Syphilis, skin, and subjectivity : historical clinical photographs in the Saint Surgical Pathology Collection

Date
2017-03
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: This study concerns an archive of disused historical clinical photographs within the Saint Surgical Pathology Collection (SSC) that originally served as teaching aids for the benefit of student doctors at the University of Cape Town's (UCT) medical school. Focusing on images of patients diagnosed with syphilis produced between 1920 and 1961, this study represents the first critical visual enquiry of these images and, as such, has directly contributed to their current life within a (publically accessible) learning collection at UCT's Pathology Learning Centre (PLC). Set against a backdrop of psycho-social notions of health and disease, this study engages the visual coding of syphilis in relation to Cape Town's medical history, and the developing conventions of photography within this scientific field. Through close readings of selected images, a critical focus on extra-clinical details, inconsistencies, and emotive qualities within the photographic frame allows a consideration of how these photographs take part in a continuous meaning-making process that troubles any easy, fixed, or disinterested reading. By focusing on concepts of sublimation and projection, I unpack the photographic depiction of ruptured skin in the SSC as an attempt to render the syphilitic patient-body a passive object of medical knowledge. To achieve this the work of Hal Foster, Erin O'Connor, and Jill Bennett form the theoretical foundation to address the affective potential of imaging disease necessarily limited in efforts to secure the diagnostic function of this clinical material. However, while these photographs emerge in this discussion as decisively structured and composed, I likewise address how the 'Syphilis' images offer a way of seeing beyond their institutional use. While acknowledging the disciplinary motivations of the Foucauldian medical gaze, my argument ultimately privileges the subjects of these images while critically considering how the conspicuous nature of this disease may have seen it pose a particular threat to a notion of stable subjecthood. This was especially the case in the context of 20th century South Africa where those most vulnerable to the disease were in many respects second-class citizens. Ultimately, this investigation seeks to (re)address the SSC in an attempt to unpack how these photographs may speak beyond their historical medical purpose. By examining how photographic representations of patients provide a means of seeing beyond their institutional intent, I suggest ways in which these images offer up points of fracture that offset and even resist a medical gaze and instead provide an opportunity for the human subject to be retrieved from the objectifying tendencies of medicine.
AFRIKAANSE OPSOMMING: Hierdie studie vervat 'n argief van historiese kliniese foto's wat deel vorm van die Saint Surgical Pathology Collection (SSC) en oorspronklik gedien het as onderrighulpmiddels ten bate van die student-dokters aan die Universiteit van Kaapstad (UK) se mediese skool. Hierdie studie van foto’s van pasiënte wat met sifilis gediagnoseer is en wat tussen 1920 en 1961 geneem is, is die eerste kritiese visuele ondersoek van hierdie beelde en sodanig dra dit direk by tot hul huidige bestaan binne 'n (openbaar toeganklike) opvoedkundige versameling by die UK se Pathology Learning Centre (PLC). Teen ‘n agtergrond van psigososiale begrippe van gesondheid en siekte, betrek die studie visuele kodering van sifilis in verhouding tot die mediese geskiedenis van Kaapstad en die ontwikkeling van konvensies van fotografie in hierdie wetenskaplike veld. Deur noue evaluering van geselekteerde beelde, 'n kritiese fokus op buite-kliniese besonderhede, teenstrydighede, en emosionele kwaliteite binne die fotografiese raam, kan oorweeg word hoe hierdie foto’s deel uitmaak van 'n proses van deurlopende-betekenis wat enige maklike, vaste, of belangelose interpretasie kwel. Deur te fokus op konsepte van sublimasie en projeksie, ontleed ek die fotografiese uitbeelding van geskeurde vel in die SSC in 'n poging om die liggaam van die sifilispasiënt as 'n passiewe voorwerp van mediese kennis daar te stel. Om dit te bereik, vorm die werk van Hal Foster, Erin O'Connor en Jill Bennett die teoretiese grondslag om die affektiewe potensiaal van die uitbeelding van siekte, wat noodwendig beperk word deur pogings om die diagnostiese funksie van hierdie kliniese materiaal te verseker, aan te spreek. Alhoewel hierdie foto’s in hierdie bespreking as beslissend gestruktureer en saamgestel na vore kom, spreek ek ook aan hoe die 'Sifilis'-beelde 'n manier bied om hulle buite hul institusionele gebruik te betrag. Met inagneming van die dissiplinêre motivering agter Foucault se medical gaze, bevoordeel my argument oplaas die menslike onderwerpe van hierdie fotografiese beelde, terwyl dit die opvallende aard van hierdie siekte se besonderse bedreiging tot die denkbeeld van 'n stabiele subjektiwiteit krities oorweeg. Dit was veral die geval in die konteks van 20ste eeu Suid-Afrika waar die kwesbaarste vir dié siekte in vele opsigte as tweedeklas burgers beskou was. Ten laaste word die SSC in hierdie ondersoek aangespreek in ‘n poging om die foto’s buite hul historiese mediese doeleindes te laat getuig. Deur verdere ondersoek in te stel namate fotografiese uitbeeldings van pasiënte ‘n manier kan voorsien om buite hul institusionele doel gesien te word, stel ek wyse voor waarop hierdie beelde fraktuurpunte bied wat die medical gaze kontrasteer en selfs teenstaan. In hierdie studie bied die beelde eerder ‘n geleenthheid om die menslike onderwerp vanuit die objektiverende neigings van geneeskunde te verwyder en hierdeur hul menslikheid te herstel.
Description
Thesis MA(VA)--Stellenbosch University, 2017.
Keywords
History of medicine, Syphilis in Cape Town, Saint Surgical Pathology Collection, Clinical photography, UCT's Pathology Learning Centre (PLC), UCTD
Citation