Normality

A Critical Genealogy

Peter Cryle, Elizabeth Stephens

• Publisher: University of Chicago Press
• Year: 2017
• Print ISBN: 9780226484051, 9780226483863
• eBook ISBN: 9780226484198
• Topic: History
• Subtopic: French History
• Index: History

The concept of normal is so familiar that it can be hard to imagine contemporary life without it. Yet the term entered everyday speech only in the mid-twentieth century. Before that, it was solely a scientific term used primarily in medicine to refer to a general state of health and the orderly function of organs. But beginning in the middle of the twentieth century, normal broke out of scientific usage, becoming less precise and coming to mean a balanced condition to be maintained and an ideal to be achieved. 

In Normality, Peter Cryle and Elizabeth Stephens offer an intellectual and cultural history of what it means to be normal. They explore the history of how communities settle on any one definition of the norm, along the way analyzing a fascinating series of case studies in fields as remote as anatomy, statistics, criminal anthropology, sociology, and eugenics. Cryle and Stephens argue that since the idea of normality is so central to contemporary disability, gender, race, and sexuality studies, scholars in these fields must first have a better understanding of the context for normality. This pioneering book moves beyond binaries to explore for the first time what it does—and doesn't—mean to be normal.

PART I

The Normal in Nineteenth-Century Scientific Thought

CHAPTER ONE

The “Normal State” in French Anatomical and Physiological Discourse of the 1820s and 1830s

At the outset, we can see two ways of engaging with the history of normality. The high road is mapped out in the work of Georges Canguilhem, whose Le Normal et le pathologique offers a powerful philosophical history of our general topic. Canguilhem’s essay fully deserves to be called historical, since it examines the work of the most influential writers on biological questions in nineteenth-century France. Yet it remains unswervingly philosophical in that it puts forward normativity—the requirement that the normal serve as a rule—as its guiding concept, arguing that the capacity to impose order on surrounding organisms is a constitutive property of living creatures. Even an amoeba, says Canguilhem, “prefers and excludes.” All organisms are shaped and oriented by “the propulsion and repulsion of the objects of satisfaction proposed.”1 This is what he means by “vital normativity,” and he uses that as a conceptual yardstick by which to measure the value of nineteenth-century biological writing.2 It follows that he is not particularly concerned to describe historical patterns of thinking in their own terms. His interest is in the underdeveloped presence of a vitalist understanding of normativity in the nineteenth century, and he regularly points to its weakness or its absence in places where in his view it ought to have played a role. So Canguilhem does not simply offer an account of what took place in the past but frames his analysis with considerations about what people ought to have thought if they had given full value to the philosophical principle that grounds his own position. His stated concern is less with the historical accidents that may have befallen thinking about normality than with “the notion of norm in the normative sense of the word.”3 Normativity, for Canguilhem, is thus more than a topical matter: it is a proper constraint on thinking. To write a philosophical history of the norm is in his view to respect and rehearse the self-confirming circularity of the central concept. That makes his own history exemplary in a specific philosophical sense. As he talks about the norm, he everywhere affirms and applies its significance as a literally vital constraint on biological thinking. From Canguilhem’s point of view, the only proper way to write about the normal is to respect and reflect this fundamental truth. To put it in an appropriately circular fashion, the history of normativity he produces is itself a normative one, imposing a philosophical order on some rather disparate historical productions.

Our book is shaped by other ambitions, and that is why we will not engage directly with Canguilhem’s philosophical view of the norm. We will continue to refer to his work throughout our study, but we will not take the path he surveyed. We will not put forward a philosophical theory of normality but will attend instead to whatever concepts or notions of the normal present themselves along the way, seeking as far as possible to understand them in their own terms. That choice of method, it should be said, does not reflect any lack of ambition on our part. We will begin roughly where Canguilhem began, focusing on some French medical thinkers he discusses and others he does not consider, before moving beyond the geographical and disciplinary regions he mapped. Our search for emergent ways of talking and thinking about normality will lead us to analyze developments in medical thinking, in anthropometrics, and sexology. We aim to produce a quite broad history of intellectual and cultural change over the nineteenth and twentieth centuries, focused initially on France, then expanding to include Belgium, Italy, Britain, and the United States. But at every point the steps we take toward our goal will be measured ones. We will simply attempt to understand what the normal meant in context, how it functioned then and there, and we will make our history out of the incidents of its becoming. We will describe the intellectual formations and cultural practices that shaped normality through time.

