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The biggest accomplishments of the Medici were in the sponsorship of art and architecture, mainly early and High Renaissance art and architecture. The Medici were responsible for the majority of Florentine art during their reign. Their money was significant because during this period, artists generally only made their works when they received commissions in advance. Giovanni di Bicci de' Medici, the first patron of the arts in the family, aided Masaccio and commissioned Brunelleschi for the reconstruction of the Basilica of San Lorenzo, Florence in 1419. Cosimo the Elder's notable artistic associates were Donatello and Fra Angelico. The most significant addition to the list over the years was Michelangelo Buonarroti (1475-1564), who produced work for a number of Medici, beginning with Lorenzo the Magnificent, who was said to be extremely fond of the young Michelangelo, inviting him to study the family collection of antique sculpture. Lorenzo also served as patron to Leonardo da Vinci (1452-1519) for seven years. Indeed Lorenzo was an artist in his own right, and author of poetry and song; his support of the arts and letters is seen as a high point in Medici patronage.
Although none of the Medici themselves were scientists, the family is well known to have been the patrons of the famous Galileo Galilei, who tutored multiple generations of Medici children, and was an important figurehead for his patron's quest for power. Galileo's patronage was eventually abandoned by Ferdinando II, when the Inquisition accused Galileo of heresy. However, the Medici family did afford the scientist a safe haven for many years. Galileo named the four largest moons of Jupiter after four Medici children he tutored, although the names Galileo used are not the names currently used.
Lorenzo de' Medici "the Magnificent" (1449-1492), was more capable of leading and ruling a city; however, he neglected the family banking business, leading to its ultimate ruin. To ensure the continuance of his family's success, Lorenzo planned his children's future careers for them. He groomed the headstrong Piero II to follow as his successor in civil leadership; Giovanni (future Pope Leo X) was placed in the church at an early age; and his daughter Maddalena was provided with a sumptuous dowry when she made the politically advantageous marriage to a son of Pope Innocent VIII. When Giuliano, Lorenzo's brother, was assassinated in church on Easter Sunday (1478), Lorenzo adopted his illegitimate son, Giulio de' Medici (1478-1535), the future Clement VII. Unfortunately, all Lorenzo's careful planning fell apart to some degree under the incompetent Piero II, who took over as the head of Florence after his father Lorenzo's death.
The Medici Bank (1397–1494) was the largest and most respected bank in Europe during the 15th century. There are some estimates that the Medici family was for a period of time the wealthiest family in Europe. Estimating their wealth in today's money is difficult and imprecise, considering that they owned priceless art, land, gold and much more.
With this monetary wealth, the family acquired political power initially in Florence, and later in the wider spheres of Italy and Europe.
A notable contribution to the profession of accounting was the improvement of the general ledger system through the development of the double entry system of tracking credits and debits.
Giovanni di Bicci de' Medici was the first Medici to enter banking on his own, and while he became influential in Florentine government, it was not until his son Cosimo the Elder took over that in 1434 as gran maestro that the Medici became unofficial head of state of the Florentine republic.
An early sign of the decline was the near-failure of the Lyons branch because of its manager's venality, saved only by heroic efforts by Francesco Sassetti (9 March 1421-April 1490); its troubles were followed by the troubled London branch, which got into trouble for much the same reason the Bruges branch would, which was unwisely loaning to secular rulers (a class notorious for their delinquencies) - in this case, Edward IV the Yorkist usurper; though in a sense that branch had no choice but to make the loans, since he faced domestic opposition from merchant and clothier interests in London and also from their representatives in Parliament, was only granting the necessary export licenses if well-bribed with loans.