Ospedale Maggiore
Encyclopedia
The Ospedale Maggiore, traditionally named Ca' Granda (i.e. Big House), is a building in the center of Milan
Milan
Milan is the second-largest city in Italy and the capital city of the region of Lombardy and of the province of Milan. The city proper has a population of about 1.3 million, while its urban area, roughly coinciding with its administrative province and the bordering Province of Monza and Brianza ,...

, northern Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

, constructed to house one of the first community hospitals, the largest such undertaking of the fifteenth century. Commissioned by Francesco Sforza
Francesco I Sforza
Francesco I Sforza was an Italian condottiero, the founder of the Sforza dynasty in Milan, Italy. He was the brother of Alessandro, with whom he often fought.-Early life:...

 in 1456 and designed by Antonio Filarete
Filarete
Antonio di Pietro Averlino , also "Averulino", known as Filarete was an Italian Renaissance architect, sculptor and architectural theorist from Florence. He is perhaps best remembered for his design of the ideal city of Sforzinda, the first ideal city plan of the Renaissance.-Biography:Antonio di...

 it is among the first examples of Renaissance architecture
Renaissance architecture
Renaissance architecture is the architecture of the period between the early 15th and early 17th centuries in different regions of Europe, demonstrating a conscious revival and development of certain elements of ancient Greek and Roman thought and material culture. Stylistically, Renaissance...

 in Lombardy
Lombardy
Lombardy is one of the 20 regions of Italy. The capital is Milan. One-sixth of Italy's population lives in Lombardy and about one fifth of Italy's GDP is produced in this region, making it the most populous and richest region in the country and one of the richest in the whole of Europe...

.

Even if the old buildings of the Ospedale Maggiore host today the State University of Milan
University of Milan
The University of Milan is a higher education institution in Milan, Italy. It is one of the largest universities in Europe, with about 62,801 students, a teaching and research staff of 2,455 and a non-teaching staff of 2,200....

, you can still find in it – apart from the beautiful original architecture - some of the “relics” of its glorious medical and sanitary history.

History

In 1456, the Duke of Milan Francesco Sforza founded the Magna Domus Hospitalis (Ca' Granda), a hospital dedicated to Annunciata (a municipality of the province of Brescia, Northern Italy). He did this primarily to gain the affection of its people who were followers of the Visconti family of Milan, even though the Duke was married to Bianca Maria Visconti
Bianca Maria Visconti
Bianca Maria Visconti was Duchess of Milan from 1450 to 1468.-Early years:Born near Settimo Pavese, Bianca Maria was the illegitimate daughter of Filippo Maria Visconti, Duke of Milan and last of the Visconti rulers, and Agnese del Maino, the only person the shy, secluded Filippo ever loved...

 at the time.

The Duke, entering Milan victorious on 25 March 1450 (the day of Annunciation
Annunciation
The Annunciation, also referred to as the Annunciation to the Blessed Virgin Mary or Annunciation of the Lord, is the Christian celebration of the announcement by the angel Gabriel to Virgin Mary, that she would conceive and become the mother of Jesus the Son of God. Gabriel told Mary to name her...

), decided to dedicate a charitable institution to Annunciata. It was then that the new foundation became the Spedale della Nunciata. Designed by the renowned architect Filarete
Filarete
Antonio di Pietro Averlino , also "Averulino", known as Filarete was an Italian Renaissance architect, sculptor and architectural theorist from Florence. He is perhaps best remembered for his design of the ideal city of Sforzinda, the first ideal city plan of the Renaissance.-Biography:Antonio di...

 and built by the engineer Guiniforte Solari
Guiniforte Solari
Guiniforte Solari , also known as Boniforte, was an Italian sculptor, architect and engineer.Born in Milan, he was the son of the architect Giovanni Solari, and brother of Francesco Solari....

 (responsible for the courtyard of the Certosa di Pavia, a monastery complex in Lombardy, Northern Italy), the hospital formed part of the completion of the reform of hospitals started by the Archbishop Rampini, in the years of the Golden Ambrosian Republic.

The completion of the cloisters and their ornamentation was carried out by Giovanni Antonio Amadeo, the Solari’s son-in-law and pupil. Although the hospital was founded for the poor, it was, from the beginning, a hospital where people with some hope of recovery were treated. Chronic diseases were treated in hospitals outside of the city. For this reason, the Ospedale Maggiore has always been the centre of health information in the city.

At the start of the 20th century, it was decided that the hospital would be moved to a location beyond the canal
Navigli
The navigli was a system of navigable and interconnected canals around Milan, Italy.The system consisted of five canals: Naviglio Grande, Naviglio Pavese, Naviglio Martesana, Naviglio di Paderno, Naviglio di Bereguardo. The first three were connected through Milan via the Fossa Interna, also known...

