Mondino And The Medical School Of Bologna
The most important contributions to medical science made by the Medical
School of Salerno at the height of its development were in surgery. The
text-books written by men trained in her halls or inspired by her
teachers were to influence many succeeding generations of surgeons for
centuries. Salerno's greatest legacy to Bologna was the group of
distinguished surgical teachers whose text-books we have reviewed in the
cha
was to win a place in medical history, however, mainly in connection
with anatomy, and it was in this department that she was to provide
incentive especially for her sister universities of north Italy, though
also for Western Europe generally. The first manual of dissection, that
is, the first handy volume giving explicit directions for the dissection
of human cadavers, was written at Bologna. This was scattered in
thousands of copies in manuscript all over the medical world of the
fourteenth and early fifteenth centuries. Even after the invention of
printing, many editions of it were printed. Down to the sixteenth
century it continued to be the most used text-book of anatomy, as well
as manual of dissection, which students of every university had in hand
when they made their dissection, or wished to prepare for making it, or
desired to review it after the body had been taken away, for with lack
of proper preservative preparation, bodies had to be removed in a
comparatively short time. Probably no man more influenced the medical
teaching of the fourteenth and fifteen centuries than Mundinus, or, as
he was called in the Italian fashion, Mondino, who wrote this manual of
dissection.
Mundinus quem omnis studentium universitas colit ut deum (Mundinus,
whom all the world of students cultivated as a god), is the expression
by which the German scholar who edited, about 1500, the Leipzig edition
of Mundinus' well-known manual, the Anathomia, introduces it to his
readers. The expression is well worth noting, because it shows what was
still the reputation of Mundinus in the medical educational world nearly
two centuries after his death.[12]
Until the time of Vesalius, whose influence was exerted about the middle
of the sixteenth century, Mondino was looked up to by all teachers as
the most important contributor to the science of anatomy in European
medicine since the Greeks. He owed his reputation to two things: his
book, of which we have already spoken, and then, the fact that he
reintroduced dissection demonstrations as a regular practice in the
medical schools. His book is really a manual of making anatomical
preparations for demonstration purposes. These demonstrations had to be
hurried, owing to the rapid decomposition of material consequent upon
the lack of preservatives. The various chapters were prepared with the
idea of supplying explicit directions and practical help during the
anatomical demonstrations, so that these might be made as speedily as
possible. The book does not comprise much that was new at that time, but
it is a good compendium of previous knowledge, and contains some
original observations. It was entirely owing to its form as a handy
manual of anatomical knowledge and, besides, because it was an incentive
to the practice of human dissection, that it attained and maintained its
popularity.
Mondino followed Galen, of course, and so did every other teacher in
medicine and its allied sciences, until Vesalius' time. Even Vesalius
permitted himself to be influenced overmuch by Galen at points where we
wonder that he did not make his observations for himself, since,
apparently, they were so obvious. The more we know of Galen, however,
the less surprised are we at his hold over the minds of men. Only those
who are ignorant of Galen's immense knowledge, his practical common
sense, and the frequent marvellous anticipations of what we think most
modern, affect to despise him. His works have never been translated
into any modern language except piecemeal, there is no complete
translation, and one must be ready to delve into some large Latin, if
not Greek, volumes to know what a marvel of medical knowledge he was,
and how wise were the men who followed him closely, though, being human,
there are times when necessarily he failed them.
For those who know even a little at first hand of Galen, it is only what
might be expected, then, that Mondino, trying to break away from the
anatomy of the pig, which had been before this the basis of all
anatomical teaching in the medical schools (Copho's book, used at
Salerno and Bologna before Mondino's was founded on dissections of the
pig), should have clung somewhat too closely to this old Greek teacher
and Greek master. The incentive furnished by Mondino's book helped to
break the tradition of Galen's unquestioned authority. Besides this, the
group of men around Mondino, his master, Taddeo Alderotti, with his
disciples and assistants, form the initial chapter in the history of the
medical school of Bologna, which gradually assumed the place of Salerno
at this time. There is no better way of getting a definite idea of what
was being done in medicine, and how it was being done, than by knowing
some of the details of the life of this group of medical workers.
Mondino di Liucci, or Luzzi, is usually said to have been born about
1275. His first name is a diminutive for Raimondo. It used to be said of
him that, like many of the great men of history, many cities claimed to
be his birthplace. Five were particularly mentioned--Florence, Milan,
Bologna, Forli, and Friuli. There is, however, another Mondino, a
distinguished physician, who was born and lived at Friuli, and it is
because of confusion with him that the claim for Friuli has been set up.
