The ancient San Gallicano Hospital

The ancient San Gallicano Hospital was established by Pope Benedict XIII in 1725 and was one of the first dermatological centres in Europe.
A rich international bibliography and other contributions testify the long experience of health care started by Don Emilio Lami and the details of the engineering masterpiece planned by the architect Filippo Raguzzini.
On March 14, 1725, Pope Benedictus XIII celebrated mass on a temporary altar manufactured for the occasion. Accompanied by a procession of cardinals and a multitude of people, he set the cornerstone in the foundations of the church of the Institute which was to become one of the most functional medical structures in Europe at that time, and one of the first specialized centres in skin diseases.
As a dermatological hospital, San Gallicano Institute is even antecedent to the prestigious Saint Louis Hospital in Paris, which was built in 1607 but specialized only on November 27, 1801. On March 30, 1645 an apostolic Breve had made two hospitals merge, the Santo Spirito and the San Lazzaro, to face the impossible challenge of taking care of the huge crowds of indigent people affected by leprosy, scabies and tinea. The new institute came to fit into the eighteenth-century Rome, a city apparently magnificent but in fact dramatically divided into a rich privileged class and a great mass of extremely poor people, where diseases showed in repugnant forms. Even if confronted with a number of difficulties, the prestigious architect Filippo Raguzzini drew the project of what is now the Santa Maria e San Gallicano Institute for the oncoming jubilee year, between 1730 and 1740. It was a work of great impact for its dimensions, functionality and architecture in one of the most famous and characteristic popular districts of ancient Rome, Trastevere.
The history of the construction of the hospital highlights the role of the many professionals who worked on it. Architect Possenti is supposed to have been involved in the initial plan. He was the work manager since Raguzzini only attended to the artistic aspect leaving practical tasks to other architects such as Possenti and Michetti.
In one of his drawings engraved by Vasconi and printed by the Chalcography workshop of the Apostolic Camera, Raguzzini places under the façade of the hospital his dedication to Benedictus XIII. The pope himself had commissioned him to build the hospital in the place agreed, asking him to be as fast as possible in the execution of the works.
The Santa Maria e San Gallicano Institute was the right conclusion of the painstaking work of a humble priest, Don Emilio Lami who had been made prior in Santa Galla Hospice. There he had the chance of cultivating his inclination for health care by studying and experimenting a number of treatments. Because of his charitable spirit he drew from everywhere many suffering people who found in specific ointments relief from their disfiguring skin diseases.
The success of his work and the rising number of patients asking for treatment, convinced him to convert the Hospice into a hospital.
In a meeting with cardinal Corradini, who later became San Gallicano’s patron, it was decided to carry out the project in a house named “il palazzaccio”, in Piazza in Piscinula. The original hospital had 40 beds and 2 altars; men and women were sheltered, treated and supported thanks to charities.
On January 15, 1722 an apostolic Breve by the Pope appointed Lami with the task of healing people affected by tinea and leprosy in the hospital. These events show how the clergy still had at the time the traditional role of being an authority and expert in the field of health care, a role which gradually waned after the French Revolution giving way to remarkable changes in the organization of the health care and in the spreading of culture by the scientific world.
For the inauguration of the big building, called by the natives of Trastevere “l’Ospedalone” because of its long longitudinal plan, an official medal with the effigy of Benedictus XIII was coined in 1727.
The foundation Bull “Bonus ille” of 6 October 1726 refers to the building as the result of the will of the Pope himself to provide the city with a new medical centre. As is written on the commemorative stone inside the hospital, it was created to shelter and treat marginalized people affected by severe and repugnant diseases. This was also in tune with the atmosphere of moral protection and assistance to sick people of the time.
This example of civilization was a Middle Age inheritance, documented in thousands of archives in Roman hospitals of that period and always respectful of the founders and patrons’ intention to separate the medical purpose from the religious one.
Most historians consider the will of Benedictus XIII to build the San Gallicano both as a humanitarian action, tending to mark his pontificate with a remarkable initiative, and as a building program that considered functionality and effectiveness fundamental parameters to develop and support at best the praiseworthy initiative of Lami.