To mark this difference of method and to indicate what might be at stake in our choice, consider, for example, Canguilhem’s discussion of an article in Diderot and d’Alembert’s Encyclopédie that deals with the standardization of artillery equipment in eighteenth-century France. The article, says Canguilhem, contains “almost all the concepts utilized in a modern treatise on normalization, with the exception of the term ‘norm.’” So, he concludes, the article can be said to contain “the thing without the word.”4 He thus accepts with no apparent difficulty that there might indeed be abstract “things”—here, figures of knowledge or knowledge practices—in the absence of words that refer to and implement them.5 Our own position is much closer to that of Michel Foucault, who argued at length in Les Mots et les choses that words and knowledge formations are caught up by their very nature in a sustaining circular relationship.6 In keeping with Foucault’s view, we will be engaging in a history that allows lexical developments to count as events. Certain terms, we will suppose, become by their emergence markers of conceptual change. As might be expected then, our history of normality will pay close attention to shifting uses of the word “normal,” making the assumption that the thing we now know as normality has been molded by discursive usage.

We can build here on the work of Caroline Warman, who has studied uses of the word “normal” in French and English in the late eighteenth and early nineteenth centuries, commenting as she did so that there was no need to make any great difference between the two languages because “the countries were so intellectually entwined.”7 Following a method consonant with our own, Warman is able to confirm Canguilhem’s broad historical account while providing fine lexical detail that significantly inflects it. She tracks the word through dictionaries, observing that “the term ‘normal’ entered [them] relatively late: having been a synonymous but less common alternative for ‘perpendicular’ in geometry.”8 The geometrical usage to which she refers did not simply disappear at the end of the eighteenth century, and we have found “une normale” still used in that way in a physics treatise published in 1822.9 But the import of “normal” was much extended when it began to be used as an adjective in conjunction with some key nouns. What Warman calls the first “figurative” use of the term occurred in the expression école normale, normal school, as a place for teacher training that served to standardize educational practice.10 Whether such usage should indeed be understood as figurative is a moot point. Was it thought that the perpendicular or the upright signified discipline? Whatever the semantic basis for the term’s extension from geometry to education, there emerged in the normal school a particular kind of thing that has remained relatively stable in French and English until the present day.

It was not, as it happened, the notion of the normal school that served during the early decades of the nineteenth century as a locus of complicated and contested thinking about normality, but rather that of the “normal state” (or condition). That term emerged in medical discourse around 1820. And while Canguilhem has nothing to say about adjectival as opposed to nominal uses, he does identify the field of medicine as the critical one for his history. Philosophical considerations about norms and the normal, he says, “ought to benefit, for the purposes of question-asking and clarification, from direct medical culture.”11 His reasons for focusing on this field are manifest. Seeking to understand how the normal and the pathological functioned in the nineteenth century as a binary pair, he advances the general thesis that medical thinkers failed to produce a concept of the norm grounded in biology, and were thus unable to define the pathological as its proper theoretical contrary. Instead, he argues, physiologists typically conceived of the relation between the normal and the pathological as a matter of degree. Pathology was understood as excess or inadequacy, as quantitative divergence from the “normal state.”12 Our research has persuaded us that the field of nineteenth-century medicine is indeed the domain that will most reward close examination—for more reasons, indeed, than Canguilhem himself acknowledges. So that is where we will begin our analysis. In this chapter, we will examine how the term “the normal state” came to be used, and we will consider the theoretical import of its emergence.

We can attest that “the normal state” had no place in French scientific discourse before about 1820. Yet by the 1830s it was in quite widespread use. Indeed, the term was routinely used in the medical academy during the mid-1830s. So we have found evidence of a discursive event, although of course the significance of that event is yet to be made clear. Even as we ask how and why the change came about, we will not be preoccupied with matters of agency, since we do not consider that widespread discursive change is brought about by singular intervention. Our primary interest here is in the shift itself, rather than in identifying an originary moment or an agent of change. Yet precisely because our focus at this point is on discursive fields as such, we must do all we can to identify the intellectual places in which the shift occurred. We have spoken so far of medical discourse as the locus of contest and complexity, and we will follow through on that engagement, but we need to mark from the outset the areas of scientific activity that had a bearing on the field of medicine. The most prominent, very much to the fore in Canguilhem’s history, was physiology. But leading writers in that field did not come to speak of the normal state before about 1830. François-Joseph-Victor Broussais may have been the first to use the term freely, doing so in an essay published in 1828, but it was entirely absent from the essays Broussais himself published during the preceding twenty-five years, including one published as late as 1822. Could it be that such a theoretically explicit and highly polemical author simply slipped unaware into a new discursive pattern? Or did Broussais, as Canguilhem might suggest, simply find a new word to name a topical thing that was already present in his work? Those are questions that will help to shape a later section in this chapter devoted to the normal state as it was conceived and spoken of by physiologists.

