The Ospedale Maggiore, known as Ca’ Granda, was founded in 1456 by will of Francesco Sforza, Duke of Milan, and was considered for almost five centuries a model for Milanese, Italian and even European healthcare. Attracting patients from all over Europe, the Ca’ Granda distinguished itself for the introduction of new treatments and innovative health reforms. In the burial ground of the hospital still lie the bodies of the deceased patients, who came from the poorest strata of the population. The study of their remains aims to give back a general identity and a story to each of these persons as well as reconstruct a fraction of the sixteenth century population of Milano as concerns lifestyle and disease and examine practises and therapy of this exceptional hospital. It is estimated that about two million commingled bones and articulated skeletons rest in the crypt, together with other types of findings (e.g., ceramic, coins, clothing). These remains are the object of a large project involving various disciplines ranging from humanities to hard sciences. The aim of this paper is to bring this historical gem to the attention of scholars and provide a glimpse of what its contents have already revealed.

A Medieval contribution to the history of legal medicine: the first European Necroscopic Registry Up to now scanty information on mortality and cause of death of past populations has come mainly from church registries or coroners' archives [1]. The authors here introduce the medical/necroscopic 1 registry of deaths established in Milan in 1452, the very first in Europe of its kind. The exceptional qualities of this Registry, similar to modern ones, consist in the intention of the Public Authority to register all deaths (both natural and suspicious) with a specific medical report. This Registry, presently preserved at the Archivio di Stato of Milano, reflects the will of the Duke of Milano, Francesco Sforza, to check population mortality and morbidity and suspicious or violent deaths in one of the most important cities in Europe at the time, with a population of over 100,000 [2,3]. The Registry requested the annotation of all deaths, with name, age (calculated in years or months, days and even hours for infants), city district and parish, and cause of death complete with previous symptoms and signs, diagnosed by a qualified doctor or by personnel with medical training (eg. Catelano), with clear references to scientific bibliography of the period [4] (Figure 1). A preliminary study of the first 4 years (6200 deaths) showed surprising medical and medico-legal prowess. For natural deaths, both sexes are equally represented, as are most age ranges (some individuals reached 100 years), with a peak for infants. Some examples of medical reports are: "a febre continua ac dolore matricis ex ritentione eorum quae post partum expurgari debuerint" ("continuous fever and pain to the uterus due the retention of that which should be naturally expelled post-partum"); "appoplesia forti apostemata posterioris partis celebri" ("accidental apoplexy due to abscess in the posterior part of the brain/cranium"); "ex febre continua cum dolore laterale et sicha tussi et cum inflamatione brachii dexteri ("continuous fever due to pleurisy [5] and dry cough with inflammation of the right arm"); "a cancro in mammila sinistra" ("cancer to the left breast"); "ex sincopi causata ex sanguinis coagulatione in stomaco et intestinis" ("syncope due to blood coagulation in the stomach and intestines"). Violent deaths (accidents, homicide and suicide) mainly concerned men and are equally well described: "ab offensa circha posteriorem partem cerebi et cervicem ex precipiti casu super dorsum" ("damage around the posterior part of brain/cranium and neck due to an accidental fall on the the back"). This preliminary note illustrates the historical origin of modern necroscopic practice and the social and medical advances of a historical period undeservedly classed as "dark".

The Mortorum Libri of Milano (1452-1801) represent the first register in Europe based on the daily recording of the dead and detailed information about the social ties of decease people. Mortorum Libri protocol is the first example of a monitoring and prevention chain based on ethical and juridical individual responsibility. The causes of death were codified according to the International Classification of Diseases (ICD-10) to relate the original classification with the present one. This study has a particular reference to the Registers of the 15th century and analyzes the mortality in 1480 as an example of the database application in epidemiology.

Historical death registration was conducted primarily to assess the presence of plague. The Liber Mortuorum of Milan was one of Europe’s first registers with many socio-demographical details. In this work, we consider 1480 to make spatial and temporal analyses of the event of death to find possible explanations about the events’ distribution and the events’ trend over time. The spatial analyses involved Moran’s I, the LISA, and the heatmaps; the temporal analysis applied the Durbin-Watson test. All the analyses were conducted separately on all subjects (1813), children (765), and adults (1046). Contrade (districts) were considered for spatial analysis. Moran’s I and the Durbin Watson test were significant on all subjects and children’s analyses, and the LISA showed the same results for those groups. Children may significantly impact the distribution of death and the trend over time. At least half of the children were 0 years old, and survival in the very first childhood period was closely linked to the family, so that it could be a proxy of the conditions of an area.