Madness and Civilzation ( A History of Madness)

by Foucault, Michel -

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  ucts which will be sold the world over; in short, a people would be poor which had no paupers. Indigence becomes an indispensable element in the State. In it is concealed the secret but also the real life of a society. The poor constitute the basis and the glory of nations. And their poverty, which cannot be suppressed, must be exalted and revered: "My purpose is merely to attract a share of that vigilant attention [that of the government] to the suffering portion of the People . . .; the succor it is owed derives essentially from the honor and the prosperity of an Empire, of which the Poor are everywhere the firmest support, for a sover­eign cannot preserve and extend his realm without favoring the population, the cultivation of the Land, the Arts, and commerce; and the Poor are the necessary agents of these great powers which establish the true strength of a Peo­ple."6 Here is an entire moral rehabilitation of the Pauper, which designates, at a deeper level, a social and economic reintegrarion of his role and character. In the mercantilist economy, the Pauper, being neither producer nor con­sumer, had no place: idle, vagabond, unemployed, he be­longed only to confinement, a measure by which he was exiled and as it were abstracted from society. With the nascent industry which needs manpower, he once again plays a part in the body of the nation.

  Thus, economic thought elaborates on new foundations the notion of poverty. There had been the entire Christian tradition for which the Poor Man had had a real and con­crete existence, a presence of flesh and blood: an always individual countenance of need, the symbolic passage of God in man's image. The abstraction of confinement had removed the Poor Man, had identified him with other fig­ures, enveloping him in an ethical condemnation, but had not dissociated him from his features. The eighteenth cen­tury discovered that "the Poor" did not exist as a concrete

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  and final reality; that in them, two realities of different natures had too long been confused.

  On one hand, there was Poverty: scarcity of commodi­ties and money, an economic situation linked to the state of commerce, of agriculture, of industry. On the other, there was Population: not a passive element subject to the fluctu­ations of wealth, but a force which directly contributed to the economic situation, to the production of wealth, since it is man's labor which creates—or at least transmits, shifts, and multiplies—wealth. The "Poor Man" was a vague no­tion in which were combined that wealth which is Man and the state of Need which is acknowledged as essential to humanity. Indeed, between Poverty and Population, there is a rigorously inverse relation.

  Physiocrats and economists are in agreement on this. Population is in itself one of the elements of wealth; it forms, indeed, its certain and inexhaustible source. For Francois Quesnay and his disciples, man is the essential mediation between the land and wealth: "A man is worth as much as the land, according to an old proverb. If a man is valueless, so is the land. With men, one doubles the land one possesses; one clears it, one acquires it. God alone could from the earth make a man, whereas all over the world it has been possible to have land by means of men, or at least the product of the land, which comes down to the same thing. It follows that the first good is the possession of men, and the second, of the land."7

  For the economists, the population is a good quite as essential, if not more so, since in their view wealth is cre­ated not only in agricultural labor, but in every industrial transformation, and even in commercial circulation. Wealth is linked to a labor actually effected by man: "The State having real wealth only in the annual products of its lands and in the industry of its inhabitants, its wealth will be at a

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  maximum when the product of each acre of land and of the industry of each individual is raised to its maximum."8 Paradoxically, a population will be precious in proportion to its numbers, since it will afford industry a cheap labor force, which, by lowering the cost price, will permit a de­velopment of production and of commerce. In this in­finitely open labor market, the "fundamental price"—what corresponds for Turgot to the worker's subsistence—and the price determined by supply and demand ultimately coincide. A nation will therefore be favored in commercial competition to the degree that it has at its disposal the great­est potential wealth of a numerous population.

  Confinement was a gross error, and an economic mis­take: poverty was to be suppressed by removing and main­taining by charity a poor population. Actually, it was poverty that was being artificially masked; and a part of the population was being really suppressed, wealth being always constant. Was the intention to help the poor escape their provisional indigence? They were kept from doing so: the labor market was limited, which was all the more dangerous in that this was precisely a period of crisis. On the contrary, the high cost of products should have been palliated by a cheap labor force, their scarcity being com­pensated by a new industrial and agricultural effort. The only reasonable remedy: to restore this entire population to the circuit of production, in order to distribute it to the points where the labor force was rarest. To utilize the poor, vagabonds, exiles, and emigres of all kinds, was one of the secrets of wealth, in the competition among nations: "What is the best means of weakening the neighboring states whose power and industry tend to overshadow us?" asked Josias Tucker apropos of the emigration of the Prot­estants. "Is it to force their subjects to remain at home by refusing to receive and incorporate them among us, or is it

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  to attract them to us by good wages, allowing them to enjoy the advantages of the other citizens?"

