"KING OF SPAIN PHILIP IV AUTOGRAPH ON VERY LARGE HANDWRITTEN PARCHMENT" 
Appointment of the Neapolitan Doctor Carlo Pignataro as a Protomedic of the Kingdom, Buen Retiro Palace in Madrid, July 1, 1662
Size: 27" x 20.4" (68 cm x 52 cm), Stamp and numerous signatures of  the King's officers and advisors.  
Philip IV (Spanish: Felipe, Portuguese: Filipe; 8 April 1605 – 17 September 1665) was King of Spain and (as Philip III) Portugal. He ascended the thrones in 1621 and reigned in Portugal until 1640. Philip is remembered for his patronage of the arts, including such artists as Diego Velázquez, and his rule over Spain during the Thirty Years' War.
By the time of his death in 1665, the Spanish Empire had reached approximately 12.2 million square kilometres (4.7 million square miles) in area but in other respects was in decline, a process to which Philip contributed with his inability to achieve successful domestic and military reform.
CARLO PIGNATARO, from the City of Noce radelli Pagani, famous doctor, Philosopher, and Lecturer of the primary Practice of Medicine in the public Studies of Naples, from 1660. He was Protomeric del Regno: to the present Vice Chancellor of the College de 'Medici, he will give birth here to first a work in his profession, of great Theoretical, and worthy of his much erudition, and doctrine.
But the most obvious example is that of the traditionalist Carlo Pignataro (+1694). Completely immersed in the Neapolitan medical world, he received his doctorate from the College of Doctors in 1644 (9). Just ten years later, still thirty years old, he was conferred the primary chair of medicine at the Neapolitan office and in 1678 he became vice-chancellor of the college, that is, prior of that part of the college responsible for doctors. When he published the Petitorium, that is the official pharmacopoeia, in 1684, he was also dean of the firm, director of the viceroy's chamber and palatine knight. He was first appointed protomedico by the viceroy Garcia d'Avelaneda y Haro, the count of Castrillo, in 1656, and would eventually receive the post five more times (from 1656 to 1665 and from 1683 to 1689), reaching the longest period of tenure of all the proto-doctors to the Spanish Viceroys section.
"Philippus Dei Gratia Rex Castellae, Aragonum, Legionis, utriusque Siciliae, 
Jerusalem, Portugalliae, Ungariae, Dalmatiae, Croaciae, Navarrae, Granatae, Toleti, Valenciae, Galleciae, Maioricarum, Hispalis, Sardiniae, Cordubae, Corsicae, Murciae, Giennis, Algarbii, Algezirae, 
Gibrallaris, Insularum Canarie nec non Indiarum Orientalium et Occidentalium, Insularum ac Terrae firmae maris Oceani; Archidux Austriae, Dux Burgundiae, Brabantiae, Modiolani, Atenarum, 
et Neopatriae; Comes Habspurgii, Flandriae, Tyrolis, Barcinonae, Rossilionis, et Ceritaniae; Marchio Oristanni, et Goceani.Fidelis nobis Dilecti V.I.D. Carolo Pinataro, Portulano Civitatis nostris Auersa, etusque 
Casaluntatis Aursa omsquc Casalium indussis casalibus Sancti Luliani et Sancti Antimi dicti Citerioris Sicilia Regni..." 
"Philip Grace of God, King of Castille, Aragon, Leon, both of Sicily; Of Jerusalem, of Portugal, Hungary, Dalmatia, Croatia, of Navarre, of Granada, Toledo, Valencia, of Galicia, Majorca, Sevilla, of Sardinia, of Cordova, a, Corsica, of Murcia, Jaen, Algarve, Algeciras, Gibraltar, for the Canary Islands of the East and of the West as well as of the Indies, the Islands of the sea, the ocean, and the earth of a firm; Archduke of Austria, Duke of Burgundy, Brabant, Modiolani, Atene, and Neopatria; The count Habsburg, of Flanders, of Tyrol, on, Barcelona, Roussillon, and Cardinia; Marquis Oristano and Goceano. Dear faithful to us V.I.D. Carlos Pinataro, Portulano our towns Auersa, erusque Casaluntatis Aursa omsquc Casale indusse casalibus St. Julian and St. antimi said Citerioris Sicily Kingdom..."