Guislain, this was one ol the advantages of "isolation in the
treatment
oi insanity": "Based on a leeling of dependence that he makes the insane person feel ( .
Foucault-Psychiatric-Power-1973-74
Dupre's cure offers us, we see them at work as tactical points of support, strate- gic elements, maneuvers, plans, and nodes in the relationships between I he patient and the asylum structure ltseli.
Later, we will see how they are detached from it in order to enter another type of discourse.
A The manuscript adds: "it is there that Freud will look lor them. "
79 December 7973 167
? 168 PSYCHIATRIC POWER
1. Opiates, preparations with an opium base, renowned lor suspending attacks ol lury and restoring order between ideas, were recommended, in preference to purgatives and bleedings, by Jean Baptiste Van Helmont (1577-1644) and Thomas Sydenham (1624 1689). Their use in treating "maniacal" or "furious" torms ol madness developed in the eighteenth century. See, Philippe Hecquet (1661 1737) Reflexions sur /'usage cle /'opium, des calmants el des narcoliques pour la guerison des maladies (Paris: G. Cavalier, 1726) p. 11;
J. Guislain, Traile sur Valienation meniale et sur les hospices des alienes, vol. I, book IV: "Moyens diriges sur le systeme nerveux central. Opium," pp. 345 353. See also the pages devoted to
this substance by M. Foucaull, in Hisloire de lajolie, pp. 516 319 (omitted Irom the English translation).
In the nineteenth century, Joseph Jacques Moreau de Tours ( 1804-1884) recommended
the use ol opiates in the treatment ol mania: "In the opiates (opium, datura, belladonna, henbane, aconite, etcetera) we can still find an excellent means ol calming the usual agita-
tion of maniacs and the passing Iits ol rage of monomaniacs. " "Lettres medicales sur la colome d'alienes de Gheel" Annales medko-psychologiques, vol. V, March 1845, p- 271. See,
C. Michea, De I'emploi des opiaces dans le trailement d'alienalion meniale (Pans: Malteste, 1849), and Rechcrches experimentales sur I'emploi des principaux agents de medication slupefianle dam le trailement de I'alienation meniale (Paris: Labe, 1857); H. Legrand du Saulle, "Recherches chnic|ues sur le mode d'administration de l'opium dans la manic" Annales medico-psychologiques, 3U series, vol. V, January 1857, pp. 1 27; H. Brochin, "Maladies nerveuses. ? Narcoliques" in Diclionnaire encyclopedique des sciences medicales, 2 series, vol. XII (Paris: Masson/Asselin, 1877), pp. 375 376; and, J. B. Fonssagrives, "Opium" ibid.
2,ul series, vol. XVI, 1881, pp. 146 240.
2. Laudanum, a preparation in which opium was combined with other ingredients, ol which
the most widely used was the liquid laudanum ol Sydenham, or "*>/>/ d'opium compose," was recommended lor digestive disorders, the treatment ol nervous illnesses and hysteria; see,
T. Sydenham, "Observaliones Medicae" (1680) in Opera Omnia (London: W. Greenhill, 1844) p. 113; English translation, "Medical Observations" in The Works of Thomas Sydenham, trans. R. G. Latham (London: The Sydenham Society, mdcccxlvm) vol. 1, p. 173. See Diclionnaire encyclopediaue des sciences medicales, 2 series, vol. II (Pans: Masson/Asselin, 1876) pp. 17 25.
3. Since Pinel, who asserted "the absolute necessity lor an invariable order ol work" (Traile medico-philosophique, section V: "Police generale et ordre journaher du service dans les hospices d'alienes" p. 212; A Treatise on Insanity, "General police and daily distribution ol services in lunatic asylums," p. 206) the alienists constantly stressed the importance ol regulations. Thus,J. P. Falret, "Du traitement generale des alienes" Des maladies menlales et des asiles d'alienes, p. 690: "What do we see in modern asylums? We see a strictly observed positive regulation, which fixes the use ol every hour ol the day and forces every patient to react against the irregularity of his tendencies by submitting to the general law. He is obliged to place himsell in the hands ol a loreign will and to make a constant ellort on himsell so as not to incur the punishments attached to inlnngemenls ol the rule. "
4. The problem of the dietary regime occupied a privileged place, both as a component of the daily organization of asylum time, and as a contribution to treatment. Thus, Francois Fodere states that "lood is the lirst medicine" Traite du delire, vol. II, p. 292. See, J. Daquin, La Philosophic de la jolie, republished with a presentation by C. Quetel (Paris: Editions Frenesie, 1987) pp. 95 97; and, J. Guislain, Traile sur I'alienation meniale, vol. II, book 16: "Regime alimentaire a observer dans I'alienation mentale" pp. 139 152.