  Confinement is open to criticism because of the reper­cussions it can have on the labor market; but still more, because it constitutes, and with it the entire enterprise of traditional charity, a dangerous financing. Like the Middle Ages, the classical period had always sought to provide aid to the poor by the system of foundations. This meant that a share of land capital or income was thereby immobilized. And for good, since, in the just concern to avoid the com­mercialization of the charity enterprises, all juridical mea­sures were taken so that these goods would never return to circulation. But with the passage of time, their utility di­minished; the economic situation changed, poverty altered its aspect: "Society does not always have the same needs; nature and the distribution of property, the division be­tween the different orders of the people, the opinions, the customs, the general occupations of the nation or of its different portions, the climate itself, the diseases and other accidents of human life undergo a continual variation; new needs are born; others cease to make themselves felt."9 The definitive character of the foundation was in contradiction to the variable and indefinite rate of the accidental needs which it was supposed to satisfy. Without the wealth which it immobilized being restored to circulation, new wealth had to be created as new needs appeared. The share of funds and revenues which were set aside constantly in­creased, thereby diminishing the productive share. Which inevitably led to a greater poverty, hence to more numer­ous foundations. And the process could extend indefinitely. The moment could come when "the ever multiplying foundations would ultimately absorb all funds and all pri­vate property." Upon close scrutiny, the classical forms of aid were a cause of impoverishment, the gradual immobili-

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  zation and in a sense the slow death of all productive wealth: "If all the men who ever lived had had a tomb, it would have been quite necessary, in order to find land to cultivate, to overturn these sterile monuments, and to stir the ashes of the dead in order to feed the living."10

  What disappeared, in the course of the eighteenth cen­tury, was not the inhuman rigor with which madmen were treated, but the evident necessity of confinement, the total unity in which they were situated without difficulty, and those countless threads that wove them into the continuous texture of unreason. Madness was set free long before Pinel, not from the material constraints which kept it in the dungeon, but from a much more binding, perhaps more decisive servitude which kept it under the domination of unreason's obscure power. Even before the Revolution, madnes
s was free: free for a perception which individual­ized it, free for the recognition of its unique features and for all the operations that would finally give it its status as an object.

  Left alone, and detached from its former relations, within the crumbling walls of confinement, madness was a problem—raising questions it had hitherto never formu­lated.

  Above all, it embarrassed the legislator who, unable to keep from sanctioning the end of confinement, no longer knew at what point in the social sphere to situate it-prison, hospital, or family aid. The measures taken imme­diately before or after the beginning of the Revolution re­flect this indecision.

  In his circular on the lettres de cachet, Breteuil asked the administrators to indicate the nature of the detention orders in the various houses of confinement, and what reasons jus­tified them. After a year or two of detention at the most, those men were to be set free "who, having done nothing

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  that could expose them to the severity of the punishments pronounced by the laws, had abandoned themselves to the excesses of libertinage, debauchery, and dissipation." On the other hand, those prisoners were to be kept in the houses of confinement "whose minds are deranged and whose imbecility makes them incapable of conducting themselves in a world where their rages would make them dangerous. With respect to these, all that is necessary is to ascertain whether their condition is still the same, and un­fortunately it becomes indispensable to continue their de­tention as long as it is acknowledged that their freedom is harmful to society, or a useless benefit to themselves." This was the first stage: to reduce as much as possible the prac­tice of confinement with regard to moral transgressions, family conflicts, the most benign aspects of libertinage, yet to leave it untouched in its principle, and with one of its major meanings intact: the internment of the mad. This is the moment when madness actually takes possession of confinement, while confinement itself is divested of its other forms of utility.

  The second stage was that of the great investigations prescribed by the National Assembly and by the Constitu­ent Assembly, immediately following the Declaration of the Rights of Man: "No man may be arrested or detained except in the cases determined by law and according to the forms therein prescribed. . . . The law must permit only the penalties strictly and evidently necessary, and no one may be punished under a law established and promulgated subsequent to the crime." The era of confinement was over. There remained only an imprisonment shared for the moment by condemned or presumed criminals and the mad. The Committee on Mendicity of the Constitutent As­sembly designated five persons to visit the houses of con­finement in Paris. The Duke de la Rochefoucauld-Liancourt presented the report (December 1789); he declared

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  that the presence of madmen gave the houses of correction a degrading aspect and was likely to reduce the inmates to a status unworthy of humanity; the melange tolerated there proved a great frivolity on the part of the authorities and the magistrates: "This carelessness is far from the enlight­ened and scrupulous pity for misfortune whereby it re­ceives all possible alleviation and consolation . . . ; in seek­ing to succor poverty, can one ever consent to appear to degrade humanity?"

  If the mad defile those with whom they have been im­prudently confined, a special internment must be reserved for them; a confinement that is not medical, but that ought to be the most efficacious and the easiest form of aid: "Of all the misfortunes that afflict humanity, the condition of madness is still one of those that with most reason call for pity and respect; it is for this condition that our attentions must with most reason be prodigal; when there is no hope of a cure, how many means still remain that can afford these unfortunates at least a tolerable existence." In this text, the status of madness appears in all its ambiguity: it is necessary both to protect the confined population from its dangers, and to grant it the benefits of a special aid.

