Part II/Ch. 2

Epoché (XV), 18. 2. 2021

A synopsis of our reading of The Normal and the Pathological by Georges Canguilhem

Part II/Ch. 2 “A Critical Examination of Certain Concepts: The Normal, Anomaly and Disease; The Normal and the Experimental” (pp. 125-149)

Abridgment by: Sebastjan Vörös
[his outline and commentary of the whole book can be found here]

Chapter II: A Critical Examination of Concepts – The Normal, Anomaly and Disease, The Normal and The Experimental

C. starts the chapter by providing some definitions of the word “normal” that have become established in the scientific community:

(i) norma (etym.) = T-square → (lat.) rule

(ii) normal = that which conforms to the rule, regular;

(iii) normal = that which bends neither to the right nor left, that which remains in a happy medium (125).

As it turns out this definition is ambiguous:

(1) fact vs. value: normal means both (a) that which is such that it ought to be (value judgement), and (b) that which is met with in the majority of cases of a determined kind (factual judgement) (125).

(2) habitual vs. ideal: normal state can stand for both (a) habitual (regular, ordinary) and (b) ideal (optimal, excellent), i.e., state one wants to reestablish.

With regards to this last point (2), there is a further ambiguity, namely whether (i) normal as “ideal” is called thus because the therapeutics’s goal is to obtain it or (ii) whether normal as “ideal” is called thus because it is the patient who strives towards it? C. adopts the second option (i.e., ii):

“It is true that in medicine the normal state of the human body is the state one wants to reestablish. But is it [i] because therapeutics aims at this state as a good goal to obtain that it is called normal, or is it [ii] because the interested party, that is, the sick man, considers it normal that therapeutics aim at it? We hold the second statement to be true. We think that medicine exists as the art of life because the living human being himself calls certain dreaded states or behaviors pathological (hence requiring avoidance or correction) relative to the dynamic polarity of life, in the form of a negative value. We think that in doing this the living human being, in a more or less lucid way, extends a spontaneous effort, peculiar to life, to struggle against that which obstructs its preservation and development taken as norms.” (126)

And when C. speaks of the “patient” he does not want to limit this notion solely to beings capable of language and conscious thought:

“We, on the other hand, think that the fact that a living man reacts to a lesion, infection, functional anarchy by means of a disease, expresses the fundamental fact that life is not indifferent to the conditions in which it is possible, that life is polarity and thereby even an unconscious position of value; in short, life is in fact a normative activity. Normative, in philosophy, means [a] every judgment which evaluates or qualifies a fact in relation to a norm, but this mode of judgment is essentially subordinate to that which establishes norms. Normative, in the fullest sense of the word, is [b] that which establishes norms. And it is in this sense that we plan to talk about biological normativity.” (126-7) [!!!] [vitalism]a

But isn’t this a form of anthropomorphism? C. does not think so; he is adamant that he is not trying to ascribe human content to vital norms, but believes it necessary to ask oneself how normativity that is essential to consciousness could be explained if it did not in some way exist in embryo in life:

“We ask ourselves how a human need for therapeutics would have engendered a medicine which is increasingly clairvoyant with regard to the conditions of disease if life’s struggle against the innumerable dangers threatening it were not a permanent and essential vital need. From the sociological point of view it can be shown that therapeutics was first a religious, magical activity, but this does not negate the fact that therapeutic need is a vital need, which, even in lower living organisms (with respect to vertebrate structure) arouses reactions of hedonic value or self-healing or self-restoring behaviors.” (127) [!]

