Political anatomy of the body. Medical knowledge in Britain in the twentieth century

This book belongs to the category describing itself as "thought provoking". For once this claim is well grounded. Quite explicitly, the author sets out to apply the methods of Foucault to the analysis of conceptual change within medicine in the present century. Although not a slavish imitation of Foucault, the hand and name of the master are never far from sight. But the book is also sufficiently original and scholarly to be refreshing and challenging to both sociologists and historians. Dr Armstrong stands apart from the mainstream of both subjects. His approach will not be universally applauded. Many of the objections to this book are the same as those which have already been applied to Foucault's work. Some will view Armstrong's book as a challenging work of synthesis; others will regard it as an unscientific fiction. However, from the soc[al historian's point of view there is much to admire. For instance, rather than restricting himself to a limited field the author deals with subjects as diverse as school clinics, paediatrics, venereology, psychiatry, geriatrics, and general practice. He thus monitors change in twentieth-century medicine less in terms of the high-technology specialisms than with respect to lower-status specialisms which nevertheless occupy an important social function. An elaborate mosaic is constructed demonstrating the significance of numerous key elements which have hitherto been omitted from the picture painted by both sociologists and historians, or which, as in the case of the Peckham Health Centre, have only just received the attention they deserve. Figures such as Balint, Pickles, and especially Ryle (accidentally not included in the index), or initiatives such as the Goodenough Report on Medical Education, the Oxford Institute of Social Medicine, or the Social Survey, all find their places in Armstrong's explanatory framework. True to his neo-structuralist affiliations, Armstrong enriches our vocabulary by adding to the by now familiar concept "panopticon", his own invention "Dispensary". Dispensary is nowhere defined precisely, but it is loosely characterized on a great number of occasions in the book as the "new way", "new gaze", "new extended clinical gaze" of modern medicine, involving the "extension of the panoptic vision to a whole society". He is able to sustain this view with respect to a wide variety of instances taken from the medical specialisms under review, and by this means to demonstrate that modern medicine has extended its domain from human anatomy to control of the entire "social space" …