Saturday, November 24, 2018

The Medical Bacground of Aristotle's Philosophy IV: Social Pathologies



A central problem in all political philosophy is that the political leadership is incarnated.  The king, president or archon is subject to sickness, madness and passion because they are embodied.  As a result, the regime is at the mercy of physical nature; the decay of the leader’s health-and ethics-so often leads to the sickness and death of the polis.  The Politics is about the structure of regimes and the history of their breakdowns-an etiology.  The Ethics is about those bodies which occupy the most sensitive position in the regime-thus, it implies an epidemiology.   Taken together, these works represent an account of how ethical sickness is generated and spreads in the social body.

Politike is the science of the city-state, the polis, and its members, not merely in our narrow ‘political’ sense of the word but also in the sense that a civilized existence is, according to Plato and Aristotle, only possible in the polis”. (Ethics, fn.8, p.4)  The polis is the site of the fulfillment of human nature, for “..the good of man is an activity of the soul in conformity with excellence or virtue” (Ethics, 1098a15-6, p.17), and virtue is possible only under the condition of the polis.  But further, it is the polis which maintains the traditions of subject formation, it is the community which defines health, it is the polis which creates the form which health is to take: “the main concern of politics is to engender a certain character in the citizens and to make them good and disposed to perform noble actions”. (Ethics 1099b30-2, p.23)

How does “seeing about health...indeed belong to...the ruler in a sense, but in another sense not but rather to the doctor”? (Politics 1258a32-3, p.49)  In the ideal city-state, the leaders are themselves not only virtuous, but see the polis holistically such that they rule for the sake of the ruled.  (This follows from the rule that the the part is for the sake of the whole).  Similarly, in the actual life of the virtuous man, pleasures are ranked with a view to the happiness of the whole person, rather than the pleasure of the individual part.  The virtue of a ruler consists in his ability to reproduce-to externalize-this right prioritization of ends in the other members of the community and in their interrelations; to duplicate, on the level of the polis and through through the regime, what has already occurred on the level of the aristocratic body through regimen: the proper ordering and arrangement (taxis) of the parts to form the whole. “Taxis is defined as the balanced adjustment of the details of a work separately, and, as to the whole, the arrangement of the proportion with a view to a symmetrical result.”[1]

Aristotle’s Ethics and Politics use a powerful medical language in the discussion of norms for human life.  Together they make up a medical philosophy of human life.  For, ethics is an art of living and “an art of living-as medicine is in the full sense of the word-implies a science of life”. (Canguilhem p. 87)  Neither ethics nor politics admits of scientific knowledge, yet medicine must draw upon the available knowledge of elemental qualities.  Similarly, there is real political and ethical knowledge which invokes scientific knowledge, via medicine.  That is a consequence of Aristotle’s world-structure: there is no Cartesian chasm between the human being and the world, but a continuum, in which certain principles are at work at any level.  From our own, contemporary point of view, that makes Aristotle’s ethics and politics, as medical philosophy, a scientific ideology:

Ideology is an epistemological concept with a polemical function, applied to systems of representation that express themselves in the languages of politics, ethics...and metaphysics.[2]  The existence of scientific ideologies implies the parallel and prior existence of scientific discourses. (Ibid., p.33)

In the case at hand, Greek science applied principles of quality, balance, and opposition to the human body in order to yield medical thought; in turn, medicine became the metaphor bed for political thought.  That is how Aristotle’s ethical and political reasoning is structured by models drawn from the physical world.  “To what end are specific theoretical conclusions severed from their premises and applied...to human experience in general?  To a practical end.” (Ibid., p.37)

Ethics is a matter of action. (Ethics 1103b26-30, p.35)  The body of the aristocrat was medicalized in order to yield right action in the polis; more exactly, to yield a dynamic system composed of desire/pleasure/act: “the desire that leads to the act, the act that is linked to pleasure, and the pleasure that occasions desire”.[3]  The application of disciplines to the cycle of acts, desires and pleasures is moral training: “to be a competent student of...politics generally, one must first have received a proper upbringing in moral conduct”. (Ethics 1095b4-6, p.7)  Therefore the political life of the polis depends on balance in the bodily desires of the leaders; tyranny is rooted in the moral-and that means physical-sickness of a leader overcome with desire. (Politics 1311a3-5, p.168)  The Ethics is a complete way of life for the aristocrat: a formula for the successful distribution of pleasures and pains in the aristocrat’s own body and therefore in the polis.  As well as a medical ideology, it is an aesthetic ideology, in a double sense-it aims at the aesthetic ideal of order, of symmetry; and it is rooted in the pleasures and pains of the feeling body-αισθεσιs.

