HistoryofMadnessPraiseforthisnewedition:

‘OneofthemajorworksofthetwentiethcenturyisfinallyavailableinEnglish.This comprehensive translation finally overcomes one of the great divisionswithintheworldofreason;anoccasiontorevisitMadnessandCivilizationasitwaswritten.’PaulRabinow,UniversityofCalifornia,Berkeley

‘With this beautiful and moving book, Michel Foucault transformed ourunderstandingoftheprocessesthathadmadepsychiatrypossible—theprocesswhichhadbroughtitsobject,mentalillness,intoexistence,andwhichinscribedit into our modern imagination as pathology, negativity, incompetence anddeficiency.Instudyingthehistoryofmadnessinthisway,Foucaultalsotaughtus crucial lessons about the assembling of what we have come to call‘civilization’.Now,atlast,Englishspeakingreaderscanhaveaccesstothedepthof scholarship that underpinned Foucault’s analysis: I have no doubt that thislongawaitedtranslationwillhaveatransformativeeffectonanewgenerationofreaders.’NikolasRose,LondonSchoolofEconomics

ReviewsoftheoriginalFrenchedition:

‘A thick manuscript arrived: a philosophy thesis on the relations betweenmadnessandunreason in theclassicalage,byanauthor Ididnotknow. IwasdazzledwhenIreadit.’PhilippeAriès

'This magnificent book . . . reuires a mind that is capable of being in turn ahistorian,aphilosopher,apsychologist,andasociologist. . .neversimplyoneofthese...Thisisnotamethodthatcouldbeofferedasanexample;itisnotwithin the reach of just anybody. Something more than talent is necessary.’FernandBraudel,Annales

MichelFoucault

HistoryofMadness

EditedbyJeanKhalfaTranslatedbyJonathanMurphyandJeanKhalfa

Firstpublished2006

byRoutledge

2ParkSquare,MiltonPark,Abingdon,Oxon,OX144RN

RoutledgeisanimprintoftheTaylor&FrancisGroup,aninformabusiness

FirstpublishedinFrenchas'FolieetDéraison:Histoiredelafolieàl'âgeclassique'LibrariePlon,Paris,1961.

Thiseditionisatranslationof'HistoiredelaFolieál'âgeclassique'©EditionsGALLIMARD,Paris,1972

Appendices'Moncrops,cepapier,cefeu'and'Lafolie,l'absenced'œuvre'©EditionsGALLIMARD,Paris,1972

Appendix'ReplytoDerrida'fromMichelFoucault,DitsetEcritsVolII©EditionsGALLIMARD,Paris,1994

ThisEnglishTranslation©2006Routledge

IntroductionandEditorialMatter©2006JeanKhalfa

Foreword©2006IanHacking

OuvragepubliéavecleconcoursduMinistèrefrançaischargédelaculture–CentreNationalduLivre

ThiseditionispublishedwiththehelpoftheFrenchMinistryofCulture–NationalBookCentre

TypesetinJoannabyRefineCatchLimited,Bungay,SuffolkPrintedandboundinGreatBritainbyMPGBooksLtd,Bodmin

Allrightsreserved.Nopartofthisbookmaybereprintedorreproducedorutilisedinanyformorbyanyelectronic,mechanical,orothermeans,now

knownorhereafterinvented,includingphotocopyingandrecording,orinanyinformationstorageorretrievalsystem,withoutpermissioninwritingfromthepublishers.

BritishLibraryCataloguinginPublicationDataAcataloguerecordforthisbookisavailablefromtheBritishLibrary

ISBN10:0–415–27701–9

ISBN10:0–203–64260–0(eBook)

ISBN13:978–0–415–27701–3

ISBN13:978–0–203–64260–3(eBook)

BiographyofMichelFoucaultMichelFoucaultwasborninPoitierson15June1926,thesonofadoctor.Hefinished his secondary education in Paris at the LycéeHenry IV in 1946 andwent on to study philosophy at the prestigious École Normale Supérieure,attendinginparticularthelecturesofMauriceMerleau-PontyandworkingwithJean Hyppolite, on Hegel, and with Louis Althusser. Despite suffering fromsporadic bouts of depression and a suicide attempt in 1948, Foucault secureddegrees in philosophy in 1948 and in psychology in 1950. He passed hisagrégation in philosophy in 1951. He joined the French Communist Party in1950andquitin1952.

LecturingattheÉcoleNormaleSupérieureandworkingasapsychologistattheHôpital Sainte-Anne, in the early 1950s, he became dissatisfied with theconfines of French academic life and held diplomatic and academic posts inSweden (where he met and worked with Georges Dumézil), Poland andGermany,whilstworkingonhisthesisFolieetDéraison:Histoiredelafolieàl’âgeclassique.InitiallyrejectedbyGallimard,itwaspublishedin1961bythegreat historian PhilippeAriès at Librairie Plon, the publisher of Claude Lévi-Strauss. Itwashailed as ‘magnificent’byFernandBraudel.Severalothernowfamousworksfollowed,includingTheBirthoftheClinic,TheOrderofThings,andTheArchaeologyofKnowledge.In1968,Foucaultwasappointedtoachairatthenew,experimental,UniversityofVincennesand,in1970,waselectedtoaprestigious chair at the Collège de France where he taught the History ofSystemsofThought.

Whileproducingaverylargeandinfluentialbodyofresearchduringthe1960sand 1970s, Foucault threw himself into political and social activism. Hecampaigned in particular on behalf of homosexuals and for prison reform. In1975hepublishedoneofhismostfamousworks,DisciplineandPunish:Birthof thePrison.Foucault travelled toNorthAmerica in the late1970sandearly1980s, teaching annually at the University of California at Berkeley. FreelyexperimentingwithLSDand the liberal sexual environment, he livedwhat he

termed ‘limit experiences’. During that period, in addition to many articles(published posthumously in four volumes), hewrote the three volumes of hisHistoryofSexuality.

Fatally ill with AIDS,Michel Foucault died in Paris on 25 June 1984 in theSalpêtrièreHospitalattheageoffifty-seven.Afterhisdeath,theFrenchprimeministerissuedatributeandmemorialhomagesfeaturedonthefrontpagesofallthe national press. In his obituary, Georges Dumézil wrote, ‘Foucault’sintelligenceliterallyknewnolimits.’

ContentsForewordbyIanHackingIntroductionbyjeanKhalfaPrefacetothe1961editionPrefacetothe1972editionPARTONEIStultiferaNavisIIThegreatconfinementIIIThecorrectionalworldIVExperiencesofmadnessVTheinsanePARTTWOIntroductionIThemadmaninthegardenofspeciesIIThetranscendenceofdeliriumIIIFiguresofmadnessIVDoctorsandpatientsPARTTHREEIntroductionIThegreatfearIIThenewdivisionIIITheproperuseoflibertyIVBirthoftheasylumVTheanthropologicalcircleAPPENDICESIMadness,theabsenceofanoeuvre.Appendix1of1972editionIIMybody,thispaper,thisfire.AppendixIIof1972editionIIIReplytoDerrida('MichelFoucaultPaideia(Tokyo)February1972)EndnotesANNEXES

IDocumentsIIFoucault'soriginalbibliographyIIIBibliographyofEnglishworksquotedinthistranslationIVCriticalbibliographyonFoucault'sHistoryofMadnessIndex

ForewordIanHacking

Thank goodness this enormous book is finally available in English. Amasterpiece needs no foreword, so I shall hardly go beyond the title. Theoriginalone isabit likeAlice’sCheshireCat,ofwhichnothing is leftbut thegrin.ItstartsoutasMadnessandUnreason:HistoryofMadnessintheClassicalAge,andfadesawaysothatweareleftwithourpresentHistoryofMadness. Ishallgothroughthesteps.Itisagradualdisappearingact,andIshallpointyouinthedirectionofthedisappeared‘unreason’,nottoexplainit,buttoencourageyoutonoticeit.Inthetaleofthetitlesandofunreason,thereareallthesignsofFoucaultchanginghismindaboutmadness.The exact title in 1961 wasFolie et Déraison. Histoire de la folie à l’âge

classique.VeryoftenonlythefirstwordofaFrenchtitleiscapitalised.In1961the second noun, déraison, was also given a capital letter. Daniel Defert,Foucault’s longtime intellectual colleague, companion, and posthumous editor,laid emphasis on the exact title of the original. He does so in his incrediblyvaluabledate list, far richer than anyordinary chronology, at thebeginningofDitsetécrits,thecollectionofFoucault’spublishedessays,interviews,speechesandprefaces.‘Unreason’wasrightuptherealongside‘Madness’.Thebigbookof1961was

severelyabridged,andappearedasapaperbackin1964.Halfofthefirstprefacewassuppressed.OnthecoverweseeonlyHistoiredelafolie.Onthetitlepagethefull1961titleappearsinblockletters,butwithFolieetDéraisoninsmallerprintthanthesubtitle.Fading,likethecat.Thisversionwastranslatedintomanylanguages,whileonlyanItalianpublisherdidtheunabridgedbook.Forthe1965Englishversion,Foucaultrestoredalittlematerialthathehadcutfromthe1964Frenchabridgement.Foramoment,aflickermoreofthecat’sfacecameback.ForherearethemostvividassertionsaboutUnreasontobefoundintheentirework.Theywillhardlymakesenseoutofcontext,soIreferyoutothepagesinquestionwhichweresuppressedandthenrestored(pp.225–250).Youwillfind

sentenceslikethis:‘HowcanweavoidsummingupthisexperiencebythesinglewordUnreason?Bythatwemeanallthatforwhichreasonisatoncenearestandmostdistant,fullestandmostempty.’In 1972 Foucault published a second edition of the entire book, plus three

appendices,butwithasubstitutepreface.TheFrenchtitlehadbecomewhatwasformerlythesubtitle,HistoryofMadnessintheClassicalAge.Whatisthedéraisonthatdroppedfromthetitlebutwasstillalloverthetext?

Unreason is not identical tomadness but something that contrastswith it. Forexample,

intheanxietyofthesecondhalfoftheeighteenthcentury,thefearofmadnessgrewatthesamerateasthedreadofunreason,andforthatreasonthetwinobsessionsconstantlylenteachothermutualsupport.

(p.362)

Laterwereadthatsincetheendoftheeighteenthcentury‘thelifeofunreason’nolongermanifestsitselfexceptintheflashesoflightningfoundinworkslikethoseof‘Hölderlin,Nerval,NietzscheandArtaud’whichresisted‘throughtheirown strength that gigantic moral imprisonment’. Standard French history andiconography of psychiatry represents Pinel casting off the chains of madmensoonaftertheBastillehadfallen,sothatisastoryofliberatingthemad.Herewearetoldthatthenew‘moral’treatmentofinsanitywasalsotheimprisonmentofunreasonthathadflashedsoopenlyonthecanvassesofHieronymusBosch.CasualreferencebooksdiagnoseHölderlinasaschizophrenicpoet,Nietzsche

as a philosopher suffering from dementia caused by terminal syphilis, andArtaudasabipolar(manic-depressive)playwright.Nervalkilledhimself:wesaysuicideiscausedbyseveredepressiveillness.It isacentralthesisofthisbookthat, far from these being inevitable ways of conceiving of four very strangemen,itrequiresaspecificorganizationofthoughttocategorisethem—andsomanyotherpeople—intermsofmentaldisorder.Foucaultdoesnotpandertothe thought thatgeniusandmentaldisturbanceareofapiece.Theartof thesemen, as he shouts at the end of the book, is the exact opposite of insanity:‘Wherethereisanœuvre,thereisnomadness’(p.577).Alongside madness there is also unreason. It had much fuller play in the

Renaissance, an unreason that Foucault evokes by the ship of fools and thepaintings of Bosch, especially The Temptation of Saint Anthony. (Foucault is

marvellouswithpaintings:lookhowmuchhedrawsfromGoyaattheendofthebook, and one knows the tour de force on Velasquez that openThe Order ofThings.)Heevensaysthatintheearlydaysofconfiningthemad,theexperienceofunreasonsmotheredsomethingelse,theconsciousnessofmadness(p.362).Butthentwodistinctobsessionsemerged,hetellsus,madnessandunreason.

