welcome to this Liberstoria lecture on
epidemics:
an historical view so in this lecture
we're going to be examining the way that
epidemics have been conceived of
over the past few thousand years of
human history
the idea that epidemics are part of
nature
something that we have to interact with
deal with be scared of
that has been around for a long time
however
the more political element of how an
epidemic
is dealt with it's
political aspect, is something much
more recent
the idea that you can fight an epidemic
control an epidemic by controlling a
population
that is something that is much more
recent and it has to do with something
deep in european enlightenment thinking
that
subsequently went across the world
so in the first section here we're going
to be dealing with
just briefly because there are too many
examples to give
the more naturalistic approach to what
an epidemic is about
so if we begin with this first text here
which is a book
written by scholars collecting aphorisms
and other sayings of the life of
the buddha Siddhartha Gautama
we see here a very good example of what
you could call
eastern naturalistic
whatever you want to term it a kind of
naturalistic approach towards
what disease is and buddhism is a great
example buddhist
thought buddha's thought is a great
example
of seeing epidemics
seeing disease as part of the human
experience not fighting it
not seeing it as an enemy not seeing it
as an
invisible enemy to fight a war against
so if we dive right in here we can see
that the buddha is recalling a story
about a man called king Padmaka so he
says
there once reigned in Benares (Varanasi) a just and
powerful king
named padmaka now a strange
epidemic suddenly swept through the city
those who were stricken turned
completely yellow
and even in the sunshine they shivered
with cold the king took pity on his
subjects
he tried to find some way to cure them
he consulted the most famous physicians
he distributed medicines
and he himself helped to nurse the sick
but it was all hopeless
the epidemic continued to rage
padmaka grieved one day an old
doctor came to him and said
my lord i have a remedy that will cure
the inhabitants of benares
and what is it ask the king
he answered it is a large fish named
rohita
have him caught and give a peace no
matter how small
to all who are sick and the epidemic
will disappear
the king thanked the old physician and
he ordered the fish
rohita to be found in the seas in the
river
but nowhere could it be found again the
king was in despair
sometimes in the morning or in the
evening he could hear plaintiff voices
crying outside his palace we are
suffering a king
save us and he himself would be
weep bitterly finally he thought
what good is wealth or royalty
what good is life if i cannot secure
those who are racked with pain
he summoned his eldest son and he said
to him
my son i leave you my fortune and my
kingdom
then he ascended to the terrace of the
palace
he offered a perfume and flowers to the
god
and he cried gladly do i sacrifice a
life
that i consider useless may
the sacrifice benefit all those
afflicted
may i become the fish royita and be
found in the river that flows through
the city he threw himself from the
terrace
and immediately reappeared in the river
as the fisheries
so i think this text is a very powerful
text
and you know whatever you make of the
truth
of the story uh what what it's really
saying
is that don't fight nature don't fight
disease don't fight death be ready to
give away everything no matter how
powerful you might be
how much you like you have to look
forward to
and instead it's all about building
something
for others and being willing to give up
all for others right so that was a very
typical
um naturalistic approach to disease
in the ancient world and
you know plagues epidemics diseases
communicable
communicable diseases they were not
really seen as something
you know alien to the everyday human
experience it was something that
everyone
grew up with it was very common thing
for people to lose their brothers their
sisters
their children to disease that their
older people in the
in the villages and the towns to disease
it was not seen as something you could
do anything about
now the greeks the ancient greeks have
some of the earliest texts
dealing with how to deal with these
things and doing something about it
so here we start to see something that
grows in the european tradition
starting with the ancient greek text and
then
building up towards the later
renaissance and
enlightenment texts that we'll see later
on and what we start to see is much more
the concept of trying to grab the
disease
trying to measure and observe what it is
doing
even though it is this invisible enemy
you can start to describe what's
happening to the patients
now there's no one better to start with
on this account
than hippocrates and his text his famous
text airs waters
and places so here's what he writes
he's talking about what a doctor should
be able to do
and remember hippocrates is usually
called the father of
medicine so he says from these things he
the doctor must proceed to investigate
everything else
for if one knows all these things well
or at least the greater part of them
he cannot miss knowing when he comes
into a strange city
either the diseases peculiar to the
place
or the particular nature of the common
diseases
so that he will not be in doubt as to
the treatment of these diseases
or commit mistakes as is likely to be
the case
provided one had not previously
considered these matters
and in particular as the season and the
year advances
he can tell what epidemic diseases will
attack the city
either in summer or in winter and what
each individual will be in danger of
experiencing
from the change of regimen for knowing
the changes of the seasons
the risings and settings of the stars
how each of them takes place
you'll be able to know beforehand what
sort of year
is going to ensue so we see here with
hippocrates that he's
you know he's trying to make sense of
what
what is happening in the city by
observation right he's saying
observe things check what's happening
look at the way the diseases are
happening and he notes
as well that diseases attack different
cities in different ways
so he's bearing in mind all these
different factors which you know you can
then start to trace
human factors which we know today as
genetic differences you know dna the way
people react to different diseases
but he's already mentioning this but
notice at the end
he's basically saying that it's through
astrology
you know astronomy the ability to watch
the stars
and the seasons this is what in
hippocrates's view this is something
that can prepare the doctor to
understand what's happening
with the disease so obviously that is
still
very linked with the
naturalistic view that the disease is
something from heaven
from nature and therefore there's no way
of fighting it
so this next text here it's not really a
direct historical text it's rather a
text that was written in the 1900s
talking about looking back it's a
historian
Bertram Puckle he's writing about the
impact of the plague on europe
and in asia the great plagues
of the 1400s 1300s 1400s
1500 1600s right the black plague
bubonic plague
and what we see here is is that there is
a kind of
middle ground now we're starting to
shift we start to see the rise of
statistics of doctors
going into very much like what
hippocrates was saying
in the previous text doctors coming into
cities observing what is happening
dealing with the disease
but at the same time the level of
mortality the
number of people who die is so massive
that it's you know people see this as a
visitation this is the term that is used
a visitation from
god a visitation from above this is
