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PREFACE
PASCAL: "Men are so necessarily mad, that not to be mad would
amount to another form of madness." And Dostoievsky, in his DIARY
OF A WRITER: "It is not by confining one's neighbor that one is
convinced of one's own sanity."
We have yet to write the history of that other form of
madness, by which men, in an act of sovereign reason, confine
their neighbors, and communicate and recognize each
other through the merciless language of non-madness; to
define the moment of this conspiracy before it was permanently
established in the realm of truth, before it was revived
by the lyricism of protest. We must try to return, in history, to
that zero point in the course of madness at which madness is
an undifferentiated experience, a not yet divided experience
of division itself. We must describe, from the start of its
trajectory, that "other form" which relegates Reason and
Madness to one side or the other of its action as things
henceforth external, deaf to all exchange, and as though
dead to one another.
This is doubtless an uncomfortable region. To explore it we
must renounce the convenience of terminal truths, and never
let ourselves be guided by what we may know of madness.
None of the concepts of psychopathology, even and
especially in the implicit process of retrospections, can play
an organizing role. What is constitutive is the action that
divides madness, and not the science elaborated once this
division is made and calm restored. What is originative is the
caesura that establishes the distance between reason and
non-reason; reason's subjugation of non-reason, wrest
(ix)
ing from it its truth as madness, crime, or disease, derives
explicitly from this point. Hence we must speak of that initial
dispute without assuming a victory, or the right to a victory;
we must speak of those actions re-examined in history,
leaving in abeyance all that may figure as a conclusion, as a
refuge in truth; we shall have to speak of this act of scission,
of this distance set, of this void instituted between reason and
what is not reason, without ever relying upon the fulfillment of
what it claims to be.
Then, and then only, can we determine the realm in which
the man of madness and the man of reason, moving apart,
are not yet disjunct; and in an incipient and very crude
language, antedating that of science, begin the dialogue of
their breach, testifying in a fugitive way that they still speak to
each other. Here madness and non-madness, reason and
non-reason are inextricably involved: inseparable at the
moment when they do not yet exist, and existing for each
other, in relation to each other, in the exchange which
separates them.
In the serene world of mental illness, modem man no
longer communicates with the madman: on one hand, the
man of reason delegates the physician to madness, thereby
authorizing a relation only through the abstract universality of
disease; on the other, the man of madness communicates
with society only by the intermediary of an equally abstract
reason which is order, physical and moral constraint, the
anonymous pressure of the group, the requirements of
conformity. As for a common language, there is no such thing;
or rather, there is no such thing any longer;
the constitution of madness as a mental illness, at the end of
the eighteenth century, affords the evidence of a broken
dialogue, posits the separation as already effected, and
thrusts into oblivion all those stammered, imperfect words
without fixed syntax in which the exchange between madness
and reason was made. The language of psychiatry,
(x)
which is a monologue of reason about madness, has been
established only on the basis of such a silence.
I have not tried to write the history of that language, but
rather the archaeology of that silence.
The Greeks had a relation to something that they called
******;. This relation was not merely one of condemnation; the
existence of Thrasymachus or of Collides suffices to prove it,
even if their language has reached us already enveloped in
the reassuring dialectic of Socrates. But the Greek Logos had
no contrary.
European man, since the beginning of the Middle Ages, has
had a relation to something he calls, indiscriminately,
Madness, Dementia, Insanity. Perhaps it is to this obscure
presence that Western reason owes something of its depth,
as the ******| of the Socratic reasoners owes something to the
threat of ******. In any case, the Reason-Madness nexus
constitutes for Western culture one of the dimensions of its
originality; it already accompanied that culture long before
Hieronymus Bosch, and will follow it long after Nietzsche and
Artaud.
What, then, is this confrontation beneath the language of
reason? Where can an interrogation lead us which does not
follow reason in its horizontal course, but seeks to retrace in
time that constant vertically which confronts European culture
with what it is not, establishes its range by its own
derangement? What realm do we enter which is neither the
history of knowledge, nor history itself; which is controlled by
neither the teleology of truth nor the rational sequence of
causes, since causes have value and meaning only beyond
the division? A realm, no doubt, where what is in question is
the limits rather than the identity of a culture.
The classical period—from Willis to Pinel, from the frenzies
of Racine's Oreste to Sade's Juliette and the Quinta
(xi)
del Sordo of Goya—covers precisely that epoch in
which the exchange between madness and reason
modifies its language, and in a radical manner. In the
history of madness, two events indicate this change
with a singular clarity: 1657, the creation of the Hopital
General and the "great confinement" of the poor; 1794,
the liberation of the chained inmates of Bicetre.
Between these two unique and symmetrical events,
something happens whose ambiguity has left the
historians of medicine at a loss: blind repression in an
absolutist regime, according to some; but according to
others, the gradual discovery by science and
philanthropy of madness in its positive truth. As a
matter of fact, beneath these reversible meanings, a
structure is forming which does not resolve the
ambiguity but determines it. It is this structure which
accounts for the transition from the medieval and
humanist experience of madness to our own experience,
which confines insanity within mental illness.
In the Middle Ages and until the Renaissance, man's
dispute with madness was a dramatic debate in which
he confronted the secret powers of the world; the
experience of madness was clouded by images of the
Fall and the Will of God, of the Beast and the
Metamorphosis, and of all the marvelous secrets of
Knowledge. In our era, the experience of madness
remains silent in the composure of a knowledge which,
knowing too much about madness, forgets it. But from
one of these experiences to the other, the shift has
been made by a world without images, without positive
character, in a kind of silent transparency which
reveals— as mute institution, act without commentary,
immediate knowledge—a great motionless structure;
this structure is one of neither drama nor knowledge; it
is the point where history is immobilized in the tragic
category which both establishes and impugns it.
(xii)
CONTENTS
I "Stultifera Navis" 3
II The Great Confinement 38
III The Insane 65
IV Passion and Delirium 85
V Aspects of Madness 117
VI Doctors and Patients 159
VII The Great Fear 199
VIII The New Division 221
IX The Birth of the Asylum 241
Conclusion 219
Notes 201
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