Florence and Milan are considered out of the question. Mondino was
probably born in or near Bologna. The fact that there should have been
this multiple set of claims shows how much was thought of him. Indeed,
his was the best known name in the medical schools of Europe for nearly
two centuries and a half. He seems to have been a particularly brilliant
student, for tradition records that he had obtained his degree of doctor
of medicine when he was scarcely more than twenty. This seems quite out
of the question for us at the present time, but we have taken to pushing
back the time of graduation, and it is not sure whether this is, beyond
peradventure, so beneficial as is usually thought.
That his early graduation did not hamper his intellectual development,
the fact that, in 1306, when he was about thirty-one years of age, he
was offered the professorial chair in anatomy, which he continued to
occupy with such distinction for the next twenty years, would seem to
prove. His public dissections of human bodies, probably the first thus
regularly made, attracted widespread attention, and students came to him
not only from all over Italy, but also from Europe generally. In this,
after all, Mondino was only continuing the tradition of world teaching
that Bologna had acquired under her great surgeons in the preceding
century. (See Great Surgeons of the Medieval Universities.)
Mondino came from a family that had already distinguished itself in
medicine at Bologna. His uncle was a professor of physic at the
university. His father, Albizzo di Luzzi, seems to have come from
Florence not long after the middle of the thirteenth century, for the
records show that, about 1270, he formed a partnership with one
Bartolommeo Raineri for the establishment of a pharmacy at Bologna.
Later this passed entirely under the control of the Mondino family, and
came to be known as the Spezieria del Mondino. In it were sold, besides
Eastern perfumes, spices, condiments, probably all sorts of toilet
articles, and even rugs and silks and feminine ornaments. The stricter
pharmacy of the earlier times developed into a sort of department store,
something like our own. The Mondini, however, insisted always on the
pharmacy feature as a specialty, and the fact was made patent to the
general public by a sign with the picture of a doctor on it. This drug
shop of the Mondini continued to be maintained as such, according to Dr.
Pilcher, until the beginning of the nineteenth century.[13]
One of the fellow students of Mondino at the University of Bologna had
been Mondeville. He came from distant France to take a course in surgery
with Theodoric, whose high reputation in the olden time, vague with us
half a century ago, is now amply justified by what we know of him from
such ardent students and admirers as Pagel and Nicaise. Not long after
Mondino's death, Guy de Chauliac came from France to reap similar
opportunities to these, which had proved so fruitful for Mondeville. The
more that we learn about this time the more do we find to make it clear
how deeply interested the generation was in education in every form,
artistic, philosophic, but, also, though this is often not realized,
scientific.
The long distances, so much longer in that time than in ours, to which
men were willing, and even anxious, to go, in order to obtain
opportunities for research, and to get in touch with a special master,
the associations with stimulating fellow pupils of other lands, the
scientific correspondences, almost necessarily initiated by such
circumstances, all indicate an enthusiasm for knowledge such as we have
not been accustomed to attribute to this period. On the contrary, we
have been rather inclined to think them neglectful of all education, and
have, above all, listened acquiescently while men deprecated the lack of
interest in things scientific displayed by these generations. Indeed,
many writers have gone out of their way to find a reason for the
supposed lack of interest in science at this time, and have proclaimed
the Church's opposition to scientific education and study as the cause.
At this time Italy was the home of the graduate teaching for all Europe.
The Italian Peninsula continued to be the foster-mother of the higher
education in letters and art, but also, though this is less generally
known, in science, for the next five centuries. Germany has come to be
the place of pilgrimage for those who want higher opportunities in
science than can be afforded in their own country only during the latter
half of the nineteenth century. France occupied it during the first half
of the nineteenth century. Except for short intervals, when political
troubles disturbed Italy, as about the middle of the fourteenth century,
when the removal of the Popes to Avignon brought their influence for
education over to France and a short period at the beginning of the
eighteenth century, when the Netherlands for a time came into
educational prominence, Italy has always been the European Mecca for
advanced students. Practically all our great discoverers in medicine,
until the last century, were either Italians, or else had studied in
Italy. Mondino, Bertrucci, Salicet, Lanfranc, Baverius, Berengarius,
John De Vigo, who first wrote on gun-shot wounds; John of Arcoli, first
to mention gold filling and other anticipations of modern dentistry;
Varolius, Eustachius, Caesalpinus, Columbus, Malpighi, Lancisi, Morgagni,
Spallanzani, Galvani, Volta, were all Italians. Mondeville, Guy de
Chauliac, Linacre, Vesalius, Harvey, Steno, and many others who might be
named, all studied in Italy, and secured their best opportunities to do
their great work there.
