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Semiotics of Medical Imaging: Inside Out, Outside Looking In

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Semiotics of Medical Imaging: Inside Out, Outside Looking In University of Alberta Semiotics of Medical Imaging: Inside Out, Outside Looking In by Yun-Csang GHIMN /gS A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Sociology Communications and Technology Edmonton, Alberta Fall 2008 Library and Bibliotheque et 1*1 Archives Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A0N4 Ottawa ON K1A0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-46323-9 Our file Notre reference ISBN: 978-0-494-46323-9 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library permettant a la Bibliotheque et Archives and Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par Plntemet, prefer, telecommunication or on the Internet, distribuer et vendre des theses partout dans loan, distribute and sell theses le monde, a des fins commerciales ou autres, worldwide, for commercial or non­ sur support microforme, papier, electronique commercial purposes, in microform, et/ou autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in et des droits moraux qui protege cette these. this thesis. Neither the thesis Ni la these ni des extraits substantiels de nor substantial extracts from it celle-ci ne doivent etre imprimes ou autrement may be printed or otherwise reproduits sans son autorisation. reproduced without the author's permission. In compliance with the Canadian Conformement a la loi canadienne Privacy Act some supporting sur la protection de la vie privee, forms may have been removed quelques formulaires secondaires from this thesis. ont ete enleves de cette these. While these forms may be included Bien que ces formulaires in the document page count, aient inclus dans la pagination, their removal does not represent il n'y aura aucun contenu manquant. any loss of content from the thesis. Canada Thank you— Eun Jin, my ABD wife (4%«fl-S-); Noel, our sweetest daughter. Rob, from Carleton to Edmonton; Marco, another supervisor; Committee members and other mentors too. Librarians in Ottawa and Montreal; Archivists et al. for permission to reuse images. Friends like cc; Family back home (#*r tM 4) and Cyril's; And here's to Eun Jin's health again. Abstract When illness happens, diagnostic technology delivers pathological signs from the patient towards his or her physician who mostly sees things. An interpretation of such data turns ambiguity into synthetic certainty. With this plan based on Gilles Deleuze et al.'s stoicism, I ask: "what are the few consistencies in representing humans?" This dissertation contributes to a history of medical knowledge; for such exploration, semiotics is my chosen method. Science studies has referred to Algirdas Julien Greimas' notion of actor/actant i.e. social agency; Charles Sanders Peirce seems more faithful to sem(e)iotics' ancient symptomatological legacy. Flat diagrams in Peircian vocabulary, consisting of spots and lines, frequently demonstrate the component homology since mediaeval autopsy sketches were copied manually. For example, positron emission tomography measures where and how many isotopes have been concentrated, fulfilling some conditions for resemblance to a decreasing extent. Indices or spectra from a person have been, according to Roland Barthes, applied upon mechanically reproduced images. I conclude by questioning whether visualization helps sharing pain more than language. While the psychology of Peirce merged into behaviorism, that of William James—"an exciting object elicits certain bodily alterations, then our feeling of them is the emotion"—still teaches: if one can distinguish passion from the whole affect, no warning function of suffering disappears under analgesia. There is, at the interpersonal level, a mystery of sympathy—or comfort from the Aristotelian tradition of ethics and rhetoric. Table of Contents 1. Introduction 1 2. Theoretical background 10 2. 1. Continental reading of Stoicism 10 2. 1. l.GillesDeleuze 11 2. 1. 1. 1. Stoic ontology 13 2. 1. 1.2. Stoic semantics 18 2. 1.2. Bruno Latour, Regis Debray and Friedrich A. Kittler 21 2. 1.2. 1. Neither actor-network theory nor science studies 23 2. 1.2. 2. Mediology? 24 2. 1. 2. 3. Graph vs. gram 25 2. 2. Visual and linguistic communication (1)—in the history of medicine 28 2. 2. 1. How the Hippocratic writer(s) dealt with the Other 29 2. 