his considerable talents as a practicing physician, his towering
preeminence as an anatomist, his resourcefulness as an experimental
physiologist, and his infinite patience with detail.”^2
How patient was Morgagni in preparing his book? While treating his
patients in Bologna and Padua, he spent the next six decades collecting
information, organizing the material, and writing the book that would
change the way that physicians looked at patients and thought about the
essential nature of disease. Morgagni published his book De Sedibus et
causis morborum per anatomen indagatis (Of the seats and causes of
diseases investigated through anatomy) in 1761 at the advanced age of
eighty while still treating patients.
De Sedibus is written in conversational style, as if to a friend, and is
organized into seventy letters to a young physician (perhaps fictional). The
sum total of these seventy letters encompasses seven hundred cases, and is
organized into five books: Diseases of the Head, Diseases of the Thorax,
Diseases of the Belly, Surgical and Universal Disorders, and Supplement
(including index). For each case, “historical background is given, the
evolution of contemporary thinking is reviewed, authorities are quoted,
their opinions discussed, and the logical development of the professor’s
conclusions, step by step, become clear.”^3 Compiled over decades, the
cases are meticulously organized and indexed, so that a young student
could search the book by symptom, such as “chest pain,” and investigate a
similar case, searching for truths and possible effective treatments.
One hundred years earlier, Galileo had challenged the unscientific and
superstitious view of the heavens. Morgagni occupied a world where
physicians throughout the world were still ensnared in the ancient
Hippocratic traditions, perseverating over humors, the seasons, miasmas,
bad air, and celestial judgements. Morgagni’s De Sedibus dealt the final
death blow to humoral medicine, and turned the mind of the physician to
“specific derangements of particular structures within the body.”^4 The
anatomist and physician Morgagni concluded, in perhaps the most
iconoclastic statement in medical history, that symptoms were quite
simply the “cry of suffering organs.” Succinctly and beautifully captured,
this new appreciation of disease focused the attention of the physician on a
particular organ or body part. Instead of gazing at the stars or considering
imbalances of mysterious fluids, Morgagni realized that disease was the
manifestation of dysfunctional (and often painful) organs.