The Mauriziano Hospital

From the 1930s of XIX century onwards the question of leprosy had become topical again, particularly in the Ligurian territory.

From an investigation commissioned by King Carlo Alberto in 1837 it emerged that the twenty or so lepers taken care of by the Order of Saints Maurice and Lazarus were concentrated in the provinces of Nice, Chiavari, Savona, Sanremo and Oneglia. The leaders of the Mauritian Order therefore decided to find a more suitable place for the management of the infirmity, where the sick could be properly treated.
Since the intendenza of Oneglia was the one most affected, at first it was decided to locate a specific hospital in that area for the care and reception of lepers. Later Carlo Alberto ordered a specially constituted commission to go there to recognise and identify all the lepers in the various territories, and to provide them with a monetary subsidy (one lira per head per day) until other more suitable measures were taken.

The Royal Magistral Commission on Leprosy, formed by Doctor Lorenzo Granetti and Secretary Mella, visited the lepers of the two Rivieras (Nice division and Genoa division) from 2 March to 2 June 1839. In a report drawn up on 8 March 1841 by Dr Granetti there were twelve cases of lepers, six of whom were in Turbia (Nice), one in Montalto, one in Camporosso and four in Varazze.
In Sanremo, on the other hand, two cases of leprosy were reported in 1841, four in 1842 and six in 1844. The situation was therefore quite serious and was further complicated by the fact that some lepers escaped all control, while others, not lepers, exposed their disease to the authorities as leprosy, perhaps even certified by a medical declaration. The fact that the situation was not improving is confirmed by a report sent to Carlo Alberto by the secretariat of the Mauritian Order on 4 June 1841. The report expressed the opinion that the only useful remedy to remedy the situation would be the admission of lepers to hospital.
At the same time a series of clinical reports on leprosy were being drawn up, including the one compiled by Doctor Granetti in 1839 and that of Doctor Trompero in February 1843.
In the meantime, at Carlo Alberto's request to the Council of the Order of Saints Maurice and Lazarus, having ascertained the advisability of founding the new "hospital of the lepers" on the Riviera, an evaluation of the various sites for its location was carried out.

As early as March 18, 1837, the first secretary of the Grand Magistry of the Mauritian Order, Venceslao Arborio Gattinara, informed the intendant of Oneglia, Carlo Farcito di Vinea, and the vicar foraneo, Giambattista Belgrano, that the king intended to entrust them with the task of building a leprosy hospital in their town.
A project was studied to transform the convent of Saint Augustine, which had a capacity of twenty-six beds, into a leprosarium, or to erect a new one with sixty-six beds at the civil hospital.
On July 2, 1839 Granetti sent a plan for the construction of the leprosarium in Oneglia, drawn by Luigi Celestino Foppiani, professor of civil architecture at the University of Genoa, a plan that closely resembled that of the royal asylum in Genoa, built by the architect Carlo Barabino.
A report drawn up in 1847 by Count Maurizio Nicolis di Robilant, provisional delegate for the supervision of the Order's hospitals, detailed the characteristics of the "premises visited", with a "warning" on their transformability.

These included two buildings in Albenga (formerly convents of the Franciscans and San Bernardino of the Observant Friars Minor), which were judged too small and too costly to transform; three spaces in Oneglia (the convent of Sant'Agostino, already proposed in 1838 to become a leprosy hospital, which was also judged difficult to transform; a convent in Porto Maurizio owned by the Bishopric of Albenga, which however could not be used as a temporary leper colony because of the chronic lack of water during the summer; and finally, in Sanremo, the « room built by the City for use as a seminary.... which is located on the highest part of the City... just before reaching the magnificent Temple dedicated to the Virgin, called della Costa, [where] once stood a convent of Nicolites ».

