Hektoen International

A Journal of Medical Humanities

Vincenzo Chiarugi, who freed the insane from their chains

Vincenzo Chiarugi. Via Wikimedia.

Vincenzo Chiarugi was one of the pioneers of a more humane treatment of the mentally ill, along with William Tuke (1732–1822) in York and Philippe Pinel (1745–1826) and Étienne-Jean Georget (1795–1828) in Paris. They all lived at a time when those with mental illness were frequently confined in dungeons and ill-treated, chained to the wall, beaten, or used to entertain the citizens of the city. Vincenzo Chiarugi (1759–1820) is perhaps the least known of the group, even though in his youth he served as physician in the Tuscan regiment in the American War of Independence.

He was born in Florence and lived there at a time of change, when the Habsburg Grand Duke Peter Leopold (1747–1792) had become absolute ruler of the city at the age of eighteen. Imbued with the spirit of liberalism of his time, Peter Leopold forbade torture, abolished the death penalty, and established an institute for the rehabilitation of juvenile delinquents.1 In 1774 he promulgated the “law on the insane,” the first of its kind in Europe. In 1785, he began to build a new hospital for the mentally ill, the Bonifacio Hospital. In 1788 he placed at its head the twenty-six-year-old Chiarugi.

Chiarugi introduced many reforms. A detailed history was to be taken of each patient admitted to the hospital, high hygienic standards were to be observed, the men were separated from the women, no force was to be used on the patients, and the only methods of restraint allowed were straitjackets and strips of cotton.2 The staff were to respect the mentally ill individual as a person, “to gain his confidence and trust, to be tactful and understanding, and to try to lead the patient to the truth and to instill reason into him little by little, in a kind way.” Nurses and doctors were to be authoritative but pleasant and “adapted to the impaired mind of the patient.” “Generally,” taught Chiarugi, “it is better to follow the patient’s inclinations and give him as many comforts as is advisable from a medical and practical standpoint.” Patients were not to work for the hospital, except by a special prescription of the physician as a form of therapy.

During the years 1793–1794, Chiarugi published his three-volume work, On Insanity, in Florence.1,2 He divided insanity into three chief classes: melancholia, mania, and dementia. In 1802, he was appointed professor of dermatology and mental diseases, and later of physiology, pathology, and materia medica in the newly established medical school of Florence. He continued his reform efforts and taught until his death in 1820.

He was a philanthropist and social reformer, and an opponent of the slave trade and of the death penalty. He supported the arts and culture and was a patron of several artists and writers. He is regarded as the “father of Italian psychiatry.”



  1. Vincenzo Chiarugi. Wikipedia. https://en.wikipedia.org/wiki/Vincenzo_Chiarugi.
  2. George Mora. Vincenzo Chiarugi (1759-1820) and his Psychiatric Reform in Florence in the Late 18th Journal of the History of Medicine and Allied Sciences 1959;14(4):424-33.
  3. ChatGPT was consulted in the creation of this article.
  4. Kathleen Grange. Pinel or Chiarugi? Medical History 1963;7(4):371-80.



GEORGE DUNEA, MD, Editor-in-Chief


Winter 2023  |  Sections  |  Psychiatry & Psychology

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