Diana Bullen Presciutti’s Visual Cultures of Foundling Care in Renaissance Italy is a sharply focused look at the figurative imagery deployed by hospitals caring for orphaned and abandoned children. Hospitals in Renaissance Italy have long been a subject of research: John Henderson’s The Renaissance Hospital: Healing the Body and Healing the Soul (2006) is a recent example of broad treatment, and Il mercante, l’ospedale, i fanciulli: La donazione di Francesco Datini, Santa Maria Nuova e la Fondazione degli Innocenti (eds. Stefano Filipponi, et al., 2010) is an example of specialized institutional studies. Historians have sought to chart the emergence of hospitals in the late medieval city and to understand their evolving social roles. Changing concepts of wealth and poverty, charity, childhood, and the proper role of municipal governments in the provision of care to the sick poor underlie these studies.

Art historians, by contrast, have concentrated on the art and architecture commissioned by hospitals and their patrons, especially monumental works such as Filippo Brunelleschi’s Innocenti Hospital (begun 1419), the Portinari altarpiece for Sant’Egidio by Hugo van der Goes (installed 1483), and Matthias Grünewald’s Isenheim altarpiece (ca. 1515) for the monastery of St. Anthony in Isenheim.

Italian, especially Tuscan, hospitals were the first to embrace a civic role in promoting the health and well-being of the city. Propelled by changing attitudes toward wealth, private patrons founded hospitals to promote their reputations, assure their salvation, and enhance the magnificence of their cities. Lay confraternities, tertiary orders, craft guilds, and communal governments partnered with private citizens to build and manage hospitals. Their support across a broad spectrum of the urban populace reflected widely received ideals of the common good. From ca. 1250 to 1550, the concept of charity evolved from generalized care toward specialized treatment of groups. Hospitals that served specific populations emerged, particularly in the period following the Black Death in 1348.

Their structures were designed to transmit values of harmony and beauty in accordance with the principles of early Renaissance architecture. At the same time, the function of hospitals to promote spiritual and bodily health was furthered by the devotional and didactic imagery that adorned hospital spaces. While the works cited above have been shown to respond to their settings in different ways, Presciutti’s work takes a synthetic view of images created specifically for foundling hospitals. In this she examines not just monumental works by prestigious artists, but also manuscript illuminations, insignia, processional banners, and reliquaries. Adopting the methodology and vocabulary of visual culture studies, she reveals the way in which images shaped and promoted the mission of foundling hospitals. Her work breaks new ground in its comparative approach, which examines hospitals in Florence, Siena, Bologna, and Rome as well as smaller foundations in other cities. Her contention that visual culture fostered “a widespread consensus that infant abandonment (and its corollary, infanticide) was an urgent social ill, that foundling care was a most praiseworthy and virtuous form of charity, and that hospitals for abandoned children were essential features of a well-governed and honorable city” (6) is supported by well-researched chapters that comprise the bulk of the book. Her argument is compelling, although I remain slightly unsatisfied by the impersonal nature of her argument that is perhaps inherent in her method.

Presciutti’s account reaches beyond conventional iconography, borrowing concepts from social science, particularly “frame analysis,” to probe how the problem of infant abandonment was understood by Renaissance audiences. In Presciutti’s view, framing the social problem of infant abandonment was accomplished through images and texts, which in particular presented infanticide as detrimental to the social cohesion of the city. The “infanticide frame” promoted an ideal of the foundling hospital as a safe haven for illegitimate newborns. Other strategies included the co-opted images of the Virgin, especially the Madonna della Misericordia, to serve as emblems of foundling hospitals (the “Virgin as foundling hospital frame”); the “pious child frame” in which the foundling was depicted as an intercessor for the city; the “imperiled newborn frame,” which linked swaddled infants with the “holy innocents” slain at Herod’s order; or the imperiled child saved by Solomon’s wisdom. Similarly, patrons and administrators of foundling hospitals often took their places in hospital imagery, treated to the “surrogate guardian frame” in which they were presented as fathers or protectors. Images of lactating women, especially wet nurses, draw on the iconography of the Madonna Lactans and of the Caritas figure and comprise the “foundling care as breastfeeding frame,” while other images present foundling care more broadly as one of the biblical acts of mercy.

