by Roderick Conway Morris

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Santa Maria della Scala, Siena
The Treatment of the Sick by Domenico di Bartolo, 1440-41

Siena's New Cultural Citadel

By Roderick Conway Morris
SIENA 18 November 1995


Hospital, medical school, guesthouse, orphanage and old folk's home, bakery, soup kitchen, safe-deposit, pawn-shop, church and cemetery, Santa Maria della Scala, known to the Sienese as simply 'Lo spedale', has been for over 900 years this Tuscan hill-top town's principal treatment and charitable center, and symbol of its philanthropic ideals.

This summer virtually the last medical and surgical departments were transferred to the modern hospital outside the city walls, leaving only a couple of wards and a first-aid clinic. What should be done with this vast, in places eight-storey high, medieval complex - which occupies the entire side of a hill between the city's cathedral and Francesco di Giorgio's San Sebastiano church - when staff and patients departed, has been the subject of intense interest and debate for decades. But now, following an international competition won by the Italian architect Guido Canali, Siena's municipality has unveiled its plans to convert the hospital's 3,500 cubic metres of empty space into a multi-faceted 'cultural citadel'.

The 150 billion-lire project, which poses delicate restoration problems as well as opportunities for bold restructuring, will take about 10 years to complete. The good news, however, is that the Spedale's medieval and Renaissance nucleus, which contains among other things a unique cycle of 15th-century 'realist' frescoes depicting the hospital's daily life, has meanwhile been opened to the public for the first time.

'Santa Maria della Scala is, of course, already a museum in itself, and we wanted to make it as accessible as possible at once,' said Siena's mayor, Pierluigi Piccini. 'Some parts of the hospital will also be available for special exhibitions and conferences. At the same time, the first stage of the work, the stripping away of later accretions to the complex - most of them added since the last war - will begin to restore the original outside contors of the buildings.'

Certainly one of the most exciting stages of the project, for which we will have to wait a little longer, will be the re-opening of a presently-inaccessible, brick-vaulted medieval street that zig-zags its way through the bowels of the building from the main entrance in Piazza del Duomo to Piazzetta della Selva, which will be liberated of the later additions constructed over it, and see the light of day as a public thoroughfare again.

The earliest-known mention of the Spedale dates to 1090 (35 years, in fact, before the Comune, or muncipality, of Siena itself). Its first priority was the care of orphans, but by the following century it was already an hospital and even a medical teaching center. This was a period when an ever larger number of pilgrims were making the journey to Rome from northern Europe, and accommodating and aiding these travelers obliged the Spedale to greatly expand its activities. In due course it became a key stopping- place on the 'Via Francigena', or pilgrims' road to Rome, and the hospital's surviving records offer a vivid picture of the times.

Apart from providing food and clothing for Siena's needy and for impecunious pilgrims (not to mention its own catacombs beneath the building for the burial of the dead), additional services grew up, including a pawn-shop and safe-deposit service (many pilgrims finding it convenient to leave some of their cash and valuables here before braving the Eternal City's muggers, conmen and tourist traps. (Unreclaimed deposits provided the hospital with a modest extra source of income.) Interestingly, quite a number of women seem to have been traveling alone, and from as far afield as Scotland and Spain.

In 1399 Santa Maria della Scala had 130 beds for male patients and pilgrims, with others for women and children and several overspill wards for busy periods of the year. By this time a large, well-endowed and prestigious institution, the hospital was also a leading patron of the arts.

The extensive frescoes in the Sala del Pelligrinaio (Pilgrims' Reception Hall, and until recently a regular ward full of beds), painted in the 1440s by Lorenzo Vecchietta, Domenico di Bartolo and Priamo della Quercia, proudly present the hospital's multiple activities. In Bartolo's 'The Tending of the Sick', against a background of a clean, bright, airy ward, a young man is being washed before a surgeon treats a gash in his thigh, two physicians examine a urine sample in a glass flask and an orderly gently lays a patient on a stretcher.

Also illustrated are the progress of a foundling girl, from abandoned babe-in-arms being suckled by one of the hospital's wet-nurses, to the schoolroom and playtime, to marriage in a fine dress with a generous dowry provided by the Spedale; the daily distribution of food and clothing to pilgrims and the poor; and important events in the institution's history, from the mythical story of its inception (the pious founder's mother had a dream in which she saw infants ascending a ladder - the 'scala' of the hospital's name - to the Virgin Mary in heaven), to the first buildings' construction and the investiture of a Rector.

Other artistically interesting parts of the ancient hospital now open are the Old Sacristy and the lofty internal Santissima Annunziata church which have further fine works by Vecchietta, Bartolo and others.

The most ambitious long-term project for the Spedale is that it should become a home for a new museum of Sienese art throughout the ages, wherein all the major collections presently scattered around the town should be gathered together under one roof. The complex is so large that this could certainly be done without compromising the other envisaged uses, which include restoration workshops, artists' and craftsmens' studios, new premises for the University's Art and Archeology departments, auditoriums, bookshops, restaurants and bars. The obstacle to the museum is that several different public bodies - the municipality, province, region and state - own the art works. If, however, the all-too-familiar internecine rivalries and mass of bureaucratic red tape can be overcome, Siena would be able to create in this superb setting a new museum of international significance that would be worth traveling a long way to see.

First published: International Herald Tribune

© Roderick Conway Morris 1975-2023