In Manet’s painting, a barmaid gazes out of frame, observed by a shadowy male figure. The whole scene appears to be reflected in the mirror behind the bar, creating a complex web of viewpoints. Wall borrows the internal structure of the painting, and motifs such as the light bulbs that give it spatial depth. The figures are similarly reflected in a mirror, and the woman has the absorbed gaze and posture of Manet’s barmaid, while the man is the artist himself. Though issues of the male gaze, particularly the power relationship between male artist and female model, and the viewer’s role as onlooker, are implicit in Manet’s painting, Wall updates the theme by positioning the camera at the centre of the work, so that it captures the act of making the image (the scene reflected in the mirror) and, at the same time, looks straight out at us.
The main body of the work is an historical study of the emergence of clinical medicine around the time of the French revolution, at which time the transformation of social institutions and political imperatives combined to produce modern institutional medicine for the first time. The leitmotif of the work is the notion of a medical “gaze”: modern medicine is a matter of attentive observation of patients, without prejudging the maladies one may find, in the service of the demographic needs of society. There is some significant tension between the methodology and the rest of the book, however, with much of what is talked about in the book clearly not being signifiers themselves. The fulfillment of the intention announced at the beginning of The Birth of the Clinic is found rather in Foucault’s next book, The Order of Things , first published in 1966.
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Histoire de la folie was an expansive work, consisting of 943 pages of text, followed by appendices and a bibliography.  Foucault submitted it at the University of Paris , although the university's regulations for awarding a State doctorate required the submission of both his main thesis and a shorter complementary thesis.  Obtaining a doctorate in France at the period was a multi-step process. The first step was to obtain a rapporteur , or "sponsor" for the work: Foucault chose Georges Canguilhem .  The second was to find a publisher, and as a result Folie et déraison would be published in French in May 1961 by the company Plon , whom Foucault chose over Presses Universitaires de France after being rejected by Gallimard .  In 1964, a heavily abridged version was published as a mass market paperback, then translated into English for publication the following year as Madness and Civilization .