SANTORIO, SANTORIO

also known as Sanctorius

(b. Justinopolis, Venetian Republic [now Koper, Yugoslavia], 29 March 1561; d. Venice, Italy, 6 March 1636)

medicine, physiology, invention of measuring instruments.

Santorio was the son of Antonio Santorio, a nobleman from Friuli who had come to Justinopolis (also named Capraria and Capodistria) as a high official of the Venetian Republic. While serving there, he married Elisabetta Cordonia, the heiress of a local noble family.

Santorio, the eldest of four children, received at his baptism his family name as his given name—a practice fashionable at that time in Istria. He was educated at Justinopolis and Venice, where his father’s friendship with an illustrious nobleman, Morosini, enabled Santorio to share the same tutors as Morosini’s sons, Paolo and Andrea. (The latter became a famous historian and a reformer of the University of Padua.) Thus Santorio acquired a thorough knowledge of classical languages and literature.

In 1575 Santorio enrolled at the Archilyceum of Padua, where he followed the traditional sequence of studying philosophy and then medicine. He obtained his doctor’s degree in 1582. At the very beginning of his medical practice. Santorio carried out a systematic study of the changes in weight that occurred in his own body following the ingestion of food and the elimination of excrement.

Most biographers assert that, following an invitation from king Maximillan, Santorio lived for a long time in Poland. The only document supporting time in Poland. The only document supporting this statement is late testimony quoting a copy of a letter written by Nicolò Galerio, vicar of the University of Padua. In 1587 an important person requested a qualified physician from the medical faculty at Padua; the faculty replied through Galerio that Santorio— the most suitable choice because of his learning, his loyalty, and his zeal—was ready to undertake the journey. It is claimed that Galerio’s response was addressed to the king of Poland, but this is an unproved conjecture. The original document has disappeared. Capello was Santorio’s only biographer to have seen the draft (also lost) of Galerio’s letter, which, according to Capello’s testimony, was written “for a certain Polish prince.” Therefore, it can be assumed that the draft did not bear the name of the intended recipient. The polish archives contain no material indicating that Santorio ever stayed in Poland, but there are several pieces of evidence attesting his presence in Croatia, particularly in Karlovac, during the last decade of the sixteenth century. The invitation of 1587 would thus seem to have come from a leading Croatian nobleman, probably Count Zrinski. From 1587 to 1599 Santorio spent most of his time, not in Poland, but among the South Slavs. It was on the Adriatic coast, at or near Senj, that Santorio made the first trials with both his wind gauge and a new apparatus designed to measure the force of water currents.

Santorio often returned to his native city and maintained cordial relations with the scientists of Venice and Padua. In 1599 he finally left Croatia and established a medical practice in Venice. One reason for his departure was perhaps a desire to esxcape the plague that in 1598 began to ravage the valley of the Sava River. Also, he was attracted by the exchange of new ideas and the intellectual fervor that Venice was then enjoying. The home of the Morosinis had become a true meeting place for the proponents of the new science: Santorio met Galileo and became friendly with Paolo Sarpi, Girolamo Fabrici, Giambattista Della Porta, and Francesco Sagredo, among other. In 1607 Santorio treated Sarpi after the latter had been wounded during an attempted political assassination.

Santorio’s first book appeared in 1602, Methodi vitandorum errorum omnium qui in arte medica contingunt. It is a comprehensive study on the method to be followed in order to avoid making errors in the art of healing. Without breaking with the Galenic tradition, Santorio ventured certain criticisms of classical physiology and expressed ideas that prefigured the mechanistic explanations of the iatrophysical school. According to Santorio, the properties of the living body do not depend only on the four elementary qualities, nor even on the secondary and tertiary qualities, as they were defined by Galen, but also on “number, position, form, and other accidental factors.” Santorio employed the analogy (later used by Descartes) between an organism and a clock, the movements of which depend on the number, the form, and the disposition of its parts. Nevertheless, he remained faithful to traditional humoral pathology and tried to explain all internal diseases as particular cases of humoral dyscrasia.

Although Santorio accepted the ancient scheme that attributed diseases to a bad mixture of the four humors, he modified it profoundly by some quantitative attributions. In the pathology of Hippocrates and Galen there is no discontinuity between eucrasia and the innumerable possible pathological deviations. Santorio, starting from certain remarks of Galen on the “degrees” of dyscrasia, defined the discontinuity of morbid states and proposed to make known, by mathematical deduction, all the possible diseases. (According to his calculations, their total number was about 80,000.) In Methodi vitandorum errorum. Santorio mentioned a few measuring instruments (the scale and the “pulsilogium”) but did not seem to attach special importance to them. It should be emphasized, however, that theoretical considerations form only the back ground to this medical textbook, which is of an eminently practical orientation. The book contains several good descriptions of diseases and offers model cases of differential diagnostics, for example, the clinical distinction between an abscess of the mesentery and intestinal ulcerations.

