Let us then blush, in this so ample and so wonderful field of nature (where performance still exceeds what is promised), to credit other men's traditions only, and thence come uncertain problems to spin out thorny and captious questions. Nature herselfe must be our adviser; the path she chalks must be our walk; for so while we confer with our own eies, and take our rise from meaner things to higher, we shall at length be received into her closet-secrets.
--Preface to Anatomical Exercitations concerning the Generation of Living Creatures, 1653. William Harvey.
MORGAGNI, THE FATHER OF PATHOLOGY.
"VIR INGENII, MEMORIAE, STUDII, INCOMPARABILIS."
--HALLER.
In 1894, when the International Medical Congress met at Rome, Prof. Virchow of Berlin, the greatest living pathologist at the time, was asked to deliver the principal address. He chose as his subject John Baptist Morgagni, the distinguished Italian physician and original investigator of the eighteenth century, whom he hailed as the Father of Pathology. No medical scientist of the nineteenth century was in a better position than Virchow to judge who had been the founder of the science for which he himself did so much. Virchow besides, through long and faithful study of the history of medicine, knew well whereof he spoke. In pathology especially modern medicine has made its sure advances, so that Morgagni's ground-breaking work may well be considered the beginning of the most recent epoch in medical science. As a matter of fact, medicine lost much of its obscurity by losing all its vagueness when Morgagni's methods came into general use.
As a medical student scarcely twenty years of age, he revolutionized medical observation by studying his fatal cases with a comparative investigation of their clinical symptoms and the postmortem findings. This had been done before, but mainly with the idea of finding out the cause of death and the principal reasons for the illness which [{30}] preceded. Morgagni's investigations in pathology consisted in tracing side by side all the clinical symptoms to their causes as far as that might be possible. This looks so simple now as to be quite obvious, as all great discoveries are both simple and obvious once they have been made; but it takes a genius to make them, since their very nearness causes them to be overlooked by the ordinary observer so prone to seek something strange and different from the common.
How much Morgagni's studies from this new viewpoint of the investigation of all the symptoms of disease has meant for modern medicine, may be best appreciated by a quotation from an address delivered before the Glasgow Pathological and Clinical Society in 1864, by Professor Gairdner, who thus tersely describes the character of the distinguished Italian pathologist's work:
"In investigating the seats of disease, Morgagni is not content to record the coincidence of a lesion in an organ with the symptoms apparently due to disordered function in that organ.
"For the first time almost in medical inquiry, he insists on examining every organ, as well as the one suspected to be chiefly implicated; not only so, he marshals with the utmost care, from his own experience and that of his predecessors, all the instances in which the symptoms have existed apart from the lesion, or the lesion apart from the symptoms. He discusses each of these incidents with severe exactness in the interest of truth, and only after an exhaustive investigation will he allow the inference either that the organ referred to is or is not the seat of the disease.
"And in like manner in dealing with causes: a group of symptoms may be caused by certain organic changes--it may be even probable that it is so--but, according to Morgagni's method, we must first inquire into all the lesions of [{31}] organs which occur in connection with such symptoms; in the second place, we must know if such lesions ever occur without the symptoms; and again if such symptoms can be attributed in any cases to other causes in the absence of such lesions."
During over sixty years of a long life Morgagni continued to follow out the idea that he had developed as a boy, and his works contain the first definite account of pathological lesions and clinical manifestations that attracted attention.
As a proof of the striking difference between the value of observation and theory in medicine, it may be said that many hundreds of volumes containing the most elaborate medical theories were published during the eighteenth century, and that practically none of these is ever read now, except for curiosity's sake by some seeker after the quaint and distant in medicine, while Morgagni's books still contain a precious fund of information, to which pathologists at least, and not a few clinicians, turn often with interest and come away always with profit. They are not infrequently quoted from, and, as we shall see, have been highly appreciated by some of the best medical authorities of the present and the immediately preceding generations.