The Poor
According to Foucault, the poor were the primary target of the “Great Confinement.” This is because people thought poverty was a moral failing on the part of individuals rather than an economic failing on the part of society. These seemingly-unproductive members of society needed to be separated from the more functional members of society. Because the poor were the main component of the larger category of “unreason” in which madness got included as well, they also set the terms for how the mad were viewed. The ethical dimensions of productivity and labor applied to the mad, who were thought to be those who could not contribute to society.
The Mad
The mad are the main subjects of Foucault’s study, but this is because of the changing meanings attached to them throughout the period his book covers. At first, the mad were considered part of a larger category of social misfits, as described above. But by the end of the classical age, madness was considered its own special thing, a psychological problem distinct from criminality or poverty. This is why the mad also needed to be confined in their own special places, with the asylum replacing the original hospitals in which the mad were confined along with others.
Samuel Tuke
Tuke is one of the two great asylum founders Foucault discusses at the end of his book. He created the Tuke Retreat in England for the treatment of the mad. A Quaker, Tuke’s treatment of madness was primarily religious. His aim was to make the madman confront his own guilt and actions in order to learn to function sanely once more. Thus the main principles of the Retreat were surveillance and judgment: a constant sense of observation, ritualized throughout the Retreat, in which madmen were judged and could learn to judge themselves. This would lead them to repair their actions and behaviors in line with a moral vision of the world.
Philippe Pinel
The second asylum developer Foucault considers is Philippe Pinel, who was less religious than Tuke but still committed to a moral vision of madness, in other words, a view of madness as a moral failure. The ideas of morality Pinel rested on where from his own social background and included family and economic values: being a good member of a family and a productive laborer in society. Conceiving of madness as a failure to meet these norms meant that madness was essentially a “social failure,” the failure of someone to conform to society, and the asylum was essentially “an instrument of moral uniformity and of social denunciation,” disciplining people into conformity.
The Medical Personage
Tuke and Pinel were both founders of asylums to reform or cure the mad. They varied in their techniques as well as their national contexts, Tuke in England and Pinel in France. But they both believed in the importance of the “medical personage,” or the idea that asylums should be run by doctors, especially doctors with almost dictatorial power. This completes, for Foucault, the development of madness as a matter of psychological medicine, requiring the intervention of medical authority. Asylums, run by doctors, are very different from the earlier “hospitals,” which were more like prisons run by wardens.
