What is disability theory? Often it is what o/Other theory lacks. It improves the scholarly apparatuses that before a certain time prevented even the sharpest social critics from recognizing the benefits of analyzing disability as a profound vector in human organization. The most sophisticated and well-cited disability theory shows us how canonic theories about the body and mind traffic in assumptions about the value of able-bodiedness that narrow the analytic possibilities in considering non-normative forms. Tobin Siebers's unearthing of a rigidly able-bodied figure underneath Foucault's "docile bodies" 1 or Rosemarie Garland-Thomson's formulation of the overlooked contiguity of disability and feminist scholarship 2 or Douglas Baynton's discovery of the many refusals of disability at the heart of American justifications of inequality 3 are just a few examples of the way disability studies points out the hollows in others' studies of difference. Once you apprehend these gaps, like the chink in the armor you thought was mint, it is hard to imagine good theory without disability.

Torqueing or refining previous legacies might just be the business we are in as critical disability scholars. But what is disability theory when it doesn't make itself in the gaps of existing literatures? If it is true, as many texts in the field have illustrated, that disability is part of a universalizing model of difference, not itself a "minority" category as if it neatly cleaves off from centrifugal tendencies toward "normalcy," then where do we go for strong theories of disability? Where can we find the kind of theory that explains the centrality of disability to social and cultural order-making, not just in broad strokes but in terms that help explain the word-universes that swirl around disability and in turn diffuse into many arenas of social and cultural life?

In this article I suggest one place to look. When French philosopher Georges Canguilhem submitted his dissertation to the Faculty of Medicine at the University of Strasbourg in 1943, there was no such thing as "disability studies." When he added a second section to the original text so it could be published in book form twenty years later, there was still no "disability studies." The text in fact only mentions the word "disability" a handful of times. The Normal and the Pathological is, however, a work with deep, kindred intellectual ties with our contemporary research field.

Here I consider what we might gain from reading this text as foundational. I want to understand how the field has already taken up the text. But further, I argue for The Normal and the Pathological as a keystone of disability theory, but currently taken up with curiously reserved energy. I start with a précis on the text before offering a condensed citation analysis of the book. In the latter part of the paper, I suggest how the monograph might inform current conversations, concluding with some speculations on method we might glean from what Canguilhem calls the "propulsive atavism" of his form of historical epistemology.

The Normal and the Pathological

Georges Canguilhem lived almost the entire span of the twentieth century, from 1904 to 1996. During his life he enjoyed a certain amount of affection from a generation of French intellectuals who he mentored into their prominence in the 1960s, including Michel Foucault, Jacques Derrida, Louis Althusser, and Jacques Lacan. Though he remains relatively less well-known among Anglophone audiences, he exerted considerable influence on midcentury French philosophical traditions, in no small part because of the work he initiated during his doctoral research in medicine that later became The Normal and the Pathological.

Canguilhem is most readily recognized as a historian of the life sciences, though this topical categorization glosses over the methodological innovations he developed throughout his life's work. Like his contemporary Gaston Bachelard with whom he is often linked, Canguilhem insisted that the proper domain of philosophy is the theory of knowledge, an approach that illustrates the contingency of the the relations among subjects and objects across historical periods. To understand what he calls the "knowledge of life" in his characteristic form of "historical epistemology," Canguilhem examined a series of key oppositions (between continuity and discontinuity, vitalism and mechanism, equilibrium and disequilibrium). He started with an analysis of the normal and the pathological.

In his own words on the project of his dissertation:

[W]e looked into the historical origins and analyzed the logical implications of the principle of pathology, so often still invoked, according to which the morbid state in the living being is only a simple quantitative variation of the physiological phenomena which define the normal state of the corresponding function. 4

Canguilhem's unique philosophical work involved excavating key terms of art in medicine, thus the technical vocabulary he uses is often the vocabulary he attempts to refine and reconfigure. He takes "pathology" to mean the study of disease and "physiology" to mean the study of the normal state of health. In particular with "pathology," he means "somatic nosology or pathological physiology" and not, for need to limit the scope of an otherwise enormous topic, "teratology or pathological psychology." 5 In other words, the text deals mainly with disease as it relates to the body and not to the mind.