a sickness that destroys people on a
massive scale
and therefore it is something that you
cannot fight
and often of course in medieval europe
and in other places as well like
medieval islamic
countries this was seen as the wrath of
god
that god had placed these diseases
in order to punish sinful behavior right
so this is what Bertram Puckle
writes in
funeral customs here chapter 10 he says
it is to be hoped that with all that
modern science has done
towards the better ordering of our
sanitary arrangements
remember that he's writing in the 1900s
here 19 early 1900s
and the scientific treatment of the
refuse of the cities we in this country
may never
again experience such a devastating
scourge
as the plague which swept over this land
in earlier centuries
even now in india china and other
countries
the mortality from these awful
visitations
exceed anything we can imagine in our
comparative security
that despite organized relief the death
role from plague in a fearsome companion
famine wiped out in the affected
districts
hundreds of thousands of human lives and
we cannot pretend to have dealt
the subject of death without
consideration
of the provisions made in such
calamities
to dispose of great numbers of bodies
moaned down
like corn under the sickle far exceeding
all visitations of the kind in europe
stands out the black death of the 14th
century the
1300s and the great plague of the 17th
century
1600s the black death which appeared in
london
in 1348 started in china
and rapidly spread from country to
country
leaving an appalling devastation in its
wake
of the three or four million who then
formed the population of england
more than one half were swept away in
its repeated visitations
the black death left its mark on all
phases of national life
for 150 years while no accurate estimate
could ever be expected
the death roll is probably not
overestimated as having claimed
20 millions of victims
in attempting to relieve the most urgent
necessities of the sick
the great religious institutions which
in the middle ages represented sanctuary
shelter and such medical care as they
could offer to the people
were quickly overwhelmed and rented
powerless by the losses
which they themselves sustained
by infection when tending to the body
bodily and spiritual needs of the sick
and the dying
of course that's something we are
hearing about today
many doctors and nurses the healthcare
professionals
they're the frontline healthcare
professionals they're the ones who
are having the highest infection rates
in this current uh crisis so here then
Puckel adds
uh an anecdote he says there is an old
story which so well
illustrates the effects of the terror it
caused
that is worth recalling a pilgrim made
his way to baghdad
in iraq and was overtaken on his journey
by grisly figure
who are you asked this pilgrim
i am the plague was the response and i'm
going to back dad to kill a thousand
people
on his return journey the pilgrim
overtook the spectre again
and stopping him said why did you tell
me that
you're only going to kill a thousand in
baghdad
whereas i found tens of thousands of
your victims in the city
and the plague replied i spoke truly i
killed only one thousand
and the remainder died from fright
dr gasquet speaking of the ravages of
the black plague says
there was no time for christian burial
the corpse was hurried to the nearest
church where it was consigned to the
tomb
with the least attempted ceremony
consecrated ground was quickly filled to
the overflowing
and it became necessary to dr to dig
trenches into which the bodies were
placed in the hundreds
layer upon layer without little earth
sprinkled
in between till the pit was full to the
top
Di Tura, at Sienna,
a contemporary chronicler says: "and i, Agniolo Di Tura,
carried with my own hands my
five little sons to the pit
and what i did many others did likewise
so great was the labor of burying the
dead
little wonder that fear sees the stout
its hearts
so as we can see the the idea of
epidemic in the ancient and even the
medieval
world around the world not just in
you know ancient greece or india
under you know in the period of buddha
but also in asia
also in italy as you saw there in the
last example
in england there was a constant fear of
the plague
constant fear of epidemics as being
something that is either a judgment or
something natural that is beyond
comprehension but even in these early
times we see the beginnings
of this more political more technocratic
more combative approach towards dealing
with play
there's this idea that you can fight the
plague that you can control the plague
and underneath this idea of course is
the idea that you can control the plague
by controlling people
and this is what we see here in this
final text from the ancient times
and that is in plato's republic right
and in this
passage he's discussing this is socrates
plato's teacher
who's being used as the voice of plato's
ideas
in this final text of plato
the republic and
he's uh he's basically examining
the idea of how politics and political
groups
take part in a city in the in the
republic in the cities political
activities
and here this is interesting because he
uses the word plague
as a way of describing the way people
different groups of people who are
undesirable in plato's opinion
how they gather within a city so this is
what he's saying
that however was not so the dialogue
here
is between socrates who's doing
most of the talking and his interlocutor
another philosopher who's listening and
replying
so this is socrates here that however
was not
as i believe your question you rather
desired to know
what is that disorder which is generated
alike
in oligarchy and in democracy and is
therefore the ruin of both so oligarchy
is a system in which
elite rule and democracy is the rule by
the mob
by the people just so replies the
person who's talking with socrates so
socrates continues
well i meant to refer to the class of
the idle
spendthrifts of whom the more courageous
are the leaders
and the more timid the fl the followers
the same whom
we were comparing to drones some
stingless and others have stings
drones here he's talking the metaphor is
towards bees
you have the worker bees the drones some
of them have stings
others are stingless a very just
comparison
these two classes are the plagues of
every city says socrates
in which they are generated being what
phlegm and bile are to the body
and the good physician and law giver of
the state ought
like the wise bee master to keep them at
a distance
and prevent if possible they're ever
coming in
so you can see of course plato is just
messing around with ideas of
democracy oligarchy how to organize a
system
political system but you can see here
already the idea that
control of populations because people
are like plagues now of course this is
not
a medical conception is simply a
metaphor right but you can see here
the beginnings of that control
you know this is the beginnings of it
now if we move forward here we go
towards the
you know late medieval early modern
enlightenment period
we're going to see several texts that
continue this
similar metaphor of the plague
the epidemic as something that has to be
controlled
okay as not the plague itself the
disease itself but rather the
population who are part of the spreading
of the plague
and we see then the shift right what's
sometimes called a paradigm shift
between plague epidemic diseases are
something that has to do with
individual or collective nature
god judgment anything that has to do
with
something outside towards
what we're going to be seeing in this
towards the end of this lecture
which is that the plague becomes humans
themselves
as carriers of disease you know the
epidemic
is in itself part of
