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The Popes And Medical Education And The Papal Medical School

( Originally Published 1911 )

After the story of the Papal Physicians, the most important phase of the relations of the Popes to the medical sciences is to be found in the story of the Papal Medical School. While it seems to be generally ignored by those who are not especially familiar with the history of medical education, a medical school existed in connection with the Papal University at Rome during many centuries according to excellent authorities, from the beginning of the fourteenth century and this medical school had, as we have said elsewhere, during nearly two centuries some of the most distinguished professors of medicine in its ranks, and boasts among its faculty some of the greatest discoverers in the medical sciences, and especially in anatomy. For these two centuries it had but two important rivals, Padua and Bologna. Both of these were in Italy, and one, that of the University of Bologna, was in a Papal city, that is, was under the political dominion of the Popes. The best medical teaching, then, was to be found in the Papal States and under conditions such, that if there had been the slightest opposition, or indeed anything but the most cordial encouragement for medical study, the medical schools of Rome and Bologna would surely have languished instead of flourishing beyond all others.

Just about the beginning of the fourteenth century Pope Boniface VIII., who was himself one of the distinguished scholars of his time, determined that, besides the university of the Papal Court, which had existed for nearly a century at Rome, but which was mainly occupied with philosophy and theology and mainly attended by ecclesiastics, there should also be a university of the City of Rome for the people of his capital. This determination was reached only a short time before the culmination of the difficulty between Pope Boniface and the King of France, which eventually resulted in what has been called the outrage of Anagni and the subsequent death of the Pope within a short time. It has usually been thought, then, that in spite of certain extant Papal documents creating the University of the City of Rome, this university had not been organized before Pope Boniface's death, and as his successor did not take his seat at Rome, but at Avignon, it has usually been assumed that the University of the City came into existence at most only in an abortive form. Denifle, whose History of the Universities of the Middle Ages is looked upon as the best authority in such matters, however, insists that a complete university of the City of Rome did come into existence as a result of Boniface's decree.

All during the time when the Popes were at Avignon this university continued to exist, and in spite of the fact that at one time, as a consequence of a great earthquake followed by a pestilence, and then serious political troubles because of the absence of the Popes, Rome had only something less than ten thousand inhabitants, the university continued its work. Denifle calls attention to the fact that there are letters of Pope John XXII. which show that he paid out of the Papal revenues the salary of a teacher of physic at the University of the City of Rome while the Papal Court was at Avignon. It is rather interesting to find the names of the two Popes, Boniface VIII, and John XXII., whose Papal decrees are supposed to have prevented the study of anatomy and chemistry, thus cropping up on unquestionable authority as the founder and the patron of medical teaching in the City of Rome. Pope Boniface VIII. is now generally credited with having been the founder of the Sapienza, the medical school of which, at the beginning of the sixteenth century, was to develop into one of the most important schools of its kind in Europe, and to have on its faculty list the greatest teachers of their time, who had been tempted to come to Rome because the Popes wished to enhance the prestige of the medical school of their capital.

While it may be a surprise for those who have been accustomed to think of the Popes as inalterably opposed to all science, and especially to medical science, thus to find them encouraging and fostering medical teaching, it will only be what would naturally be expected by those who know anything of the real history of medicine in the earlier Middle Ages. There is no doubt at all, that during the so-called "dark ages," that is, when the invasion of the barbarians had put out the lights of the older civilizations, it was mainly ecclesiastics who preserved whatever traditions there were of the old medical learning and carried on whatever serious teaching of medicine, in the sense of medical science, that existed during this time. The monks were the most prominent in this ; and the Benedictines, after their foundation in the sixth century, added to their duties of caring for the other temporal needs of the poor, who so often appealed to them, that of helping them as far as they could in any bodily ailments with which they might be afflicted. There are even definite traditions that a certain amount of training in medicine, or at least in the care of the sick, was one of the features of the Benedictine monasteries.