Thus, the dynamic polarity of life, the normativity it expresses is an epistemological fact: “Biological pathology exists but there is no physical or chemical or mechanical pathology.” Or as Bichat puts it: “Nothing in the physical sciences corresponds to what is therapeutics in the physiological sciences.” (128)

Now, following Descartes, Comte and Bernard tried to abolish the Aristotelian distinction between the natural and the unnatural (violent) movement, proclaiming all movement “natural”. However, this proved to be problematic:

“In establishing the science of movement on the principle of inertia, modern mechanics in effect made the distinction between natural and violent movements absurd, as inertia is precisely an indifference with respect to directions and variations in movement. Life is far removed from such an indifference to the conditions which are made for it; life is polarity. The simplest biological nutritive system of assimilation and excretion expresses a polarity.” (128-9) [!!!] [vitalism]

Example: build-up of waste in the organism follows (physical, chemical, etc.) laws but doesn’t follow the norm, which is the activity of the organism itself [!].

Crucially:

“There is no biological indifference, and consequently we can speak of biological normativity. There are healthy biological norms and there are pathological norms, and the second are not the same as the first.” (129)

Here, C. reverts to natural selection, and points out that – just like the term “medicine” in the term vis medicatrix naturae (“natural medical activity”) – “selection” designates a biological technique that is practiced deliberately and rationally by man. If we are not careful, this can lead to what Bergson called the illusion of retroactivity, where we project human utilities and goals onto pre-human activity. However, C. underlines an important distinction:

“But it is [a] one thing to think that natural selection would utilize anything that resembles pedigrees, and vis medicatrix, cupping glasses, and another [b] to think that human technique extends vital impulses, at whose service it tries to place systematic knowledge which would deliver them from much of life’s costly trial and error.” (129-30)

The main drawback of the two terms (“natural selection” and “natural medical activity”) is that they seem to embed vital techniques within the framework of human techniques, while the opposite seems to be true:

All human technique, including that of life, is set within life, that is, within an activity of information and assimilation of material. It is not because human technique is normative that vital technique is judged such by comparison. Because life is activity of information and assimilation it is the root of all technical activity. In short, we speak of natural medicine in quite a retroactive and, in one sense, mistaken way, but even if we were to assume that we have no right to speak of it, we are still free to think that no living being would have ever developed medical technique if the life within him – as within every living thing – were indifferent to the conditions it met with, if life were not a form of reactivity polarized to the variations of the environment in which it develops.” (130) [!]

In sum:

“It is life itself and not medical judgment which makes the biological normal a concept of value and not a concept of statistical reality. For the physician, life is not an object but rather a polarized activity, whose spontaneous effort of defense and struggle against all that is of negative value is extended by medicine by bringing to bear the relative but indispensable light of human science.” (131) [!!!] [vitalism]

C. then moves on to the analysis of “anomaly” and “abnormal”. In French, apparently, they are used as synonyms, with “abnormal” being the adjective of “anomaly” (according to C., “anomalous” – Fr. anomal – has fallen into disuse). C. points to a peculiar etymological confusion that has determined the contemporary use of the two terms:

(a) semantical/etymological rendition:

anomaly (from Gr. omalos = even, regular, etc. → anomalia = an-omalos [ = un-even, rough, irregular): factual, descriptive term

abnormal (Gr. nomos = Lat. norma = law or rule → ab-norma = not inline with the law or rule): evaluative, normative term

(b) actual (“pragmatic”) rendition:

anomaly (mistakenly derived from nomos): evaluative, normative term

abnormal: factual, descriptive term (131-2)

C. goes through a short historical overview of the use of two terms. He mentions Étienne Geoffroy Saint-Hilaire, who, although he did make the etymological error, still insisted on the purely descriptive (factual) meaning of “anomaly”. In Saint-Hilaire’s view, it is wrong to speak of peculiarities of nature or of irregularity with regard to animals. Exceptions exist only with regard to the laws of naturalists, not with regard to the laws of nature, for – as C. puts it – “in nature all species are what they must be, equally presenting variety in unity and unity in variety”. In anatomy, the term “anomaly” should thus designate “unusual” and “unaccustomed” (132-3).

Saint-Hilaire then goes on to connect the notion of “anomaly” to two biological facts:

(i) individual variation: all living species present a multitude of variations;

(ii) specific type: there is a complex of traits “common to the vast majority of individuals who compose a species”.