Thefearofoneandthedreadoftheotherweretamedintheasylum.Thelifeofunreason could break through the resulting silence only in the voices of thosewho were classified among the mad but who, through their art, rose abovemadnesstoactasstandardstowhichthesaneandclassifyingworldisunabletoanswer.Aromanticfantasylurkshere,thepurityofthepossessed,thosewhonotonly

speak the truth in paradox, like the fools in Shakespeare, but who are alsothemselvesthetruth.The fantasy leapsout atyou from the1961preface, inwords suppressed in

1964:‘amadnesswhosewildstatecanneverbereconstituted;butintheabsenceof that inaccessible primitive purity...’ (p. xxxiii). There it is: the inaccessibleprimitive purity. That is whatmade the book so attractive to the British anti-psychiatricmovement.SomuchisclearfromtheendofDavidCooper’sprefaceto theEnglish (asopposed to theAmericanedition)versionof1967—and itwasCooperwhohadcoinedtheneologism‘anti-psychiatry’in1962.By 1964, half the prefacewas cut, and by 1972 it had all gone. In a new,

splendidlybrief,andseeminglytransparentpreface,MichelFoucaultspeaks,aswas then his wont, of a book being an event, which if it lives, lives throughrepeateddoublingsandsimulacra.Ithasitsownlife,freeoftheauthor.Doublings:Isuggestthatyouholdinyourhandstwodistinctbooks.Themain

textofeachisthesame.ItisalltooeasytocomparethesetwobookstothetwoDon Quixote invented by Borges, the one written by Cervantes, the other,identicalinwords,writtenmuchlaterbyanimaginedPierreMenard.Despitethewordsbeingthesame,somuchhashappenedthatthemeaningisdifferent.1

Oneofthesebooksisgovernedbyanideaofdéraison,inwhichtherelurksadream ofmadness in thewild, as something prediscursive, inaccessible, pure.Theotherbookiswhatthefirstbecame,strippedofromanticillusion.The 1961 preface promised an archaeology of a silence — and not an

archaeology of psychiatry, that ‘monologue of reason about madness’. What

Foucaultnamed‘archaeology’shows,inpart,howadiscoursebecomespossible.He did not show how the psychiatricmonologue became possible: hemerelyrecordedthatitcameintobeing.Thesilencewassilenceaboutunreason.Thatcausesusdifficulty.Unreasonis

stillaword,butit isnolongerpartofdailylanguage.MuchthesamegoesforFrenchdéraison(p.156).Fromtheveryfirstparagraphofthisforewordyouwillhave been wondering what it means. Rightly so.Madness is the visible grin,unreasonthecatthathasfadedaway.‘Archaeologyof a silence’— that is from the part of the 1961preface that

remained in 1964, but then disappeared. Once Foucault’s idea of archaeologyhadmatured,itappearsthatanarchaeologycanonlybeofwhatissaid.Ifso,thesecondbook(ofthetwoidenticaltexts)isnolongeranarchaeologyofsilence.Itistheworkofanauthorwhoisnolongerobsessedbythefearofmadnessanddread of unreason. He has made peace with both, and has moved on to thegreatestofhisarchaeologies,TheOrderofThings(1966).

IntroductionJeanKhalfa

Foucault’sHistoryofMadnesshasyettoberead.MadnessandCivilisation,theEnglish translation ofHistoire de la Folie, was based on an abridged Frencheditionfromwhichroughly300pageshadbeenremoved,togetherwithmostofthe scholarly apparatus (about 800 footnotes and the bibliography).1 Mostinterpretations and criticismsmade of the book in theEnglish-speakingworldwere therefore based on a partial perspective. Additionally, because of thehistorical circumstances of its appearance, the book was largely confined todebates surrounding the anti-psychiatric movement: the Introduction to theEnglisheditionwaswrittenbyDavidCooper,andthereader’snoteR.D.Lainghadwritten forRoutledge (reproducedhere)wasused for thebackcover. It istruethatFoucaultdidnotmarkhisdistancefromsuchreadings,perhapsbecausehisdesirewas,hesaid,

thatthisobject-event,almostimperceptibleamongsomanyothers,shouldrecopy,fragment,repeat,simulateandreplicateitself,andfinallydisappearwithoutthepersonwhohappenedtoproduceiteverbeingabletoclaimtherighttobeitsmaster,andimposewhathewishedtosay,orsaywhathewantedittobe.

(1972Preface)

Rereading it today, and in theway it requests that historical events should beunderstood,thatisbyreferringthemtotheconditionsoftheirgenesisandnottotheiraftermath,itappearsmuchmorecomplexthanthesereadingsimplied.First,itiswithoutdoubtananalysisofthehistoryofmadnessconsideredasa

cultural, legal, political, philosophical and then medical construct, from theRenaissancetothebeginningofthenineteenthcentury.Butitisalsoareflectionon the notion of history and on themethodology of the historian, a reflectioninfluenced by Nietzsche’s criticism of historical teleologies.2 The book, fromthis point of view, shows how a non-teleological approach to historicalphenomenacandenaturalisewhat is tousmost familiarbyunearthing its longforgottenandoftenunpalatableoriginsthroughthestudyofforgottenarchives,

tracesofa realityoftenvery removed fromwhatwas tobecome thedominantnarrative. From a philosophical point of view, this book is themoment whenFoucault’s thought starts to look beyond phenomenology and towardsstructuralism,movingfromatheoryofformsofconsciousnesstoadescriptionof historical systems of thoughts.Most of its vocabulary is phenomenologicalanditsavowedobjectisaparticularexperience,thatoftheotherasmad:‘Totrytorecapture,inhistory,thisdegreezeroofthehistoryofmadness,whenitwasundifferentiatedexperience,thestillundividedexperienceofthedivisionitself’(1961Preface).Yet the idea is that specific structuresofpowerdetermine thisexperience differently at different moments. Finally this book also marks therejectionofaparticularconceptionofphilosophyas irreducible to thematerialcircumstances of its production. This is what is at stake in the violent debatewithDerridaonDescartes’exclusionoftheinsane(Foucault’stextsonthistopicarereproducedintheappendicestothepresentedition).

MADNESSAsahistory, the thesis of this book is thatwhethermadness is described as areligious or philosophical phenomenon (an experience of inspiration, a loss ofmind, etc.), or as an objectivemedical essence (as in all the classifications oftypesofmadnessthathavebeendevelopedbypsychiatry),theseconceptionsarenot discoveries but historical constructions of meaning. When comparing theconceptions of madness prevailing in different civilisations, Foucault realisedthat there could be a history of madness itself, in other words that it was a‘phenomenonofcivilisation,asvariable,asfloatingasanyotherphenomenonofculture’ and, as a consequence, that ‘curing the mad is not the only possiblereaction to the phenomenon ofmadness’. There is amoment in historywhenmadness started tobeperceivedas adisease, as anobjectof scientific inquiryandifthistransformationisinterestingfromthepointofviewofthehistoryofpsychiatry andofmedicine ingeneral, it is perhapsmore important inwhat ittells us about what must have changed in a society as a whole for such atransformationtooccur.Inotherwords,Foucaultdoesnotlookatmadnessfromthe point of view of the classical historian of a scientific discipline, herepsychiatry,whowould trace thedevelopmentof a science from inchoate earlynotions towards itsmodern, rational state.Ratherhe is interested indecisions,limitsandexclusionswhichtookplaceatparticularpointsintimeandindicateshifts in the way certain phenomena were experienced. These shifts oftencoincidedoroverlappedwithothertransformationscomingfromdifferentpartsofasociety,butmadetheirwayintorupturesofwhichwearenolongerawareprecisely because what they excluded (an earlier experience of madness) hasdisappeared.Sothehistoryofmadnessisnotthehistoryofadisease(ofwhatwenowconsider tobe such,of its treatments andof the institutionsdeveloped todealwithit).Rather,andinordertograspwhatisnolongerdirectlyaccessible,itisthehistoryofthegestureofpartage,division,separation,througheachofitsmoments, incarnations or figures, to use the Hegelian vocabulary so presentthroughoutthebook(andstillsodominantinFrenchphilosophyat thetimeofitswriting),todescribeaprocessofdivisionthroughwhicharealitysplitsinto

radicallydifferentpartsuntilanewrealisationtakesplace,asynthesiswhichinitselfisanewreality.Foucault distinguishes three periods in the separation betweenmadness and

reason (or in the construction ofmadness as unreason, as the title of the firstFrench edition, of 1961,made clear:Folie etDéraison.Histoire de la folie àl’âgeclassique).First, theRenaissancewhen the conversation between reasonandmadnesswhichdominatedintheMiddleAgesissubtlytransformedintoareflectiononwisdom;thentheradicalseparationofreasonandmadnessinwhathecallstheClassicalAge, that is, roughly, theseventeenthcenturyanda largepart of the eighteenth,whenmostof the social institutionsof confinement arecreated—aperiodhecallstragicbecauseitstagesacontradictionwithoutanyhopeof a reconciliation; and finally themodern experience ofmadnesswheremadness is now perceived as factual or positive, an object of science, as adiseaseoraseriesofdiseases,aperiodwhichstartsattheendoftheeighteenthcentury and which, Foucault indicates, has already been transformed in somerespects by a new, literary experience of madness, obvious in late romanticworks(Nerval)andinsomeoftheavant-gardeofthetwentiethcentury(Roussel,Artaud).Themainthesisofthebook,asaworkofhistory,isthatthepassagefromone

phasetotheotherisnotaprogressionfromobscureorinhumanconceptionstoafinal understanding of the truth about madness (as a disease, the object of amedicineof thesoul,a ‘psychiatry’). InfacteachphasereflectsforFoucaultadifferent mode of production of society itself through a different system ofexclusion.Thus,forhim,themodernmedicalpositivismwhichdevelopedfromtheendoftheeighteenthcenturyisbasedonanattemptatobjectifyingmadnesswhich,whenlookedatindetail,inparticularintheinstitutionsitaccompanies,isanewmodeofsocialcontrol.ThisisnottosaythatforFoucaulttheconstructionofmodernWesternsocietycouldbeconceivedsimplyasbasedonanexclusionof madness. He will later on consider many other types of ruptures andexclusions. But studying madness allows one to recognise deeper and muchlargertransformations.Inthefirstphase,theRenaissance,Foucaultfocusesinitiallyontheworksof

artists,toshowthatmadnesswasperceivedasasortofknowledge,akintosomereligiousexperience,thatofapossiblechaosoftheworld,obviousinparticular

in depictions of the apocalypse.Themadwouldbe thosewhohave the tragicexperienceofpossibleworldswhichconstantlymenacetherealoneandoftheessential frailtyofhuman institutions.Able toperceive forceswhich, from theinside, threaten the great organisation of theworld and of humanity, themadseemtorevealandbelongtothelimitsofourworld.Thisexperienceiswhattheproliferationof images relating tomadnessduring theRenaissanceattempts toconvey.ButatthesametimeFoucaultnotesthatanotherformofconsciousnessofmadness seems to emerge, in texts this time, and it is no longer tragic butcritical.Theroleofmadnessistoindicateadiscrepancybetweenwhatmenareand what they pretend to be, a great theme in humanist writing, for exampleMontaigne,Rabelais orErasmus.Wise is themanwho can see that there is amadness in all claims by reason to have found an absolute truth. From aChristian point of view, human reason is madness compared to the reason ofGod,butdivinereasonappearsasmadnesstohumanreason.Soherethereisstilla presence of unreasonwithin reason, but both are looked at from a superiorpoint of view, that of awisdomwhichwould understand the limits of reason,while earlier madness was experienced, so to speak, from the inside. A first,embryonic division between two forms of experience of madness has thusoccurred.3

