Morgagni, Giovanni Battista
MORGAGNI, GIOVANNI BATTISTA
(b. Forlì, Italy, 25 February 1682; d. Padua, Italy, 5 December 1771)
medicine, anatomy, pathological anatomy.
Morgagni was the son of Fabrizio Morgagni and Maria Tornielli. After completing his early studies at Forlì, in 1698 he went to Bologna, where he attended the university, taking the degree in philosophy and medicine in 1701. His principal university teachers were Antonio Maria Valsalva and Ippolito Francesco Albertini, both former pupils of Malpighi, who trained him in Malpighi’s methods and in the rational medicine that follows from them. Having received his degree, Morgagni remained in Bologna to work in the three hospitals of that city and carry out further anatomical studies with Valsalva.
Morgagni was admitted to the Accademia degli Inquieti in 1699 and became its head in 1704. He reformed the academy on the model of the Paris Académie Royale des Sciences and accepted an invitation to hold meetings in the mansion belonging to Luigi Ferdinandino Marsili, thus paving the way for its incorporation into the Istituto delle Scienze that was founded by Marsili in 1714. It was to the Inquieti that Morgagni in 1705 communicated his Adversaria anatomica prima, which he also dedicated to them. The Adversaria was published in Bologna in 1706 and earned Morgagni international fame as an anatomist.
At the beginning of 1707 Morgagni moved to Venice, where he stayed through May 1709. Venice offered him the opportunity to study chemistry with Gian Girolamo Zanichelli, to investigate the ana-tomical structure of the great fishes, and to secure a number of rare and choice books. He also conducted a number of dissections of human cadavers with Gian Domenico Santorini, who was at that time dissector and lector in anatomy at the Venetian medical college. In June 1709 Morgagni returned to Forli, where he practiced medicine with great success. In September 1711 he was called to the second chair of theoretical medicine at Padua University; the chair had become vacant when Antonio Vallisnieri was promoted to the first chair, following the death of Domenico Guglielmini. Morgagni delivered his inaugural lecture, Nova institutionum medicarum idea, on 17 March 1712. He was appointed to the first chair of anatomy at Padua in September 1715 and began teaching that subject on 21 January 1716. He held this post until his death. Morgagni’s teaching was always clear and gave the impression of a perpetually fresh mind.
The Adversaria anatomica prima is a series of researches on fine anatomy conducted according to the tradition established by Malpighi, although Morgagni showed greater caution in the use of the microscope and in making anatomical prepa-rations. Morgagni’s profoundly inquiring intellect is apparent in even this early work. Despite the modesty of its title—“Notes on Anatomy”—Morgagni’s book actually records a whole succession of discoveries regarding minute organic mechanisms, including the glands of the trachea, of the male urethra, and of the female genitals. These represent new contributions to the mechanical interpretation of the structure of the organism, as do the descriptions contained in Morgagni’s five subsequent Adversaria (1717–1719), Epistolae anatomicae duae (published in Leiden by Boerhaave in 1728), and Epistolae anatomicae duodeviginti on Valsalva’s writings (1740).
Morgagni’s most important work, however, is his De sedibus et causis morborum per anatomen indagatis of 1761. This book grew out of a concept of Malpighi, which Morgagni then developed into a major work. The concept may be stated simply as the notion that the organism can be considered as a mechanical complex. Life therefore represents the sum of the harmonious operation of organic machines, of which many of the most delicate and minute are discernible, hidden within the recesses of the organs, only through microscopic examination.
Like inorganic machines, organic machines are subject to deterioration and breakdowns that impair their operation. Such failures occur at the most minute levels, but, given the limits of technique and instrumentation, it is possible to investigate them only at the macroscopic level, by examining organic lesions on the dissecting table. These breakdowns give rise to functional impairments that produce disharmony in the economy of the organism; their clinical manifestations are proportional to their location and nature.
This thesis is implicit in the very title De sedibus et causis morborum per anatomen indagatis. In this book Morgagni reasons that a breakdown at some point of the mechanical complex of the organism must be both the seat and cause of a disease or, rather, of its clinical manifestations, which may be conceived of as functional impairments and investigated anatomically. Morgagni’s conception of etiology also takes into account what he called “external” causes, including environmental and psychological factors, among them the occupational ones suggested to Morgagni by Ramazzini.
The parallels that exist between anatomical lesion and clinical symptom served Morgagni as the basis for his “historiae anatomico-medicae,” the case studies from which he constructed the De sedibus. There had, to be sure, been earlier collections of case histories, in particular Théophile Bonet’s Sepulchretum (1679), but Bonet’s work was, as René Laënnec wrote of it, an “undigested and incoherent compilation,” while the special merit of Morgagni’s work lies in its synthesis of case materials with the insights provided by his own anatomical investigations. In his book Morgagni made careful evaluations of anatomic medical histories drawn exhaustively from the existing literature. In addition, he describes a great number of previously unpublished cases, including both those that he had himself observed in sixty years of anatomical investigation and those collected by his immediate predecessors, especially Valsalva, whose posthumous papers Morgagni meticulously edited and commented upon. The case histories collected in the De sedibus therefore represent the work of an entire school of anatomists, beginning with Malpighi, then extending through his pupils Valsalva and Albertini to Morgagni himself.