Dr. Payne in his article on the History of Medicine in the Encyclopedia Brittanica said : " In civil history there is no real break. A continuous thread of learning and practice must have connected the last period of Roman medicine with the dawn of science in the Middle Ages. But the intellectual thread is naturally traced with greater difficulty than that which is the theme of civil history ; and in periods such as that from the fifth to the tenth century in Europe, it is almost lost. The chief homes of medical as of other learning in these disturbed times were the monasteries. Though the science was certainly not advanced by their labors, it was saved from total oblivion, and many ancient medical works were preserved in Latin or the vernacular versions. It was among the Benedictines that the monastic studies of medicine first received a new direction and aimed at a higher standard. The study of Hippocrates, Galen, and other classics was recommended by Cassiodorus (sixth century), and in the original mother abbey of Monte Cassino medicine was studied, though there was probably not what could be called a medical school there nor had this foundation any connection (as has been supposed) with the famous school of Salerno."

A review of some of the interesting features of the early history of medical education will serve to show that, not only was there no ecclesiastical interference with the new developing science, but, on the contrary, without the personal aid and the intelligent patronage of ecclesiastics of all degree, and especially of arch-bishops and Popes, the development of medical teaching that took place at Salerno would probably not have had the significance in history that it now enjoys. While there was no institutional connection between the medical school of Salerno and the Benedictine Monastery at Monte Cassino, it is known that at the end of the seventh century there was a branch Benedictine monastery at Salerno, and some of the prelates and higher clergy occupied posts as teachers in the school, and even became distinguished for medical acquirements.

Though the Salernitan medical school proper was a secular institution, there is no doubt that the Benedictines had great influence in it and had fostered its formation. How close the monks of Monte Cassino were allied to the Popes, everyone knows. The Benedictines considered themselves the special wards of the Papacy, and a number of the Abbots of Monte Cassino, or monks be-longing to the community, and of men who had been educated in the monastery, had been raised to the Papacy during the Middle Ages. The origin of modern medical teaching is thus closely associated not only with the Benedictines, but through them with the Popes, without whose encouragement and sanction the work would not have flourished as it did.

In advance of the formal establishment of medical schools, in the modern sense of the word, two Popes were distinguished before their elevation to the Papacy for their attainments in all the sciences, and especially in medicine, one of whom actually founded an important school of thought in medicine, while the other was a professor at Salerno. The first of these is the famous Gerbert, who, under the name of Sylvester IL, was Pope at the end of the millenium and carried Christianity over what was supposed to be the perilous period of the completion of the first thousand years, when the end of the world was so universally looked for. Gerbert was famous for his attainments in every branch of science, and indeed so many wonderful traditions have collected around his name in this matter that one hesitates to accept most of them. There seems to be no doubt, how-ever, that he was the beloved master of Fulbert of Chartres, who did much for medicine in France at the beginning of the eleventh century and who was the founder of the so-called school of Chartres and himself the teacher of John of Chartres, who became the physician to King Henry I., of France, and of Peter of Chartres and Hildier and Goisbert.

Before the end of the eleventh century Pope Victor III., who had been the Abbot of Monte Cassino, was elected Pope much against his will. He occupied the Papal throne only for about a year and a half. He had been especially recommended by Pope Gregory VII., the famous Hildebrand, as a very suitable successor. Desiderius, as he was called before becoming Pope, was one of the best scholars of his time, and had taught for some years with great distinction at Salerno. It is not known absolutely that he taught medicine, but, as the university of Salerno is usually considered not to have been founded until the middle of the next century, and as be-fore that time the main teaching faculty was that of the medical school and all other teaching was subordinated to it, Desiderius must surely be considered as a teacher at least of medical students. At that time a physician was expected to know something more than merely his profession. Mathematics and philosophy were the two favorite subjects to which, besides medicine, they de-voted themselves. The presence of the future Pope at Salerno is, moreover, the best possible index of the sympathy between the ecclesiastical authorities and the medical school.

Besides there are definite records of the friendship which existed between Alphanus, Archbishop of Salerno, and Desiderius, while they were both members of the Benedictine Community of Monte Cassino. Alphanus subsequently taught medicine at Salerno, and some of his writings on medicine have been preserved for us. He was the author of a work bearing the title De Quatuor Elementis Corporis Humani, a treatise on the four elements of the human body, which is a compendium of most of the knowledge of anatomy and physiology of the time, though it also contains much more than the in-formation with regard to the merely physical side of man's being. The fact that Alphanus should have been promoted from the professorship in the medical faculty to the Archbishopric of Salerno is only another proof of the entire sympathy which existed between the Church and the professors of medical science at that time.