Theclassicalexperienceofmadness(seventeenthandeighteenthcenturies)isvery different. Now madness is perceived as unreason, that is, the absoluteoppositeofreason.Thisisthetimewhenthemadarelockedupinsteadofbeingsent out of the cities to live at their limits, when the movement towards theexclusionoftheirrationalbysocietymeets‘legrandrenfermement’,themomentwhen, from the middle of the seventeenth century onwards, places ofconfinementarecreatedalloverEurope.Foucault insists that these institutionswere not perceived as medical establishments and that what happened insidethemwasunrelatedtothemedicalknowledgeandpracticesofthetime.Inthemthe mad were locked up with the blasphemous and the unemployed, withprostitutesandotherdeviants,andwereconsideredashavingfreelychosenthepath of mistake, against truth and reason. The perspective was ethical, notmedical: they were made to reverse this choice by a meticulously describedsystem of physical constraints and rewards. But, as in the first phase, in theRenaissance, alongside these institutional developments, another movement

occurs.Whileforthepowerswhichhadorganisedtheirinternmentthemadwereguiltybecause theyhadmade the choice to rejectnature, formedical doctors,madnesswasbecominganaturalobject:themadwerenolongerperceivedasanaberrationbut as aphenomenonworthyof scientific study.Foucault envisagesseveralreasonsforthisdevelopmentbutanimportantone,importantpreciselyinthatitgivesitsfullroletothecontingentinhistory,isthatthemad,becausetheywere now locked up, could precisely be an object of observation (which ofcourseraisesthequestion:whydidtheybecometheobjectofthemedicalgazewhile prostitutes, vagrants, etc. became the object of other disciplines in themaking,forinstancesociologyorcriminology).Thedivisionorpartagebetweenreasonandmadnesshasclearlytakenplace,

there is no longer a surface of contact between them as therewas during theRenaissanceandthisdivisionparallelsthesocialdivisioninstitutedbythehouseofconfinement.Ofcoursetherearemanywaystointerpretthesocialcausesofthisgreatmovementofconfinementofallthosewhodidnotwork:regulationofthenumberoftheunemployedandofprices(theworkhouseswherepeoplewerebarely paid served to keep prices down); getting rid of undesirable charactersthrough means that side-stepped the normal judiciary procedures (internmentcould be decreed by royal lettres de cachet and the Hôpital Général, aninstitutional space of legal exception, was beyond the reach of judicialauthorities); fulfilment of the charitable purposes of the church, etc. Suchexplanations of confinement by its social function are true for Foucault whodeclared that social sensibility tomadnesschangedasa functionof the riseofmercantilismandthebourgeoisfamily,buttheyrefertospecificdecisionswhichalwayspresupposea specific formofawarenessor theexperienceof theotherand of a group as un-reasonable, as fundamentally alien to the norm. Herehowever, what really interests Foucault is that the act of exclusion is in factcontemporary to or even predates and in a sense produces the alienation.Suddenlyanewfigurebecomesperceptibleandthisperceptionwillinturnhaveneweffects.Thethird,modernphaseemergesattheendoftheeighteenthcenturywiththe

end of the Hôpitaux Généraux and the creation of institutions exclusivelydedicatedtothecareofthemad.Madnesshasnowbecometheexclusiveobjectofamedicalperception.

Thelunaticasylumorpsychiatrichospitalistheresultofasynthesisbetweenthenewlyperceivedneed to cure themadwhom their family cannot afford totreatathomeandtheoldneedtoprotectsociety.Butthissynthesisofaspaceofcure and a place of exclusion is soon forgotten in its historical origin andbecomesperceivedasnatural:themadarenowlockedupinordertobecured.At first, internment was perceived confusedly as a reflection of the nature ofmadness viewed as a loss of the natural freedom ofman. Now it is the onlyspacewherethenecessarytreatments toprotect thisfreedomandrestore itcanbeadministered.Madness,whichhasbeenalienatedbysociety,isnowdefinedaspsychologicalalienation,analienationoftheselffromitselfandthespaceofconfinement a space where the self can gather itself again. So in importantrespects,forFoucault,themedicalliberationofthemadby‘philanthropists’,forinstanceTukeinEnglandandPinelinFrance,famousforhavingremovedtheirchains,thissuddenand‘real’understandingofmadness,isamyth,based,likeallmyths,ontheforgettingofhistoricalorigins.Thetransformationoftheexclusionspaceintoamedicalspacemadeitpossibleformadnesstobecomeanobjectofscientificobservationandexperimentation.Toobjectify themadwas tomasterthem, since they were defined as the product of natural causalities, and inpracticeitclearlybecameanewwayofexertingapoweruponthem(ofwhichtheinventionofthestraitjacketisamodel,analysedindepthbyFoucault).Intheendtheasylum,wheremancouldbesystematicallyperceivedandstudied,wasoneofthebirthplacesoftheideaofthe‘humansciences’.ButFoucault’stargethere isnot scientific truth in itself but the claims to scientificityofdisciplineswhich take as natural an object that they have in fact shaped inways and forreasonsthatareoftenlargelyexteriortotheobjectitself.Inthat,hisapproachissimilar to thatofMauriceMerleau-Ponty inhiscriticismofbehaviourismasafalsescienceinTheStructureofBehaviour,ortothatofGeorgesCanguilheminhisstudiesontheconstructionofscientificconcepts.4

HISTORYFoucault describes the book as a ‘history of the conditions of possibility ofpsychology’: the first dimension of theHistory of Madness was to trace theorigins of our conception of humanbeings as psychological subjects from themomentwhenaradicalseparationbetweenmadnessandreasonhadtakenplace,the classical age, and when the possibility of a science of this new objectappears. This clearly shows the aims of the particular brand of historiographythat Foucault named, in this book, the ‘archaeology of knowledge’.What wespontaneously see as the final elimination of archaic and largelyincomprehensiblevisionsof themadby themodernmedical truthwasnot thefruit of a linear progress. Rather, it resulted from a complex series oftransformationswhere theevolutionof structuresof socialcontrolgave rise tonewformsofconsciousnesswhich in turnproducednewstructuresofcontrol.So,howeverHegelianthevocabulary(andhoweverpropheticorapocalypticthetone sometimes is), Foucault constantly rejected the idea that the trajectory ofmadnesswasdeterminedfromthebeginningandattemptedtoavoidtheillusionsbornfromaretrospectivegazewhichnecessarilynaturalisesthepresent.5

Butinadditiontothishistoricalanalysisofmadnessanditsinstitutions,andtoa reflection onWestern historiography, the book also contains the germs of areflection on history in general. The reason is that the exclusion of madnesscoincidedforFoucaultwiththebirthofacertainconceptionofhistoricaltimeasunified, directed and meaningful, as opposed to the chaotic violence, themonotonous repetition of ameaningless fury, the paradoxical ‘tale told by anidiot’.Thehistoryofmadnesswasthusalsoimplicitlyahistoryoftheconditionsofthepossibilityofhistorytakeninthissense.Itsawintheexclusionofthemadthrough the construction of madness as unreason one of these conditions, adimensionparticularlyemphasisedinthefirstpreface:

ThenecessityofmadnessthroughoutthehistoryoftheWestislinkedtothatdecisiveactionthatextractsasignificantlanguagefromthebackgroundnoiseanditscontinuousmonotony,alanguagewhichistransmittedandculminatesintime;itis,inshort,linkedtothepossibilityofhistory.

PHILOSOPHYA third dimension of this book is that it marks the passage between twophilosophicalperspectives.Thevocabularyofthephenomenologicalapproachisstill common here, in particular in the first preface and what is at stake isdescribedasaparticularexperience (thisword isperhaps themostcommoninthebook).6Butthereareseveralexperiencesorformsofexperienceofmadnessand theyarehistoricallyverydifferenteven though they interfereandoverlap.Theyarenotusedasindicatorsofthestructuresofatranscendentalsubjectivitybut, rather, described as historically constructed, as forms of culture. In fact,whenreadingthebookcloselyitissoonobviousthatthemeansthroughwhichthese‘experiences’areaccessedbyFoucault,thearchives,thedifferenttypesofdocuments which form the material of the historical inquiry become its realobject.Whenhementionsanexperience,heneverdoesanythingother than topoint to a difference in historical configurations of practices, beliefs andinstitutions.Thus,whenwritingabout‘thetwomajorformsof theexperiencesofmadnessthatwerejuxtaposedthroughouttheclassicalage[and]bothfollowtheir own chronological index’, he notes that ‘the formulations that justifyconfinement are not presentiments of our [modern] diseases, but representinsteadanexperienceofmadnessthatintersectswithourpathologicalanalyses,butwhichcouldnevercoincidewiththeminanycoherentmanner’.Thepurposeofhistoryisthereforenolongertoextracttherealmeaningofdocumentswhichwould have so far remained obscure (here, to decipher, behind the crudedescriptionsof the registersof confinement, archaicwaysof seeing the realityanalysedbymoderntaxonomiesofmentaldiseases)buttoseeratherhowthosespecific descriptions articulate with certain norms or principles (in particularmoral and religious) of their time. Rather than simply seeking to identify anobsessionalneurosisbehindthedescriptionofthe‘derangedmindinventingitsown devotion’, the aim is to understand the moral order against which thisdisturbance is perceived as madness. The Introduction to Foucault’s majormethodologicaltext,TheArchaelogyofKnowledge,notedthatthepassagetoanarchaeologicalanalysisapplied to thehistoryof ideas, thoughtorscience, ‘has

broken up the long series formed by the progress of consciousness, or theteleologyofreason,ortheevolutionofhumanthought’:

Thus,inplaceofthecontinuouschronologyofreason,whichwasinvariablytracedbacktosomeinaccessibleorigin,itsfoundingopening,therehaveappearedscalesthataresometimesverybrief,distinctfromoneanother,irreducibletoasinglelaw,scalesthatbearatypeofhistorypeculiartoeachone,andwhichcannotbereducedtothegeneralmodelofaconsciousnessthatacquires,progressesandremembers.

