Console and classify: the French psychiatric profession in the nineteenth century

Even when he ploughs such deep furrows as the Schreber case or Freud's own 'Autobiographical Study', he has new lessons to teach us. It is salutary to be reminded, too, that Freud "attributed [Emma Eckstein's] neurosis to masturbation and, following Fliess's 'reflex nasal neurosis' theory, saw the nose as the source of her masturbatory activity". The treatment, as Porter aptly puts it, was "anti-masturbatory nasal surgery". Since then the therapeutic armamentarium of psychiatry has progressed to insulin coma, electroshock, lobotomy, and psychotropic drugs. "This book", summarizes Porter, "has argued that there is a 'story from below' which needs telling." There is, indeed, and he has told it eloquently. And to what end? Herein, perhaps, lies the greatest strength of this fine book which, concludes Porter, "has not pleaded a cause; neither has it had any palpable design upon its readers." Although it may not have been Porter's aim to plead a cause, one cannot write a book on so emotion-laden a subject as madness without, at least tacitly, doing so. If, then, the Whig interpretation of the history of psychiatry pleads the cause of uninterrupted medical progress in the diagnosis and treatment of mental illness, what cause does the Tory interpretation plead? That we must never stop pondering the dilemmas of human existence; and that the social-psychiatric engineering we undertake ought to be peaceful and piecemeal, as Karl Popper has urged, and not violent and revolutionary, as the much-ballyhooed "reforms" of psychiatry have been, especially in this, our own violent and revolutionary century.