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A
Tuscan Military Field Hospital in 1636
DOCUMENT CITATION: TRANSLATION: In the book, the Steward or Chaplain will inscribe the day, month and year of the soldier’s arrival, including his name, patronymic, place of origin and company. He will likewise describe the soldier’s clothing and its quality, noting whatever money and weapons he may be carrying. Then he will hear his confession and afterwards accompany the patient to his bed. Having gathered the patient’s belongings, he will consign them to the Wardrobe Master with a list bearing the patient’s name. Should it please our Lord God to restore the patient’s health, his belongings can thus be returned to him, with each item checked against the inventory, though only after he is officially dismissed by the Doctor. It is essential that the Wardrobe Master not return the patient’s clothing before his dismissal by the Doctor, since this could give rise to the usual problems that occur when this is done prematurely. The date of the soldier’s dismissal or death will be inscribed in the book.
The Steward must take particular care that the soldiers’ comrades from outside don’t bring them anything which might imperil their health. Card games are forbidden for everyone, including staff, on pain of dismissal. The following procedure is to be followed in examining the sick: The Doctor will be accompanied by the Apothecary with his book, as well as the Practical Surgeon with his book of mouths [ie. register of people.] The first will note the necessary medicines. The second will determine what the patient should eat, indicating each one by name according to the number of his bed, stating what he should be eating and drinking, whether meat, wine, chicken, mashed food, spelt, special diet, etc. The same will be done with the medicines. When the examination is finished, the doctor will personally sign both books every day. In this way, it will be known without any disorder how many patients there were in any given month and what they ate. During the lunch and dinner hours, the following procedure will be observed: The Steward, the Chaplain and the other staff members including the Practical Surgeon with the book of mouths, will go from bed to bed, bringing whatever the Doctor indicated in the book. This they will do with all possible politeness, encouraging the weak, and helping them eat with the outmost patience and charity until they have finished eating. The staff will eat afterwards and will not allow outsiders to enter for at least an hour, so that the patients can get some rest. Those patients who are eating meat can be given half a pound of veal for lunch and the same for dinner along with soup. For every meal they shall also be given six ounces of bread and ten ounces of wine. The special diet will consist of a bowl made up of bread mush, spelt, grated bread or rice, plus two ounces of raisins or else something like a cooked apple or pear. The mashed food is to be made with chicken or veal, according to the circumstances.
The terminally ill are not to be admitted to the hospital; nor those afflicted with contagious diseases like the French disease [syphilis], ring-worm, lice, etc. TRANSCRIPTION: Et il Maggiordomo o Cappellano, notorà nel suo libro il giorno, mese et anno nel quale venne detto soldato, scrivendo suo nome, cognome di chi è figlio, de che Terra, et di qual Compagnia. Così medesimamente il vestito che porta, di che qualità, et il dinaro, et arme che porta. Poi lo confessarà. Fatto questo menarà il infermo al letto, et ricolta la robba, se li metterà un bollettino con il suo nome, et si intregharà allo Guardarobba acciò che essendo il Signore Iddio servito di darli salute, se li restituisca, per detto inventario, cosa per cosa, essendo però licenziato da detto Medico. Advertendo che il detto Guardarobba non dii li vestiti avanti di essere licenciati da detto Medico per molti inconvenienti che sogliono nascere da questo per darseli avanti tempo. Si notarà il giorno che il soldato sarà licenziato, o morto. Se qualche d’uno non si volesse confessare d’entro di doi giorni: sia licenciato et si mandi fuori del Hospitale. L’istesso si farà con quello che riniegorà, o sarà impaciente o mal sopportabile et non vorrà observare quello li sarà ordinato dal Medico o Chirurgo in beneficio della sua salute. Il Maggiordomo haverà particolar cura non portino li soldati forastieri sue camarate, alli ammalati cose che li possino far danno alla sua salute. Non si permettino giochi di carte, ne anche alli Officiali di casa, su pena di esser licenciati. Nel visitar delli infermi si guardarà il ordine seguente. Venerà con Medico il speciale con suo libro et il Practico di Chirurgia con il libro delle bocchè, acciò notino l’uno le cose di medicina, l’altro, quello che haverà da mangiare il infermo, ponendo li suoi nomi nel numero delli letti, acciò sappi quello che doverà mangiare et bere detto infermo, o carne, vino, pollo, pisto, farro o dieta, etc. Parimente le medicine. Li quali libri finita la visita, firmarà il Medico di sua mano giornalmente. Così si saprà quanti sono stati quel mese li amalati et quello che hanno mangiato senza confusione alcuna. Alle hore di dar da mangiare et cenare alli infermi si observarà questo ordine. Il Maggiordomo, Cappellano, et altri Offiziali con il libro delle bocche che portarà il Prachico di Chirurgia andaranno di letto al letto, portando quello li sarà notato nel detto libro dal Medico, et questo con ogni politessa animando alli deboli et adgiutandoli a mangiare con ogni pacienza di carità infine che habbino finito di mangiare. Poi andaranno a pranzo li Offiziali et non permetteranno per una hora almeno entrino forastieri, acciò, possino alquanto riposare detti ammalati. Quelli ammalati che mangiaranno carne se li può dare mezza libbra di vitella a disinare, et altro tanto a cena con sua minestra. Di pane sei onzie per pasto. Et vino dieci onzie per pasto. La dieta sarà una scutella di panatella, o farro, o pane grattato, o risotte, et se li potrà dare due oncie di sebebbi, o altra cosa, come un pomo roslito, o pero. Li pisti si fanno di pollo, o vitella, secondo la occorenza.