the political social character of being
of human
organization so we see someone here
the earl of shaftesbury using this
almost the same
concept as plato of mixing the political
with the
epidemic the medical so he says it has
been the wisdom of some wise
nations to let people be fools as much
as they pleased
and never punished seriously anything
that deserved only to be laughed at
and was after all best cures by best
cured by that innocent remedy
okay so he's talking about how should a
government how should a governor
or a you know president king whatever
how should they react
to punishing and controlling the people
so you can see his purely political
concept here and then he adds there are
certain humors in mankind
that can't be suppressed the human mind
and body are both naturally subject to
commotions
and just as there are strange ferments
in the blood
which in many bodies lead to an
extraordinary extraordinary discharge
so in reason too there are heterogeneous
particles
which must be thrown off by fermentation
so we're starting to see here
just as people get very hot hot and
bothered you get angry your blood is
boiling
same thing with the political
environment people sometimes get really
angry
let them get angry this is what
shaftesbury is giving as a
good liberal thinker he's advising the
kings and
leaders of england if people start to
write people start to get angry
let them vent their anger just like a
body
you let it cool off from the anger
and this is his suggestion but notice
that now the
the political aspect has been very
closely tied to the medical
and we're going to see this
so he had if physicians tried to stop
these ferments of the body absolutely
or attack the humans back then the
humans was this you know greek concept
of
medicine and it was still popular back
then in the 1700s
in uh you know around around europe
if if the doctor was to attack the
humors that reveal themselves in such
eruptions they might instead of making a
cure
risk starting an epidemic plague
and there are equally bad physicians of
the body politic
right so this is something that we see
rising in the enlightenment
the idea of the body politic which had
already been established by thomas
hobbes
a couple hundred years before this text
and will
will i'm sure have a chance to examine
that concept in detail
in another lecture but you see that
there's already the rise of this concept
of the population as a mass as a
multitude
being like the constituent parts of an
individual body
right and dealing with it in the same
way right
and then he adds i'm referring to the
ones who insist on tampering with these
mental eruptions and on the plausible
pretense of healing this itch of
superstition
and of saving souls from the contagion
of enthusiasm
set all nature in an uproar and turn a
few innocent carbuncles into an
inflammation and fatal gangrene so
carbuncles ( a few little spots) and then you
know the doctor
the metaphor he's using the doctor gets
too enthusiastic
tries to fight the illness with too much
effort
and what happens in the end is you end
up having a worse disease
right the disease becomes a plague so of
course
the concept is here politically if you
have people who are upset
let them get to the streets let them
ride let them protest and then
they will vent off cool off and then
come back
society go back to normal so here
shaftsbury talks again
at this time talking about the way that
people get upset in crowds
and create protests or rebellions
and notice how he's still using the
medical
epidemic analogy here still using the
language
medical concept to discuss this
political problem
so he says there's a good reason to
label as a panic
every passion that is aroused in a
multitude
and conveyed from person to person in
the crowd by just how they look
i.e by contact or by sympathy right
if you've ever been in a crowd which
loses its patience
loses its mind right you know what he's
talking about here people can just from
their very look
enrage one another and thus popular fury
can be called a panic
when as when as we have sometimes seen
the people are besides themselves of
rage especially when religion comes into
it
when people are in this state their very
looks become
infectious infectious right the fury
flies from the face to face the disease
is no longer is no sooner seen than
caught
you see he's adding the medical concept
onlookers who have witnessed a multitude
under the power of this passion
while they themselves were in a better
frame of mind
have admitted that they saw in men's
faces something more ghastly
and terrible than is ever expressed by
an individual
on the most passionate of occasions that
shows the force of society
of being together together with other
people
in bad passions as well as in good ones
it shows that any affection is very much
stronger when it is social and
communicative
thus there are many panics in mankind in
addition to the panic that only concerns
fear
for example religion is also panic and
panic occurs when enthusiasm of any kind
is worked up
as often on sad occasions it is for
vapors naturally rise and especially in
bad times where men's spirits are low
in public emergencies during periods of
bad food
and unhealthy air when convulsions
happen in nature
storms earthquakes or amazing prodigies
at those times the panic is bound to run
high and the magistrate has to give way
to it
now notice here there's an explanation
here of why
the medical aspect and the political
aspect of tide and that's because in the
old
science and the old concept of disease
diseases
were actually communicable through moods
and
the airs the scents the airs the humors
as
as we saw earlier this greek concept
so if you are feeling angry or upset
that your humors could actually be
communicated to someone else
and you'll probably have heard of this
because it's the concept of miasma
unhealthy air like the air itself as a
miasma could
translate negative emotions negative
moods
from one person to the other so you can
see still here even though there is this
beginning of this concept of control
uh human reasoning human understanding
of the disease and control of it
just as there is human understanding of
politics
you can see here that there's still this
concept of
disease epidemics as being purely
something naturalistic
you know a visitation what he's
suggesting here is how to control that
as much as you can
what he says is the alternative to that
the alternative to giving way
and when he says the magistrate he's
talking about the leader
for the leader his shaftesbury is
suggesting that there should be a kind
of
moderate response give way let people
vent
their anger let them have their panic
let them calm down
reduce the illness the social illness
the political illness
but there's also the alternative and
shafsori says
if however the leader
applies a serious remedy using military
force
or civil punishments as a cure notice
again the medical
analogy here this is bounced to make
things
even sadder increasing the cause of the
social illness
forbidding men's natural fears and
trying to overpower them
by other fears what an unnatural
procedure that is
right acting as a dictator acting
harshly towards people to try and force
them
to stop being fearful to stop getting
onto the streets to stop being angry
by using your own anger by using your
own fear
he's saying that this of course will
only increase the fear in the air
will only increase the anger in the air
right uh if you've ever heard that of
course
if you've heard that phrase there is a
lot of anger
in the air this comes back to these
older concepts where
people literally meant anger is in the
air you know they meant that literally
not just as a metaphor
if the magistrate if the leader has any
