As
Foucault
recalls in Histoire de la folie, pp.
Foucault-Psychiatric-Power-1973-74
444 445-
14. In fact Foucault will not keep to this program apart from some comments on the role of childhood in the generalization ol psychiatric knowledge and power in the 1974-1975 College de France lectures of 5,12, and 19 March: Les Anormaux, pp. 217 301; Abnormal, pp. 231 321.
15- From the Old English, ordal, judgment, the "judgment of God" or "ordeal," means to settle contentious questions with the idea that God intervenes in the case to judge during tests likes those of "fire," the "branding iron," "cold or boiling water," and the "cross," etcetera. See L. Tanon, Histoire des tribunaux de /'Inquisition en France (Pans: L. Larose and Forcel, 1893) on the penalties of "lire" (pp. 464-479) and the "cross" (pp. 490-498). As J. -P. Levy emphasizes in his, La Hierarchie des preuves dans le droit savant du Moyen Age, depuis la renaissance du droit romain jusqu'a la fin du xivc siecle (Paris: Sirey, 1939), in this procedure "the trial is not an investigation with the aim of finding out the truth ( . . . ) . It is originally
a struggle, and later, an appeal to God; the concern with making the truth come out is left up to Him, but the judge does not seek it himselt" (p. 163).
Foucault referred to the question of the ordeal in the third lecture of the 1970-1971 College de France lectures, "The Will to Knowledge," in which he noted that in "the treat
ments to which madness was subjected, we find something like this ordeal test of the truth. " The ninth lecture of the 1971 1972 lectures, devoted to accusatory procedure and
the system of proof, refers to it (see above note 12). See also, M. Foucault, "La verite et les
iormes juridiques"; "Truth and Juridical Forms. " See, A. Esmein, Histoire de la procedure criminelle en France, et specialement de la procedure inquisitoire depuis le xiii' siecle jusqu'a nos jours (Paris: Larose et Forcel, 1882) pp. 260 283; E. Vacandard, "L'Eglise et les ordalies" in
filudes de critique et d'histoire religieuse, vol. I (Paris: V. Lecoffre, 1905) pp. 189 214; G. Glotz, Etudes sociales et juridiques sur I'antiquite grecque, ch. 2, "L'ordalie" (Paris: Hachette, 1 9 0 6 ) pp. 69 97; A. Michel, "Ordalies" in, A. Vacant, ed. , Dictionnaire de theologie catholique, vol. XI (Paris: Letouzey et Ane, 1930) col. 1139-1152; Y. Bongert, Recherches sur les cours la'iques du xe au xiif siecles (Paris: A et J. Picard, 1949) pp. 215-228; H. Nottarp, Gottehurteilstudien (Munich: Kosel Verlag, 1956); and J. Gaudemet, "Les ordalies au Moyen Age: doctrine, legislation et pratique canonique" in Recueil de la Societe Jean Bodin (Brussels: 1965) vol. XVII, Part 2, La Preuve.
16. In the basically accusatory procedures that involved taking God as witness so that he pro- duces the accuracy or retraction oi the accusation, confession was not enough to pronounce sentence. See, H. C. Lea, A History of the Inquisition of the Middle Ages, vol. 1, pp. 407-408;
A. Esmein, Histoire de la procedure criminelle, p. 273; andj. P. Levy, La Hierarchie des preuves, pp. 19 83. On confession, see Surveiller et Punir, pp. 42-45; Discipline and Punish, pp. 37-40.
17. Torture, unlike the sovereign means of proof by ordeal--the expression of God's testimony--was a way of provoking judicial confession. The inquisitorial procedure was integrated into canon law in 1232 when Pope Gregory IX called upon the Dominicans to establish a tribunal of Inquisition specifically lor the search lor and punishment ol heretics. Recourse to judicial torture was approved by the bull, Ad Extirpanda, of Pope Innocent IV of 15 May 1252, and later, in 1256, by that of Alexander IV, Ut Negotium Fidei. Referring to the question of the Inquisition in the third lecture of the 1970-1971 lectures, "The Will to Knowledge," Foucault said that "it is a matter of something other than obtaining a truth, a confession ( . . . ) . It is a challenge which, within Christian thought and practice, takes up the forms of the ordeal. " See Surveiller et Punir, pp. 43-47; Discipline and Punish, pp. 38-42; "Michel Foucault. Les reponses du philosophe" Dits et Ecrits, vol. 2, pp. 810-811. See, H. C. Lea, A History of the Inquisition, vol. 1, ch. 9, "The Inquisitorial Process," pp. 399 429, and on torture, pp. 417-427; L. Tanon, Histoire des tribunaux de I'Inquisition, section III,
23, January 1974 257
? 258
PSYCHIATRIC POWER
18.
19.
20.
21.
"Procedure des tribunaux de 1'Inquisition," pp. 326 440; E. Vacandard, L'Inquisition. Etude historique et critique sur le pouvoir coercitif de I'Eglise (Paris: Bloud et Gay, 1907, 3 ed. ) p. 175; H. Leclercq, "Torture" in F. Cabrol, H. Leclercq, H. I. Marrou, eds. Diclionnaire d'archeologie chretienne et de liturgie, vol. XV (Paris: Letouzey et Ane, 1953) col. 2447-2459; P. Fiorelli, La Tortura giudi^iaria nel diritto comune (Milan: Giuiire, 1953). On the Inquisition in general, see, J. Guiraud, Histoire de /'Inquisition au Moyen Age, in two volumes (Paris: A. Picard, 1935 1938); and H. Maisonneuve, Etudes sur les origines de /'Inquisition (Paris: J. Vrin, 1960, 2nd ed. ).