The "principle of pathology" that became his focal object of study emerged in the 19^th century, when, in Canguilhem's estimation, medicine needed a way to reassure itself about the efficacy of human technique by "delegat[ing] the task of restoring the diseased organism to the desired norm" to technical means. 6 This new kind of optimism replaced an earlier one, what he calls the "dynamic model," that viewed disease in relation to the whole person through a qualitative commixing of the body's humors. The disturbance of a holist harmony in this earlier model is what was understood to cause disease, and was "an effort on the part of nature of effect a new equilibrium in man." 7 The departure from the dynamic model of disease, we must note, was an attendant feature of a large shift in medical thought from vitalist 8 conceptions of the body that compartmentalized health into totalities of good and evil. What Canguilhem calls the new "ontological theory" of disease is the object of his study.

Canguilhem is not chiefly interested in this shift, or the exact mechanism of optimism in medical therapies, or even the longer intellectual legacy of these competing notions of disease. He is more concerned with how the "ontological" notion came to be and how its effects ramify from medicine into other domains of knowledge. He is interested in the implications of a logical condition that, in its simplest version, says: "[P]athological phenomena are identical to corresponding normal phenomena save for quantitative variations." 9 The normal and the pathological, in other words, differ in degree but not in kind.

Anyone who has confessed to not feeling "100% well" will recognize the concept Canguilhem seeks to unearth: a process by which quantitative variation between ultimately homogenous states of health and disease outpaced qualitative and holistic notions of well-being irreducible to positive technical determination.

To explain this "scientifically guaranteed dogma" 10 that pathology is imagined as exactly the same as physiology (i.e., science of the "normal") save for a quantitative variation, Canguilhem looks at three key figures. Auguste Comte and Claude Bernard were instrumental in expounding the dogma, so Canguilhem traces their intellectual influence, in a sense diagnosing their use and eventual remediation of the thesis. Their status as "standardbearers" for the principle Canguilhem is interested in extends beyond the medical domain and thus they become pivot points for a philosophical structure that was also important in social and political arenas. He counterbalances these two figures with René Leriche, a lesser-known writer but one whose work turns out to be a perfect foil and whose significance Canguilhem tries to unearth. Leriche stands in as a judicious defender of the dynamic model of medicine that Canguilhem wants to reclaim. After this introduction of these key actors, he conducts a careful survey of the quantitative relationship between the normal and the pathological for the field of medicine as a "science," using certain concepts — "anomaly" and "average" chief among them — to trace a longer history of the thinking around the central thesis. Then, in an addition to the book that was written between 1963 and 1966, Canguilhem adds a thorough consideration of the relationship between rules of the norm governing organisms and rules of the norm governing societies. This latter section is heavily influenced by the prevailing cybernetic turn of the time and introduces a crucial concept of "error," discussed further below.

In reading Auguste Comte, Canguilhem shows how he expanded on a principle offered by François-Joseph-Victor Broussais, that "diseases are merely the effects of simple changes in intensity in the action of the stimulants which are indispensable for maintaining health." 11 Comte elevates this principle to give it "universal significance in the order of biological, psychological, and sociological phenomena." 12 If a link between a designated condition and a corresponding variation from this condition were found, instances of disease could be understood as "spontaneous experiments which allow a comparison to be made between an organism's various abnormal states and its normal state." 13 In this reasoning we see a larger project of positivism at work, since the simple quantitative mirroring between the normal and the pathological opens up the possibility for testing positive comparisons in new arenas. Canguilhem notes that while this kind of logic helped established faith in determinist postulates, it stemmed from a craving for a rational science of the body that prematurely jettisoned earlier — and not yet exhausted — conceptions of the body. Canguilhem ultimately critiques Comte for having confused marking with measuring: "Augmentation and diminution are concepts which connote quantity, but alteration [between states of health] is a concept of qualitative force." 14 The veneer of quantitative attribution masks an affirmation of a qualitative system at work that Canguilhem claims was lost with the "dynamic" model of the body-system.