On 6 October 1611 Santorio was appointed professor of theoretical medicine at the University of Padua. He owed his appointment to the success of his book, to his growing reputation as a practitioner, and to the support of his friends in the upper Venetian nobility. Originally he was supposed to have held the position for six years; but at the end of that period, in 1617, the Venetian Senate extended his contract for six more years and granted him an exceptionally for six more years and granted him an exceptionally high salary. Santorio’s talents as an orator, the originality of his ideas, and his demonstrations of new methods of clinical examination made his courses very popular. As professor of theoretical medicine. Santorio was required to present and comment upon the Ars parva of Galen, the Aphorisms of Hippocrates, and the first book of the Cannon on Ibn Sīnā. This obligation led him to publish most of his own views in the restricted form of scholarly commentaries on these three works. Cautions and introverted. Santorio preferred to express himself through allusions and to envelop his bold and original ideas in a thick layer of conventional erudition. Still, as early as 1602, he clearly set forth his personal creed: “One must believe first in one’s own senses and in experience, then in reasoning, and only in the third place in the authority of Hippocrates, of Galen, of Aristotle, and of other excellent philosophers” (Methodi vitandorum errorum, 215).

In 1612 Santorio published Commentaria in artem medicinalem Galeni, a large volume of commentaries on Galen that contains the first printed mention of the air thermometer. In 1614 he published De statica medicina, a short work on the variation in weight experienced by the human body as a result of ingestion and excretion. The latter work made him famous. Filled with incisive and elliptic aphorisms, De statica medicina dazzled his contemporaries, although its style is rather irritating to modern readers. The book briefly describes the results of a long series of experiments that Santorio conducted with a scale and other measuring instruments. Its success stemmed chiefly from the simplicity and apparent precision of the methods by which he promised to preserve health and to direct all the therapeutic measures.

On 9 February 1615 Santorio sent a copy of De Statica medicina to Galileo. In an accompanying letter he explained that his work was based on two principles: first, Hippocrates’ view that medicine is essentially the addition of what is lacking and the removal of what is superfluous: and second experimentation. The origin of “static medicine” was, in fact, the Hippocratic conception that health consists in the harmony of the humors. One expression of this harmony is the equilibrium between the substances consumed by the organism and those rejected by it. According to this view, pathological conditions should be accompanied by a quantitative disequilibrium of the exchanges by a quantitative disequilibrium of the exchanges between the living body and its surroundings. To verify this supposition, Santorio turned to quantitative experimentation. With the aid of a chair scale, he systematically observed the daily variations in the weight of his body and showed that a large part of excretion takes place and showed that a large part of excretion takes place invisibly through the skin and lungs (Persiratio insensibilis). Moreover, he sought to determine to magnitude of this visible excretion: its relationship to visible excretion: and its dependence on various factors, including the state of the atmosphere, diet, sleep, exercise, sexual activity, and age. Thus he invented instruments to measure ambient humidity and temperature. From this research he concluded (1) that perspiratio insensibilis, which had been known since Erasistratus but which was considered imponderable, could be determined by systematic weighing: (2) that it is, in itself, greater than all forms of sensible bodily excretions combined: and (3) that it is not constant but varies considerably: as a function of several internal and external factors: for example, cold and sleep lessen it and fever increases it.

The invention of the thermometer gave rise to a priority dispute between Santorio, Galileo, Sagredo, and several other scientists. It seems probable that Galileo invented the first open-air thermoscope. Santorio built a similar device, and whether or not he knew of Galileo’s, he was the first to add a scale, thereby transforming the thermoscope into the thermometer. The exact date of this invention is unknown, but it falls between 1602 and 1612. The fixed reference points that Santorio employed to create a thermometric scale—namely, the temperature of snow and the temperature of a candle flame—are mentioned in his commentaries on Galen, although not in the first edition of that work. Galileo made no use at all of the thermoscope. In contrast. Santorio attempted to measure body temperature in health and illness and employed his thermometer in physiological experiments and in medical practice. It is not possible to estimate the accuracy of the figures that Santorio obtained with his apparatus. In any case, the instrument did have the great drawback of being subject to variations in barometric pressure, a factor that was still unknown.

Santorio also invented other measuring instruments and medical devices, including a hygrometer, a pendulum for measuring the pulse rate, a trocar, a special sysringe for extracting bladder stones, and a bathing bed. He spoke of these inventions in his lectures and demonstrated their uses. For example, he publicly used the trocar for abdominal and thoracic paracentesis and even for a tracheotomy. Although Santorio promised to reveal the methods of construction of his apparatus in a book entitled De instrumentis medicis, the work never appeared.

Santorio was an advocate of the Copernican system and a fierce opponent of astrology. These stands involved him in difficulties with certain of his colleagues, who accused him, among other things, of neglecting his professional duties. An adept of the occult sciences, Ippolito Obizzi, professor at Ferrara, violently attacked De statica medicina and Santorio felt himself obliged to respond in a new edition of his book. Many of the criticisms were justified (Santorio had attributed to static medicine a practical significance that proved to be grossly exaggerated), but Obizzi was wrong in attacking Santorio’s experimental method.

