When leprosy began to disappear after the Crusades (1100-1300), the remaining colonies, the leprosariums, were converted to other uses. These establishments were soon filled with all types of persons considered deviant: orphans, vagabonds, madmen, incurables, prostitutes, widows, criminals. These "cities of the damned" had the power of "authority, direction, administration, commerce, police, jurisdiction, correction and punishments," and had at their disposal "stakes, irons, prisons and dungeons." Later in 1657, two French facilities were established: the Salpetriere, which housed 1,416 women and children; and the Bicetre, which held 1,615 men.

During this time, "idiot cages" became common in town centers to "keep people with disabilities out of trouble." They may have served as entertainment for townspeople.