(p.8)

A spectacular consequence of this shift from an analysis of experience to ananalysisofstructuresandpracticesistheconnectionestablishedbyFoucaultatthebeginningofthesecondchapterofthefirstpartoftheHistoryofMadness,betweentherefusalbyDescartestoconsiderthepossibilityofhisownmadnessas a legitimate reason for doubting the reality of the world and of his ownexistence,andtheinventionofvasthousesofconfinementroughlyatthesametime. These would be two aspects of the same ‘event’. One of the questionsDescartes asks, in his systematic exploration of the reasons for scepticism, is:how do I know that I am not mad? But instead of examining the question,Descartesdismissesitinanexclamationallthemoreastonishingwhencomingfrom a philosopher who defined the two causes of error as prejudice andprecipitation:‘Butsuchpeopleareinsane,andIwouldbethoughtequallymadifI tookanything fromthemasamodel formyself ’ (MetaphysicalMeditations,1641. The French translation, reviewed and approved by Descartes, is evenstronger. It can in turn be translated as: ‘I would be equally mad if I tookanythingfromthemasamodelformyself’).Foucaultseemstohavebeenthefirst modern reader of Descartes to note this gap in an otherwise watertightargument.7 He sees the a priori exclusion of madness from the process ofthought,wherethemad,asin-sane,arecharacterisedsolelybywhattheylack,assymptomaticoftheparallelformationofmodernrationalismandofinstitutionsofconfinement,bothformingthetwosidesofwhathecalls‘theclassicalevent’.This connection established between the detail of an argument within the

canonicalexpositionofDescartes’philosophy—anextraordinarilymethodicaland meticulous metaphysical meditation, and a large-scale historical-socialtransformation,drewtheattentionofJacquesDerridawhopublishedin1964acritique of Madness and Unreason, under the title ‘Cogito and history of

madness’,8 initiating a violent debate which led Foucault to clarify his basicassumptions.InsubstanceDerridaraisedtwoobjections.First,herejectedFoucault’sreading.IfDescartesmovessoquicklyfromthe

argumentofmadnesstotheargumentofthedream—anessentialmomentintheconsideration of sceptical arguments since the experience of the dream showsthat there is no criterionwe could use, ‘within’ the field of consciousness, toassert the reality of an existence ‘exterior’ to this field — it is because theexperience of the dream is common and perhaps universal, as opposed to theexperience of madness. The voice which excludes the mad from the field ofrationalinquirywouldthusnotbethatofthephilosopherbutofthelayman,inthe hypothetical dialoguewhichwould be contained in this ‘meditation’. Thismanwouldneverconsiderasserioustheargumentofmadnessbutwouldeasilybeshaken,asanyphilosophyteacherknows,bytheargumentofthedream.So,for Derrida, the strength of madness as a radical questioning of beliefs inwhateverexists,initsproximitythereforetothescepticalmomentofphilosophy,ishere, inDescartes, triumphant in thehyperboleof thedreamitself.Farfromindicatingagestureofexclusion,thesubstitutionoftheargumentofthedream,claimsDerrida,isthe‘hyperbolicexasperationofthehypothesisofmadness’.The second important pointofDerrida’s critique is of amuchmoregeneral

nature.Heseesinwhathecalls‘thehyperbolicaudacityoftheCartesianCogito,itsmad audacity’, a fundamentalmove,which is the essence of philosophicalthought itself. ‘It is the [. . .] point of certainty fromwhich the possibility ofFoucault’s narration, as well as of the narration of the totality, [in fact] theproject of thinking this totality by escaping it, is embedded.’ That audacity inDescartes comes frombeyondDescartes, and it shouldnotbepinneddown toanyparticularmomentinhistorybecauseitisthecondition,saysDerrida,ofallhistories or all narration. This audacity is Philosophy or, more precisely, theinitialexcessorextravaganceofthephilosophicalgesturewhenitquestionsthetotality of what exists, and therefore can ask the question of the nature andmeaningofbeing(whatevertheansweris,theologicalornot).Bydoingthat,headds,thisinitialgestureopensupaspaceatthesametimeformadnessandforreason, and also for history, as history is always ameaning imposed onto theinfinite multiplicity of the real. In other words, what Foucault attributes to amoment in time (the division reason/unreason, the idea of history as a

meaningful whole) is in fact the initial philosophical gesture, without whichFoucault could not have written his book, for this gesture of freedom whichquestionsthetotalityofbeingassuch,asinthefirstofDescartes’MetaphysicalMeditation,isinexcessof,ortakesplacebeforeadiscursivepracticehasstarted,before a book has been written to answer it, and therefore cannot be totallyreduced to thehistorical conditionsunderwhichbooksarewrittenor thoughtsexpressed.IgnoringthatwouldbeasignonthepartofFoucaultofwhatDerridacalls a ‘historicist totalitarianism’, which would reduce all thought to theconditions of its production and would therefore ipso facto endanger its ownclaimtotruthfulness.9

Foucault,respondedin1972,inthesecondeditionofthebook,bythencalledHistory of Madness, in two ways. First he removed the Preface of 1961, onwhichDerridahadconcentratedhismoregeneralattack,andsecondheaddedtothe book an important appendix, ‘My body, this paper, this fire’, which is asystematicrebuttalofDerrida’sargument,soviolentintonethatthetwowritersstopped communicating for ten years.We publish here both prefaces and thistexttogetherwithasecondappendixFoucaultinsertedinthe1972edition(attheinsistence of Gilles Deleuze), which reformulates and develops some of thethemesof thefirstPreface: ‘Madness, theabsenceofanœuvre’.This textwasoriginally published inMay1964.The present edition also contains an earlieranddifferentversionofFoucault’sanswertoDerrida,publishedintheJapanesejournalPaideiainFebruary1972.ThereislittledoubtthatonthetextualanalysisofDescartesFoucaulthasno

difficultycounteringDerrida’sargument.ThemeditationasatypeofdiscursivepracticeisradicallydifferentfromthedialogueanditisonlythroughdistortionsofthetextthatDerridacanclaimotherwise.10Inparticularhedoesnotseethatinthemovementofthemeditation,theveryactofthinkingaboutthedream,theparticular steps of this thought as eventswithin themeditativeprocess, are anessentialelementinblurringtheborderbetweendreamandrealityandoperateatransformationofthemeditatingsubjecthimself.InotherwordsDerridafailstoseethatinDescartes’textmeditationisactionasmuchasdemonstration(astheCogitoitselfwillagaindemonstrateintheSecondMeditation).Hencetheviolentconclusion:

itwasnotatallonaccountoftheirinattentivenessthatclassicalscholarsomitted,beforeDerridaand

likehim,thispassagefromDescartes.Itispartofasystem,asystemofwhichDerridaistodaythemostdecisiverepresentative,initsfinalexplosion:areductionofdiscursivepracticestotextualtraces;theelisionofeventsthatareproducedthere,leavingonlythemarksforareading;theinventionofvoicesbehindthetext,soasnottohavetoexaminethemodesofimplicationofthesubjectindiscourses;theassignationoftheoriginaryassaidandnot-saidinthetextinordertoavoidreplacingdiscursivepracticesinthefieldoftransformationwheretheyarecarriedout.

Foucaultgoesontosaythattheverystatementofanaprioriirreducibilityoftheopening of a critical (philosophical) thought to the historical conditions of itsemergence is itself a discursive practice, reducible to the conditions of itsemergence:

Iwouldsaythatitisahistoricallywell-determinedlittlepedagogy,whichmanifestsitselfhereinaveryvisiblemanner.Apedagogywhichteachesthestudentthatthereisnothingoutsidethetext,butthatinit,initsinterstices,initsblanksandsilences,thereserveoftheoriginreigns;thatitisnevernecessarytolookbeyondit,butthathere,notinthewordsofcourse,butinwordsascrossings-out,intheirlattice,whatissaidis‘themeaningofbeing’.Apedagogythatinverselygivestothevoiceofthemastersthatunlimitedsovereigntythatallowsittoindefinitelyre-saythetext.

In its defence of the methods of the new historiography of ideas, with itsinsistence on ‘thresholds,mutations, independent systems, and limited series’,TheArchaeologyofKnowledgeexplainstheviolenceofFoucault’sreactionandtheimportanceofDescartesinthisdebate:

Ifthehistoryofthoughtcouldremainthelocusofuninterruptedcontinuities,ifitcouldendlesslyforgeconnectionsthatnoanalysiscouldundowithoutabstraction,ifitcouldweavearoundeverythingthatmensayanddo,obscuresynthesisthatanticipateforhim,preparehim,andleadhimendlesslytowardshisfuture,itwouldprovideaprivilegedshelterforthesovereigntyofconsciousness.

(p.12)

ButthenFoucault’sanswerdoesnotexplaininthisbookhowitispossibleforathought that claims to bedoing an archaeologyof systemsof thoughts,whichthus must study accurately the conditions of its own production and theconstraints that bear on its own exercise, a thought therefore that can neitherpostulateforitselfanabsoluteorigin(sayintheactofinstitutionofaratio),nora detachment from its own time— how it is possible for such a thought toexplain the freedom within which it operates and the truthfulness of thestructures it constructs when studying history. Must philosophy postulate thetranscendenceofthoughttohistory?Thisisthequestionofthisbooksinceasahistoryofmodernconceptionsofmadness italsoopensup thepossibilityofa

history of forms of rationality.One could read a large part of Foucault’s laterworkasanattempttoaddressthisquestion.

Prefacetothe1961EditionPascal: ‘Menare sonecessarilymad, that not beingmadwouldbebeingmadthroughanothertrickthatmadnessplayed.’1Andthatothertext,byDostoevsky,from A Writer’s Diary: ‘It is not by locking up one’s neighbour that oneconvincesoneselfofone’sowngoodsense.’

We need a history of that other trick that madness plays — that other trickthrough which men, in the gesture of sovereign reason that locks up theirneighbour,communicateandrecogniseeachother in themerciless languageofnon-madness;weneedtoidentifythemomentofthatexpulsion,2beforeitwasdefinitelyestablishedinthereignoftruth,beforeitwasbroughtbacktolifebythelyricismofprotestation.Totrytorecapture,inhistory,thisdegreezeroofthehistoryofmadness,whenitwasundifferentiatedexperience,thestillundividedexperienceof thedivision itself.Todescribe, from theoriginof its curve, that‘othertrick’which,oneithersideofitsmovement,allowsReasonandMadnesstofallaway,likethingshenceforthforeigntoeachother,deaftoanyexchange,almostdeadtoeachother.Itis,nodoubt,anuncomfortableregion.Topassthroughitwemustrenounce

thecomfortsofterminaltruthsandneverallowourselvestobeguidedbywhatwemightknowofmadness.Noneoftheconceptsofpsychopathology,evenandabove all in the implicit play of retrospection, can be allowed to play anorganisingrole.Thegesturethatdividesmadnessistheconstitutiveone,notthesciencethatgrowsupinthecalmthatreturnsafterthedivisionhasbeenmade.Thecaesura thatestablishes thedistancebetweenreasonandnon-reason is theorigin;thegripinwhichreasonholdsnon-reasontoextractitstruthasmadness,fault or sickness derives from that, and much further off. We must thereforespeak of this primitive debate without supposing a victory, nor the right tovictory;wemustspeakoftheserepeatedgesturesinhistory,leavinginsuspenseanythingthatmighttakeontheappearanceofanending,orofrestintruth;andspeakofthatgestureofseverance,thedistancetaken,thevoidinstalledbetweenreason and thatwhich it is not,without ever leaningon the plenitude ofwhat

reasonpretendstobe.Then, and only then, will that domain be able to appear, where men of

madnessandmenofreason,departingfromeachotherandnotyetseparate,canopen,inalanguagemoreoriginal,muchrougherandmuchmorematutinalthanthatofscience,thedialogueoftheirrupture,whichproves,inafleetingfashion,that theyarestillonspeaking terms.There,madnessandnon-madness, reasonandunreasonareconfusedlyimplicatedineachother,inseparableastheydonotyetexist,andexistingforeachother, inrelationtoeachother, intheexchangethatseparatesthem.In the midst of the serene world of mental illness, modern man no longer

communicates with themadman: on the one hand is theman of reason, whodelegates madness to the doctor, thereby authorising no relation other thanthrough the abstract universality of illness; and on the other is the man ofmadness,whoonlycommunicateswiththeother throughtheintermediaryofareasonthatisnolessabstract,whichisorder,physicalandmoralconstraint,theanonymous pressure of the group, the demand for conformity. There is nocommonlanguage:orrather,itnolongerexists;theconstitutionofmadnessasmentalillness,attheendoftheeighteenthcentury,bearswitnesstoaruptureinadialogue,givestheseparationasalreadyenacted,andexpelsfromthememoryall those imperfectwords, of no fixed syntax, spoken falteringly, inwhich theexchange between madness and reason was carried out. The language ofpsychiatry, which is a monologue by reason about madness, could only havecomeintoexistenceinsuchasilence.Myintentionwasnottowritethehistoryofthatlanguage,butratherdrawup

thearchaeologyofthatsilence.