Throughout his reading of Comte, Canguilhem hints at a critique that develops more fully in his analysis of Claude Bernard's writing. When he writes, "an ideal of perfection soars over this attempt at a positive definition [of the normal state]," 15 he suggests that physicians are unduly focused on restoring a patient to a supposedly achievable "normal" state. In his section on Bernard, Canguilhem shows how this ideal minimizes the true sense of disease, which is an entirely new lived phenomenon. As with Comte, Canguilhem finds, Bernard employs "a deceptive mingling of quantitative and qualitative concepts in the given definition of pathological phenomena." 16 In questioning whether disease can be understood as objective through quantitative measures, he is also suggesting that the conscious experience of sickness introduces a criterion that necessarily divorces it from a state of health. Canguilhem finds that sickness cannot be thought in localized terms:

In the final analysis, would it not be appropriate to say that the pathological can be distinguished…as an alteration of the normal state, only at the level of organic totality, and when it concerns man, at the level of conscious individual totality, where disease becomes a kind of evil? 17

The imperceptibility of this "organic totality" to the physician in the clinic connects to an even more elemental argument Canguilhem makes: that physicians only become aware of a patient's illness once the patient himself has called attention to it. Hence the true "totality" of lived, embodied sickness is obscured by medicine's positive project: "Here [the unreliability of felt evidence] is perhaps why until now pathology has retained too little of that character which disease has for the sick man — of being really another way of life." 18

Canguilhem finds in the work of René Lreiche a theory that neither Bernard nor Comte could proffer, one that takes seriously the testimony of a sick person and preserves the dynamism (i.e., holistic complexity) of the body. In his definition of health as "life lived in the silence of the organs," 19 Leriche establishes that the sick man's lived experience — and not his physician's attempt at objective examination — forms the basis of truth. Pain, as the felt expression of a divergence from a normal state, exists in relation to a person's whole self: "[P]ain-disease[…]is a fact at the level of the entire conscious individual, it is a fact which Leriche's fine analyses, relating the participation and collaboration of the whole individual to his pain, allow us to call 'behavior.'" 20 This leads us to what Canguilhem glosses as Leriche's most important insight about disease, that it is our bellwether for understanding the normal without reducing disease to a quantitative mirror of it. "This is indeed one of the most profound insights on the problem of the pathological," Canguilhem writes, quoting Leriche, "'At every moment there lie within us many more physiological possibilities than physiology would tell us about. But it takes disease to reveal them to us.'" 21 If we take this to be true, then disease is not a subordinate state that helps us better understand the normal through a series of convenient natural experiments. "Diseases," he says, "are new ways of life." 22

Although this primer is brief, it starts to hint at the alternative medical consciousness Canguilhem has in mind. In the next section I offer a partial citation analysis to understand how the text has already been taken up by disability studies. After that, I offer a tour of some of the insight from the latter part of his classic text (since the preceding introduction only discussed his dissertation, the first half of the book later published) and I pair this insight with disability studies scholarship as it might be taken up in the field.

The Norm-Referenced and the Pathological

It is not fair to say that disability studies has ignored Canguilhem. According to Google Scholar, 23 the text has been cited 1,591 times. Of those, 457 mention "disability" and 154 mention "disability studies." 24 We cannot assume these are the only places where Canguilhem has been taken up, but this pool gives us a good vantage point to apprehend how the field has already reckoned with Canguilhem's work. As my survey of these citations finds, there is surprisingly little variation in the way disability studies has employed The Normal and the Pathological.