However, the building of the new hospital was also wrongly considered as a more general plan of the Pope to concentrate sick and disagreeable people in peripheral areas. So the intention would be to eliminate diseases like tinea and scabies by isolating the patients in specialized

hospitals that should become a shelter for the abandoned and unfortunate people affected by painful skin diseases whom nobody wanted to take care of.
Indeed, a thorough analysis of health care and hospital evolution between 1600 and 1700 offers a new interpretation of the eighteenth-century relaunch of the hospital structures, also seen as a result of the Enlightenment influence. They became scientific, rational and modern edifices, divided in autonomous medical branches. Evidence of this approach are the texts of medicine, general pathology, surgery, engineering and healthcare treasured in the library of San Gallicano Institute.
In this period the general idea of the treatment begins to change, even if partially, opening the way to the birth of the modern hospital. An outstanding aspect is the strong separation between spiritual care, which is a Church’s duty, and medical assistance, which is a task of the hospitals. At the same time the first differentiations of the hospitals appears according to special kinds of diseases. Evidence of this statement lays in the attention of the architect and the customer for architectonic elements, overhangs, swellings, brisures and ornamentation that give the façade a scenographic effect.
In 1731, in the Roman office of Girolamo Mainardi, the historical and scientific text “Le Regole” del Venerabile Spedale di Santa Maria e San Gallicano approvate dall’eminentissimo principe il “Signor Cardinale Pietro Marcellino Corradini protettore d’esso Spedale” was printed. It represents the moral and juridical foundation stone of the Roman hospital: the strict regulations stated in the document make the establishment of the hospital official. They were strengthened during the pontificate of Benedictus XIV with the “Stabilimenti introdotti nel Venerabile Spedale di Santa Maria e San Gallicano per il buon servizio dei rognosi febbricitanti” in 1743, when the treatment of people affected by scabies started in the hospital.
The rules of 1731 represent the most ancient regulations of a dermatological hospital in Europe. Medical prescriptions and moral precepts are listed which define at the same time the appropriate ethical and social behaviour to be observed in a hospital: a clear separation of competences is fundamental to avoid malfunction and confusion.
It is in the rules regarding the patients that the spirit of this institution mostly appears: the poor not admitted to hospital could be examined in the outpatients’ department and in winter time a fireplace heated at night the shelter prepared for them; all sick people are exempted from fasting in the times established by liturgy; the recovered patients leaving the hospital are donated the old clothing of the trireme sailors by the commander of the mercantile fleet; free medicaments and ointments are given to poor people even out of the hospital.
With time the number of the workers as well as of the patients at San Gallicano Hospital increases, and its regulations improve. When the diffusion of leprosy, scabies and tinea decreased the enemies to control became the dermatological and sexually transmitted diseases and cancer.
The site is clearly marked for the first time in Tempesta’s map of 1593, while the hospital building appears later, in Nolli’s map of 1748 for the first time, then in the updated one of Falda in 1757, and finally in Vasi’s map of 1748.
According to a historiographical research, the choice of Trastevere as an area fit for the building of the new hospital was based on two main reasons. The first was the preference for a peripheral and secluded location more convenient for poor people and in tune with the deep-rooted assistance vocation of the place. Indeed, from the foundation of Santo Spirito Hospital and later, since the fifteenth century, many health institutions such as Santa Maria dell’Orto, San Michele and Santa Maria della Pietà were established in the area.
Moreover, the few people living in Trastevere belonged to the middle and low class and the presence of the hospital there was not considered as a problem.
A second reason for the choice was quite practical: the area was rich in water, and this satisfied the functional and sanitary necessities of the future hospital. However the choice was also probably due to economic reasons and to an obvious preference of Lami for peripheral areas, as well as to the long-term characterization of Trastevere as an experimented area for treatment and assistance.
The interest produced all over Europe by the new hospital was mostly due to its health care engineering innovations. Its modernity laid on the one hand in the creation of a system to supply the hospital with fresh water (from the aqueduct Acqua Paola) and especially in the internal distribution through minor water channels for different uses; on the other hand, it consisted in the construction of a sewer system to which the toilet bowls for the patients were connected, placed between two beds and framed into the thickness of the façade wall. Thus, a high number of toilets were created, and this was a real novelty at that time.
The building is an extremely significant work for the early eighteenth-century years and it was considered a fundamental step in the evolution of health care architecture. The first historical information dates back to the beginning of the twentieth century. At that time numerous texts provided new elements for studies about the evolution of health care centres, both from an “ecclesiastical commemorative” point of view and from a lay perspective related to the Roman architecture of the eighteenth century.
The relevance of the new hospital and its importance for the city was soon appreciated and pointed out by the contemporaries who provide us with first-hand evidence. The first monograph publication “Breve ragguaglio dello Spedale nuovamente eretto in Roma dalla Santità di Sig.re Benedetto XIII sotto il titolo di Santa Maria e San Gallicano”, dates back to the initial construction and was printed to celebrate the event.
Further evidence of the hospital’s outstanding excellence lays in the Ordinamento of 1826 by Pope Leone XIII which established the obligation for the students of medicine to attend the dermatology lessons in its elegant Anatomy Theatre. The large oval room was a work of the architect Palazzi and its creation is due both to the development of medical needs and events and to the celebration of the hundredth anniversary of the hospital.