*

TheGreekshadarelationtoathingtheycalledüβpiç(hubris).Therelationwasnot solely one of condemnation: the existence of Thrasymachus, or that ofCallicles, is proof enough of that, even if their discourse comes down to usalreadyenvelopedinthereassuringdialecticsofSocrates.ButtheGreekLogoshadnoopposite.Europeanman, since thedepthsof theMiddleAges,hashada relation toa

thingthatisconfusedlytermedMadness,DementiaorUnreason.Itisperhapsto

thatobscurepresencethatWesternReasonowessomethingofitsdepth,aswiththethreatofhubris,theσωφροσυ'νη(sophrosyne)ofSocraticspeechmakers.Inanycase,theReason—UnreasonrelationconstitutesforWesterncultureoneofthe dimensions of its originality: it accompanied it long before HieronymusBosch,andwillfollowitlongafterNietzscheandArtaud.But what then is this confrontation below the language of reason? Where

might this interrogation lead, following not reason in its horizontal becoming,but seeking to retrace in time this constant verticality, which, the length ofWestern culture, confronts it with what it is not, measuring it with its ownextravagance? Towards what region might it take us, which was neither thehistory of knowledge nor history plain and simple, which was commandedneither by the teleology of the truth nor the rational concatenation of causes,which only have value or meaning beyond the division? A region, no doubt,whereitwouldbeaquestionmoreofthelimitsthanoftheidentityofaculture.We couldwrite a history of limits—of those obscure gestures, necessarily

forgotten as soon as they are accomplished, through which a culture rejectssomething which for it will be the Exterior; and throughout its history, thishollowed-out void, this white space by means of which it isolates itself,identifiesitasclearlyasitsvalues.Forthosevaluesarereceived,andmaintainedinthecontinuityofhistory;butintheregionofwhichwewouldspeak,itmakesitsessentialchoices,operatingthedivisionwhichgivesaculturethefaceofitspositivity: this is the originary thickness in which a culture takes shape. Tointerrogateacultureaboutitslimit-experiencesistoquestionitattheconfinesofhistoryaboutatearthatissomethingliketheverybirthofitshistory.3There,ina tension that is constantly on the verge of resolution, we find the temporalcontinuityofadialecticalanalysisconfrontedwiththerevelation,atthedoorsoftime,ofatragicstructure.Atthecentreoftheselimit-experiencesoftheWesternworldistheexplosion,

ofcourse,ofthetragicitself—Nietzschehavingshownthatthetragicstructurefromwhich thehistoryof theWesternworld ismade isnothingother than therefusal,theforgettingandthesilentcollapseoftragedy.Aroundthatexperience,whichiscentralasitknotsthetragictothedialecticofhistoryintheveryrefusalof tragedy by history, many other experiences gravitate. Each one, at thefrontiers of our culture, traces a limit that simultaneously signifies an original

division.In the universality of theWestern ratio, there is this division which is the

Orient: theOrient, thought of as theorigin, dreamtof as thevertiginouspointfromwhichnostalgiaandpromisesofreturnareborn,theOrientofferedtothecolonising reason of the Occident, but indefinitely inaccessible, for it alwaysremainsthelimit:thenightofthebeginning,inwhichtheOccidentwasformed,but inwhichit tracedadividingline, theOrient isfor theOccidenteverythingthat it is not, while remaining the place in which its primitive truth must besought.Whatisrequiredisahistoryofthisgreatdivide,allalongthisOccidentalbecoming,followingitinitscontinuityanditsexchanges,whilealsoallowingittoappearinitstragichieratism.Other divisionsmust also be told: in the luminous unity of appearance, the

absolutedivisionofdreams,whichmancannotpreventhimselffromquestioninginsearchofhisowntruth—beitthatofhisdestinyorthatofhisheart—butwhichheonlyquestionsbeyondanessentialrefusalthatconstitutesitandpushesitintothederisionoftheoneiric.Itwillalsobenecessarytowritethehistoryofsexual prohibitions, and not simply in terms of ethnology: and speak, in ourcultureitself,ofthecontinuouslymobileandobstinateformsofrepression,notto write a chronicle of morality or tolerance, but to reveal, as a limit of ourOccidentalworldandtheoriginofitsmorality,thetragicdivisionofthehappyworldofdesire.Finally,andfirstly,wemustspeakoftheexperienceofmadness.The following studywill only be the first, and probably the easiest, in this

long line of enquiry which, beneath the sun of the great Nietzschean quest,would confront the dialectics of history with the immobile structures of thetragic.

*

What then ismadness, in itsmostgeneralbutmost concrete form, for anyonewhoimmediatelychallengesanyholdthatknowledgemighthaveuponit?Inallprobability,nothingotherthantheabsenceofanœuvre.What place could the existence ofmadness have in becoming?What is its

wake?Quiteprobablyverynarrow;afewmildlyworryinglines,whichleavethegreatreasonablecalmofhistoryunchanged.Whatweightmighttheyhave,inthefaceofthefewdecisivewordsthatwovethebecomingofWesternreason,these

vainwords, thesedossiersof indecipherabledelirium, juxtaposedbychance tothewordsofreasoninprisonsandlibraries?Isthereanyplaceintheuniverseofour discourses for the thousands of pages where Thorin, an almost illiteratelackey and ‘frenzied madman’, transcribed, at the close of the seventeenthcentury, his fugitive visions and the roaring of his terror?4 All that is merelyfallentime,thepoorpresumptionofapassagerefusedbythefuture,athinginbecomingwhichisirreparablylessthanhistory.It is that ‘less than’ thatwemust investigate, immediately freeing it of any

associationwith the pejorative. From its originary formulation, historical timeimposes silence on a thing that we can no longer apprehend, other than byaddressing it as void, vanity, nothingness.History is only possible against thebackdropoftheabsenceofhistory,inthemidstofagreatspaceofmurmurings,thatsilencewatches like itsvocationandits truth:‘Iwillcalldesert thiscastlethat you were, night this voice, absence your face.’5 An obscure, equivocalregion:pureorigin,asitisfromtherethatthelanguageofhistorywouldbeborn,slowly conquering so much confusion with the forms of its syntax and theconsistencyofitsvocabulary—andultimateresidue,asterilebeachofwords,sandthathasrunitscourseandisimmediatelyforgotten,keepingnothing,initspassivity,otherthantheemptyimprintsofabstractedfigures.Thegreatœuvreof thehistoryof theworld is indeliblyaccompaniedby the

absence of an œuvre, which renews itself at every instant, but which runsunalteredinitsinevitablevoidthelengthofhistory:andfrombeforehistory,asitisalreadythereintheprimitivedecision,andafteritagain,asitwilltriumphin the lastwordutteredbyhistory.Theplenitudeofhistory isonlypossible inthe space, both empty and peopled at the same time, of all thewordswithoutlanguagethatappeartoanyonewholendsanear,asadullsoundfrombeneathhistory, the obstinate murmur of a language talking to itself — without anyspeakingsubjectandwithoutaninterlocutor,wrappedupinitself,withalumpinits throat, collapsing before it ever reaches any formulation and returningwithoutafusstothesilencethatitnevershookoff.Thecharredrootofmeaning.That is not yet madness, but the first caesura from which the division of

madnessbecamepossible.Thatdivision is its repetitionand intensification, itsorganisation in the tight unity of the present; the perception thatWesternmanhasofhisowntimeandspaceallowsastructureofrefusaltoappear,onthebasis

ofwhichadiscourseisdenouncedasnotbeinglanguage,agestureasnotbeingan œuvre, a figure as having no rightful place in history. This structure isconstitutiveofwhatissenseandnonsense,orratherofthatreciprocitythroughwhichtheoneisboundtotheother;italonecanaccountforthegeneralfactthatinourculturetherecanbenoreasonwithoutmadness,eventhoughtherationalknowledgethatwehaveofmadnessreducesitanddisarmsitbylendingit theslenderstatusofpathologicalaccident.Thenecessityofmadnessthroughoutthehistory of theWest is linked to that decisive action that extracts a significantlanguage from the backgroundnoise and its continuousmonotony, a languagewhich is transmitted and culminates in time; it is, in short, linked to thepossibilityofhistory.This structure of the experience of madness, which is history through and

through, butwhose seat is at itsmargins,where its decisions aremade, is theobjectofthisstudy.Which means that it is not at all a history of knowledge, but of the

rudimentarymovements of an experience. A history not of psychiatry, but ofmadnessitself,inallitsvivacity,beforeitiscapturedbyknowledge.Weneedtostrainourears,andbenddowntowardsthismurmuringoftheworld,andtrytoperceive somany images that have never been poetry, somany fantasies thathaveneverattainedthecoloursofday.Butitis,nodoubt,adoublyimpossibletask, as it would require us to reconstitute the dust of this concrete pain, andthoseinsanewordsthatnothinganchorsintime;andaboveallbecausethatpainandthosewordsonlyexist,andareonlyapparenttothemselvesandtoothersintheactofdivisionthatalreadydenouncesandmastersthem.Itisonlyintheactofseparation,andfromit,thatwecanthinkofthemasdustthathasnotyetbeenseparated. Any perception that aims to apprehend them in their wild statenecessarily belongs to a world that has captured them already. The liberty ofmadness can only be heard from the heights of the fortress in which it isimprisoned.There,freedom‘hasonlythemoroseregistryofitsprisons,anditswordless experience as a persecuted thing; allwehave is its description as anescapedconvict’.6

Towritethehistoryofmadnesswillthereforemeanmakingastructuralstudyofthehistoricalensemble—notions,institutions,judicialandpolicemeasures,scientificconcepts—whichholdcaptiveamadnesswhosewildstatecannever

be reconstituted; but in the absence of that inaccessible primitive purity, thestructural study must go back to that decision that both bound and separatedreasonandmadness;itmusttendtodiscovertheperpetualexchange,theobscurecommonroot,theoriginaryconfrontationthatgivesmeaningtotheunityandtheopposition of sense and senselessness. That will allow that lightning flashdecision to appear once more, heterogeneous with the time of history, butungraspable outside it, which separates the murmur of dark insects from thelanguageofreasonandthepromisesoftime.

