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1-Page Summary of Civilization

Overview

Michel Foucault’s book, Madness and Civilization, is a history of how Western societies came to conceptualize madness. He talks about the Middle Ages but focuses on the “classical age,” which began in the late 1500s and lasted until around 1800. During this period, people started thinking of madness as a distinct phenomenon requiring its own medical specialties.

Foucault begins by describing how leper colonies were established in the Middle Ages. These places were used to confine people with leprosy, because it was thought that they could spread disease. He then describes how this concept of confinement continued into the Renaissance and Classical ages; however, instead of being confined for having leprosy, people who had mental illnesses were now confined there. Just as society once feared those with leprosy spreading disease, it now feared people with mental illness spreading insanity.

Chapter 2 discusses the confinement of people during this time period, which was considered a moral failing. It started with the creation of a hospital-like place to confine poor and criminal people in 1657. This was called the General Hospital of Paris, but it wasn’t really like modern hospitals at all because it confined many more people who were seen as threats to society. The main reason for this confinement was because poverty was viewed as an ethical problem rather than an economic one that needed to be solved by changing society’s structures and systems. The mad were also confined along with these other groups because they didn’t contribute anything productive or valuable to society either—they were just another group that needed help from others.

Chapter 3 starts off by noting how quickly the Great Confinement became overcrowded in Paris, leading doctors there to look for new ways of dealing with madness outside institutions (Foucault calls them “the great outdoors”). These included large public festivals where both sane and insane would participate together (a precursor for today’s Burning Man festival), workhouses designed specifically for those lacking morals or discipline, houses where families could come together again after being split up due to imprisonment of some members, and even colonies set up in remote places where inmates could live freely without constraint on their behavior while still being supervised by doctors working behind-the-scenes (these are precursors for today’s mental health facilities).

In Chapter 3, Foucault explores how people started thinking of madness differently. He says that it was because of the proliferation of scientific and philosophical attention to different kinds of madness—mania, melancholia, hysteria, hypochondria—that people started viewing madness as a distinct thing. In addition to this change in thought processes about what caused mental illness and its treatment (from medicine-based “cures” to psychological ones), there were also new ways for patients to be treated. Instead of confronting their perceived moral failings in order to achieve sanity (as they did before), patients had to confront their own feelings of guilt for doing something bad or immoral.

In chapters 7 and 8, Foucault argues that as more knowledge about madness developed, people started to think it was not logical for the mad to be confined with criminals and poor people. This wasn’t because they needed protection from criminals or the poor. On the contrary, other people had to be protected from them because they feared madness as a terrible condition which can spread like an epidemic.

This led to a new kind of confinement called asylums, which were specifically for the mentally ill. The idea was that they would be studied by doctors and treated so that they could return to society. Foucault ends his book with an analysis of two innovators in this field: Samuel Tuke in England and Philippe Pinel in France. Both men believed that it was important for doctors to have control over patients, rather than having judges or wardens do it.