The Normal and the Pathological (review)

Abstract

too many repetitions for such a svelte volume. The print should be larger, especially considering the wide left-hand margins and expansive figures. All criticisms aside, I urge that Oxnard proceed apace to synthesize and analyze species of the Anthropoidea with a similar approach. Further, I hope that he will seek a publisher who will devise a series of transparent overlays that would allow direct visual comparisons of the star diagrams, and that an acronymic system (e.g., RnL, FlL, CrL, RcL, Can, Udg, Hsp, Vsp, Ssp, Lsp, CIm, SlQ, Scr, Frt, GmN, LBF, and Anm) will replace the numbers that mark 17 characteristics of niche, ringing the stars. Russell H. Tuttle Department of Anthropology University of Chicago The Normal and the Pathological. By George Conguilhem, with an introduction by Michel Foucault. Translated by Carolyn R. Fawcett. New York: Zone Books, 1989. Pp. 327. The reissued English translation of this book examines the notions of health and disease from both the redefinitions offered by scientific advances over the past 200 years and the broad intellectual influences that determine our concept of the pathological. The author exhibits many incisive insights and an intellectualism rarely encountered in modern attempts at characterizing medicine's infrastructure . The general construct of Conguilhem's thinking is based on recognizing that the history of science passes normative judgments about the science it studies; thus, he adopts a skeptical view about the distortion scientific ideology casts on its subject. He worried about how such ideology assumes existing science as its norm. A history of the pathological offered an excellent opportunity to examine the conception of norms, which in nineteenth-century medicine are especially illustrative of his general posture. The extension of the normal to the pathological along a continuum became a formalized problem for nineteenth-century pathology. Various schools converged on the central concept that the abnormal followed the same laws as the normal, and the phenomena of disease differed from health only in intensity. The prospect of quantitation has a dual nature—it offered the objectification that a chemomechanistic biology sought and at the same time was resisted by the instability and irregularity that were viewed as essential characteristics of biology. To what degree were arithmetic norms descriptive of individual behavior ; or, more precisely, to what degree are organic phenomena reducible to chemomechanical laws? This dialectic helped us to comprehend Bernard's notion of the pathological and by historical extension our own conceptualization. He accepted the essential continuity of the normal-pathological axis. However, at the same time that he assumed that biochemistry and organic chemistry followed the same laws, he steadfastly held to the unique dynamics ofthe biological state. Conguilhem perceived the ambiguity in Bernard's scientific program as a deceptive mingling of quantitative and qualitative concepts in describing the 618 Book Reviews pathological. The story of nineteenth-century physiology and medicine may be largely reduced to this conception. We are heirs to this formulation; although more dynamic models have been proposed, none has replaced it. Alfred I. Tauber Boston University School of Medicine 80 East Concord Street Boston, Massachusetts 02118 AXOPLASMIC JOURNEY (sung to the tune of "Sentimental Journey") Gonna make an axoplasmic journey. Gonna hop that synapse track. Gonna take the glutamate expressway Anterograde and never come back. Got my freight, I got my destination. Got kinesin by the tail. Gonna board the finest transportation, The Microtubule Monorail. "Synapsin!" That's my boarding call, "Synapsin!" Microseconds are elapsing. Over in a day, a one-way ride, Kinesin glide. Never felt my glutamate so yearnin'. Excitement is potentially mine. Gonna take an axoplasmic journey On a fast transcellular line. Evelyn Tiffany-Castiglioni Perspectives in Biology and Medicine, 34, 4 · Summer 1991 619 ...