Inheriting Madness: Professionalization and Psychiatric Knowledge in Nineteenth Century France by Ian Dowbiggan, and: Women and Madness: The Incarceration of Women in Nineteenth-Century France by Yannick Ripa (review)
- Victorian Review
- Johns Hopkins University Press
- Volume 18, Number 1, Summer 1992
- pp. 79-83
- View Citation
- Additional Information
Reviews79 Ian Dowbiggan. Inheriting Madness: Professionalization and Psychiatric Knowledge in Nineteenth Century France. Berkeley: U of Cahfornia P1 1991. 217. $29.95 US (cloth). Yannick Ripa. Women and Madness: The Incarceration of Women in Nineteenth-Century France. Minneapolis: U of Minnesota P, 1990. 175. $39.95 US (cloth). The antipsychiatric movement ofrecent years has stimulated scholarly debate on die history of psychiatric medicine and die treatment of die mentally iU. The nineteenth century, with its obsessive interest in madness and its enthusiastic construction of asylums, has proved a rich field for research. Until the publication of Jan Goldstein's study of early French psychiatry (Console and Classify), most of the research and debate centered on AngloAmerican psychiatry. These two books, by Dowbiggan and Ripa, not only provide important information on the French experience, but they also contribute to current debates on die extent of medical power and die experience of internment. Inheriting Madness is a careful, scholarly study ofpsychiatric theory and its relation to professional power. Ian Dowbiggan, an historian of medicine, is interested in why French psychiatrists overwhelmingly adopted die theory of hereditary degeneracy in die second half of die nineteentii century. This theory postulated tiiat mental illness would result, over several generations, in the deterioration of whole families. Yet, as Dowbiggan demonstrates, hereditary degeneracy was not a coherent explanation of madness. Nor did it arise from the practical experience of French asylum doctors. Radier, he argues, the tiieory provided psychiatrists with an effective defence of dieir considerable legal and institutional powers at a time when these powers were increasingly contested. His book dierefore supports and develops Jan Goldstein's diesis that nineteenth-century psychiatric theory must be seen primarily as an attempt by asylum doctors to achieve power and professional status tiirough medical knowledge. Dowbiggan acknowledges his debt to Michel Foucault's perceptions of power, social control, and the development of professional knowledge. But, like many historians, Dowbiggan judges that "there is a seamless quality to Foucault's model that, like many sociological models, fits historical reality poorly" (170). More specifically, tiieories of psychiatric power and control do not seem to fit the historical reality of the middle years of die nineteenth century, when French asylum doctors were under attack from a strong political and public antipsychiatric movement. Although Dowbiggan does refer to psychiatrists as agents of a society that wanted to exclude the insane, his emphasis is on a group in crisis, marginalized within the medical 80Victorian Review profession, vulnerable to pubUc attack, and as much concerned with "preserving power as with extending power" (170). It is titis "alienation of the alienists" (9), he argues, that is the key to understanding die medical interest in theories of degeneration. By thoroughly examining the medical Uterature and die antipsychiatric campaigns of the period, Dowbiggan effectively conveys the beleaguered state of French psychiatry at mid-century. The law of 1838 had given asylum doctors die monopoly of treating the insane but, by the 1860s, as Dowbiggan nicely puts it, their "therapeutic record was a source of considerable pubUc embarrassment" (141). Public asylums appeared to be filled with the chronically Ul and, despite psychiatrists' claims of expertise, the rate of cure was less than thirty percent. The public clearly distrusted these doctors and the antipsychiatric campaign of the 1860s, led by the French press and poUticians, portrayed asylums as modem BastiUes and psychiatrists as agents of unjustified internment. Widi dieir legal monopoly of die treatment of madness under attack, asylum doctors were, as Dowbiggan illustrates, uncomfortably aware of die inadequacies of their medical theories. The concept of degeneration, already current in literary and intellectual circles, offered psychiatrists an attractive solution to dieir philosophical and professional problems. Dowbiggan argues tiiat the psychiatric theory of hereditary degeneracy "not only reflected . . . cultural concerns and anxieties but also refracted them in a way that served die interests of mental medicine" (154). Using die extensive medical literature on hereditary degeneracy from Bénédict-Augustin Morel's treatises in the 1850s to the famous debates of die Société médico-psychologiquein die mid-1880s, Dowbiggan demonstrates that it was precisely the eclecticism and vagueness of die theory that made it so useful. In his words...