Anomaly, in his view, is “every deviation from the specific type”, which means that it is a purely empirical or descriptive content, i.e., a statistical deviation (133).

But a problem presents itself here, namely whether “anomaly” should be considered as equivalent to “monstrosity”. Saint-Hilaire argues against this: monstrosity is but one species of the genus of anomaly. More specifically, he classifies anomalies into four categories:

(i) varieties: simple, slight anomalies, which do not obstruct the performance of any function or produce any deformity (a double renal artery, a supernumerary muscle, etc.);

(ii) structural defects: simple anomalies, but they make the performance of one or more functions impossible or produce a deformity (a defective anus, harelip, etc.);

(iii) heterotaxies: complex anomalies, serious in appearance, but with no impediments to function and not apparent on the outside (situs inversus = complete transposition of viscera; heart on the right side)

(iv) monstrosities: very complex and serious anomalies, which make the performance of one or more functions impossible or difficult, or produce a (serious) defect (ectromelia or cyclopia) (133-4).

The reason why this classification is interesting is because it uses two different classificatory criteria:

(a) increasing complexity: this criterion is purely objective

(b) increasing seriousness: this criterion has a less clear-cut logical character: the gravity of anomaly lies in the importance of the organ as far as its anatomico-physiological connections are concerned; while, for the naturalist, “importance” is an objective idea, it is essentially, a subjective one in the sense that it includes a reference to the life of a living being (it qualifies this same life according to what helps or hinders it). For this reason, Saint-Hilaire added two further criteria:

(c) relationship anatomy-physiology: what impact changes in anatomy have on the physiological functions.

(d) harmful (disturbing) influence: how harmful (disturbing) these changes actually are for the functioning of the organism (C. points out that this a clearly psychological criterion) (134).

Note that (d) does not play a subordinate role in this classificatory scheme, which is most obvious in the cases of heterotaxies (modifications of inner organization without changes in function and/or appearance), which emphasize its precise meaning and its considerable biological value. Such cases suggest that the anomaly is ignored insofar there is no manifestation of it in the order of vital values. Thus, even a scientist will acknowledge that an anomaly is known to science only if it is first perceived in the consciousness, be it in the form of an obstacle to the performance of functions, or discomfort or harmfulness. But such consciousness must be deemed normative as it involves (implicit) reference to a function and to an impulse to the completeness of their exercise. Lastly, to be able to speak of anomaly in scientific terms, a being must have appeared to itself or to others as abnormal in the, albeit unformulated, language of the living (135).

Thus:

“As long as the anomaly has no functional repercussions experienced consciously by the individual, in the case of man, or ascribed to life’s dynamic polarity, in every other living thing, the anomaly is either ignored (in the case of heterotaxies) or constitutes an indifferent variety, a variation on a specific theme; it is an irregularity like the negligible irregularities found in objects cast in the same mold. It might form the subject of a special chapter in natural history, but not in pathology.” (135)

C. emphasizes that the whole issue of anomalies and teratology has an extremely important impact on biological sciences as it opens a “new point of view” in biology and carves out a “new territory”:

“This point of view is that of vital normativity. Even for an amoeba, living means preference and exclusion. A digestive tract, sexual organs, constitute an organism’s behavioral norms. Psychoanalytic language is indeed right to give the name poles to the natural orifices of ingestion and excretion. A function does not work indifferently in several directions. A need places the proposed objects of satisfaction in relation to propulsion and repulsion. There is a dynamic polarity of life. As long as the morphological or functional variations on the specific type do not hinder or subvert this polarity, the anomaly is a tolerated fact; in the opposite case the anomaly is felt as having negative vital value and is expressed as such on the outside. Because there are anomalies which are experienced or revealed as an organic disease, there exists first an affective and then a theoretical interest in them. It is because the anomaly has become pathological that it stimulates scientific study. The scientist, from his objective point of view, wants to see the anomaly as a mere statistical divergence, ignoring the fact that the biologist’s scientific interest was stimulated by the normative divergence. In short, not all anomalies are pathological but only the existence of pathological anomalies has given rise to a special science of anomalies which, because it is science, normally tends to rid the definition of anomaly of every implication of a normative idea. Statistical divergences such as simple varieties are not what one thinks of when one speaks of anomalies; instead one thinks of harmful deformities or those even incompatible with life, as one refers to the living form or behavior of the living being not as a statistical fact but as a normative type of life.” (135-6) [!!!] [vitalism] (136-7)