It must be remarked that the larger issue here is one of the key themes of Western political discourse, that is, the organic model of the political entity.  It is a model which can trace its roots back to Plato and Aristotle: “Greek philosophers conceived of society as a reality of an organic type, having an intrinsic norm, its own health, rules of measure, equilibrium and compensation, a replication and imitation...of the universal law which made a cosmos of the totality of beings”. (Canguilhem p. 259)  Health and medicine are much more than metaphors introduced to make clear political and ethical points.  In fact, these metaphors are able to do their work for deep structural reasons, reasons which converge on the living body as governed by a regime.

We have argued that Aristotle’s account of the maintenance and decay of the polis is an expansion of his account of the individual life, that Aristotle’s Ethics and Politics together make up a medical philosophy of human life.  For, ethics is “an art of living-as medicine is in the full sense of the word” (Canguilhem p. 87).  Illness is one of the fundamental experiences of any life form; but it is so for human beings in the additional sense that the polis is a response to sickness-the regime, the laws, the systems of regimen are meant to order a disordered set of elements, highly reactive elements which would explode the state with their violence if they were not carefully blended and maintained according to certain formulae.  “Medical advances...are products of the sparks between the scientific knowledge of the time and the demands of the community.  But what the community demands is determined to a large extent by publicity, apparent or hidden.” (Dubos p.95)  The visceral, carnal character of the category of health renders it a powerful rhetorical tool.  Since it inheres in our bodies, health has the aura of the natural or objective.  Yet, it is also a normative concept; it is linked to culture and convention.  Is not the category of health and sickness just as charged as that of incest?  For health, too, “scandalously” combines the universality of the natural with the regulativity of the cultural.  In “health”, too, “we recognize the conflicting features of two mutually exclusive orders”.[4]

If the community demands health, what is meant by the term “health”?  In closing we suggest that the key danger of an organic model of social life like that of Aristotle lies precisely in the deployment of the metaphor of health and sickness-a medicalized normative rhetoric-by which the state is reified and by which selected individuals are conceived of as pathological.  We can take, for example, the conceptualization of the Jews as syphilitic or cancerous (Sontag, pp. 81-4) or how “the ruling class cast the working class as...carriers of disease” during the cholera of 1832 in Paris.[5]  And witness the awful treatment of the pharmakos in Athens.[6]  A “belief in the superiority of the physically strong and the contempt for the weak and the sick” (Edelstein, p.315) too often plays a part in the formation of an aristocratic medical aesthetic.  Obviously, a great deal of work remains to be done on the application of medical categories to political thought; if such use is often accompanied by political horrors, maybe it is because the obsession with health is always a reaction to-and is, itself-a sickness.



[1]. Vitruvius, De Architectura quoted in Classical Architecture Alexander Tzonis and Liane Lefaivre MIT, 1986 p. 18
[2]. Canguilhem, Ideology and Rationality in the History of the Life Sciences Arthur Goldhammer, trans. M.I.T., 1988 p.29
[3]. Foucault, Use of Pleasure R. Hurley, trans. Vintage, 1990 pp. 42-3
[4]. Levi-Strauss, Elementary Structures of Kinship (quoted by Derrida in ‘Structure, Sign and Play in the Discourse of the Human Sciences’, in Writing and Differance, Alan Bass, trans. Chicago, pubs. 1978 p.283 and in Of Grammatology Gayatari Spivak, trans. Johns Hopkins 1974 p.104)
[5]. Francois Delaporte Disease and Civilization Arthur Goldhammer, trans. MIT, 1986 p.8
[6]. Denis D. Hughes, Human Sacrifice in Ancient Greece Routledge, 1991 pp. 139-56 and Walter Burkert, Greek Religion John Raffan, trans. Harvard, 1985 pp.82-4

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