5. Work, an essential component ol moral treatment, was conceived ol in the double perspec live of therapy (isolation) and discipline (order). See, P. Pinel, Traile medico-philosophique, section V, ? xxi: "L01 fondamentale de tout hospice d'alienes, celle d'un travail mecanique": "Constant work changes the vicious circle ol ideas, clanhes the laculties ol understanding by exercising them, alone keeps order wherever the insane are assembled, and dispenses with a host ol detailed and often pointless rules in order to maintain inter
nal police" p. 225; A Treatise on Insanity, "Mechanical employment essential to the success
ful management of lunatic hospitals" p. 217. Cf. , C. Bouchct, "Du travail applique aux alienes" Annales medico-psychologiques, vol. XII, November 1848, pp. 301-302. In Hisloire de
? lajolie, pp. 505 506; Madness and Civilisation, pp. 247 249, Foucault refers to a study by Jean Calvet, from 1952, on the historical origins ol the work ol patients in insane asylums. 6. P. Pinel lends his authority to the shower by making it an instrument of both treatment and conditioning. See the second, revised and expanded edition of his Traitemedico-
philosophique sur {'alienation mentale (Paris: Caille et Ravier, 1809) pp. 205-206. See also, H. Girard de Cailleux, "Considerations sur le traitement des maladies mentales" Annales medico-psychologiques, vol. IV, November, 1844, pp. 330-331; H. Rech (de Montpellier), "De la douche et des affusions d'eau Iroide sur la tete dans le traitement des alienations men- tales" ibid. vol. IX, January 1847, pp. 124 125. It is Francois Leuret especially who makes use of it in Traitement moral de lafolie, ch. 3, ? "Douches et affusions froides" pp. 158-162. See Foucault's discussion of M. Dupre's cure in this and the following lecture (above, French p. 143 sq. and below, French p. 173 sq). Foucault devotes several pages to this cure in: Maladie mentale et Psychologic (Paris: P. U. F. , 1962) pp. 85-86; English translation, Mental Illness and Psychology, trans. Alan Sheridan (Now York: Harper and Row, 1976) p. 72; Histoire de lajolie, p. 338 and pp. 520-521; Madness and Civilisation, p. 172 and pp. 266 267; and "L'eau et la iolie" Dils et Ecrits, vol. 1, pp. 268-272. He returns to it in "Sexuality and Solitude" London Review of Books, 21 May 5 June 1981, p. 3 and pp. 5 6, reprinted in The Essential Works oj Foucault, 1954-19$/l, vol. 1: Ethics: subjectivity and truth, ed. Paul Rabinow, trans. Robert Hurley and others (New York: The New Press, 1997) pp. 175 176; French translation, "Sexualite et solitude," trans. F. Durand Bogaert, Dits el Ecrits, vol. 4. , pp. 168 169.
7. The rotary swing was perfected by the English doctor Erasmus Darwin (1731-1802) and used to treat madness by Mason Cox, who praised its eilectiveness: "I think it can be put
to both a moral and a physical use, and be employed with success both as a means of rebel
and as a means oi discipline, in order to make the patient more adaptable and docile" Observations sur la demence, p. 58. | It has not been possible to consult the first, 1804, edi tion of Practical Observations on Insanity, on which the French translation is based, and the passage quoted here does not appear in the second, 1806, edition. However, reierence is made to the rotary swing elsewhere in the 1806 edition, e. g. , p. 137; G. B. ] See, L. Amard, Traite analytique de la folie et des moyens de la guerir (Lyon: printed by Ballanche, 1807)
pp. 80 93; J. Guislain, Traite sur Valienation mentale, vol. I, book IV, and, Moyens diriges sur le systeme nerveux cerebral. De la rotation (Amsterdam: Van der Hey, 1826) p. 374 and p. 404; C. Buvat Pochon, Les Traitemenls de choc d'autrejois en psychiatric Leurs liens avec les therapeu- tiques modernes, Medical thesis, Paris, no. 1262 (Paris: Le Francois, 1939). See Histoire de la
Jolie, pp. 341 342; Madness and Civilisation, pp. 176-177.
