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Giovanni Battista Morgagni

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Giovanni Battista Morgagni
Born(1682-02-25)25 February 1682
Forlì
Died6 December 1771(1771-12-06)(aged 89)
Padua
NationalityItalian
Known foranatomical pathology
Scientific career
Fieldsanatomist
Academic advisorsAntonio Maria Valsalva
Notable studentsAntonio Scarpa

Giovanni Battista Morgagni(25 February 1682 – 6 December 1771) was an Italiananatomist,generally regarded as the father of modernanatomical pathology,who taught thousands of medical students from many countries during his 56 years as Professor of Anatomy at theUniversity of Padua.

His most significant literary contribution, the monumental five-volumeOn the Seats and Causes of Disease,embodied a lifetime of experience in anatomical dissection and observation, and established the fundamental principle that most diseases are not vaguely dispersed throughout the body, but originate locally, in specific organs and tissues.

Education

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His parents were in comfortable circumstances, but not of thenobility;it appears from his letters toGiovanni Maria Lancisithat Morgagni had ambitions to improve his rank. It may be inferred that he succeeded from the fact that he is described on a memorial tablet atPaduaasnobilis forolensis,"noble ofForlì",apparently by right of his wife. At the age of sixteen he went toBolognato study philosophy and medicine, and graduated with much praise as adoctorin both faculties three years later, in 1701. He acted asprosectortoAntonio Maria Valsalva(one of the distinguished pupils ofMalpighi), who held the office of demonstrator anatomicus in the Bologna school, and whom he assisted more particularly in preparing his celebrated work on theAnatomy and Diseases of the Ear,published in 1704.[1][2]

Career

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Early career

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Many years after, in 1740, Morgagni edited a collected edition of Valsalva's writings, with important additions to the treatise on the ear, and with a memoir of the author. When Valsalva was transferred toParmaMorgagni succeeded to his anatomical demonstratorship. At this period he enjoyed a high repute in Bologna; he was made president of the Academia Enquietorum when in his twenty-second year, and he is said to have signalized his tenure of the presidential chair by discouraging abstract speculations, and by setting the fashion towards exact anatomical observation and reasoning.[3]

He published the substance of his communications to the academy in 1706 under the title ofAdversaria anatomica,the first of a series by which he became favorably known throughout Europe as an accurate anatomist; the book includedObservations of theLarynx,theLachrymal Apparatus,and thePelvicOrgansin the Female.After a time he gave up his post at Bologna, and occupied himself for the next two or three years at Padua, where he had a friend in Domenico Guglielmini (1655–1710), professor of medicine, but better-known as a writer onphysicsand mathematics, whose works he afterwards edited (1719) with a biography. Guglielmini desired to see him settled as a teacher at Padua, and the unexpected death of Guglielmini himself made the project feasible,Antonio Vallisneri(1661–1730) being transferred to the vacant chair, and Morgagni succeeding to the chair of theoretical medicine. He came to Padua in the spring of 1712, being then in his thirty-first year, and he taught medicine there with the most brilliant success until his death on 6 December 1771.[3]

Middle career

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When he had been three years in Padua, which at the time was part of theRepublic of Venice,an opportunity occurred for his promotion (by theVenetiansenate) to the chair of anatomy. In this prestigious position he became the successor of an illustrious line of scholars, includingVesalius,Gabriele Falloppio,Geronimo Fabrizio,Gasserius, and Adrianus Spigelius, and enjoyed a stipend that was increased from time to time by vote of the senate until it reached twelve hundred goldducats.Shortly after coming to Padua he married a noble lady ofForlì,who bore him three sons and twelve daughters.[3]

Morgagni enjoyed an unequaled popularity among all classes. He was of tall and dignified figure, with blonde hair and lilac eyes, and with a frank and happy expression; his manners were polished, and he was noted for the elegance of hisLatinstyle. He lived in harmony with his colleagues, who are said not even to have envied him his unprecedentedly large stipend; his house and lecture-theatre were frequentedtanquam officina sapientiaeby students of all ages, attracted from all parts of Europe; he enjoyed the friendship and favor of distinguished Venetian senators and ofcardinals;and successive popes conferred honours upon him.[3]