This question was the topic ol the third lecture of the 1971 1972 lectures, "Penal Theories and Institutions," devoted to confession, investigation and proof. See the course summary, "Theories et institutions penales" Dits et Ecrits, vol. 2, pp. 390-391, English translation "Penal Theories and Institutions" Essential Works oj Foucault, 1, pp. 18 20.
See, M. Eliade, Forgerons et Alchimistes (1956) (Paris: Flammarion, 1977 rev. ed. ): "No virtue or erudition could do without the initiatory experience which was alone able to bring about the break of level implied in the 'transmutation' " (p. 136) and "Every initia
tion includes a series ol ritual tests which symbolize the neophyte's death and resurrection"
(p. 127).
As Lucien Braun will recall in a paper on "Paracelse et Palchimie," "the alchemist's approach must be relentlessly that ol a seeker on the look out (. . . ). Paracelsus sees con stant parturition in the alchemical process, in which the subsequent moment is always a surprise in relation to the one preceding it" in J. C. Margolin and S. Matton, eds. A/c/iimie
et Philosophie a la Renaissance (Actes du colloque international de Tours, yt-7 decembre 1991) (Paris: Vrin, 1993) p. 210. See also, M. Eliade, pp. 126-129, on the phases of the "opus alchymicum. "
See, W. Ganzenmuller, (1) Die Alchcmie im Mittelalter (Paderborn: Bonilacius, 1938), French translation by G. Petit Dutaillis, UAlchimie au Moyen Age (Paris: Aubier, W O ) , and ( 2 ) studies collected in Beitrdge %ur Geschichte der Technologic und der Alchimie (Weinheim: Verlag Chemie, 1956); F. Sherwood Taylor, The Alchemists, Founders oj Modern Chemistry (New York: H. Schuman, 19/l9); R. Alleau, Aspects de I'alchimie traditionnelle (Paris: Editions de Minuit, 1953); T. Burckhardt, Alchimie, Sinn und Wellbild(Olten: Walter Verlag, 1960); M. Caron and S. Hutin, Les Alchimistes (Pans: Le Scuil, 1964, 2nd cd. ); H. Buntz, E. Ploss, H. Roosen Runge, and H. Schipperges, Alchimia: Ideologic und Technologic (Munich: Heinz Moos Verlag, 1970); B. Husson, Anthologie de I'alchimie (Paris: Belfond, 1971); F. A. Yates, Giordano Bruno and the Hermetic Tradition (London: Routledge and Kegan Paul, 1964). Foucault broaches the question ol alchemy in his third lecture (23 May 1973)
on "La verite et les lormes juridiques"; "Truth andjuridical Forms," and in "La maison des fous" Dits et Ecrits, vol. 2, pp. 693-694.
Hippocrates was born in 460 A. D. on the Dorian island oi Cos in Asia Minor and died around 375 A. D. at Larissa in Thessaly. His works, written in the Ionian dialect of the learned, constitute the core of what became the Hippocratic corpus. See, Gossen, "Hippocrates" in A. F. Pauly and G. Wissowa, eds. , Realencyclopadie der classischen Altertumswissenschaft, vol. VIII (Stuttgart: Metzler, 1901) col. 1810-1852; M. Pohlenz, Hippokrates und die Begriindung der wissenschaftlichen Median (Berlin: De Gruyter, 1938); C. Lichtenthaeler, La Medicine hippocratique (studies in French and German) in 9 volumes (Geneva: Droz, 1948 1963); L. Edelstein, "Nachtrage: Hippokrates," in Realencyclopadie, supplement VI, 1953, col. 1290-1345; R. Joly, Le Niveau de la science hippocratique. Contribution a la psychologic de I'histoire des sciences (Paris: Les Belles Lettres, 1966); J.
Jouanna, Hippocrate. Pour une archeologie de I'ecole de Cnide (Paris: Les Belles Lettres, 1974). The basic edition ol the works oi Hippocrates is the bilingual Littre edition (see above, note 10). The basic, bilingual, English edition is the Loeb Classical Library edition ol Hippocrates, in 8 volumes (Cambridge, Mass. : Harvard University Press, 1923-1995). Thomas Sydenham (1624-1689) was an English practitioner known for the changes he introduced into medical knowledge. As Foucault notes in Histoire de lafolie, pp. 205 207 (omitted from the English translation), he organized knowledge ol pathology according to new norms by making a method ol observation, taking into account the symptoms described by the patient, against the medical systems, like Galenism or iatrochemistry, which relied on a speculative approach--earning him the name "the English
22.
23.
? 24.
Hippocrates"--and by developing a "naturalist" description ol diseases offering the possibility ol reducing clinical cases to morbid "species" delined in a botanical style. He published the results of his observations in his Observationes medicae circa morborum aculorum historiam et curationem. Methodic curandi febres, propiis observalionibus superstructa ( L o n d o n : Kettilby, 1676); English translation, Medical Observations Concerning the History and Cur of Acute Diseases, trans. R. G. Latham, in The Works of Thomas Sydenham, M. D. , vol. 1 (London: The Sydenham Society, 1848). See, K. Faber, Thomas Sydenham, dcr englische Hippocrates, und die Krankheitsbegri/je der Renaissance (Munich: Medizinische Wochenschrift, 1932) pp. 29 33; E. Bergholl, Entwicklungsgeschichte des Krankheitsbegrijjes (Vienna: W. Maudrich, 1947) pp. 68 73; and L. S. King, "Empiricism and rationalism in the works ol Thomas Sydenham," Bulletin of the History of Medicine, vol. 44, no. 1, 1970, pp. 1 11.