8. While he was alive, Leuret had to defend himself from critics who condemned his practice
as, in his own words, "retrograde and dangerous" (DM traitement moral de lafolie, p. 68). His main opponent was E. S. Blanche, in his paper to the royal Academy of medicine, Du dan-
ger des rigueurs corporelles dans le traitement de lajolie (Paris: Gardembas, 1839), as well as in his short work, De Fetal actuel du traitement de lajolie en France (Paris: Gardembas, 1840). These polemics were echoed in Leuret's obituary notices: U. Trelat, "Notice sur Leuret" Annales d'hygiene publique et de medecine legale, vol. 45, 1851, pp. 241-262; and A. Brierre de Boismont, "Notice biographique sur M. F. Leuret" Annales medico-psychologiques, 2nd series, vol. III,July 1851, pp. 512 527.
9. It is Observation XXII: "Bearers ol imaginary titles and ranks" Du traitement moral de la folie, pp. 418-462.
10. 11. 12.
Ibid. pp. 421-424.
Ibid. p. 429.
P. Pinel, Traile medico-philosophique, op. cit. , section II, ? ix: "Intimider Pahene, mais ne point se permettre aucun acte de violence" p. 61; A Treatise on Insanity, "Intimidation too often associated with violence" pp. 64-65.
13. J. E. D. Esquirol, "De la folie" (1816) in Des maladies mentales vol. 1, p. 126; Mental Maladies, "Insanity," p. 76.
14. See above note 3. Already, for J.
Guislain, this was one ol the advantages of "isolation in the treatment oi insanity": "Based on a leeling of dependence that he makes the insane person feel ( . . . ) lorced to conform to a loreign will" Traile sur I'alienation mentale, vol. I, p. 409.
19 December 1973 169
? 170 PSYCHIATRIC POWER
15- F. Leuret, Du irailemenl moral de lajolie, p. 422: "Dupre is a name oi convenience, a name oi disguise; his true name, as we well know, is Napoleon. "
16. Ibid. p. 423: "The distinctive sign of his Halcyon status is his constant ability to enjoy the pleasures of love. "
17. Ibid. p. 423: "Only he in the home is a man; all the others are women. "
18. EJ. Georgct, De lafolie. Considerations sur cette maladie, p. 284.
19. F. Leuret, Du traitement moral de lafolie, p. 429.
20. Ibid. p. 430. 21. Ibid. p. 430. 22. Ibid. p. 422. 23. Ibid. p. 431.
24. Ibid. p. 431. 25. Ibid. p. 432. 26. Ibid. p. 422.
27. Ibid. , p. 432.
28. Leuret defined his treatment thus: "I understand by moral treatment oi madness the reasoned use o( all means that act directly on the intelligence and passions of the insane" ibid. p. 156.
29. J. P. Falret, Des maladies mentales et des asiles d'alienes, p. 690.
30.
31.
32. 33. 34. 35-
J. E. D. Esquirol, "De la folie" (1816) in Des maladies mentales, vol. I, p. 126; Mental Maladies, "Insanity," p. 76.
F. Leuret, Du traitement moral de lajolie, p. 424.
Ibid. p. 434.
Ibid. p. 435.
Ibid.
