XVIII-CENTURY MEDICINE
Applied Pathology
During the eighteenth century there appeared the pioneers
who demonstrated the importance of morbid anatomy, and who
showed how important to the physician was a knowledge of
pathology. The leader of the movement was GIOVANNI BATTISTA
MORGAGNI (1682-1771), whom Castiglioni refers to as " a master
in the best sense of the word and a tireless investigator." * He
studied under Valsalva at Bologna and then returned to practise
in his native town of Forli. An ardent student of the classics, a
poet and archaeologist, and already an anatomist of repute, his
fame spread, so that at the age of twenty-nine he was called to be
Professor of Anatomy at Padua, a position which he held with
distinction for fifty-six years. His great achievement was the
union which he effected between anatomy and pathology on the
one hand, and clinical medicine on the other. Post-mortem
findings became correlated with clinical symptoms. Morgagni
was, in fact, the founder of pathological anatomy. Throughout his
long life he strenuously pursued his search for the causes of disease,
and for the changes which are found on post-mortem examination.
He did not publish his results until he had reached the age of
seventy-nine.2 The masterpiece which he then wrote gives details
of case histories and pathological appearances in no less than
seven hundred cases. Many were the discoveries he described,
including cirrhosis of the liver, pneumonic consolidation of the
lung, and many forms of tumour. He was the first to show that
cerebral abscess was a result rather than a cause of suppurative
otitis. This great work, De sedibus et causis morborum (On the
sites and causes of diseases), in five volumes, appeared in 1761.
During the later years of the century pathological anatomy
was enriched by the work of another gifted observer, MARIE
FRANgois XAVTER BICHAT (1771-1802), the pupil and assistant of
Desault in Paris.3 He it was who founded the science of histology,
the study of tissues or " membranes," by directing attention to
the pathological changes in cellular, nervous, osseous, fibrous,
muscular, and other tissues, twenty-one in all. His views, were the
1 A. Castiglioni, A History of Medicine, trans, by E. B. Krumbhaar, New York, 1941,
p. 602 ; E. R. Long, A History of Pathology, 1928 ; H. E. Sigerist, Great Doctors, 1933,
p. 229
2 Sir B. W. Richardson, Disciples of Aesculapius, 2 vols., 1896, vol. i. p. 283
a T. J. Pettigrew, Medical Portraits, 1838-40, vol. i; E. T. Withington, Medical
History from the Earliest Times, 1804, p. 358
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