"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 [{238}] 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 role 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 [{239}] 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 resume 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 [{240}] 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 rewarded 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 [{241}] 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, [{242}] 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 wherever 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. [Footnote 29]
[Footnote 29: Most of these details are taken from Hirsch's Biographisches Lexicon der hervorragenden Aertzte aller Zeiten und Völker. Wien und Leipzig, 1886.]
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 [{243}] 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.