"VIR INGENII, MEMORIAE, STUDII, INCOMPARABILIS."
--HALLER.
In 1894, when the International Medical Congress met at Rome, Prof.
Virchow of Berlin, the greatest living pathologist at the time, was
asked to deliver the principal address. He chose as his subject John
Baptist Morgagni, the distinguished Italian physician and original
investigator of the eighteenth century, whom he hailed as the Father
of Pathology. No medical scientist of the nineteenth century was in a
better position than Virchow to judge who had been the founder of the
science for which he himself did so much. Virchow besides, through
long and faithful study of the history of medicine, knew well whereof
he spoke. In pathology especially modern medicine has made its sure
advances, so that Morgagni's ground-breaking work may well be
considered the beginning of the most recent epoch in medical science.
As a matter of fact, medicine lost much of its obscurity by losing all
its vagueness when Morgagni's methods came into general use.
As a medical student scarcely twenty years of age, he revolutionized
medical observation by studying his fatal cases with a comparative
investigation of their clinical symptoms and the postmortem findings.
This had been done before, but mainly with the idea of finding out the
cause of death and the principal reasons for the illness which {30}
preceded. Morgagni's investigations in pathology consisted in tracing
side by side all the clinical symptoms to their causes as far as that
might be possible. This looks so simple now as to be quite obvious, as
all great discoveries are both simple and obvious once they have been
made; but it takes a genius to make them, since their very nearness
causes them to be overlooked by the ordinary observer so prone to seek
something strange and different from the common.
How much Morgagni's studies from this new viewpoint of the
investigation of all the symptoms of disease has meant for modern
medicine, may be best appreciated by a quotation from an address
delivered before the Glasgow Pathological and Clinical Society in
1864, by Professor Gairdner, who thus tersely describes the character
of the distinguished Italian pathologist's work:
"In investigating the seats of disease, Morgagni is not content to
record the coincidence of a lesion in an organ with the symptoms
apparently due to disordered function in that organ.
"For the first time almost in medical inquiry, he insists on
examining every organ, as well as the one suspected to be chiefly
implicated; not only so, he marshals with the utmost care, from his
own experience and that of his predecessors, all the instances in
which the symptoms have existed apart from the lesion, or the lesion
apart from the symptoms. He discusses each of these incidents with
severe exactness in the interest of truth, and only after an
exhaustive investigation will he allow the inference either that the
organ referred to is or is not the seat of the disease.
"And in like manner in dealing with causes: a group of symptoms may
be caused by certain organic changes--it may be even probable that
it is so--but, according to Morgagni's method, we must first inquire
into all the lesions of {31} organs which occur in connection with
such symptoms; in the second place, we must know if such lesions
ever occur without the symptoms; and again if such symptoms can be
attributed in any cases to other causes in the absence of such
lesions."
During over sixty years of a long life Morgagni continued to follow
out the idea that he had developed as a boy, and his works contain the
first definite account of pathological lesions and clinical
manifestations that attracted attention.
As a proof of the striking difference between the value of observation
and theory in medicine, it may be said that many hundreds of volumes
containing the most elaborate medical theories were published during
the eighteenth century, and that practically none of these is ever
read now, except for curiosity's sake by some seeker after the quaint
and distant in medicine, while Morgagni's books still contain a
precious fund of information, to which pathologists at least, and not
a few clinicians, turn often with interest and come away always with
profit. They are not infrequently quoted from, and, as we shall see,
have been highly appreciated by some of the best medical authorities
of the present and the immediately preceding generations.
To the modern thinker, accustomed to look rather to the northern
nations or to France for great advances in science, it may prove
somewhat of a surprise to have an Italian thus put forward as the
founder of modern medicine, and especially of the most scientific
department of it. Those who are familiar with the history of medicine
since the revival of civilization after the Dark Ages will realize
what a prominent place Italy has always held in the development of
medical science. The first great Christian medical school was founded
at Salerno, not far from Naples, in the tenth century. The first
regular practical teaching of anatomy by means of {32} dissections of
human bodies and demonstrations on the cadaver was done at Bologna by
Mondino at the beginning of the fourteenth century. The great Father
of Modern Anatomy, Vesalius, was a Belgian, but he did all the work
for his epoch-making book, the _De Fabrica Humani Corporis_, at the
Universities of North Italy, especially at Padua, Bologna and Pisa,
during the first half of the sixteenth century. Every student of
medicine in those times who was desirous to secure wider opportunities
for medical education went down into Italy, and on the rosters of the
Italian medical schools of the sixteenth century are to be found the
names of most of the men who in all the countries of Europe became
famous for their medical attainments.