skill
he should have a gentler hand and
instead of using caustics incisions and
amputations
he should use the gentlest appointments
he should with a kind of sympathy enter
into people's concerns
and take their passions on himself
the influence of shaspree on other
thinkers is evident
as they began to move away of course
from this older scientific model
of miasma of the air you know the heirs
and the humors
moving away from that hypocrite
hippocrates model the greek model
to the new science but they maintain
this concept of the people
needing to be themse we see this in
another liberal
thinker jeremy bentham one of the great
liberal thinkers of the english
enlightenment
and you can see here he's talking about
public offences those offenses that can
hurt the public in general
so you can see here already the
criminalization the penalization
the organization of a system of control
of people
right so he says here offenses through
calamity
can be classified according to the
nature of the calamities that can befall
man
and the various things that are of use
to him these will be considered in
another place
pestilence may serve as an example
without intending to create such
calamity a man may expose an entire
neighborhood to the danger of it
by breaking his quarantine okay and
there's that
nice there's that magic word quarantine
that
we've gotten used to these uh this past
year
but you can see the concept here for
quarantine
and of penalizing people for breaking
quarantine
it's no longer a question of disease is
a natural thing
disease is something that you have to be
willing to sacrifice to if you remember
the buddhist text and it's no longer a
question of
even the airs or the moods are what
affect
disease which is what we saw in the
previous text shaftesbury
instead now there is a much more medical
concept of what diseases
and the people themselves the
individuals are potential disease
carriers
so this process that we just saw
between shaftesbury bentham these are
just two examples there are many
examples of
german italian
french doctors researchers thinkers
political thinkers
many others who all contributed to this
enlightenment
european enlightenment so 1600 1700s
1800s thinking and controlling of the
population of the multitude
and that was very much the the research
effort of a
very influential french historian of
much later times of the 1950s 1960s
1970s Michel Foucault and his whole work
historically as a historian was focused
on trying to trace the
way these these ideas of the
enlightenment became also kind of a
nightmarish vision of control
so on the one hand it was this kind of
enlightenment of freeing knowledge
learning about the world understanding
for example diseases
being able to take the invisible enemy
of disease and give it a face
by constantly observing it monitoring it
controlling the populations
using quarantines as we have just seen
with bentham
technocracy a system of technocratic
control
um as this grew 1600s
1700s 1800s as that grows
the the other side of the flip side of
that coin
the other side of that face is the of
course
the negative the dystopian not the
utopian the
optimistic the one that control that
controls and improves lives
but also the one that has the negative
impact the one in which
people lose control over their lives as
individuals
people lose their sense of natural
relationships with
with the world with earth with gods with
disease you know the very right to die
the very right to be sick becomes
robbed from people and they become
increasingly
supervised controlled less and less free
in a way and that is a very much part of
what his work was about
so here we're going to examine this in
one influential text called the birth of
the clinic
so he writes the medical gaze
and here he's talking about this gaze as
a as a way of understanding the way
doctors starting in the 1400s 1500s
building on what we saw with hippocrates
with the humors these ancient greek
ideas of medicine
but as they started to experiment as
they started to understand more about
the body
about disease they built this core of
knowledge this body of knowledge
medicine
medical knowledge and of course today
that
body of knowledge has become massive
international
just a gigantic body of knowledge it's
not just medicine
it's surgery surgery techniques
anesthetics
it's epidemiology it's all these
different branches
sub branches but this is what remember
that this is what foucault is talking
about when he says the medical gaze
he means the way in which everything is
seen every problem is seen within the
medical
understanding of it not necessarily
through a human
or a religious or a natural or a
political, even a purely political way
it's more a medical
technocratic class and body of knowledge
which starts to shape
our understanding of disease and our
response to disease
especially epidemics so he writes the
medical gaze
circulates within an enclosed space
in which it is controlled only by itself
in sovereign fashion
so of course you'll be thinking right
now about this clash
that we're currently seeing regarding
sovereign nation states and their
responses to this current
epidemic pandemic and
the international body of medical
knowledge and the
medical experts who have clashed with
those
countries that already was happening
back then that
the doctors and technocrats in medical
system
were beginning to carve out a
kind of powerful space in which they
could
uh interact with citizens with subjects
with individuals in all the countries in
various countries
and start to control them you know on
the basis of the medical information
now notice that of course Foucault is not
saying anything
he's not making any judgment about
whether this is good about
right he's describing the development
itself okay he's not saying it's bad
that medicine
improved that it learned how to fight
diseases
that people live much longer that many
it has eradicated many diseases
all of those things of course very true
but
you have to but what what um Foucault is
trying to do is trying to give you this
kind of concept of the development
itself
trying to analyze it right not just
making a judgment of it
but understand the dynamic of it what is
behind
the development itself so that
development is the rise of this
medical technocracy you know
international medical technocracy
and it does that in a sovereign fashion
as he says and he says
it distributes to daily experience the
knowledge that it has borrowed from afar
and of which it has made itself both the
point of concentration and the center of
diffusion
so it is international in its scope
not just international the afar there
also talks about history
it gets information and knowledge about
diseases
from history from historical experiences
you know we build the knowledge
of how a disease behaves as we're seeing
right now
today people who study knowledge people
who study viruses and
you know epidemiology they're looking
back into historical records trying to
understand how
viruses hurt particular people during
hundreds of years of statistics
right in some cases they are reviving
old viruses that are frozen
in parts of the world to try and study
them
so this is the point there is no limit
to the level of knowledge that is being
absorbed
that's number one and number two there
is the point of concentration
and the center of the fusion and what he
means by that is that the
in this hierarchy of medical knowledge
the doctors and the people above that
the specialist the technocrats
they're all bringing in everything both
the observation point
and the reaction point to the people in
one point
you see so all this they are completely
spread out that's true
but it's also extremely tight you know
when when you need to find out about
