1 Currently, there may be a paradox to the clinic, in that when the notion is called into question within its domains of predilection, it ends up being claimed by many other branches of the social sciences. Indeed, in the fields where it was traditionally found, there have been many alarming acknowledgements of the languishing decline, the decline and sometimes the death of the clinic, in somatic medicine but also in psychiatry, psychology and of course in psychoanalysis. [1] All of the healthcare field seem to be undergoing a momentous transformation, which readily consigns interpersonal encounters to the status of an outdated craft. Now that approaches are based on evidence, advances in medical imaging, the triumph of pharmacology and personalized medicine, [2] what remains of the “unique dialogue” that Foucault had already disdained? At the same time, however, we witness a surprising spread of the term in the social sciences, where it has not only been taken up as an object of study in ethics and in medical humanities, [3] but also as a specific mode of investigation and knowledge that is not limited to psychology, affecting education, criminology, sociology, anthropology, and even geography or law. Crisis on the one hand, inflation on the other: today, the notion of the clinic truly seems doubly afflicted.

2 If the clinic arouses the interest and bewilderment of philosophy, it is because it presents a certain number of enigmatic difficulties: for a start, its very relevance, since there are those who question its status as a source of knowledge, firstly by means of Aristotelian rationalism, then, in the modern era, under the influence of the development of the experimental (and statistical) sciences. Next, there is the difficulty of its extension, once it can be claimed by disciplines that are no longer (just) therapeutic, starting with psychology. Finally, there is the difficulty of its modes, as its well-known and persistent hesitations (science or art, theoretical or practical, positive or axiological, neutral or empathetic) are just so many conceptual oscillations between inspired interpretation and justifiable, transmissible knowledge; between ordering and contrast; between the submissive and the unconstrained relationship to theory. Not to mention the particularly protean nature of the very word “clinic,” which as a noun can refer to both a psychoanalytic and an activity clinic and, as the adjective “clinical,” can be applied to a method, an approach, a posture, a position, a framework, an interview, or clinical work. “Clinic” can therefore, in turn, indicate a mode of address, a state of mind, an effect, a baroque way of thinking, an ontology, a phenomenology, an anthropology, an epistemology, and so on.

3 The hypothesis behind this issue is that while there may not be any form of unity underlying these various uses of the term, there is at least some kind of similarity between them, a sort of “clinical thought.” This clinical thought has its own scope, embedded (sometimes hidden) within practices but irreducible to the usual, manifest methods, and cutting across various scientific (and technical) disciplines, but not all of them, for reasons that remain to be discovered. The point, then, is not to overwork the notion in order to extend it metaphorically to every area of knowledge and practice, nor to forcibly limit its application to the sole field of medicine, but just to take a serious look at the question of the affinity behind these uses, insofar as it denotes a problem more than it evokes a mere family resemblance. Hence the mainly criteriological nature of this investigation, which seeks to identify the principal characteristics of this kind of speculation, whose originality is suspected without being fully understood, or in many cases, even glimpsed. One of the leitmotivs of the contributions, contrary to the myth of the transparent “encounter,” is the necessarily mediated nature of the clinic, whether this mediation takes an experimental, technical, statistical, or interpretive form. Moreover, in addition to the fact that the concept of the clinic is no longer focused on health care alone, it is unclear whether it can be defined by way of individuals alone, given that many sciences now lay claim to them. [4] Consequently, the question of the possibility of knowing the singular, and the modes of knowing it, in its uniqueness, is the theme that ties the articles together.

4 The investigation is carried out in various directions, in the fields of somatic medicine and psychiatry, as well as in those of the social sciences, associating epistemological reflections with metaphysical considerations and practical issues.

5 Jean-Christophe Weber, a professor of internal medicine at the Centre hospitalier universitaire (CHU) in Strasbourg, attempts to bring the clinic back into the fold of medicine, by granting it the role of a laboratory, in the sense of a renewed spirit of experimentation and inventiveness. Contrary to appearances, a neo-Canguilhemian approach of this kind is anything but mundane and easy nowadays. [5] On the one hand, the championing of the clinical encounter for a deeper understanding of the patient thwarts the objectivity resulting from “evidence,” techniques and machines (imaging machines in particular), bioinformatic profiling or the neuronization of mental illnesses. [6] On the other hand, many dimensions – populational (epidemiological, evolutionary), laboratory-based (clinical tests), statistical (medical AI), and even institutional (public health) – infer a new definition of health that casts doubt on the “humanist” [7] idea that the clinic could serve as the basis for medicine. [8] Furthermore, recent work in biology has added greater complexity to the notion of the individual, both beyond the organism and within it. [9] However, for Weber – as for Lantéri-Laura [10] – the clinic remains the cornerstone of medicine, and therefore of health. [11] Of course, he sees it as a productive technique for various remediations, a technique that draws on diverse bodies of knowledge and skills to find solutions to the specific problems of the individuals who avail themselves of it. But because it remains vague and conjectural, since it differs from person to person, [12] and despite its use of biotechnologies and algorithms, the clinic is essentially infra-technical, making use of sensibilities, a praxis, and practical discernment. This epistemological heterogeneity is therefore the only one suited to its object and its importance.

