The ‘Normal’ and the ‘Pathological’: ‘Obesity’ and the Dis-eased ‘Fat’ Body

Abstract

Fundamental to Foucault’s analysis in The Birth of the Clinic is his discussion of the new ‘politicisation’ of medicine in the eighteenth century, and his detailing of a shift from a guiding interest in health, to normality in nineteenth century medicine (Foucault, 2003, p. 40). As described in the above quotation, Foucault claims that in the nineteenth century medicine became not only a mode of treating/curing illness, but rather was politically situated as a field of knowledge that was responsible for establishing standards and models for living. Key to the methodological foundations of this new clinical medicine was the establishment of norms, set against an increasing ‘literacy’ in the category of the pathological, both within medical discourse itself, and in lay society. In this way, clinical medicine was elevated from the treatment of illness to a branch of state governance and a mode of social control that involved surveillance and discipline, both internal and external to the subject. Foucault suggests that central to this control of the population and the rise of scientific rationalism in the nineteenth century, was a new interest in categorising bodies in a binary structure of ‘normal’ versus ‘pathological’. Foucault argues that following this socio-political shift, modern medicine was required to expand its approach beyond the application of a simple set of curative therapies, towards the formation of “a knowledge of healthy man, that is, a study of non-sick man and a definition of the model man” (2003, pp. 39–40).

As a word, ‘normal’…acquired its present most common meaning only in the 1820’s…The normal was one of a pair. Its opposite was the pathological and for a short time its domain was chiefly medical. Then it moved into the sphere of — almost everything. People, behaviour, states of affairs, diplomatic relations, molecules: all these may be normal or abnormal (Hacking cited in Osborne, 1998, p. 269).

…the prestige of the sciences of life in the nineteenth century, their role as model, especially in the human sciences, is linked originally not with the comprehensive, transferable character of biological concepts, but, rather, with the fact that these concepts were arranged in a space whose profound structure responded to the healthy/morbid opposition. When one spoke of the life of groups and societies, of the life of the race, or even of the ‘psychological life’, one did not think first of the internal structure of the organised being, but of the medical bipolarity of the normal and the pathological (Foucault, 2003, p. 41, original emphasis).