An anomaly is, says C., a “fact of individual variation”, i.e., it is that which prevents two beings being completely identical (being able to take the place of each other completely). Yet variety is not disease; the anomalous is not pathological:

Pathological implies pathos, the direct and concrete feeling of suffering and impotence, the feeling of life gone wrong. But the pathological is indeed abnormal.” (137)

So, in sum: anomalous =/= pathological, while abnormal = pathological.

There is, however, one way of considering the pathological normal, and that is by defining “normal” and “abnormal” in terms of relative statistical frequency. In this regard, one could say that continuous perfect health is, in fact, abnormal (= a statistical deviation). The reason for this, says C., lies in the equivocal meaning of the term “health” (and, as will be seen below, the corresponding equivocal meaning of the term “life”):

(i) absolute meaning: normative concept = ideal type of structure and behaviour

(ii) qualified meaning: descriptive concept = individual’s particular disposition and reaction with regard to possible diseases (137).

When saying that that continuous perfect health is abnormal, we are merely saying that health (in the absolute [i] sense) is a norm and that norms do not exist, i.e., that the experience of life includes disease (here, “abnormal” merely means non-observable, non-existing). But although life includes disease, the latter is still experienced as a state against which it is necessary to struggle in order to go on living, i.e., it is an abnormal sense in terms of the vital norm, i.e., in terms of the persistence of life which here serves as the norm.

But anomaly (anomalous) and pathology (pathological) need to be distinguished also for the following reason: human consciousness does not perceive each as being divergences of the same kind:

“An anomaly manifests itself in spatial multiplicity, disease, in chronological succession. It is a characteristic of disease that it interrupts a course; in fact it is critical. Even when the disease becomes chronic, after having been critical, there is a past for which the patient or those around him remain nostalgic. Hence we are sick in relation not only to others but also to ourselves. This is the case with pneumonia, arteritis, sciatica, aphasia, nephritis, etc. It is the characteristic of an anomaly that it is constitutional, congenital, even if its appearance is delayed with respect to birth and is contemporary only with the performance of a function – for example, in the congenital dislocation of the hip. The person with an anomaly cannot then be compared to himself.” (138-9)

When anomaly is interpreted in terms of its effects in relation to the individual’s activity and thus in relation to the representation which develops from its value, an anomaly is an infirmity. Infirmity as a being’s forced limitation to a unique and invariable condition is judged pejoratively in terms of the normal human ideal, which is the potential and deliberate adaptation to every condition imaginable:

“It is the possible abuse of health which lies at the bottom of the value accorded to health […] Normal man is a normative man, the being capable of establishing new, even organic norms. A single norm in life is felt privately, not positively. [Example] A man who cannot run feels injured, that is, he converts his injury into frustration, and although those around avoid throwing up to him the image of his incapacity […] the invalid feels sensitively by what restraing and avoidance on the part of his fellows each difference between him and them is apparently cancelled out.” (139-40)

What holds true of infirmity, also holds true of certain states of fragility or debility.
Example: hemophilia: h. is a kind of anomaly with a possible pathological character, characterized by an obstacle that is met by an essential vital function, namely, the separation of interior and exterior environment (in h., the hemorrhages are interminable, as if the blood were indifferent to its situation inside and outside of its vessels).

