[the notes from the book were retrieved with kobogarden, with the purpose of aiding to create a map of the ideas the book left me. The full list of book highlights can be found here — but I'm still reading it.]

The first few sentences of the book describe its motivation — to trace the consequences of — or more accurately, "an epilogue to" — the industrial age. The notion of mass production looms over the first few pages and it goes hand in hand with scientific progress; for the latter, there is some hope of wielding it to the benefit of society — but it feels like there is no alternative to the inevitable growth of mass production.

A first case in point — and I am yet unsure whether it represents the aforementioned dual nature of scientific progress — is to b found on medicine. Illich will establish a first turning point in the year of 1913, but its fairly quick deterioration into a kind of monopoly by the medical class. From then on, the deliverance of arguments is fast-paced and a grim portrait of the field lends to questioning whether its advancement led to humanity being better off (eg. by extending sick life, or how its specialization supressed the valuable role of familiar care). The most risky argument calls for an inversion of perspective on rich and poor countries; and, nonetheless, China has apparently reversed this tendency (although it would be relevant to have a modern perspective on the matter).

a powerful image, again: protecting humans against an hostile environment, in cities that in very little resemble the natural upbringing of just a couple generations prior.

On a world-wide scale, but particularly in the U. S. A., medical care concentrated on breeding a human stock that was fit only for domesticated life within an increasingly more costly, man-made, scientifically controlled environment. One of the main speakers at the 1970 AMA convention exhorted her pediatric colleagues to consider each newborn baby as a patient until the child could be certified as healthy. Hospital-born, formula-fed, antibiotic-stuffed children thus grow into adults who can breathe the air, eat the food, and survive the lifelessness of a modern city, who will breed and raise at almost any cost a generation even more dependent on medicine.

There is, then, this contrast between the first and the second watershed moments in medicine (summarised, respectively, here and here); but the notion of two watershed moments can be abstracted to other important fields:

Other industrial institutions have passed through the same two watersheds. This is certainly true for the major social agencies that have been reorganized according to scientific criteria during the last 150 years. Education, the mails, social work, transportation, and even civil engineering have followed this evolution. At first, new knowledge is applied to the solution of a clearly stated problem and scientific measuring sticks are applied to account for the new efficiency. But at a second point, the progress demonstrated in a previous achievement is used as a rationale for the exploitation of society as a whole in the service of a value which is determined and constantly revised by an element of society, by one of its self-certifying professional élites.