Morgagni may thus be considered to be the founder of pathological anatomy. This work was, in turn, developed by Baillie, who classified organic lesions as types (1793); Auenbrugger and Laënnec, who recognized organic lesions in the living subject (1761 and 1819, respectively); Bichat, who found the pathological site to be in the tissue, rather than the organ (1800); and Virchow, who traced the pathology from the tissue to the cell (1858).
I. Original Works. Morgagni’s writings include Adver-saria anatomica prima (Bologna, 1706); Nova institutionum medicarum idea (Padua, 1712); Adversaria anatomica altera et tertia (Padua, 1717); Adversaria anatomica quarta, quinta et sexta (Padua, 1719); Epistolae anatomicae duae (Leiden, 1728); Epistolae anatomicae duodeviginti ad scripta perti-nentes celeberrimi viri A. M. Valsalvae (Venice, 1740); De sedibus et causis morborum per anatomen indagatis (Venice, 1761); Opuscula miscellanea (Venice, 1763); Opera omnia (Venice, 1764); and Opera postuma (Rome, 1964–1969), vol. I, Le autobiografie, and vols. II-IV, Lezioni di medicina teorica.
A bibliography is Renato Zanelli, “Catalogo ragionato delle edizioni Morgagnane in ordine cronologico,” in Le onoranze a G. B. Morgagni, Forli, 24 maggio 1931–IX (Siena, 1931), 137–147.
II. Secondary Literature. Bibliographies are Carlo Fiorentini, Giovanni Battista Morgagni: Primo saggio di bibliografia sintetica (Bologna, 1930); and Loris Premuda, “Versuch einer Bibliographic mit Anmerkungen über das Leben und die Werke von G. B. Morgagni,” in Markwart Michler, ed. and trans., Sitz und Ursachen der Krankheiten (Bern-Stuttgart, 1967), 163–195.
More recent works include Luigi Belloni, “Aus dem Briefwechsel von G. B. Morgagni mit L. Schrück und J. F. Baier,” in Nova acta leopoldina, 36 (1970), 107–139; “Lettere del 1761 fra D. Cotugno e G. B. Morgagni,” in Physis, 12 (1970), 415–423; “Contributo all’epistolario Boerhaave—Morgagni. L’edizione delle Epistolae anato-micae duae, Leida 1728,” ibid., 13 (1971), 81–109; “L’epis-tolario Morgagni—Réaumur alia Biblioteca Civica di Forli,” in Gesnerus, 29 (1972), 225–254; “L’opera di Giam-battista Morgagni: dalla strutturazione meccanica dell’or-ganismo vivente all’anatomia patologica,” in Simposi clinici, 9 (1972), I-VIII; and in Morgagni, 4 (1971), 71–80; and “G. B. Morgagni und die Bedeutung seines ’De sedibus et causis morborum per anatomen indagatis,’” in Erna Lesky and Adam Wandruzka,eds., Gerard van Swieten und seine Zeit (Vienna-Cologne-Graz, 1973), 128–136. See also Giuseppe Ongaro, “La biblioteca di Giambattista Morgagni,” in Quaderni per la storia dell’Università di Padova, 3 (1970), 113–129.
Giovanni Battista Morgagni
Giovanni Battista Morgagni
Italian Physician and Anatomist
Giovanni Battista Morgagni holds a highly respected place in the history of medicine as the anatomist who established the science of morbid anatomy. Morgagni's anatomical and pathological research helped to replace the ancient humoral doctrine with a new approach to viewing disease.
Born in Forli, Italy, Morgagni studied medicine and philosophy at the University of Bologna. He graduated in 1701 and assisted Antonio Maria Valsalva with the publication of Anatomy and Diseases of the Ear (1704). When Valsalva took a position in Parma, Morgagni became demonstrator of anatomy at Bologna. Morgagni became professor of medicine at the University of Padua in 1710. Five years later, he was promoted to the chair of anatomy.
From 1706 to 1719, Morgagni published his anatomical observations under the title Adversaria Anatomica. These studies were highly regarded and widely praised by anatomists and physicians. Morgagni's remarkable pioneering study of morbid anatomy, On the Seats and Causes of Diseases Investigated by Anatomy, was published in 1761, when Morgagni was 80 years old. This massive five-volume landmark in the history of pathology is based on almost 700 cases. In his comments on each case, Morgagni attempted to correlate clinical observations of the signs and symptoms of disease with his postmortem investigations of specific lesions.