It would be amusing, if it were not amazing, to have serious writers of
history in the light of this plain story of graduate teaching of science
in Italy for over five centuries, write about the opposition of the
Church to science during the Medieval and Renaissance periods. It is
particularly surprising to have them talk of Church opposition to the
medical sciences. The universities of the world all had their charters
from the Popes at this time, and were all ruled by ecclesiastics, and
most of the students and practically all of the professors down to the
end of the sixteenth century belonged to the clerical order. The
universities of Italy were all more directly under the control of
ecclesiastical authority than anywhere else, and nearly all of them were
dominated by papal influence. Bologna, while doing much of the best
graduate work in science, especially in medicine, was, in the Papal
States, absolutely under the rule of the Popes. The university was,
practically, a department of the Papal government. The medical school at
the University of Rome itself was for several centuries, at the end of
the Middle Ages, the teaching-place where were assembled the pick of the
great medical investigators, who, having reached distinction by their
discoveries elsewhere, were summoned to Rome in order to add prestige to
the Papal University. All of them became special friends of the Popes,
dedicated their books to them, and evidently looked to them as
beneficent patrons and hearty encouragers of original scientific
research.
While this is so strikingly true of medical science as to make contrary
declarations in the matter utterly ridiculous, and to suggest at once
that there must be some motive for seeing things so different to the
reality, the same story can be told of graduate science in other
departments. It was to Italy that men came for special higher studies
in mathematics and astronomy, in botany, in mineralogy, and in applied
chemistry, so far as it related to the arts of painting, illuminating,
stained-glass making, and the like. No student of science felt that he
had quite exhausted the opportunities for study that were possible for
him until he had been down in Italy for some time. To meet the great
professors in Italy was looked on as sure to be a source of special
incentive in any department of science. This is coming to be generally
recognized just in proportion as our own interest in the arts and
crafts, and in the history of science, leads us to go carefully into the
details of these subjects at first hand. The editors of the Cambridge
Modern History, in their preface, declared ten years ago that we can no
longer accept with confidence the declaration of any secondary writer on
history. This is particularly true of the medieval period. We must go
back to the writers of those times.
If it seems surprising that the University of Bologna should have come
into such great prominence as an institute for higher education at this
time, it would be well to recall some of the great work that is being
done in this part of Italy in other departments at this time. Cimabue
laid the foundation of modern art towards the end of the thirteenth
century, and during Mondino's life Giotto, his pupil, raised an artistic
structure that is the admiration of all generations of artists since.
Dante's years are almost exactly contemporary with those of Giotto and
of Mondino. If men were doing such wondrous work in literature and in
art, why should not the same generation produce a man who will
accomplish for the practical science of medicine what his friends and
contemporaries had done in other great intellectual departments.
In recent years we have come to think much more of environment as an
influence in human development and accomplishment than was the custom
sometime ago. The broader general environment in Italy, with genius at
work in other departments, was certainly enough to arouse in younger
minds all their powers of original work. The narrower environment at
Bologna itself was quite as stimulating, for a great clinical teacher,
Taddeo Alderotti, had come, in 1260, from Florence to Bologna, to take
up there the practice and teaching of medicine. It was under him that
Mondino was to be trained for his life work.
To understand the place of Mondino, and of the medical school of
Bologna, in his time, and the reputation that came to them as world
teachers of medicine, we must know, first, this great teacher of Mondino
and the atmosphere of progressive medicine that enveloped the university
in the latter half of the thirteenth century. In the chapter on Great
Surgeons of the Medieval Universities we call particular attention to
the series of distinguished men, the first four of whom were educated at
Salerno, and who came to Bologna to teach surgery. They were doing the
best surgery in the world, much better than was done in many centuries
after their time; indeed, probably better than at any period down to our
own day. Besides, they seem to have been magnetic teachers who attracted
and inspired pupils. We have the surgical contributions of a series of
men, written at Bologna, that serve to show what fine work was
accomplished. At this time, however, the field of medicine was not
neglected, though we have but a single great historical name in it that
has lived. This was Taddeo Alderotti, a man who lifted the medical
profession as high in the estimation of his fellow citizens at Florence
as the great painters and literary men of his time did their
departments, and who then moved to Bologna, because of the opportunity
to teach afforded him by the university.
It is sometimes a little difficult for casual students of the time to
understand the marvellous reputation acquired by this medieval
physician. It should not be, however, when we recall the enthusiastic
reception and procession of welcome accorded to Cimabue's Madonna, and
the almost universal acclaim of the greatness of Dante's work, even in
his own time. In something of that same spirit Bologna came to
appreciate Taddeo, as he is familiarly known, looked upon him as a
benefactor of the community, and voted to relieve him of the burden of
paying taxes. He came to be considered as a public institution, whose
presence was a blessing to his fellow citizens, and whose goodness to
them should be recognized in this public way. One is not surprised to
hear Villani, the well-known contemporary historian, speak of him as the
greatest physician in Christendom.