During the thirteenth century universities were founded in some twenty important cities in Europe, and in connection with most of them a medical school was established. These educational institutions were the result of the initiative of ecclesiastics ; their officials all belonged to the clerical body, most of their students were considered as clerics and indeed this was the one way to secure them against the calls for military service which would otherwise have disturbed the enthusiasm for study and the Popes were considered the supreme authority over all the universities. In spite of this thoroughly ecclesiastical character of the universities and educational institutions, there is not a hint of interference with the teaching of medical science and abundant evidence of its encouragement. Indeed, for anyone who knows the story of the universities of the thirteenth century, it is practically impossible to understand how there could have arisen any tradition of ecclesiastical opposition to education in any form, and there is not a trace of foundation for the stories with regard to ecclesiastical intolerance of science, which are supposed to be supported by certain Papal decrees.

The best possible demonstration of the maintenance of the most amicable relations between churchmen and physicians during the century in which these decrees were issued is also the most interesting fact in the history of medicine during the thirteenth century. It is not generally known that one of the most distinguished physicians of the thirteenth century, one who wrote a book on the special subject of eye diseases that is still a classic, afterwards became Pope under the name of John. He is variously known as John XIX., John XX., or John XXI., according as certain occupants of the Papal throne are considered to be of authority or not. He was educated at Paris, and probably spent some time at Montpelier. Under the name of Peter of Spain, though he was what we should now call a Portuguese, he subsequently taught physic at the University of Sienna. Here he wrote the famous little work on the Diseases of the Eye, which was reviewed by Dr. Petella, physician-in-chief of the Royal Italian Marine, in Janus, the International Archives for the History of Medicine and for Medical Geography in 1898. Petella does not hesitate to proclaim him one of the greatest men of his time. Daunou, one of the continuators of the Benedictines' literary history of France,' says that this Peter of Spain was one of the most notable persons in Europe in his generation.

Pope John XXI., before his accession to the Papacy, had certainly accomplished remarkable work in medicine, and of a kind that makes his writings of great interest even at the present day. There is scarcely an important pathological condition of the eye which does not receive some consideration in this little book, and it is a constant source of surprise in reading it to find, with their limited knowledge and lack of instruments, what good diagnosticians the ophthalmologists of the thirteenth century were. Cataract is described, for instance, under the name of "water that descends into the eye," and a distinction is made between cataract from internal and external causes. Hardening of the eye is mentioned and is declared to be very serious in its effects. There seems no doubt that this was glaucoma. Conditions of the lids, particularly, were differentiated and treated by rational measures, some of them quite modern in sub-stance. A curious anticipation of modern therapeutics is the frequent recommendation of extracts of the livers of various fishes for external and internal use, that is a reminder of the present employment of cod-liver oil. The book is acknowledged to be a classic In medicine. The fact that its author should have become Pope later, is the best proof that instead of opposition there was the greatest sympathy between medicine and ecclesiasticism in his time.

With these thoroughly amicable relations between the Church and the medical schools during the thirteenth and preceeding centuries, it will not be so much of a surprise as it might otherwise be, to learn of the foundation of the Medical School of Rome and of the continuation of Papal patronage of it even while the Popes were absent at Avignon. University records do not say much about it during the next two centuries. With the coming of the Renaissance, however, and the entrance of a new spirit into education, the Popes also were touched by the educational time-spirit, and there came a rejuvenation of the University of the City, which now acquired a new name, that of the Sapienza, and became the home of some of the most distinguished teaching in Europe in every department Early in the sixteenth century the medical department of the Sapienza, or Papal University at Rome, became one of the most note-worthy institutions of Europe because of the work in medicine accomplished there, and had among its faculty the most distinguished investigators in medical science, and especially in that department of medicine anatomy which by an unfortunate tradition the Popes are said to have hampered.