Morgagni only forms a final link in the chain of great Italian medical
scientists, connecting medieval with modern medicine. From the time of
Vesalius to that of Morgagni there was never a period when Italy did
not possess the leading medical investigator of Europe. We need only
mention such names as those of Fallopius, who added so much to our
knowledge of abdominal anatomy; Eustachius, to whom we owe many
important details of the anatomy of the head; Spigelius, whose name is
forever associated with the liver, and Malpighi, to whom the whole
round of the biological sciences allied most closely to medicine owes
more than perhaps to any other single investigator, to show the
complete justification for this claim. As a matter of fact, every
encouragement to the progress of medicine was extended both by the
secular and the ecclesiastical authorities in Italy during these
centuries, and the Italian peninsula was from the beginning of the
sixteenth to the end of the eighteenth centuries the mecca for ardent
medical students desirous of exhausting the medical knowledge of their
time, quite as Germany has been in our day.
{33}
John Baptist Morgagni was born on February 25, 1682. His birthplace
was Forli in Romagna. It was the capital of a little papal state,
lying at the foot of the Apennines to the southeast of Bologna. The
modern American traveler is likely to know something about it, because
it is one of the principal stopping places on the road from Bologna to
Rimini, for at least the feminine portion of any travelling party will
want to make a pilgrimage to the home of Dante's poor Francesca and to
the scene of the heroic exploits of Catarina Sforza, the great woman
of the Renaissance, to whom in all honor, and without any tinge of the
discredit it has since come to convey, was given the proud title of
the Virago of Forli. The little town is noted for the beauty of its
situation, and well deserves a visit for itself, for it contains a
famous palace built after designs made by Michael Angelo. The town had
decreased in importance and population at the end of the seventeenth
century, when Morgagni was born there, but it was favorably known for
the high standard of cultivation among its inhabitants, possessed a
good library, a number of schools and a well-known college.
Like many another great man, Morgagni seems to have been especially
fortunate in his mother. He was left an orphan at a very early age.
His mother, however, whose maiden name was Maria Tornieli, not only
bore her loss bravely, but devoted her life and talents to the
education of her gifted son. She seems to have been a woman of
uncommon good sense and remarkable understanding. Morgagni often spoke
of her during the course of his life, and attributed much of his
success to the training he had received from her. It is the custom
sometimes to think that women have come to exert great cultural
influence only in these latter days. Nothing could be more untrue. All
through history are abundant traces of women exerting the {34} highest
intellectual influences in their own sphere, and the North Italians in
their era of highest cultural development seem to have been happier in
nothing more than their recognition of the possibilities that lay in
providing educational facilities for women.
These times and this part of Italy are famous in history for some of
the opportunities afforded women in the matter of higher education. It
has been suggested that it is perhaps to the liberal culture of the
mothers we owe the fact that this part of Italy furnished for one
hundred and fifty years about this time the greatest men in science of
the time. It is well known that women occasionally held professorships
at the University of Bologna, not far from Morgagni's birthplace. The
general culture of the women of this section was very high. Modern
masculine historians have even been ungenerous enough to point out
that Bologna was famous for two things--the opportunities provided for
the higher education of women and the extensive manufacture of various
forms of prepared food, the best known of which, the classical Bologna
sausage, has come down as a precious heritage to hurried housekeepers
in our own time.
