‘De la non-existence de la monomanie’, by Jean-Pierre Falret (1854)

Abstract

The following text is the conclusion of a two-part translation of Falret's 1854 essay arguing against the concept of monomania. In order to shine new light on the conceptual understanding of madness, the text emphasizes the importance of thorough clinical observations and the perspective of the whole patient, rejecting the disproportionate attention given to isolated symptoms, and in this respect his work represents a turning point away from the more traditional alienism.

Alternatives to Gold Standard Diagnostic Tools for Distinguishing “Natural Kinds” on the Autism Spectrum

“…We can now return to the starting point, the principles recorded by Falret in his Clinical Lessons in 1864, which enabled him to identify “circular insanity” (1854), now known as bipolar disorder, which he considered, along with general paralysis, to be a model of “natural forms” ( 47 – 49 ).…”

“…The second principle is to characterize “disease individuality,” “describing the subject observed and what distinguishes that subject individually, rather than describing the phenomena common to this and other subjects according to existing classifications” ( 49 ).…”

“…Detached from their context, the signs or symptoms lose their significance; it is the context that allows its clinical value to be assessed ( 54 ). “It is not enough to note the odd and extraordinary words pronounced by the insane patient, and the eccentric and muddled actions he committed; one must, above all, assess and carefully analyze the internal psychic state that gives birth to these words and actions” ( 47 , 49 ). “When faced with an agitated patient, it is therefore important to search carefully for the cause of such agitation, to determine whether it is automatic and muscular, or voluntary, driven by an idea” ( 47 ).…”

The erudite humility of the historian: the ‘critical epistemology’ of Georges Lantéri-Laura

“…The unity of alienation is, indeed, precisely the denial of the plurality of morbid species, thereby making impossible any semiological and therapeutic differentiation, namely, clinical examination based on rational medicine. Within this context, according to Lantéri-Laura, the 1854 article by Jean-Pierre Falret ‘De la non-existence de la monomanie’ (see Lepoutre, 2012) marked a turning point, insofar as it opposed the theory of the unity of alienation by claiming the primacy of clinical observation and consequently the application of the differential method (Lantéri-Laura, 1998: 95ff.). In this respect, Lantéri-Laura emphasizes also the advance of the semiology outlined by the Paris school (J.-N. Corvisart, J-B.…”