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my silence is just another word of my pain
मेरो मौनता मेरो पीडाको अर्को शब्द हो
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my silence is just another word ofmy pain
मेरो मौनता मेरो पीडा को लागी अर्को शब्द हो
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sometimes silence is just another word for the our pain
मेरो मौनता मेरो पीडाको अर्को श
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happy birthday to my best friend who probably hates the same people i do dislikes the food i hate and who is just eavally evil like me you inspire me motivate me and of course you make me laugh knowing someone as fabulous me is the only birthday present you need you 20 death 0 well played zaynii i just want you to be happy and crazy but mainly. happy on your birthday here are some words of wisdom smile while you have teeth i just want you to know that you're so precious to me i hope that t
nepali language
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translator’s note one of the characteristics of foucault’s language is his repeated use of certain key words. many of these present no difficulty to the translator. others, however, have no normal equivalent. in such cases, it is generally preferable to use a single unusual word rather than a number of familiar ones. when foucault speaks of la clinique, he is thinking of both clinical medicine and the teaching hospital. so if one wishes to retain the unity of the concept, one is obliged to use the rather odd-sounding ‘clinic’. similarly, i have used the unusual ‘gaze’ for the common ‘regard’, except in the book’s subtitle, where i have made a concession to the unprepared reader. ix preface this book is about space, about language, and about death; it is about the act of seeing, the gaze. towards the middle of the eighteenth century, pomme treated and cured a hysteric by making her take ‘baths, ten or twelve hours a day, for ten whole months’. at the end of this treatment for the desiccation of the nervous system and the heat that sustained it, pomme saw ‘membranous tissues like pieces of damp parchment …peel away with some slight discomfort, and these were passed daily with the urine; the right ureter also peeled away and came out whole in the same way’. the same thing occurred with the intestines, which at another stage, ‘peeled off their internal tunics, which we saw emerge from the rectum. the oesophagus, the arterial trachea, and the tongue also peeled in due course; and the patient had rejected different pieces either by vomiting or by expectoration’ [1]. less than a hundred years later, this is how a doctor observed an anatomical lesion of the brain and its enveloping membranes, die socalled ‘false membranes’ frequently found on patients suffering from ‘chronic meningitis:’ their outer surface, which is next to the arachnoidian layer of the dura mater, adheres to this layer, sometimes very lightly, when they can be separated easily, sometimes very firmly and tightly, in which case it can be very difficult to detach them. their internal surface is only contiguous with the arachnoid, and is in no way joined to it…. the false membranes are often transparent, especially when they are very thin; but usually they are white, grey, or red in x preface colour, and occasionally, yellow, brown, or black. this matter often displays different shades in different parts of the same membrane. the thickness of these accidental productions varies greatly; sometimes they are so tenuous that they might be compared to a spider’s web…. the organization of the false membranes also displays a great many differences: the thin ones are buffy, like the albuminous skins of eggs, and have no distinctive structure of their own. others, on one of their sides, often display traces of blood vessels crossing over one another in different directions and injected. they can often be reduced to layers placed one upon another, between which discoloured blood clots are frequently interposed [2]. between pomme, who carried the old myths of nervous pathology to their ultimate form, and bayle, who described the encephalic lesions of general paralysis for an era from which we have not yet emerged, the difference is both tiny and total. for us, it is total, because each of bayle’s words, with its qualitative precision, directs our gaze into a world of constant visibility, while pomme, lacking any perceptual base, speaks to us in the language of fantasy. but by what fundamental experience can we establish such an obvious difference below the level of our certainties, in that region from which they emerge? how can we be sure that an eighteenth-century doctor did not see what he saw, but that it needed several decades before the fantastic figures were dissipated to reveal, in the space they vacated, the shapes of things as they really are? what occurred was not a ‘psychoanalysis’ of medical knowledge, nor any more or less spontaneous break with imaginary investments; ‘positive’ medicine is not a medicine that has made an ‘objectal’ choice in favour of objectivity itself. not all the powers of a visionary space through which doctors and patients, physiologists