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although I certainly do claim there is such a change. Rather, my conception of the ‘norm’ is much more specific, and hence so too are my claims. This serves as the fundamental point of difference between my thesis and a superficially similar survey of the sociology of morals under capitalism such as that by Luc Boltanski and Eve Chiapello.2 This does not mean that what I say is meant to contradict such accounts. Rather, I would hope mine ultimately dovetails productively with others.3

      What I mean by a norm is, in short, a model for the perfect operation of the thing to which it pertains.4 I believe that this definition of the norm is the one with which Foucault and Canguilhem work, and which can be found in historical discourses about norms from the seventeenth century on. Other scholars disagree that this is Foucault’s understanding of the norm, but this ultimately does not matter for the purposes of this book. Regardless of its provenance, this is what I mean in this book when I refer to the norm and derived terms.

      Modern medicine is based on a notion of medical normality, which is to say on defining health as accordance with a predefined norm. Canguilhem’s key question is that of the origin of this norm. Modern medicine clearly considers itself to be a scientific enterprise, based on empirical study and objective criteria. Its basic norms do not really measure up to this self-image, however.

      In fact, the word ‘normal’ only came to be associated with averages when statisticians in the late nineteenth century applied this word – which was by that time already in use in other technical fields, and in medicine in particular – to an extant statistical idea that they had called by other names previously, dubbing this now the ‘normal distribution’.6 However, I will argue that this invention of a statistical notion of the normal thenceforth serves to give a patina of objectivity to the concept of normality in general.

      Canguilhem concludes that the medical notion of normality, although presented as an objective and scientific judgement, is in fact normative, which is to say, a judgement of what things should be like. Such normative judgements cannot be empirical inferences from scientific study – as Ian Hacking points out, statistical judgements of normality cannot have any normative implications7 – but rather must be a priori principles. These principles are, in a word, norms, imaginary standards of perfection to which reality is held.

      Although it might seem like a great scandal that medicine is based on prejudices, Canguilhem does not reject these norms. He is instead quite clear that modern medicine needs the yardstick of normality to operate. Discarding it would cost untold lives. He instead suggests reforming the standard of normality by abandoning the pretence that it is objective and acknowledging its subjectivity by making patients themselves the final arbiters of whether they actually are sick.

      The concept of normality implies an underlying concept of the norm, the norm being the measure of what counts as normal. This is somewhat obscured in English by the fact that the word ‘normal’ is much more prominent than ‘norm’, perhaps because it came into our language first, only to be followed by the word ‘norm’ later.8 It is the latter word that is older, however, in the tongues in which these terms originated, namely the Romance languages.

      ‘Norm’ comes from an old Latin word for a carpenter’s rule, norma. For a long time in European languages, cognates of norma were synonymous with the cognates of a different Latin word with a similar literal meaning, regula (from which we get the English word ‘rule’, in all its senses). At a certain point, the meanings of these two terms diverged sharply. Canguilhem finds that this new sense of the cognates of ‘norm’ first appears in relation to seventeenth-century French ‘normative grammar’.9

      Foucault finds that, in the Middle Ages, there was initially only one systematic method for dealing with contagious disease, namely that used to deal with leprosy: to remove the visibly sick from society in order to prevent the spread of disease.10 This approach did not work with the Black Death pandemic that descended on Europe in the fourteenth century, however, because that new disease was so contagious that people spread it before they could be exiled. So a practice was adopted of continuously monitoring habitations once plague had appeared in a vicinity, looking for signs of infection and isolating any household in which it appeared. Though this was not exactly the twenty-first-century lockdown with contact tracing with which we are now so familiar, it nonetheless represents the same basic approach. This in effect requires norms – that is, specific ideas about exactly what a healthy person should be like in order to detect relatively small variations from these. This is still the basic approach we have taken today with COVID, where a cough or elevated temperature raises an alarm. Hence I do not see in our response to the contemporary pandemic a new normal strictly speaking, so much as an instantiation of an old one, albeit in an age of hand sanitizer and phone apps.

      This pervasive normalization began relatively modestly. French normative grammar was invented

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