The feelings of the citizens of Bologna, it may well be confessed, were
not entirely unselfish, or due solely to the desire to encourage a great
scientific genius. Few men of his generation had done more for the city
in a material way quite apart from whatever benefits he conferred upon
the health of its citizens than Dr. Taddeo. It was he who organized
medical teaching in the city on such a plane that it attracted students
from all over the world. Bologna had had a great law school before this,
founded by Irnerius, to which students had come from all over the world.
With the advent of Taddeo from Florence, and his success as a medical
practitioner, there began to flock to his lectures many students who
spread his fame far and wide. The city council could scarcely do less
than grant the same privileges to the medical students and teachers of
Taddeo's school as they had previously accorded to the faculty of law
and its students. The city council recognized quite as clearly as any
board of aldermen in the modern time how much, even of material benefit,
a great university was to the building up of a city, though their
motives were probably much higher than that, and their enlightened
policy had its reward in the rapid growth of Bologna until, very
probably at the end of the thirteenth century, it had more students than
any university of the modern time. The number was not less than fifteen
thousand, and may have been twenty thousand.
To this great university success Taddeo and his medical school
contributed not a little. The especially attractive feature of his
teaching seems to have been its eminent practicalness. He himself had
made an immense success of the practice of medicine, and accumulated a
great fortune, so much so that Dante, in his Paradiso, when he wishes
to find a figure that would represent exactly the opposite to what St.
Dominic, the founder of the Dominicans, did for the love of wisdom and
humanity, he takes that of Taddeo, who had accomplished so much for
personal reputation and wealth.
This might easily lead to the impression that Taddeo's teaching was
unscientific, or merely empiric, or that he himself was a narrow-minded
maker of money, intent only on his immediate influence, and hampered by
exclusive devotion to practical medicine. Nothing could be farther from
the truth than any such impression. Taddeo was not only the head of a
great medical school, a great teacher whom his students almost
worshipped, a physician to whom patients flocked because of his
marvellous success, a fine citizen of a great city, whom his fellow
citizens honored, but he was a broad-minded scholar, a philosopher, and
even an author in branches apart from medicine.
In that older time it was the custom to combine the study of philosophy
and medicine. For centuries after that period in Italy it was the custom
for men to take both degrees, the doctorate in philosophy and in
medicine at the same time. Indeed, most of those whose work has made
them famous, down to and including Galvani, did so. Taddeo wrote
commentaries on the works of Hippocrates and Galen, but he also
translated the ethics of Aristotle, and did much to make the learning of
the Arabs easily available for his students. His was a broad, liberal
scholarship. Dr. Lewis Pilcher, in his article on The Mondino
Myth,[14] does not hesitate to say that to the spirit which, from his
professorial chair, Taddeo infused into the teaching and study of
medicine undoubtedly is due the high position which for many generations
thereafter the school of Bologna continued to maintain as a centre of
medical teaching.
Of course, erudition had its revenge, and carried Taddeo too far. The
difficult thing in human nature is to stay in the mean and avoid
exaggeration. His methods of illustrating medical truths from many
literary and philosophical sources often caused the kernel of
observation to be hidden beneath a blanket of speculation or, at least,
to be concealed to a great extent. Even the Germans, who have insisted
most on this unfortunate tendency of Taddeo, have been compelled to
confess that there is much that is valuable in what he accomplished, and
that even his modes of expression were not without a certain vivacity
which attracted attention and doubtless added materially to his success
as a teacher. Pagel, in Puschmann's Handbuch, says: It cannot be
denied [this is just after he has quoted a passage of Taddeo with regard
to dreams] that Taddeo's expressions have a certain liveliness all their
own that gives us some idea why he was looked upon as so good a teacher,
a teacher who, as we know now, also gave instruction by the bedside of
patients. Pagel adds, Taddeo's greatest merit and his highest
significance in medical education consist in the fact that a great many
(zahlreiche) physicians followed directly in his footsteps and were
counted as his pupils. They were all men, as we know them, who as
writers and practitioners of medicine succeeded in going far beyond the
level of mediocrity in what they accomplished.
This was the teacher who most influenced young Mondino when he came to
the University of Bologna, for it seems not unlikely that as a medical
student he was actually the pupil of Taddeo, then in a vigorous old age.
If not, he was at least brought under the direct influence of the
teaching tradition created during more than thirty years by that
wonderful old man. Knowing what we do of Taddeo it is not surprising
that his pupil should have accomplished work that was to influence
succeeding generations more than any other of that wonderful thirteenth
century. Dr. Pilcher in the article on The Mondino Myth, so often
placed under contribution in this sketch, says that It needs no great
stretch of the imagination to picture somewhat of the effect that
contact with such a man as Taddeo di Alderotto[15] might have, in
molding the character of his young neighbor and pupil, the chemist's
son, who a few years later, by his devotion to the study of human
anatomy, was to re-establish the practical pursuit of study on the
human cadaver as the common privilege of the skilled physician, and was
to engrave his own name deeply on the records of medicine.
