Madness & Civilization: A History of Insanity in the Age of Reason, by Michel Foucault, is an examination of the ideas, practices, institutions, art & literature relating to madness in Western history. It's an abridged English edition of Histoire de la folie à l'âge classique, originally published in 1961 as Folie et déraison. Histoire de la folie à l'âge classique. A full translation, The History of Madness, was published by Routledge in 6/2006. This was his 1st major book, written while Director of the Maison de France in Sweden.
This history begins in the Middle Ages, noting the social & physical exclusion of lepers. It argues that with the gradual disappearance of leprosy, madness came to occupy this excluded position. The ship of fools in the 15th century is a literary version of one such exclusionary practice, the practice of sending mad people away in boats. However, during the Renaissance, madness was regarded as a common phenomenon because humans couldn't attain Divine Reason. As Cervantes' Don Quixote, all humans are weak to desires & dissimulation. Therefore, the insane, understood as those who had come too close to God's Reason, were accepted in the middle of society. It isn't before the 17th century, in a movement famously called the Great Confinement, that unreasonable people systematically were institutionalized. In the 18th century, the mad came to be seen as having lost what made them human & become animalistic & treated as such. It isn't before 19th century that madness was regarded as an illness to be cured.
Foucault wasn't talking about medical institutions designed specifically for the insane but about the creation of houses of confinement for social outsiders, including not only the insane but also vagrants, the poor & orphans, & what effect those houses of confinement had on the insane & perceptions of madness in the West. He demonstrates that while confinement of social outcastes was a generally European phenomenon, it had a unique development in France & distinct developments in other countries such as Germany & England.
Foucault also argues that madness during the Renaissance had the power to signify the limits of social order & to point to a deeper truth. This was silenced by Enlightened Reason. He also examines the rise of modern scientific & humanitarian treatment of the insane, notably at the hands of Philippe Pinel & Samuel Tuke. He claims these modern treatments were no less controlling than previous methods. Tuke's country retreat for the mad consisted of punishing them until they gave up their commitment to madness. Similarly, Pinel's treatment of the mad amounted to an extended aversion therapy, including such treatments as cold showers & straitjackets. This treatment amounted to repeated brutality until the pattern of judgment & punishment was internalized by the patient.