In following chapters, Presciutti analyzes images from particular institutions to describe more precisely how preexisting imagery was adapted and reformulated to communicate meaning and institutional identity. Chapter 3 focuses on the famous insignia of the Innocenti Hospital, the swaddled infant, memorably depicted in Andrea della Robbia’s glazed terra-cotta roundels on the hospital’s loggia. The author traces the evolution of the swaddled infant segno (insignia) from its early appearance on a reliquary box ca. 1451 where the infant is depicted deposited in the pila, the repository for abandoned infants. Connotations of protection and care were attached to the pila thereby transmitting the mission and social value of the Innocenti. By 1487, when the polychromed roundels were inserted into the loggia façade, the imagery had evolved to the standing infant, without the pila; and each infant assumed a different pose, its drapery keyed to varied movement. In this way, the imagery responded to the rich panoply of spiritelli (putti or sprites) that graced contemporary Florentine monuments such as the cantorie (singing galleries) by Donatello and Luca della Robba in the Duomo.

Chapter 4 moves to Rome to consider the extensive cycle in the Ospedale di Santo Spirito, which presents the history of the hospital and its refoundation as part of Pope Sixtus IV’s renovation of the papal city painted by an anonymous artist in ca. 1476–8. In a series of scenes at the beginning of the sequence, birth and infanticide are shown side by side, followed by the depiction of the hospital’s founding by Pope Innocent III upon being shown dead infants retrieved from the Tiber. Innocent is depicted with Solomon-like dignity as he builds the hospital to remedy the pressing social problem, while Sixtus, in the sequence depicting the refounding of the institution, is repeatedly presented as a new Augustus, the legendary builder of ancient Rome. Although Santo Spirito was a large multiservice hospital, the care of foundlings was highlighted in the murals as a device to connect Sixtus’s contemporary building activities with the historical foundation of the hospital and to present Sixtus as a “surrogate guardian” and “Father of the Church.”

Domenico Ghirlandaio’s sumptuous Adoration of the Magi, painted between 1486 and 1489 for the main altar of the Innocenti Hospital’s chapel, is the focus of chapter 5. Part of a campaign by the prior of the hospital and the consuls of the silk guild who administered it to refurbish the hospital chapel, the altarpiece was to be the center of an up-to-date, unified, and beautiful architectural complex that visualized the mission and social prominence of the Innocenti. In Presciutti’s analysis, the imagery of the altarpiece, which combines the scene of the Adoration of the Magi with vignettes of the Massacre of Innocents, kneeling worshipping innocents, and portraits of the artist, prior, and consuls deliberately conflates foundlings with the holy innocents slaughtered by Herod, and the Virgin of the Innocenti as the Virgin of the Holy Innocents. As Presciutti demonstrates, the imagery was unprecedented in Florence, but it was promoted by the gift of relics of the child martyrs to the hospital church at its consecration in 1451. In addition, the selection of the Adoration theme linked the Innocenti with its venerable neighbor, Santa Maria Nuova, whose church of Sant’Egidio was the recent recipient of the monumental Portinari triptych showing the Adoration of the Shepherds. The narrative of the Adoration also recalls the cult of the Magi, especially fostered by the Compagnia dei Magi and associated with the Medici family, and links the consuls of the silk guild with the idea of charitable magnificence. Through deft manipulation in which preexisting images were elided, conflated, co-opted, and reformulated, the altarpiece projects the mission and institutional identity of the Innocenti in resonant and powerful ways.

By the sixteenth century, as revealed in chapter 6, the consensus that promoted foundling care deteriorated in the face of competition from other charitable avenues. The emergence of aristocratic regimes engendered shifts in the visual language by which institutions were branded and promoted.

Visual Cultures of Foundling Care in Renaissance Italy is a significant addition to our understanding of the multivalence of visual language in the Renaissance city, elucidated through focused analyses of images and deep probing of textual sources. The author presents significant insights about works of art both well known and obscure. This reader has been well informed and intrigued, though questions remain: Who was responsible, for example, for the innovations in the Innocenti Adoration—Ghirlandaio, or Prior Tesori, or the anonymous consuls? Perhaps we cannot know.