disease especially
epidemic disease is the doctors on the
ground who do the observations and note
things down
and take note of who has been affected
by the disease
right they're the ones who form the
basis of the statistics the observation
but at the same time they're the ones
who also take the information
coming from above the guidance of the
technocrats
about whether a disease is dangerous how
to react to it how to deal with it
whether to quarantine
they take that information from above
from the various technocrats
at the international national regional
levels
that comes down to the doctors who then
pass that on to the population or to the
political leaders or whatever you know
the social leaders
in whatever region this is what Foucault is
noting here
that there is a very tight rigid system
of control but at the same time
totally open and absorbing information
from everywhere
both in time and place and of course
he's not describing
what's happening today he's talking
about something that's been happening
for 300 years at least
right so he says in that experience
medical space can coincide with social
space
or rather it traverses it and only
wholly penetrates it
now if you have someone you know who's a
doctor in your family you'll understand
this sentence because
a doctor's space of course as a human
being that doctors are human beings like
anyone else
but when they're dealing with the
medical aspect you'll know this if
you've ever had a doctor
in your family and you talk to them that
of anything else that's going on in life
and they'll just be talking to you like
any other person
but if you start to talk to them about
disease you're scared of having a
disease you feel sick or something
they immediately switch i bet you've had
that before right they switch to these
various questions these questionnaires
in their minds
because that's what their training has
done with them
they're able to like switch like
almost like this parallel world right
they enter this parallel
universe of medical space the moment
they put on their hat
as a doctor even if they're a familiar
person to you
the mind switches for them and they
suddenly become a doctor
okay and actually it switches for you as
well because you suddenly become patient
and that's what he's talking about here
right that
medical space has a special type of
sovereignty in which
it can totally penetrate in society
without having any
in a way what foucault is mentioning
here is that there is a kind of um
a dangerous innocence to this right
if uh if a politic think about this if a
political
leader was coming in and saying you know
open up all your various um
and of course here we're talking about
medical doctors in a
biological sense you know so if you have
a pain epidemic etc
but you can also apply this to
psychology right open up
all of these things that are in your
mind to me talk to me about anything
that you've dreamed
dream dreamt of talk to me about
anything that's on your mind
or in the case of a doctor tell me about
any problems you have with your body
if it was a political leader in your
local town
or a city it's very unlikely that you
would just feel
happy to open up to that right but
because it's this
medical body sovereign fashion medical
gaze
it has the ability to penetrate social
space
individual space as well so this is what
Foucault is saying one began to conceive
he's talking about in history over the
past 300 years 400 years
one began to conceive of a generalized
presence of doctors
who's intersecting gazes form a network
and
exercise at every point in space and at
every moment
in time a constant mobile differentiated
supervision
it's no longer again these visitations
from above this
uh you know the plague has hurt us
because
god is punishing us etc it now becomes a
kind of constant battle
in which these soldiers these doctors
are enlisted
almost like in a military system right
of course it's very innocent
you know you don't go to your doctor and
feel that you're entering a military
barracks
which you don't of course in the social
space the doctor is a friendly person
who's just discussing things with you
but in the medical space when he's
putting on his medical hat
when he or she is putting on his medical
hat
that is now a different space right that
is now
a place where he takes the statistics he
observes and he's trying to give these
invisible enemies these
diseases epidemic or not a
solid form right and this that therefore
becomes an
endless task this is what foucault is
getting at there is no
end to fighting the disease so he adds
here talking about the epidemic
in particular foucault says whether
contagious or not
an epidemic has a sort of historical
individuality
hence the need to employ a complex
method of observation
when dealing with it being a collective
phenomenon
it requires a multiple gaze a unique
process
it must be described in terms of its
special accidental
unexpected qualities the event must be
described in detail but it must also be
described in accordance with the
coherence
implied by multi-perception being an
imprecise form of knowledge
insecurely based while ever partial
incapable of exceeding
of itself to the essential or
fundamental it finds its own range
only in the cross-checking of viewpoints
in repeated
corrected information which finally
circumscribes
where the gazes meet the individual
unique
nucleus of these collective phenomena
now
you know that's very complicated way of
describing how
with an epidemic you're talking about
something
which is itself uh shifting
right an epidemic disease is con it's a
it's a living thing a virus a bacteria
it's a living thing that's constantly
shifting and the way it impacts the
individuals
different groups of people and also
through time in different periods of
time
it's a shifting thing and therefore it's
a constant battleground
in which you're trying to find these one
or two or three or ten
characteristics which allow you to give
that thing that virus that bacteria give
it a name give it a characteristic so
that you can keep catching it
so in a sense you're trying to catch an
invisible thing
and give it a existence in the real
world
right and this is the this is the the
challenge
of the medical gaze towards the epidemic
so he adds at the end of the 18th
century
this form of experience was being
institutionalized
in each sub-delegation he's talking
about
in france the 1800s 1700s 1800s
the way the medical gaze medical
professions
medical uh studies how these were all
organized right he says uh each
sub-delegation
a physician a doctor and several
surgeons were
appointed by the intendant the
provincial administrator
to study those epidemics that might
break out in their canton
in their region they were in constant
correspondence with the chief physician
of the generalité
which is a treasury subject subdivision
back in the old days
in france concerning both the reigning
disease
and the medical medicinal topography of
their canton
and when four or five people succumbed
to the same disease
the sindic, the syndicate of the doctors
the kind of uh
the union the local
organizational group of doctors
they had to sub to notify the sub
delegate
and he sent the physician the doctor to
prescribe the treatment to be
administered
daily by the surgeons in some more
serious cases the
doctor the physician of the generalité
the general doctor from
paris from the center of france would
actually visit the scene of the outbreak
himself
right lots of details there it's not
something you should worry about but the
point being
that you start to have a bureaucracy
technocracy
of the medical gaze right 1700s 1800s
and the idea here is that because you're
dealing with this mobile
accidental special shifting
