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== Mad Travelers:Reflections on the Reality of Transient Mental Illnesses ==

Mad Travelers: Reflections on the Reality of Transient Mental Illnesses (1998) is a book by the Canadian philosopher of science Ian Hacking. The book provides an historical account of a medical condition that used to be known as fugue or mad travel. Fugue emerged as ‘a specific, diagnosable type of insanity’ (p.8) in late nineteenth century France and then spread to Italy, Germany and Russia. It is characterised by a compulsion to travel, which, if fulfilled, manifests itself in impetuous travelling during which the voyager loses sense of their identity. Hacking gives as an example the case of the first officially diagnosed fuguer, Albert Dadas, and describes briefly his symptoms as follows:

‘In his normal state, at home, in the factory, or as a cook in the army, he was a good worker, timid respectful, shy with women. He never drank and when he was on a fugue had a particular hostility to alcohol. At home he would have a regular and uneventful life. Then would come about three days of severe headaches, anxiety, sweats, insomnia, masturbation five or six times a night, and then – he would set out.’(p.24).

As Hacking (p.196) reports, the fugue was introduced as a distinct disorder for the first time in DSM-III (1980) under the name ‘psychogenic fugue’ which was associated with: 1. ‘the predominant disturbance is sudden, unexpected travel away from home or ones’ customary place of work, with inability to recall one’s past’ 2. ‘confusion about personal identity or assumption of new identity (partial or complete)’ 3. ‘the disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e.g. , a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy)’ 4. ‘the symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Hacking uses’

Hacking uses Albert Dadas as a case study of what he terms ‘transient mental illness’: ‘an illness that appears at a time and in a place, and later fades away. It may spread from place to place and reappear from time to time. It may be selective for social class or gender, preferring poor women or rich men.’ (p.1). The concept of a transient mental illness has provoked debates as to whether the condition is real or socially constructed; Hacking, however, does not follow this line of argument but focuses instead on how knowledge, scientific practices and ordinary life in a particular context allow for socially permissible diagnoses and diseases to emerge. To explore the major factors which may be involved in the emergence of a disease, Hacking introduces the term ‘ecological niche’ (p.2). For a disease to emerge and thrive, it should: fit into the larger taxonomy of illnesses; be situated between some virtuous and vicious elements of the contemporary culture; be observable as a disorder; and provide, alongside all the pain and suffering, some release.