BAGLIVI, MORGAGNI, SCARPA, SPALLANZANI, TISSOT AND GALVANI; ITALY’S MOST ILLUSTRIOUS PHYSICIANS DURING THE EIGHTEENTH CENTURY

Giorgio Baglivi, the most distinguished Italian physician of the seventeenth century (1669–1707), was probably the first medical author in that country to lay stress upon the importance of studying disease through direct observation rather than from books. In his treatise on the practice of medicine, which was first published in Latin at Rome in 1696 and afterward translated into several modern languages (London, 1704; Paris, 1757), he makes the following remarks:—

There are several obstacles which have hitherto stood in the way of a more general adoption of the maxim that direct observation constitutes the best method of studying disease. They are the following: the widespread contempt for the authority of the physicians of antiquity; the false opinions and prejudices to which men became attached as if they were idols; the habit of making erroneous comparisons and of drawing hasty conclusions, as well as the formulating of analogies that are based upon untrustworthy reports; reading books which have been unwisely chosen or reading without exercising a discerning judgment; incorrect interpretation of the author’s meaning; the craze for reducing everything to a system; and the abandonment, by authors, of the habit of expressing their thoughts in the form of maxims.

Giovanni Battista Morgagni, one of the greatest anatomists of the eighteenth century and the prince of anatomo-pathologists, was born on February 25, 1682, at Forli, an Italian town situated about forty miles southeast of Bologna. The death of his father when the boy was only seven years old made it necessary for his mother to assume entire control of his early education. She performed this duty so faithfully and with such excellent judgment that, by the time Giovanni had attained his fourteenth year, he was so thoroughly familiar with the literature of Italy, and also of European countries generally, that the Academy of Forli unhesitatingly accepted him as a member of that organization. Two years later Giovanni went to Bologna and began the study of medicine under the guidance of such distinguished teachers as Hyppolyte Albertini and Antonius Valsalva; and three years later (in 1701) he was given the degree of Doctor of Medicine.

Morgagni’s biographers say little or nothing about his personal traits of character and about the manner in which he spent the larger part of his time during the early years of his professional career. His published writings, however, make it perfectly clear that almost from the very first his chief interest was centred in the study of anatomy as revealed to him by dissections of the dead human body; and, as the years rolled past, he evidently grew more and more strongly interested in the changes which take place in the organs and tissues of the body as the result of accidental injuries and of disease. From these same writings one learns further that he was in the habit of writing down, with the most painstaking minuteness, all the various departures from the normal standard as fast as they revealed themselves to his critical vision. He left no opportunity for the occurrence of errors due to a defect in his memory.

In 1706 he published a treatise bearing the title “Adversaria Anatomica.” It was this work which first laid the foundation of his reputation. In 1716 he was given the Chair of Anatomy at the University of Padua, and he continued to hold this position up to the time of his death in 1771.

Relatively late in life—that is, in 1767—he published his treatise “De Sedibus et Causis Morborum” (on the seats and causes of different diseases). This work, says Rokitansky, stands for all time, notwithstanding its defects, as a monument in honor of its author, by reason of the great industry and perseverance which it displays, and because of its wealth of detail, orderliness of arrangement, acuteness of reasoning, and excellence in the choice of methods,—in short, because of its originality. ThÉophile Bonnet’s great work on the same subject (“Sepulchretum”) was published in 1700, but, like its successor, its usefulness to-day is limited, at least in large measure, to that of a huge museum of pathological specimens. Rokitansky, of Vienna, was in reality the first anatomist who appreciated at its full value the fact that these lifeless specimens furnish most useful lessons in the theory and practice of medicine.

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Lazarus Spallanzani was born in 1729 at Scandiano, a small town in the northeastern corner of the Apennines, about fourteen miles from Modena, Italy. At the age of fifteen he began to study physics, mathematics and philosophy at the University of Bologna, under the guidance of his relative, Laura Bassi, one of the most distinguished members of the Faculty of the Bologna Institute of Science. At the same time he cultivated a knowledge of Greek, Latin and French, as well as of his native language. As his father was anxious to have him do so, he also studied jurisprudence for a certain length of time, but he abandoned this study when his father, who had been persuaded by Antonio Vallisnieri, Professor of Natural History at the University of Padua, that the lad was much better fitted to follow the career of a biologist than that of a jurist, gave his son full permission to adopt whatever line of studies best suited his tastes and inclination. Accordingly, from this time forward Spallanzani devoted himself with increased zest to the study of mathematics and the dead and living languages.