In sum:

“[A]n anomaly can shade into disease but does not in itself constitute one. It is not easy to determine at what moment an anomaly turns into a disease. Must [example] the sacralization of the fifth lumbar vertebra be considered a pathological fact or not?” (140)

The problem of distinguishing between an anomaly and a pathological state is not a clear one, but is a very important one from the biological perspective, as it leads us to the general problem of the variability of the organisms and the significance and scope of this variability:

“To the extent that living beings diverge from the specific type, are they [i] abnormal in that they endanger the specific form or are they [ii] inventors on the road to new forms?”

The answer to this question depends on whether one is a fixist or a transformist.

Example: drosophilia: when d. with wings gives birth to d. without wings – is this a pathological fact or not? Some biologists-fixists (Caullery and Bounoure) would claim that we are here dealing with pathologies. But others (Guyénot, C. himself) emphasize that mutations can be the origin of new species. Whether an anomaly proves to be [i] or [ii] depends on the environment. But the problem here is that what is true for species is also true for environments: their stability is not guaranteed (i.e., they tend to change). The reason why a given environment is called “normal” is because a living being lives out its life better there, i.e., it maintains its norm better there. An environment is “normal” only in terms of a morphological and functional norm.

Example (Teissier): butterflies: certain regions of Germany and England have noticed a gradual disappearance of grey butterflies and the appearance of black ones; it was observed that the black coloration in these butterflies was accompanied by an unusual vigour; further, in the captivity, the black (and more vigorous) varieties eliminated the grey varieties; but why doesn’t the same happen in nature? primarily because the black colour stands out more against the bark of the trees and attracts the attention of the birds; but in the industrial regions, where the population of birds was diminished, “butterflies can be black with impunity”; in sum: “this butterfly species […] offers two combinations of opposing characteristics and they balance each other: more vigor is balanced by less security and vice versa”; according to Tessier – in C.’s words – “life, using the variation of living forms, obtains a kind of insurance against excessive specialization without reversibility, hence without flexibility, which is essentially a successful adaptation” (142-3).

C. emphasizes that today the appearance of new species cannot be (pace “mutationists”) reduced solely to random mutations in the genetic material, but must be placed “at the intersection of innovations brought about by mutations and oscillations in the environment”. Such “Darwinism rejuvenated by mutationism”, he believes, is the most flexible and comprehensive explanation of the fact of evolution. Most importantly:

“The species is the grouping of individuals, all of whom are different to some degree, whose unity expresses the momentary normalization of their relations with the environment, including other species, as Darwin had clearly seen. Taken separately, the living being and his environment are not normal: it is their relationship that makes them such.” (143) [!] [vitalism]

But what does it mean that an environment is “normal” for a given life-form (and vice versa)?

“[a: normal environment] For any given form of life the environment is normal to the extent that it allows it fertility and a corresponding variety of forms such that, should changes in the environment occur, life will be able to find the solution to the problem of adaptation – which it has been brutally forced to resolve – in one of these forms. [b: normal life-form] A living being is normal in any given environment insofar as it is the morphological and functional solution found by life as a response to the demands of the environment. Even if it is relatively rare, this living being is normal in terms of every other form from which it diverges, because in terms of those other forms it is normative, that is, it devalues them before eliminating them.” (143-4) [!]

This has direct bearing on the issue of the relationship between anomaly and pathology:

“Hence, finally, we see how an anomaly, particularly a mutation, i.e., a directly hereditary anomaly, is not pathological because it is an anomaly, that is, a divergence from a specific type, which is defined as a group of the most frequent characteristics in their average dimension. Otherwise it would have to be said that a mutant individual, as the point of departure for a new species, is both pathological, because it is a divergence, and normal, because it maintains itself and reproduces. In biology the normal is not so much the old as the new form, if it finds conditions of existence in which it will appear normative, that is, displacing all withered, obsolete and perhaps soon to be extinct forms.” (144) [!!!]