As Foucault recalls in Histoire de la folie, pp. 3 0 5 3 0 8 (Madness and Civilisation, pp. 146 150) Sydenham was among those who contributed to a prelerence lor an explanation of hysteria in terms ol physiological disorders of the nerves, attributed to disorders ol the "animal spirits," against the traditional explanation which relerred to the uterus and the humoral model of the "vapors": "it is not any corruption ol either the semen or the menstrual blood, to which, according to many writers, this disease is to be relerred. It is rather the faulty disposition ol the animal spintis" Dissertatio cpistolaris ad G. Cole de obser- valionis nuperis circa curationem variolarum, confuentium, necnon de ajjeclione hysterica ( L o n d o n : Kettilby, 1682); English translation, "Epistolary Dissertation" trans. R. G. Latham, The Works oj Thomas Sydenham, vol. 2,1850, p. 95; French translation in, CEuvres de medecine pra- tique, vol. II, trans. A. F. Jault and J. B. Baumes (Montpellier: J. Tourel, 1816), p. 85. See, I. Veith, "On hysterical and hypochondnacal allections," Bulletin of the History of Medicine, vol. 30, no. 3, 1956, pp. 233 240, and I. Veith, Hysteria: the History of a Disease (Chicago: Chicago University Press, 1965). More generally, see, C. Daremberg, Histoire des sciences medicates, comprcnanl /'anatomic, la physiologic, la medecine, la chirurgie et tes doctrines de patholo-
gic generate, vol. II ( Paris: J. B. Bailliere, 1870), ch. 23, "Sydenham, sa vie, ses doctrines, sa pratique, son influence," pp. 706-7Vv, K. Dewhurst, Dr Thomas Sydenham ( 162/I-16C^9): His Life and Original Writings (London: Wellcome Historical Medical Library, 1966). Foucault bases himself on the work, relerred to in the manuscript, oljohn Barker, Essai sur la conjormite de la medecine des anciens el des modernes, en comparaison entre la pratique d'Hippocrate, Galien, Syndenham et Boerhaave dans les maladies aigue's, trans. R. Schomberg (Paris: Cavalier, 1749) pp- 75 76: "Of necessity, it is indispensable lor the doctor to have a basic knowledge of the doctrine ol crises and critical days ( . . . ) to be able to discover whether or not the heat ol the humors is as it should be, at what moment to expect the cri sis, of what kind it will be, and whether or not it will prevail over the disease. " See also J. B. Aymen, Dissertation fsur] les Jours critiques (Paris: Rault, 1752). The importance ol the notion is indicated by the fact that the article "Crise" in the Encyclopedic ou Dictionnaire raisonne des sciences, des arts et des metiers ol D'Alembert and Diderot was written by a great name in medicine, Theophile Bordeu (1722 1776) and Iills 18 lolio pages (vol. IV, Lausanne: Societe typographique, 1754).
The Kaipo^ designates the moment in the evolution ol the illness when a decisive change occurs: "There is crisis in diseases when they increase, get weaker, are transformed into another disease or end" Hippocrates, Afjeclions, ? 8, in CEuvres completes, vol. VI (1847); English trans lation, Affections, in Hippocrates, vol. V, trans. Paul Potter (Cambridge, Mass: Harvard University Press, Loeb Classical Library, 1988). See, G. Hamelin, "Crtse" in Dictionnaire ency- clopedique des science medicates, T1 series, vol. XXIII (Paris: Masson/Asselin, 1879) pp. 258 319; P. Chantraine "xcupo^" in Dictionnaire etymotogique de la langue grecque, vol. II, p. 584; L. Bourgey, Observation et experience chevies medecins de la Collection Hippocratique(Paris: Vnn, 1953) pp. 236-247. On the Greek medical terms: N. Van Brock, Recherches sur le vocabulaire medical du grec ancien. Soins et guerison (Pans: Klincksieck, 1961). See Foucault, "La maison des fous" Dits et Ecrits, vol. 2, pp. 693 694.
25.
26. This is more or less the definition put torward by Sydenham in his Observationes medicae, Section 1, ch. 1, ? 1; Medical Observations, p. 29: " ( ? . . ) a disease ( . . . ) is nothing more than an effort ol Nature, who strives with might and main to restore the health of the patient by the elimination of the morbilic matter. "
23 January 1974 259
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PSYCHIATRIC POWER
27.
In Hislnire de lafolie, p. 285 and p. 245, Madness and Civilisation, p. 123 and p. 86, Foucault noted the shiit carried out in eighteenth century medicine, when it is "from the body's lie] uid and solid elements that the secret of disease was sought" rather than from the "animal spirits. " Hermann Boerhaave (1668 1738), integrating the contributions of physics, chemistry and the natural sciences, made illness the result ol an alteration of the balance ol solids and liquids: lnstitittiones medicae, in usus annae exercitationis domesticos digestae (Leyden: Van der Linden, 1708) p. 10, French translation by J. O. de La Mettrie, Institutions de medecine, vol. I (Paris: Huart, 1740). See, C. Daremberg, Histoire des sciences medicates, vol. II, ch. xxvi, pp. 897 903; L. S. King, The Background of Hermann Boerhaave's Doctrines (Boerhaave Lecture, September M1'1, 196yi) (Leyden: University of Leyden publications, 1965).