Michel Foucault is alluding here to the "money-excrement" relationship, which had a great
iuture in psychoanalytic literature. Mentioned by Freud in a letter to Fliess of 22 December
1897 (French translation in La Naissance de la psychanalyse. Lettres a Wilhelm Fliess, 1887-1902, trans. A Berman [Paris: P. U. F. , 19561 p. 212; English translation, The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887-190/I, trans. J. M. Masson [Cambridge, Mass. : The Belknap Press of Harvard University Press, 1985] p. 288), this symbolic relationship
is developed in the theory of anal eroticism. See, S. Freud, "Charakter und Analerotik"
( 1 9 0 8 ) in Gesammelle Werke | hereafter, GW] (Frankfurt: S. Fischer Verlag, 1941) vol. VII,
pp. 201 209; English translation "Character and Anal Eroticism" in The Standard Edition
oj the Complete Psychological Works of Sigmund Freud | hereaiter Standard Edition], trans, under General Editorship of James Strachey (London: The Hogarth Press, 1953 1974) vol. 9; "Uber Triebumsetzung insbesondere der Analerotik" (1917) in GW (1946) vol. X,
pp. 401 410; "On Transformations of Instinct as Exemplified in Anal Eroticism," Standard Edition, vol. 17. See also, E. Borneman, Psychoanalyse des Geldes. Eine kritische Untersuchungpsy- choanalytisher Geldtheorien (Frankiurt: Suhrkamp Verlag, 1973); French translation, Psychanalyse de Vargent. Une recherche critique sur les theories psychanalytiques de I'argent, trans. D. Guerineau (Paris: P. U. F. , 1978); English translation, The Psychoanalysis of Money
(New York: Urizen Books, 1976).
G. Ferrus, Des alienes. Considerations sur I'etat des maisons qui leur sont destinees, lanl en France qu'en Anglelerre; sur le regime hygienique et moral auquel ces malades doivent etre soumis; sur quelques questions de medecine legale el de legislation relatives a leur elat civil (Pains: printed by Mme. Huzard, 1834) p. 234.
36.
37. Ibid.
38. See above, lecture of 5 December 1973, note 18.
39. The "Sainte Anne iarm" derived irom the donation made by Anne of Austria in 1651 for
the construction of an establishment for taking in the sick during epidemics. Partially con structed, the land remained under cultivation. In 1833, Guillaume Ferrus (1784-1861), head doctor at Bicetre, decided to use it to put to work convalescents and able bodied incurables irom the three sections of the asylum. A decision oi the commission set up on 27 December i860 by the prefect Haussmann to "study the improvements and reforms to be carried out in the service for the insane of the Seine department" marked the end oi the iarm. The construction of an asylum, begun in 1863 according to the plans established
? under the directive oi Girard de Cailleux, was inaugurated on 1 May 1867. See, C. Guesstel,
AsHe d'alienes de Saintc-Anne a Paris (Versailles: Aubert, 1880).
'lO. Henri Girard de Cailleux (1814 1884) iilled the posts of head doctor and director ol the
Auxerre insane asylum lrom 20 June 1840 until his appointment in i860 as Inspector General for the Seine service for the insane. The quotation comes from his article: "De la construction et de la direction des asiles d'alienes" Annales d'hygiene publique et de medecine legate, vol. 40, 1st Part, July 1848, p. 30.
11. H. Belloc, Les Asiles d'alienes transformed en centres d'exploitation rurale, moyen d'exonerer en tout ou en partie les departements des depenses c/u'ils font pour leurs alienes en augmentant le bien-etre de ces maladcs, et en les rapprochant des conditions d'existence de Vhomme en societe (Pans: Bechet, 1862) p. 15.
|2. Foucault is alluding here to several earlier propositions: (a) In the lecture of 7 November 1973 he argues that the doctor's therapeutic process does not require "any discourse ol truth" (above, p. 10); ( b ) in that of 14 November Foucault claims that the "game ol truth, within delirium and of delirium, will be completely suppressed in the psychiatric practice that commences at the start oi the nineteenth century" (above, p. 35); and (c) in the lec- ture of 12 December 1973 he concludes that in psychiatric power the question of truth is never posed (above, p. 134).
15. F. Leu ret, Du traitement moral de lajolie, p. 423 and pp. 435 436.
14. Ibid.
15. Ibid. 16. Ibid. 17. Ibid. 18. Ibid. 19. Ibid.
50. Ibid.
51. Ibid,
p. 438.
p. 439.
p. 440.
pp. 440 442. p. 444.
pp. 444 445.
pp. 441 442.
