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Abstract: «Having certified the doctor of the insane...». The hospital of Santa Maria della Pietà in Rome during the Napoleonic period: experimentation and reform     During the Napoleonic period, the hospital of Santa Maria della Pietà, used entirely for the internment of the insane beginning in the sixteenth century, underwent a series of reforms. While these reforms may be considered part of a wider project for the reorganization of the city’s hospital system, they also had a specihc intention which can be traced to the experimentation conducted in Paris by Dr. Philippe Pinel. His figure served as inspiration for Joseph-Marie de Gérando, member of the Special Council for the Roman States, when he appointed a young Roman doctor, Alessandro Flajani with the medical management of the hospital. Flajani was already well trained in the most recent developments on the subject thanks to his instruction in the principal European hospitals and a broad series of studies. However he didn’t have the time or the means to reform the hospital because of resistance on the part of the hospital administration and the subsequent Restoration which brought about his dismisal. A number of crucial problems, the object of debate abroad, were however highlighted: the relationship between hospitalization and treatment, the role and influence of the doctor in the management of the institution and, finally, the question of guarantees against arbitrary internment.