But there is another field pertinent to medical thought that will be given priority in our history, precisely because the term “the normal state” appeared there in 1818 as a self-conscious terminological innovation, ten years before it was used in Broussais’s essay in physiology. The field in question is comparative anatomy. Canguilhem’s history has relatively little to say about anatomy, although he does make some passing observations about it to which we will return. That does not constitute reprehensible omission on his part, since the stated topic of his history is the binary opposition between the normal and the pathological, which affords him a direct entrée into medical thinking. But we are going to argue here that the normal state as conceived in comparative anatomy was defined in a rather different way that owed less to binary logic. Canguilhem might well have contended that developments in anatomy mattered less in the long run for the history of normativity, and we cannot claim for our part that anatomy was more important for medical thinking than physiology. The dominant figures in physiology were all practicing physicians, whereas that was not generally the case in comparative anatomy, where the leading exponents were natural historians and zoologists.13 But the fact remains that the concept of the normal state first took shape in anatomical writing, and that this change occurred about a decade before physiologists began to use the term. It does not follow from our analysis that physiologists “took” the concept of the normal from anatomy, or indeed that the term signified exactly the same thing within the two fields. But there is every reason to believe that physiologists, wherever they may have happened on the term, thrived on its usage, finding it remarkably convenient for their own purposes. So when the term came into prominent theoretical use in both fields during the early 1830s before being taken up by doctors as part of their professional routine, it seems reasonable to suppose that discursive authority for the medical usage was derived from both fields—if not from their narrow convergence, then at least from some conceptual overlap. We cannot be sure whether physiologists coined the term more or less independently of anatomists, but we can clearly observe congruent changes in both fields accompanied by a shift in everyday medical terminology. The appearance of a widely successful new expression, we will argue, marked the emergence of a rather new conceptual thing.

THE NORMAL STATE IN COMPARATIVE ANATOMY

A prime example of the emerging usage of the “normal state” can be found in a treatise by Étienne Geoffroy Saint-Hilaire, Philosophie anatomique, the first volume of which was published in 1818. Geoffroy’s scientific work located itself somewhat restively within a long tradition of “natural history” that looked back through the prestigious eighteenth-century productions of Linnaeus and Buffon to the classical writings of Aristotle. The central purpose of this learned tradition was to study living things in a manner that was both descriptive and comparative, putting like with like while noting shades of difference so that each creature observed could be placed as nearly as possible to those that most resembled it. Reasoned proximity of this kind was itself an artifact of scientific knowledge. Furthermore, observations so arranged could be readily grouped into classes. An array of living beings could be put on display, and the regularities of nature manifested as an orderly disposition of nuanced similarity and difference. But when Geoffroy offered an overview of natural history in his own time, he made a critical distinction that threatened to disturb the stability of this whole field of inquiry. Or rather, he asserted that natural history was already being divided against itself by the coexistence of two knowledge practices that could only be expected to produce divergent effects. The first of these approaches—a classical one that could be traced back to Aristotle, although Geoffroy did not need to name the great predecessor—always began with mankind, taking humans as the point of reference for its account of natural regularities and making them the standard for every measurement of difference. Human organs were declared to be “the most perfect” by definition. The “organs” in question, it should be noted in passing, were simply the constitutive elements of bodily “organ-ization” as understood by all natural historians of the time: they included not only such things as the heart and the spleen, but also bones and muscles. The critical point made by Geoffroy was that when humans were taken as the point of departure for scientific description, organs as they were found in lesser animals were routinely described according to the degree to which they fell short of the human standard. Organs were thus diversified and graded precisely insofar as they could be considered “deformed.”14

To this classical anthropocentric approach Geoffroy opposed a form of analysis that did not take for granted the generic perfection of human anatomical forms. He thus gave “comparative anatomy” a rather different orientation. It was now a matter, he said, of “considering organs wherever they are at the maximum of their development, and following them from degree to degree as far as zero existence.”15 The concept of (human) perfection was displaced by that of maximal organic development, which might happen to occur in any species. It was patent that the “maximum” of which Geoffroy spoke had nothing to do with size. Development had to do with what he called the “compositional” (or structural) importance held by the organ in its anatomical environment.16 Comparative analysis would then proceed by considering what an organ “became” as one moved from one class of animal to another. At one point, Geoffroy took the example of the furcula (forked) clavicle. In mammals, this bone took an uncertain or inconsistent (équivoque) form, occurring in a “more or less rudimentary state.” But as one moved from mammals to birds, the furcula clavicle became “something more precise and more persistent.” It played a greater rol...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Introduction
• I  the normal in nineteenth-century scientific thought
• II  the dissemination of the normal in twentieth-century culture
• Conclusion
• Acknowledgments
• Notes
• Bibliography
• Index