Fnednch Hoffmann (166O 1742), a doctor at Halle, considered diseases to he the result of alterations of the solid and liquid parts of the body and of their functions, and, in accordance with his mechanistic perspective, he gave a major role to modifications of the tomcity of the fibers and of the mechanics ol the blood How: (1) Fundamenta medicinae ex principiis mechanicis el practicis in usum Philiatrorum succincte proposita . . . jam aucla et emendata, et cetera (Halle: Magdeburgicae, 1703), English translation, Fundamenta Medicinae, trans. L. S. King (London/New York: Macdonald/American Elsevier, 1971) p. 10; (2) Medicina rationalis systemica, in 2 volumes (Halle: Renyeriana, 1718-1720), French translation by J. J. Bruhier (Paris: Brlasson, I738). See C. Daremberg, Histoire, vol. II, pp. 905-952; K. E. Rothschuh, "Studien zu Friedrich Hoffmann (1660-1742)" Studhoffs Archiv fur Geschichte der Medizjn, vol. 6 0 , 1976, pp. 163 193 and pp. 235 270. On this eighteenth century med icine, see, L. S. King (1) The Medical World of the Eighteenth Century (Chicago: University ol Chicago Press, 1958), and (2) "Medical theory and practice at the beginning of the eigh teenth century," Bulletin of the History of Medicine, vol. 46, no. 1, 1972, pp. 1 15.
28. Hippocrates, Epidemies, I, 3 section, ? 12 in CEuvres completes, vol. II (1840), pp. 679 681; English translation, Epidemics, Book 1, (iii), 26, in G. E. R. Lloyd, ed. Hippocratic Writings, trans. J. Chadwick and others (Harmondsworth and New York: Penguin, 1978), p. 101: "Fevers attended by paroxysms at even numbers of days, reach their crisis also in an even number; il the paroxysms are on odd days, so is the crisis. The hrst period of [lever] in those maladies which reach the crisis in an even number ol days is 4, 6, 8, 10, 14, 20, 24, 30, 40, 60, 80 or 120 days. (. . . ). It must be noted that il a crisis occurs on any other day than those mentioned, there will be a relapse and also it may prove a latal sign. One must pay attention to these days which have been specified in the course of a particular fever and realize that on them a crisis may take place leading to recovery or death, to improvement or to deterioration. "
29. On the determination ol lucky or ill lated days (or consulting the oracle, see P. Amandry, La Mantique appollinienne a Delphes. Essaisur lefontionnemenl de Coracle (Paris: E. de Boccard, 1940) ch. vn, "Frequence des consultations" pp. 81 85. On Greek "mantictsm" in general, derived from the verb (xavTeuRcrOou meaning "to prophecy," to conjecture according to ora- cles, to act as a seer ((xavrts"), the basic book, although old, ts still that ol A. Bouche Leclercq, Histoire de la divination dans VAntiquile, in 4 volumes (Paris: Leroux, 1879 1882). Also, W. R. Halliday, Greek Divination: A Study of its Methods and Principles (London: Macmillan, 1913);J. Defradas, "La divination en Grece" in A. Caquot and M. Lcibovici, eds. La Divination, vol. I (Paris: Presses universitaires de France, 1968) pp. 157 195; R. Flaceliere, Devins et Oracles grecs; and ed.
J. P. Vernant, Divination et Rationalite (Paris: Le Seuil, I974).
30. Hippocrates "considers an important part ol the art of medicine" to be the ability "to
observe the order of the critical days and to extract the elements ol prognosis from it. When we know these things, we know too when and how to give nourishment to the patient" Hippocrates, Epidemies, III, 3ul section, ? 16, in CEuvres completes, vol. Ill; English translation, Hippocrates, Epidemics, 3, trans. W. H. S. Jones, Hippocrates, vol. I, Loeb Classical Library (Cambridge, Mass: Harvard University Press, 1923).
31. Hippocrates, Pronostic, ? 1: "The best doctor seems to me to be one who can know in advance . . . He will treat best those diseases whose future course he can loresee with the help of the present condition" CEuvres completes, vol. II, p. 111; Prognosis ? 1, in Hippocratic Writings: "It seems to be highly desirable that a physician should pay much attention to
? prognosis. . . . he will be better able to effect a cure if he can loretell, trom the present
symptoms, the future course of the disease. " p. 170.
}2. In Hippocrates's own terms, the doctor's task is to "combat (avrayoviaaBai) each of the
accidents through his art. " Or again, "if we know the cause of the disease, we will be in a position to administer what is useful to the body, starting from contraries to counter (SK TOV evavTtov ermao[tEVo<;) the disease" Des Vents, I, in Guvres completes, vol. VI, p. 93 (translation amended by J. L. |; English translation, Airs, I, in Hippocrates, vol. I, Locb Classical Library (1923).
33. Taken from juridical language, the term krisis means "judgment," "decision," before desig nating in medicine the crucial moment at which "the disease judges | KpiveTcu] lor death
or life "Des Affections internes,21 220, 9, in GLuvres completes, vol. VII, p. 217; "Internal Affections," trans. Paul Potter, Hippocrates, vol. VI, Loeb Classical Library (1988). Or again there is this expression in Epidemies, I, 2IK section, ?