After an excellent preliminary education at Forli, always under the
careful supervision and enlightened encouragement of his mother,
Morgagni, as might have been expected from the place of his birth,
went to the neighboring university town of Bologna for his higher
studies. Bologna was at this time at the very acme of its reputation
as the greatest of existent medical schools. The science of anatomy
had been especially developed here as the result of important
investigations and discoveries made by some of the greatest men in the
history of medical science. Mondino had, very early in the fourteenth
century, recreated the modern science of anatomy as we know it. He was
the first to realize the importance {35} and urge the necessity for
the dissection of human bodies, if any real lasting progress in human
anatomy was to be made. Medical teaching before this time had been
largely by lectures and disputations upon the work of Aristotle,
Hippocrates and Galen, but actual observation on human tissues and
organs now replaced the older method. Bologna became a papal city in
1512, and it is especially after this date that, under the fostering
care of the Popes, the University of Bologna became the centre of
medical teaching for the whole world for several centuries.
As the result of actual observation and patient study instead of idle
theorizing there came a large number of great discoveries in anatomy.
From Mondino to Morgagni there is a continuous series of great men in
connection with the University of Bologna such as no other institution
can show. About midway between the first and last came the great
Vesalius, who taught at Bologna as well as at Padua and Pisa, and
whose work on anatomy was to be a treasure for anatomists of all
countries for many generations. It was while teaching at Bologna that
Vesalius made the famous series of dissections which formed the
subjects of the illustrations for his great work on anatomy. Titian,
the celebrated Venetian artist, who had come down from Venice in order
to study anatomy for artistic purposes at the famous school of anatomy
and under the supervision of its great teachers, is said to have
executed the plates for the book. The work remains a worthy monument
of the two great masters in their respective professions whose
collaboration created it.
During the century before Morgagni's entrance into the University of
Bologna, the distinguished English physician Harvey, who was to lay
the foundation of modern physiology by the discovery of the
circulation of the blood, was attracted to Bologna because of the
opportunities it presented for {36} advanced work in the studies in
which he was so much interested. While repeating some of the
dissecting work that Vesalius had done Harvey was led to suspect the
existence of the circulation and had his thoughts directed in the
channel which finally led to his masterly exposition of the subject.
In a word, here at Bologna the study of the physical side of life, so
important a characteristic of latter-day science, became a distinct
and recognized branch of science. As Professor Benjamin Ward
Richardson said, in his sketch of the life of Morgagni, "Since that
time there has been no decline in interest in these studies and
medicine has been developed in a manner as daring in project as it has
been useful in application."
Bologna was, at the time, certainly an excellent place for Morgagni.
He went there as an inquiring youth of fifteen and began his medical
studies at once. He became a student of two of the most celebrated
professors of the time--Albertini, a leader in his day, though since
more or less forgotten, and Valsalva, whose investigations into the
anatomy of the ear assure him a permanent place in the science of
anatomy for all time. When Morgagni went to the university, Valsalva
was at the zenith of his brilliant career as an anatomist. He was in
the midst of his great work on the organ of hearing. This extremely
intricate piece of human mechanism had never been understood before
his time, and the working out of its details proved a time-taking but
intensely interesting investigation.
It was not long before the genial insight of Valsalva picked out
Morgagni as a person excellently fitted to assist him in his
dissecting work. Morgagni had not only an enthusiasm for the work, but
had, what is much more precious under the circumstances, untiring
patience and industry and unswerving perseverance. These were the
qualities that were {37} afterward to prove the foundation of his
reputation. His genius consisted certainly in the faculty for hard
work, and his special talent was an infinite capacity for taking
pains. Nearly all of the dissections which Valsalva required for his
demonstrations during lecture hours, or for the illustrations of his
books, are said to have been made by Morgagni under the master's
personal supervision.
After four years of this precious training and study at the
university, Morgagni took his degree as Doctor of Medicine and of
Philosophy. The late Benjamin Ward Richardson, one of the great
English medical men of the end of the nineteenth century, says that
this is a happy combination of qualifications which might, with great
advantage, be required of the graduate in the present day, when so
much of medicine and so little of philosophy is demanded of the
student, to the manifest detriment of both departments of knowledge.
