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of all medical bureaucracy is historically contingent both with respect to its political origins and technological underpinnings. However we may tell the story of the open past, the dream of an unconstrained encyclopedia is evanescent. |
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This is not of itself surprising. Towers of Babel are perhaps the rule, not the exception. To classify is human and all cultures at all times have produced classification systems. Modern Western culture has produced more than most, often without realizing it. It is often asserted that Eskimos have fifty terms to describe snow. On close examination, this is an urban legendEskimos have only a handful of such terms (Pullum 1991). On the other hand, however, Arctic explorers have hundreds, scientifically laid out in their expedition manuals (Pyne 1986). |
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A consistent finding of the history of science is that there is no such thing as a natural or universal classification system (see for example Lakoff 1987, Latour 1987). Classifications that appear natural, eloquent, and homogeneous within a given human context appear forced and heterogeneous outside of that context. Borgès gives a wonderful invented list created by the Chinese emperor: "animals are divided into: (a) belonging to the emperor, (b) embalmed, (c) tame, (d) sucking pigs, (e) sirens, (f) fabulous, (g) stray dogs, (h) included in the present classification, (i) frenzied, (j) innumerable, (k) drawn with a very fine camelhair brush, (l) et cetera, (m) having just broken the water pitcher, (n) that from a long way off look like flies" (cited in Foucault 1970, 15). |
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In a similar trope, Bertillon (1895, 263) pointed out the incongruity of Farr's "natural" (for the 1850s) grouping of gout, anemia, cancer, and senile gangrene as a single kind of disease. In like fashion, our own lists can appear strange to outsiders. Thus supporters of the rival schools in modern biological classifications--cladistics and numerical taxonomy--each make rapprochement between species or splits between them that jar common sense perceptions. The ICD as an information infrastructure is an invisible underpinning to medical practice. On close examination it constitutes a classification as strange in its way as Borgès'. But as with many strange things, it has become well adapted to modern bureaucracy. We can tell the story of this adaptation as the integral, costructuring rise of both the modern state and the new information technologies. |
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As for the ICD, we saw that one could foreground state interests and see the developing ICD as reflecting and partially determined by these |
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