Silvio Berlusconi's personal doctor put off a decision on when Italy's prime minister should be released from hospital, saying the 73-year-old's injuries were worse than initially announced.

Dr Alberto Zangrillo said the media tycoon had lost half a litre of blood after being hit in the face with a plaster souvenir during an attack on him at a rally in Milan on Sunday night. Zangrillo said although his patient would not need an operation, it would take the prime minister at least 25 days to recover fully.

"The consequences are more serious than we could say [on Sunday] evening," he said after seeing Berlusconi. "I found him shaken, annoyed – as if woken, really out-of-sorts, from a bad dream."

Italy's billionaire leader suffered a fractured nose and two broken teeth after being hit by a replica of Milan's famously jagged cathedral, the Duomo, which took place as he mingled with the crowd in the city. He was cut under one eye and his top lip was split in two places.

An earlier medical bulletin issued by the San Raffaele hospital in Milan to which he was admitted said he was in "persistent" pain. It said Berlusconi was being given antibiotic and anti-inflammatory drugs. A doctor reported the prime minister was eating only with difficulty.

As Berlusconi began his recovery, there was speculation the attack would complicate Italy's already intensely polarised and febrile politics.

A 42 year-old man, Massimo Tartaglia, was arrested and jailed, accused of premeditated assault. Police said he was found to be carrying a pepper spray.

An electronics technician whose inventions once earned him an interview in Il Giornale, the Berlusconi family's newspaper, Tartaglia was reported to have a 10-year history of mental instability. But his assault came against a background of passionate anti-Berlusconi protest.

Zangrillo said that while still bloodied, the prime minister had told him: "There is a climate of hatred. I expected this to happen."

Claiming to be victimised by leftwing prosecutors and judges, he has vowed to overhaul the constitution so as to curb their independence, leading some Italians to believe he threatens the very foundations of their democracy. On 5 December, an estimated 250,000 flocked to a "No Berlusconi Day" in Rome. In the hours following Sunday's attack, several tens of thousands of people signed up to Facebook pages celebrating Tartaglia as a hero.

In a front-page editorial beneath a huge picture of the injured prime minister, Il Giornale said the attack was a first triumph for "an anti-[Berlusconi] hate front".

But Antonio Di Pietro, a former magistrate who once prosecuted the prime minister for alleged corruption and now leads a small, stridently anti-Berlusconi party, said the prime minister had "instigated" the violence by his actions. His words were swiftly disowned by most centre-left politicians, and Pierluigi Bersani, the leader of Italy's biggest opposition group, the Democratic party, visited Berlusconi in hospital.

Professor James Walston, of the American University of Rome, said: "The difficulty for the opposition now will be to separate personal sympathy for someone who has had his faced smashed in from institutional antipathy towards what it is Berlusconi stands for."

He added: "The attack has had an immediate sympathy-generating effect and it could – but this is not yet clear – help his people to bounce legislation through parliament to change the relationship between the judiciary and the executive."

Among other questions still to be answered is whether the legendarily image-conscious Berlusconi, who has had a hair transplant and a facelift, would seek to disguise his injuries or flaunt the scars as evidence of the alleged savagery of his opponents.

Some commentators speculated that Italy was at risk of slipping back into political violence. Professor Walston said: "Unless the social situation, and particularly the job situation, gets worse I don't think we'll be close. But we are getting closer."

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