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American Annals of the Deaf

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Damned for Their Difference: The Cultural Construction of Deaf People as Disabled

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A view of a diverse humanity that was imbued with almost infinite difference gave way to a view of an essentially uniform humanity that was surrounded on its edges, on its margins, by the pathological foils to that uniformity or “normality.” But no “pathological” population could exist until one was culturally constructed. And so, we turn to the processes of diagnosis, the ideological practice by which “the pathological” were separated from the former flux of humanity, the process by which normality was constructed and reconstructed through each diagnosis.

The Diagnosis of the Pathological

Diagnosis involves the interpretation and evaluation of characteristics and behaviors in terms of preconceived conceptualizations and classifications of the world. It is the taxonomic ordering of “reality.” The medical classification, interpretation, and evaluation of human characteristics and behavior were developed through the transformation of concepts of health and illness that were based on the concepts of normality and pathology. How these diagnoses proceeded and how the body and human behavior were understood were rooted in the Cartesian dualism of mind and body.

The Cartesian dualism of mind and body, while elevating the products of the mind to the status of eternal, disembodied knowledge, also stressed the materiality of the body, which was to be understood like any other physical object—like a well-made clock, to use Descartes’s own imagery. Accordingly, in the development of “scientific” medicine, the clinical gaze was directed to the physical body and to the taxonomies of pathologies that were built on knowledge gained from cadavers, from lifeless objects. Medical knowledge was to be based solely on sensory perception, on observation, on “a perpetual and objectively based correlation of the visible and the expressible” (Foucault 1975, 196).

The focus on death and on the dissection of cadavers resulted in a rush for bodies. The major but very limited official source of bodies in Britain was people sentenced to death as criminals. In France after the Revolution, the Reign of Terror in which people accused of being opposed to the Revolution were guillotined or slaughtered provided an unparalleled source of cadavers for dissection, but throughout Europe, the demand for bodies for medical schools was so great that an illegal trade in corpses flourished; people were paid to steal bodies from graves or even from houses where they lay awaiting their funerals. In 1829, Burke and Hare, two body snatchers in Edinburgh, were found guilty of murdering people to sell their bodies to anatomists. At the same time, Britain passed a law providing that bodies of poor people who died without relatives to pay for a funeral would be given to medical schools. In London, the famous surgeon Astley Cooper, who will feature in our discussion of the history of ear surgery in part 2, boasted that he could acquire in a few days the body of any person who had recently died in the United Kingdom through a wide network of body snatchers. The availability of severed heads in France provided for rapid advances in anatomical knowledge of the ear.

With the body reconstituted as a machine-like object, the clinical gaze focused on its order, on its “regularity,” judged in terms of deviations from a physical “norm.” Whereas medicine had, up to the end of the eighteenth century, focused on health rather than normality, nineteenth-century medicine was concerned more with normality than health (see Foucault 1975, 35). Its concern was with departures of the physical condition from what was understood as the normative standard. Both the clinical gaze and its objects of diagnosis were ruled by the five senses. The patient’s health was judged not only in terms of the person’s physical normality and pathology but also in terms of the effective functioning of the five senses. To lack one of the five senses was to become less than sensible or less than normal and, thus, to be incapable of sensibility or rationality.

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