In 1624, at the end of his second term as professor at Padua, Santorio wished to retire from his post. His request was granted by the Venetian Senate. Which, as a sign of its regard for his services, also awarded him an annual pension and the permanent title of professor, Subsequently Santorio declined offers from the universities of Bologna, Pavia, and Messina and returned to Venice.

In 1625 he published there his commentaries on Ibn Sīnā’s Canon (Commentaria in primam fen primi libri Canonis Avicennae). The chief value of this work lies in its revelation (still quite hesitant, although accompanied by diagrams for the first time) of the principles of construction of various instruments. In 1630 Santorio was given the task of organizing measures against an epidemic of plague in Venice. In the same year he was elected president of the Venetian College of Physicians.

A misogynist, Santorio never married. Although frugal and little concerned with personal comfort, he was eager for gain and in fact assembled a considerable fortune. He was restrained and prudent, but his style occasionally ran to incisive irony. Above all, Santorio was endowed with a highly critical intelligence. He quickly accepted the ideas of Galileo on mechanics and on the nature of the celestial bodies as well as those of Kepler on optics. Curiously, despite his penchant for mechanistic explanations, he did not grasp the significance of Harvey’s discovery of the circulation of the blood.

Santorio died from a disease of the urinary tract. He was buried in the Church of the Servi in Venice, but his skeleton was removed when the church was demolished in 1812. His skull is now at the museum of the University of Padua.

Throughout the seventeenth century and the first half of the eighteenth, physicians sympathetic with the doctrines of iatrophysics praised Santorio as one of the greatest innovators in physiology and practical medicine. Many scientists agreed with Baglivi that the new medicine was based on two pillars: Santorio’s statics and Harvey’s discovery of the circulation of the blood. Boerhaave wrote of De statica medicina that “no medical book has attained this perfection.” The exaggerated praise accorded to Santorio’s little book detracted from its author’s reputation in the nineteenth century, by which time scientists had rejected as illusory the medical content of his teaching, namely, the claim that knowledge of the quantity of perspiratio insensibilis provides essential information for hygiene, diagnostic, and therapeutics. Although static medicine is no longer a viable medical doctrine, the method through which it emerged is no less fruitful on that account. Santorio’s great achievement was the introduction of quantitative experimentation into biological science. Undoubtedly inspired by the ideas of Galileo, Santorio opened the way to a mathematical and experimental analysis of physiological and pathological phenomena.

BIBLIOGRAPHY

I. original Works. Santorio’s most famous work is Ars de statica medicina sectionibus aphorisnorum septem comprehensa (Venice, 1614): the second, greatly revised ed. is De medicina statica libri octo (Venice, 1615). This second ed. was reprinted about forty times, either by itself or with commentaries by M. Lister, Baglivi, J. Gorter, D. L. Rüdiger. or A. C. Lorry. It was also translated into English (1676), Italian (1704), French (1722), and German (1736).

Santorio’s other writings are Methodi vitandorum errorum omnium qui in arte medica contingunt (Venice, 1602); Commentaria in artem medicinalem Galeni (Venice, 1612); Commentaria in primam fen primi libri Canonis Avicennae (Venice, 1625); and Liber de remediorumn inventione (Venice, 1629). These works are contained in his Opera onmia quatuor tomis distincta (Venice, 1660).

II. Secondary Literature. The most helpful old biographies are A. Capello, De vita cl, viri Sanctorü Sanctorü (Venice, 1750); and J. Grandi, De laudibus Sanctorü (Venice, 1671). Further details can be found in M. Del Gaizo, Ricerche storiche intorno a Santorio Santorio ed alla medicina statica (Naples, 1889) and Alcune conoscenze di Santorio intorno ai fenomeni della visione ed il testamento di lui (Naples, 1891); and in P. Stancovich, Biografie degli uomini illustri dell’Istria, II (Trieste, 1829).

More recent studies of Santorio’s life and work include A. Castiglioni, La vita e l’opera di Santorio Santorio Capodistriano (Bologna-Trieste, 1920), with English trans, by E. Recht in Medical Life, 38 (1931), 729–785; M. D. Grmek, Istarski liječnik Santorio Santorio i njegovi aparati i instrumenti (Zagreb, 1952); and R.H. Major, “Santorio Santorio,” in Annals of Medical History, n.s. 10 (1938), 369–381.

For an appraisal of Santorio’s role in the history of science. see M. D. Grmek, L’Introduction de l’expérience quantitiative dans les sciences biologiques (Paris, 1962) and H. Miessen, Die Verdienste Sanctorü Santorüum die Einführung physikalischer Methoden in die Heilkunde (Düsseldorf, 1940). On static medicine see E. T. Renbourn. “The Natural History of Insensible Perspiration,” in Medical History, 4 (1960), 135–152. The best work on the invention of the thermometer is W.E.K.Middleton, A History of the Thermometer and Its Use in Meteorology (Baltimore, 1966).

M. D. Grmek