Cabanis, comprendre l'homme pour changer le monde by Mariana Saad (review)

This book addresses the work of Pierre-Jean-Georges Cabanis, an influential French physician and philosopher of the Revolutionary and Bonapartist periods who proposed a comprehensive "science of man." Distinguishing her approach from that of historians like Martin Staum, Mariana Saad describes it as epistemological: she aims to show that Cabanis's materialist philosophy shaped everything from his views on the proper way to "read" disease and conceive of inner life, to his vision of a harmonious society structured to ensure the well-being of its citizens. She intertwines close readings of famous texts like the Rapports du physique et moral de l'homme (1802) with discussions of less studied works where Cabanis sketched projects for reforming medical care, education, and social organization in general.

Saad begins with an overview of Cabanis's vitalism, which entailed an "energetic" conception of sensibility as a vital force that drove a complex play of forces and counterforces within the human being. Chapter 2 considers his medical semiotics, the aspect of his thought most closely aligned to the language theories of the Idéologues (to whom he was personally tied). Chapter 3 addresses the causal logic Cabanis applied to medicine, and surveys his theories on climate and temperament as factors in health. Chapters 4 to 6 delve into Cabanis's approach to mental illness, his views on women, the political role he claimed for physicians and for medicine in the remaking of public education, and his theory of "infinite" perfectibility.

The three key points of Saad's book are identified by Jackie Pigeaud in his preface: Cabanis's notion of sensibility without sensation; his idea of a physiologically rooted "inner self"; and the theory (later developed by Freud in his work on melancholy) that thinking is grounded in a physical, viscerally located disorder or distress. Cabanis did, indeed, play a key role in the theoretical elaboration of these ideas. However, Saad tends to exaggerate his originality in elaborating them, a problem she could have avoided by engaging more directly with the work of scholars like François Azouvi, Jean Starobinski, and Caroline Jacot Grapa on the "pre-history" of inner sensations and pre-Revolutionary models of psychophysiology. Closer attention to the ways in which Cabanis's ideas emerged from the medical and philosophical thought of eighteenth-century Europe would also have helped to contextualize other aspects of his thinking: for example, his model of the exquisitely insightful physician-philosopher, his linking of crime to mental disorder and social pathologies, and the inverted relationship he posited between exceptional intellectual ability and bodily health. That last idea was a truism of works on the diseases deemed peculiar to men of letters, a discursive genre that popularized some of the case histories related by Cabanis: for example, Blaise Pascal, whom doctors often cited to illustrate the link between genius and the obsessive delirium characteristic of melancholy.

Saad uses the case of Pascal to argue that Cabanis does not deserve the label of misogyny that other scholars have applied to his theories about women's nature, most particularly his views on women intellectuals, whom he depicted as "denatured." She contends that Cabanis tied women to geniuses like Pascal by describing both as examples of the pathogenic powers of a "lively and mobile" imagination that affected the body's visceral regions (p. 175). However, when Cabanis ascribed a visceral location to nervous/mental disorder, he did so in highly gendered terms—and did not replace the old "black bile" etiology with a sexual etiology for both sexes. The melancholic man, in his estimation, suffered from digestive ailments, whereas the ailments of oversensitive, overimaginative women arose from their reproductive organs. Far from using viscerality to open up the possibility of genius for women, Cabanis deployed it to make them ineligible for the "infinite" perfectibility he envisioned for men of a certain type, in a certain climate, who followed a particular regimen of moral/physical hygiene.

Despite those shortcomings, Saad's...