It becomes clear when you sift through these 154 texts that cite both Canguilhem and disability studies that The Normal and the Pathological is referenced in many central texts of the field. We can take one example that is emblematic of the way Canguilhem is employed in many well-cited disability studies works.

In a chapter called "Theorizing Disability" from Rosemarie Garland-Thomson's Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature, she discusses Aristotle's conflation of disability and femaleness in defining a "generic type" of able-bodied maleness against which all deviance gets defined.

[W]ithout the monstrous body to demarcate the borders of the generic, without the female body to distinguish the shape of the male, and without the pathological to give form to the normal, the taxonomies of bodily value that underlie political, social, and economic arrangements would collapse. 25

This in-text reference to Canguilhem is followed by an endnote, whose treatment of Canguilhem is representative of many other texts from the field: "For a seminal discussion of the normal-pathological dichotomy, see Georges Canguilhem, The Normal and the Pathological, trans. Carolyn R. Fawcett with Robert S. Cohen (New York: Zone Books, 1989)." 26

There are good reasons why many authors quickly cite Canguilhem like this. The "the normal-pathological dichotomy" affects, as Canguilhem shows, not just medical knowledge but social and political organization. To render Canguilhem's sinuous epistemological excavations would take up a great deal of page space. And anyway, his writing is not easy to read. As Paul Rabinow says of Canguilhem's style, it has "the density of kryptonite." 27 The Normal and the Pathological is by no means a form of accessible scholarship disability studies has modeled. Here I simply want to characterize the way that Canguilhem has already been taken up. And we can do so fairly easily: Canguilhem is cited, but only rarely given serious consideration as a seminal text in disability studies (unlike, for example, the work of Michael Foucault 28).

In Simi Linton's Claiming Disability: Knowledge and Identity from 1998, a passage from Canguilhem is cited that looks at the semantics of diagnostic terms (i.e., hyper- and hypo- are used to designate the pathological more than a- or dys- which confirms its status as a quantitative variation on the norm), but the text does not mention Canguilhem's larger project of sketching the normal-pathological relationship. 29 Lennard Davis cites a similar passage on the relationship between grammar and the birth of the metric system from Canguilhem in his essay "Bodies of Difference: Politics, Disability, and Representation" 30 without mentioning Canguilhem's findings. Many citations reference a quote from Canguilhem with no other discussion of his text's rather complex aims. 31

These partial Canguilhem citations would not much be noteworthy if they did not often reinscribe the oppositional configuration of the normal and the pathological that Canguilhem wanted to unveil only in order to undo. This, more than the partial nature of disability studies' uptake of Canguilhem, is why disability scholars need to pay greater attention to the text. It is not that "the pathological give[s] form to the normal," but that the birth of scientific medicine as Canguilhem traces it attempts to make this truism seem natural when it is not. In fact, Canguilhem says, the two modes of existence should be distinct. We could read Canguilhem's work (as many historians of medicine do) as an example in examining how something like the normal-pathological dichotomy gets constructed, but we should not forget that Canguilhem was not content in simply showing the contingent nature of the "ontological" theory of disease; he wanted to reassemble that theory from its vestigial intellectual roots.

There are notable exceptions to this trend in citing Canguilhem. In Narrative Prosthesis: Disability and the Dependencies of Discourse, David Mitchell and Sharon Snyder sketch Canguilhem's larger historical project, specifically mentioning the insufficiency of quantitative variation of the pathological from the normal. 32 They go further in their article "Re-engaging the Body: Disability Studies and the Resistance to Embodiment" by citing Canguilhem's preference for "anomaly" over "dysfunction" as a way to incorporate environmental adaptation in medical conscience. 33 Lennard Davis, in Bending Over Backwards: Disability, Dismodernism, and Other Difficult Positions, even goes so far as to cite Canguilhem's specific gloss on Comte's positivism. 34 And Bill Hughes, in his article "Medicine and the Aesthetic Invalidation of Disabled People," notes that Canguilhem gives disability studies a "critical seed" for establishing the social model of disability that has been central to the field's staying power. 35 These authors cite not just the normal-pathological dichotomy, but more importantly its historically contingent nature that is the true focus of Canguilhem's analysis.