The most important event in the history of the institution, after its foundation, was its establishment in the home which it was to occupy down to our own time. Its new habitation was prepared for it by the Pope who has probably been the most maligned in history Alexander VI. A magnificent site was appropriated for it, and the construction of suitable buildings begun. A little more than a decade later, Leo X., another one of the misunderstood Popes, came to the conclusion that the two universities in Rome, that of the Papal Court and that of the City, would do better work if combined into one, and accordingly this combination was effected. This made provision for one very strong teaching faculty in Rome. The final steps for the completion of the union of the two universities were taken by Pope Alexander VII., and the buildings which the new university was to occupy were finished in a manner worthy of the great institution of learning which it was hoped to create in Rome.

The first of the great professors who made the Papal Medical School famous was Realdo Colombo, often spoken of as Columbus simply, who was invited to teach in Rome by Pope Paul III., the same Pope who issued the bull founding the Jesuits. Some people might consider the two actions as representing contrary tendencies in education, but they are not such as know either the history of the Jesuits, or of the constant endeavor of the Popes to foster education. Columbus came to Rome, as we have said, with the prestige of having succeeded Vesalius at Padua, and later having been specially tempted by the reigning prince in Pisa, who wanted to create a great medical school in connection with his university in that city, which he was at that moment trying to raise to distinction, to accept the professorship of anatomy there.

Vesalius was still alive at this time, and the period when, if we would credit certain historians who emphasize the opposition between the Church and science, it was dangerous to dissect human bodies had not yet passed. It is interesting to read the account of Columbus's reception in Rome, and the interest manifested in his work by all classes in the Roman University. at this time. His course in anatomy was so enthusiastically attended that, as he himself tells in a letter to a friend, he often had several hundred persons in his audience when he gave his anatomical demonstrations on the cadaver. These were not all medical students, but many of them were ecclesiastics, and some of them important members of the hierarchy. Even cardinals manifested their interest in anatomy, and occasionally attended the public dissections public, that is, as far as the University is concerned which were made by Columbus.

Columbus's enthusiasm for anatomy was such that, as Dr. Fisher said of him in the Annals of Anatomy and Surgery, Brooklyn, 1878-1880, " he dissected an extra-ordinary number of human bodies, and so devoted him-self to the solution of problems in anatomy and physiology that he has been most aptly styled the Claude Bernard of the sixteenth century." In one year, for in-stance, he is said to have dissected no less than fourteen bodies, demonstrating, as Dr. Fisher has said, that " it was an age of remarkable tolerance for scientific investigation."

Besides being an investigator, Columbus was a great teacher, and many of our modern methods of instruction in medical schools had their origin in the system of demonstrations introduced by him. His descriptions of the demonstrations for students upon living animals, show that some of the most recent ideas in medical teaching were anticipated by this Roman professor of anatomy and medicine in the Renaissance period. His demonstrations of the heart and blood-vessels and of the actions of the lungs are particularly complete, and must have given his students a very practical working knowledge of these important physiological functions. In a word, the medical teaching - of the Roman University, under him at this time, far from being merely theoretic and distant from actual experience and demonstration, was thoroughly modern in its methods.

It is no wonder, then, that practically all the ecclesiastical visitors who came in such numbers to Rome, made it a custom at this time to attend one or more of Columbus's anatomical lectures. They were looked upon as one of the features of the Roman university life of the time. How much good was accomplished by this can scarcely be estimated. The example must have had great influence especially on members of faculties of various educational institutions who came to the Papal See. To some degree at least these interesting teaching methods must have aroused in such men the desire to see them emulated in their own teaching institutions, and therefore must have done much to advance medical education. The fact that these things were done in the Papal Medical School only emphasized the significance of them for ecclesiastics, and made them more ready to bring about their imitation in other teaching centers.