Before he had been long in Padua the students of the German nation, of all the faculties there, elected him their patron, and he advised and assisted them in the purchase of a house to be a German library and club, for all time. He was elected into the imperial Caesareo-Leopoldina Academy in 1708 (originally located at Schweinfurth), and to a higher grade in 1732, into theRoyal Societyin 1724, into theParis Academy of Sciencesin 1731, theSt. Petersburg Academyin 1735, and theBerlin Academy of Sciencesin 1754. Among his more celebrated pupils wereAntonio Scarpa(who died in 1832, connecting the school of Morgagni with the modern era),Domenico Cotugno(1736–1822), andLeopoldo Marco Antonio Caldani(1725–1813), the author of the magnificent atlas of anatomical plates published in 2 volumes at Venice in 1801–1814.[3]

In his earlier years at Padua, Morgagni brought out five more series of theAdversaria anatomica(1717–1719); these his strictly medical publications were few and casual (ongallstones,varices of theVenae cavae,cases of stone, and several memoranda on medico-legal points, drawn up at the request of the curia). Classical scholarship in those years occupied his pen more than anatomical observation.[3]

Late career

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De sedibus,1765

It was not until 1761, when he was in his eightieth year, that he brought out the great work which, once for all, madepathologicalanatomy a science, and diverted the course of medicine into new channels of exactness or precision—theDe Sedibus et causis morborum per anatomen indagatis"Of the seats and causes of diseases investigated through anatomy", in five books printed as twofoliovolumes,[4]which during the succeeding ten years, notwithstanding its bulk, was reprinted several times (thrice in four years) in its original Latin,[3]and was translated into French (1765, republished 1820),[5]English[6](1769), and German languages (1771). In 1769, he gave possibly the first description of what was later namedCrohn's disease.[7]

The only special treatise on pathological anatomy previous to that of Morgagni was the work of Théophile Bonet ofNeuchâtel,Sepulchretum: sive anatomia practica ex cadaveribus morbo denatis,"The Cemetery, or, anatomy practiced from corpses dead of disease", first published (Geneva,2 vols. folio) in 1679, three years before Morgagni was born; it was republished at Geneva (3 vols., folio) in 1700, and again atLeidenin 1709. Although the normal anatomy of the body had been comprehensively, and in some parts exhaustively, written by Vesalius and Fallopius, it had not occurred to any one to examine and describe systematically the anatomy of diseased organs and parts.Harvey,a century after Vesalius, poignantly remarks that there is more to be learned from the dissection of one person who had died oftuberculosisor other chronic malady than from the bodies of ten persons who had been hanged.[3]

Francis Glissonindeed (1597–1677) shows in a passage quoted by Bonet in the preface to theSepulchretum,that he was familiar with the idea, at least, of systematically comparing the state of the organs in a series ofbodies,and of noting those conditions which invariably accompanied a given set of symptoms. The work of Bonet was, however, the first attempt at a system of morbid anatomy, and, although it dwelt mostly upon curiosities and monstrosities, it enjoyed much repute in its day;Hallerspeaks of it as an immortal work, which may in itself serve for a pathological library.[3]

Morgagni, in the preface to his own work, discusses the defects and merits of theSepulchretum:it was largely a compilation of other men's cases, well and ill authenticated; it was prolix, often inaccurate and misleading from ignorance of the normal anatomy, and it was wanting in what would now be called objective impartiality, a quality which was introduced as decisively into morbid anatomy by Morgagni as it had been introduced two centuries earlier into normal human anatomy by Vesalius.[3]

Morgagni has narrated the circumstances under which theDe Sedibustook origin. Having finished his edition of Valsalva in 1740, he was taking a holiday in the country, spending much of his time in the company, of a young friend who was curious in many branches of knowledge. The conversation turned upon theSepulchretumof Bonet, and it was suggested to Morgagni by his dilettante friend that he should put on record his own observations. It was agreed that letters on the anatomy of diseased, organs and parts should be written for the perusal of this favoured youth (whose name is not mentioned); and they were continued from time to time until they numbered seventy. Those seventy letters constitute theDe sedibus et causis morborum,which was given to the world as a systematic treatise in 2 vols., folio (Venice, 1761), twenty years after the task of epistolary instruction was begun.[3]

The letters are arranged in five books, treating of the morbid conditions of the bodya capite ad calcem,and together containing the records of some 646 dissections. Some of these are given at great length, and with a precision of statement and exhaustiveness of detail hardly surpassed in the so-called protocols of the German pathological institutes of the present time; others, again, are fragments brought in to elucidate some question that had arisen. The symptoms during the course of the malady and other antecedent circumstances are always prefixed with more or less fullness, and discussed from the point of view of the conditions found after death. Subjects in all ranks of life, including several cardinals, figure in this remarkable gallery of the dead. Many of the cases are taken from Morgagni's early experiences at Bologna, and from the records of his teachers Valsalva and I.F. Albertini (1662–1738) not elsewhere published. They are selected and arranged with method and purpose, and they are often (and somewhat casually) made the occasion of a long excursus on general pathology and medicine.[3]