thing this epidemic you need to have
that multi-perception you need to have
that constant
multiple view viewpoints and
cross-checking
um so it becomes a kind of um
a war of many multiple resources you
know to the point at which we are today
where
you know it's kind of international
organizations and
entire nation states mobilizing against
these
uh these epidemics and and uh
the point here the essential point you
have to remember here
is the the why why all this is happening
is because
epidemic and disease is no longer part
of the human experience
that's the point okay that as we go
through the technocracy as the
enlightenment has had its effect
it has wiped out or has tried to wipe
out
epidemic and disease and in doing this
it no longer
gives the choice to people of
disease epidemics of a natural life that
is no longer acceptable
so we went from this kind of much more
sacrificial approach remember with
buddha with the buddha's story
the king himself the ruler the political
ruler was willing to throw himself
and sacrifice himself in the belief that
he would heal the sick
right even though of course this was a
belief that had no proof
no evidence then we went from that to
shaftesbury
and you know plato of shaftesbury and
bentham where they were talking about
quarantining
and controlling the people themselves
because the people are a kind of disease
the multitude and their passions so
controlling them
can reduce the spread of diseases
epidemics
including political epidemic of anger
but also medical epidemic
and now we've moved on to the
late enlightenment 1700s 1800s and what
we're seeing in the late enlightenment
is a total shift where the disease
itself
is what has to be wiped the foucault
adds now
towards the end of his book the birth of
the clinic
he says this structure in which space
language and death are articulated
what is known in fact as the anatomo-
clinical method
constitutes the historical condition of
a medicine
that is given and accepted as positive
positive here should be taken in the
strong sense
so disease breaks away from the
metaphysic of evil
to which it had been related for
centuries
and it finds in the visibility of death
full form in which its contents appear
in positive terms conceived in relation
to nature
disease was then the non-assignable
negative
of which the causes forms and
manifestations
were offered only indirectly and against
an
ever receding background seen in
relation to death
disease becomes exhaustively legible
i know what you're thinking didn't
understand anything okay
let's break it down what he's saying
here
is that by turning disease visible
you also turn it into something that is
part of our characteristic so
in the phys philosophical in the
as he says here metaphysical meaning
uh you know experience of life in
general
not just the factual but just the
spiritual everything philosophical
in that sense having disease as a part
of nature
having disease is something that god
sends to punish you
that puts disease away from something
inside of you
okay when disease becomes visible and
part of something inside of you
especially in the case of epidemics in
which you become a
carrier of a disease and not just you
but also things in nature
like other animals right then it becomes
as he says at the end
embodies embodied in the living bodies
of individuals
and therefore death becomes part of life
and embedded into life as opposed to
something
you know counter to life something that
is
black and white life and death
instead life and death become collapsed
into
your experience the experience of
individuals
okay now what he's saying of course at
the end here is that he's not again he's
not judging whether that's a good thing
or bad in terms of
you know people live longer obviously
thanks to this medical anatomo-
clinical method people are living longer
lives having surgeries
but the point being that the life itself
is no longer
a life in the full sense of the word it
becomes more of a
life becomes an experience
which includes death right and includes
disease
and everyone knows that they'll have a
disease of some kind
right so just to finish off here a
couple more texts
um here this this text is written by a
recent historian
a current contemporary historian who's
working in
um i think in in scotland Christos
Lynteris
and he wrote recently a article
interesting article talking about two
plague outbreaks in
china in 1910 and in 1920
and it's interesting because here his
idea is that the
the epidemics became increasingly events
so it goes a little bit further than
what foucault was talking about in terms
of lay enlightenment
the idea that epidemic and disease and
this kind of medical technocracy
that this had created a change in the
way
disease was understood and controlled
and people
populations politics social life was
being increasingly
interfered with or intersecting with the
sovereignty of
the medical gaze right this was what
Foucault was suggesting there
and here also we have an interesting
aspect which is where you're bringing in
the the media and the kind of
information society which is you know
europe
that had already begun much earlier the
public sphere
in europe had begun in the 1700s 1800s
but you really see it kicking off
in the 1900s with the birth of the
telegraph
earlier you know 50 years earlier the
telegraph telegrams
telephone radio later on and of course
we're going into today's world you know
satellite tv internet and so therefore
the media has a role
in putting pressure on governments and
putting pressure on
these technocratic um medical
you know groups core of medical
specialists
in in dealing with these epidemics in a
very competitive way in a way that has
almost geopolitical uh aspects to it so
we actually see an interesting case
study here because
this is lynteris his article talking
about the history in
manchuria which is northern china today
in 1910 1920. see writes plague first
made its appearance in north manchuria
on 13th of october 1910 in the border
town of Manzhouli
by december 1910 it had spread along the
newly built railway lines
to the cities of harbin and changchun
reaching beijing by the 12th of january
1911
and the provinces of jilin and shandong
by february
by the time it finally waned it had
killed approximately 60 000 people
the recorded mortality rate amongst
humans was around
was 100 percent making it one of the
most lethal epidemics in recorded
human history as plague spread the
streets of manchurian cities and
towns were filled with people staggering
about and collapsing to their death
scenes of horror were depicted in the
international press which adorned its
front pages
with the sensational pictures of
corpses, death and anarchy
the plague the spread of the plague
along chinese russian and japanese
railway lines
involved the three empires which are the
time controlled
different parts and cities in the region
in a conflict over the explanation
containment of the disease this conflict
took an immediate
biopolitical and geopolitical character
since what was at stake was both the
definition of the disease at hand
and the decision as regards which
imperial power was scientific and modern
enough
to both explain and control the epidemic
an ability
readily translatable into manifest
destiny
over the control of manchuria as a whole
so you can see there
that the ability of the these countries
these imperial powers and their
technocracy
core you know medical specialists their
ability to control and explain
the plague would prove their ability to
rule
so it became a very competitive aspect a
competitive event
right and that's what he's saying here
right so he says the first manchurian
plague epidemic
functioned as an event precisely in so
far as it