How well the Popes were justified in their estimation of Columbus's genius as an anatomical investigator will be best appreciated from his discovery of the pulmonary circulation, which formed, as Harvey confesses at the beginning of his work on the circulation, the foundation on which Harvey's great discovery naturally arose. It is probable that Columbus would not have come to Rome, in spite of the flattering offers held out to him, only that he was already the personal friend of a number of high ecclesiastics, and even of the Pope who ex-tended the invitation. How well the Popes continued to think of Columbus after his years of work in the Roman Medical School will be well understood from the fact that, when his great work De Re Anatomica was published after his death by his sons, Pope Pius IV. accepted the dedication of it. This was of course not an unusual thing, for many books on other sciences were dedicated to the Popes, and the example thus set was subsequently imitated. Twenty-five years later, Professor Piccolomini dedicated his Anatomical Lectures to Pope Sixtus V. Subsequent anatomical publications of the Papal Medical School were issued under like patronage. The famous edition of Eustachius's anatomical sketches, published under the editorship of Lancisi, is a notable example of this, and went to press mainly at the expense of Pope Clement XI., who realized how valuable they were likely to be for the teaching of anatomy.

These two great discoverers in anatomy, Columbus and Eustachius, were succeeded, as is so often the case in the history of university faculties, by a man more capable of writing about great discoveries than of making them himself. This was Piccolomini, who devoted himself to showing how much the ancients had taught about anatomy, though at the same time he also made clear the place occupied by modern anatomical discoveries. While his name is not attached to any great discovery in the science of anatomy, he is generally acknowledged to have been one of the great teachers of his time and one who was needed just then in order to make people realize how the old and the new in anatomy must be coordinated. Piccolomini's successor in the chair of anatomy at Rome was another original genius and investigator whose name, however, and fame has never been as great among English-speaking people as in Italy, or among the Latin races generally. The fact that he was a rival of Harvey's in the matter of the discovery of the circulation of the blood has always made the Italians exaggerate his position in medical history, while it has undoubtedly made English writers of medical history diminish the importance of his work.

Historians of science consider him worthy to be called the greatest living scientist of his time the end of the sixteenth century. He was not only a scientific physician, but he was an authority in all the sciences related to medicine, and indeed had profound interests in every branch of physical science. His contemporaries looked up to him as a leader in scientific thought. To anyone who examines the question of the discovery of the circulation of the blood with freedom from bias, there can be no doubt but that the honor for this discovery has been unduly taken away from Caesalpinus in English-speaking countries, to be conferred solely on Harvey. Not that there is any wish to lessen the value of Harvey's magnificent original work, nor make little of his wonderful powers of observation, nor of the marvelous experimental and logical method by which he followed out his thoughts to their legitimate conclusion, but that I would insist on giving honor where honor is due, though most writers in English refuse to give Caesalpinus's claims a proper share of attention.

The Italians have always declared that Caesalpinus was the real discoverer of the circulation, and there is no doubt that his career occurs just at that point in the evolution of the medical sciences, and especially anatomy and physiology in Italy, where this discovery would naturally come. Lest it should be thought, however, that my interest in the Popes and the Papal Medical School has led me to exaggerate the claims of Celalpinus as a great naturalist and medical scientist, I prefer to quote the description of him given by Professor Michael Foster in his lectures on the History of Physiology, delivered in this country as the Lane Lectures, at the Cooper Medical College in San Francisco, and published by the Cambridge University Press, 1901. Professor Foster was not one to exaggerate the claims of any Italian, and least of all of any Italian who might be sup-posed to have a claim that would stand against Harvey's. The soupçon of Chauvinism in his treatment of Servetus and Columbus in this regard is indeed rather amusing. He said:

" Of a very different stamp to Columbus was Andreas Caesalpinus. Born at Arezzo in 1519, he was for many years Professor of Medicine at Pisa, namely, from 1567 to 1592, when he passed to Rome, where he became Professor at the Sapienza University and Physician to Pope Clement VIII., and where at a ripe old age he died in 1603.

" If Columbus lacked general culture, Caesalpinus was drowned in it. Learned in all the learning of the ancients and an enthusiastic Aristotelian, he also early laid hold of all the new learning of the time. Naturalist as well as physician, he taught at Pisa botany as well as medicine, being from 1555 to 1575 Professor of Botany, with charge of the Botanic garden founded there in 1543, the first of its kind one remaining until the present day."

