A history of the history of madness

Madness and Civilization was a hugely influential book by the French post-modernist philosopher Michel Foucault and is often cited as a key ‘anti-psychiatry’ text owing to its claim that the modern concept of madness was an Enlightenment idea developed to allow the confinement of people that others in society found unacceptable.

What I wasn’t aware of is that Madness and Civilization is actually a cut-down translation of the original French text where most of the references to source material remained untranslated.

A full translation, renamed with its correct title History of Madness, was released last year and was given a damning review in The Times by medical historian Andrew Scull who derided Foucault’s “isolation from the world of facts and scholarship”.

Actually, Foucault’s major claim that 17th Europe undertook the “great confinement” of the mad through the building of asylums has been debunked before. The much-missed medical historian Roy Porter pointed out that France was the only country in Europe to centralise its administration of services for the ‘pauper madman’ while other countries didn’t typically have any legislation in place until the 19th century.

I was also interested in Scull’s debunking of the myth that visitors could pay to view the patients of London’s ‘Bedlam‘ Hospital:

Foucault alleges, for example, that the 1815–16 House of Commons inquiry into the state of England’s madhouses revealed that Bedlam (Bethlem) placed its inmates on public display every Sunday, and charged a penny a time for the privilege of viewing them to some 96,000 sightseers a year. In reality, the reports of the inquiry contain no such claims. This is not surprising: public visitation (which had not been confined to Sundays in any event) had been banned by Bethlem Royal Hospital’s governors in 1770, and even before then the tales of a fixed admission fee turn out to be apocryphal.

I looked this up in Russell’s Scenes From Bedlam (ISBN 1873853394) that confirms the ban on visitation in 1770, but does make reference to paying visitors, although it gives the impression that the arrangement was much more ad-hoc than is commonly assumed and casts doubt on the huge figures Foucault quotes.

Unfortunately, it doesn’t reference any historical documents on the matter, and neither does any other book I have, so I’ll have to do further investigation.

However, this is just one point among many where Scull notes that with the benefit of the fully translated version, we can see that Foucault’s research is just not up to scratch and doesn’t support his major historical claims.

But it’s probably worth saying that Foucault’s other major idea, that madness is not a fixed entity but is defined as much socially and politically as in medical terms is still as valid today. Particularly in an era where we are increasingly medicalising what we previously considered unfortunate but non-medical problems and stresses.

Link to Times article ‘The fictions of Foucault’s scholarship’.