A private, "liberal" medicine, sought out by individual initiative and subject to the mechanisms of supply and demand-and to its side, or perhaps facing it, a medical management determined by the authorities, supported by an administrative apparatus, framed by strict legislative structures, and addressing itself to the entire collectivity.Is it productive to demarcate a clear opposition and to determine which of these two types of medicine was the first, from which the other was derived?Is it necessary to suppose, at the origin of Western medicine, a collective practice from which the forms of individual relationships would have slowly disassociated?Or must we imagine that modern medicine first developed in singular relations (relationships with clients and clinical relations) before a series of corrections and adjustments would have integrated it into a politics and a management of the group?Posing the problem in this way supposes a somewhat fictional separation.In every society, illness-the manner in which the sick person demonstrates and expresses it, that which for the sick person and for others distinguishes it from health, the signs by which it is recognized, the behaviors that it induces-makes reference to collective systems.Better: the doc-torʹs intervention-the form of his action, right down to the secret of his remedies and their 1 Translator: This essay was first published in Les Machines à guérir.Aux origines de lʹhôpital moderne (Brussels: Pierre Mardaga, 1979), 7-18, and is translated from Dits et Ecrits,
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