Abstract
THE ESSENTIAL FUNCTION OF psychiatric power is to be an effective agent of reality, a sort of intensifier of reality to madness. In what respect can this power be defined as a surplus-power of reality?
* In the manuscript this lecture is given the title: “The psychiatric cure.”
Psychiatric power. ~ A treatment by François Leuret and its strategic elements: 1-creating an imbalance of power; 2-the reuse of language; 3-the management of needs; 4-the statement of truth. ~ The pleasure of the illness. ~ The asylum apparatus (dispositf).
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Notes
Opiates, preparations with an opium base, renowned for suspending attacks of fury and restoring order between ideas, were recommended, in preference to purgatives and bleedings, by Jean-Baptiste Van Helmont (1577–1644) and Thomas Sydenham (16241689). Their use in treating “maniacal” or “furious” forms of madness developed in the eighteenth century. See, Philippe Hecquet (1661–1737) Réflexions sur l’usage de l’opium, des calmants et des narcotiques pour la guérison des maladies (Paris: G. Cavalier, 1726) p. 11
J. Guislain, Traité sur l’aliénation mentale et sur les hospices des aliénés, vol. I, book IV: “Moyens dirigés sur le système nerveux central. Opium,” pp. 345–353. See also the pages devoted to this substance by M. Foucault, in Histoire de la folie, pp. 316–319 (omitted from the English translation). In the nineteenth century, Joseph Jacques Moreau de Tours (1804–1884) recommended the use of opiates in the treatment of mania: “In the opiates (opium, datura, belladonna, henbane, aconite, etcetera) we can still find an excellent means of calming the usual agitation of maniacs and the passing fits of rage of monomaniacs.” “Lettres médicales sur la colonie d’aliénés de Ghéel” Annales mèdico psychologiques, vol. V, March 1845, p. 271. See, C. Michéa, De l’emploi des opiacés dans le traitement d’aliénation mentale (Paris: Malteste, 1849), and Recherches expérimentales sur l’emploi des principaux agents de médication stupéfiante dans le traitement de l’aliénation mentale (Paris: Labé, 1857)
H. Legrand du Saulle, “Recherches cliniques sur le mode d’administration de l’opium dans la manie” Annales médico-psychologiques, 3rd series, vol. V, January 1857, pp. 1–27
H. Brochin, “Maladies nerveuses. § Narcotiques” in Dictionnaire encyclopédique des sciences médicales, 2nd series, vol. XII (Paris: Masson/Asselin, 1877), pp. 375–376
T. Sydenham, “Observationes Medicae” (1680) in Opera Omnia (London: W. Greenhill, 1844) p. 113
The problem of the dietary regime occupied a privileged place, both as a component of the daily organization of asylum time, and as a contribution to treatment. Thus, François Fodere states that “food is the first medicine” Traité du délire, vol. II, p. 292. See, J. Daquin, La Philosophie de la folie, republished with a presentation by C. Quétel (Paris: Éditions Frénésie, 1987) pp. 95–97
Work, an essential component of moral treatment, was conceived of in the double perspective of therapy (isolation) and discipline (order). See, P. Pinel, Traité médico-philosophique, section V, § xxi: “Loi fondamentale de tout hospice d’aliénés, celle d’un travail mécanique”: “Constant work changes the vicious circle of ideas, clarifies the faculties of understanding by exercising them, alone keeps order wherever the insane are assembled, and dispenses with a host of detailed and often pointless rules in order to maintain internal police” p. 225; A Treatise on Insanity, “Mechanical employment essential to the successful management of lunatic hospitals” p. 217. Cf., C. Bouchet, “Du travail appliqué aux aliénés” Annales mèdico-psychologiques, vol. XII, November 1848, pp. 301–302. In Histoire de la folie, pp. 505–506; Madness and Civilisation, pp. 247–249, Foucault refers to a study by Jean Calvet, from 1952, on the historical origins of the work of patients in insane asylums.
P. Pinel lends his authority to the shower by making it an instrument of both treatment and conditioning. See the second, revised and expanded edition of his Traité médico-philosophique sur l’aliénation mentale (Paris: Caille et Ravier, 1809) pp. 205–206. See also, H. Girard de Cailleux, “Considérations sur le traitement des maladies mentales” Annales médico-psychologiques, vol. IV, November, 1844, pp. 330 331
H. Rech (de Montpellier), “De la douche et des affusions d’eau froide sur la tête dans le traitement des aliénations mentales” ibid. vol. IX, January 1847, pp. 124–125. It is François Leuret especially who makes use of it in Traitement moral de la folie, ch. 3, § “Douches et affusions froides” pp. 158–162. See Foucault’s discussion of M. Dupré’s cure in this and the following lecture (above, French p.143 sq. and below, French p.173 sq). Foucault devotes several pages to this cure in: Maladie mentale et Psychologe (Paris: P.U.F., 1962) pp. 85–86
The rotary swing was perfected by the English doctor Erasmus Darwin (1731–1802) and used to treat madness by Mason Cox, who praised its effectiveness: “I think it can be put to both a moral and a physical use, and be employed with success both as a means of relief and as a means of discipline, in order to make the patient more adaptable and docile” Observations sur la démence, p. 58. [It has not been possible to consult the first, 1804, edition of Practical Observations on Insanity, on which the French translation is based, and the passage quoted here does not appear in the second, 1806, edition. However, reference is made to the rotary swing elsewhere in the 1806 edition, e.g., p. 137; G.B.] See, L. Amard, Traité analytique de la folie et des moyens de la guérir (Lyon: printed by Ballanche, 1807) pp. 80–93
J. Guislain, Traité sur l’aliénation mentale, vol. I, book IV, and, Moyens dirigés sur le système nerveux cérébral. De la rotation (Amsterdam: Van der Hey, 1826) p. 374 and p. 404
C. Buvat-Pochon, Les Traitements de choc d’autrefois en psychiatrie. Leurs liens avec les thérapeutiques modernes, Médical thesis, Paris, no. 1262 (Paris: Le François, 1939). See Histoire de la folie, pp. 341–342; Madness and Civilisation, pp. 176–177.
