Madness and Civilization
(The following essay is reprinted from the last issue of The New York Review, where it appeared with certain passages out of order.)
There is much to be said in criticism of Foucault’s study of madness. It is written in a prose of an obscurity so dense as to be often impenetrable. This is not so much the result of its genuine difficulty of thought as of the author’s arrogance, carelessness, and imprecision. Helterskelter he employs whole sets of technical philosophical terms which are only half-assimilated to the matters he is discussing. Indeed he rarely bothers to define them, much less to use them consistently. The tone of the prose is high-flown and portentous. Foucault’s powers of exposition are equally uncertain. Although his book is organized generally along chronological lines, and although each chapter focuses upon a distinct topic, reading through most of these chapters is like wading through several feet of water: Paragraphs do not follow one another in logical and sometimes not even in associative order; great lacunae open up between what are apparently supposed to be consecutive parts of a discussion; conclusions are sometimes offered in advance of evidence, and sometimes they are offered in place of evidence.
The author’s scholarship is to say the least irregular; one need only compare his discussion of seventeenth- and eighteenth-century medical theories of mental ailments with those contained in a recent standard work of medical history—Ilza Vieth’s Hysteria: the History of a Disease (Chicago, 1965), for example—to see at once how idiosyncratic is his use of sources. His scholarship is in addition surprisingly provincial. The sub-title is “A History of Insanity in the Age of Reason,” but the book’s conclusions apply in fact almost exclusively to France. Italy is pretty much ignored as being apparently outside history: Germany seems hardly to have made it to the Age of Reason; and of much of Foucault’s material on England, well, the less said the better.
Such charges would be grave indeed if they were brought to bear upon another book. In Foucault’s work they seem in the end hardly to matter. In spite of all the defects I have listed, it seems to me that Foucault has written a work of unquestionable originality and importance. It is certainly worth putting up with its flaws in order to get what it has to offer, and one’s disagreements should be reserved for the arguments in the book itself.
FOUCAULT BEGINS his account with a discussion of leprosy. Throughout the Middle Ages leprosariums, or lazar-houses, had been established at the gates and margins of the towns of Europe. Within these precincts an immense number of sufferers were segregated, removed to a “sacred distance” from the world. It is revealing of the ambivalence with which medieval society regarded the leper that it simultaneously drove him out of it and confined him within it, at its very periphery—a periphery which, as the cities expanded, was to become in turn a new center. As a figure in…
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