Some idea of the estimation in which Morgagni was held at this time
may be gathered from the fact that, though scarcely more than
twenty-one years of age, he was sometimes allowed to assume Valsalva's
lecture obligations during the master's absence. After graduation he
spent some time at the university doing special work in connection
with the science of anatomy, in which he was so much interested, and
as an assistant professor and tutor. Bologna at this time enjoyed as
wide a European reputation as at any period of its history. Students
from all countries in Europe flocked here, especially to make their
legal and medical studies. Among the medical students Morgagni was
always a moving spirit, a leader in the phases of thought in many
lines that were occupying students' minds at the time.
He was the founder and director of a society of young professors and
maturer students, whose object was the discussion of scientific
subjects of many kinds. The standard of the {38} new society was
personal investigation and observation as a means of arriving at
scientific truth. The principal maxim that guided their discussions
seems to have been that nothing was to be accepted on authority,
merely because it was authority. In the physical sciences thought had
been frequently cramped to fit the old theories inherited from Galen
and Pliny and Aristotle and Hippocrates. A quotation from one of these
classic authors on a point at issue was supposed to throw light on any
difficulty that might be the subject of discussion.
Morgagni's society was called the Academia Inquietorum--"The Academy
of the Restless"--the idea of the curious name being that the members
were not satisfied to rest peacefully in the knowledge to be gleaned
from the older authors, but preferred to get at science for themselves
by direct observation and planned experiment. Morgagni's idea in
founding the society seems to have been premature. The fate of the
Academy of the Restless is involved in some obscurity, but biographers
seem to hint that it failed of its purpose. Neither the university nor
the times were yet ready for such freedom of thought as this. Even in
our own day such a scheme would be considered radical and chimerical.
The discouragement met with finally led to the abandonment of the
meetings, and Morgagni gave up his attempt to inspire others with his
own industry and enthusiasm for original investigation in the physical
sciences.
For some years after this he seems to have been absent from Bologna.
His time was spent especially at the medical schools of the great
universities of Pisa and of Padua. Students who wished to make some
special branch of medicine such as physiology, or anatomy, or the,
then as yet scarcely known, science of pathology, their prime object
in life, had to visit various universities in order to find
opportunity and {39} suggestion for study. Morgagni devoted himself so
faithfully to his work that his eyesight failed him for a time and
very probably his general health also. For some years he returned to
his native town to recuperate. Here he took up the active practice of
medicine. As so often happens, this period of rest after years of
study proved especially broadening in its influence upon Morgagni.
After his rest his contemporaries begin to realize his great
possibilities as a scientist.
His first publication was a series of notes on anatomy. These were
published in the form of collected essays, with the title _Adversaria
Anatomica_. The title has a pugnacious sound, but Morgagni did not
indulge in controversy and _adversaria_ is only the Latin name for
note-books. The first articles thus collected were really
communications made by Morgagni to the "Academy of the Restless"
during his presidency of that body. This opened his career as a
writer, and it is interesting to note that his last book was to be
published some sixty-three years later--a period of fecund authorship
almost unprecedented.
As the result of the reputation gained by this work he was offered a
teaching position at the University of Padua and later was transferred
to the chair of the second professorship of anatomy. After a few years
he succeeded to the first professorship of anatomy at the university,
at that time the most important post in the medical school. This gave
him, at the age of about thirty-five, one of the greatest university
professorships in the world. Opportunities for research were now amply
provided. He was in a position where his communications would be
received with due attention and his reputation was secure.
A university professorship in those days was a position of more
importance than even in our own, and Morgagni was {40} especially
favored in the fact that it had come early in life, so as to enable
him to round out his career. His work was eminently congenial to him,
and the labor it involved was that which constituted for Morgagni the
highest form of recreation. He made many friends among professors and
students. The lectures which Morgagni delivered to the university
became so popular that his lecture-room was overcrowded and new
quarters had to be provided. Many foreign students were attracted to
the university by his wide-spread reputation as a great and suggestive
teacher. These students came in great numbers especially from the
northern countries of Europe. At one time there were over a thousand
German students at the University of Padua, and when they organized
into a guild for mutual help and social purposes, Morgagni was chosen
by them to act as their patron.
