After four years as the full governing authority of the National Asylum for the Insane, psychiatrists encountered a barrage of criticism from state and civil actors who charged that psychiatrists’ institutional remedies had failed. Many state officials defended the asylum from these attacks, but they also sought to intervene in asylum functioning. For these officials, the asylum's modernization served as an example of state power. It operated as a physical and symbolic object that enabled the state, through the provision of health care as a public good, to showcase its functions and duties. Wresting the offices of charity from colonial Leviathan institutions such as the Santa Casa de Misericordia was fundamental to the republican administration; it had come into power with promises to federalize social assistance. While this process elevated the importance of assistance to all the nation's poor and “unfortunates,” the insane held a special place in a hierarchy of the needy. Unlike young, able-bodied vagrant men or criminals, they constituted one of the populations that, in the republican modernist mindset, deserved aid and rehabilitation.

Republican spokesmen who sought to increase the infrastructural power of the state through the secularization of key colonial institutions seized upon the asylum and the insane as sites on which to graft a political program of liberalism. Infrastructural power refers to the capacity of the state to coordinate society by diffusing law and administration into areas of social life that, before the nineteenth century, had remained outside the scope of state concern. In the case of early republican Brazil, the administration that came into power focused on the insane because the imperial government had marked this vulnerable population as one of its significant clients for state patronage. Just as imperial statesmen used advances in the treatment of the insane and the asylum itself as a political tool to garner public favor during a period of crisis, republican officials used the conversion to psychiatric control and functionality to validate their legitimacy. Imperial public institutions and ways of life had to be rejected, fully appropriated, or possibly even eradicated in order to create new political forms and new social mores in their stead. The infrastructural power of the republican state, after declaring the asylum to be under new psychiatric management, could be measured in part by the success of its management of the asylum.