Under this worthy compatriot and contemporary of the great Florentines,
Mondino was inspired to be the teacher that did so much for Bologna.
Until recent years it has usually been the custom to give too much
significance to the work of the men whose names stand out most
prominently in the early history of departments of the intellectual
life. Mondino's reputation has shared in this exaggerative tendency to
some extent, hence the necessity for realizing what was accomplished
before his time and the fact that he only stands as the culmination of a
progressive period. Carlyle spoke of Dante as the man in whom ten
silent centuries found a voice. The centuries, however, were only
silent because the moderns did not know how to listen to their message.
We know now that every country in Europe had a great contributor to
literature in the century before Dante. The Cid, the Arthur Legends, the
Nibelungen, the Troubadours, naturally led up to Dante. He was only the
culmination of a great period of literature. We know now that men had
worked in art before Cimabue and Giotto, and had done impressive work
that made for the progress of art. These names, however, have come to
represent in many minds the sort of solitary phenomena that Dante has
seemed sometimes even to scholars.
Because Mondino did such good work in medical teaching it is sometimes
declared, even in rather serious histories, that he was the first to
accomplish anything in his department, and that before his time there is
a blank. Some historians, for instance, have insisted that Mondino was
the first to do human dissections, and that he did at most but two or
three. Only those who are unacquainted with the magnificent development
of surgery that took place during the preceding century, the evidence
for which is so abundantly given in modern historians of medicine and
especially in Gurlt's great work on the history of surgery, from which
we have quoted enough to give a good idea of the extent to which the
movement went, are likely to accept any such declaration. There could
not have been all that successful surgery without much dissection not
only of animals but also of human bodies. The teaching of dissection was
not regularly organized until Mondino's time, but it seems very clear
that even he must have dissected many more bodies than the number
usually attributed to him. Professor Lewis Stephen Pilcher of Brooklyn,
who made a special study of Mondino traditions in Bologna itself, and
collected some of the early editions of his books, feels so acutely the
absurdity of the ordinarily accepted tradition in this matter, that he
has written a paper on the subject bearing the suggestive title, The
Mondino Myth. He says:[16]
We are accustomed to think of the practice of dissection as
having been re-created by Mondino, and at once fully
developed, springing into acceptance. The year 1315 is the
generally accepted date for the first public anatomical
demonstration upon a human body made by Mondino, and yet it is
true that among the laws promulgated by Frederick II, more
than seventy-five years before (A.D. 1231), was included a
decree that a human body should be dissected at Salernum at
least once in five years in the presence of the assembled
physicians and surgeons of the kingdom, and that in the
regulations established for admission to the practice of
medicine and surgery in the kingdom it was decreed that no
surgeon should be admitted to practise unless he should bring
testimonials from the masters teaching in the medical faculty,
that he was 'learned in the anatomy of human bodies, and had
become perfect in that part of medicine without which neither
incisions could safely be made nor fractures cured.'
Salernum was notable in its legalization of the dissection of
human bodies before the first public work of Mondino, for,
according to a document of the Maggiore Consiglio of Venice of
1308, it appears that there was a college of medicine at
Venice which was even then authorized to dissect a body every
year. Common experience tells us that the embodiment of such
regulations into formal law would occur only after a
considerable preceding period of discussion, and in this
particular field of clandestine practice. It is too much to
ask us to believe that in all this period, from the date of
the promulgation of Frederick's decree of 1231 to the first
public demonstration by Mondino, at Bologna in 1315, the
decree had been a dead letter and no human body had been
anatomized. It is true there is not, as far as I am aware, any
record of any such work, and commentators and historians of a
later date have, without exception, accepted the view that
none was done, and thereby heightened the halo assigned to
Mondino as the one who ushered in a new era. Such a view seems
to me to be incredible. Be that as it may, it is undeniable
that at the beginning of the 14th century the idea of
dissecting the human body was not a novel one; the importance
of a knowledge of the intimate structure of the body had
already been appreciated by divers ruling bodies, and specific
regulations prescribing its practice had been enacted. It is
more reasonable to believe that in the era immediately
preceding that of Mondino human bodies were being opened and
after a fashion anatomized. All that we know of the work of
Mondino suggests that it was not a new enterprise in which he
was a pioneer, but rather that he brought to an old practice a
new enthusiasm and better methods, which, caught on the rising
wave of interest in medical teaching at Bologna, and preserved
by his own energy as a writer in the first original systematic
treatise written since the time of Galen, created for him in
subsequent uncritical times the reputation of being the
Restorer of the practice of anatomizing the human body, the
first one to demonstrate and teach such knowledge since the
time of the Ptolemaic anatomists, Erasistratus and Herophilus.