and practitioners communicated (stretched and twisted nerves, burning dryness, hardened or burnt organs, the new birth of the body in the beneficent element of cool waters) have disappeared; it is, rather, as if they had been displaced, enclosed within the singularity of the patient, in that region of ‘subjective symptoms’ that—for the doctor—defines not the mode of knowledge, but the world of objects to be known. far from being broken, the fantasy link between knowledge and pain is reinforced by a more complex means than the mere permeability of the imagination; the presence of disease in the body, with its tensions preface xi and its burnings, the silent world of the entrails, the whole dark underside of the body lined with endless unseeing dreams, are challenged as to their objectivity by the reductive discourse of the doctor, as well as established as multiple objects meeting his positive gaze. the figures of pain are not conjured away by means of a body of neutralized knowledge; they have been redistributed in the space in which bodies and eyes meet. what has changed is the silent configuration in which language finds support: the relation of situation and attitude to what is speaking and what is spoken about. from what moment, from what semantic or syntactical change, can one recognize that language has turned into rational discourse? what sharp line divides a description that depicts membranes as being like ‘damp parchment’ from that other equally qualitative, equally metaphorical description of them laid out over the tunic of the brain, like a film of egg whites? do bayle’s ‘white’ and ‘red’ membranes possess greater value, solidity, and objectivity—in terms of scientific discourse—than the horny scales described by the doctors of the eighteenth century? a rather more meticulous gaze, a more measured verbal tread with a more secure footing upon things, a more delicate, though sometimes rather confused choice of adjective—are these not merely the proliferation, in medical language, of a style which, since the days of galenic medicine, has extended whole regions of description around the greyness of things and their shapes? in order to determine the moment at which the mutation in discourse took place, we must look beyond its thematic content or its logical modalities to the region where ‘things’ and ‘words’ have not yet been separated, and where—at the most fundamental level of language—seeing and saying are still one. we must re-examine the original distribution of the visible and invisible insofar as it is linked with the division between what is stated and what remains unsaid: thus the articulation of medical language and its object will appear as a single figure. but if one poses no retrospective question, there can be no priority; only the spoken structure of the perceived—that full space in the hollow of which language assumes volume and size—may be brought up into the indifferent light of day. we must place ourselves, and remain once and for all, at the level of the fundamental spatialization and verbalization of the pathological, where the loquacious gaze with which the xii preface doctor observes the poisonous heart of things is born and communes with itself. modern medicine has fixed its own date of birth as being in the last years of the eighteenth century. reflecting on its situation, it identifies the origin of its positivity with a return—over and above all theory—to the modest but effecting level of the perceived. in fact, this supposed empiricism is not based on a rediscovery of the absolute values of the visible, nor on the predetermined rejection of systems and all their chimeras, but on a reorganization of that manifest and secret space that opened up when a millennial gaze paused over men’s sufferings. nonetheless the rejuvenation of medical perception, the way colours and things came to life under the illuminating gaze of the first clinicians is no mere myth. at the beginning of the nineteenth century, doctors described what for centuries had remained below the threshold of the visible and the expressible, but this did not mean that, after over-indulging in speculation, they had begun to perceive once again, or that they listened to reason rather than to imagination; it meant that the relation between the visible and invisible—which is necessary to all concrete knowledge—changed its structure, revealing through gaze and language what had previously been below and beyond their domain. a new alliance was forged between words and things, enabling one to see and to say. sometimes, indeed, the discourse was so completely ‘naive’ that it seems to belong to a more archaic level of rationality, as if it involved a return to the clear, innocent gaze of some earlier, golden age. in 1764, j.f.meckel set out to study the alterations brought about in the brain by certain disorders (apoplexy, mania, phthisis); he used the rational method of weighing equal volumes and comparing them to determine which parts of the brain had been de-hydrated, which parts had been swollen, and by which diseases. modern medicine has made hardly any use of this research. brain pathology achieved its ‘positive’ form