And further:

No fact termed normal, because expressed as such, can usurp the prestige of the norm of which it is the expression, starting from the moment when the conditions in which it has been referred to the norm are no longer given. There is no fact which is normal or pathological in itself. An anomaly or a mutation is not in itself pathological. These two express other possible norms of life. If these norms are inferior to specific earlier norms in terms of stability, fecundity, variability of life, they will be called pathological. If these norms in the same environment should turn out to be equivalent, or in another environment, superior, they will be called normal. Their normality will come to them from their normativity. The pathological is not the absence of a biological norm: it is another norm but one which is, comparatively speaking, pushed aside by life.” (144)

Short reflective intermezzo: “Normal facts” are but expressions of the “vital norm”, i.e., they draw their normative sustenance from it, and as such, cannot overthrow it. They are are deemed “normal” only under specific conditions – as long as they, so to speak, “serve life” -; if these conditions change, they may become “abnormal” (= pathological). An anomaly – as a statistical divergence from the most common type – is not, in itself, abnormal (= pathological). It becomes so with regards to how well it is able to express the vital norm: if it does it in a way that is equal or perhaps even superior, then it is characterized as “normal” (super-normal? the new normal?); if it does it in a way that is inferior, it is deemed “abnormal” (and hence pathological).

At this point C. opens a new problem, namely that of the relationship between the normal and the experimental. One might attempt to arrive at an objective definition of “normal” by means of “laboratory standardization”. In this context, what counts as normal phenomena are phenomena that (i) are amenable to regular laboratory testing and whose (ii) measured characteristics for any given individual are identical to themselves in identical conditions, and (iii) – aside from some divergences of a clearly defined amplitude – identical from one individual to another in identical conditions.

C. puts forward the following objections:

(1) The physiologist sets up experiments whose results he compares using the fundamental mental reservation that these data are valid “all other things being equal”. That is to say: other conditions would bring forth other norms. The physiologist thus merely gives a content to the concept of the biological norm, but does not figure out in what way such a concept is normative. Put more concisely: “The living being’s functional norms as examined in the laboratory are meaningful only within the framework of the scientist’s operative norms.” The physiologist objectively studies the relations that hold within normal conditions, but does not really objectively define which conditions are normal (145).

(2) If “abnormal/pathological” is defined as statistically divergent or unusual (as it usually is among physiologist), then it must said that, from a purely objective point of view, the laboratory conditions place the living in a pathological situation. For instance, Prus (see above) voices this objection in the following way:

“When we irritate, puncture, cut the brain and cerebellum in order to learn the functions of these organs, or when we cut out a more or less considerable portion, the animal subjected to similar experiments is certainly as far removed as possible from the physiological state; it is seriously sick and what is called experimental physiology is obviously nothing other than a real artificial pathology which is similar to or creates diseases.” (146)

C. also quotes the following passage, in which Bernard struggles with this selfsame difficulty:

“Certainly an experiment introduces disturbances into the organism, but we must and can bear this in mind. We must [i] restore the part of the anomalies which is due to them to the conditions in which we place the animal, and [ii] suppress the pain in animals as well as in man in order to remove causes for error brought about by suffering. But the very anesthetics we use have effects on the organism which can give rise to physiological modifications and new causes for error in our experiments’ results” (146-7)

C. adds a very poignant remark with regards to this passage:

“A noteworthy passage, which shows how close Bernard is to assuming that it is possible to discover a determinism of the phenomenon, independent of the determinism of the operation of knowledge; and how he is honestly obliged to acknowledge the alteration, in clearly unassignable proportions [!], to which knowledge subjects the known phenomenon because of the technical preparation it involves. When we glorify the contemporary theorists of wave mechanics for their discovery that observation interferes with the observed phenomenon, it happens that, as in other cases, the idea is a bit older than they are.” [!]

(3) In relation to (2), the physiologist must tackle three difficulties:

(a) he must be certain that (i) the subject called normal in the experimental situation is identical with (ii) the subject of the same species in the normal (nonartificial) situation;

(b) he must be certain of the similarity between (i) the pathological state brought about by the experiment and (ii) the pathological state brought about spontaneously (often, the subject of the spontaneous pathological state belongs to a different species than the subject in the experiment, e.g. human vs. dog);

(c) he must compare the result of the two preceding comparisons (i.e., (a) and (b)), for it involves a great breadth of the margin of uncertainty (147).

