[The collection from which this excerpt is taken was originally published in 1964 under the title Essais critiques.]
[In Folie et déraison: Histoire de la folie à l'âge classique, Foucault] has not written the history of madness, as he says, in a style of positivity: from the start he has refused to consider madness as a nosographic reality which has always existed and to which the scientific approach has merely varied from century to century. Indeed Foucault never defines madness; madness is not the object of knowledge, whose history must be rediscovered; one might say instead that madness is nothing but this knowledge itself: madness is not a disease, it is a variable and perhaps heterogeneous meaning, according to the period; Foucault never treats madness except as a functional reality: for him it is the pure function of a couple formed by reason and unreason, observer and observed. And the observer (the man of reason) has no objective privilege over the observed (the madman). It would thus be futile to try to find the modern names for dementia under its old names.
Here is a first shock to our intellectual habits; Foucault's method partakes at once of an extreme scientific discretion and of an extreme distance with regard to "science"; for on the one hand, nothing happens in the book which is not nominally given by documents of the period;… and on the other hand, the historian here studies an object whose objective character he deliberately puts in parentheses; not only does he describe collective representations (still rarely done in history), but he even claims that without being mendacious these representations somehow exhaust their object; we cannot reach madness outside the notions of men of reason (which does not mean, moreover, that these notions are illusory); it is therefore neither on the side of (scientific) reality nor on the side of the (mythic) image that we shall find the historical reality of madness: it is on the level of the interconstituent dialogue of reason and unreason, though we must keep in mind that this dialogue is faked: it involves a great silence, that of the mad: for the mad possess no metalanguage in which to speak of reason. In short, Michel Foucault refuses to constitute madness either as a medical object or as a collective hallucination; his method is neither positivist nor mythological; he does not even shift, strictly speaking, the reality of madness from its nosographic content to the pure representation men have made of it; he keeps identifying the reality of madness with a reality at once extensive and homogeneous with madness: the couple formed by reason and unreason. Now this shift has important consequences, both historically and epistemologically.
The history of madness as a medical phenomenon had to be nosographic: a simple chapter in the general—and triumphant—history of medicine. The history of reason/unreason, on the other hand, is a complete history which brings into play all the data of a specific historical society; paradoxically, this "immaterial" history immediately satisfies our modern insistence on a total history, which materialistic historians or ideologists appeal to without always managing to honor it. For the constitutive observation of madness by men of reason is very quickly seen to be a simple element of their praxis: the fate of the mad is closely linked to the society's needs with regard to labor, to the economy as a whole; this link is not necessarily causal, in the crude sense of the word: simultaneous with these needs appear representations which establish them in nature, and among these representations, which for a long time were moral ones, there is the image of madness; the history of madness always follows a history of the ideas of labor, of poverty, of idleness, and of unproductivity. Michel Foucault has taken great care to describe simultaneously the images of madness and the economic conditions within the same society; this is doubtless in the best materialist tradition; but where this tradition is—happily—transcended is in the fact that madness is never offered as an effect: men produce in the one impulse both solutions and signs; economic accidents (unemployment, for example, and its various remedies) immediately take their place in a structure of significations, a structure which may well pre-exist them; we cannot say that the needs create values, that unemployment creates the image of labor-as-punishment: rather the two meet as the true units of a vast system of signifying relations: this is what Foucault's analyses of classical society unceasingly suggest: the link which unites the foundation of the Hôpital Général to the economic crisis of Europe (beginning of the seventeenth century), or on the contrary the link which unites the disappearance of confinement to the more modern sentiment that massive internment cannot solve...
(The entire section is 2026 words.)