14. In fact Foucault will not keep to this program apart from some comments on the role of childhood in the generalization ol psychiatric knowledge and power in the 1974-1975 College de France lectures of 5,12, and 19 March: Les Anormaux, pp. 217 301; Abnormal, pp. 231 321.
15- From the Old English, ordal, judgment, the "judgment of God" or "ordeal," means to settle contentious questions with the idea that God intervenes in the case to judge during tests likes those of "fire," the "branding iron," "cold or boiling water," and the "cross," etcetera. See L. Tanon, Histoire des tribunaux de /'Inquisition en France (Pans: L. Larose and Forcel, 1893) on the penalties of "lire" (pp. 464-479) and the "cross" (pp. 490-498). As J. -P. Levy emphasizes in his, La Hierarchie des preuves dans le droit savant du Moyen Age, depuis la renaissance du droit romain jusqu'a la fin du xivc siecle (Paris: Sirey, 1939), in this procedure "the trial is not an investigation with the aim of finding out the truth ( . . . ) . It is originally
a struggle, and later, an appeal to God; the concern with making the truth come out is left up to Him, but the judge does not seek it himselt" (p. 163).
Foucault referred to the question of the ordeal in the third lecture of the 1970-1971 College de France lectures, "The Will to Knowledge," in which he noted that in "the treat
ments to which madness was subjected, we find something like this ordeal test of the truth. " The ninth lecture of the 1971 1972 lectures, devoted to accusatory procedure and
the system of proof, refers to it (see above note 12). See also, M. Foucault, "La verite et les
iormes juridiques"; "Truth and Juridical Forms. " See, A. Esmein, Histoire de la procedure criminelle en France, et specialement de la procedure inquisitoire depuis le xiii' siecle jusqu'a nos jours (Paris: Larose et Forcel, 1882) pp. 260 283; E. Vacandard, "L'Eglise et les ordalies" in
filudes de critique et d'histoire religieuse, vol. I (Paris: V. Lecoffre, 1905) pp. 189 214; G. Glotz, Etudes sociales et juridiques sur I'antiquite grecque, ch. 2, "L'ordalie" (Paris: Hachette, 1 9 0 6 ) pp. 69 97; A. Michel, "Ordalies" in, A. Vacant, ed. , Dictionnaire de theologie catholique, vol. XI (Paris: Letouzey et Ane, 1930) col. 1139-1152; Y. Bongert, Recherches sur les cours la'iques du xe au xiif siecles (Paris: A et J. Picard, 1949) pp. 215-228; H. Nottarp, Gottehurteilstudien (Munich: Kosel Verlag, 1956); and J. Gaudemet, "Les ordalies au Moyen Age: doctrine, legislation et pratique canonique" in Recueil de la Societe Jean Bodin (Brussels: 1965) vol. XVII, Part 2, La Preuve.
16. In the basically accusatory procedures that involved taking God as witness so that he pro- duces the accuracy or retraction oi the accusation, confession was not enough to pronounce sentence. See, H. C. Lea, A History of the Inquisition of the Middle Ages, vol. 1, pp. 407-408;
A. Esmein, Histoire de la procedure criminelle, p. 273; andj. P. Levy, La Hierarchie des preuves, pp. 19 83. On confession, see Surveiller et Punir, pp. 42-45; Discipline and Punish, pp. 37-40.
17. Torture, unlike the sovereign means of proof by ordeal--the expression of God's testimony--was a way of provoking judicial confession. The inquisitorial procedure was integrated into canon law in 1232 when Pope Gregory IX called upon the Dominicans to establish a tribunal of Inquisition specifically lor the search lor and punishment ol heretics. Recourse to judicial torture was approved by the bull, Ad Extirpanda, of Pope Innocent IV of 15 May 1252, and later, in 1256, by that of Alexander IV, Ut Negotium Fidei. Referring to the question of the Inquisition in the third lecture of the 1970-1971 lectures, "The Will to Knowledge," Foucault said that "it is a matter of something other than obtaining a truth, a confession ( . . . ) . It is a challenge which, within Christian thought and practice, takes up the forms of the ordeal. " See Surveiller et Punir, pp. 43-47; Discipline and Punish, pp. 38-42; "Michel Foucault. Les reponses du philosophe" Dits et Ecrits, vol. 2, pp. 810-811. See, H. C. Lea, A History of the Inquisition, vol. 1, ch. 9, "The Inquisitorial Process," pp. 399 429, and on torture, pp. 417-427; L. Tanon, Histoire des tribunaux de I'Inquisition, section III,
23, January 1974 257
? 258
PSYCHIATRIC POWER
18.
19.
20.
21.
"Procedure des tribunaux de 1'Inquisition," pp. 326 440; E. Vacandard, L'Inquisition. Etude historique et critique sur le pouvoir coercitif de I'Eglise (Paris: Bloud et Gay, 1907, 3 ed. ) p. 175; H. Leclercq, "Torture" in F. Cabrol, H. Leclercq, H. I. Marrou, eds. Diclionnaire d'archeologie chretienne et de liturgie, vol. XV (Paris: Letouzey et Ane, 1953) col. 2447-2459; P. Fiorelli, La Tortura giudi^iaria nel diritto comune (Milan: Giuiire, 1953). On the Inquisition in general, see, J. Guiraud, Histoire de /'Inquisition au Moyen Age, in two volumes (Paris: A. Picard, 1935 1938); and H. Maisonneuve, Etudes sur les origines de /'Inquisition (Paris: J. Vrin, 1960, 2nd ed. ).
