Chapter 2 Bolognese Works on Anatomy

An organized Medical Faculty existed at Bologna at least as early as 1156,152 though the first record of dissection there is of considerably later date. In February 1302 a certain Azzolino died under suspicious circumstances. Poison was suspected, an inquest was held and a post-?mortem examination ordered.

The investigation was conducted by two physicians and three surgeons, who unanimously agreed 'that the said Azzolino assuredly met his death by no poison, but on the contrary, we assert that the quantity of blood collected in the great vein known as the vena chilis [vena cava]153 and in the veins of the liver adjacent thereunto, has prevented the due movement of the spiritus throughout the body, and has thus produced the diminution or rather extinction of the innate heat and thereby induced a rapid post-?mortem discoloration. Of this condition we have assured ourselves by the evidence of our own senses and by the anatomization of the parts.'154

The first anatomical document emanating from the University of Bologna is, however, of still earlier date, and is the work of William of Saliceto (1210?–80). This writer was educated at Bologna, and it is claimed that he was the first to dissect the human body there.155 His Cyrurgia, which was completed in 1275 (editio princeps, Piacenza, 1476), is divided into five books, of which the fourth and shortest is devoted to anatomy. Its descriptions are brief and concise. They are often clearly the result of actual observation, and they show hardly any trace of the absurd and irritating teleology that the influence of the Arabians and of Galen made customary in early anatomical literature. The anatomy of Saliceto appears to us very sensible and so far as it goes practical. It betrays the method rather of the Salernitan than of the Arabian anatomical writings, and is on the whole the best European work of the kind before the Renaissance. It was, however, soon replaced by the text-book of Mondino di Luzzi (1285–1327),156 which, though inferior to that of Saliceto, held the field until the subject was revolutionized by Vesalius.

Plate XXXIII.?The FIVE-FIGURE SERIES BODLEIAN MS. ASHMOLE 399,

about 1292 Fos. 18 r–22 r VEINS, &c.????ARTERIES???????NERVES????????BONES??????MUSCLES

From the DRESDEN GALEN MS. Plate XXXIV.?DEMONSTRATIONS OF ANATOMY

Second half of XVth Century

Mondino was professor at Bologna till his death in 1327. His work, easily accessible in one of its many editions, 'is corrupted by the barbarous leaven of the Arabian schools, and his Latin defaced by the exotic nomenclature of Avicenna and Rhazes'.157 But it is not the language alone that has suffered. The schoolman's attitude, well fitted for the classification of ideas, is an ill instrument for the investigation of Nature, and in the scholastic Mondino the very basis of scientific judgement is undermined, so that he readily accepts the views of the ancients against what must often have been the evidence of his own senses. The work, however useful to the contemporary student, was thus essentially reactionary as against the efforts of the earlier Salernitan anatomists and of William of Saliceto. This is the more remarkable because it is quite clear that he was accustomed to demonstrate on the actual body-a privilege denied to the early Salernitan school,-and he was, moreover, a popular and successful teacher. His work is a manual of dissection rather than a treatise on anatomy. This, added to its conciseness and brevity, strengthened its appeal to the 'practical' man-an epithet claimed then, as now, by the majority of stupid and unpractical people. The personal influence and enthusiasm of its author no doubt helped also towards the phenomenal success of this work, which for two hundred years held a position without rival as the text-book of the medical schools of Italy, where even as late as the sixteenth century Mondino 'was still worshipped by all the students as a very god'.158

Mondino was succeeded in the chair of Surgery at Bologna by his pupil, the Lombard Bertuccio, who died in the Black Death of 1347. Bertuccio's surviving work is unnoteworthy, but he was the anatomical teacher of Guy de Chauliac, whose Surgery159 is of great value and was very influential in standardizing practice, especially in the north and west of Europe. Nevertheless it appears to us that the anatomical section is the weakest part of Guy's great work. The teleology that is a blot in Mondino has here become a perfect plague, and Guy's anatomy consists of one-?third description and two-?thirds wearisomely reiterated reasons for the existence of imperfectly described structures. Through Guy de Chauliac the anatomical tradition of Mondino passed over into the University of Montpellier.

