But there is no certainty that madness was content to sit locked up in its immutable identity, waiting for psychiatry to perfect its art, before it emerged blinking from the shadows into the blinding light of truth. Nor is it clear that conﬁnement was above all, or even implicitly, a series of measures put in place to deal with madness. It is not even certain that in this repetition of the ancient gesture of segregation at the threshold of the classical age, the modern world was aiming to wipe out all those who, either as a species apart or a spontaneous mutation, appeared as ‘asocial’. The fact that the internees of the eighteenth century bear a resemblance to our modern vision of the asocial is undeniable, but it is above all a question of results, as the character of the marginal was produced by the gesture of segregation itself. For the day came when this man, banished in the same exile all over Europe in the mid-seventeenth century, suddenly became an outsider, expelled by a society to whose norms he could not be seen to conform; and for our own intellectual comfort, he then became a candidate for prisons, asylums and punishment. In reality, this character is merely the result of superimposed grids of exclusion.
The gesture that proscribed was as abrupt as the one that had isolated the lepers, and in both cases, the meaning of the gesture should not be mistaken for its effect. Lepers were not excluded to prevent contagion, any more than in 1657, 1 per cent of the population of Paris was conﬁned merely to deliver the city from the ‘asocial’. The gesture had a different dimension: it did not isolate strangers who had previously remained invisible, who until then had been ignored by force of habit. It altered the familiar cityscape by giving them new faces, strange, bizarre silhouettes that nobody recognised. Strangers were found in places where their presence had never previously been suspected: the process punctured the fabric of society, and undid the familiar. Through this gesture, something inside man was placed outside of himself, and pushed over the edge of our horizon. It is the gesture of conﬁnement, in short, which created alienation. It follows from this that to rewrite the history of that banishment is to draw an archaeology of alienation. What is to be determined is not the pathological or police category that was targeted, which would be to suppose that alienation pre-existed exclusion, but to understand instead how the gesture was accomplished, i.e. the operations which together, in their equilibrium, composed its totality, and the diverse horizons from which those who suffered the same exclusion originated, to investigate how men of the classical age experienced themselves at the moment when familiar faces began to become strange, and lose their resemblance with that image. If the decree does have a meaning, where modern men have designated their own alienated truth in the mad, then it must be in the extent to which the ﬁeld of alienation where the mad found themselves banished (together with other ﬁgures who to our way of thinking had so little in common with them) had already been constituted before it came to be symbolised and peopled by the insane. That ﬁeld was circumscribed in real terms in the space of conﬁnement, and the form it took should show us how the experience of madness came into existence.
—Michel Foucault, History of Madness