This question was the topic ol the third lecture of the 1971 1972 lectures, "Penal Theories and Institutions," devoted to confession, investigation and proof. See the course summary, "Theories et institutions penales" Dits et Ecrits, vol. 2, pp. 390-391, English translation "Penal Theories and Institutions" Essential Works oj Foucault, 1, pp. 18 20.
See, M. Eliade, Forgerons et Alchimistes (1956) (Paris: Flammarion, 1977 rev. ed. ): "No virtue or erudition could do without the initiatory experience which was alone able to bring about the break of level implied in the 'transmutation' " (p. 136) and "Every initia
tion includes a series ol ritual tests which symbolize the neophyte's death and resurrection"
(p. 127).
As Lucien Braun will recall in a paper on "Paracelse et Palchimie," "the alchemist's approach must be relentlessly that ol a seeker on the look out (. . . ). Paracelsus sees con stant parturition in the alchemical process, in which the subsequent moment is always a surprise in relation to the one preceding it" in J. C. Margolin and S. Matton, eds. A/c/iimie
et Philosophie a la Renaissance (Actes du colloque international de Tours, yt-7 decembre 1991) (Paris: Vrin, 1993) p. 210. See also, M. Eliade, pp. 126-129, on the phases of the "opus alchymicum. "
See, W. Ganzenmuller, (1) Die Alchcmie im Mittelalter (Paderborn: Bonilacius, 1938), French translation by G. Petit Dutaillis, UAlchimie au Moyen Age (Paris: Aubier, W O ) , and ( 2 ) studies collected in Beitrdge %ur Geschichte der Technologic und der Alchimie (Weinheim: Verlag Chemie, 1956); F. Sherwood Taylor, The Alchemists, Founders oj Modern Chemistry (New York: H. Schuman, 19/l9); R. Alleau, Aspects de I'alchimie traditionnelle (Paris: Editions de Minuit, 1953); T. Burckhardt, Alchimie, Sinn und Wellbild(Olten: Walter Verlag, 1960); M. Caron and S. Hutin, Les Alchimistes (Pans: Le Scuil, 1964, 2nd cd. ); H. Buntz, E. Ploss, H. Roosen Runge, and H. Schipperges, Alchimia: Ideologic und Technologic (Munich: Heinz Moos Verlag, 1970); B. Husson, Anthologie de I'alchimie (Paris: Belfond, 1971); F. A. Yates, Giordano Bruno and the Hermetic Tradition (London: Routledge and Kegan Paul, 1964). Foucault broaches the question ol alchemy in his third lecture (23 May 1973)
on "La verite et les lormes juridiques"; "Truth andjuridical Forms," and in "La maison des fous" Dits et Ecrits, vol. 2, pp. 693-694.
Hippocrates was born in 460 A. D. on the Dorian island oi Cos in Asia Minor and died around 375 A. D. at Larissa in Thessaly. His works, written in the Ionian dialect of the learned, constitute the core of what became the Hippocratic corpus. See, Gossen, "Hippocrates" in A. F. Pauly and G. Wissowa, eds. , Realencyclopadie der classischen Altertumswissenschaft, vol. VIII (Stuttgart: Metzler, 1901) col. 1810-1852; M. Pohlenz, Hippokrates und die Begriindung der wissenschaftlichen Median (Berlin: De Gruyter, 1938); C. Lichtenthaeler, La Medicine hippocratique (studies in French and German) in 9 volumes (Geneva: Droz, 1948 1963); L. Edelstein, "Nachtrage: Hippokrates," in Realencyclopadie, supplement VI, 1953, col. 1290-1345; R. Joly, Le Niveau de la science hippocratique. Contribution a la psychologic de I'histoire des sciences (Paris: Les Belles Lettres, 1966); J.
Jouanna, Hippocrate. Pour une archeologie de I'ecole de Cnide (Paris: Les Belles Lettres, 1974). The basic edition ol the works oi Hippocrates is the bilingual Littre edition (see above, note 10). The basic, bilingual, English edition is the Loeb Classical Library edition ol Hippocrates, in 8 volumes (Cambridge, Mass. : Harvard University Press, 1923-1995). Thomas Sydenham (1624-1689) was an English practitioner known for the changes he introduced into medical knowledge. As Foucault notes in Histoire de lafolie, pp. 205 207 (omitted from the English translation), he organized knowledge ol pathology according to new norms by making a method ol observation, taking into account the symptoms described by the patient, against the medical systems, like Galenism or iatrochemistry, which relied on a speculative approach--earning him the name "the English
22.
23.
? 24.
Hippocrates"--and by developing a "naturalist" description ol diseases offering the possibility ol reducing clinical cases to morbid "species" delined in a botanical style. He published the results of his observations in his Observationes medicae circa morborum aculorum historiam et curationem. Methodic curandi febres, propiis observalionibus superstructa ( L o n d o n : Kettilby, 1676); English translation, Medical Observations Concerning the History and Cur of Acute Diseases, trans. R. G. Latham, in The Works of Thomas Sydenham, M. D. , vol. 1 (London: The Sydenham Society, 1848). See, K. Faber, Thomas Sydenham, dcr englische Hippocrates, und die Krankheitsbegri/je der Renaissance (Munich: Medizinische Wochenschrift, 1932) pp. 29 33; E. Bergholl, Entwicklungsgeschichte des Krankheitsbegrijjes (Vienna: W. Maudrich, 1947) pp. 68 73; and L. S. King, "Empiricism and rationalism in the works ol Thomas Sydenham," Bulletin of the History of Medicine, vol. 44, no. 1, 1970, pp. 1 11.