Here at the University of Padua Morgagni was to found the new science
of pathological anatomy. Normal anatomy had received its development
at the hands of the other great masters in the schools of North Italy.
To Morgagni was to be given to describe the changes which take place
in organs as the result of disease. Needless to say, this is the most
important practical branch of modern medical science. The symptoms of
disease mean very little unless we know just what organs are affected
and what changes have taken place. Morgagni's work on _The Seats and
Causes of Disease_ contains the foundation of modern pathology. Modern
advances might seem to put it out of date, but the acuity of its
author's observations and the truth of his investigations make it an
enduring classic.
Of this work of Morgagni's, Professor Benjamin Ward Richardson, said:
"To this day no medical scholar can help being delighted and
instructed by the study of this wonderful book. To move into it from
the midst of a body {41} of current medical literature, is like
passing from the periodical flux of current general literature to the
perusal of a Shakespearean drama, the _Pilgrim's Progress_, or
_Paradise Lost_. It is a transition from the mediocrity of incessant
repetition of well-known truths told in long and hackneyed terms, back
to descriptions derived direct from nature and fresh from her
treasury. It matters not where the book is opened, it is always good
and instructive reading, full of suggestion and rich in original
narrative."
Some of Morgagni's work in clinical medicine and in pathology, as
detailed in these volumes, remains of perennial interest and is often
referred to. Many an after-time discovery, proclaimed loudly by its
author, will be found, at times only in embryo but often enough in
entirety, in its pages. There are frequent surprises to the reader in
the anticipation of what are supposedly much later thoughts in
medicine. Some of these passages of more general interest I venture to
present here.
It was Morgagni who first realized that minute connections between
parts of the nervous system might very easily provide the basis for
symptoms quite distant from the site of actual disease. He gives, for
instance, a detailed account of a curiously interesting case in which
the patient, a man somewhat beyond middle life, was annoyed on a
number of occasions by violent sneezing. These attacks of sneezing
became more and more frequent and finally were accompanied by
difficulty of breathing and a sense of pressure over the chest. These
symptoms became more and more marked, until finally, during an
especially violent attack of sneezing, the man suddenly died.
Up to this time anatomists generally had declared that there was no
direct nervous connection between the mucous membrane of the nose and
the diaphragm. Sneezing is {42} due to a violent contraction of the
diaphragm and is almost invariably caused by the presence of an
irritant in the nose. This is, in fact, nature's method of getting rid
of irritant material on the sensitive nasal mucous membranes by an
explosive expulsion of air through the nose. This expulsion of air is
brought about by a convulsive contraction of the diaphragm. It had
always been supposed that the sneezing was due to irritation
transmitted through the brain to the diaphragm.
Morgagni, in discussing the reason why the diaphragm should be excited
into sympathetic reaction by the presence of an irritant in the nose,
pointed out a fact that had been forgotten or the significance of
which had not been appreciated. The membrane of the nose concerned in
smell is supplied by the first pair of cranial nerves, the so-called
olfactory nerves. Between this olfactory nerve and the nerve which
supplies the diaphragm, the phrenic nerve, which is a cervical and not
a cranial nerve, that is to say, comes from the central nervous system
through the spinal cord in the neck and not directly from the brain,
the older anatomists declared there was no connection. Morgagni
pointed out that the mucous membrane of the nose is partly supplied
also from the fifth pair of cranial nerves. From the fifth nerve,
small branches of connection with the cervical nerves, as low even as
the intercostal nerves, had been traced by Meckel. This shows the
possibility of a nervous reflex; that is, of a communication of nerve
impulses without the necessity for the intervention of the central
nervous system.
This was the first direct tracing of distant reflex nervous action in
human physiology. The problem of nervous reflexes was to remain
obscure for more than a century later, until light was thrown upon it
by the investigation of the French physiologist, Claude Bernard. Here,
however, was {43} the pregnant suggestion of the explanation of the
seeming mystery. In subsequent cases Morgagni looked for the
confirmation of his theory in this matter and found it. He pointed out
that there was a relationship between the abdominal viscera and the
olfactory mucous membrane of the nose. In one of his cases an
epileptic seizure was always accompanied by a sense of discomfort in
the upper abdominal region and a fetid odor. This odor was entirely
subjective; that is, though extremely annoying to the patient it could
not be noticed by any one else, even though the patient was close at
hand and exhaled his breath at the moment of the observation.
