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On one hand, I think you have to give some credit to Foucault. The ideas in this book are almost trivial now, and we have a lot of conceptual tools to describe it in relatively straightforward terms. He was, somewhat ironically, ushering in a new episteme in which humans are self-conscious of their status as episteme-makers, without the aid of the episteme in which that idea makes sense. It's recursive in a way that none of the previous epistemic revolutions really had to contend with.

On the other hand, it's hard to see how there's any value in this book for a modern audience except as a historical artifact. It sets out to do two things, and barely does either comprehensibly at all. First, it's a statement of the idea of epistemes. But Foucault spares no time to actually explain that idea, or orient us to how his examples demonstrate it. Second, it's an intellectual history. But it's an extremely unsatisfying one. Again, he gives no orientation whatsoever on the lives, cultures, problems, or any kind of context or background whatsoever on the thinkers he references. It's just not very informative, but it's also not very readable. The really bad part is that he makes no effort to organize the text in a way that clarifies when he's paraphrasing ideas people held in the past, commenting on those ideas, or giving his own ideas. There's no structure at all beyond the section headings themselves. What it feels like more than anything is a kind of stream of consciousness diary for a philosopher taking notes that make sense in the context of premises he has become too used to to bother stating, but also which he lacks the words to clearly articulate. It's quite frustrating and I'm sooooooooo glad modern science and philosophy have both essentially made this book (if not the fairly indubitable central idea) obsolete.