The Conceptions of René Leriche

Abstract

The invalidity of the sick man’s judgment concerning the reality of his own illness is an important theme in a recent theory of disease. This is Leriche’s theory, which, though at times rather wavering, is nuanced, concrete, and profound. It seems necessary to present and examine it after the preceding theory, which it extends in one direction and from which it clearly deviates in others. “Health”, says Leriche, “is life lived in the silence of the organs” [73, 6.16–1]. Conversely, “disease is what irritates men in the normal course of their lives and work, and above all, what makes them suffer” [73, 6.22–3]. The state of health is a state of unawareness where the subject and his body are one. Conversely, the awareness of the body consists in a feeling of limits, threats, obstacles to health. Taking these formulae in their full sense, they mean that the actual notion of the normal depends on the possibility of violating the norm. Here at last are definitions which are not empty words, where the relativity of the contrasting terms is correct. For all that the primitive term is not positive; for all that the negative term does not represent nothingness. Health is positive, but not primitive, disease is negative, but in the form of opposition (irritation), not deprivation.