Although anatomy is an ancient and valued aspect of medical research, Morgagni's treatise is generally considered the first systematic textbook of morbid anatomy. His approach located diseases within individual organs rather than in disturbances of the humors. Meticulous observations on hundreds of patients before and after death allowed Morgagni to establish the hidden internal changes associated with the progression of diseases. Morgagni also carried out experiments and dissections on various animals in order to understand pathological processes in humans. He believed that systematic postmortem studies would determine the structural and functional changes associated with disease. Morgagni thought that such knowledge would eventually help physicians establish the causes of diseases and allow them to evaluate the efficacy of different remedies and therapeutic interventions.
Morgagni thought that normal human anatomy had been well established by his predecessors and contemporaries, but other anatomists had not yet explored the origin and seat of the diseases that caused the pathological changes observable in the cadaver at the postmortem autopsy. All parts of the body were described in some detail, but the longest section in Morgagni's treatise deals with disorders of the belly. After carefully describing each case history, Morgagni attempted to correlate observations of the symptoms of the illness with his findings at autopsy. Sometimes the autopsy revealed serious errors in diagnosis and inappropriate treatments that might have been directly related to the death of the patient. In one case, a physician had treated the patient for stomach problems, but the autopsy revealed that the patient had a normal stomach and diseased kidneys.
As a pioneer of morbid anatomy, Morgagni initiated a new epoch in medical science. Even though Morgagni did not directly challenge prevailing medical philosophy and essentially remained a humoralist in terms of clinical medicine, his work inevitably marked a departure from general humoral pathology towards the study of localized lesions and diseased organs. The new morbid anatomy encouraged physicians to think of disease in terms of localized pathological lesions rather than disorders of the humors. Thus, Morgagni's work encouraged a new attitude towards specific diagnostic categories and the efficacy of surgical interventions.
Morgagni's work helped to establish an anatomical orientation in pathology and a recognition that unseen anatomical changes in the living body were reflected in the clinical picture. He was the first to attempt a systematic examination of the connection between the symptoms of disease in the living body and postmortem results revealed only to the dedicated investigator. Confirmation of a diagnosis could only be found in the autopsy room, but recognition of the relationship between symptoms and internal lesions encouraged an interest in finding ways of "anatomizing" the living, that is, detecting hidden anatomical lesions in living patients.
Morgagni was honored and respected by students, colleagues, cardinals, and popes. When only 24 years of age, he was elected president of the Accademia Inquietorum. He was elected to many prestigious scientific societies, including the Accademia Naturae Curiosorum, the Royal Society, the Academy of Sciences of Paris, the Imperial Academy of St. Petersburg, and the Berlin Academy.
LOIS N. MAGNER
Giovanni Battista Morgagni
Giovanni Battista Morgagni
The Italian anatomist Giovanni Battista Morgagni (1682-1771) was the founder of pathological anatomy and the first to demonstrate the relation between disease symptoms and pathological changes in organs.
Giovanni Battista Morgagni was born on Feb. 25, 1682, in Forli. At 15 Giambattista, as he often signed his name, entered the University of Bologna to study medicine and received a degree in 1701. For a short time he continued studying and teaching at Bologna but soon entered medical practice in his native Forli.
In 1706 Morgagni published the first volume of Adversaria anatomica, a collection of medical essays communicated to the Academia Inquietorum which established Morgagni in the scientific community. Later contributions were published from 1717 to 1719. In 1711 he was offered the assistant professorship of theoretical medicine at the University of Padua, a school noted for its brilliant achievements in anatomy for 2 centuries. Morgagni accepted the post in 1712 and in 1715 was elevated to the rank of professor of anatomy. He remained at Padua as a popular teacher, anatomist, and clinical consultant until his death on Dec. 6, 1771.
In 1761, at the age of 79, Morgagni published his great work De sedibus et causis morborum per anatomen indagatis libri quinque (On the Seats and Causes of Disease, Anatomically Studied). For centuries physicians had been guided by the conviction that disease was always generalized throughout the whole body. Although pathological changes in organs had been noted before and although 17th-and early-18th-century anatomists recognized that such changes were sometimes related to the symptoms of specific diseases, De sedibus proved conclusively that this relationship was a valid one and demonstrated its full meaning.
Morgagni's work was based on years of careful observation and experiment, including over 600 postmortem examinations, in which he pinpointed pathological changes leading to death and showed the relationship with the symptoms of the illness preceding death. He also recognized the role of the nervous system in making symptoms felt at a point distant from the seat of the disease and the possible influence of such external factors as weather, age, and occupation in causing pathological changes. These achievements, plus his brilliant descriptions of pathological conditions, make Morgagni the founder of pathological anatomy, both as a distinct part of anatomical study and as a critical basis for understanding the cause of illness.
Morgagni's De sedibus is readily available, since an English translation made in 1769 by Benjamin Alexander was reprinted in 1960. There is no adequate biographical study of Morgagni. However, his work is discussed in almost all general histories of medicine, many of which contain some biographical data. Of particular help is the chapter on Morgagni in Henry Sigerist, The Great Doctors: A Biographical History of Medicine (1933). His life and work are discussed against a background of developments in pathology in Esmond R. Long, A History of Pathology (rev. ed. 1965). □