The Limits of Medical Discourse: Photography, Facial Disfiguration, and Reconstructive Surgery in England, 1916-1925

This thesis explores two albums of photographs of facial plastic surgery cases from the First World War. Drawing on the assumption that a photograph’s meaning comes from its use and the context in which we view it, and emerging from the archive experience and the affect that this encounter has on me as a viewer, I examine how the photographs elicit readings, affect my historical consciousness, and shape their content for me as a viewer. The study begins with a definition of Foucault’s concept of medical discourse as a means of putting the photographs into their historical context. The use of photographs to illustrate and support surgical progress played a key part in shaping medical thinking and the dissemination of information on facial surgery. The previously separate discourses of dentistry and surgery began to integrate and ‘speak’ together; photographs facilitated exchanges between dentists and surgeons and functioned as conduits through which these professions could bridge their knowledge and skills.

Reading the photographs through medical discourse only takes us so far in understanding what they mean today. During the course of this research I encountered a multiplicity of reinterpretations, including uses of these photographs as part of a re-evaluation of First World War history and some instances of being integrated into family history. These photographs raise difficult questions about their function within, and potentially, across historical discourses. These surgical images problematise Foucault’s claims to using coded ways of seeing to access the photograph’s past. The surgical photographs emerged from and in turn decisively shaped one specific medical discourse. The surgical images are historical photographs, meaningful within the kinds of discursive frameworks Foucault proposed. And yet these surgical photographs in particular can affect me —and not only me — in a way that seems to cut across time and cultural convention, that generates a spark of recognition, a connection—however brief — that cannot be discursively contained. I suggest that this kind of connection lies outside what Foucault calls history. The surgical photographs complicate, or even undermine, my own understanding of history. From one point of view they are important historical documents, but from another they function in a completely different way.

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