6 Mathieu Corteel then revisits the disputed question of the origins of the modern clinic – putting forward the hypothesis of its epistemological ambivalence, and its hesitation between the great names and the great numbers, between tact on the one hand and probability/statistics on the other – in order to better emphasize the importance of that equivocity in contemporary debates. The author points out to what extent the numerical tradition constitutes the forgotten double of the anatomo-clinical method – which Foucault nearly admits when he says that “the clinic is a concealed statistic.” In fact, the method of Pierre-Charles-Alexandre Louis, which has its roots in the opposition to Broussais’s physiologism, played a considerable role in the serial comparison of medical cases. It therefore has clear but complex and indirect connections with evidence-based medicine, [13] right down to its contemporary relations with artificial intelligence. Symmetrically, however, the fact that AI does not play a direct role in clinical decision-making, but must content itself with an indirect function of documenting, serves as a reminder that the patient’s individuality must be respected, and that the ambiguous status of the clinic cannot, therefore, be overcome. Consequently, unlike medicine without doctors or patients, the medical gaze and the person to be treated retain key roles in contemporary health care practices – hence the need for a renewal of the Hippocratic oath to the benefit of a cooperative form of medicine and of medical knowledge as a common good. [14]

7 The two contributions that follow, complementing each other, emphasize to what extent the clinic considers the singular and thinks on the basis of it. Guénaël Visentini, a specialist in psychopathology, endeavors to emphasize the originality, among the health care professions, of what Lagache called the psychoanalytic “ultra-clinic.” While the history of “clinical thought” has, on the whole, been one of a process of desingularization – since the dialogue between care-giver and care-receiver has become increasingly mediated by standardized protocols and techniques in the interests of efficiency – psychoanalysis is an exception, as it accompanies its “rises in generality” with a process of “descending into singularity.” Early on, Freud had noted that certain unique ideas, expressed by his patients on a case-by-case basis, were the most effective therapeutic tools for a series of psychic disorders and illnesses. His epistemic legacy thus consists in reproblematizing the question of the effective logical levels in the clinical field: for the best treatment, should one strive for the truth on the level of the general (as in medicine), the typical (as in psychology), or the unique (an innovation from psychoanalysis)? A rereading of the famous case of Lucy R., taken from Freud’s Studies in Hysteria (1895), brings clarity to these issues, which are still just as relevant today. Visentini concludes that it is necessary to limit the notion of the clinic to the realm of health care, instead of extending it indefinitely to other fields (art, literature, the social sciences) merely because attention is paid to the singular in those areas.

8 Elisabetta Basso looks into the connection that the phenomenological variant of psychopathology has maintained throughout its history with typological research in psychology and psychiatry. Beyond the focus on singularity, which is regularly asserted by practitioners, Basso stresses the constant concern among mental health specialists for inferring general ideas from their clinic, emphasizing by the same token how wrong it is to reduce the clinic’s ambition to a mere monograph. In particular, she demonstrates to what extent Ludwig Binswanger was among the first to systematically question the intrinsic rationality of clinical knowledge, and tackle the problem of the relation between general and singular that arises when a “case” is described and analyzed in its “exemplarity.” These issues of typification, which inhere to the clinic, recur often in contemporary critiques of psychiatric classifications (e.g. the DSM), pharmacological experimentations and the use of AI for the diagnosis of mental illnesses. [15]

9 Philippe Lacour explores the paradox underlying the idea of a clinic of the social, a strange oxymoron born of the recent claim to the notion of the clinic by some of the social sciences. To account for an extrapolation of this nature, he shows that the spread of the term in these fields was already underway by the early 20^th century. He first examines how clinical psychology could oddly affirm a social extension, then how the more or less independent projects of clinical sociology and clinical anthropology came into existence and acquired legitimacy. He also highlights certain epistemological issues involved in such an approach: the object (the individual) counts less than the gaze that makes it unique, the abstract inference hesitates between the general and the universal, and the clinic is a field of knowledge that tries to be critical as well. By way of this social extension, the notion of the clinic takes an astoundingly sweeping turn, as Deleuze and Guattari also point out: they even apply it to literature and political thinking, the better to return to institutional psychiatry, [16] or to current reflections on the pathologies of the social and the clinic of injustice. [17]

10 Finally, in the Interview, the “critic of science” Jean-Marc Lévy-Leblond questions the relevance of defining the clinic via the singular: aren’t the physical sciences just as interested in that category? On the one hand, scientific investigations can only begin with singularities (a given meteorite, for example) even if they consider their originality as irrelevant with regard to the explanatory criteria that are ultimately used (the fact of being a shergottite). On the other hand, while it is true that scientific research strives to create generic concepts, it does not however neglect the tangible variety of reality: the multiplicity of molecular structures in chemistry, the diversity of living species, the disparity of the exoplanets, persistent enigmas, etc., even if it is impossible to account for all of the characteristics of the object in question, and even if technical instruments are more likely to give rise to a process of discrimination rather than one of singularization. Moreover, the use of natural language is not what characterizes the social sciences either, since the “hard” sciences rely on it just as much, although they are less inclined to admit it. The result is that the potential interest that the social sciences have in the singular, and in the desire to understand it, does not involve specificities of method or language, but quite simply their human orientation, for our personal singularities are precisely of interest to us insofar as we are human individuals. Therefore, the clinical orientation may have meaning for the fundamental sciences on an ethical level above all, as an extra layer of self-reflexivity in the choice of objects, and in the evaluation of the consequences of their results.