Foucault describes the transition from focusing on the movement of spirits through the space of the body, focusing on a moral judgment of the sensibility or emotional state of the patient. The idea of movement in the space of the body is derived from the ancient explanation of hysteria. The penetration of the body by various spirits assumed that the body was essentially open inside. The shift from the idea of movement and space to that of moral judgment comes through the notion of sympathy. Sympathy implies a certain sensitivity of the nervous system. By over-stimulating the emotions and nerves, a drastic response could ensue.

For the first time outside influences on the body became important. Rather than an imbalance of the interior parts of the body, hysteria and hypochondria were diseases resulting from lifestyle. The fact that they had a clear external cause was important in the labeling of these conditions as mental disease. However, they were also a kind of madness. Hysterical people were blinded by experiencing too much. This blindness left the way open for madness.

By a complicated route, hysteria and hypochondria offer a way for medicine to pass moral judgment on madness. The development of certain ideas about the relationship between mental disease and lifestyle was the beginning. Because disease was created by lifestyle, medicine can disapprove of that way of life. When that disease becomes associated with madness, madness can be seen as something of which to disapprove. Morality has a new power over madness, which became a punishment for a "bad" lifestyle. This is different to the morality of labor that helped to create confinement because it was linked to medicine and idea about the body. Psychiatry, which Foucault views with some suspicion, rests upon this idea of applying morality to madness.

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