The changes have been rung by medical historians upon a
casual reference in Mondino's chapter on the uterus to the
bodies of two women and one sow which he had dissected, as if
these were the first and the only cadavers dissected by him.
The context involves no such construction. He is enforcing a
statement that the size of the uterus may vary, and to
illustrate it remarks that 'a woman whom I anatomized in the
month of January last year, viz., 1315 Anno Christi, had a
larger uterus than one whom I anatomized in the month of March
of the same year.' And further, he says that 'the uterus of a
sow which I dissected in 1316 (the year in which he was
writing) was a hundred times greater than any I have seen in
the human female, for she was pregnant and contained thirteen
pigs.' These happen to be the only reference to specific
bodies that he makes in his treatise. But it is a far cry to
wring out of these references the conclusion that these are
the only dissections he made. It is quite true that if we
incline to enshroud his work in a cloud of mystery and to
figure it as an unprecedented awe-inspiring feature to break
down the prejudices of the ages, it is easy to think of him as
having timidly profaned the human body by his anatomizing zeal
in but one or two instances. His own language, however,
throughout his book is that of a man who was familiar with the
differing conditions of the organs found in many different
bodies; a man who was habitually dissecting.
(Quotations from the work of Mundinus showing his familiarity
with dissections. The leaf and line references are to the
Dryander edition, Marburg, 1541.)
I do not consider separately the anatomy of component parts,
because their anatomy does not appear clearly in the fresh
subject, but rather in those macerated in water. (Leaf 2,
lines 8-13.)
... these differences are more noticeable in the cooked or
perfectly dried body, and so you need not be concerned about
them, and perhaps I will make an anatomy upon such a one at
another time and will write what I shall observe with my own
senses, as I have proposed from the beginning. (Leaf 60,
lines 14-17.)
What the members are to which these nerves come cannot well
be seen in such a dissection as this, but it should be
liquefied with rain water, and this is not contemplated in the
present body. (Leaf 60, lines 31-33.)
After the veins you will note many muscles and many large and
strong cords, the complete anatomy of which you will not
endeavor to find in such a body but in a body dried in the sun
for three years, as I have demonstrated at another time; I
also declared completely their number, and wrote the anatomy
of the muscles of the arms, hands, and feet in a lecture which
I gave over the first, second, third, and fourth subjects.
(Leaf 61, lines 1-7.)
Very probably the best evidence that we have of the comparative
frequency at least of dissection at this time is to be found in the
records of a trial for body-snatching that occurred in Bologna. The
details would remind one very much of what we know of the difficulties
with regard to dissection in America a couple of generations ago, when
no bodies were provided by law for dissection purposes. In the course of
some studies for the history of the New York State Medical Society (New
York, 1906) I found that nearly every one of the first half dozen
presidents of the New York Academy of Medicine, which is not much more
than sixty years old, had had body-snatching experiences when they were
younger. Dr. Samuel Francis, the medico-historical writer, tells of a
personal expedition across the ferry in the winter time, bringing a body
from a Long Island graveyard. In order to avoid the constables on the
Long Island side and the police on the New York side, because there had
been a number of cases of body-snatching recently and the authorities
were on the lookout, the corpse was placed sitting beside the physician
who drove the wagon, with a cloak wrapped around it, as if it were a
living person specially protected against the cold. Similar experiences
were not unusual. The lack of bodies for dissection is sometimes
attributed to religious scruples, but they have very little to do with
it, as at all times men have refused to allow the bodies of their
friends to be treated as anatomical material. This is the natural
feeling of abhorrence and not at all religious. It is only when there
are many unclaimed bodies of strangers and the poor, as happens in large
cities, that there can be an abundance of anatomical material.
The details of this body-snatching case are strangely familiar to those
who know the history of similar cases before the middle of the
nineteenth century. The case occurred in 1319 in Bologna, just four
years after Mondino's public dissections. Four students were involved in
the charge of body-snatching, all of them from outside the city of
Bologna itself, three from Milan and one from Piacenza. In modern
experience, too, as a rule, students from outside of the town where the
medical college was situated, were always a little readier than natives
to violate graveyards. These four students were accused of having gone
at night to the Cemetery of St. Barnabas, outside the gate of San
Felice,--suburban graveyards were usually the scene of such
exploits,--and to have dug up the body of a certain criminal named
Pasino, who had been hanged a few days before. They carried the body to
the school in the Parish of San Salvatore, where Alberto Zancari was
teaching. The resurrection had been accomplished without witnesses, but
there were several witnesses who testified that they recognized the body
of Pasino in the school and students occupied with its dissection. If
evidence for the zeal of the medical students of that time for
dissection were needed, surely we have it in the testimony at this
trial. At a time when body-snatching has become a criminal offence
usually there have been many repeated occurrences of it before the
parties are brought to trial, so that it seems not unlikely that a good
many dissections of illegally secured bodies were being done at Bologna
at this time.