In 1754 the University of Reggio—a town which is only a few miles distant from Scandiano—elected him to the Chair of Logic, Mathematics and Greek; and this position he continued to hold with credit to himself during the following six years; and during this period he devoted all his leisure hours to the observation of Nature. In this way he was able to make a few discoveries concerning the animalcules that are found in infusions; and it was not long before these discoveries attracted the attention of those distinguished Swiss naturalists—von Haller, of Berne, and Bonnet, of Geneva.

In 1760 Spallanzani was invited to occupy a chair in the University of Modena, and he taught in that institution for a period of eight years. During his term of office at this institution he published two memoirs—one on the animal nature of microscopic animalculi, and a second on the changes effected in the shapes of stones by the action of running water.

In 1767, the Empress Maria Theresa decided to render the University of Pavia more effective as a scientific institute, and with this purpose in view she established certain new professorships, and among the number one on natural history. As the first incumbent of this new chair she called (in 1768) Spallanzani, who by this time had acquired a great reputation in the scientific world as a biologist. His extensive knowledge in a variety of departments was associated with a remarkable genius; his methods were simple and easily understood, and—to speak figuratively—he took his auditors by the hand and led them to a clear understanding of the truth, or to the point where they could appreciate that the truth was not far distant and was certainly attainable in the near future. He possessed the art of interpreting Nature by her own methods, and by this art he was able to render wonderfully clear all the subjects with which he dealt in his lectures. All those who heard him speak gave him credit for being at times positively eloquent.

Lack of space will not permit me to furnish more than a few details of the original investigations which he made at this period of his career. Although at first glance it may be thought that Spallanzani’s work had very little to do with the science of medicine, on closer examination it will be seen that a study of the vital processes in the lower forms of life (which was Spallanzani’s chief occupation) are largely the same as those which characterize the higher forms, and therefore—since great difficulties attend the study of the same processes in man—it is of the very greatest importance that the search for light on this subject should be conducted on the lower organisms, even on the minute organisms which are found in stagnant water. Spallanzani was therefore engaged, in a very direct manner, in laying the foundations of the true science of medicine. Von Haller, the great Swiss pioneer in biology, was fully aware of this fact when he dedicated the fourth volume of his “Elementa Physiologiae”

To that most illustrious man, Lazarus Spallanzani, to whom credit is due for the fact that, although he had already explored the most minute and inaccessible of Nature’s pathways, he still sought to learn whether the existing limits of our knowledge of the truth might not be extended.^[13]

In 1780, during his residence at Pavia, Spallanzani published two new volumes containing memoirs on vegetable and animal physiology. In one of these he discusses with great thoroughness the subject of digestion, and describes the difficult experiments which he made, largely upon birds, in order to ascertain the nature of this process. In this manner he ascertained that, in a very large number of animals (insects excepted), digestion is effected by a juice or fluid which dissolves the alimentary substances that have been introduced into the stomach. “One is filled with admiration,”—says his biographer and friend, Jean Senebier, of Geneva, Switzerland,—“as one peruses Spallanzani’s account of this series of experiments, and notices with what scrupulous care he formulates the conclusions which he draws from them with regard to the causes of the phenomena observed.” And yet, in 1786, John Hunter, the distinguished English anatomist and biologist, published a memoir (“Observations on Certain Points of the Animal Economy”) in which he dissents—somewhat sharply, says Senebier—from these conclusions. In 1788 Spallanzani published his reply to the observations made by Hunter and in this he points out, “with a logic so clear and convincing that it permits of no reply,” the errors of the English physiologist’s criticism.

In several other published memoirs Spallanzani deals with the problems of generation, the circulation of the blood, the respiration, etc.

To this very brief and imperfect sketch of one of the greatest biologists of the eighteenth century, I will simply add the statement: His death occurred, after a brief illness, February 11, 1799. In the parish church of Scandiano there has been erected a magnificent mausoleum in honor of Spallanzani.