The Order's attention was immediately focused on this building, which had been the seat of the Discalced Augustinian monastery since 1681, transformed into a seminary in 1831 (though it was never used as such) and located not far from the sanctuary of the Madonna della Costa, in a very airy position with a splendid view of the sea.
The fact that the building had not been used as a seminary, due to a series of disagreements between the Bishop of Ventimiglia and the municipal administration, which would have been inclined to exchange the buildings in order to obtain revenue for the 'great work of a port that is always under consideration', as well as the considerable size of the building, seemed to indicate that it was the most suitable for transformation into a leper colony. The five-storey building was equipped with its own cistern, to which it was possible to ensure an adequate flow of water by diverting the supply canal built by the municipality to feed the city's fountains.
In addition to the general services, sixty "cells" could also be obtained, while - the report notes - it would be appropriate to immediately acquire the adjoining garden, already belonging to the building, and at that time assigned free of charge to the "Nuns called Turchine".
According to the estimates made by the head of the Order's administration and litigation division, Giuseppe Guinzio, who went to Sanremo to inspect the building, which seemed to the Count of Robilant to be the most suitable, the cost of transforming the complex would have amounted to 20,000 lire, compared to the 30,000 initially requested, plus another 5,000 lire for the purchase of the nuns' garden, with a final outlay of 85,000 lire.

By an act of 8 January 1847, however, the king had already allocated the proceeds of the Commenda di Montonero, which he had enjoyed up to that moment, for the sum of 26,000 liras, which would soon be increased to 30,000. In 1848 the complex of the former convent and the nuns' garden was purchased, to which a further strip of land was added, cultivated as an orchard, to be used by the patients. At the same time, the first design of the building was begun, commissioned by the Count of Robilant from the Order's engineer, Carlo Bernardo Mosca. The Order's Council was informed that the purchase deeds had been completed and that Mr Mosca had been commissioned to carry out assessments to make the building suitable for its new function as a lazaret at an extraordinary meeting on 26 February 1848. In the meantime, Mosca went to San Remo, together with the Order's patron saint, to carry out an inspection of the site, entrusting the task of preparing the preliminary studies to an outstanding local technician: the engineer from the province of San Remo, Davide Pontremoli.

As soon as he received the assignment, engineer Mosca had no objections to the location of the future leprosarium, but he did express some scepticism about how the new building would be constructed, and so he asked the Royal Academy of Medicine of Turin to be consulted on a series of points set out in a questionnaire. The Royal Academy of Medicine, through its president Secondo Berruti, answered all the questions, but especially insisted on the following points:
1) since leprosy was a contagious disease, lepers had to be hospitalized in single rooms;
2) the number of beds was to be sixty in order to meet all the needs of the hospital;
3) a simple water bath and a sulphur bath were to be installed.
After receiving the opinion of the Academy, the Council of the Mauritian Order decided to build the leprosarium in San Remo according to the funds at its disposal.

The official version of the project was drawn up on 30 October 1850, and was only "signed" by Cavalier Mosca, but its actual draft dates back to 8 November 1848, and was signed by the engineer Davide Pontremoli, who was therefore the real author. However, the transfer of the grandiose project into a truly feasible programme was the responsibility of engineer Ernesto Camusso, who was permanently at the service of the Sacred Religion for all hospital projects.
The overall project transformed the old monastery into a nosocomial system of great visual impact in a dominant position, but far enough away from the most densely populated nucleus, endowing it with an evident classicist connotation, with the insignia of the Order of Saints Maurice and Lazarus prominently displayed, at a total cost of 329,762 lire. In 1853 a further wing was added to the convent to accommodate lepers.

On 19th September 1855 the engineer Giovenale Gastaldi arrived in Sanremo, sent there by Vittorio Emanuele II, to take over the supervision of the works for the renovation of the old convent.
After the completion of the building, on 18 September 1858 Victor Emmanuel II issued a decree entrusting the first secretary of the Grand Magistry of the Order of Saints Maurice and Lazarus, Luigi Cibrario, with the task of taking the necessary measures for the inauguration of the leprosarium, which read as follows:
« Victor Emmanuel II King of Sardinia, Cyprus and Jerusalem, Duke of Savoy, Monferrato and Genoa, Prince of Piedmont, General Grand Master of the Order of Saints Maurice and Lazarus: one of the ardent vows of my August Lord and Father, of glorious memory, is now fulfilled, thanks to the completion of the Hospital for lepers of both sexes that the aforementioned Sovereign prescribed should be built in the City of Sanremo; pleased that this new charitable institution of the Order of Saints Maurice and Lazarus, which remains under the dependence of our Secretariat of the Grand Magistry, has been completed and desiring that it be opened without further delay for the prompt relief of the poor lepers: We command Our First Secretary of the Grand Magistry, Don Luigi Cibrario, Knight of the Grand Cross, decorated with the Grand Cordon of the aforementioned Order, Knight of the Order of Civil Merit of Savoy, Senator of the Kingdom, to proceed in Our name with the opening of that establishment and to make all the necessary arrangements. And desiring that the memory of this deed shall not perish, we order that a special inscription be placed on the marble tombstone, declaring: 'It is Our will that one of the three originals of the present diploma be walled up behind the tombstone, and that the other original be kept in the Royal Archives of the Order after the usual registrations ».

