What <i>Sujet de la folie</i>? Gladys Swain and Marcel Gauchet’s Search for an Alternative History of Madness

Abstract

Inspired by three monographs of Gladys Swain and Marcel Gauchet, my presentation traces the rise of the new science of psychiatry in Revolutionary France, with Philippe Pinel and his student J.-E. Esquirol. As the directors of the division of the aliénés in the Hôpital Bicêtre (Paris), Pinel and Esquirol pioneered a therapeutic programme that spread out between their “traitement moral” (reasoning with the passions) and an “energetic repression,” wherever necessary. The discipline they created sought to gain autonomy from medicine treating diseases of the body, much as pathology would do in regard to physiology, some fifty years later. Using Canguilhem, Foucault’s teacher and significant influence, I show how the unfolding of a science of disorders (for Canguilhem, this was pathology) poses questions of taxonomy and runs the inevitable ‘risk’ of extensive fragmentation. This is what happens in France after Pinel. However, Pinel, above all, will have made one contribution that—by Swain and Gauchet’s argument—stands in stark contrast to the theses of the young Foucault. Rather than sequestering and excluding the fou by forcing him or her into exaggerated, discursive revelations or silence, Pinel and Esquirol “discover” the sense, or sens, at the heart of madness, notably in what Pinel called “manie intermittente.” Esquirol takes this discovery one step further, to discern in various attacks, a certain rationality. This rather modern conception of madness exerts a considerable influence on literature, criticism, philosophy, and medicine in their time. Hegel’s understanding of madness will come directly from Pinel, and it will see in folie the internal division of subjective Reason. From this characterization comes a therapeutics based on the conviction that one could often reintegrate the mad into society, and avoid prolonged sequestration and exclusion. Thus the presentation focuses on Swain and Gauchet’s question to Foucault (Histoire de la folie à l’âge classique, notably), using the work of Pinel and Hegel to illustrate their claim.