This would seem to point to the fact that Morgagni suspected there
were other connections between the special senses and important organs
besides those which had been discovered by anatomists up to that time.
As a matter of fact the so-called sympathetic nervous system does
place all the organs of special sense in direct connection with the
other important organs of the body. Morgagni's suspicions were to be
confirmed by the discoveries made in this sympathetic system during
the succeeding century.
Morgagni first of all seems to have realized what was the mechanism by
which alcohol injures the human system. He pointed out that the
excitation of the heart due to the action of alcohol was reflected in
an overdistention of the arteries. This overdistention gradually led
to degenerations in the arterial walls. The loss of elasticity thus
induced brought on a disturbance of the circulation in the important
organs of the body, and so gave rise to symptoms of wide-spread
interference with organic functions.
Morgagni's studies in aneurism, that is, in the dilatation of
bloodvessels, show how thoroughly he understood the mechanism of the
formation of this serious pathological {44} condition. He pointed out
that the first noticeable disease change that occurs is a degeneration
of the inner coat of the artery. This leads to the formation of
furrows on the inner wall of the vessels and finally brings on
weakness of the middle coat of the artery. He realized that the
progress of these arterial changes is due to a large extent to blood
pressure within the arteries. He felt, too, that blood pressure could
be kept from being dangerously high by strict attention to diet
limitation. If aneurisms are discovered in early stages the patient's
life may well be prolonged by these simple measures. This idea
contains the germ of the Tufnell treatment, which has been the most
successful therapeutic measure for the treatment of aneurism in the
nineteenth century.
The Italian anatomist's acumen led him to appreciate better than ever
before in medical history the influence of the mind on the
circulation. He pointed out that emotions have a powerful influence on
the circulatory system in all its parts. How much the peripheral
bloodvessels are affected can be seen in the tendency to blushing
during certain forms of excitement, involving shame or embarrassment;
on the contrary, pallor in anger, or indignation, or fright. He
pointed out, too, that the heart is affected by such emotions and is
sometimes strenuously excited and sometimes very much retarded.
Morgagni understood that the influence of such emotions in especially
excitable individuals leads to wear and tear on the bloodvessels and
so to a shortening of lives. He thought of some aneurisms, even those
affecting the large bloodvessels, might be caused by sudden intense
emotions, and especially by violent efforts to suppress or conceal
emotions. We know now, however, that these pathological conditions are
due to human passions, but quite other than those which Morgagni had
in mind.
It is interesting to note that comparative {45} pathology--that is,
the study of the diseases of animals as illustrating corresponding
conditions in human beings--had already attracted the attention of the
Bolognese school of medicine. Albertini, who had been a professor of
Morgagni's, pointed out that aneurisms are rarely found in animals,
because brutes were not subject to emotions as are human beings.
Morgagni made still further observations in this line to confirm his
own conclusions in the matter. For a time in his earlier life he
devoted himself to the study of fishes, because they seemed to promise
to throw light on certain problems in human anatomy and pathology.
How closely he studied pathological changes in tissues can be gathered
from the fact that his observations led him to point out that aneurism
of the aorta occurs most frequently at that part of the curvature of
the aorta against which blood is constantly projected by the heart.
The realization of the importance of this mechanical factor in the
production of aneurism is one of the first successful results of
carefully applied observation and knowledge of physical laws in the
causation of changes in the tissues as opposed to elaborate theories
with very little foundation in fact.
Variations in the pulse attracted his attention, and he was among the
first to point out that the occurrence of flatulency is liable to
cause disturbance of the heart's action and to bring on noticeable
cardiac palpitation in the absence of any organic affection of the
heart itself. Morgagni also pointed out that intermittence of the
pulse may be due to nervous conditions. He showed that severe mental
shock or trying emotions may cause irregularity of the heart's action
and pulse intermittency. Some of his observations in this matter show
an intuition with regard to the nerve supply of the heart that is
quite beyond the anatomy of his time, and seems to indicate that he
suspected the existence and {46} function of the sympathetic system
and also the existence of a special nerve supply to the small
arteries.