52. F. Leuret, Fragments psychologiques sur lajolie, pp. 121-124.
53. T. Leuret, Du traitement moral de la /olie, pp. 449450.
54. Ibid. p. 449.
55.
Later, we will see how they are detached from it in order to enter another type of discourse.
A The manuscript adds: "it is there that Freud will look lor them. "
79 December 7973 167
? 168 PSYCHIATRIC POWER
1. Opiates, preparations with an opium base, renowned lor suspending attacks ol lury and restoring order between ideas, were recommended, in preference to purgatives and bleedings, by Jean Baptiste Van Helmont (1577-1644) and Thomas Sydenham (1624 1689). Their use in treating "maniacal" or "furious" torms ol madness developed in the eighteenth century. See, Philippe Hecquet (1661 1737) Reflexions sur /'usage cle /'opium, des calmants el des narcoliques pour la guerison des maladies (Paris: G. Cavalier, 1726) p. 11;
J. Guislain, Traile sur Valienation meniale et sur les hospices des alienes, vol. I, book IV: "Moyens diriges sur le systeme nerveux central. Opium," pp. 345 353. See also the pages devoted to
this substance by M. Foucaull, in Hisloire de lajolie, pp. 516 319 (omitted Irom the English translation).
In the nineteenth century, Joseph Jacques Moreau de Tours ( 1804-1884) recommended
the use ol opiates in the treatment ol mania: "In the opiates (opium, datura, belladonna, henbane, aconite, etcetera) we can still find an excellent means ol calming the usual agita-
tion of maniacs and the passing Iits ol rage of monomaniacs. " "Lettres medicales sur la colome d'alienes de Gheel" Annales medko-psychologiques, vol. V, March 1845, p- 271. See,
C. Michea, De I'emploi des opiaces dans le trailement d'alienalion meniale (Pans: Malteste, 1849), and Rechcrches experimentales sur I'emploi des principaux agents de medication slupefianle dam le trailement de I'alienation meniale (Paris: Labe, 1857); H. Legrand du Saulle, "Recherches chnic|ues sur le mode d'administration de l'opium dans la manic" Annales medico-psychologiques, 3U series, vol. V, January 1857, pp. 1 27; H. Brochin, "Maladies nerveuses. ? Narcoliques" in Diclionnaire encyclopedique des sciences medicales, 2 series, vol. XII (Paris: Masson/Asselin, 1877), pp. 375 376; and, J. B. Fonssagrives, "Opium" ibid.
2,ul series, vol. XVI, 1881, pp. 146 240.
2. Laudanum, a preparation in which opium was combined with other ingredients, ol which
the most widely used was the liquid laudanum ol Sydenham, or "*>/>/ d'opium compose," was recommended lor digestive disorders, the treatment ol nervous illnesses and hysteria; see,
T. Sydenham, "Observaliones Medicae" (1680) in Opera Omnia (London: W. Greenhill, 1844) p. 113; English translation, "Medical Observations" in The Works of Thomas Sydenham, trans. R. G. Latham (London: The Sydenham Society, mdcccxlvm) vol. 1, p. 173. See Diclionnaire encyclopediaue des sciences medicales, 2 series, vol. II (Pans: Masson/Asselin, 1876) pp. 17 25.
3. Since Pinel, who asserted "the absolute necessity lor an invariable order ol work" (Traile medico-philosophique, section V: "Police generale et ordre journaher du service dans les hospices d'alienes" p. 212; A Treatise on Insanity, "General police and daily distribution ol services in lunatic asylums," p. 206) the alienists constantly stressed the importance ol regulations. Thus,J. P. Falret, "Du traitement generale des alienes" Des maladies menlales et des asiles d'alienes, p. 690: "What do we see in modern asylums? We see a strictly observed positive regulation, which fixes the use ol every hour ol the day and forces every patient to react against the irregularity of his tendencies by submitting to the general law. He is obliged to place himsell in the hands ol a loreign will and to make a constant ellort on himsell so as not to incur the punishments attached to inlnngemenls ol the rule. "
4. The problem of the dietary regime occupied a privileged place, both as a component of the daily organization of asylum time, and as a contribution to treatment. Thus, Francois Fodere states that "lood is the lirst medicine" Traite du delire, vol. II, p. 292. See, J. Daquin, La Philosophic de la jolie, republished with a presentation by C. Quetel (Paris: Editions Frenesie, 1987) pp. 95 97; and, J. Guislain, Traile sur I'alienation meniale, vol. II, book 16: "Regime alimentaire a observer dans I'alienation mentale" pp. 139 152.