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Antonio Scarpa (1747–1832), a native of Motta near Treviso, Northern Italy, received his medical education at the University of Padua. He was particularly devoted to the study of anatomy, and, already in the second year of the course, he had made such progress that he was allowed to act as one of the prosectors. Morgagni, who was his teacher, became very much attached to him and did everything in his power to advance Scarpa’s interests. While he was still in the student stage of his career Scarpa went to Bologna and devoted himself for a few months to the cultivation of surgery. On his return to Padua he passed successfully the required examinations and was given the degree of Doctor of Medicine. Not long afterward he was called to fill the Chair of Anatomy and Surgery at the Medical School of Modena. After eight years of service in that institution he resigned and then visited France and England for the purpose of gaining further knowledge in those branches of medicine in which he was specially interested. In 1783 he accepted a call from the University of Pavia to occupy the Chair of Anatomy, and remained undisturbed in this position for twelve years. In the year 1796, however, at the time when Pavia became a part of the newly founded Cisalpine Republic, Scarpa was asked to take the oath of allegiance to the new government, an oath which was required of all the functionaries of the university. Not being willing to do this he was obliged to resign his professorship. In 1805, Napoleon, after being crowned King of Italy at Milan, passed through Pavia on his way back to Paris. On this occasion he asked to have the university professors presented to him, and, failing to find Scarpa among those who attended the reception, he asked what had become of him, for his great reputation as an anatomist was well known to him. Then he learned how Scarpa had been compelled, by reason of his unwillingness to sign the oath, to resign his position in the university. “Well,” replied Napoleon, “what if he did refuse to take the oath, and what have political opinions to do with teaching anatomy? Scarpa confers honor upon the University and upon the country which I now govern, and I wish that he be restored to his former position.” He was accordingly restored to his professorship and during the following seven years—that is, up to 1812—Scarpa continued his work of teaching anatomy and of conducting the surgical clinic. During the later years of his life he was a great sufferer from calculous nephritis and chronic disease of the urinary bladder, and these diseases finally caused his death on October 31, 1832.

Dezeimeris, in his estimate of the part played by Scarpa in advancing the science of medicine, lays particular stress upon the following two things: first, he was very active and persisted in his efforts to impress upon surgeons the importance of considering a knowledge of anatomy as affording the only safe and sure route to progress in the surgical art; and, second, he furnished a number of beautiful examples that showed the necessity of throwing additional light upon the different diseases by the employment of demonstrations in topographical and pathological anatomy.

His more important published works are—aside from the value of the text—chefs-d’oeuvre of iconography. Such, for example, are the following: “De Structura Fenestrae Rotundae Auris etc.,” Modena, 1772; “De Grangliis et Plexubus Nervorum,” Modena, 1779; “Anatomicae Disquisitiones de Auditu et Olfactu,” Pavia, 1789; and “Opuscoli di Chirurgia,” Pavia, 1825–1832, 3 vols.

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Samuel-Auguste-AndrÉ-David Tissot (1728). The Tissots are of Italian origin. Alessandro Tissoni, the youngest son of one of the first families of Spoleto, accompanied Prince Louis on his crusade to the Holy Land in 1147, and, after escaping from the disasters incident to the siege of Damascus, he managed to regain his native land along with the forlorn remnants of Louis’ army. As he had joined the expedition contrary to the wishes of his parents he felt that it would not do for him to return to Spoleto. At first, therefore, he was a homeless wanderer in his own country. Fortunately for him, however, three of his companions in arms bequeathed to him all their property just before they died from their wounds; and consequently one of his first cares, after he returned to Italy, was to gain possession of his legacies. In the case of one of the three men there was a sister living, and so—partly from love and partly in order to escape any unpleasant legal complications—Alessandro married her, and the couple took possession of the deceased brother’s landed property. Some of this property, it so happened, was located in Franche-ComtÉ, near the present city of BesanÇon, and it was while he resided in this part of France (1152) that he changed his name to Tissot, thus putting an end to the possibility that his relatives in Spoleto would ever be able successfully to claim any part of his property. Samuel-AndrÉ’s father, Pierre Tissot, a land surveyor who resided in Grancy, not far from Lausanne, entered his son’s name (May 15, 1741) at the Academy of Geneva, in the department of belles-lettres. In August, 1745, he received the degree of M.A., and on the fourteenth of the following month of September he started on his journey to Montpellier where he was to study medicine. Four years later he passed all his examinations creditably and was given the degree of M.D. He chose Lausanne as his place of residence, and was successful, at the end of one year, in obtaining the position of Physician of the Poor. Early in 1745 he made the acquaintance of Albrecht von Haller, the celebrated physiologist of Berne, and about the same time he became deeply attached to Dr. ThÉodore Tronchin, a native of Geneva, but engaged in active practice at Paris. These two men were the most distinguished Swiss Physicians of that period.