Perhaps Morgagni's most penetrating evidence of insight in pathology
and its relations to clinical medicine is with regard to tuberculosis.
Over a century and a half ago he insisted on its contagiousness. He
refused to make autopsies on patients who had died of tuberculosis,
and his position in the matter was undoubtedly of the greatest service
in directing the attention of his contemporaries, and especially those
closely in contact with him, to the important question of intimate
association with tuberculous patients as a potent factor in the
acquirement of the disease, more potent even than heredity which then
occupied all men's minds on this subject.
It might be deemed that this advanced position of Morgagni was due
rather to intuitive abhorrence of the disease than to the conviction
of actual observation, and that his conclusions were the result more
of prejudice than of real knowledge. Any such opinion, however, is
absolutely contradicted by the fact that he knew and understood better
than any one of his generation the pathology of consumption. He
pointed out at a time when any chronic affection of the lungs was
liable to be considered consumption that there are a number of forms
of chronic bronchitis that are not due to pthisis pulmonalis, but to
other slow-running conditions within the lungs.
He anticipated very completely the present position of surgery with
regard to the treatment of cancer. He advised the operative removal of
these malignant tumors whenever possible. As Benjamin Ward Richardson
points out, this advice was given evidently not with the idea that the
disease could be always thus completely cured, but because early
operation gave speediest relief of annoying {47} symptoms and assured
the greatest prolongation of life. Many other methods of removal of
cancerous growths were suggested in Morgagni's time, as in our own,
and many false promises made and false hopes raised by their
advocates. He pointed out that the quickest, the safest, the surest
and in the end, for the patient, the easiest method of removal is by
the knife in the hands of the bold and skilful surgeon. After a
century and a half of vauntedly great advance, especially in surgery,
we are practically in the same position as when Morgagni's advice was
penned, and his opinion remains practically as valuable to-day as
then.
In another important point of medicine Morgagni seems to have
anticipated the opinion of our own time. It was the custom to practise
venesection very freely. On one or two occasions in his own lifetime
Morgagni fell ill and venesection was recommended. His biographer says
that he constantly refused this method of treatment, adding very
naively, "and he who had often cured others by venesection would never
allow this remedy to be used upon himself because, as I believe, he
had a natural abhorrence to it."
It was an index of thoroughgoing independence of thought in those days
to stand out, even for personal reasons, against the overwhelming
tradition in favor of blood-letting. But Morgagni had well-grounded
doubts as to the remedial efficacy of abstraction of blood, and at
least avoided it in his own case.
Besides his skill in practical and theoretic medicine, Morgagni was a
man of cultivated taste in art, and he was conversant not only with
the literature of his own language, but also of French, Latin and
Greek. He was always welcomed in the literary circles of the cities of
Northern Italy, and counted among his friends many of the great
writers of the time. His success in winning the friendship of rulers
was especially {48} noteworthy, and had not a little influence for the
advantage of education and science. The patricians of Venice were
proud to consider him as a personal friend, and to the Venetian Senate
he owed his professorship at Padua. The King of Sardinia, Emanuel III,
looked upon him as an intimate acquaintance. All the Popes, five in
number, of the second half of his life were on terms of personal
intimacy with him, and his advice was asked on many important
questions with regard to educational matters in his own day.
Some of these Popes are among the most influential pontiffs that ever
occupied the Roman See. The great Benedict XIV, himself a native of
Bologna and an intimate friend of the scientist, in his classic work
"De Beatificatione Servorum Dei" mentions Morgagni in terms of special
commendation. His scarcely less famous successor, Clement XIII, had
often consulted Morgagni professionally at Padua before his elevation
to the See of Rome. After his election as Pope he assures Morgagni of
his continued esteem and friendship, and asks him to consider the
Vatican always open to him on his visits to Rome. In an extant letter
Clement praises his wisdom, his culture, his courtesy, his charity to
God and men, and holds him up as an example to others, since with all
his good qualities he had not aroused the enmity or envy of those
around him.
