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Giovanni Battista Morgagni (1682–1771): His Anatomic Majesty's Contributions to the Neurosciences

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Giovanni Battista Morgagni (1682–1771): His Anatomic Majesty's Contributions to the Neurosciences Childs Nerv Syst (2012) 28:1099–1102 DOI 10.1007/s00381-012-1797-6 CLASSICS IN PEDIATRIC NEUROSURGERY Giovanni Battista Morgagni (1682–1771): his anatomic majesty's contributions to the neurosciences R. Shane Tubbs & Dominik T. Steck & Martin M. Mortazavi & Mohammadali M. Shoja & Marios Loukas & Aaron A. Cohen-Gadol Received: 6 February 2011 /Accepted: 30 April 2012 /Published online: 15 May 2012 # Springer-Verlag 2012 Abstract Keywords Anatomy . History . Italy . Neuroanatomy . Introduction Giovanni Battista Morgagni is considered the Pathology . Brain Father of Pathology and contributed much to our early understanding of neuropathology. For example, he intro- duced the concept that diagnosis, prognosis, and treatment Introduction of disease must be based on an exact understanding of the pathologic changes in anatomic structures. Additionally, he For those who they have dissected or inspected many, contributed to what would become the discipline of neuro- have at least learn’d to doubt when the others, who are surgery and, for example, performed trepanation for head ignorant of anatomy, and do not take the trouble to trauma. attend to it, are in no doubt at all. Conclusions It is the contributions of such early pioneers as Giovanni Battista Morgagni Morgagni that our current understanding of the neurosciences is based. His life Giovanni Battista Morgagni (Fig. 1) was born in Forli, Italy (40 mi southeast of Bologna and near the Adriatic Sea) on 25 R. S. Tubbs (*) Section of Pediatric Neurosurgery, Children’s Hospital, February 1682 [4]. The period marked the onset of the Spanish 1600 7th Avenue South ACC 400, domination of Italy [1]. His parents were Fabrice and Marie Birmigham, AL, USA Fornielli, and from a very early age, he was interested in science e-mail: [email protected] and literature as well as philosophy [2]. At the age of 16, he D. T. Steck began studying at the University of Bologna. After completing University of Bonn, his early studies at Forli, in 1698, at the age of 16, he began Bonn, Germany studying medicine in Bologna and received his doctorate in philosophy and medicine in 1701 and went on to work in three A. A. Cohen-Gadol Department of Neurological Surgery, hospitals in Bologna, particularly studying anatomy and clini- Goodman Campbell Brain and Spine, Indiana University, cal medicine at the hospital Santa Maria della Morte as prosec- Indianapolis, IN, USA tor to Antonio Maria Valsalva (1666–1723) who was one of the more well-known students of Malpighi (Father of Histology) M. Loukas Department of Anatomical Sciences, St. George’s University, who influenced Morgagni to study pathology [7]. In 1706, he St. George’s, Grenada published his first major work, the Adversaria Anatomica, : which was the foundation for his reputation as an anatomist. M. M. Mortazavi M. M. Shoja In 1707, he replaced Valsalva and took his position as a Division of Neurosurgery, University of Alabama, 1600 7th Avenue South ACC 400, demonstrator of anatomy when Valsalva left Bologna. In Birmigham, AL, USA 1709, Morgagni returned to Forli and practiced as a physician 1100 Childs Nerv Syst (2012) 28:1099–1102 In September 1711, he was invited to Padua as a professor in the second chair of theoretical medicine, to replace Antonio Vallisnieri (1661–1730), who had been promoted to the first chair, following the death of Domenico Guglielmini (1655– 1710). Morgagni delivered his inaugural lecture, Nova insti- tutionum medicarum idea, on 17 March 1712 [6]. In 1715, he was appointed as the first chair of anatomy. He began his teaching of this subject with an inaugural address on 21 January 1716, and from 1826, he was the only professor of this discipline at Padua [9]. After his Adversaria Anatomica in 1719, Morgagni pub- lished no major works until 1761, at the age of 79 years [6]. In 1761, his undisputedly most important work, De sedibus, et causis morborum per anatomen indagatis—“Seats and causes of disease investigated by means of anatomy,” was published (Fig. 2). De Sedibus et Causis Morborum per Anatomen Indagatis Fig. 1 Giovanni Battista Morgagni In 1679, Theophilus Bonetus published the Sepulchretum Sive Anatomica Practica. It is considered the first book to until 1711 when he was asked to be the second chair of describe signs and symptoms and correlate them with find- theoretical medicine at the University of Padua, where he gave ings at dissection. Almost 3,000 cases were described in this his inaugural lecture in 1712. At this time, he married Paola treatise, including clinical histories and reports of the dis- Vergieri of Forli with whom he had 15 children, 12 daughters sections, a larger second edition was published in 1700 [4]. and3sons[2]. In 1715, he was appointed chair of anatomy (a In 1740, the idea for Morgagni's De Sedibus et Causis very prestigious position at that