  The third stage was the great series of decrees issued between the twelfth and the sixteenth of March 1790. In them, the Declaration of the Rights of Man received a con­crete application: "In the space of six weeks, beginning with the present decree, all persons detained in fortresses, religious houses, houses of correction, police houses, or other prisons whatsoever, by lettres de cachet or by order of the agents of the executive power, so long as they are not convicted, or under arrest, or not charged with major crimes, or confined by reason of madness, will be set at liberty." Confinement is thus definitively reserved for cer­tain categories of convicted criminals and for madmen. But for the latter, a special arrangement is in order: "Persons

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  detained for reasons of dementia will be, for the space of three months, starting from the day of publication of the present decree, at the suit of our procurators, interrogated by the magistrates in the usual manner, and by virtue of their disposition visited by physicians who, under the su­pervision of the directors of the district, will pronounce upon the true circumstances of the patients in order that, after the sentence that will have certified as to their condi­tion, they may be released or cared for in hospitals indi­cated for that purpose." It appears that the choice is hence­forth made. On March 29, 1790, Bailly, Duport-Dutertre, and a police administrator went to La Salpetriere to deter­mine in what manner this decree could be carried out; they then made a similar visit to Bicetre. The difficulties were numerous; to begin with, there existed no hospitals in­tended or at least reserved for the mad.

  In the face of these material difficulties, to which were added certain theoretical uncertainties, a long phase of hesi­tation was to begin. From all sides, the Assembly was asked to provide a text which would grant protection from mad­men even before the promised creation of the hospitals. And by a regression, which was to be of great importance for the future, madmen were brought under the sway of immediate and unchecked measures adopted not even against dangerous criminals, but against marauding beasts. The Law of August 16-24, 1790, "entrusts to the vigilance and authority of the municipal bodies . . . the care of ob­viating and remedying the disagreeable events that may be occasioned by madmen set at liberty, and by the wander­ing of vicious and dangerous animals." The law of July 22, 1791, reinforces this arrangement, making families respon­sible for the supervision of the insane, and permitting the municipal authorities to take all measures that might prove useful: "The relatives of the insane must care for them, prevent them from straying, and see that they do not

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  commit offenses or disorders. The municipal authority must obviate the inconvenience that may result from the negligence with which private persons fulfill this duty." By this detour around their liberation, madmen regained, but this time within the law itself, that animal status in which confinement had seemed to isolate them; they again became wild beasts at the very period when doctors began to at­tribute to them a gentle animality. But even though this legal disposition was put in the hands of the authorities, the problems were not solved thereby; hospitals for the insane still did not exist. /

  Countless requests flooded the Ministry of the Interior. Delessart answered one of them, for example: "I feel as you do. Monsieur, how important it is that we labor without respite toward the establishment of houses designed to serve as retreats for the unfortunate class of the insane. . . . With regard to those insane persons whom the lack of such an establishment has relegated to the various pris­ons of your department, I do not see any other means at present of removing them from those places so unsuited to their state, except to transfer them temporarily, if pos­sible, to Bicetre. It would therefore be appropriate for the Directory to write to the Paris establishment in order to ascertain a way to have them admitted to that house, where the costs of their upkeep will be paid by your department or by the communes where these unfortunates reside, if their families are not in a position to assume that expense." Bicetre thus became the great center to which all the insane were sent, especially once Saint-Lazare was closed. The same was true for the women at La Salpetriere: in 1792, t
wo hundred madwomen were taken there who had been installed five years previously in the former novitiate of the Capucines on the Rue Saint-Jacques. But in the remote provinces, there was no question of sending the insane to the former hopitaux generaux. Generally, they were de-

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  tained in the prisons, as was the case for example at the fortress of Ha, at the Chateau of Angers, or at Bellevaux. The disorder in such places was indescribable, and contin­ued for a long time—until the Empire. Antoine Nodier gives some details about Bellevaux: "Every day, the uproar warns the neighborhood that those confined are fighting and persecuting one another. The guards rush upon them. Constituted as they are today, the prison guards are the laughingstock of the combatants. The municipal admin­istrators are implored to intervene in order to re-establish peace and quiet; their authority is flouted; they are shamed and insulted; this is no longer a house of justice and deten­tion."

  The disorders are as great, greater perhaps, at Bicetre; political prisoners are kept there; hunted suspects are hid­den there; poverty and famine keep many people hungry. The administration never ceases to protest; it asks that criminals be kept separate; and—it is important to note-some people still suggest that, in their place of detention, madmen be confined as well. On the ninth Brumaire, Year III, the bursar of Bicetre writes to "Citizens Grandpre and Osmond, members of the Committee on Administra­tion and Tribunals": "I submit that at a moment when humanity is decidedly the order of the day, there is no one who does not experience an impulse of horror upon seeing crime and indigence united in the same asylum." Was it necessary to recall the September massacres, the continual escapes, and, for so many innocent eyes, the sight of strangled prisoners, of swinging chains? The indigent and the old "have before their eyes nothing but chains, bars, and bolts. Add to this the groans of the prisoners that sometimes reach them. ... It is on this basis that I ur­gently ask either that the prisoners be removed from Bi­cetre, leaving only the indigent there, or that the indigent be removed, leaving only the prisoners." And here, finally,