Non si devono ammettere incurabili, ne anche infirmitate contagiose, come Mal francese, tigna, rogna, etc..". HISTORICAL CONTEXT: Ne uccide più la penna del dottore, che la spada del cavaliere: The doctor’s pen kills more than the gentleman’s sword. (Traditional Tuscan Proverb) When we consider the general state of hospitals in past centuries, we are perhaps most struck by the relative primitiveness of the conditions and the seemingly unscientific vagaries of the medical treatment. It is certainly true that people entering hospitals (particularly military hospitals) were as likely to leave in a hearse as on their own feet. Though festered battle wounds were a major cause of death, numerous strains of "hospital fever" fomented by inadequate sanitation could prove even more lethal. This is not to say that military hospitals were viewed merely as God’s waiting room for the wounded. Since soldiers were difficult to find and expensive to train, the authorities had a vested interest in seeing that the infirm lived to fight another day. Though the hospital described in the present document might seem eccentric by modern standards (there was a full-time chaplain, but no specified cleaning staff), it was managed with meticulous care and very considerable expense (judging by the size of the staff and the quality of the food.) Indeed, it is an open question whether this paradigmatic ideal was ever actually realized in battlefield conditions in the mid-seventeenth century. In any case, the historical context of the present document is clear. The Medici were obligated by treaty to provide 4,000 foot soldiers and 400 horsemen to the Spanish crown any time its possessions in Italy came under direct attack. This was one of the central conditions of the investiture of Siena, a territory which the Medici held as fief of the King of Spain. This agreement, which was ratified by Cosimo I de’Medici and Felipe II de Austria in 1557, represented a considerable financial and political burden for the Tuscan state, which the succeeding Medici grand dukes did their best to evade, not always successfully. Thus in 1636, they found themselves defending the Duchy of Milan (a Spanish possession) against the invading French. Even today, God is often referred to in Italy as "Il Gran Medico" (The Great Doctor), all recoveries being attributed ultimately to Divine Will. In the present document, it is perhaps the spiritual and moral dimension of the field hospital that emerges most clearly. All soldiers had to confess within two days of admission or else suffer eviction. Gambling was prohibited; not only could card games excite the patients unduly and lead to conflict, but they were (and in the Tuscan countryside still are) traditionally accompanied by colorful, usually blasphemous language. A further consideration is that field hospitals were frequently set up in commandeered convents and monasteries, which offered adequate space, appropriate infrastructure (kitchens, stables and so forth) and a suitably sacral context for God-assisted healing. Another priority was safeguarding the soldier’s personal property, especially his clothes, money and weapons. A detailed inventory was to be made by the hospital’s Wardrobe Master, though not merely to avoid loss or theft. The nature and quality of a patient’s clothing and weaponry would have been the key to his social identity, especially in the likely event that he was unconscious or otherwise unable to communicate. In the hierarchical society of the ancien régime, it was only natural that an officer or a gentleman should be accorded a higher level of attention than a common soldier, although the prescribed charitable behavior by the hospital staff was somewhat of a social equalizer. The document also notes that returning the patient’s clothing in advance of his officially sanctioned dismissal "could give rise to the usual problems that occur when this is done prematurely". Seemingly the most evident problem was that the patient might check himself out of the hospital before fully cured, perhaps leaving behind debts as well. Whilst the doctor, the highest ranking medical practitioner in the hospital hierarchy, was responsible for prescribing each patient’s medicine and nourishment, the implementation of the feeding regime was the responsibility of a member of the surgical team. Some of the food was actually quite expensive, well beyond the normal means of a common soldier, who was in any case required to pay for his stay in the hospital. During the Wars of Castro (1641-44, the Tuscans’ next major military venture after the Milanese excursion) hospitalized soldiers had to pay 8 soldi and 4 denari a day (1 soldo = 12 denari), plus their bread ration, for medical fees. This would have represented nearly half of their gross monthly wage since the average foot soldier was paid 560 soldi a month. [Biblioteca Nazionale Centrale di Firenze, Palatino: Capponi 207, "Nota dei soldati ospedalizzati" from 1644, f. 299r.] In peacetime, it was common practice to charge all of the soldiers of a particular garrison for medical care even when healthy. For example, soldiers in Livorno in 1640 each contributed 20 soldi a month for the upkeep of the local hospital and its staff [Archivio di Stato di Firenze, Mediceo del Principato 2331, f. 620r; note on deductions from soldiers’ pay.) ILLUSTRATION NOTE:
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 © 2002 by The Medici Archive Project |
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