On the morning of 18 October 1858, in the presence of the secretary and minister of the Order of Saints Maurice and Lazarus, Luigi Cibrario, representing the sovereign, of Cavalier Luigi Sassi, the first medical director of the hospital, from the hospital in Valencia, of the bishops of Ventimiglia, Lorenzo Biale, and of Nice, Jean-Pierre Sola, the inauguration ceremony for the new leprosarium took place.

The official speech was given by Dr. Alessandro Rambaldi, who, in the course of his intervention, is reported to have declared among other things:
« But it is also true that in the most afflicted emergencies, privileged men of great heart and high feeling always show themselves, who, working tirelessly for the public benefit, know how to acquire the most sacred right to the blessings of their contemporaries and the gratitude of the most distant generations. The Hospitallers of Jerusalem were in fact such - a model of every sublime virtue. Not only did they receive pilgrims from the Christian provinces who came to visit the Holy Places in a special hospice; not only did they defend them as brave and generous warriors from the attacks of the Turks and Arabs, but they also gave the sick with leprosy every kind of humble and compassionate service. So that in these men, who, as the most enlightened Alibert rightly says, while they assisted the unfortunate with one hand and fought the infidels with the other, sometimes peaceful, sometimes warlike, humanity equalled military valour. This was also the case of the illustrious and never duly praised religious-military Order of St. Lazarus, an institution worthy of honour throughout the centuries. - And indeed, how many ways would it be worth to enumerate and describe the highest qualities, with which its Knights were richly endowed? What praise could be paid to their evangelical heroism? They, like the first Spedaliers, consecrated their lives to helping the pitiful lepers who languished in the abandonment of mankind, prescribed them in appropriate Hospitals, and comforted them in every way. The fame of their loving care, widely spread among the Christian peoples, made the wealthy families compete to help them in their humanitarian work, so conspicuous were the accumulated wealth, that around 1300 Christendom counted 29,000 Maladrerie. Here we must not pass over in silence and without well-deserved praise the Monarchs of France, Louis VII, Philip Augustus, and Louis VIII, as splendid protectors of the Order of St. Lazarus, and in a very special way that Saint Louis IX, who, burning with that same zeal for which St. Basil in the Hospital of Caesar was known. Basil in the Hospital of Caesarea nec aegrotis admoveri gravabatur, sed ut fratres amplectebatur, leprosos deosculabatur, after having brought every kind of charitable help to lepers, treating them himself, and always preferring the most counterfeit and most stomach-churning, left in his will legacies for two thousand lazarettos. And to complete the picture of the eminent virtues that so distinguished the Knights of the Order, I will point out how they not only had no difficulty in admitting lepers into their corporation, but even considered it appropriate that the Grand Master should be a leper, - so that - as Cantù observes - he might better know how to console the evils he had experienced. - And it was only in 1572 that the immortal Emmanuele Filiberto obtained from the Roman Pontiff Gregory XIII the creation of the Order of St. Maurice, and united it to that of St. Lazarus, and that therefore the most valiant and religious Dukes of Savoy were declared Grand Masters of the double Order ».

