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Until the seventeenth century, care of mad Tuscans fell predominantly to their families. This situation changed in 1640 when a former chaplain of Florence’s Stinche prison persuaded city elites to build a hospital devoted solely to the care of the severely mentally disturbed. Forty years later, the famous old hospital Santa Maria Nuova designated a ward for the care of poor, mentally ill men. In concert with ducal administrators and the city’s court of wards, these hospitals aimed to relieve families of the care of the mad at the same time that they sought to prevent a small but wretched part of the Florentine population from inundating the city’s streets and prisons. Chronically underfunded and burdened by the competing agendas of individual, corporate, and governmental agents, these two experiments in social welfare show the challenges associated with early modern efforts at “healthscaping” small-scale urban environments.