We know of a regulation of the University in force at this time, which
required the teachers at the University to do an anatomy or dissection
for students if they secured a body for that purpose. The students seem
to have used all sorts of influence, political, monetary, diplomatic,
and ecclesiastical, in order to secure the bodies of criminals.
Sometimes when they failed in their purpose they waited until after
burial and then took the body without leave. When we recall the awfully
deterrent condition in which bodies must have been that were thus
provided for dissecting purposes, it is easy to understand that the
enthusiasm of the students for dissection must have been at a very high
pitch. Certainly it was far higher than at the present day, when, in
spite of the fact that our dissecting-rooms have very few of the
old-time dangers and unpleasantnesses, dissection is only practised with
assiduity if special care is exercised in requiring attendance and
superintending the work of the department.
In my book on The Popes and Science I have gathered the traditions
relating to Mondino's assistants in the chair of anatomy at Bologna.
They furnish abundant evidence of the fact that dissections, far from
being uncommon, must have been not at all infrequent at the north
Italian universities at this time. Curiously enough, one of these
assistants was a young woman who, as was not infrequently the custom at
this time in the Italian universities, was matriculated as a student at
Bologna. She took up first philosophy, and afterwards anatomy, under
Mondino. While it is not generally realized, co-education was quite
common at the Italian universities of the thirteenth and fourteenth
centuries, and at no time since the foundation of the universities has a
century passed in Italy without distinguished women occupying
professors' chairs at some of the Italian universities. This young
woman, Alessandra Giliani, of Persiceto, a country district not far from
Bologna, took up the study of anatomy with ardor and, strange as it may
appear, became especially enthusiastic about dissection. She became so
skilful that she was made the prosector of anatomy, that is, one who
prepares bodies for demonstration by the professors.
According to the Cronaca Persicetana, quoted by Medici in his History
of the Anatomical School at Bologna:
She became most valuable to Mondino because she would cleanse most
skilfully the smallest vein, the arteries, all ramifications of the
vessels, without lacerating or dividing them, and to prepare them for
demonstration she would fill them with various colored liquids, which,
after having been driven into the vessels, would harden without
destroying the vessels. Again, she would paint these same vessels to
their minute branches so perfectly and color them so naturally that,
added to the wonderful explanations and teachings of the master, they
brought him great fame and credit. The whole passage shows a wonderful
anticipation of our most modern methods--injection, painting,
hardening--of making anatomical preparations for class and demonstration
purposes.
Some of the details of the story have been doubted, but her memorial
tablet, erected at the time of her death in the Church of San Pietro e
Marcellino of the Hospital of Santa Maria de Mareto, gives all the
important facts, and tells the story of the grief of her fiance, who was
himself Mondino's other assistant.[17] This was Otto Agenius, who had
made for himself a name as an assistant to the chair of anatomy in
Bologna, and of whom there were great hopes entertained because he had
already shown signs of genius as an investigator in anatomy. These hopes
were destined to grievous disappointment, however, for Otto died
suddenly, before he had reached his thirtieth year. The fact that both
these assistants of Mondino died young and suddenly, would seem to point
to the fact that probably dissection wounds in those early days proved
even more fatal than they occasionally did a century or more ago, when
the proper precautions against them were not so well understood. The
death of Mondino's two prosectors in early years would seem to hint at
some such unfortunate occurrence.
As regards the evidence of what the young man had accomplished before
his untimely death, probably the following quotation, which Medici has
taken from one of the old chroniclers, will give the best idea:
What advantage indeed might not Bologna have had from Otto
Agenius Lustrulanus, whom Mondino had used as an assiduous
prosector, if he had not been taken away by a swift and
lamentable death before he had completed the sixth lustrum of
his life!
How well the tradition created by Mondino continued at the university
will be best understood from what we know of Guy de Chauliac's visit to
the medical school here about the middle of the century. The great
French surgeon tells us that he came to Bologna to study anatomy under
the direction of Mondino's successor, Bertruccius. When he wrote his
preface to his great surgery he recalled this teaching of anatomy at
Bologna and said, It is necessary and useful to every physician to
know, first of all, anatomy. For this purpose the study of books is
indeed useful, but it is not sufficient to explain those things which
can only be appreciated by the senses and which need to be seen in the
dead body itself. He advises his students to consult Mundinus' treatise
but to demonstrate its details for themselves on the dead body. He
relates that he himself had often, multitoties, done this, especially
under the direction of Bertruccius at Bologna. Curiously enough, as
pointed out by Professor Pilcher, Mondino had used this same word
multitotiens (the variant spelling makes no difference in the meaning)
in speaking about his own work. In describing the hypogastric lesion he
mentions that he had demonstrated certain veins in it many times,
multitotiens.
