The subject of Laure Murat¡¯s fascinating history of French psychiatry is the nature of the relationship between folly and history, between mental illness and the historical contexts in which it manifests itself. Are people more likely to lose their mind when they are confronted with unsettling and traumatic historical events? Or is it the case that violent and rebellious acts ¨C during a revolution or a civil war, for example ¨C occur precisely because their authors are insane to begin with?

In the 1960s and 1970s, Michel Foucault¡¯s pioneering works set forth the view that folly was largely defined by the ways in which different societies fixed the limits between ¡°normal¡± and ¡°deviant¡± behaviour. In his reading, the scientific definition of madness and the means employed to treat it were the products of evolving forms of social discipline. Thus the medical understanding of mental illness developed in parallel to the growing ambition, on the part of modern states, to shape the lives of their citizens in every detail. Murat¡¯s work is partly inspired by Foucault¡¯s original intuition about the political uses of the notion of madness (after all, one does not need to go very far back in history to find authoritarian regimes treating political dissidents as lunatics). However, her study offers a less militant, more nuanced picture of the complex relations that connect folly to historical events.

Scientific expertise was placed at the heart of both capital punishment and imprisonment on medical grounds, but the result was not a detached approach

Writing in 1816 after the end of the Napoleonic wars, Jean-?tienne-Dominique Esquirol ¨C one of the French medical practitioners who feature in Murat¡¯s narrative ¨C claimed that it was possible to write the history of the revolution of 1789 and of Bonaparte¡¯s empire through the study of mental illness. One could begin this ¡°parallel¡± history in 1790: during that year the newly established French Constituent Assembly voted for, among many other items of legislation, two significant measures. The first was the adoption of the guillotine ¨C an invention designed and perfected by medical experts ¨C as a new instrument of capital punishment, intended to make death both quick and painless. The second measure concerned the internment of people said to be suffering from mental illness. Until then, internments were arbitrarily decided by the families of sufferers or by political authorities; now people could be committed only on the joint advice of doctors and magistrates. Thus in one stroke the Assembly placed scientific expertise at the heart of both capital punishment and imprisonment on medical grounds, and yet the outcome would be far from the clinical, detached approach that legislators had intended.

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If not exactly pleasant and ¡°refreshing¡±, as claimed by its inventors, death by guillotine was far less cruel and gruesome than the torments and mutilations dispensed under the Ancien R¨¦gime. However, in the years of revolutionary terror, the guillotine¡¯s constant presence on the public square and the executions of prominent personalities stimulated collective imagination, generating all sorts of morbid fantasies. Did people really die when they were struck by the blade? In spite of medical reassurance to the contrary, bystanders mistook the real or imagined spasms of severed heads and bodies for signs of continuing life. Soon there were reports of post-mortem apparitions of beheaded victims, whose ghosts haunted the scaffold as in folktales of old. At the same time, asylums registered among their inmates a significant number of people who claimed to have ¨C literally ¨C lost their head. (Interestingly, Robert Badinter, a prominent French lawyer and later the minister of justice who would oversee the abolition of capital punishment in France in 1981, echoed this original horror of the guillotine by describing to the jurors in a 1970s murder trial how, were they to vote for death, a living human being would be cut in two.)

It is hardly surprising that the sight of protracted violence, or the fear of imminent death, should push people over the edge, causing irreparable psychic damage to the most vulnerable. But in the context of the 1790s, an eloquent counter-revolutionary literature was ready to label the revolution itself a form of collective delirium. Corrupted by radical propaganda and deluded by false promises of justice and prosperity, the French people, it was argued, had simply lost their reason, succumbing to hallucinations and turning into a mass of bloodthirsty beasts. The very belief in democracy, in the Utopia of a society of equals, was a sign of mental derangement and a dangerously contagious disease.

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The association between revolution and folly was originally set forth in 1790 by Edmund Burke in his famous pamphlet Reflections on the Revolution in France; the claim would return over and over again in the writings of conservative authors throughout the 19th century on the occasion of every new revolutionary episode, down to the tragic insurrection of the Paris Commune in 1871. What was originally a political condemnation of democratic ideals morphed into a clinical diagnosis, with morbus democraticus becoming an acknowledged form of mental illness. The descent into madness of some disappointed revolutionaries, such as the unfortunate feminist militant Th¨¦roigne de M¨¦ricourt, was produced as evidence of this phenomenon. It is easy to dismiss these views as the desperate resistance of a threatened ruling class unwilling to resign itself to the loss of its original power. There is, however, surely some truth in the notion that the opposition to established values and the adoption of radical ideologies can seem to defy reason. (After all, we often react to the actions of today¡¯s terrorists by claiming that they must be ¡°mad¡±.)

A further illustration of the psychological consequences of political disruption can be found in the phenomenon evoked by the title of this worthy book. It turns out that the popular picture of the madman in Napoleon¡¯s hat is closer to reality than one might expect. In 1840 the body of the emperor, who had died in St Helena some 20 years before, was brought back to Paris and reburied with great pomp at the Invalides. The same year, the doctor F¨¦lix Voisin recorded the presence in the asylum of Bic¨ºtre of some 14 ¡°Napoleons¡±. Throughout the 19th century, the number of patients suffering from megalomania who claimed to be the emperor greatly outnumbered those who identified with, say, Jesus Christ or Louis XVI. Why was Napoleon so popular with lunatics? Murat offers an interesting answer, namely that there was an obvious element of folly in Bonaparte¡¯s own measureless ambition. It had taken him just five years ¨C from 1799 to 1804 ¨C to turn from victorious republican general to emperor of the French, crowned in Notre Dame like Charlemagne. As a usurper, one may argue, he had no more right to his title than the next man: enough to justify the ¡°why not me?¡± response of other, less successful megalomaniacs.

Murat¡¯s analysis, informed by extensive archival research, shows how difficult it is to disentangle the intricate connections that link individual sensibility and imagination to the currents of history. Is our identity entirely shaped by our environment, or do we simply adjust our fears and dreams to external circumstances? And what exactly constitutes a ¡°normal¡± attitude towards one¡¯s own times? Some of these questions are bound to remain open: this compelling book offers a valuable opportunity to consider them, and to explore some of the answers.