Pilgrim Haven to Hospital:
Ospedale Santa Maria della Scala
(Re-posted - somehow it got deleted)
(Re-posted - somehow it got deleted)
If you travel
to Siena don’t miss a visit to the Ospedale Santa Maria della Scala. The latter
part of the name derives from the steps of the cathedral next door.
A feature of
medieval and early Renaissance times was a pilgrimage to a holy site. In Europe
the three principal destinations were Jerusalem, Santiago de Compostela (burial
site of St. James), and Rome (burial site of St. Peter). The route to Jerusalem
was closed after the Muslim takeover, but the other two routes remained open.
Pilgrimages were popular, not only for religious reasons but because the
journey earned a remission of sins and an easier entry into Heaven. The journey
was fraught with hazards, including illness, injuries, and banditry.
The principal north-south route, called the Via Francigena, ran, in its
full extent, from Canterbury through Siena to Rome. The Archbishop of
Canterbury documented his journey in the late tenth century, but it existed
well before then. To accommodate weary, hungry, or ill pilgrims a large number
of hostel/hospitals sprang up. A prominent one was Ospedale Santa Maria della Scala, which functioned as a hospital
until 1990, over 1000 years.
Legend has it that the Ospedale was founded by a poor cobbler named
Sorore, but the first documentation is dated 1090, labeling it as a
“xenodochium et hospitalis” – a hostel and hospital. The term “xenodochium” goes
back to early Byzantium when it referred to a hostel or shelter for the poor,
while the “nosokomeian” (“hosptialis” here) functioned specifically to care for
the sick. Later, on the pilgrim routes further west, the two functions appear
to have been combined. Churches and monasteries were the main early providers
of ospedales, but the clerical function of caring for the sick was gradually
taken over by secular healers, and was officially ended in 1130 at the Council
of Clermont. This corresponded with the rise of the secular medical school in
Salerno and the rise of universities elsewhere. In 1193 a papal bull by
Celestine III removed all Cathedral control over Santa Maria della Scala. The
first lay rector was in 1200.
Over time the Ospedale became a large concern, and self-sufficient. Through generous bequests
and purchases it acquired or built numerous farms, granaries, and small
ospedales in the surrounding countryside, eventually becoming one of the
biggest landowners and economic entities of the State. The size concerned the
State authorities, enough to insist in 1433 on being the ones to nominate the Rector,
whom they could control.
In addition to assisting pilgrims the Ospedale cared for the sick in
general. Trying to cure patients rather than simply comforting them was an
early goal. A physician, a surgeon, and an apothecary were kept as salaried employees. Surprisingly,
for the times, there was only one patient per bed and the beds were covered
with sheets, changed if dirty. In time student physicians and surgeons assisted
in the work and more specific medicines were used, such as Peruvian bark. Nutritious
diet (and wine) was provided, most from their own farms.
Another function included the care of foundlings, a common problem. In
1298 there were over 300 under care, increasing to 1212 in 1618. The mortality
rate of the infants was high. Identifying objects and records were kept in case
the parents showed up later to reclaim the child. The infants were first handed over to wet nurses,
then brought back in and educated in a trade (the boys) or sewing and weaving
(the girls). Any earnings from their work were saved for the time of discharge
at age 18, if they wanted to leave, and for girls money was granted as a dowry
or to enter a convent.
Finally, not losing sight of its religious origins, the Ospedale
dispensed food to the poor three times a week, the Rector himself presiding on
feast days.
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| Pellegrinaio (photo by author) |
This being Siena, art was not neglected. The front façade was originally
covered with fresco, but the surface has been lost. In the interior, frescoes decorated
various chapels, but to the medical historian the most fascinating are the
frescoes of the “Pellegrinaio” – the Pilgrims’ Hall. The photo nearby shows the
large hall, an open ward up until 1983, whose walls are covered with 15th
century murals, beautifully preserved. Most are painted by Domenico di Bartolo,
the tutor of Piero della Francesca, and illustrate numerous details.
You can zoom in on the pictures.
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| Caring for the Sick (photo by author) |
Look at “Caring for the Sick” (1440-1). In the center the Rector and some oblates of the hospital are next to a surgeon examining a man with a cut in his right thigh. To the left is a patient being eased onto a stretcher and two doctors examining a container of urine. On the right is a priest hearing confession and attendants are carrying a stretcher. The architectural details are said to be accurate.
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| Distribution of Alms (photo by author) |
Next, look at “The Distribution of Alms” (1441). In the center an almost
nude man is being clothed, on the right bread is passed out (a woman with a baby
already has her basket), and a cripple waits on the ground. On the left the
Rector is taking off his hat in deference to a nobleman, probably an important
benefactor. The background is a church within the Ospedale.
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| Payment to the Wet Nurses with Money (photo by author) |
“Payment of to the Wet Nurses with Money” was painted later, in the 16th
century, after an addition to the hall, by Metro d’Achille Crogi and Giovanni
di Raffaele Navesi. Wet nurses were paid in grain or money, and the painting
shows the monetary payment and the care of the foundlings. The purpose of the
two large men is not clear to me.
The Ospedale modernized with the times and functioned as a full hospital
until 1990, when it was transferred to a large, modern building on the edge of
the city. The old building is now a museum, still in the process of discovering
all its ancient treasures, only a brief glimpse of which I have given.
The Ospedale maintains a web site showing more details of the paintings
and other treasures inside the building complex: http://www.santamariadellascala.com/w2d3/v3/view/sms2/storia--22/index_en.html
Other
reproductions are available at:
Works consulted:
Baron, JH: The Hospital of Santa Maria della Scala. BMJ 1990. v301, pp
1449-51
Risse, GB: Mending Bodies, Saving
Souls: A History of Hospitals. Oxf Univ Press,
1999.
Museum-published book on the Ospedale.