instituted a subject of what medical
historians of china call
hygienic modernity a subject unthinkable
or unintelligible unintelligible before
the particular incident
from an anthropological point of view
what rendered the first
manchurian plague epidemic an event
leading to an
epistemological and political paradigm
shift
was a void not in the scientific ability
to contain
the spread of the plague but in the
available categories and classifications
of subjectivity in the particular social
cultural
context right what he's saying there is
in previously in manchuria in china
northern china the idea that you could
not only fight a plague
and you know reduce the dangers of the
plague but rather
politically change the system in order
to deal with the plague with this
invisible enemy that represented
hygienic modernity the fact that you
could for example
implement all these rules about you know
wearing masks and
distancing one another and washing
actually
one of the things he later says in this
article is that many of these early
rules
that were later adopted by international
bodies you know medical bodies
such rules to deal with plagues were
actually first pioneered by
uh you know some chinese medical teams
in northern manchuria in 1910 during
this first plague epidemic
you know the first of these manchurian
plagues in 1910
so that this is a very important aspect
and what he goes on to say in the
article is the second one
in 1920 by that time many of these
previously unknown
practices social political reordering of
life
for a certain period of time in order to
fight this
previously what would have been
considered a natural disease something
that you can't really
you know do anything about you just put
your head down get on with things
you know take care of one as one self on
an individual level
now these these whole new different
techniques to fight this
plague um you know basically had become
not only something which was um you know
something used for the medical aspect
but also a political
and media event and this was used by the
chinese
authorities back then in the press and
in
domestic propaganda to the chinese
people themselves
as a way of showing that china was
capable modern nation that can handle
the plague
and can uh you know meet
the level of modernity you know be as
modern
as capable as any other country and
that's why he's saying
that was paradigm shift there was a big
shift between
what had happened before and what was
happening at that point
later on in the article the terrorist
goes on to add
what happened after the second
manchurian play so if the first
manchurian plague was a paradigm shift
because
for the first time people were being
reorganized their lives were being
reorganized to fight this invisible
enemy the second one was very important
because it reorganized
the historical view and the
understanding of how people saw
their own civilization the chinese
civilization so he writes
the reason i think it is fruitful to
consider the second manchurian plague
remember that's in 1920
from this perspective is that it allows
us to see how the particular epidemic
was experienced as an
incident during which what appeared in
its truth
was not plagued as a bacteriological
threat
but instead a cultural and political
disease acclaimed by the full subject
institute by the invent of the first
plague outbreak
so what he's saying is in the first
round
plague number one 1910 the problem
was identified which was how people were
organized they were spreading the
disease and therefore they needed to be
better organized
use of masks all these technical aspects
but by the time the second plague broke
out
the reaction to that was the problem is
not that they're not organized but it's
their mental
problem as he says here as you can see
the enduring poison of king queen china
the queen dynasty was the pre-modern
dynasty in china
1800s you know before the the uh
you know the reforms of modern china the
the enduring poison of queen china the
evil weed of obscurantism
and ignorance constituting the prime
enemy
of the chinese race as such right
so he's saying that the second round of
plague
pushes the whole society including
people within the society
let alone the medical doctors or
technocrats that foucault had
identified so you can see here how the
plague and the idea of epidemic has
shifted
from where we started the lecture has
now shifted no longer
from being you know kind of natural
outbreak or something from god as a
punishment
and it's no longer even a job for uh
leaders
you remember shaftesbury and um
and bentham that you have kind of laws
and leaders who can organize people
quarantine them
and it's no longer even a question of
the technocrats
which are identified by foucault in the
previous text
by this time you see that it's actually
even people themselves
not every member of the society but a
significant portion of them
who are now convinced that the reason
why people are dying is because
the stupidity the ignorance the
stubbornness of these traditional people
in their society
they themselves are the plague they are
the ones who are spreading it
not only because they're carrying the
it's not just that they are literally
carrying the disease
whether or not they're carrying the
disease it's not as he says here
it's not the question of the
bacteriological threat itself
but rather the cultural and political
disease the poison
of ignorance and obscurity so
now let us come to our final text here
uh which is and this is called this is a
short
piece that he wrote discussing post
script on the societies of control
and here it's an interesting distinction
that he makes between societies of
discipline and that he identifies with
foucault
the text that we had seen earlier
and then he adds that the the i the um
phenomenon that foucault was describing
the technocracy
the system of you know medical gaze et
cetera
that was more uh about a society of
discipline
in which people are disciplined
literally in the term
just like in a discipline you know you
go to university you go to college
university school
you learn a discipline so the same way
that a doctor learns his discipline
becomes specialized in this
specific discipline then they are
disciplined to put on their medical hat
take on the medical gaze you know as
foucault was mentioning the sovereignty
the space the medical space interfering
into the social and political space
fine that's the society of discipline
but the learners are describing
something that is
with the media and the uh
you know the developments of the 20th
century in which
you have less and less this kind of real
world
interaction and much more of this
mediated
interaction and we already saw the
beginnings of that in the previous
article
we saw the beginnings of that with the
manchurian plague
right the two manchurian plagues and the
way that the media
put pressure uh geopolitical pressure on
the perception of the plague itself well
delusion is saying that you know through
the 20th century
going into our century that has become
the
more efficient the more pertinent way to
understand
epidemics alongside of course here he's
not just talking about epidemics he's
talking about
all sorts of things but in this post
script i thought it's a good
point to end this lecture because we're
seeing
uh the way that the you know
it's gone full circle from being a
natural phenomenon
which you have no control over into
society itself
has to control not a technocracy not the
leaders
but society itself has to motivate
yourself
as individuals to control yourself to
quarantine yourself to isolate yourself
to distance yourself you know all these
things was hearing today
um to to inform yourself through social
media to share memes to share