when bichat, and above all récamier and lallemand, used the celebrated ‘hammer, with a broad, thin end. if one proceeds with light taps, no concussion liable to cause disorders can result as the skull is full. it is better to begin from the rear, because, when only the occipital has to be broken, it is often so mobile that one misses one’s aim…. in the case of very young children, the bones are too supple to be broken and too thin to be preface xiii sawn; they have to be cut with strong scissors’ [3]. the fruit is then opened up. from under the meticulously parted shell, a soft, greyish mass appears, wrapped in viscous, veined skins: a delicate, dingylooking pulp within which—freed at last and exposed at last to the light of day—shines the seat of knowledge. the antisanal skill of the brain-breaker has replaced the scientific precision of the scales, and yet our science since bichat identifies with the former; the precise, but immeasurable gesture that opens up the plenitude of concrete things, combined with the delicate network of their properties to the gaze, has produced a more scientific objectivity for us than instrumental arbitrations of quantity. medical rationality plunges into the marvelous density of perception, offering the grain of things as the first face of truth, with their colours, their spots, their hardness, their adherence. the breadth of the experiment seems to be identified with the domain of the careful gaze, and of an empirical vigilance receptive only to the evidence of visible contents. the eye becomes the depositary and source of clarity; it has the power to bring a truth to light that it receives only to the extent that it has brought it to light; as it opens, the eye first opens the truth: a flexion that marks the transition from the world of classical clarity—from the ‘enlightenment’—to the nineteenth century. for descartes and malebranche, to see was to perceive (even in the most concrete kinds of experience, such as descartes’s practice of anatomy, or malebranche’s microscopic observations); but, without stripping perception of its sensitive body, it was a matter of rendering it transparent for the exercise of the mind: light, anterior to every gaze, was the element of ideality—the unassignable place of origin where things were adequate to their essence—and the form by which things reached it through the geometry of bodies; according to them, the act of seeing, having attained perfection, was absorbed back into the unbending, unending figure of light. at the end of the eighteenth century, however, seeing consists in leaving to experience its greatest corporal opacity; the solidity, the obscurity, the density of things closed in upon themselves, have powers of truth that they owe not to light, but to the slowness of the gaze that passes over them, around them, and gradually into them, bringing them nothing more than its own light. the residence of truth in the dark centre of things is linked, paradoxically, to this sovereign power of the empirical gaze that turns their darkness into xiv preface light. all light has passed over into the thin flame of the eye, which now flickers around solid objects and, in so doing, establishes their place and form. rational discourse is based less on the geometry of light than on the insistent, impenetrable density of the object, for prior to all knowledge, the source, the domain, and the boundaries of experience can be found in its dark presence. the gaze is passively linked to the primary passivity that dedicates it to the endless task of absorbing experience in its entirety, and of mastering it. the task lay with this language of things, and perhaps with it alone, to authorize a knowledge of the individual that was not simply of a historic or aesthetic order. that the definition of the individual should be an endless labour was no longer an obstacle to an experience, which, by accepting its own limits, extended its task into the infinite. by acquiring the status of object, its particular quality, its impalpable colour, its unique, transitory form took on weight and solidity. no light could now dissolve them in ideal truths; but the gaze directed upon them would, in turn, awaken them and make them stand out against a background of objectivity. the gaze is no longer reductive, it is, rather, that which establishes the individual in his irreducible quality. and thus it becomes possible to organize a rational language around it. the object of discourse may equally well be a subject, without the figures of objectivity being in any way altered. it is this formal reorganization, in depth, rather than the abandonment of theories and old systems, that made clinical experience possible; it lifted the old aristotelian prohibition: one could at last hold a scientifically structured discourse about an individual. our contemporaries see in this accession to the individual the establishment of a ‘unique dialogue’, the most concentrated formulation of an old medical humanism, as old as man’s compassion. the mindless phenomenologies of understanding mingle the sand of their conceptual desert with this half-baked notion; the feebly eroticized vocabulary of encounter’ and of the ‘doctor/patient relationship’ (le couple médecin-malade) exhausts itself in trying to communicate the pale powers of matrimonial fantasies to so much non-thought clinical experience—that opening up of the concrete individual, for the first time in western history, to the language of rationality, that major event in the relationship of man to himself and of language to things—was soon taken as a simple, preface xv unconceptualized confrontation of a gaze and a face, or a glance and a silent body; a son of contact prior to all discourse, free of the burdens of language, by which two living individuals are ‘trapped’ in a common, but non-reciprocal situation. recently, in the interests of an open market, so-called ‘liberal’ medicine has revived the old rights of a clinic understood as a special contract, a tacit pact made between one man and another. this patient gaze has even been attributed with the power of assuming—with the calculated addition of reasoning (neither too much nor too little)—the general form of all scientific observation: in order to be able to offer each of our patients a course of treatment perfectly adapted to his illness and to himself, we try to obtain a complete, objective idea of his case; we gather together in a file of his own all the information we have about him. we ‘observe’ him in the same way that we observe the stars or a laboratory experiment [4]. miracles are not so easy to come by: the mutation that made it possible—and which continues to do so every day—for the patient’s ‘bed’ to become a field of scientific investigation and discourse is not the sudden explosive mixture of an old practice and an even older logic, or that of a body of knowledge and some strange, sensorial element of ‘touch’, ‘glance’, or ‘flair’. medicine made its appearance as a clinical science in conditions which define, together with its historical possibility, the domain of its experience and the structure of its rationality. they form its concrete a priori, which it is now possible to uncover, perhaps because a new experience of disease is coming into being that will make possible a historical and critical understanding of the old experience. a detour is necessary here if we are to lay the foundations of our discourse on the birth of the clinic. it is a strange discourse, i admit, since it will be based neither on the present consciousness of clinicians, nor even on a repetition of what they once might have said. it may well be that we belong to an age of criticism whose lack of a primary philosophy reminds us at every moment of its reign and its fatality: an age of intelligence that keeps us irremediably at a distance from an original language. for kant, the possibility and necessity of a critique were linked, through certain scientific contents, to the fact that there is such a thing as knowledge. in our time—and nietzsche xvi preface the philologist testifies to it—they are linked to the fact that language exists and that, in the innumerable words spoken by men—whether they are reasonable or senseless, demonstrative or poetic—a meaning has taken shape that hangs over us, leading us forward in our blindness, but awaiting in the darkness for us to attain awareness before emerging into the light of day and speaking. we are doomed historically to history, to the patient construction of discourses about discourses, and to the task of hearing what has already been said. but is it inevitable that we should know of no other function for speech (parole) than that of commentary? commentary questions discourse as to what it says and intended to say; it tries to uncover that deeper meaning of speech that enables it to achieve an identity with itself, supposedly nearer to its essential truth; in other words, in stating what has been said, one has to re-state what has never been said. in this activity known as commentary which tries to transmit an old, unyielding discourse seemingly silent to itself, into another, more prolix discourse that is both more archaic and more contemporary—is concealed a strange attitude towards language: to comment is to admit by definition an excess of the signified over the signifier; a necessary, unformulated remainder of thought that language has left in the shade—a remainder that is the very essence of that thought, driven outside its secret—but to comment also presupposes that this unspoken element slumbers within speech (parole), and that, by a super-abundance proper to the signifier, one may, in questioning it, give voice to a content that was not explicitly signified. by opening up the possibility of commentary, this double plethora dooms us to an endless task that nothing can limit: there is always a certain amount of signified remaining that must be allowed to speak, while the signifier is always offered to us in an abundance that questions us, in spite of ourselves, as to what it ‘means’ (veut dire). signifier and signified thus assume a substantial autonomy that accords the treasure of a virtual signification to each of them separately; one may even exist without the other, and begin to speak of itself: commentary resi
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