2. 2. John Locke's longing for communication: impossible? 39 2. 2. 3. Charles Sanders Peirce's "qualisign" to be embodied? 42 2. 2. 4. Louis Hjelmslev's "content-purport" to be "formed"? 46 2. 2. 5, Roland Barthes' medical language as the "universal interpreter"? 49 2. 2. 6. Julia Kristeva's "semiotic (chora)" to be "symbolized"? 51 2. 2. 7. Paris school's semiotique of passions 54 3. Synthetic framework 57 3.1. Triad in medical imaging 57 3. 1. 1. First step: illness—an error within bodies 58 3. 1.2. Second: becoming-sign 59 3. 1.3. Third: dia- or prognosis 60 3. 1.4. Between secondness and thirdness: virtualization 61 3. 2. Retroactive discussions 64 3.2. 1. Are old technologies forced to obsolescence by new ones? 64 3. 2. 2. Did the sign replace its symptoms? 66 3.2.3. How have people compared five kinds of sensation? 68 3. 2. 4. In all these respects, what can be learned from classical medicine? 70 4. Methodology 72 4. 1. Hypothetically qualitative 72 4. 2. Semiotic examples 78 4. 2. 1. Peircian diagrammatic legisign: pseudo-anatomy 83 4, 2. 2. Zoological and botanical metaphors: car(di)nal autopsy 86 4. 2. 3. Iconic and indexical sinsigns: camera lucida 89 5. Je ne croy que ce queje voy 93 5. 1. A failure of 19th-century photography in medical practices 96 5. 1. 1. If looks could kill 98 5. 1.2. Ultra-violet: in the flesh, under the skin? 103 5. 1. 3. U gonna die anyway 108 5.2. On-the-surface conventions from camera obscura to ultrasound 116 5.2. 1. Manually tinted photography 116 5. 2. 2. Camera obscura-influenced engraving 117 5. 2. 3. Tissue characterization vs. colour processing 121 6. Initially indices: x-rays 124 6. 1. Rontgenstrahlen 124 6. 2. The year of x-ra(y)/ted mysticism 127 6. 2. 1. No-brainer 131 6. 2. 2. Never-minder 132 6. 2. 2. 1. Spiritist photography and thoughtography 135 6. 2. 2. 2. Media archaeology 140 1 ... then plural iconicity 146 7. 1. Computer-assisted tomography 147 7. 1. 1. La semiotique des samourais 147 7. 1.2. CAT jumped in, cross-sectionally 149 7. 2. Nuclear magnetic resonance imaging 153 7. 2. 1. Iconology revisited (1) 153 7. 2. 2. Two abbreviations 155 7. 3. Positron emission tomography 160 7. 3. 1. PET, another species 160 7. 3. 2. Iconology revisited (2) 165 7. 3. 2. 1. Social studies of scien...tists? 166 7. 3.2. 2. It takes Dutch 169 7. 3. 2. 3. Which semiotics of medicine? 171 7. 3. 2. 4. It takes Dutch, and others 177 8. Virtual medicine 183 8. 1. Centrifugal diagnosis 183 8. 1. 1. Mediated auscultation 184 8. 1.2. Variola pictures revisited 187 8. 1. 3. Teleoroentgenography vs. tele-radiography? 190 8. 2. Centripetal diagnosis 192 8. 2. 1. La methode graphique: phonocardiography 192 8.2.1.1. First of its triad: beat 194 8. 2. 1. 2. Second: transduction 195 8. 2. 1. 3. Third: interpretation 197 8. 2. 1. 4. Between secondness and thirdness: wire-connected service 199 8. 2. 2. Desirable telemedicine 201 9. "That the mental faculties follow the bodily constitution" 206 9. 1. From classical philosophy to empirical semiotic of pain-emotion 209 9. 2. "We don't tremble because we are fearful; vjefeel afraid because we tremble" 213 9. 3. Visual and linguistic communication (2)—in diagnostics vs. of pain 220 9. 4. Epilogue 223 Bibliography 227 Tables 2. 1. 1. 1-l.Logicof The Logic of Sense 17 2. 1. 1.2-1. Senses vis-a-vis linguistic cognition 19 2. 2. 3-1. Trichotomies of sign 43 3. 1.4-1. Bergsonist metaphysics 63 4. 2-1. Pathological signs in the Middle Ages 80 4. 2.3-1. Peircian trichotomies of sign 92 5.2.2-1. Folios antedating viscera/tissue pathology 120 7-1. High-cost noninvasive nuclear medicine 146 9. 2-1. James-Lange [1885] theory of emotion 214 9.2-2. James-Lange scheme of pain 218 Figures 1-1. Sources of each sense from matter (acorja) 5 2. 1. 1. 1-1. Epicurus' conception of release 14 2. 1. 1. 1-2. Lucretius' dichotomy of sensation 16 2. 2. 2-1. Double signification in Locke's semiotics 40 2. 2.4-1. Bifacial and triplex diagram of sign function 47 2. 2. 5-1. Model drawn after Hjelmslev's of proto- and post-clinic diagnoses 50 3. 1.4-1. Three-plus-one schema 62 3. 2. 2-1. Double signification of symptoms 67 3. 2. 3-1. Reproduction of figures in 2. 1. 1. 1 69 3.2.4-1. Schema and four heuristics 71 4. 1-1. Schema of contents 74 4. 2. 1-1. Persian six-picture series 85 4. 2.2-1. Vincian metaphorical post-mortem 88 5-1. A gunshot casualty 94 5.1.2-1. Set-up of UV imaging 104 5.1. 2-2.
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