Mondino was just past fifty when he finished his little book and
permitted copies of it to be made. Though the book occurs so early in
the history of modern book-making the author offers his excuses to the
public for writing it, and quotes the authority of Galen, to whom he
turns in other difficult situations, for justification. As prefaces go,
Mondino's is so like that of many an author of more recent date that his
words have a bibliographic, as well as a personal, interest. He said:
A work upon any science or art--as saith Galen--is issued for
three reasons: first, that one may satisfy his friends.
Second, that he may exercise his best mental powers. Third,
that he may be saved from the oblivion incident to old age.
Therefore, moved by these three causes, I have proposed to my
pupils to compose a certain work on medicine.
And because a knowledge of the parts to be subjected to
medicine (which is the human body, and the names of its
various divisions) is a part of medical science, as saith
Averrhoes in his first chapter, in the section on the
definition of medicine, for this reason among others, I have
set out to lay before you the knowledge of the parts of the
human body which is derived from anatomy, not attempting to
use a lofty style, but the rather that which is suitable to a
manual of procedure.
Some of the early editions of Mondinus' book are said, according to old
writers, to have contained illustrations. None of these copies have come
down to us, but the assertion is made so definitely that it seems likely
to have been the case. The editions that we have contain wood engravings
of the method of making a dissection as frontispiece, so that it would
not be difficult to think of further such illustrations having been
employed in the book itself. As we note in the chapter on Great
Surgeons of the Medieval Universities, Mondeville, according to Guy de
Chauliac, had pictures of anatomical preparations which he used for
teaching purposes. It is easy to understand that the value of such aids
would be recognized at a time when the difficulty of preserving bodies
made it necessary to do dissections hurriedly so as to get the rapidly
decomposing material out of the way.
Beyond his book and certain circumstances connected with it we know very
little about Mondino. What we know, however, enables us to conclude
that, like many another great teacher, he must have had the special
faculty of inspiring his students with an ardent enthusiasm for the work
that they were taking under him. Hence the body-snatching and other
stories. Mondino continued to be held in high estimation by the
Bolognese for centuries after his death. Dr. Pilcher calls attention to
the fact that his sepulchral tablet, which is in the portico of the
Church of San Vitari in Bologna, and a replica of which he was allowed
to have made in order to bring it to America, is the only one of the
sepulchral tablets in the great churches of Florence, San Domenico, San
Martino, the Cathedral and the Cloister of San Giacomo degli Ermitani,
which has not been removed from its original location and placed in the
halls of the Civic Museum. Their removal he considers a kind of
desecration which does violence to one's sense of sanctity and
propriety. Fortunately, thus far, the Mondino Tablet has escaped the
spoiler. Very probably Dr. Pilcher's replica of the tablet which he
was required to deposit in the Civic Museum at the time when the copy
was made to be brought to America may save the tablet to be seen in its
original position for many generations.
Mondino's career is of special interest because it foreshadows the life
and accomplishment of many another maker of medicine of the after time.
He did a great new thing in medicine in organizing regular public
dissections, and then in making a manual that would facilitate the work.
He waited patiently for years before completing his book in order that
it might be the fruit of long experience, and so be more helpful to
others. He was so modest as to require urging to secure the publication.
He had the reward of his patience in the popularity of his little work
for centuries after his time. The glimpse that we get of his relations
to his young assistants, Agenius and Alessandra, seems to show us a
teacher of distinct personal magnetism. Undoubtedly the reputation of
his book did much for not only the medical school of the University of
Bologna, but also for the medical schools of other north Italian
universities, and helped to bring to them the crowds of students that
flocked there during the fourteenth and fifteenth centuries.
Taddeo and Mondino turned the attention of the medical students of their
generations Bolognawards. Before that time they had mainly gone to
Salerno. After their time most of the ardent students of medicine felt
that they must study for a time at least at Bologna. Other important
medical schools of Italian universities at Padua, at Vicenza, at
Piacenza, arose and prospered. During the time when the political
troubles of Italy reached a climax about the middle of the fourteenth
century, while the Popes were at Avignon, there was a remission in the
attendance at all the Italian universities, but with the Popes' return
to Rome and the coming of even comparative peace to Italy, Bologna once
more became the term of medical pilgrimages for students from all over
the world. In the meantime Mondino's book went forth to be the most used
text-book of its kind until Vesalius' great work came to replace it. To
have ruled in the world of anatomy for two centuries as the best known
of teachers is of itself a distinction that shows us at once the
teaching power and the scientific ability of this professor of anatomy
of Bologna in the early fourteenth century.
More
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