time former chairs being, Morborum per Anatomen Indagatis was born. A young for example, Andreas Vesalius, Realdo Colombo, Giro- friend of Morgagni, Lelius, asked him to record his findings lamo Fabricius of Aquapendente, and Gabriello Fallopio) and comment on them for Bonetus' book [4]. Morgagni andheldthispositionuntilhisdeath[2]. He was well complied with Lelius' request, and over the next 20 years, respected among his students and his colleagues, both for he wrote 70 letters comprising documentations of his dis- his academic work and his personaltity, and he was called sections, as well as the corresponding patient histories; the his anatomic majesty by his students [5]. His reputation not letters also contained comments and critiques on Bonetus' only attracted students from Italy but from all across Sepulchretum. These 70 letters were the foundations for De Europe. He was a member of numerous prestigious academic Sedibus, a work that was published in 1761, when Morgagni societies, such as the Academia Naturae Curiosorum, the was 79, and consisted of five books, one for each foreign Royal Society, and the Academy of St. Petersburg [3]. academy that accepted Morgagni, and documented the Morgagni was admitted to the Accademia degli Inquieti in results of over 700 autopsies [9]. Each book addressed 1699 and became its head in 1704 [7]. He reformed the acad- a different organ system: (1) diseases of the head, (2) emy on the model of the Paris Académie Royale des sciences diseases of the thorax, (3) diseases of the abdomen, (4) andacceptedaninvitationtoholdmeetingsinthemansion diseases of a general nature and disease requiring surgi- belonging to Luigi Ferdinandino Marsili, thus paving the cal treatment, and (5) a supplement. The book became way for its incorporation into the Istitutio delle Scienze that very successful, resulting in seven editions and transla- was founded by Marsili in 1714. It was to the Inquieti in tions into three languages [2]. 1705 that Morgagni presented his series of lectures, Adver- saria anatomica prima. In 1706, Morgagni succeeded Val- Contributions to neuropathology salva as anatomical demonstrator, but after a short time, he gave up that post and in the beginning of 1707 moved to Many of the cadavers that Morgagni dissected were known Venice, where he stayed through May 1709. In Venice, he to have neurological diseases. Some of his reports focused conducted a number of dissections of human cadavers with on infectious diseases, such as meningitis, which he theo- the anatomist Giovanni Domenico Santorini (1681–1737) rized often arose in the sinuses [5]. In a case of syphilis, who was at that time dissector and lector in anatomy at Morgagni described swelling of the dura, which adhered to the Venetian Medical College [7]. the brain in a patient that died in 1717 and suffered from Childs Nerv Syst (2012) 28:1099–1102 1101 Fig. 2 Title page of Morgagni's De Sedibus et Causis Morborum per Anatomen Indagatis fever and headaches. He also reported that in a young boy according to Morgagni, epileptic seizures [9]. An injury of with tuberculosis of the lungs who died after a long course of the heart also could harm the brain, due to air in the brain his disease, after being confused and suffering from vomiting vessels. Following head traumas, Morgagni often only and seizures and basal meningitis with optic nerve atrophy. found the tabula externa was damaged but sometimes sev- Morgagni saw a connection between findings in the lung, due eral foci of contusion could also be found (coup and contre- to the tuberculosis, and the meningitis. In several cases, he coup). Morgagni described contralateral palsies and aphasia assumed that an abscess of the brain might have been the in left-sided head traumas [8]. An epidural hematoma with cause of meningitis and he also described the possible entry intact skull and only superficial soft tissue injury caused into the ventricles [3]. Bone destruction and brain abscesses death within 4 h after a left temporal head trauma in a 50- were seen in cases of chronic otitis media, as well as basal year-old alcoholic with syphilis [4]. Emphysema in cerebral meningitis and thrombosis of the transverse sinus. Morgagni vessels due to injuries was distinguished by Morgagni from saw another possible cause of meningitis in head trauma, even gas formation due to putrefaction, which he considered minor ones [8]. Morgagni observed several patients with important in forensic questions [7]. encephalitis who died within few days [3]. He was the first to describe cerebral gumma and proved Valsalva's contention Stroke that cerebral lesions result in paralysis on the opposite side of the brain [7]. Stroke played a major role in Morgagni's neuropatholog- ical work. According to him, stroke might occur after the Contributions to neurotrauma excessive use of wine or after accidents and even during sleep. When dissecting the cerebral vessels of the elderly, Morgagni's work and findings in the field of neurotrauma Morgagni often found rigid deposits that he believed de- were very important.
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