 (where work had already been started on its expansion). This move coincided with the founding of the state University which took possession of the old buildings of the Ca' Granda, where it remains today. The Ospedale Maggiore moved to a vast area between the streets of Francesco Sforza (the site of the canal
Canal
Canals are man-made channels for water. There are two types of canal:#Waterways: navigable transportation canals used for carrying ships and boats shipping goods and conveying people, further subdivided into two kinds:...

), Porta Romana, Lamarmora and Commenda.

The obstetrics and gynaecology department was the first to be inaugurated, by Luigi Mangiagalli (the first Chancellor of the University) and still today, the department bears his name.

At the time of the hospital’s move, it had been decided that a general hospital would be created in the area of Niguarda
Niguarda
Niguarda is a district of Milan, Italy. It is an area located within Zona 9 of the city. It was an independent village till 1923, then became part of the city after the Giunta Mangiagalli ....

 (a neighbouring municipality which had become part of Milan in 1923). This hospital was designed by Giò Ponti and inaugurated in 1932. It kept the name Ca' Granda, while the new general hospital took the name Ospedale Maggiore.

Further additions to the hospital institution included the San Carlo Borromeo di Milano (also designed by Giò Ponti) and the Sesto San Giovanni
Sesto San Giovanni
Sesto San Giovanni is a comune in the Milan metropolitan area, located in the province of Milan and region of Lombardy in Italy. Its railway station is the northernmost stop on the Milan Metro M1 line. The city is informally referred to as "Sesto"...

 hospitals. The institution was later divided up, giving autonomy to the different institutes, while others were founded independently and included later.

In 1909, the Adelina brothers and Marco De Marchi founded the Asilo per le madri povere legittime "Regina Elena" (Regina Elena Refuge for Poor Mothers), which remained an independent service until 1990. In 1957, it was converted into a specialist hospital and became the Regina Elena Institute of Obstetrics-Gynaecology and Paediatrics in 1968. From 1998 to 2004 the clinical Institutes of Faithful Improvement, Mangiagalli and Regina Elena were placed under the same authority
Authority
The word Authority is derived mainly from the Latin word auctoritas, meaning invention, advice, opinion, influence, or command. In English, the word 'authority' can be used to mean power given by the state or by academic knowledge of an area .-Authority in Philosophy:In...

.

In 2010 the name of the hospital was changed, reverting to its former name of Ca' Granda.

Insignia and logo

The organisation’s insignia used to bear the scene of the Annunciation and the Latin motto "ave gratia plena" ("hail, full of grace"). Later it was simplified to a picture of the dove of the Holy Spirit.

The heraldic representation, still the basis of the Foundation’s current logo, is closely linked with the Visconti firm of the flaming, radiant turtle-dove. The olive branch
Olive branch
The olive branch in Western culture, derived from the customs of Ancient Greece, symbolizes peace or victory and was worn by brides.-Ancient Greece and Rome:...

 in the bird’s beak
Beak
The beak, bill or rostrum is an external anatomical structure of birds which is used for eating and for grooming, manipulating objects, killing prey, fighting, probing for food, courtship and feeding young...

 was added later. Until 1825 the Organisation had the duty of assisting children in need, and who, considered as "the hospital’s children", took the surname
Surname
A surname is a name added to a given name and is part of a personal name. In many cases, a surname is a family name. Many dictionaries define "surname" as a synonym of "family name"...

 "Colombo", inspired by the hospital’s insignia.

The Niguarda, Sesto San Giovanni and San Carlo Borromeo hospitals also obtained insignias or sculptures reminiscent of the dedication.

Banner

The hospital has two banners of honour: one large banner, maintained in a museum collection, and a pair of smaller banners for use in ceremonies.

The need for a banner to display at ceremonies and funerals of benefactors arose in 1927, and inspiration was taken from the banner of the Municipality of Milan, which has particularly solemn connotations. The front of the banner represents the Annunciation
Annunciation
The Annunciation, also referred to as the Annunciation to the Blessed Virgin Mary or Annunciation of the Lord, is the Christian celebration of the announcement by the angel Gabriel to Virgin Mary, that she would conceive and become the mother of Jesus the Son of God. Gabriel told Mary to name her...