Eynard, Tissot’s biographer, says that up to the end of his life he preferred to carry on his epistolary correspondence in Latin; and yet at the same time he was the author of several medical treatises that were extremely popular. One of them in particular (“L’Avis au Peuple”) passed through many French editions,^[14] and was translated, in the course of the next twenty-five years, into all the leading European languages. Strange as it may appear to us moderns, this book was not written originally for the general public, but only for the peasants of the Canton de Vaud, who were constantly falling victims to charlatans and itinerant quacks; and yet the universities of Goettingen and Giessen recommended the work as proper reading matter for their students. In order to show the high degree of esteem in which Tissot was held by his fellow citizens of Lausanne, the authorities conferred on him the rights and privileges of citizenship “on account of his praiseworthy efforts to improve the condition of its inhabitants”; and as, in the course of time, the limits of the city were extended, the name “Avenue Dr. Tissot” was bestowed on one of its finest residence streets.

In 1765 Stanislas Augustus, King of Poland, invited Tissot to accept the office of First Physician of his Majesty at Warsaw. Although the invitation was couched in the most friendly terms, Tissot was not willing to leave his beloved Lausanne. All sorts of influences were brought into play by the King to make him change his mind, but his resolution remained fixed. In his reply to the letter Tissot said:—

My first reason for declining your highly flattering offer is this: I am very much attached to my father and mother and to my uncle, who have brought me up from infancy with the tenderest care, and who, owing to their advanced age, are likely at any time to need my aid and advice, and who would be heartbroken if I were to go far away from them. My second reason consists in the sentiment that I am not in any way fitted to fill such a position with entire satisfaction to all the interests concerned, for it involves many important duties beside that of watching over your health—as, for example, the superintendence of the different institutions in your kingdom which are devoted to the preservation of the health of your subjects; the duty of reporting to you any evidences of mismanagement that I may discover and the suggestion of such new measures as are likely to remedy any such deficiencies; the promotion of the efficiency of your schools of medicine, surgery, midwifery, pharmacy, etc.; and, last of all, there is the important consideration that my position here in Lausanne is in every respect most satisfactory to me. Why, then, should I abandon these surroundings in which my life is most happy, for a position in which I might easily lose a large part of this happiness?

Notwithstanding Tissot’s decided refusal to accept the flattering offer made by King Stanislas, the latter did not give up all hope of persuading him eventually to accept the position of First Physician. Three times in succession, at short intervals, he sent him a renewal of the invitation, each time adding some fresh inducement in the hope of overcoming Tissot’s objections; and, just as the latter had nearly made up his mind to yield to the King’s urgent request—the death of his much-beloved uncle a few days previously having removed one of the strongest obstacles in the way of his acceptance—the ruling authorities of the Academy of Lausanne notified him that a Chair of Medicine had been created by them and that he had been appointed its first occupant. Stanislas then at last recognized that he must definitely abandon his cherished project, and he accordingly sent a fine portrait of himself to Tissot, with a charming letter in which he said:—

I am truly afflicted by your decision, but I take comfort in the thought that probably my persistent efforts to bring you to Warsaw had something to do with hastening the decision of the Berne authorities to establish the Chair of Medicine at Lausanne for your benefit. I congratulate you on your good fortune and your compatriots on their having had the wisdom to appreciate the value of your services to Switzerland. I pray God, Monsieur Tissot, that He may have you in safe keeping.

Warsaw, March 5, 1765.

Lausanne in 1765, it should here be stated, still recognized the Bernese Government as its overlord. It was only at a somewhat later date that it acquired entire independence.

In closing this brief account of Tissot’s correspondence with the King of Poland, I ought to add that it was largely through the intercession of Albrecht von Haller, the distinguished physiologist and himself a citizen of the Swiss metropolis, that the senators at Berne were induced to found a Chair of Medicine at Lausanne for the express purpose of preventing Tissot from leaving Switzerland. I also should state that Tissot himself was entirely ignorant at the time that von Haller had been instrumental in effecting the establishment of this new professorship at Lausanne.

Here is an anecdote which is told by Lantier in his book “Les Voyageurs en Suisse.” While it relates only indirectly to Tissot it furnishes an amusing illustration of what may easily happen in the experience of any physician who has a large office practice:—

A certain Adolphe D. called at Tissot’s residence and rang the door bell. An elderly female servant, who opened the door, said that her master, the doctor, was not at home. “But,” she added, “if you have come to consult him about some malady, I warn you that you will lose your money and have nothing to show for your trouble. For the past twenty years I have had a pain in my stomach, and the doctor has not been able to cure it.” Tissot, to whom I related the incident, joined me in a hearty laugh over the affair.