Morgagni's life must have been in many ways ideally happy. Rewards for
his scientific success began early in life, even before his
professorship, and continued all during his long career. The Royal
Society of England elected him a fellow in 1724; the Academy of
Sciences of Paris made him a member in 1731. In 1735 the Imperial
Academy of St. Petersburg conferred a like honor upon him. In 1754 the
Academy of Berlin elected him to honorary membership.
His English biographer, Dr. William Cook, says quaintly {49} that all
the learned and great who came into his neighborhood did not depart
without a visit to Morgagni. He was in correspondence with most of the
great men of his time, and the terms of intimate relationship that
this correspondence reveals are the best evidence of the estimation in
which Morgagni was held, especially by the prominent scientists of his
time. Among them were such men as Ruysch, Boerhaave, Sir Richard Mead,
Haller and Meckel. This wide acquaintanceship of itself was a great
distinction at a time when the means of communication were so much
more limited than at present.
It is gratifying to think that Morgagni must have been enviably
content in his private life, though, as usually happens when this is
the case, very little is said explicitly on this subject. His untiring
labor deserved the compensation of a loving domestic circle. During
his retirement at Forli, after his graduation from the university and
when, from overwork, his health failed him for a time, he married the
descendant of a noble family of the town, Paola Vergieri by name, a
companion for him who, biographers declare, could not have been
surpassed in judgment or in affection. They had a family of fifteen
children, eight of whom survived their father though he lived to the
ripe age of eighty-seven years. There were three sons, one of whom
died in childhood; another became a Jesuit and taught in the famous
Jesuit school at Bologna whose magnificent building has now become the
municipal museum, the Accademia delle Belle Arte. The third followed
his father's profession, married and settled in Bologna, but died
before his father, who assumed the care of his grandchildren. All
Morgagni's daughters who grew up to womanhood, eight in number, became
nuns in various religious orders.
The spirit of science had not disturbed the development {50} of a
homely simple faith in the family. The great Father of Pathology, far
from being disturbed by the unselfish self-sacrifice of so many of his
children, bore it not only with equanimity but even rejoiced at it.
His relations to his children were ever most tender. After the
suppression of the Jesuits, his son, who had been a member of the
order, worked at science with his father at the University of Bologna
and not without distinction.
The estimation in which Morgagni was held by his contemporaries can be
judged from the fact that twice when invading armies had entered the
Emilia and laid siege to Bologna, their commanders, as in old Greek
history did the Grecian generals with regard to Pindar and Archimedes,
gave strict orders that special care was to be taken that no harm come
to Morgagni, and that his work was not to be hampered. Having lived
his long life amidst the reverent respect of all who knew him, he died
full of day and honors.
Succeeding generations have not been backward in acknowledging
Morgagni's merits. I have already spoken of Virchow's tribute to his
greatness. The Italians have long considered him as one of their most
brilliant names in medicine. One of the best known of the
representative Italian medical journals is _Il Morgagni_, published at
Milan. To its pages the foreigner seeking to know the progress of
Italian medicine turns almost as the first resort. _Il Morgagni_ was
founded some fifty years ago, and continues to uphold its reputation
as one of the world-known medical periodicals.
The great medical scientist whose work was to prove the foundation of
modern pathology, and thus be the source of more blessings to mankind
than ever even he dreamed of, remained in the midst of the reverence
and gratitude of his generation, one of those beautifully simple
characters whom all the world delights to honor. As a teacher he was
the {51} idol of his students. No great scientist who came to Italy
felt that his journey had been quite complete unless he had had the
privilege of an interview with Morgagni. This friend of Popes and of
many of the European rulers was the happy father of a houseful of
members of religious orders, and considered himself blest that so many
of them had chosen the better part. He was himself all during his long
life the ardent seeker after truth, who did well the work that came to
his hand and followed his conscience in sincere simplicity of heart
and reaped his personal reward in the peace that is beyond
understanding to those who have not the gift of faith to appreciate
the things that are beyond the domain of sense.
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