A later fourteenth-?century Bolognese writer was Tommaso di Garbo (died 1370), who did little but comment on Avicenna. A surgeon of the next generation, however, Pietro d'Argellata, deserves to be remembered for his description of the examination of the body of Pope Alexander V, who died suddenly at Bologna on May 4, 1410. His account throws light on the customary procedure and may be rendered here.160

'I ordered the attendants', he says, 'first to cut the abdomen from the pomegranate [i.e. the Adam's apple or laryngeal cartilage161] to the os pectinis [i.e. the symphysis pubis]. Then, so that they should not rupture the intestines, I myself sought the rectum and ligatured it in two places and then cut it between. Next I removed all the intestines as far as the duodenum and dealt with them as with the rectum, and so I had the intestines clean and without fetor. After this I extracted the liver, seizing its ligaments; then the spleen and then the kidneys, and these were all placed together in a jar. I now passed to the spiritual members [i.e. the thorax] and removed lung and heart and all their ligaments. Then I ligatured the meri [the Arabian term for oesophagus] and removed the stomach. When this had been done there were some who wished to remove the tongue but knew not how. I however cut under the chin and extracted the tongue through that hole, together with trachea arteria [trachea] and meri. Then I passed to the arteria adorti [aorta] and vena chilis [vena cava]. Lastly I removed the ligatured remnant of the intestines as far as the anal margin.'

Giovanni da Concoreggio (died 1438), who was lector in Surgery at Bologna in the early part of the fifteenth century, left a few anatomical observations of little note,162 and not very much more can be said for his successors and Manfredi's contemporaries Gabriele Gerbi (de Zerbis, died 1505) and Alessandro Achillini (1463–1512). Gerbi163 does little but repeat in the most verbose fashion the work of Mondino and of Avicenna, some of whose errors, however-e.g. the three ventricles of the heart-he omits. He wrote also an anatomy of the infant, or rather of the foetus,164 and a treatise taken mainly from Avicenna's De generatione embryonis. Like all his work, these are in the full scholastic style of a professor of Logic, a position to which, in fact, he ultimately attained.

Achillini's work165 is but a slight advance on that of Gerbi. It is really little else than a note-book for students, and gives the baldest directions for dissection, accompanied by a few comments taken from Avicenna. Achillini occasionally ventures to criticize Mondino, and his work has at least the advantage of brevity. He has a claim to be remembered in that he was the first to describe the duct of Wharton and is said to have been the first to describe the ear ossicles, malleus and incus. Achillini, like Gerbi, was a windy and very 'scholastic' disputator. He was best known to his contemporaries as a supporter of the philosophy of Averroes. In 1506, when driven from Bologna with the other supporters of Bentivoglio, he became professor of Philosophy at Padua.

Fig. 8.?THE ABDOMINAL MUSCLES

From Berengar of Carpi's Commentary on Mondino, Bologna, 1521.

With Giacomo Berengario da Carpi we come at length to one who definitely advanced the science, and who may be regarded as the first modern anatomist, so far as printed works are concerned. He was professor of Surgery from 1502 to 1527, and during that period published his great anatomical work.166 This volume, though modestly put forward as a commentary on Mondino, is in reality an original contribution of great value. It is the earliest anatomical treatise that can properly be described as having figures illustrating the text (Fig. 8).167 Carpi does not hesitate to criticize the work on which he comments-as for instance when he denies the existence of the 'rete mirabile' below the brain, though descriptions of the 'rete mirabile' had been based on the statement of no less an authority than Galen. Furthermore he was the first to describe the vermiform appendix, and he gave the earliest correct account of several other organs, e.g. the choroid plexus and the olfactory nerves. He was an industrious dissector, and he tells us that he had examined more than a hundred bodies.

With Carpi we close our series of Bolognese anatomists. Into that group we now proceed to fit the writer with whom we are here specially concerned, Hieronymo Manfredi.

From a drawing in the Library, WINDSOR CASTLE Plate XXXV.?VIEW OF THE INTERNAL ORGANS

LEONARDO DA VINCI

From a Drawing in the ASHMOLEAN MUSEUM, OXFORD, attributed to BARTOLOMEO MANFREDI (1574?–1602) Plate XXXVI.?THE TWO FIGURES DISSECTING ARE TRADITIONALLY SAID TO REPRESENT MICHELANGELO AND ANTONIO DELLA TORRE