information through social media
to discuss the virus
to discuss the disease the epidemic as
it's a kind of
the single most um
you know kind of constructed the single
fundamental fact of life as it is today
it becomes a reorganization of our
perspective
you know and this is all done without
any
technocracy or leader or particular
country
pushing this it's done from a very uh
you know multiple sources is done by
people themselves
as they react to this so let's have a
look at Deleuzes' text
just to finish off and you can make your
own mind about
you know what with this what we've
examined in this lecture
so de la says foucault uh
located the disciplinary societies in
the 18th and 19th century so remember
that um
1700's 1800's
they reached their height at the outset
of the 20th century
1900s 1910s 1920s
they initiated these disciplinary
societies initiated the organization of
vast spaces of enclosure
the individual never ceased to be
passing from one closed
environment to another each having its
own laws
first you you go to the family then the
school and then you are no longer your
family
then you go to the barracks and you surf
in the military and you're no longer at
school
then you go to the factory and then from
time to time you end up in the hospital
maybe the prison which was the
pre-eminent
instance of the enclosed environment
it's the prison that serves as the
analogical model
so then he goes on he says Foucault has
brilliantly analyzed the ideal project
of these environments of enclosure
particularly visible within the factory
to concentrate
to distribute in space to order in time
to compose a productive force within the
dimensions of space-time
whose effects will be the greater than
the sum of its component forces
so again he's saying here of course the
example of the factory is excellent
from 100 people in a factory right by
organizing them
by taking care of their time by making
sure that they have the technical
needs that they need they require you
allow
them to to take a set of raw materials
iron rubber whatever it is
glass and you within a few days a few
weeks you turn that into a finished car
right
so you have as he says here you have
created something
greater than the sum of its parts or in
this case component forces the
individuals working in the factory
but what foucault recognized as well was
that it was the transience of this model
it succeeded the societies of
sovereignty all right the sovereignty
ones were the medieval societies
in which a sovereign a king a leader an
emperor
was the one who organized life or in in
some cases it was religion
you know the king being for example
jesus christ you know the
christian king and christian sovereignty
and as he notes here de los notes these
societies of sonji had the goal and
functions
which were different you know to tax
rather tax rather than organized
production
and to rule on death rather than
administer life
that's an important distinction here
when we're talking about epidemics
remember what foucault was mentioning
about
death became part death and disease
became part of life
part of the experience of life the
difference between the two
were mixed but in the old medieval
societies
whether they were religious or in terms
of kings and
emperors etc the role of the sovereign
had to do more with death
than with life how you lived your life
was none of the business
but if you decided to be a traitor then
the king would cut your head off
right if you decided to be a sinner then
you would end up in death
living in the afterlife in hell you
would be punished by god
right so it was much less concerned with
life and much more concerned with death
because life was something that you
owned as
yourself you the societies of
sovereignty was not just the sovereignty
of the church of the religion
of the kings and emperors it was also
your own sovereignty over your own life
as an individual you had sovereignty
over your own life
you could decide if you wanted to take a
risk if you wanted to do this or that
right and we saw of course the
transition that's what he's
mentioning here the transition took
place over time
and play and space so of course with the
displaced society there was a shift
from that as we sort of go towards
disciplining and disciplining included
what we saw in previous texts with
shaftesbury
with um bentham the idea of quarantining
of public offences
that you no longer have sovereignty of
yourself right and that your life
is what is matters and what has to be
controlled right and
we saw this of course with the also the
technocratic
medical gaze that Foucault outlined but
what deleuze is
uh suggesting at the end here is that
actually in the societies of control
beginning in the 1950s
1960s and onwards today what's sometimes
been called the postmodern and
postmodern society you know you could
also call it
uh post enlightenment society
we're moving towards something very
different so what Deleuze says is
what counts is that we're at the
beginning of something in the prison
system
the attempt to find penalties of
substitution
at least for petty crimes and the use of
electronic collars
that force the convicted person to stay
at home during certain hours
for the school system continuous forms
of control
and the effect on the school of
perpetual training
the corresponding abandonment of all
university research and the introduction
of the corporation at all
levels of schooling for the hospital
system
something that's most interesting for us
right now
the hospital system the new medicine
without doctor a patient that singles
out potential sick people
and subjects at risk which in no way
attests to individuation as they say
but substitutes for the individual or
numerical body
the code of a divisional material to be
controlled
so what deleuze is really saying there
is
all these new programs you know all
these new technologies
some of which are definitely coming out
you know, like what's called the nanotech
nanomedicine
all these new kind of technologies that
are coming out over this century
which are proposing for people to be
constantly monitoring themselves
right so we're already seeing that a
little bit with this
current situation you know the idea of
doing testing etc
but this is really going to roll out
over the next decades
and it's all about controlling and what
he says is that the way it's marketed to
people
it's all about individuation so take
care of yourself you're an individual
make sure that you live an individual
life and that you are you know
monitoring yourself
but of course the way it really works is
through data banks and through
dividual material you know the the
constant analysis of dividuals
meaning you as... it is very complicated
here...
he's saying you as an individual no
longer matter it's more about the
statistics you know
what is your blood rate what is your
pressure what is your
blood sugar level and you can of course
think and we've had plenty of stories
like that or
movies about this kind of dystopian
future in which people
are controlled even to the level at
which they're healthy or not
right um so this is what he's he's
pointing out that
you know that the nigh.. the kind of
nightmare of the enlightenment is that
it unleashed this
uh power of observation
research uh understanding which has gone
so far that
now the individual itself has
disappeared the individual person
and now sickness itself is just a
set of data that needs to be uh
dealt with interpreted controlled
regardless of
what happens for the individual himself
or herself
you know from a human point of view that
doesn't matter anymore
all that matters is the data bank... statistics
so thank you for listening to this
lecture i hope you've enjoyed it
and take care out there