On the day of the inauguration, a plaque was placed under the bust of Victor Emmanuel II, which no longer exists, as does the bust of the sovereign, on which the following inscription was engraved, dictated by Count Cibrario: « Providentia atque munificentia Regum / Caroli Alberti et Victorii Emanuelis II / Magistrorum Ordinis Mauritiani Lazzariani / valetudinarium / in solatium aegrorum / lepris laborantium constitutum / anno MDCCCLVIII. / Curam agente Aloisio Cibrario V. E. Equite Senatore / Ordinis Maurit. Lazar. antistite / Friderico Colla V. E. Equite Senatore Praefecto Aerarii / Ernesto Camusso architecto ».

Even after its transformation into a civil hospital in 1883, the Mauriziano would have kept two sections for lepers, one for males and the other for females, which took the name of "infirmary Carlo Alberto", putting at the disposal of the Municipality sixteen beds for the department of cholera sufferers, the so-called "lazzaretto"; also the hospitalisation of these patients would have been at the expense of the municipal administration.

After the solemn inauguration, the new hospital immediately began to provide care, admitting five men and four women, to which another four patients were added within the year, up to a maximum of twenty. The leprosarium was staffed by a director, a secretary, a treasurer, a clerk, an ordinary doctor, an ordinary surgeon, an internal assistant surgeon and a chaplain.
After Cavalier Sassi, Cavalier Mercet, Commendator Giulio Ferrero, Cavalier Bachelet and Cavalier Giuseppe Torazzi took over the administration of the leprosarium.
Dr. Alessandro Rambaldi was appointed head physician. He won the competition over Dr. Francesco Onetti, author of a publication on leprosy, who had claimed that the disease was not to be considered dangerous, while Dr. Rambaldi believed it to be highly contagious and easily transmitted from one person to another through bodily contact. In addition to his position as medical director of the Sanremo leprosarium, Dr Rambaldi also took on the role of district doctor for the assistance of the city's poor.
During the management of Commendator Ferrero, due to some serious administrative errors, the fund of the charitable institution was entrusted to the architect Giovenale Gastaldi, who took on the role, confirmed on June 28, 1863, of sole administrator of the leprosarium, remaining in office until 1881, when he retired.

The number of lepers admitted to the hospital was fairly large in the first few years: 14 in 1858, 19 in 1860, 29 in 1861, 25 in 1862, falling to four in 1864 and none in 1867. There would then be a slight upturn, but from 1874 to 1880 there would be no more than seven or eight admissions per year. This was due to several concomitant factors: a general decrease in the sources of contagion, the cession of the county of Nice to France, the death of the oldest lepers.
For these reasons, by means of the royal magistral licences of 14 June 1871 and 1 December 1872, in-patients suffering from other contagious diseases began to be admitted.

In spite of this fallback, it seemed to the municipal administration that such a large building, for the construction of which, among other things, considerable sums had been spent, could better serve the community by changing its use, especially as the old hospital had become insufficient to meet the needs of the growing population of Sanremo. Hence the request to the Ordine Mauriziano to transfer the leprosarium to the Municipality.

With the agreement signed on June 22, 1882 by the notary Taccone between the Municipal Administration of Sanremo and the Order of Saints Maurice and Lazarus, the latter ceded the leprosarium to the Municipality to be used as a civic hospital. As Paolo Boselli would write, the regime of the new institute was established as follows:
« Lepers and other dermatosis were to be received and treated there in accordance with the regulations in force, on the initiative of the Order, which retained a right of high patronage over the hospital to be exercised through a special delegate, and twenty free beds were available for them. The endowment of the leprosarium, which had been reduced from an initial annual amount of 33,000 lire to 26,000 lire by Royal Decrees of 11 December 1873 and 7 October 1881, was withdrawn by the Order. The value of the buildings transferred was 100,000 lire, and that of the furniture, linen and fittings 40,000 lire. A special clause in the contract also established that the building sold could never be used for any other purpose except as a Hospice for leprosy and related diseases, or as a Hospital for acute illnesses. At the same time as the agreement with the Mauritian Order, the municipality of San Remo made another agreement with the local Congregation of Charity, administrator of the Civic Hospital, to which it also transferred the administration of the Leprosy Section, paying it one lira for each day of presence of a leper sent by the Order ».

This formal act brought to an end the long history of assistance to lepers in Sanremo by the Order of Saints Maurice and Lazarus.