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Angela D'Agostino

Forgotten cities

From the city for healthcare to healthcare for the city

Themes, connections, networks and references for the reopening, the restoration and the reuse (from the booklet Memorie dal Bianchi di P. Zizzania, Seminar or architectural and urban design 2, Arc5UE Unina, a.a. 2013/14) - ZOOM

Themes, connections, networks and references for the reopening, the restoration and the reuse (from the booklet Memorie dal Bianchi di P. Zizzania, Seminar or architectural and urban design 2, Arc5UE Unina, a.a. 2013/14)


Machines à soigner, Psychiatric hospitals that were built in compliance with medical science prescriptions, according to a bijective relationship between form and use, and decommissioned after about one hundred years, have long been struck by a damnatio memoriae.

The open project for re-introducing these forgotten cities into urban dynamic cycles, refers to the chance to plan smaller or larger interventions, which are compliant with a whole design that keeps together a diversity of stories, uses, accesses and contemporary spaces. A project embedding the issue of memory, without forgetting history.

This text and its pictures deal with the foundation and with a possible re-interpretation of former psychiatric hospitals, with a focus on the former Leonardo Bianchi’s in Naples, which has been a case study both for research by design and for university teaching.


Among the elements of today’s city a few more or less recent skeletons can be found; we are talking about areas that are disused and abandoned following economical, political, technologic and scientific changes.

Among these areas, a peculiar case is represented by former psychiatric hospitals, which were built all over Europe to accommodate thousands of people, from the end of 19th Century to the beginning of 20th Century, and were abandoned around the end of last Century owing to a sudden and radical change in medical science theories in the field of mental healthcare, and to the laws that subsequently ordered their closure.

Machines à soigner [machines for healthcare], psychiatric hospitals were designed in compliance with particular regulations given by psychiatric science and according to a clear correspondence between function and form; psychiatric buildings were conceived as tools for mental healthcare, their space as moral remedy par excellence.

Following some kind of environmental determinism, psychiatric hospitals conformed to the local prevailing mental diseases, and considered the different civil, social and climatic conditions as well.

They are actual new founded self-sufficient citadels, where patients mostly entered never to come out again, but at the end of their lives.

Fenced layouts, built along the city boundaries, mostly in green areas far from built environment, the cities for healthcare can be catalogued among those ‘institutions’, where the nature of architecture is a clear expression of a social value.

Hospitals were built according to different layout typologies: some of then were composed of pavilions spread through the green; some other, most of them, were designed according to symmetric geometric layouts, where common building (reception, management offices, kitchen, church and so on) were deployed in series, while the wards for patients were conceived as serial building separated by wide open spaces, placed on both sides of a main axis and linked by paths that design the main structure of the layout.

While in North European towns, building rehabilitation strategies have been carried out to completely recover former hospitals to host new functions and people, though keeping records of memories of past life, in Italy most cities for mental healthcare, which were closed in compliance with law Basaglia n. 180 in 1978, are now totally or partially abandoned.

Today, after about one hundred years of full life, most of our machines à soigner look like forgotten cities.

Service buildings for medicine have long been struck by a damnatio memoriae.

In this framework, reflections arise about possible hypothesis for re-cycling these forgotten cities into urban circularity, taking into consideration the coexistence of two conditions. On one side, time seems to have stopped as if the city had been struck by a sudden catastrophe and then beds, tools, documents, furniture look like still witnesses of the history of city, architecture, medicine and human life. On the other side, time has inexorably been running; neglect and decay of buildings is more and more evident, and the green, one of the main elements of former healthcare buildings, has become the prevailing element in the citadel image, a green that as for form, nature and relationship with architecture, brings back Gilles Clément’s third landscape, the green of abandoned places and of those landscapes where humans withdraw and leave way to wilderness.

It took long to close those complexes, nevertheless today the time of abandon s finally much longer than the time it took to close them.

On the basis of such a problematic legacy, these days it is impossible as well as anachronistic in Italy, thinking about a mere building rehabilitation. The design hypothesis for forgotten cities starts from Koolhaas’ idea of change, which in this case is the change of point of view. Assuming reality as a starting point for a research project means, as far as hospital are dealt with, working in order to activate different memories, confirming the continuity of the main original elements, though dismantling the unitary and hierarchic organization that was at the basis of the original building.

Thus, today’s reference is a new cultural approach, in which the idea of urban parts is replaced by the idea of a landscape that is made of simultaneous multiplicities.

In most cases, indeed, psychiatric hospitals are not characterized by high or meaningful architectural features – which is unusually true for some contemporary hospitals, e.g. the Santa Creu i San Pau’s Hospital, built in Barcelona by Lluís Domènech i Montaner – but are rather buildings, the value of which lies on their layout organizations and in the relationships among their elements. Now, when the era of damnatio memoriae can be considered over, the idea of a shift from the city for healthcare to healthcare for the city concerns exactly the chance to gain those places back, which are now surrounded and embedded in the extension of today’s city, and are now reached by infrastructural networks.

