The courtyard of the Ospedale Maggiore.
|Town or city||Milan|
|Construction started||April 1456|
|Design and construction|
The Ospedale Maggiore, traditionally named Ca' Granda (i.e. Big House), is a building in the center of Milan, northern Italy, constructed to house one of the first community hospitals, the largest such undertaking of the fifteenth century. Commissioned by Francesco Sforza in 1456 and designed by Antonio Filarete it is among the first examples of Renaissance architecture in Lombardy.
Even if the old buildings of the Ospedale Maggiore host today the State University of Milan, you can still find in it – apart from the beautiful original architecture - some of the “relics” of its glorious medical and sanitary 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 at the time.
The Duke, entering Milan victorious on 25 March 1450 (the day of Annunciation), 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 and built by the engineer Guiniforte 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 (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), 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 (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 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.
In 2010 the name of the hospital was changed, reverting to its former name of Ca' Granda.
 Historical archive
 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 in the bird’s beak 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 "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.
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. On the other side, the dove 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.
The project and its realisation were the responsibility of the Milanese architect Giò Ponti, 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 in a sarcophagus 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’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, 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 for the scribe and designer Pthamose at the beginning of the nineteenth dynasty of Egypt (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, 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.
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 and transplants
- Monteggia Department: surgery (head and neck)
- Sacco Department: radiology, cardiology, lungs
- Granelli-Marcora Department: internal medicine, gastroenterology, endocrinology, 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
- Guardia Department: A&E
- Guardia II Department:psychiatry
- Marangoni Department: immunohaematology, 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, infertility centre and occupational health outpatients’ department
- Luigi Devoto Clinic: occupational health, laboratories and emergency medicine
- Alfier Departmenti: paediatric surgery , otolaryngology, ophthalmology, Maxillofacial surgery, dental
- Bergamasco Department: oncology, algology
 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 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 past 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”.