In November, 1779, Tissot was urged to visit Paris in company with his adopted son, who was studying medicine. Believing that the young student would be greatly benefited by such a visit to the French capital he at once decided to undertake the trip. But, very soon after his arrival in Paris, he discovered that he was to have no rest so long as he remained there. His celebrity brought him almost at once many people who wished to consult him about their ailments. Often, says his biographer, the Rue des Petits Augustins, where his temporary residence was located, was filled with a long line of carriages belonging to the distinguished patients who awaited their turn to interview the great physician from Lausanne. This sort of medical practice was not at all to his taste; and when he was not busy with professional work he was attending an endless series of dinners and receptions. At the end of a few months he returned to Lausanne, and would have been well pleased to remain there permanently; but he soon recognized that, in the interest of his adopted son, he should take up his residence in some German or Italian city where there was a university. Just at this juncture of affairs Borsieri, the distinguished Professor of the Theory and Practice of Medicine at the University of Pavia, Tuscany, a man well advanced in years, sent in his resignation. Whereupon Joseph II., Holy Roman Emperor and King of Austria, immediately urged his brother Leopold II., Duke of Tuscany, to offer the position to Dr. Tissot. The latter took the invitation seriously under consideration and in due course of time accepted. His honorarium was fixed at 3000 German florins (about $1500 U. S. currency) and in addition he was accorded various important privileges—such, for example, as a suitably furnished residence; a ward equipped with six beds and arranged in such a manner that clinical instruction might be conveniently given in it; and the right to carry on private practice in the district of Milan and also outside the limits of that district whenever this could be done without interfering with his duties at the university. Further, he was permitted to resign his chair at the end of two years if he should so desire. Finally, he was reimbursed for all his traveling expenses, and was absolved from attendance upon any functions or ceremonies that might conflict with his conscientious scruples as a Protestant. For a Government that was strictly under the control of the Roman Catholic Church these terms were remarkably liberal.

Tissot appears to have been very successful, both as a teacher and in his social relations with the people whom he met during his short stay of two years at Pavia. In a letter which Spallanzani wrote on December 31, 1781, to Charles Bonnet, the distinguished naturalist of Geneva, he speaks of Tissot’s arrival at Pavia in the following terms:—

He seems to be pleased with our university, with our colleagues, and with our students. Everybody in Pavia likes him. His lectures are most instructive and well adapted to the character of our young men who have come hither from every part of Italy to profit from the teaching of this Swiss Hippocrates. Apart from the knowledge which he possesses, and which certainly is very extensive, Monsieur Tissot is the most polished, the most amiable man I have ever met.

It would be a pleasure to furnish here a rÉsumÉ of the detailed account which Tissot’s biographer gives of his lectures and of his most practical clinical instruction, but I perceive that I have already drawn out my sketch to an inordinate length, and I must therefore stop at this point. I will simply add one more item of information. Early in 1783 Tissot publicly announced his intention of resigning his professorship at the end of the period of service that had originally been agreed upon—viz., two years; and on June 12 of the same year, at which date the academic year ended, he delivered his farewell address to the students of the university. To perpetuate the memory of this occasion those students who were permanent residents of Pavia set up in one of the lecture rooms a suitably inscribed marble tablet; those who came from other parts of Europe (72 in all) prepared their memorial in the form of a small printed volume (104 pages) of sonnets written in Latin, Greek, Italian, German, French and English, and grouped together under the title:—

Sentimenti d’Affetto e di Riconoscenza Degli Studenti di medicina Verso il Loro Immortale Precettore, il Signor S. A. D. Tissot.

On the 21st of June, 1783, in company with his nephew, Tissot left Pavia for Switzerland by way of the Simplon Pass.

Already in 1794 his health began to show unmistakable signs of breaking down under the influence of a progressive pulmonary tuberculosis, and it was not long afterward that his death occurred (June 13, 1797) at his residence in Lausanne.

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Aloysius Galvani, born at Bologna, Italy, on September 9, 1759, and appointed public lecturer in anatomy at the university in 1762, published in 1791 a treatise in which he announced his discovery of a new force to which he gave the name of animal electricity, but which subsequently received that of “galvanism” in honor of its discoverer,—a name which it has retained ever since. By a mere accident Galvani discovered the fact that when two different metals—iron and copper, for example—are brought in contact with muscular tissue there results from this contact a force, seemingly an electric current, which causes the muscle to contract. Six years later—that is, in 1797—the Cisalpine Republic was formed by the joining together of what were known as the Cispadane and the Transpadane Republics—two political organizations that occupied respectively, as their names imply, territories situated the one on the north side and the other on the south side of the river Po, and both of which organizations owed their existence to the action of Napoleon Bonaparte. When the professors of the University of Bologna, which was located in the Transpadane territory, were called upon to swear allegiance to the new republic, Galvani was the only member of the Faculty who refused to take the oath, and as a consequence he lost his professorship. His death occurred in 1798.