*

Shouldwebesurprised that thisstructurewasaboveallvisibleduring the150yearsthatprecededandpreparedtheformationofapsychiatryconsideredbyusaspositive?Theclassicalage—fromWillistoPinel,fromthefuryofOrestetotheQuinta del Sordo and Juliette — covers precisely that period when theexchange between madness and reason modifies its language, in a radicalmanner. In thehistoryofmadness, twoeventssignal thischangewithsingularclarity:in1657,thefoundingoftheHôpitalGénéral,andtheGreatConfinementofthepoor;andin1794,theliberationofthemadinchainsatBicêtre.Betweenthese two singular and symmetrical events, something happened, whoseambiguityhasperplexedhistoriansofmedicine:blindrepressioninanabsolutistregime,accordingtosome,and,accordingtoothers, theprogressivediscovery,by science and philanthropy, ofmadness in its positive truth. In fact, beneaththesereversiblemeanings,astructurewastakingshape,whichdidnotundothatambiguitybutwasdecisive for it.Thisstructureexplains thepassage fromthemedievalandhumanistexperienceofmadnesstotheexperiencethatisourown,whichconfinesmadnessinmentalillness.IntheMiddleAges,andupuntiltheRenaissance, thedebatebetweenmanandmadnesswasadramaticdebate thatconfronted man with the dark powers of the world; and the experience ofmadness was absorbed in images that spoke of the Fall and the End of AllThings, of the Beast, of Metamorphosis, and of all the marvellous secrets ofKnowledge. In our time, the experience ofmadness ismade in the calm of aknowledge which, through knowing it too much, passes it over. But in themovementfromtheoneexperiencetotheother, thepassageismadethroughaworldwithoutimagesorpositivity,inasortofsilenttransparencythatallowsa

greatimmobilestructuretoappear,likeawordlessinstitution,agesturewithoutcommentary,animmediateknowledge;thisstructureisneitherthatofdramanorof knowledge; it is the point atwhich history freezes, in the tragicmode thatbothfoundsitandcallsitintoquestion.At the centre of this attempt to re-establish the value of the classical

experience of madness, in its rights and its becoming, there is therefore amotionless figure to be found: the simple division into daylight andobscurity,shadow and light, dream and waking, the truth of the sun and the power ofmidnight.Anelementaryfigure,whichonlyacceptstimeastheindefinitereturnofalimit.Another effectof that figurewas to leadman intoapowerful forgetting;he

wastolearntodominatethatgreatdivision,andbringitdowntohisownlevel;andmakeinhimselfthedayandthenight,andorderthesunofthetruthtothepale light of his truth. Having mastered his madness, and having freed it bycapturing it in the gaols of his gaze and his morality, having disarmed it bypushingit intoacornerofhimselffinallyallowedmantoestablishthatsortofrelation to the self that is known as ‘psychology’. It had been necessary forMadness to cease being Night, and become a fleeting shadow withinconsciousness,formantobeabletopretendtograspitstruthanduntangleitinknowledge.Inthereconstitutionofthisexperienceofmadness,ahistoryoftheconditions

ofpossibilityofpsychologywroteitselfasthoughofitsownaccord.

*

Inthecourseofwritingthisbook,Isometimeshadrecoursetomaterialthathadbeenalreadygathered togetherbyotherauthors. Idid thisas littleaspossible,and only in cases when I was unable to gain access to the document itself.Beyondanyreferencetoapsychiatric‘truth’,theaimwastoallowthesewordsand texts, which came from beneath the surface of language, and were notproduced toaccede to language, tospeakof themselves.Perhaps, tomymind,themost importantpartof thiswork is thespaceIhave left to the textsof thearchivesthemselves.Fortherest, itwasnecessarytoensurethatIremainedinasortofrelativity

without recourse, never looking for a way out in any psychological coup de

force, which might have turned over the cards and denounced someunrecognisedtruth.Itwasnecessarytospeakofmadnessonlythroughthatother‘trick’ that allows men to not be mad, and that other trick could only bedescribed, for itspart, in theprimitivevivacity that engages it in an indefinitedebateregardingmadness.Alanguagewithoutsupportwasthereforenecessary,alanguagethatenteredthegame,butwastoauthorisetheexchange;alanguagethatconstantlycorrecteditselftoproceed,inacontinuousmovement,totheverybottom. The aim was to keep the relative at all costs, and to be absolutelyunderstood.There, in that simple problemof elocution, the greatest difficulty that faced

theenterprisehidandexpresseditself:itwasnecessarytobringtothesurfaceofthelanguageofreasonadivisionandadebatethatmustofnecessityremainonthenearsideofit,asthatlanguageonlyhasmeaningwellbeyondthem.Whatwas requiredwas therefore a language thatwas quite neutral (fairly free fromscientific terminology, and socialormoraloptions), inorder toapproachmostcloselytheseprimitivelytangledwords,andsothatthatdistancethroughwhichmodern man shores himself up against madness might be abolished; but alanguage that remainedsufficientlyopenfor thedecisivewords throughwhichthe truth ofmadness and of reason are constituted to find their placewithoutbeingbetrayed.Ofrulesandmethods,Iretainedonlyone,summedupinatextbyChar,wherethedefinitionofthemostpressingandthemostcontainedtruthcan be read: ‘I removed from things the illusion they produce to protectthemselvesfromus,andIleftthemthepartthattheyconcedeus.’7

*

In this task, which was inevitably a slightly solitary one, many came to myassistance and have a right tomy gratitude. First of allM.GeorgesDumézil,withoutwhomtheworkwouldneverhavebeenbegun—neitherbegunin thecourse of a Swedish night, nor finished in the stubborn, bright sun of Polishliberty. I must also thank M. Jean Hyppolite, and above all M. GeorgesCanguilhem, who read this work in a still unformed state, advised me whenthingswerenotsimple,savedmefrommanyerrors,andshowedmethevalueofbeing heard. My friend Robert Mauzi, a great authority on the eighteenthcentury,providedmuchoftheknowledgethatIwaslacking.

I should also namemany others who appear not tomatter. Yet they know,these friends fromSwedenand thesePolish friends, that there is somethingoftheirpresenceinthesepages.Maytheypardonmeformakingsuchdemandsonthemandtheirhappiness,theywhoweresoclosetoaworkthatspokeonlyofdistantsufferings,andtheslightlydustyarchivesofpain.

*

‘Companionsinpathos,whobarelymurmur,gowithyourlampspentandreturnthe jewels. A new mystery sings in your bones. Cultivate your legitimatestrangeness.’8

Hamburg,February5,1960.

Prefacetothe1972EditionIreallyoughttowriteanewprefaceforthisbook,whichisoldalready.ButtheideaIfindratherunattractive.ForwhateverItriedtodo,Iwouldalwaysenduptryingtojustifyitforwhatitwas,andreinsertit,insofarassuchathingmightbepossible,inwhatisgoingontoday.Perhapsthatwouldbepossible,perhapsnot,I might do it with varying degrees of success, but it would not be an honestcourseofaction.Andaboveall, thatwouldn’tbe inkeepingwithwhatshouldbe, regarding a book, the preserve of the person who wrote it. A book isproduced, it is aminuscule event, anobject that fits into thehand.But at thatmoment, it takes its place in an incessant gameof repetitions, for its doubles,both near and far, start to multiply; each reading gives it for an instant animpalpable,uniquebody;fragmentsofitpassintocirculationandarepassedoffastherealthing,purportingtocontainthebookinitsentirety,andthebookitselfsometimesendsup taking refuge insuchsummaries;commentariesdouble thetextstillfurther,creatingevenmorediscourseswhere,itisclaimed,thebookisitself at last, avowing all that it refused to say, delivering itself from all thatwhichitsoloudlypretendedtobe.Areissueinanotherplaceandinanothertimeis yet another of these doubles, somethingwhich is neither totally an illusion,nortotallyanidenticalobject.Thetemptationisgreatforthepersonwhowrotethebooktolaydownthelaw

regardingtheseflickeringsimulacra,andprescribeaformforthem,togivethemthe ballast of an identity, imposing a uniquemark thatwould give them all acertainconstantvalue. ‘I am theauthor: lookatmy faceormyprofile; this iswhatallthesedoubledfiguresthataregoingtocirculateundermynameshouldlook like; thosewhostray from it areworthless;and it is from theirdegreeofresemblancethatyoushouldmeasurethevalueoftheothers.Iamthename,thelaw, the soul, the secret, and the balance in which these doubles should beweighed.’ So speaks the Preface, the first act in which the monarchy of theauthor is established, a declaration of tyranny: my intention should be yourprecept; youmust bendyour reading, your analyses, your criticisms towhat Iwastryingtodo,andtakenoteofmymodesty:whenIspeakofthelimitsofmy

enterprise,Imeantosetaboundaryforyourfreedom,andifIclaimthatIfeelIwasnotup to the task, it isbecause Idon’twant to leaveyou theprivilegeofsubstitutingmybookwith the fantasy of a different one, close to it, butmorebeautiful than thebook itself. I am themonarchof the things that Ihavesaid,and I keep an eminent sovereignty over them; that of my intention, and themeaningthatIwishedtogivetothem.My desire is that a book, at least for the person who wrote it, should be

nothing other than the sentences of which it is made; that it should not bedoubledbythatfirstsimulacrumofitselfwhichisapreface,whoseintentionistolaydownthelawforallthesimulacrawhicharetobeformedinthefutureonits basis. My desire is that this object-event, almost imperceptible among somanyothers,shouldrecopy, fragment, repeat, simulateandreplicate itself,andfinallydisappearwithoutthepersonwhohappenedtoproduceiteverbeingabletoclaimtherighttobeitsmaster,andimposewhathewishedtosay,orsaywhathewantedittobe.Inshort,mydesireisthatabookshouldnotcreateofitsownaccord that statusof text towhich teachingandcriticismwill all tooprobablyreduce it, but that it should have the easy confidence to present itself asdiscourse:asbothbattleandweapon,strategyandshock,struggleandtrophyorwound,conjunctureandvestige,strangemeetingandrepeatablescene.For these reasons, when I was asked to write a new preface for this book,

which is being reissued, I could only answer that the previous one should beremoved.Thatwouldbethehonestcourse.Weshouldnottrytojustifytheoldbook,norreinsertitintothepresent;theseriesofeventstowhichitbelongs,andwhich are its true law, are far frombeingover.As for novelty,we shouldnotpretend to discover in it a secret reserve or a richness that initially escapeddetection; its only novelty is the things that have been said about it, and theeventsinwhichithasbeencaughtup.Iwilladdonlytwotexts:one,alreadypublished,whereIexpandonaphraseI

ventured rather blindly: ‘madness, the absence of an œuvre’; the other,unpublishedinFrance,whereItrytoaddressaremarkablecriticismbyDerrida.

‘Butyouhavejustwrittenapreface.’

‘Atleastit’sshort.’