Legacy

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During his career as a physician he was careful to take extensive notes on many of his consultations. These writings allow the modern reader to observe his practice and description of the body through his own words. We are further able to examine the progress of Morgagni's study of anatomy as it related to his treatment of patients. We are further able to view a particular perspective of a single physician in the context of the 18th century when he lived in order better understand medical practice during this time period.[8]

The range of Morgagni's scholarship, as evidenced by his references to early andcontemporary literature,was very broad. It has been contended that he was himself not free fromprolixity,the besetting sin of the learned; and certainly the form and arrangement of his treatise are such as to make it difficult to use by subsequent practitioners, notwithstanding that it is well indexed in the original edition, in that of Tissot (3 vols., 4to, Yverdon, 1779), and in more recent editions. It differs from modern treatises insofar as the symptoms determine the order and manner of presenting the anatomical facts.[3]

His 1769 work described thepost mortemfindings of air incerebralcirculationand surmised this was the cause of death. Although Morgagni's cases resulted from gas embolism due to damage to the bowel, the same pathology is seen indecompression illness.[9]

Although Morgagni was the first to understand and to demonstrate the absolute necessity of basingdiagnosis,prognosis,and treatment on an exact and comprehensive knowledge of anatomical conditions, he made no attempt (like that of the Vienna school sixty years later) to exalt pathological anatomy into a science disconnected from clinical medicine and remote from practical experience with thescalpel.His precision, his exhaustiveness, and his freedom from bias are his essentially modern or scientific qualities; his scholarship and high consideration for classical and foreign work, his sense of practical ends (or his common sense), and the breadth of his intellectual horizon prove him to have lived before medical science had become largely technical or mechanical.[10]

His treatise was the commencement of the era of steady, or cumulative progress in pathology and in practical medicine. From that time on, symptoms ceased to be made up into more or less conventional groups, each of which was a disease; on the other hand, they began to be viewed as the cry of the suffering organs, and it became possible to developThomas Sydenham's grand conception of anatural history of diseasein a catholic or scientific spirit.[11]

A biography of Morgagni by Mosca was published at Naples in 1768. His life may also be read inAngelo Fabroni'sVitae illustr. Italor.,and a convenient abridgment of Fabroni's memoir will be found prefixed to Tissot's edition of theDe sedibus,etc. A collected edition of his works was published at Venice in 5 volumes, in 1765.[11]

Eponymous structures

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References

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  1. ^Morgagni GB (October 1903)."Founders of Modern Medicine: Giovanni Battista Morgagni. (1682–1771)".Med Library Hist J.1(4): 270–7.PMC1698114.PMID18340813.
  2. ^Creighton 1911,pp. 831–832.
  3. ^abcdefghijklmCreighton 1911,p. 832.
  4. ^Giambattista Morgagni (1761),De sedibus, et causis morborum per anatomen indagatis libri quinque,Venice: Typographia Remondini,OCLC14313521,OL24732940M
  5. ^Giambattista Morgagni (1820),Recherches anatomiques sur le siege et les causes des maladies,Paris: Chez Caille et Ravier, libraires, rue Pavée Saint-André-des-Arcs, no. 17,OCLC11288084,OL24976694M
  6. ^GB Morgagni (1769),The seats and causes of diseases investigated by anatomy,London: A. Millar; and T. Cadell, his successor [etc.],OCLC14315112,OL24732931M
  7. ^Mulder, Daniel J.; Noble, Angela J.; Justinich, Christopher J.; Duffin, Jacalyn M. (May 2014)."A tale of two diseases: The history of inflammatory bowel disease".Journal of Crohn's and Colitis.8(5): 341–348.doi:10.1016/j.crohns.2013.09.009.PMID24094598.S2CID13714394.
  8. ^Jarcho, Saul(1984).The Clinical Consultations of Giambattista Morgagni(1 ed.). Boston: The Francis A. Countway Library of Medicine.
  9. ^Acott, Chris (1999)."A brief history of diving and decompression illness".South Pacific Underwater Medicine Society Journal.29(2).ISSN0813-1988.OCLC16986801.Archived from the original on 27 June 2008.Retrieved17 April2009.{{cite journal}}:CS1 maint: unfit URL (link)
  10. ^Creighton 1911,pp. 832–833.
  11. ^abCreighton 1911,p. 833.

Sources

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