The history of the philosophies of psychiatry is yet to be written. Insight into material essential to this endeavour is provided by Classic Text No. 79 which translates an excerpt from the work of Prosper Despine (1812—92), one of the most distinguished alienist-philosophers of the second half of the 19th century. In his De la Folie …, Despine discusses, inter alia, issues concerning the referent, definition and aetiology of ‘madness’. His arguments are that putative brain lesions cannot act as a referent for ‘madness’ for they correlate poorly with mad behaviour; instead, the referent should be provided by a definition worked out by the science of psychology. Lest one commits a categorical fallacy, this association should not be taken as evidence that the brain lesions are the disease because they can be present without madness; and because the latter can develop without brain lesions. Despine seems to suggest that non-organic aetiologies such as psychogenicity should be taken into account.