5. Work, an essential component ol moral treatment, was conceived ol in the double perspec live of therapy (isolation) and discipline (order). See, P. Pinel, Traile medico-philosophique, section V, ? xxi: "L01 fondamentale de tout hospice d'alienes, celle d'un travail mecanique": "Constant work changes the vicious circle ol ideas, clanhes the laculties ol understanding by exercising them, alone keeps order wherever the insane are assembled, and dispenses with a host ol detailed and often pointless rules in order to maintain inter
nal police" p. 225; A Treatise on Insanity, "Mechanical employment essential to the success
ful management of lunatic hospitals" p. 217. Cf. , C. Bouchct, "Du travail applique aux alienes" Annales medico-psychologiques, vol. XII, November 1848, pp. 301-302. In Hisloire de
? lajolie, pp. 505 506; Madness and Civilisation, pp. 247 249, Foucault refers to a study by Jean Calvet, from 1952, on the historical origins ol the work ol patients in insane asylums. 6. P. Pinel lends his authority to the shower by making it an instrument of both treatment and conditioning. See the second, revised and expanded edition of his Traitemedico-
philosophique sur {'alienation mentale (Paris: Caille et Ravier, 1809) pp. 205-206. See also, H. Girard de Cailleux, "Considerations sur le traitement des maladies mentales" Annales medico-psychologiques, vol. IV, November, 1844, pp. 330-331; H. Rech (de Montpellier), "De la douche et des affusions d'eau Iroide sur la tete dans le traitement des alienations men- tales" ibid. vol. IX, January 1847, pp. 124 125. It is Francois Leuret especially who makes use of it in Traitement moral de lafolie, ch. 3, ? "Douches et affusions froides" pp. 158-162. See Foucault's discussion of M. Dupre's cure in this and the following lecture (above, French p. 143 sq. and below, French p. 173 sq). Foucault devotes several pages to this cure in: Maladie mentale et Psychologic (Paris: P. U. F. , 1962) pp. 85-86; English translation, Mental Illness and Psychology, trans. Alan Sheridan (Now York: Harper and Row, 1976) p. 72; Histoire de lajolie, p. 338 and pp. 520-521; Madness and Civilisation, p. 172 and pp. 266 267; and "L'eau et la iolie" Dils et Ecrits, vol. 1, pp. 268-272. He returns to it in "Sexuality and Solitude" London Review of Books, 21 May 5 June 1981, p. 3 and pp. 5 6, reprinted in The Essential Works oj Foucault, 1954-19$/l, vol. 1: Ethics: subjectivity and truth, ed. Paul Rabinow, trans. Robert Hurley and others (New York: The New Press, 1997) pp. 175 176; French translation, "Sexualite et solitude," trans. F. Durand Bogaert, Dits el Ecrits, vol. 4. , pp. 168 169.
7. The rotary swing was perfected by the English doctor Erasmus Darwin (1731-1802) and used to treat madness by Mason Cox, who praised its eilectiveness: "I think it can be put
to both a moral and a physical use, and be employed with success both as a means of rebel
and as a means oi discipline, in order to make the patient more adaptable and docile" Observations sur la demence, p. 58. | It has not been possible to consult the first, 1804, edi tion of Practical Observations on Insanity, on which the French translation is based, and the passage quoted here does not appear in the second, 1806, edition. However, reierence is made to the rotary swing elsewhere in the 1806 edition, e. g. , p. 137; G. B. ] See, L. Amard, Traite analytique de la folie et des moyens de la guerir (Lyon: printed by Ballanche, 1807)
pp. 80 93; J. Guislain, Traite sur Valienation mentale, vol. I, book IV, and, Moyens diriges sur le systeme nerveux cerebral. De la rotation (Amsterdam: Van der Hey, 1826) p. 374 and p. 404; C. Buvat Pochon, Les Traitemenls de choc d'autrejois en psychiatric Leurs liens avec les therapeu- tiques modernes, Medical thesis, Paris, no. 1262 (Paris: Le Francois, 1939). See Histoire de la
Jolie, pp. 341 342; Madness and Civilisation, pp. 176-177.