MichelFoucault

PartOne

IStultiferaNavis

AttheendoftheMiddleAges,leprosydisappearedfromtheWesternworld.Atthe edges of the community, at town gates, large, barren, uninhabitable areasappeared,where the disease no longer reigned but its ghost still hovered. Forcenturies, these spaceswould belong to the domain of the inhuman.From thefourteenth to the seventeenth century, by means of strange incantations, theyconjuredupanewincarnationofevil,anothergrinningmaskoffear,hometotheconstantlyrenewedmagicofpurificationandexclusion.From the High Middle Ages until the end of the crusades, leprosaria had

sprung up and multiplied across the surface of Europe. The exact figure isunknown,butaccordingtoMathieuParis,thereweresome19,000ofthesecitiesofthedamnedspreadthroughoutChristendom.1Intheyearsleadingupto1266,whenLouisXIIIorderedasetof statutes tobedrawnup for the lazarhouses,thereweremore than2,000 such institutions inFrance.Theynumbered forty-three in onediocese inParis alone, andBourg-la-Reine,Corbeil, Saint-Valère,andthesinisterChampPourri(RottenRow)allfigureonthelist.Charenton,aname that would resonate down the centuries, is there too. The two largesthouses—Saint-GermainandSaint-Lazare—wereon the immediateoutskirtsof Paris, and their names toowill crop up in the history of another sickness.2

Fromtheturnofthefifteenthcentury,anewemptinessappears:Saint-Germainbecomes a home for young offenders the following century, and before SaintVincent,Saint-Lazarecountedonlyoneleper,‘LeSieurLanglois,apractitionerinthecivilcourt’.TheleprosariuminNancy,whichhadbeenoneofthelargestinEurope,hadonlyfourinmatesduringtheregencyofMariedeMédicis.TheMémoiresofCatelrecountthatthereweretwenty-ninehospitalsinToulouseattheendofthemedievalperiod,sevenofwhichwereleprosaria,butattheendofthe seventeenth century the number had shrunk to three — Saint-Cyprien,ArnaudBernardandSaint-Michel.3Festivitieswerewidespreadtocelebratethedisappearance of leprosy: in 1635 for instance, the inhabitants of Reims

processedsolemnlytothankGodfordeliveringtheirtownfromitsplight.4

By that time, theFrench crownhad already been reorganising the immenselandbankthat theleperhousesrepresentedformorethanacentury.FrançoisIhadorderedacensusandaninventoryofallsuchinstitutionson19December1543 ‘toput anend to thegreatdisorder apparent in leperhouses’, and inhisturnHenri IVdecreed in1606that theaccountsofsuch institutionsberevised‘and that revenue accruing from this review be used for the upkeep of poorgentlemen and invalid soldiers’. Another such overview was ordered on 24October1612,withtheideathatthistimethesurplusrevenuebeusedtofeedthepoor.5

Infacttheleprosariaquestionwouldn’tbesettledinFrancebeforethecloseoftheseventeenthcentury,andtheeconomicimportanceofthequestionwouldbeat thebaseofmanyaconflict. In1677, therewerestill forty-four leprosaria intheprovinceofDauphinéalone.6On20February1672LouisXIV transferredcontrolofallmilitaryandhospitalorderstotheordersofSaintLazareandMontCarmel, which were entrusted with the administration of all the remainingleprosariainthekingdom.7Twentyyearslaterthe1672edictwasrevokedand,bymeansof seriesofmeasures thatcame into force fromMarch1693 to July1695,thegoodsoftheleperhouseswereredistributedamongotherhospitalsandinstitutionsforthesuccouringoftheafflicted.Thefewleperswhostillinhabitedthe1,200leprosariathatremainedweregroupedtogetherinSaint-MesminnearOrleans.8 These new orders were first brought into force in Paris whereParliament transferred the revenue in question to theHôpitalGénéral, and theexample was soon being followed in the provinces. In Toulouse, all leprosypossessionswereredirectedtothehospitalforIncurablesin1696,revenuefromBeaulieu in Normandy was transferred to the main hospital in Caen, and inVoley, the money was transferred to the Sainte-Foy hospital.9 Together withSaint-Mesmin,onlyLesGanetsnearBordeauxretaineditsformerstatus.For their million-and-a-half inhabitants in the twelfth century, England and

Scotlandhadopened220leperhouses.Butevenbythefourteenthcenturytheywerebeginningtoempty:whenRichardIIIorderedaninquiryintothestateofRipon hospital in 1342, it emerged that there were no more lepers, and thefoundation was charged with the care of the poor instead. By 1434, in thehospital founded in the late twelfth century byArchbishop Puisel, therewere

onlytworemainingbedsreservedforlepers,andtheywereoftenunoccupied.10

In 1348 the great leper house of Saint-Alban had only three inhabitants;Romanall hospital inKentwas abandoned twenty-four years later as nomoreleperscouldbefound.InChatham,theSaintBartholomewleperhousefoundedin 1078 had been one of the biggest in the country: by the time of QueenElizabethithadonlytwoinmates,anditwasfinallyclosedaltogetherin1627.11

ThesameregressionofthediseasewaswitnessedinGermany,althoughtherethe processwas slightly slower.As in England, theReformation hastened thetransfer of control of the leper houses to local city authorities,who convertedthemintohousesfor thepoororhospitals,aswas thecase inLeipzig,MunichandHamburg.In1542,allpossessionsoftheleperhousesofSchleswig-Holsteinwere handed over to hospitals. In Stuttgart, a magistrate’s report indicated in1589thatnoleperhadbeenrecordedinthecity’slazarhouseformorethanfiftyyears.InLipplingen,thelazarhousewassoonpeopledwiththeinsaneandtheincurablyill.12

This strange disappearancewas probably not the long-sought-after result ofobscuremedicalpractices,butratheraspontaneousresultofsegregation,andtheconsequence,withthecomingoftheendofthecrusades,ofcuttingthecordthatledtothemainsourceofinfectionintheMiddleEast.Leprosyretreated,andthelowlyspacessetasidefor it, togetherwith therituals thathadgrownupnot tosuppressitbuttokeepitatasacreddistance,suddenlyhadnopurpose.Butwhatlastedlongerthanleprosy,andpersistedforyearsafterthelazarhouseshadbeenemptied,were thevaluesand imagesattached to the leper,and the importancefor societyof this insistent, fearsome figure,whowas carefully excludedonlyafteramagiccirclehadbeendrawnaroundhim.If lepers were socially excluded and removed from the community of the

visiblechurch,theirexistencestillmadeGodmanifest,astheyshowedbothhisangerandhisbounty:‘Dearlybeloved’,saysaritualfromachurchinVienneinthesouthofFrance,‘ithaspleasedGodtoafflictyouwiththisdisease,andtheLord is gracious for bringing punishment upon you for the evil that you havedoneinthisworld.’TheleperwasthendraggedoutofthechurchbythepriestandhisacolytesgressuretrogradobuthewasassuredthathewasGod’switness:‘howeverremovedfromthechurchandthecompanyofthesaints,youareneverseparatedfromthegraceofGod’.Brueghel’sleperswatchfromafar,butforever,

as Christ climbs Mount Calvary accompanied by a whole people. Hieraticwitnesses of evil, their salvation is assured by their exclusion: in a strangereversalquiteopposed tomeritandprayers, theyaresavedby thehand that isnotoffered.Thesinnerwhoabandonsthelepertohisfatetherebyopensthedoorto his salvation. ‘Thus be patient in your sickness, for the Lord does notunderestimate your ills, nor separate you from his company. If you havepatience,soshallyoubesaved,liketheleperwhodiedoutsidethedooroftherich man, and was carried straight up to Heaven.’13 Abandonment is hissalvation,andexclusionoffersanunusualformofcommunion.Onceleprosyhadgone,andthefigureoftheleperwasnomorethanadistant

memory,thesestructuresstillremained.Thegameofexclusionwouldbeplayedagain, often in these same places, in an oddly similar fashion two or threecenturies later.The role of the leperwas to be played by the poor and by thevagrant,byprisonersandbythe‘alienated’,andthesortofsalvationatstakeforbothpartiesinthisgameofexclusionisthematterofthisstudy.Theformsthisexclusion tookwould continue, in a radicallydifferent culture andwith anewmeaning,butremainingessentiallythemajorformofarigorousdivision,atthesametimesocialexclusionandspiritualreintegration.

*

Butlet’snotgetaheadofourselves.The role that leprosy had playedwas first taken by venereal disease. Such

diseaseswere the natural heir to leprosy in the late fifteenth century, and thediseasewastreatedinseveralleperhospitals.UnderFrançoisI,anattemptwasmadetoconfineittothehospitaloftheParishofSaint-Eustache,andthenintheparishofSaint-Nicolas,bothofwhichhadservedaslazarhouses.Twicemore,underCharlesVIIIandagainin1559,variousbuildingsandouthousesatSaint-Germain-des-Prés previously used for lepers were converted for venerealdiseases.14 Soon the disease was so common that the construction of specialbuildingswasbeingconsidered‘incertainspaciousareassurroundingtownsandsuburbs,segregatedfrompassers-by’.15Anewleprosywasborn,whichtooktheplaceoftheformer,butnotwithoutdifficultyorconflicts.Forthesenewleperstoostruckfearintotheheartsoftheold.

Leperswerefarfromoverjoyedatbeingforcedtosharetheirspacewiththesenewcomerstotheworldofhorror:‘Estmirabiliscontagiosaetnimisformidandainfirmitas, quam etiam detestantur leprosi et ea infectos secum habitare nonpermittant’(‘Thisastonishingandcontagiousdiseaseismuchtobefeared:eventhe lepers themselves reject it in horror, and refuse to permit thosewho havecontractedthediseasetokeeptheircompany’).16Butdespitetheirlongstandingrighttostayinthesesegregatedareas,thereweretoofewofthemtomaketheirvoices heard, and thevenereal,moreor less everywhere, had soon taken theirplace.Yetintheclassicalageitwasnotvenerealdiseasesthatwouldtakeoverthe

role that leprosyhadplayedinmedievalculture.Despite theseinitialmeasuresofexclusion,venerealdiseasewassoonclassedassimplyanotherdiseaseoncemore, anddespite the reservationsof thepopulation suffererswere soonbeingtreatedinhospitals.TheyweretakeninattheHôtel-DieuinParis,17anddespiteseveral attempts to expel them, they soon blended inwith the other sick.18 InGermany,specialhouseswerebuiltforthemnottoensuretheirexclusion,butsothatappropriate treatmentcouldbegiven,and theFuggers inAugsburgsetuptwo such hospitals.The city ofNuremberg appointed a special physicianwhoclaimed to able to ‘control the French malady’.19 The major difference withleprosywasthatvenerealdiseasesbecameamedicalaffairveryearlyon,tobedealtwithbydoctors.Treatmentsspranguponallsides:theorderofSaint-Cômefollowed theArab example and usedmercury,20whereas in theHôtel-Dieu inParistreatmentreliedmainlyontheriac,theclassicalworld’scureforsnakebite.Then came the great vogue for gaiac, more precious than American gold, ifUlrich von Hutten and Fracastor’s Syphylidis are to be believed. Sweat cureswere practised everywhere. In the course of the sixteenth century, venerealdiseasestooktheirplaceamongotherillsrequiringmedicaltreatment.Theplaceofvenerealdiseaseswasfixedinawholenetworkofmoraljudgements,butthathorizon brought only minor modifications to the essentially medicalapprehensionofthedisease.21

Curiously,itwasonlyundertheinfluenceoftheworldofconfinementintheseventeenthcenturythatvenerealdiseasebecamedetachedtosomeextentfromthis medical context, and like madness entered a space of social and moralexclusion. It is not in venereal disease that the true heir of leprosy should be

sought, but in a highly complex phenomenon that medicine would take farlongertoappropriate.Thatphenomenonismadness.22Butonlyafteralonglatencyperiodofalmost

twocenturiesdidthatnewobsessiontaketheplaceofthefearthatleprosyhadinstilled in the masses, and elicit similar reactions of division, exclusion andpurification,whichareakintomadnessitself.Butbeforemadnesswasbroughtunder control towards the mid-seventeenth century, and before ancient ritualswere resuscitated in itshonour, itwas linkedobstinately tomanyof themajorexperiencesoftheRenaissance.Abriefoverviewofthispresenceandsomeoftheessentialfiguresisnowin

order.

