders structurally. (115)

Perhaps this deplenishment [of fossil fuels] is finally a kind of stroke of luck: the opportunity to un-derstand that the true question of energy is not that one, that the energy of subsistence is of interest only insofar as it contributes to an energy of existence—and is such in its capacity to project what I call the plane of consistencies. Now this is the true stake of what is today called, in an am-biguous expression, ascendant innovation. (116)

Ascendant innovation is a structural break with the organization of social relations in the industrial world based on the oppositional couple production/consumption. It is founded on motivations oriented toward consistencies, that is, toward objects of what the Greeks and the Romans called skholè and otium, which are very specific objects of atten-tion: the objects of knowledge (know-how, art of living, the disposition to theory, that is, to contemplation). (116-117)

The IP technology is on the contrary what allows the proliferation of new circuits of transindividuation, and that’s why it is massively invested in by social practices that were neither anticipat-ed nor programmed by any industrial or commercial strategy. It is thus that this technico-relational milieu tends to reconstitute associated and dialogical milieus (that is, where all those who participate in this milieu contribute to its individuation) by the unfolding of technologies of tran-sindividuation. (119)

This is not to say that these technologies cannot serve the cause of the short-circuiting of transindividuation. All attentional technologies (and these digital technologies of transindividuation belong to the group of at-tentional technologies) are pharmacological to the strict extent that, as technologies of the formation of attention, they can be reversed and upturned into technologies of the deformation of this attention, and short-circuit this attention, that is, exclude it from the process of transindividu-ation and signification: they can always produce dissociation. (119)