It is important to mention here that there should be limits on how much critical disability researchers can take up Canguilhem's text. We should remember that in one passage, Canguilhem gives a disinterested analysis of electric shock therapy, concluding that inducing comas results in an entirely new arrangement of the brain. 36 His discussion of these strong effects of shock therapy might not be an endorsement, but the tone alerts us to the fact that Canguilhem's work was not driven by a commitment to emancipation from- and reversal of the oppression that people with disabilities face as a result of culturally inscribed ableism. 37 For as much as I hope to claim him as our own in disability studies, it is obvious in many sections from his text that he nonetheless thinks of "infirmity" as an unfortunate, pitiable state of affairs.

It is also essential that we address another complication. Canguilhem's word of choice is "disease," not "disability," and this distinction is important for contemporary disciplinary boundaries that fix what we mean with each word. Diane Price Herndl's PMLA article on the differences between medical humanities and disability studies is titled, not accidentally, "Disease versus Disability." As Herndl notes, a major source of tension is that "most people in the disability community do not want to be considered ill, and most people who are ill do not want to be considered disabled." 38 The medical humanities tends to focus on disease as it is rooted specifically in the body, while disability studies does not make similar demarcations; displacing disablement into the social realm, in fact, gave rise to the "social model" that in many ways made an umbrella notion of "disability" possible in the first place. 39

However in the following sections, where I suggest various ways that The Normal and the Pathological can animate disability scholarship, I show how Canguilhem's approach to "disease" is helpfully aligned with disability scholars' activist and epistemological goals. Though there are indeed many important ways that disease and disability differ, Canguilhem's theoretical work need not stay only within the borders of studies of disease.

The Norm and the Pathological

We can start with a straightforward but bold claim about Canguilhem, that The Normal and the Pathological predates the social model of disability as it was articulated by activists and scholars in the U.S. and U.K. starting in the 1970s. In one of the only sections where he addresses the notion of disability specifically, Canguilhem writes,

For an invalid there exists in the end the possibility of some activity and an honorable social role. But a human being's forced limitation to a unique and invariable condition is judged pejoratively in terms of the normal human ideal, which is the potential and deliberate adaptation to every condition imaginable. 40

This concept of the externalization or "forced limitation" on the body is extended in a discussion of a patient whose arm was cut by a moving circular saw. The arm was saved but suffered "an atrophy of all the muscles." 41 Canguilhem returns to his insistence on disease's relation to the whole person when he says that the man will be able to operate in the end according to former norms (i.e., he will be able to take up his job again) even though he might not experience them as precisely as before the accident. This focus on what he later calls "levels of life" 42 shows an attention to the way that any organism must continually make negotiations between its hereditary script of life and its environment. 43 Canguilhem goes all the way to reckoning with theories of evolution and "Life" to understand how the environment shapes an organism, a tack that predates what we now call the "social model." When he writes near the end of his text that "it takes a great deal of clarity coupled with great courage not to prefer an idea of disease where some feeling of individual culpability can still find a place in an explanation of disease," 44 he describes precisely the weighty task early disability studies scholars were facing.

Canguilhem finds philosophical footing for a number of things that disability studies holds dear: patient activism, the suspect heft of physicians on individuals' social lives, and a consideration of environmental factors on the value attached to certain "deviant" bodies. We can see how this footing rests on the critique of the normal-pathological quantitative relationship, but Canguilhem takes it further for us. His section devoted to unpacking the difference between a "norm" and an "average" should be required reading for those interested in the rise of social statistics and the birth of human taxonomies that began to label and therefore privilege able bodies. He wants to know whether the norm, as a culturally-inscribed value system, is derived simply from the average, a quantitative measure. In a reading of Adolphe Quetelet, a progenitor of probabilistic statistics, he finds that this indeed happened by assigning, in Quetelet's words, an "ontological regularity" to the arithmetic average. In other words, the average does not immediately or ineluctably give rise to the norm, but as Quetelet and his ilk assigned meaning to this expression, the norm gave rise to a higher expression of regularity that then informs the norm. In Canguilhem's characteristically acute style of critique, he exposes a logical flaw in this reasoning while introducing a term that disability studies today might usefully crib: "A human trait would not be normal because frequent but frequent because normal, that is, normative in one given kind of life." 45 That it is only one "kind of life" where a trait is considered normative opens the door on the other worlds disability studies has tried to imagine in academic and activist circles for decades. 46