*

Thesimplestofthesefiguresisalsothemostsymbolic.A new object made its appearance in the imaginary landscape of the

Renaissance,anditwasnotlongbeforeitoccupiedaprivilegedplacethere;thiswastheShipofFools,astrangedrunkenboatthatwounditswaydownthewide,slow-movingriversoftheRhinelandandroundthecanalsofFlanders.ThisNarrenschiffwasclearlyaliteraryinvention,andwasprobablyborrowed

fromtheancientcycleoftheArgonautsthathadrecentlybeengivenanewleaseof lifeamongmythological themes,and in thestatesofBurgundyat leastnowhad an institutional function. Such shipswere a literary commonplace,with acrewofimaginaryheroes,moralmodelsorcarefullydefinedsocialtypessetoutonagreatsymbolicvoyagethatbrought them,ifnotfortune,at theveryleast,the figureof theirdestinyorof their truth.SymphorienChampier forexamplecomposedsuccessivelyaShipofPrincesandBattlesoftheNobilityin1502anda Ship of Virtuous Ladies the following year; there is also a Ship of Health,together with Jacop Van Oestvoren’s Blauwe Schute of 1413, Brant’sNarrenschiff of 1497 and JosseBade’sStultiferaenaviculae scaphae fatuarummulierum of 1498. Naturally, Bosch’s painting belongs to this same oneiricflotilla.But among these satirical and novelistic ships, theNarrenschiff alonehada

genuine existence, for they really did exist, these boats that drifted from onetowntoanotherwiththeirsenselesscargo.Anitinerantexistencewasoftenthe

lotofthemad.23Itwascommonpracticefortownstobanishthemfrominsidethecitywalls, leavingthemtorunwildinthedistantcountrysideorentrustingthem to the care of travelling merchants or pilgrims. The custom was mostcommon in Germany. In Nuremberg during the first half of the fourteenthcentury the presence of sixty-twomadmenwas recorded, and thirty-onewerechasedoutof town.Therewere twenty-onemoreenforceddeparturesover thefifty years that followed, and this was merely for madmen arrested by themunicipal authorities.24 They were often entrusted to the care of the riverboatmen.InFrankfurtin1399,boatmenweregiventhetaskofriddingthecityof a madman who walked around naked, and in the earliest years of thefollowing century a criminalmadmanwas expelled in the samemanner fromMainz.Sometimestheboatmenputthesedifficultpassengersbackashoreearlierthan they had promised: one Frankfurt blacksmith returned twice from beingexpelledinsuchmanner,beforebeingdefinitivelyescortedtoKreuznach.25ThearrivalinthegreatcitiesofEuropeoftheseshipsoffoolsmusthavebeenquiteacommonsight.It is hard topindown theprecisemeaningof thepractice. It is tempting to

thinkofitasageneralmeansofexpulsionusedbythemunicipalitiestopunishvagabondage among themad, but that hypothesis doesn’t quite fit the facts asthis was a fate that only befell certain madmen, as some were treated inhospitals,evenbeforetheconstructionofspecialhousesfortheinsanebegan.Inthe Hôtel-Dieu in Paris they had specifically allocated bunks in somedormitories reserved for them,26 and in most of the great cities of Europethroughout theMiddle Ages and the Renaissance there was always a specialplacereservedfor thedetentionof the insane, like theMelunChâtelet27or thefamousTourauxFousinCaen.28 InGermanytherewerecountlessNarrtürme,like the gates of Lübeck or the Hamburg Jungpfer.29 So the mad were notsystematically run out of town. It could be argued that only foreignmadmenwereexpelled,and thateach townonly tookresponsibility for itsowncitizenswhohad lost theirwits, and indeed in the accounts of variousmedieval citiestherearerecordsoffundsputasideforthemad,anddonationsmadeinfavouroftheinsane.30Buttheproblemisnotsosimple,fortherewerecentreswheretheinsane,more numerous than elsewhere, were certainly not indigenous. To thefore here were centres of pilgrimage like Saint-Mathurin de Larchant, Saint-

HildevertdeGournay,BesançonandGheel;suchtripswereorganisedandevenpaidforbycitiesandhospitals.31Anditmaybethattheseshipsoffools,whichhaunted the imagination of the Early Renaissance, were in fact ships ofpilgrimage, highly symbolic ships filled with the senseless in search of theirreason; some went down the rivers of the Rhineland towards Belgium andGheel,whileotherswentuptheRhinetoBesançonandtheJura.Buttherewereothertowns,likeNuremberg,whichwerecertainlynotplaces

ofpilgrimage,yetwhichcontainedahigherthanaveragenumberofmadmen,farmorethanthecityitselfcouldhavefurnished.Thesemadmenwerelodgedandpaidforoutofthecitycoffers,butwerenotcaredfor:theyweresimplythrowninto prison.32 Itmay be the case that in some big cities—where thereweremarkets and many people who came and went — the mad were brought inconsiderablenumbersbymerchantsandriverboatmen,andthattheretheywere‘forgotten’, therebycleansingtheirhometownof theirpresence.Perhaps theseplaces of ‘counter-pilgrimage’ became confused with places where the insanereallyweretakenaspilgrims.Theconcernwithcureandexclusionfusedwithinthe sacred space of the miraculous. It is possible that the town of Gheeldeveloped in this manner — a place of pilgrimage that became a place ofconfinement, a holy landwheremadness awaited its deliverance, butwhere itseemsthatmanenactedtheancientritualofdivision.Thisconstantcirculationoftheinsane,thegestureofbanishmentandenforced

embarkation,wasnotmerelyaimedatsocialutility,orthesafetyofcitizens.Itsmeaningswereclosertorituals,andtheirtraceisstilldiscernible.Soitwasforinstancethattheinsanewerebarredentrytochurches,33whileecclesiasticallawallowed them to partake of the sacraments.34 The church took no sanctionsagainstpriestswholosttheirreason,butinNurembergin1421amadpriestwasexpelledwithparticularsolemnity,asthoughtheimpuritywasmultipliedbythesacrednatureofthecharacter,yetthetownpaidthemoneythatwastoserveforhisviaticum.35Onoccasions,theinsanewerepubliclywhipped,andinasortofsimulatedhuntwerechasedoutoftownwhilebeingbeatenwithsticks.36Allofwhich indicates that the departure of the mad belonged with other rituals ofexile.So the shipof foolswasheavily loadedwithmeaning,andclearlycarrieda

greatsocial force.On theonehand, ithad incontestablypractical functions,as

entrustingamadmantothecareofboatmenmeantthathewouldnolongerroamaroundthecitywalls,andensuredthathewouldtravelfarandbeaprisonerofhis own departure. But therewasmore:water brought its own dark symboliccharge, carryingaway,butpurifying too.Navigationbroughtman face to facewiththeuncertaintyofdestiny,whereeachislefttohimselfandeverydeparturemightalwaysbe the last.Themadmanonhiscrazyboatsetssail for theotherworld,and it is from theotherworld thathecomeswhenhedisembarks.Thisenforced navigation is both rigorous division and absolute Passage, serving tounderline in real and imaginary terms the liminal situation of the mad inmedieval society. It was a highly symbolic role, made clear by the mentalgeographyinvolved,wherethemadmanwasconfinedatthegatesofthecities.His exclusion was his confinement, and if he had no prison other than thethreshold itself he was still detained at this place of passage. In a highlysymbolic position he is placed on the inside of the outside, or vice versa. Aposturethatisstillhistoday,ifweadmitthatwhatwasoncethevisiblefortressofsocialorderisnowthecastleofourownconsciousness.Waterandnavigationhadthatroletoplay.Lockedintheshipfromwhichhe

couldnotescape,themadmanwashandedovertothethousand-armedriver,totheseawhereallpathscross,andthegreatuncertaintythatsurroundsallthings.Aprisoner in themidstof theultimate freedom,on themostopen roadofall,chainedsolidlytotheinfinitecrossroads.HeisthePassengerparexcellence,theprisonerofthepassage.Itisnotknownwherehewillland,andwhenhelands,heknowsnotwhencehecame.Histruthandhishomearethebarrenwastelandbetween two lands that can never be his own.37 Perhaps this ritual lies at theoriginoftheimaginarykinshipcommonthroughoutthecultureoftheWest.Orperhaps it was this kinship that called for and then fixed the ritual ofembarkationwhoseoriginsarelostinthemistsofcivilisation.Butonethingiscertain:thelinkbetweenwaterandmadnessisdeeplyrootedinthedreamoftheWesternman.In the medieval romance of Tristan et Iseut, Tristan is put ashore by the

boatmenonthecoastofCornwall,disguisedasamadman.OnhisarrivalatthecastleofKingMark,heisrecognisedbynoone,andnooneknowswherehehascomefrom.Buthisconversationistoostrange,distantandfamiliar,andheistooawareofthewell-keptsecretsofthisworldnottohavecomefromanothervery

closeby.He isnot fromdry land,with its solidcities,but from theunceasingrestlessness of the sea, whose unknown paths reveal such strange truths, thatfantastic plain, the flipside of the world. Iseut is the first to realise that thismadmanisasonofthesea,andthathe’sbeenputashorebyunrepentantsailors,making him a harbinger of bad luck: ‘Damn the sailors who brought thismadman,would that they had thrown him in the sea!’38 she cries. The themereappears many times throughout the ages. For the mystics of the fifteenthcentury,itwastheideaofthesoulasbark,tossedontheseaofinfinitedesires,surroundedbysterileattachmentsandignoranceonallsides,anddistractedbythemeretricioussparklesofknowledge,inthemidstofthegreatunreasonoftheworld – a boat at themercy of the greatmadness of the sea, unless he dropsanchoronthesolidgroundoffaith,orspreadsitsspiritualsailssothatsothatthebreath ofGodmight bring it home to port.39 In the late sixteenth century,DeLancre blamed the demoniacal calling of a whole people on the sea; theuncertain furrowof thewake, theexclusive trustplaced in thestars, thesecretknowledge thatpassed frommariner tomariner, thedistance fromwomenandthe ceaselessly shifting plain of the surface of the seamademen lose faith ingod, and cast off the shackles of their attachment to their homeland, therebyopeningthedoortotheDevilandtheoceanofhisruses.40Theclassicalerawascontent toblametheEnglishmelancholyon the influenceofamarineclimate:the cold, wet, fickle weather and the fine droplets of water that entered thevessels and the fibres of the human body made a body lose its firmness,predisposingittomadness.41Andfinally,ignoringthehugeliterarytraditionthatstretchesfromOpheliatotheLorelei,itisperhapsenoughtoquotetheanthropo-cosmologicalanalysesofHeinroth,wheremadnessis themanifestationinmanofanobscure,aquaticelement,adark,disordered,shiftingchaos,thegermanddeathofallthingsasopposedtotheluminous,adultstabilityofthemind.42

So the ship of fools resonates in theWestern imaginationwith immemorialmotifs. But why then, towards the fifteenth century, do we get this suddenformulation of