Professor Foster admits that Caesalpinus had a wonderful power of synthetising knowledge already in hand and anticipating conclusions in science that were to be confirmed subsequently. In his Medical Questions, though the work is written in rambling, discursive vein, he enunciated views which, however he arrived at them, certainly foreshadowed or even anticipated those which were later to be established on a sound basis. Foster quotes a passage in which Caesalpinus made it very clear that he thoroughly understood the mechanism of the circulation and grasped every detail essential to it. After quoting this passage, which it must be confessed is rambling, Foster thus sums up what Caesalpinus has to say with regard to the circulation:

" He thus appears to have grasped the important truth, hidden, it would seem, from all before him, that the heart, at its systole, discharges its contents into the aorta (and pulmonary artery), and at its diastole receives blood from the vena cava (and pulmonary vein)."

"Again, in his Medical Questions he seems to have grasped the facts of the flow from the arteries to the veins, and of the flow along the veins to the heart."

That there was no change of Papal policy in the next century can be gathered from an interesting phase of Papal interest in science which, though not directly concerned with medicine, eventually resulted in important theoretic advances in medical science. This was the encouragement of Father Kircher's work at Rome. Father Kircher was the Jesuit who made the first scientific museum. As the result of his general interest in things scientific he wrote a little book on the pest. In this book he stated in very clear terms the modern doctrine of the origin of disease from little living things, which he called corpuscles. Because of this Tyndall attributes to Father Kircher the first realization of the rôle that bacteria play in disease. Even more wonderful than this, however, was Father Kircher's anticipation of modern ideas with regard to the conveyance of disease. He insisted that contagious diseases, as. a rule, were not carried, as had been thought, by the air, but were conveyed from one person to another, either directly, or by the intermediation of some living thing. He considered that cats and dogs were surely active in conveying diseases, and he even reached the conclusion that insects were also important in this matter. His expressions with regard to this are not of the indefinite character which one often encounters in the supposed anticipation of important principles in medicine, but are very precise and definite. Father Kircher is quoted by Dr. Howard Kelly, of Baltimore, in his life of Major Walter Reed, whose work in showing that yellow fever is transmitted by mosquitoes is well known, as saying in one place, " Flies carry the plague, " and in another place, " There can be no doubt that flies feed on the internal secretions of the diseased dying, then flying away they deposit their excretions on the food in neighboring dwellings, and persons who eat it are thus infected." It is interesting to find that the Professor of the Practice of Medicine in the Papal University at Rome when this book was published, far from resenting, as many professors of medicine might, the excursion of an outsider into his science, said Father Kircher's book " not only contains an excellent résumé of all that is known about the pest or plague, but also many valuable hints and suggestions on the regional spread of the disease which had never before been made. He did not hesitate to add that it was marvelous for a man, not educated as a physician, to have reached such surprising conclusions, which seemed worthy of general acceptance. All this, it may be said in passing, was within a few years after the trial of Galileo.

In this next century the Popes continued their special efforts to secure the greatest teachers of anatomy and physiology for their Roman medical school. One of the results was the appointment of Malpighi, whose name has deservedly become attached to more structures in the human body because of tissues which he first studied in detail, than any other man in the history of medicine. Malpighi represents the beginning of most of the comparative biological sciences, and his original observations upon plants, upon the lower animals, on fishes and then on the anatomical structure of man and the higher animals, stamp him as an investigating genius of the highest order. He was the personal friend of Innocent XI., who wished to have him near him at Rome as his own medical adviser, and besides desired the prestige of his fame and the stimulating example of his investigating spirit for the students of the medical school of the Sapienza. The closing years of Malpighi's life were rendered happier, and his wonderful researches were as well re-warded as such work can be, by the estimation in which he was held at Rome.

Malpighi was succeeded as Papal Physician and Professor in Rome by Tozzi, who is distinguished in the history of medicine for his commentaries on the ancients rather than for original observation, but who was looked upon in his time as one of the most prominent physicians in Italy. Tozzi had been the Professor of Medicine and Mathematics at the University of Naples, where he became famous. From here he received a flattering invitation to the chair of physic at Padua. In order that he might not desert Naples, his salary was raised and he was given the post of Protomedicus or Chief Physician to the Court. It was after this that the death of Malpighi left an important chair vacant in Rome, and there being no one apparently more worthy than this man for whom other important universities were contending, he was offered the chair on such excellent conditions that he accepted it. It is another case of the Popes being not only willing and even anxious, but also able because of their position, to secure the best talent available for their medical school at the Roman University.

