The Ospedale Maggiore Policlinico of Milan

Excerpt

The “Ospedale Maggiore” of Milan, traditionally known as “Ca’ Granda”, is one of the most ancient hospitals in Italy, being founded by the Duke Francesco Sforza (1401–1466) in 1456 (Fig. 1). The aims of the hospital were to provide free medical assistance for the poorest people of the city and to improve efficiency in healthcare by converging patients from the various institutions of Milan on a single “bigger” structure (“Domus Magna Hospitalis”). The initial building project was signed by the Renaissance architect Antonio di Pietro Averlino, known as Filarete (c. 1400–1469), but only the southern portion of the building was executed from his design (Fig. 2). Indeed in 1465, Filarete was succeeded in his office of architect by Guiniforte Solari (c. 1429–1481) who was followed in his turn by Giovanni Antonio Amadeo (c. 1447–1522) [1]. The hospital consisted of a square with buildings running through in the form of a cross (crociera). Each wing of the cross was reserved for a specific disease, and at the junction of the four arms of the crociera stood the chapel, so arranged for allowing patients to participate in the daily celebration of the Eucharistic rite. According to the Renaissance reform of hospitals promoted by the Milanese archbishop Enrico Rampini (1390–1450), only people suffering from acute diseases could be admitted to the structure, while chronic and “incurable” diseases (e.g. syphilis) were treated in hospitals outside of the city [1]. Innovative sewage systems, daily charge of sheets and room ventilation allowed to prevent the spread of infectious diseases among the patients. In addition, a permanent staff of physicians and nurses, among whom Camillus de Lellis (1550–1614) should be mentioned, was dedicated to providing care and relief to suffering people. The hospital organization, based on rules defined by the prior Gian Giacomo Gilino (c. 1445–1500), served as a model for all other institutions of that period [2].

…