8. While he was alive, Leuret had to defend himself from critics who condemned his practice
as, in his own words, "retrograde and dangerous" (DM traitement moral de lafolie, p. 68). His main opponent was E. S. Blanche, in his paper to the royal Academy of medicine, Du dan-
ger des rigueurs corporelles dans le traitement de lajolie (Paris: Gardembas, 1839), as well as in his short work, De Fetal actuel du traitement de lajolie en France (Paris: Gardembas, 1840). These polemics were echoed in Leuret's obituary notices: U. Trelat, "Notice sur Leuret" Annales d'hygiene publique et de medecine legale, vol. 45, 1851, pp. 241-262; and A. Brierre de Boismont, "Notice biographique sur M. F. Leuret" Annales medico-psychologiques, 2nd series, vol. III,July 1851, pp. 512 527.
9. It is Observation XXII: "Bearers ol imaginary titles and ranks" Du traitement moral de la folie, pp. 418-462.
10. 11. 12.
Ibid. pp. 421-424.
Ibid. p. 429.
P. Pinel, Traile medico-philosophique, op. cit. , section II, ? ix: "Intimider Pahene, mais ne point se permettre aucun acte de violence" p. 61; A Treatise on Insanity, "Intimidation too often associated with violence" pp. 64-65.
13. J. E. D. Esquirol, "De la folie" (1816) in Des maladies mentales vol. 1, p. 126; Mental Maladies, "Insanity," p. 76.
14. See above note 3. Already, for J.
Guislain, this was one ol the advantages of "isolation in the treatment oi insanity": "Based on a leeling of dependence that he makes the insane person feel ( . . . ) lorced to conform to a loreign will" Traile sur I'alienation mentale, vol. I, p. 409.
19 December 1973 169
? 170 PSYCHIATRIC POWER
15- F. Leuret, Du irailemenl moral de lajolie, p. 422: "Dupre is a name oi convenience, a name oi disguise; his true name, as we well know, is Napoleon. "
16. Ibid. p. 423: "The distinctive sign of his Halcyon status is his constant ability to enjoy the pleasures of love. "
17. Ibid. p. 423: "Only he in the home is a man; all the others are women. "
18. EJ. Georgct, De lafolie. Considerations sur cette maladie, p. 284.
19. F. Leuret, Du traitement moral de lafolie, p. 429.
20. Ibid. p. 430. 21. Ibid. p. 430. 22. Ibid. p. 422. 23. Ibid. p. 431.
24. Ibid. p. 431. 25. Ibid. p. 432. 26. Ibid. p. 422.
27. Ibid. , p. 432.
28. Leuret defined his treatment thus: "I understand by moral treatment oi madness the reasoned use o( all means that act directly on the intelligence and passions of the insane" ibid. p. 156.
29. J. P. Falret, Des maladies mentales et des asiles d'alienes, p. 690.
30.
31.
32. 33. 34. 35-
J. E. D. Esquirol, "De la folie" (1816) in Des maladies mentales, vol. I, p. 126; Mental Maladies, "Insanity," p. 76.
F. Leuret, Du traitement moral de lajolie, p. 424.
Ibid. p. 434.
Ibid. p. 435.
Ibid.