Undoubtedly one of the greatest members of the faculty that the Papal Medical School ever had is Lancisi, one of the supreme medical teachers of history, who is usually considered one of the founders of modern clinical medicine. When at the beginning of the eighteenth century Boerhaave attracted the attention of the world by his bedside teaching of medicine at Leyden, there were two occupants of thrones in Europe who proved to have particular interest in this new departure. They were perhaps the last two who might ordinarily be expected to have much use for such improvements in medical education. One of them was the Empress Maria Theresa, of Austria, whose patronage of Boerhaave's pupil, Van Swieten, secured the establishment of that system of clinical teaching which has since made the Vienna Medical School famous. The other was the Pope. With his approbation Lancisi established clinical teaching at Rome, and thus did much to maintain at Rome a great center of medical progress during the eighteenth century.

Lancisi. was graduated at the Sapienza, the Roman University, at the early age of eighteen. When only twenty-two he became assistant physician at the Santo Spirito Hospital and began to show the first hint of the brilliant genius he was to display later in life.

Some ten years later, as the result of a competitive examination which still further demonstrated his talents, he was chosen Professor of Anatomy in his Alma Mater, the Sapienza. He was only thirty-three at the time, and the fact that he should be chosen shows that the Papal University was ready to take advantage of talent where-ever it found it and did not allow itself to be won only by notoriety at a distance. The excellence of the choice was demonstrated before long by Lancisi's brilliant career as a teacher and an original investigator. Some of the most distinguished medical men from all over the world came to listen to his lectures (according to Hirsch's Biographical Lexicon of the Most Prominent Physicians of All Times and Peoples), and even Malpighi and Tozzi, the Papal physicians during the time, were among his auditors.1

After the departure of Tozzi from Rome Lancisi became the Papal physician. He continued to be the medical adviser of Popes Innocent XI. and XII. and of Clement XI. until his death in 1720. It was under Clement that he had the new clinic built, in which teaching after the manner of Boerhaave was to be established. At his death Lancisi left his fortune and his library to Santo Spirito Hospital, on condition that a new portion of the hospital should be erected for women. There is no doubt that he belongs among the most distinguished of contributors to medical science, and Hirsch declares that anatomy, practical medicine, and hygiene are indebted to him for notable achievements. His books are still classics. The one on Sudden Death worked a revolution in the medical diseases of the brain and heart. His work De Motu Cordis et Aneurysmatibus has been pronounced epoch-making, and his suggestion of percussion over the sternum in order to determine the presence of an aneurysm, made him almost an anticipator of Auenbrugger and prompted Morgagni's famous book De Sedibus et Causis Morborum, which appeared after his death. Lancisi's work on Aneurysms was not published until after his death.

Two others of his books deserve mention because they show how broad were the interests of the man in many phases of progress in medicine. Their titles are Diseases and Infections of Domestic Animals and The Climate of Rome.

The next great name in Italian medicine is that of Morgagni. He was not a regular Papal physician, nor a member of the faculty of the Papal Medical School, but he was often consulted, as we told in the chapter on Papal Physicians, both as to the health of the Popes and the methods of teaching at the Roman Medical School. His life brings us down almost to the nineteenth century, and the cordial relations of the Popes to him, far from being an exception in the history of medicine, are only typical of the attitude of the Roman Pontiffs to medical and all other scientists from the dawn of the history of science in modern times.

While the Papal Medical School at Rome, attached to the university of the city and directly under the control of the Papal Curia, more especially deserves the name thus given it, it must not be forgotten that there was in the Papal States a series of medical schools in various cities. One of these, at Perugia, founded by a bull of Pope John XXII., has come under consideration in the chapter on A Papal Patron of Medical Education. An-other medical school, that of Ferrara, which also was in the Papal States, had considerable prestige. Some distinguished professors taught there before going to Padua or Bologna. At the beginning of the sixteenth century, Bologna, after having been during the preceding three centuries under the domination of one powerful family or another, from the Pepoli to the Bentivogli, and then to the Visconti and back again to the Bentivogli, was incorporated in the Papal States under Pope Julius II. At this time the Medical School of Bologna was at the height of its reputation and was one of the two greatest medical schools in Italy. Padua was its only rival. Shortly after this Rome became a serious competitor in medical education. Practically, then, this was a second Papal medical school, almost as directly under the control of the Popes as the Roman Medical School. Far from there being any diminution in the glory or the efficiency of the Bolognese Medical School, its reputation even became enhanced after the city came under the control of the Popes.