While he was alive, Leuret had to defend himself from critics who condemned his practice as, in his own words, “retrograde and dangerous” (Dm traitement moral de la folie, p. 68). His main opponent was E.S. Blanche, in his paper to the royal Academy of medicine, Du danger des rigueurs corporelles dans le traitement de la folie (Paris: Gardembas, 1839), as well as in his short work, De l’état actuel du traitement de la folie en France (Paris: Gardembas, 1840). These polemics were echoed in Leuret’s obituary notices: U. Trélat, “Notice sur Leuret” Annales d’hygiène publique et de médecine légale, vol. 45,1851, pp. 241–262; and A. Brierre de Boismont, “Notice biographique sur M.F. Leuret” Annales mèdico -psychologiques, 2nd series, vol. III, July 1851, pp. 512–527.
A. Brierre de Boismont, “Notice biographique sur M.F. Leuret” Annales mèdico -psychologiques, 2nd series, vol. III, July 1851, pp. 512–527.
J.E.D. Esquirol, “De la folie” (1816) in Des maladies mentales vol. 1, p. 126; Mental Maladies, “Insanity,” p. 76.
J.E.D. Esquirol, “De la folie” (1816) in Des maladies mentales, vol. I, p. 126; Mental Maladies, “Insanity,” p. 76.
Michel Foucault is alluding here to the “money-excrement” relationship, which had a great future in psychoanalytic literature. Mentioned by Freud in a letter to Fliess of 22 December 1897 (French translation in La Naissance de la psychanalyse. Lettres à Wilhelm Fliess, 1887–1902, trans. A Berman [Paris: P.U.F., 1956] p. 212; English translation, The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904, trans. J.M. Masson [Cambridge, Mass.: The Belknap Press of Harvard University Press, 1985] p. 288), this symbolic relationship is developed in the theory of anal eroticism. See, S. Freud, “Charakter und Analerotik” (1908) in Gesammelte Werke [hereafter, GW] (Frankfurt: S. Fischer Verlag, 1941) vol. VII, pp. 201–209; English translation “Character and Anal Eroticism” in The Standard Edition of the Complete Psychological Works of Sigmund Freud [hereafter Standard Edition], trans, under General Editorship of James Strachey (London: The Hogarth Press, 1953–1974) vol. 9; “Über Triebumsetzung insbesondere der Analerotik” (1917) in GW (1946) vol. X, pp. 401–410; “On Transformations of Instinct as Exemplified in Anal Eroticism,” Standard Edition, vol.17. See also, E. Borneman, Psychoanalyse des Geldes. Eine kritische Untersuchung psy-choanalytisher Geldtheorien (Frankfurt: Suhrkamp Verlag, 1973); French translation, Psychanalyse de l’argent. Une recherche critique sur les théories psychanalytiques de l’argent, trans. D. Guérineau (Paris: P.U.F., 1978); English translation, The Psychoanalysis of Money (New York: Urizen Books, 1976).
G. Ferrus, Des aliénés. Considérations sur l’état des maisons qui leur sont destinées, tant en France qu’en Angleterre; sur le régime hygiénique et moral auquel ces malades doivent être soumis; sur quelques questions de médecine légale et de législation relatives à leur état civil (Paris: printed by Mme. Huzard, 1834) p. 234.
The “Sainte-Anne farm” derived from the donation made by Anne of Austria in 1651 for the construction of an establishment for taking in the sick during epidemics. Partially constructed, the land remained under cultivation. In 1833, Guillaume Ferrus (1784–1861 ), head doctor at Bicêtre, decided to use it to put to work convalescents and able-bodied incurables from the three sections of the asylum. A decision of the commission set up on 27 December 1860 by the prefect Haussmann to “study the improvements and reforms to be carried out in the service for the insane of the Seine department” marked the end of the farm. The construction of an asylum, begun in 1863 according to the plans established under the directive of Girard de Cailleux, was inaugurated on 1 May 1867. See, C. Guesstel, Asile d’aliénés de Sainte-Anne à Paris (Versailles: Aubert, 1880).
H. Belloc, Les Asiles d’aliénés transformés en centres d’exploitation rurale, moyen d’exonérer en tout ou en partie les départements des dépenses qu’ils font pour leurs aliénés en augmentant le bien-être de ces malades, et en les rapprochant des conditions d’existence de l’homme en société (Paris: Béchet, 1862) p. 15.
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Foucault, M. (2006). 19 December 1973. In: Lagrange, J., Ewald, F., Fontana, A. (eds) Psychiatric Power. Michel Foucault, Lectures at the Collège de France. Palgrave Macmillan, London. https://doi.org/10.1057/9780230245068_7
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