Michel Foucault is alluding here to the "money-excrement" relationship, which had a great
iuture in psychoanalytic literature. Mentioned by Freud in a letter to Fliess of 22 December
1897 (French translation in La Naissance de la psychanalyse. Lettres a Wilhelm Fliess, 1887-1902, trans. A Berman [Paris: P. U. F. , 19561 p. 212; English translation, The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887-190/I, trans. J. M. Masson [Cambridge, Mass. : The Belknap Press of Harvard University Press, 1985] p. 288), this symbolic relationship
is developed in the theory of anal eroticism. See, S. Freud, "Charakter und Analerotik"
( 1 9 0 8 ) in Gesammelle Werke | hereafter, GW] (Frankfurt: S. Fischer Verlag, 1941) vol. VII,
pp. 201 209; English translation "Character and Anal Eroticism" in The Standard Edition
oj the Complete Psychological Works of Sigmund Freud | hereaiter Standard Edition], trans, under General Editorship of James Strachey (London: The Hogarth Press, 1953 1974) vol. 9; "Uber Triebumsetzung insbesondere der Analerotik" (1917) in GW (1946) vol. X,
pp. 401 410; "On Transformations of Instinct as Exemplified in Anal Eroticism," Standard Edition, vol. 17. See also, E. Borneman, Psychoanalyse des Geldes. Eine kritische Untersuchungpsy- choanalytisher Geldtheorien (Frankiurt: Suhrkamp Verlag, 1973); French translation, Psychanalyse de Vargent. Une recherche critique sur les theories psychanalytiques de I'argent, trans. D. Guerineau (Paris: P. U. F. , 1978); English translation, The Psychoanalysis of Money
(New York: Urizen Books, 1976).
G. Ferrus, Des alienes. Considerations sur I'etat des maisons qui leur sont destinees, lanl en France qu'en Anglelerre; sur le regime hygienique et moral auquel ces malades doivent etre soumis; sur quelques questions de medecine legale el de legislation relatives a leur elat civil (Pains: printed by Mme. Huzard, 1834) p. 234.
36.
37. Ibid.
38. See above, lecture of 5 December 1973, note 18.
39. The "Sainte Anne iarm" derived irom the donation made by Anne of Austria in 1651 for
the construction of an establishment for taking in the sick during epidemics. Partially con structed, the land remained under cultivation. In 1833, Guillaume Ferrus (1784-1861), head doctor at Bicetre, decided to use it to put to work convalescents and able bodied incurables irom the three sections of the asylum. A decision oi the commission set up on 27 December i860 by the prefect Haussmann to "study the improvements and reforms to be carried out in the service for the insane of the Seine department" marked the end oi the iarm. The construction of an asylum, begun in 1863 according to the plans established
? under the directive oi Girard de Cailleux, was inaugurated on 1 May 1867. See, C. Guesstel,
AsHe d'alienes de Saintc-Anne a Paris (Versailles: Aubert, 1880).
'lO. Henri Girard de Cailleux (1814 1884) iilled the posts of head doctor and director ol the
Auxerre insane asylum lrom 20 June 1840 until his appointment in i860 as Inspector General for the Seine service for the insane. The quotation comes from his article: "De la construction et de la direction des asiles d'alienes" Annales d'hygiene publique et de medecine legate, vol. 40, 1st Part, July 1848, p. 30.
11. H. Belloc, Les Asiles d'alienes transformed en centres d'exploitation rurale, moyen d'exonerer en tout ou en partie les departements des depenses c/u'ils font pour leurs alienes en augmentant le bien-etre de ces maladcs, et en les rapprochant des conditions d'existence de Vhomme en societe (Pans: Bechet, 1862) p. 15.
|2. Foucault is alluding here to several earlier propositions: (a) In the lecture of 7 November 1973 he argues that the doctor's therapeutic process does not require "any discourse ol truth" (above, p. 10); ( b ) in that of 14 November Foucault claims that the "game ol truth, within delirium and of delirium, will be completely suppressed in the psychiatric practice that commences at the start oi the nineteenth century" (above, p. 35); and (c) in the lec- ture of 12 December 1973 he concludes that in psychiatric power the question of truth is never posed (above, p. 134).
15. F. Leu ret, Du traitement moral de lajolie, p. 423 and pp. 435 436.
14. Ibid.
15. Ibid. 16. Ibid. 17. Ibid. 18. Ibid. 19. Ibid.
50. Ibid.
51. Ibid,
p. 438.
p. 439.
p. 440.
pp. 440 442. p. 444.
pp. 444 445.
pp. 441 442.
52. F. Leuret, Fragments psychologiques sur lajolie, pp. 121-124.
53. T. Leuret, Du traitement moral de la /olie, pp. 449450.
54. Ibid. p. 449.
55.