. On the other side, the dove
Dove
Pigeons and doves constitute the bird family Columbidae within the order Columbiformes, which include some 300 species of near passerines. In general terms "dove" and "pigeon" are used somewhat interchangeably...

 is embroidered, surrounded by the heraldic insignias of the hospital’s main benefactors: Sforza, Macchi, Del Sesto, Parravicini, Ponti, Secco Comneno, the municipality of Milano, Pio II Piccolomini, Pio IV Medici di Marignano, Pio XI Ratti, Cardinals Saint Carlo Borromeo e Schuster, and the Order of the Holy Sepulchre
Order of the Holy Sepulchre
The Equestrian Order of the Holy Sepulchre of Jerusalem is a Roman Catholic order of knighthood under the protection of the pope. It traces its roots to Duke Godfrey of Bouillon, principal leader of the First Crusade...

.

The project and its realisation were the responsibility of the Milanese architect Giò Ponti
Giò Ponti
Gio Ponti was one of the most important Italian architects, industrial designers, furniture designers, artists, and publishers of the twentieth century.-Early life:...

, who intended to add value to the banner using both materials and techniques. The metallic parts of the banner were created by the Ravasco firm, and Alfredo Ravasco, the company director, wanted to donate precious stones. Meanwhile, the Bartelli firm had completed the gold and silver embroidery on pure silk. The banner was inaugurated by Cardinal Ildefonso Schuster on 24 March 1935 (the first day of the Festival of Forgiveness) during a solemn function held in Milan’s Duomo.

In 1938 a copy was made, in order to be able to transport it with ease with just two poles. The original was moved to a collection in 1942 and decorated with crystals by the Silvestri firm.

Book of the Dead

At the beginning of the 19th century, the Milanese Carlo Ingnazio Busca brought a mummy
Mummy
A mummy is a body, human or animal, whose skin and organs have been preserved by either intentional or incidental exposure to chemicals, extreme coldness , very low humidity, or lack of air when bodies are submerged in bogs, so that the recovered body will not decay further if kept in cool and dry...

 in a sarcophagus
Sarcophagus
A sarcophagus is a funeral receptacle for a corpse, most commonly carved or cut from stone. The word "sarcophagus" comes from the Greek σαρξ sarx meaning "flesh", and φαγειν phagein meaning "to eat", hence sarkophagus means "flesh-eating"; from the phrase lithos sarkophagos...

 and a papyrus to Milan. Today, the mummy can be found at Sforza Castle, while the papyrus is housed in the Historical Archive of the General Hospital. It is not open to public viewing, but is reproduced digitally with infra-red reflectography thanks to an agreement with the University of Milan
University of Milan
The University of Milan is a higher education institution in Milan, Italy. It is one of the largest universities in Europe, with about 62,801 students, a teaching and research staff of 2,455 and a non-teaching staff of 2,200....

’s Interdepartmental Centre of Infrared and Diagnostic Reflectography of Cultural Heritage, run by Professor Duilio Bertani.

The ancient Egyptian papyrus is called Libro per uscire dal giorno ("Book to leave the day") and reproduces the famous Book of the Dead
Book of the Dead
The Book of the Dead is the modern name of an ancient Egyptian funerary text, used from the beginning of the New Kingdom to around 50 BC. The original Egyptian name for the text, transliterated rw nw prt m hrw is translated as "Book of Coming Forth by Day". Another translation would be "Book of...

, a series of formulae aimed to facilitate the soul on its last journey beyond the western horizon toward the afterlife. The scroll, almost seven metres long, was produced in Thebes
Thebes, Egypt
Thebes is the Greek name for a city in Ancient Egypt located about 800 km south of the Mediterranean, on the east bank of the river Nile within the modern city of Luxor. The Theban Necropolis is situated nearby on the west bank of the Nile.-History:...

 for the scribe and designer Pthamose at the beginning of the nineteenth dynasty of Egypt
Nineteenth dynasty of Egypt
The Nineteenth Dynasty of ancient Egypt was one of the periods of the Egyptian New Kingdom. Founded by Vizier Ramesses I, whom Pharaoh Horemheb chose as his successor to the throne, this dynasty is best known for its military conquests in Palestine, Lebanon, and Syria.The warrior kings of the...

 (1305-1200 B.C.). It shows a complete text, full of drawings, and it mentions a series of formulae to activate several amulets, which is rare in similar papyri.

The heirs of the mummy had to decide what to do with this souvenir
Souvenir
A souvenir , memento, keepsake or token of remembrance is an object a person acquires for the memories the owner associates with it. The term souvenir brings to mind the mass-produced kitsch that is the main commodity of souvenir and gift shops in many tourist traps around the world...

, and, taking advice from Dr. Pessani of the Ciceri-Agnesi Fatebenesorelle Hospital, they were persuaded to donate it to the Institute’s pharmacy (the mummy was in fact, at the time, considered to be a pharmacological remedy). The mummy then became part of the Civic Archaeological and Numismatic Collections at Sforza Castle.