The point C. is trying to make is that it is very difficult to realize the canonical requirement of “all other things being equal”.

Examples:
          (i) epilepsy
: stimulation of certain parts of the cerebral cortex can induce a convulsive crisis; however, this crisis is not epilepsy, even if the EEG records superimposable curves.

(ii) hypoglycemia: four pancreases can be grafted onto an animal without inducing the slightest hypoglycemic disorder comparable to that induced by a small adenoma in the isles of Langerhans.

(iii) sleep: sleep can be induced by sleeping pills, but normal sleep and artificially induced sleep do not share the same or even similar phenomenology (e.g., in normal sleep diuresis usually decreases, while in artificial sleep it is often increased, etc.)

In sum:

“If we may define the normal state of a living being in terms of a normal relationship of adjustment to environments, we must not forget that the laboratory itself constitutes a new environment in which life certainly establishes norms whose extrapolation does not work without risk when removed from the conditions to which these norms relate. For the animal or for man the laboratory environment is one possible environment among others. Certainly, the scientist is right in seeing in his apparatus only the theories which it materializes, to see in the products used only the reactions they allow; he is right in postulating the universal validity of these theories and these reactions, but for the living being apparatus and products are the objects among which he moves as in an unusual world. It is not possible that the ways of life in the laboratory fail to retain any specificity in their relationship to the place and moment of the experiment.” (148-9)

marsh grass of Parnassus, Parnassia palustris (sl. močvirna samoperka)

Discussion

Presenter: Sebastjan Vörös

The highlights:

I) The nature of norm

We raised the following questions:

i) What exactly does it mean that a norm is ideal?

ii) What is the relevance of different standpoints of a physician as a scientist (who is trying to implement statistical and mechanical methodology) vs. a physician as a living being (himself a manifestation of vital needs and norms)?

Some accepted ways of doing and understanding things are circular: using a variety of examples, Canguilhem illustrates the genesis of what later becomes embedded as a norm and functions as an ideal that is usually implicitly presupposed (e.g., the ideal of objective medicine; the ideal of providing a statistical account of a disease or normality).

In order to apply statistical or mechanical techniques, one already has to have some sort of understanding of what life is, how it manifests itself, etc. While Canguilhem tries to introduce the notion of norm into life sciences and medicine, he does not expound on it: by this, he perhaps aims to show that the norm cannot be truly expounded – that it is somehow a primitive.

A scientist constructs an ideal type based on observations, i.e., on statistical averages. Living beings in the primordial sense do not do this; they are more attuned to the habits they have – on whether they are able to execute these in their life. We think that according to Canguilhem, norm is habitual rather than ideal: it is an optimal anomaly of a certain physiological or morphological feature that just by chance suffices for the organism’s survival in the environment. There are no normal facts that would exhaust the norm. Normal facts are but manifestations of a norm which embodies itself in the dynamic exchange between the organism and its environment. It is the vital norm which determines which facts are normal; also, the facts themselves do not circumscribe the normality – a given fact can, in a different setting, become irrelevant for a particular organism. In a similar manner, Canguilhem defines species as “the grouping of individuals […] whose unity expresses the momentary normalization of their relations with the environment.”

II) Normativity and plasticity

Were the norm ideal, how flexible would it be?

Canguilhem proposes that health is neither a norm nor a set of states, but a possibility of experimenting with new norms. Health is therefore the possibility of squandering health; a space to manoeuvre within a surplus of possible states. An individual’s flexibility, however, is not omnipotent: for him to be able to interact in different environments and thus to express a variety of norms, the environment first needs to be plastic enough to enable the establishment of a new norm. Canguilhem’s take on this is somewhat ambiguous: he claims that the norm and the environment are completely interconnected; on the other hand, he defines the normativity as intrinsic to the living being, i.e., as its capability to variate its norms.