In the section immediately following his reading of Quetelet and the norm/average relationship, Canguilhem writes about "a new concept in pathology" 47 that we could also call "a new concept in disability studies." This concept — error — began to enter medicine as information theory helped to shape a notion of the body that analogized things like amino acids and macromolecules to codes and messages. This helped account for conditions, such as certain metabolic diseases, that did not manifest since birth but could not be understood as simply environmental. Conceiving of hereditary biochemical disturbances as "errors" of DNA sequencing helped explain previously misunderstood phenomena. And for Canguilhem, error thankfully leaves the crudity of the normal-pathological relationship behind because it promises to reconfigure a sick individual as "the effect of universal mixing, love and chance" in a gradient structure of sickness and health.

Canguilhem also puts ethical heft behind this concept. He writes that in using a notion of error, "Disease is no longer related to individual responsibility; no more imprudence, no more excess to incriminate, not even collective responsibility as in the case of epidemics." 48 He also considers the signification of the term for those it is being used to label: "The term error mobilizes the affectivity less than the terms disease or ill, wrongly nevertheless, if it is true that the error is, at the outset, miscarriage." 49 Error becomes a way to conceptualize the mutability of health without reducing it to essential extremes. And in this way, error might help us reckon with structural problems like ableist stigma where other notions of the body fail. Canguilhem, then, gives us not only the basis for critiquing the cultural manifestations of the meteoric rise of human taxonomies attendant in modern medicine, but also its ontological underpinning.

The Normative and the Pathological

Rosemarie Garland-Thomson first introduced the notion of the "normate" in her book Extraordinary Bodies and it was taken up by many in the field as an oft-cited term. The neologism explains how absolute able-bodiedness is a veritable impossibility. The normate is not a real person, but a "cultural self": "…the figure outlined by the array of deviant others whose marked bodies shore up the normate's boundaries." 50 In being positioned closer or further away from the normate, we come to be represented as more or less human. But essential in this notion is that no single person ever truly occupies the normate position; there is no absolutely healthy, abled-bodied individual, immutably perfect. We all hope to live long enough to become disabled one day. We are all, as is often said in disability studies, temporarily able-bodied.

This insistence on the mutable character of able-bodiedness has been important for establishing disability studies' institutional presence and we can think of it as an extension of Eve Sedgwick's "universalizing notion" of sexual politics that was similarly effective for queer studies. 51 Canguilhem offers a further extension of this reasoning that might give it an even firmer base. What he calls "biological normativity" is his essential gambit in defining the pathological as a truly distinct category from the normal. He says that those with genetic abnormalities nonetheless sustain in their bodies; they have their own norms. Here he draws crucially a Darwinian notion of selection as a constant negotiation between an organism and the environment. He writes,

If biological norms exist it is because life, as not only subject to the environment but also as an institution of its own environment, thereby posits values not only in the environment but also in the organism itself. This is what we call biological normativity. 52

This is a sharp divergence from the medical dogma that established "normal" features of health and well-being that are used to assess many bodies on the same spectrum. Canguilhem, embracing a holistic complexity of each body's relation to its own norms, exposes a logical fallacy in how medicine understands deviation.

