Chiarugi, Vincenzo

   (pronounced [KEY-ah-ROO-jee])

   (1759–1820)

   The director of one of the first therapeutic asylums, Chiarugi was born in Empoli in Tuscany, his father a physician. He graduated with an M.D. from the University of Pisa in 1779, and in 1785, at the initiative of the Grand Duke Pietro Leopoldo (1747–1792), he became involved in the renovation of the ancient Bonifazio Hospital, which in 1788 opened its doors exclusively to psychiatry patients (instead of remaining a standard "hospice" of the day, mingling together the criminal, the poor, the halt, the elderly, and the insane). In accordance with the principles of the Enlightenment then much in vogue in northern Italy, Chiarugi designed ways of making the experience of institutionalization actually therapeutic instead of merely custodial. He spelled these out in his 1789 book, Administrative Guide to the S. Maria Nuova and Bonifazio Hospitals (Regolamento dei Regi Spedali di S. Maria Nuova e di Bonifazio), which gave details on gardens, divided the patients into wards on the basis of degree of illness, and insured for them proper meals and humane treatment. In 1793–1794, he wrote a psychiatry textbook in three volumes, On Insanity (Della pazzia), which was devoted for the most part to the "causes" of insanity and to classifying the major varieties. In a brief section on treatments, Chiarugi also specified some of his therapeutic ideas: for psychological sedation it was necessary to keep the patients in calm, quiet environments. "The sweet songs of gentle, moving music in many cases will represent the first-line treatment" (I, pp. 211–212). As for stimulating treatments, the patients should do moderate athletic workouts in the asylum and at home. In the treatment of melancholy, Chiarugi found it "absolutely necessary that . . . [the physician] finds his way into the patient’s heart, gaining his confidence and trust." Chiarugi referred to this approach as "the psychological treatment" (la cura morale) (II, pp. 67, 75). After the publication of his text, Chiarugi lost interest in research in psychiatry as such and devoted himself to dermatology—pellagra and venereal disease represented huge sources of psychiatric illness—resigning the superintendentship of Bonifazio in 1817.