We applied the above interpretations to the case of depression: In the Canguilhemian sense, depression manifests itself as an abnormality: the depressed person finds it difficult to establish his own normativity. We could, however, take the manifestation of vital normativity to a societal level: the growing rates of depression might indicate that as a society we are in a state of abnormality in which individuals find it very difficult to establish their normativity (and thus perceive the world as incessantly chaotic).

III) The origin of technology

Should we interpret the technology as something to be found already in the nature, meaning that the latter is replete with it, or as something unnatural that only human possesses?

Canguilhem is trying to show that there is a root to all technical activity in the very dynamics of the living/organic. Because technique usually interferes in a way that has a specific means/ends/purpose, it expresses a certain mattering: this can be done by living structures that are not neutral with regard to their environment. If Canguilhem knew the autopoietic theory of an organism, he would deem it as a better model to account for life, as it takes the polarity seriously – it incorporates it in the theory itself and thus gets closer to the source of the problem that Canguilhem addresses.

To properly understand the genesis of technique properly – and also the genealogy of knowledge – mattering needs to be taken into account. Its disregard results in the Cartesian picture of fully-formed human knowledge and dead matter, lacking the intermediaries that could ever bring them together. According to Canguilhem, the notion of living (which is usually ignored because it is lumped together with the inanimate matter) provides the needed link. Living is in itself already a qualitative jump which has specific dynamics: vital normativity carves out a new point of view or a new territory in the physical plenum (cf. Merleau Ponty’s take on projection). When you get to the level of human beings where knowledge proper develops, you might encounter further complexification which is perhaps related to another qualitative jump.

In autopoietic theory the thesis was put forth that living is cognizing: life as such has ingrained some kind of practical reason in order to survive in the circumstances it perceives. In this regard, the answer to the initial question would be that the technology is inherent to life; it helps the organism to establish its norm.

IV) Technology as a reflective procedure

Can we consider human techniques to be an extension of vital techniques?

While the dynamics between the individual and its environment remain the same in human as in every other organism, in the former the ability to pause is introduced. The human individual no longer lives in an Umwelt, but in a Welt: a world where objects have different sides, meanings and dimensions. Human lives in the world of things. (The distinction, however, is not clear-cut: it may be more accurate to think of a relation between the animals and humans as a continuum of plasticity.)

With other life-forms, it would seem that life imposes itself on the environment by producing a massive amount of real-time variations, which, for the most part, have to die off, eventually. As a human being, you can impose yourself on the environment by producing a mass amount of virtual variations, and this provides you with a powerful leeway where you are able to leave a massive imprint. The way to do this is through technology, that is, by doing something in several different ways and thus developing a technique which is not understood but enables certain kind of differences which can then sediment into the virtual selves.

The structure of the horizon is not the same as the structure of the figure. The possible virtual selves that are on your horizon are not necessarily fully developed (in the sense of having a complete knowledge of them) but are given to you as directions or pulls. The process is essentially that of becoming: virtual selves are transformations of one’s own self. Your actual self has to die for the possibility to manifest itself (e.g., when you start enacting something that has a vague appeal to you, it may turn out that the way you were presenting this to yourself was completely different from the track you were taken on).

The ability to pause is at the core of the mind. You are not endowed with a panoramic view of what is happening; it is just the moment when you are able to perceive how different realities are born, i.e., both the world you live in and the self that you are. It allows you to situate yourself in the virtual realm. This is not a classic Cartesian notion of a thinker who is making calculations on well-defined ideas. The mind is more profound. Through practice, you might get an insight into what would be the optimal attitude to take towards any possible breakdowns of your world happening: you learn to engage with the ongoing pattern of changing self and changing reality. This would be the profoundest level of wisdom. Quoting Canguilhem, “[t]thought is nothing but a disentangling of man from the world that permits us to retreat from, to interrogate and to doubt in the face of obstacles that arise. In concrete terms, knowledge consists in the construction of theories that proceed by assimilation. It is thus a general method for direct or indirect resolution of tensions between the man and the milieu.”