Departments

The Ospedale Maggiore General Hospital- Mangiagalli- Regina Elena Foundation, has two executive committees which are divided into separate departments.

Ospedale Maggiore General Hospital Committee
  • Zonda Department: general surgery
    Surgery
    Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

     and transplants
    Organ transplant
    Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be...

  • Monteggia Department: surgery (head and neck)
  • Sacco Department: radiology
    Radiology
    Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...

    , cardiology
    Cardiology
    Cardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...

    , lungs
  • Granelli-Marcora Department: internal medicine
    Internal medicine
    Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...

    , gastroenterology
    Gastroenterology
    Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...

    , endocrinology
    Endocrinology
    Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of...

    , haematology
  • Litta Department: the first to be built in the area beyond the Canal in 1895; it houses the Association of Italian Rescue Workers
  • Lamarmora Department: group practice
  • Beretta Neuro Department: brainsurgery
  • Ponti Department: neurology
    Neurology
    Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

  • Guardia Department: A&E
  • Guardia II Department:psychiatry
    Psychiatry
    Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

  • Marangoni Department: immunohaematology
    Immunohaematology
    Immunohematology, more commonly known as blood banking is a branch of hematology which studies antigen-antibody reactions and analogous phenomena as they relate to the pathogenesis and clinical manifestations of blood disorders. A person employed in this field is referred to as an immunohematologist...

    , transfusions and transplants


Mangiagalli-Regina Elena Committee
  • Mangiagalli Clinic: obstetrics & gynaecology and neo-natal pathology
  • De Marchi Clinic: paediatrics and paediatric A&E departments
  • Regina Elena Clinic: ophthalmology
    Ophthalmology
    Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

    , infertility centre and occupational health outpatients’ department
  • Luigi Devoto Clinic: occupational health, laboratories and emergency medicine
    Emergency medicine
    Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...

  • Alfier Departmenti: paediatric surgery , otolaryngology
    Otolaryngology
    Otolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....

    , ophthalmology
    Ophthalmology
    Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

    , Maxillofacial surgery, dental
    Dentistry
    Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

  • Bergamasco Department: oncology
    Oncology
    Oncology is a branch of medicine that deals with cancer...

    , algology
    Algology
    From the Greek άλγος, algos, "pain", algology is the medical treatment of pain as practiced in Greece and Turkey. The Hellenic Society of Algology and the Turkish Algology-Pain Society are the relevant local bodies affiliated to the International Association for the Study of Pain .-External...


Administrative structure

  • President: Carlo Tognoli
  • General Director: Dr. Giuseppe Di Benedetto
  • Administrative Director: Dr. Roberto Midolo
  • Health Director: Dr. Marco Triulzi
  • Scientific Director: Dr. Ferruccio Bonino

Memorial tablet of the Hospital foundation

Francesco Sforza founded this hospital in 1456 "Ad Sustentandos Christi Pauperes" ("For the sustenance of the poor of Christ"). The memorial tablet is located on the portal that today gives access to the University Law Library, under the arcades on the right of the central courtyard.

Memorial tablet of Saint Camillus de Lellis

Saint Camillus de Lellis
Camillus de Lellis
Saint Camillus de Lellis, M.I., was an Italian priest who founded a religious Order dedicated to the care of the sick.-Early life:...

 spent some time nursing the patients of this hospital as recorded by the stone tablet on a portal, near the entrance to the central Church of the Annunziata (ten meters to the right), in the central courtyard. The inscription on the tablet reads:
“SAN CAMILLO DE LELLIS 1550-1614 / INFERMIERE NELLA CROCIERA DI QUESTA ANTICA CA GRANDA / CON LA PAROLA E L’ESEMPIO / INSEGNO’ A SERVIRE I MALATI E AD AMARLI / ‘CON QUELL’AFFETTO CHE SUOL UNA AMOREVOLE MADRE / AL SUO UNICO FIGLIUOLO INFERMO’ / NEL 4° CENTENARIO – 16-4-1983”.

Luigi Mangiagalli's statue

Just passed the main entrance to the Ca' Granda, on the left, there is the big bronze statue of Luigi Mangiagalli (1849–1928), famous Italian obstetrician and gynaecologist, mayor of Milan (1922) and founder of the State University of the town (1923). On the pedestal of the statue, you can read the following inscription:
“LUIGI / MANGIAGALLI / UMANISTA / MEDICO E FILANTROPO / CREO’ L’UNIVERSITA’ / DI MILANO / VOLLE PIU’ GRANDE LA / METROPOLI LOMBARDA. / I MILANESI”.
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