Thirty years after its publication, Michel Foucault’s Madness and Civilization still provokes debate among historians. It is ‘a beautiful book’, a set of ‘over-simplifications’ flying in the face of empirical evidence, and a new model for writing the history of culture (Foucault 1965; Midelfort 1980; O’Brien 1989). A recent survey of the book’s reception claimed that there had been no real test of the fruitfulness of Foucault’s ‘complex interpretive framework’, and so for some his status as a historian of madness must remain an open question (Gutting 1994). Foucault’s writings have been a source of ‘irritation’ for historians, often because his work has raised difficult questions about the politics of history-writing and the role of the intellectual. He addressed some of these criticisms in ‘Questions of method’ (Foucault 1991) and other places where he attempted to answer the claim that his work provided no encompassing explanatory framework. He said that his critics complained of no structure in his work: ‘no infra- or superstructure, no Malthusian cycle, no opposition between state and civil society: none of these schemas which have bolstered historians’ operations, explicitly or implicitly, for the past hundred or hundred and fifty years’ (Foucault 1991: 85). The debates specifically on the history of madness continue, despite the fact that the abridged English translation still makes Foucault’s original Histoire de la folie something of an ‘unknown book’ to English readers (Gordon 1990).