The idea of an open project refers to the chance to plan smaller or larger, multiple and differing interventions for the different parts of the citadel, which may be deferred through time and are financed by private and public subjects in order to place the forgotten cities again in an urban cycle.

The shift from the city to the smart city can now be marked by the simultaneous presence of differing interventions, uses, times, spaces, subjects, actors, and so on.

Interventions must be able to decode the past by means of a present gaze.

Far from making a museum out of a city for healthcare, today’s project can and must work in the direction of dialectics between continuity and discontinuity, and recover all positive and permanent elements in those large areas – from the general layout to the set of paths, from the open space design to the buildings – according to a concept that is founded on the need of re-composing mental healthcare citadels inside today’s urban scenarios.

The new project, rather than working to build simulacrum of pre-existence or to attempt to unconditionally upgrade everything to new comfort and liveability standards, can be founded on the basis of a new urban role and re-signification of architecture.

The legacy of signs and meanings of these areas has guided the rehabilitation and reuse of some sites, when, in accordance with an idea of continuity, housing with a special address to healthcare, e.g. for the elderly, has been built. In this way, although working towards the rehabilitation and thus avoiding waste and abandonment, the idea of reclusion, which has always characterised cities for healthcare, was not actually redeemed.

The idea and the issue of changing the point of view imply an overturning of the perception of the site. The shift from considering the city for healthcare as a necessary, though alien place in the body of the city, to considering the need for some care for abandoned citadels, which are a heritage now embedded in the city, hints at the symbolic shift from the city of pain to the city of joy.

Although not claiming the necessity of a physical break of meaning between past and future, present time can be the era for constructing complexity.

A case study of open project is forwarded in the frame of the study on the former psychiatric hospital Leonardo Bianchi in Naples, which has been carried out through research and teaching. Built in early XX Century as a machine for healthcare and abandoned about one hundred years later, Leonardo Bianchi’s is a 150,000 sq m fenced off citadel on a hillock, with more than thirty pavilions deployed in wide green areas and linked by a set of sheltered paths. The citadel is disused and abandoned, and is now completely embedded in the body of the city, north-west from the city centre, next to Capodichino airport.

These days a chance for urban transformation is given by the boost of the infrastructural system, which is being enhanced. Line 1 of the underground in Naples is being completed; this line has been a turning point not only because it has widely increased the transport network through different city areas, but especially because is has been a tool for re-interpreting and re-solving urban places through the design of stations.

The concept of an open project for Leonardo Bianchi’s is thus organized with reference to a few basic objectives. First of all, the hypothesis of opening the enclosing wall and making a new entrance on the other side relative to the present one; this change aims to reverse not only the point of view, but also the direction of motion across the whole site, which was formerly strictly established.

The new entrance, on the same side of Capodichino airport and of the forthcoming underground station, is the main link between the citadel and the surrounding city.

With regard to Leonardo Bianchi’s architectural heritage, the study of its elements and of their features has fostered a few general reflections about the chances of its rehabilitation, reuse, transformation, extension and partial demolition.

The guiding principle of each single hypothesis is to gain back the whole place with different uses, and different actors. The contemporary presence of a pole for culture, public space in the neighbourhood, productive areas, flexible containers, is planned in order to re-place Leonardo Bianchi’s in the neighbourhood, in the city and in the territory.

The actions to be carried out, in accordance with the principle of multiplicity and non-unitarity , could span from just securing a few buildings in order to use them as roofed though open space, to recovering the most significant elements to a state that is very close to the original one.

The way to carry out a project that can be completed through several steps and times – dealing with rehabilitation and reuse, while some work is in progress and some other is stationary – relies on the fact that the different subjects that are responsible for the former hospital, i.e. the Local Health District (in charge of Regione Campania) that owns the site and the Commune of Naples where the Leonardo Bianchi’s is located, cooperate and involve other public and private stakeholders.

Change of point of view, open project, city of joy, principle of multiplicity are all issues that may imply the will to forget or the longing to erase one hundred years of history not only of architecture and of the city, but also of medical science and human beings. That’s not true. Once again, in accordance with the principle of reversing the point of view, this projects schedules the building of a pavilion of memory, which will be a reception next to the new entrance. This new building, meant as an alter ego of the historical entrance on Calata Capodichino street, will play the role of a voice-over telling a problematic story.


Angela D’Agostino is a University Researcher in Architectural and Urban Design (SSD ICAR/14) at the Department of Architecture at the University of Naples ‘Federico II’.

She joined several research projects and numerous national and international conferences and has carried out several applied research studies. She has widely published in national and international contexts. Her publications reflect her thematic interests concerning today’s urban and landscape transformation dynamics, modern architecture as well as disciplinary skills for the construction of sustainable projects.

Images taken from an ex psychiatric hospital: open spaces and gardens infested with vegetation, light and shadows in the covered routes, the church and the pavilions showing the signs of time and neglect - ZOOM

Images taken from an ex psychiatric hospital: open spaces and gardens infested with vegetation, light and shadows in the covered routes, the church and the pavilions showing the signs of time and neglect