As Foucault recalls in Histoire de la folie, pp. 3 0 5 3 0 8 (Madness and Civilisation, pp. 146 150) Sydenham was among those who contributed to a prelerence lor an explanation of hysteria in terms ol physiological disorders of the nerves, attributed to disorders ol the "animal spirits," against the traditional explanation which relerred to the uterus and the humoral model of the "vapors": "it is not any corruption ol either the semen or the menstrual blood, to which, according to many writers, this disease is to be relerred. It is rather the faulty disposition ol the animal spintis" Dissertatio cpistolaris ad G. Cole de obser- valionis nuperis circa curationem variolarum, confuentium, necnon de ajjeclione hysterica ( L o n d o n : Kettilby, 1682); English translation, "Epistolary Dissertation" trans. R. G. Latham, The Works oj Thomas Sydenham, vol. 2,1850, p. 95; French translation in, CEuvres de medecine pra- tique, vol. II, trans. A. F. Jault and J. B. Baumes (Montpellier: J. Tourel, 1816), p. 85. See, I. Veith, "On hysterical and hypochondnacal allections," Bulletin of the History of Medicine, vol. 30, no. 3, 1956, pp. 233 240, and I. Veith, Hysteria: the History of a Disease (Chicago: Chicago University Press, 1965). More generally, see, C. Daremberg, Histoire des sciences medicates, comprcnanl /'anatomic, la physiologic, la medecine, la chirurgie et tes doctrines de patholo-
gic generate, vol. II ( Paris: J. B. Bailliere, 1870), ch. 23, "Sydenham, sa vie, ses doctrines, sa pratique, son influence," pp. 706-7Vv, K. Dewhurst, Dr Thomas Sydenham ( 162/I-16C^9): His Life and Original Writings (London: Wellcome Historical Medical Library, 1966). Foucault bases himself on the work, relerred to in the manuscript, oljohn Barker, Essai sur la conjormite de la medecine des anciens el des modernes, en comparaison entre la pratique d'Hippocrate, Galien, Syndenham et Boerhaave dans les maladies aigue's, trans. R. Schomberg (Paris: Cavalier, 1749) pp- 75 76: "Of necessity, it is indispensable lor the doctor to have a basic knowledge of the doctrine ol crises and critical days ( . . . ) to be able to discover whether or not the heat ol the humors is as it should be, at what moment to expect the cri sis, of what kind it will be, and whether or not it will prevail over the disease. " See also J. B. Aymen, Dissertation fsur] les Jours critiques (Paris: Rault, 1752). The importance ol the notion is indicated by the fact that the article "Crise" in the Encyclopedic ou Dictionnaire raisonne des sciences, des arts et des metiers ol D'Alembert and Diderot was written by a great name in medicine, Theophile Bordeu (1722 1776) and Iills 18 lolio pages (vol. IV, Lausanne: Societe typographique, 1754).
The Kaipo^ designates the moment in the evolution ol the illness when a decisive change occurs: "There is crisis in diseases when they increase, get weaker, are transformed into another disease or end" Hippocrates, Afjeclions, ? 8, in CEuvres completes, vol. VI (1847); English trans lation, Affections, in Hippocrates, vol. V, trans. Paul Potter (Cambridge, Mass: Harvard University Press, Loeb Classical Library, 1988). See, G. Hamelin, "Crtse" in Dictionnaire ency- clopedique des science medicates, T1 series, vol. XXIII (Paris: Masson/Asselin, 1879) pp. 258 319; P. Chantraine "xcupo^" in Dictionnaire etymotogique de la langue grecque, vol. II, p. 584; L. Bourgey, Observation et experience chevies medecins de la Collection Hippocratique(Paris: Vnn, 1953) pp. 236-247. On the Greek medical terms: N. Van Brock, Recherches sur le vocabulaire medical du grec ancien. Soins et guerison (Pans: Klincksieck, 1961). See Foucault, "La maison des fous" Dits et Ecrits, vol. 2, pp. 693 694.
25.
26. This is more or less the definition put torward by Sydenham in his Observationes medicae, Section 1, ch. 1, ? 1; Medical Observations, p. 29: " ( ? . . ) a disease ( . . . ) is nothing more than an effort ol Nature, who strives with might and main to restore the health of the patient by the elimination of the morbilic matter. "
23 January 1974 259
? 260
PSYCHIATRIC POWER
27.
In Hislnire de lafolie, p. 285 and p. 245, Madness and Civilisation, p. 123 and p. 86, Foucault noted the shiit carried out in eighteenth century medicine, when it is "from the body's lie] uid and solid elements that the secret of disease was sought" rather than from the "animal spirits. " Hermann Boerhaave (1668 1738), integrating the contributions of physics, chemistry and the natural sciences, made illness the result ol an alteration of the balance ol solids and liquids: lnstitittiones medicae, in usus annae exercitationis domesticos digestae (Leyden: Van der Linden, 1708) p. 10, French translation by J. O. de La Mettrie, Institutions de medecine, vol. I (Paris: Huart, 1740). See, C. Daremberg, Histoire des sciences medicates, vol. II, ch. xxvi, pp. 897 903; L. S. King, The Background of Hermann Boerhaave's Doctrines (Boerhaave Lecture, September M1'1, 196yi) (Leyden: University of Leyden publications, 1965).