This is all the more surprising because, as we have shown, just about this time the Popes began the work of making their Medical School at Rome the most important center for medical education, especially in the scientific phases of medicine anatomy, physiology, and comparative anatomy that there was at that time in the world. In spite of this rivalry, however, nothing was done directly to hurt the prestige of the school of Bologna, and indeed the rivalry seems to have been more of an encouraging competition than in any sense a destructive struggle for existence. When the Popes took possession of Bologna, Alexander Achillini- was professor of anatomy and medicine in the Bolognese school, and his discoveries and methods of investigation attracted the attention of students from all over the world. His assistant for many years and his successor in the post was Berengar of Carpi, of whom we have already said much in the chapter Anatomy Down to the Renaissance. For some time Vesalius lectured on medicine and anatomy at Bologna, and one of Berengar's most distinguished successors in the sixteenth century was Aranzi, who occupied the post of anatomical professor for thirty-two years and who corrected a number of errors in anatomical detail that had been made by Vesalius and others of the preceding generation. He confirmed Columbus's discoveries at Rome with regard to the course which the blood follows in passing from the right to the left side of the heart, and made many important additions to the knowledge of the anatomical relations of the cavities of the heart, the valves, and the great blood vessels. There are a number of important structures in the brain which owe their names to him, and his descriptions of them are better, according to Prof. Turner, than those of other anatomists for a century after his time.

The tradition of great teachers thus carried on during the first century after the absorption of Bologna into the Papal States, continued uninterruptedly in the next century, when we find on the list of professors at Bologna such names as those of Malpighi, the greatest mind in the medical sciences of the seventeenth century, and his colleague Fracassati, who, though over-shrouded by Malpighi, still claims a prominent place in the history of medicine. Bologna has a special feature of medical development to its credit which, because of its importance for science in general as well as for medicine, deserves to be mentioned here. During the century after the Popes became the rulers of the city scientific societies were founded here, and as the professors and students of the medical school were also the most interested in science in general, the membership of these societies was largely made up of individuals connected with the medical school. A special society for the cultivation of anatomical knowledge, the first of its kind ever founded, was established in Bologna scarcely more than a century after the city came under the Papal dominion. It was called the Coro Anatomico, or anatomical choir, and had at first only nine members. Among these, however, were such distinguished men as Malpighi, Fracassati, Capponi, and Massari, to the last of whom the initiative of the foundation of the society is said to have been due. Bologna was noted during the sixteenth and seventeenth centuries for the number of foreign students of medicine who were attracted to its hospitable medical school and who carried the tradition of science for its own sake, so characteristic of this Papal Medical School, to all parts of the world.

After this consideration of the relation of the Popes to medical science during many centuries when medicine practically included all the physical sciences, it may seem utterly inexplicable to any fair-minded person that the tradition of the opposition of the Popes to science and scientific educational development should have apparently become a commonplace in history. This will not be a surprise, however, to those who know how perversive and influential has been the Protestant tradition which from the beginning of the sixteenth century has devoted itself to blackening the reputation of the Church, the Popes, and Catholic ecclesiastics generally. No-where is this more true than in history as written for English-speaking people. Those who left the old Church and their immediate descendants, justified their withdrawal to themselves as well as others, by taking every possible excuse and inventing every possible pretext, to show how unworthy of their continued allegiance the old Church had been. The point of view thus assumed was taken quite seriously by succeeding generations, until at length a whole body of historical traditions, utterly unfounded in fact, accumulated, especially in England, where it must be remembered that for several centuries Catholics were not in a position to impugn and eradicate it. This unfortunate state of affairs, and not real opposition on the part of the Popes to science, is the source of the tradition with regard to the supposed opposition between the Church and science.

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