With this in mind, we might imagine a more radical idea about normalcy: not that no one is perfectly normal, as the concept of the "normate" suggests, but instead that everyone is normal. "[I]f it represents adaptation to imposed circumstances," Canguilhem writes, "every state of the organism, insofar as it is compatible with life, ends up being basically normal." 53 If we extend this into disability studies as an argument with social and political consequences, we might say that insofar as people live in accordance with norms that they determine, "disability" loses its specificity as a process during which individuals adapt to their environments. We see how important this move is to Canguilhem since he concludes his book with it:

[W]e would like to end these new reflections on the normal and the pathological by sketching a paradoxical pathology of the normal man, by showing that the consciousness of biological normality includes the relation to disease, the recourse to disease as the only touchstone which this consciousness recognizes and thus demands. 54

The provocation to disability studies is to imagine a way to find normalcy in each instance of "disability" that we write about and conversely to divine an orientation to disability in arenas we would otherwise understand as occupying "the normal." We might think less about how disability gets set apart and more about how each experience of disability might register something fundamentally normal.

The Normally-Conceived and the Pathological

We can move to perhaps a more fine-grained line of thinking that we inherit from Canguilhem and it involves his reconfiguration of the subordinated status of technology to science. Canguilhem finds in Leriche's writings an important way of placing technique, or technology, on par, if not ahead, of science in an epistemological pecking order. Canguilhem writes,

[L]et me repeat once more that the intrinsic value of Leriche's theory[…]lies in the fact that it is the theory of a technology, a theory for which technology exists, not as a docile servant carrying out intangible orders, but as advisor and animator, directing attention to concrete problems and orienting research in the direction of obstacles without presuming anything in advance of the theoretical solutions which will arise. 55

This is because, in Canguilhem's gloss, Leriche considers "the judgment of the technician" 56 in ways that Comte and Bernard and others do not. Since it is the patient who first calls attention to the transformation caused by disease, it is the technician who then brings instruments to bear on felt evidence to then finally call up pathological reasoning. This is important because it reverses the logic often used to shore up the medical model of disability: that medicine can read the body objectively and proceed from "science" in a way that abstracts lived experience. Canguilhem and Leriche give us a way to build from the ground up, in a way of recognizing that power does not exist monolithically descending from on high. What Canguilhem calls "iatrocracy" (a word curiously absent from the Oxford English Dictionary but whose meaning we can estimate as "rule by physicians") might be successfully challenged by shifting focus from the authority of medical science to the pragmatic necessity of medical technology.

We could even say that Canguilhem's elevation of the status of technique is an early manifestation of the "descriptive turn" humanistic and critical social scientific inquiry has seen in recent years. Bruno Latour's imploration in Reassembling the Social was for researchers of the social world to describe — only describe — the assemblages that make up the world without assuming they already exist. Disability studies has begun to take up the promise of this kind of description for its capacity to depathologize individuals automatically stigmatized by ableist categorizations. 57 This line of thinking has become particularly attentive to the dangers of a critical mode that can no longer furnish robust empirical accounts of the social world, a parallel to what scientized medicine did when it subordinated the role of technique in establishing the primacy of the normal-pathological relation.

While Latour suggests ethnography as his solution to the problem of "the social," Canguilhem suggests phenomenology instead. In theorizing the technician as a kind of medium between a patient and a physician, Canguilhem foregrounded the very experience of disability beyond what ethnography might achieve through rigorous description. As a launching pad for future disability scholarship, we can ask: How could our methods begin to capture the lived-in-ness of disability as an essential way of bearing witness to the prime ontological status of experience? Might this mean that we must reimagine not just the concepts we use to label this experience, but also perhaps our very structures of language, representation, and communication? If it's true as some say of identity politics, that its contemporary crisis is in the status of personal evidence it initially made room for with revolutionary results, Canguilhem's call for a return to phenomenology might be a viable way to give critique back its steam.

Conclusion: Canguilhem's Propulsive Atavism

Today an objective pathology proceeds from physiology but yesterday physiology proceeded from a pathology which must be called subjective and thereby certainly imprudent, but certainly bold and thereby progressive.