Fnednch Hoffmann (166O 1742), a doctor at Halle, considered diseases to he the result of alterations of the solid and liquid parts of the body and of their functions, and, in accordance with his mechanistic perspective, he gave a major role to modifications of the tomcity of the fibers and of the mechanics ol the blood How: (1) Fundamenta medicinae ex principiis mechanicis el practicis in usum Philiatrorum succincte proposita . . . jam aucla et emendata, et cetera (Halle: Magdeburgicae, 1703), English translation, Fundamenta Medicinae, trans. L. S. King (London/New York: Macdonald/American Elsevier, 1971) p. 10; (2) Medicina rationalis systemica, in 2 volumes (Halle: Renyeriana, 1718-1720), French translation by J. J. Bruhier (Paris: Brlasson, I738). See C. Daremberg, Histoire, vol. II, pp. 905-952; K. E. Rothschuh, "Studien zu Friedrich Hoffmann (1660-1742)" Studhoffs Archiv fur Geschichte der Medizjn, vol. 6 0 , 1976, pp. 163 193 and pp. 235 270. On this eighteenth century med icine, see, L. S. King (1) The Medical World of the Eighteenth Century (Chicago: University ol Chicago Press, 1958), and (2) "Medical theory and practice at the beginning of the eigh teenth century," Bulletin of the History of Medicine, vol. 46, no. 1, 1972, pp. 1 15.
28. Hippocrates, Epidemies, I, 3 section, ? 12 in CEuvres completes, vol. II (1840), pp. 679 681; English translation, Epidemics, Book 1, (iii), 26, in G. E. R. Lloyd, ed. Hippocratic Writings, trans. J. Chadwick and others (Harmondsworth and New York: Penguin, 1978), p. 101: "Fevers attended by paroxysms at even numbers of days, reach their crisis also in an even number; il the paroxysms are on odd days, so is the crisis. The hrst period of [lever] in those maladies which reach the crisis in an even number ol days is 4, 6, 8, 10, 14, 20, 24, 30, 40, 60, 80 or 120 days. (. . . ). It must be noted that il a crisis occurs on any other day than those mentioned, there will be a relapse and also it may prove a latal sign. One must pay attention to these days which have been specified in the course of a particular fever and realize that on them a crisis may take place leading to recovery or death, to improvement or to deterioration. "
29. On the determination ol lucky or ill lated days (or consulting the oracle, see P. Amandry, La Mantique appollinienne a Delphes. Essaisur lefontionnemenl de Coracle (Paris: E. de Boccard, 1940) ch. vn, "Frequence des consultations" pp. 81 85. On Greek "mantictsm" in general, derived from the verb (xavTeuRcrOou meaning "to prophecy," to conjecture according to ora- cles, to act as a seer ((xavrts"), the basic book, although old, ts still that ol A. Bouche Leclercq, Histoire de la divination dans VAntiquile, in 4 volumes (Paris: Leroux, 1879 1882). Also, W. R. Halliday, Greek Divination: A Study of its Methods and Principles (London: Macmillan, 1913);J. Defradas, "La divination en Grece" in A. Caquot and M. Lcibovici, eds. La Divination, vol. I (Paris: Presses universitaires de France, 1968) pp. 157 195; R. Flaceliere, Devins et Oracles grecs; and ed.
J. P. Vernant, Divination et Rationalite (Paris: Le Seuil, I974).
30. Hippocrates "considers an important part ol the art of medicine" to be the ability "to
observe the order of the critical days and to extract the elements ol prognosis from it. When we know these things, we know too when and how to give nourishment to the patient" Hippocrates, Epidemies, III, 3ul section, ? 16, in CEuvres completes, vol. Ill; English translation, Hippocrates, Epidemics, 3, trans. W. H. S. Jones, Hippocrates, vol. I, Loeb Classical Library (Cambridge, Mass: Harvard University Press, 1923).
31. Hippocrates, Pronostic, ? 1: "The best doctor seems to me to be one who can know in advance . . . He will treat best those diseases whose future course he can loresee with the help of the present condition" CEuvres completes, vol. II, p. 111; Prognosis ? 1, in Hippocratic Writings: "It seems to be highly desirable that a physician should pay much attention to
? prognosis. . . . he will be better able to effect a cure if he can loretell, trom the present
symptoms, the future course of the disease. " p. 170.
}2. In Hippocrates's own terms, the doctor's task is to "combat (avrayoviaaBai) each of the
accidents through his art. " Or again, "if we know the cause of the disease, we will be in a position to administer what is useful to the body, starting from contraries to counter (SK TOV evavTtov ermao[tEVo<;) the disease" Des Vents, I, in Guvres completes, vol. VI, p. 93 (translation amended by J. L. |; English translation, Airs, I, in Hippocrates, vol. I, Locb Classical Library (1923).
33. Taken from juridical language, the term krisis means "judgment," "decision," before desig nating in medicine the crucial moment at which "the disease judges | KpiveTcu] lor death
or life "Des Affections internes,21 220, 9, in GLuvres completes, vol. VII, p. 217; "Internal Affections," trans. Paul Potter, Hippocrates, vol. VI, Loeb Classical Library (1988). Or again there is this expression in Epidemies, I, 2IK section, ?