—Canguilhem, The Normal and the Pathological (212)

To conclude, I would like to suggest a phrase that helps concretize the complexity of Canguilhem's work in The Normal and the Pathological while at the same time offering it as a methodological blueprint for disability studies as a method-less field. He writes in the preface to his text that he "deliberately gave [his] conclusions the appearance of propositions which were simply and moderately methodological." 58 And perhaps now we are in an appropriate place to see how this text might be understood as a methodological innovation more than an argumentative monograph.

Canguilhem traced what Michel Foucault calls in his introduction to the book the "formation of concepts" in the history of biology. These concepts, Foucault says, include "reflex, environment, monster and monstrosity, cell, internal secretion, regulation." 59 Though Canguilhem does not articulate this approach to "concepts" so specifically in the text, we see it at work during one key moment. In discussing his own reading of Comte's work, he anticipates a critique that he didn't offer us a simple chronological account of Comte's theses and how they ramified into the academy. But this was intentional because "a historical narrative always reverses the true order of interest and inquiry[…]Thus the historical origin is really less important than the reflective origin." 60 In other of his texts, Canguilhem refers to this as méthode de récurrence (recursive method), which describes a way of dissolving concepts back into their historical emergence as a way to thoroughly engage with the process of crystallization around concepts, since their crystallization is what one must understand to deploy them with accuracy. 61 This is a method we can see taken up by Foucault's "genealogies" of thought, and one that disability studies might productively consider adopting as well.

Throughout Canguilhem's text, he contends with what might be the overarching tension in his critique of medicine's normal-pathological relationship. In arguing for a notion of the pathological untethered from the normal, that is, qualitatively different, he argues for an older view of the human body. It is a vitalist vision he sketches, one that is thought to be obsolete at the time of writing. We see Canguilhem's defense of this move, which reveals to us the anxiety in a seeming backtracking of enlightened, rational thought.

It certainly cannot be denied that a scientific therapeutics is superior to a magical or mystical one[…]But it does not follow from the fact that evil is not a being, that it is a concept devoid of meaning;[…]it does not follow that the pathological state is essentially nothing other than the normal state. 62

In this, we see Canguilhem's attempt to preserve an older conception of disease without succumbing to a critique of degenerative atavism.

I would like to suggest that Canguilhem's method in The Normal and the Pathological can be understood as a "propulsive atavism." It is a way of looking at the formation of concepts that returns us to an earlier rendition that in the end moves us forward instead of backward. We take "propulsive" from Canguilhem's own formulation of one kind of "original mode of life." The propulsive mode is a flexible configuration of the "constants" necessary for life, but constants "whose stability will not keep them from being eventually transcended again." 63 This metastability captures much of what Canguilhem is getting at with a capacious and lithe notion of the "normal" that must include disease.

Disability studies, too, can imagine a methodology that traces the formation of concepts and finds a home in earlier conceptions of the body that, in the end, advances our scholarship by lingering again on notions trampled over by cultural obsessions with things like exoskeletons, 3D printed prosthetics, hacked technologies for children with autism — all scripts that lionize a certain linear narrative of progress into the "future." But backwards is not a wrong way to look and doing so might allow us to speak back to the medical knowledges that have created and maintained the stigmatization and oppression of people with disabilities. To these knowledges, we can say: it is not regressive to revisit abandoned concepts in favor of "progress." It is, indeed, necessary, propulsive.

In a curious and concise epilogue, Canguilhem's final call is to his students. He calls for them to continue to document how medicine and society interact through shared concepts, to show medicine not as a single science but as a leaky tank of knowledge claims. If Canguilhem purposefully gave his conclusions a tentative air, it's because his very form of historical epistemology compels him to think of their necessary reconfiguring that comes with successive eras of knowledge formation. Canguilhem leaves himself at the doorstep of the house that disability studies is building. The Normal and the Pathological is a handy tool for the work still to do.