Andreas Vesalius, The Reformer of Anatomy — Mondino, The Restorer Of Anatomy

[Illustration: Illuminated capital] In the year 1315, in the old Italian city of Bologna, an event occurred which marks an important epoch in the history of medicine.

A wondering crowd of medical students witnessed the dissection of a human cadaver—one of the few procedures of the kind that had occurred since the fall of the Alexandrian University.

Acting under royal authority Mondino, a man far in advance of the age, placed the body of a female upon a table where for many centuries before only the cadavera of apes, of swine and of dogs had been studied.

Mondino, known also as Mundinus, Mundini, Raimondino, or Mondino dei Luzzi, was descended from a prominent Italian family.

Little is known of his life.

The year of his birth is disputed; probably 1276 was near the time.

He was graduated in medicine in 1290 and in 1306 he became a professor in the University of Bologna, holding his chair with credit until his death in 1326. Like that of the illustrious Homer, Mondino’s nativity has been claimed by several rival cities.

Guy de Chauliac, writing in 1363, states that Mondino was a Bolognese: _Mundinus Bononiensis_ is Chauliac’s expression.

Mondino’s method of teaching anatomy is known from Chauliac’s testimony:—“Mundinus of Bologna, wrote on anatomy, and my master, Bertruccius, demonstrated it many times in this manner:—The body having been placed on a table, he would make from it four readings; in the first the digestive organs were treated, because more prone to rapid decomposition; in the second, the organs of respiration; in the third, the organs of circulation; in the fourth the extremities were treated.

” The innovation so auspiciously begun was not continued, and after the death of Mondino human dissections were made only at long intervals.

The few instances in which, in the fourteenth and fifteenth centuries, the ecclesiastical and civil authorities granted the right to make dissections only prove the contention, that the practical study of human anatomy did not gain recognition until the sixteenth century.

When Mondino began his dissections the epoch of Saracen learning had ended, but the influence of Arab medicine exerted by the writings of Albucasis, Avicenna and Rhazes had not declined.

The Arabian physicians had accomplished little for anatomy.

In this line the influence of Galen was still potent, and was rarely questioned until the publication of the _Fabrica_ of Vesalius in 1543. During a long period the little treatise of Mondino held full sway in the mediaeval schools.

Medicine was taught in the University of Bologna, which as early as the twelfth century was celebrated for its departments of literature and of law.

These studies were free of the difficulties which beset medicine.

The prejudice against dissection was so great that for nearly a century after his death few men dared to repeat the acts of Mondino.

In 1316 Mondino issued his book which remained in manuscript form for more than one hundred and fifty years, the first printed edition bearing the date 1478. Small and imperfect as it was, it marks an era in the history of science.

By command of the authorities this book was read in all the Italian Universities.

The work of Mondino contained no new facts; it was compiled largely from the writings of Galen and of Avicenna.

The descriptions, to use the words of Turner, “are corrupted by the barbarous leaven of the Arabian schools, and his Latin is defaced by the exotic nomenclature of Ibn-Sina and Al-Rasi”.

Mondino divided the body into three cavities, of which the upper contains the animal members, the lower the natural members, and the middle the spiritual members.

Many of his names are borrowed from the Arab writers.

Thus, he calls the peritoneum _siphac_, the omentum _zyrbi_, and the mesentery _eucharus_.

His description of the heart is much nearer accuracy than would be expected.

He resorted to vivisection, and tells us that when the recurrent nerves of the larynx are cut the animal’s voice is lost.

In his book we find the rudiments of phrenology.

He states that the brain is divided into compartments, each of which holds one of the faculties of the intellect.

[Illustration: MONDINO’S DIAGRAM OF THE HEART, 1513] Mondino did not himself make the dissections which are credited to him.

According to an ancient custom which lasted until the time of Vesalius, the actual cutting was done by a barber who wielded a knife as large as a cleaver.

The professor of anatomy sat upon an elevated seat and discoursed concerning the parts, while a demonstrator, who also did not soil his fingers, pointed to the different structures with a staff.

Originally Mondino’s book contained no figures; when the art of wood engraving was introduced in the latter part of the fifteenth century, a few rude woodcuts appeared which represent Mondino and his method of teaching.

In the _Fasciculus Medicinae_ of Joannes de Ketham, published at Venice in 1493, Mondino’s book is printed with an illustration showing a demonstration in anatomy.

According to Mondino the heart is placed in the centre of the body.

The valves he considers “wonderful works of nature”.

He describes a right, left and middle ventricle.

The right ventricle has thinner walls than the left, because it contains blood; the left one contains the vital spirit, which passes through the arteries to the body; and the middle ventricle consists of many small cavities “broader on the right side than on the left, to the end that the blood, which comes to the left ventricle from the right, be refined, because its refinement is the preparation for the generation of vital spirit, which should be continually formed”.

Mondino describes five bones of the head, separated by three sutures—coronal, sagittal and occipital.

The brain has two membranes: dura and pia.

There are three cerebral ventricles—anterior, posterior and middle—and in these he locates the various intellectual qualities.

He describes the cerebral nerves: olfactory, optic, motor oculi, facial, vagus, trigeminal, auditory and hypoglossal.

He calls the innominate bone _os femoris_: the femur, _canna coxae_; the humerus, _os adjutori_; while the bones of both leg and forearm are named _focilia_ major and minus.

[Illustration: ANATOMICAL DEMONSTRATION IN 1493 (Joannes de Ketham)] [Illustration: TITLE-PAGE OF MONDINO’S ANATOMY BY MELERSTAT (Printed before 1500)] Like many anatomists who succeeded him, Mondino mingled surgical ideas with his anatomical statements.

A break in the _siphac_ causes hernia and a swelling in the _mirach_.

He treated ascites by puncture and evacuation, making a valve-like opening.

Wounds of the large intestines must be sutured; if the wound be in the small intestines he advises that “you should have large ants, and, making them bite the conjoined lips of the wound, decapitate them instantly, and continue until the lips remain in apposition and then reduce the gut as before”.

He gives an explanation of the length and convolution of the intestines; “for if it were not convoluted the animals would have to be continuously ingesting food and continuously defecating, which would impede engagement in the higher occupations”.

Digestion is aided by black bile from the spleen and by red bile from the liver.

The kidneys he regards as glands in which urine is extracted from the blood.

The renal veins expand and form a fine membrane like a sieve through which the urine is filtered but blood cannot pass.

He mentions renal calculi: if small they pass through the ureter; if large they are incurable except by incision, and this is to be avoided.

The uterus and breasts are connected by veins, hence the sympathy between these organs.

Inguinal hernia is to be operated upon;

the spermatic cord and testicle may or may not be dissected out, or the hernia may be treated by the application of a caustic.

An incision in the neck of the bladder will heal, because this part is muscular; but a cut in the body of the organ will not heal.

He describes the operation for stone:—The patient being in proper position, the stone is conducted to the neck of the bladder by the finger in the rectum; an incision is made and the stone is pulled out with an instrument called _trajectorium_.

Mondino’s book passed through not less than twenty-three editions between the years 1478-1580. The only manuscript extant is in the National Library at Paris.

The first printed edition of the _Anathomia Mundini_, Pavia, 1478, is a folio of twenty-two leaves.

The Strassburg edition, 1513, is a small octavo volume of forty leaves.

It contains a diagram of the heart and an astrological figure, a cadaver with the thorax and abdomen opened, surrounded by the signs of the zodiac.

Such was the volume which for more than two hundred years was supposed to contain all that was to be said of human anatomy!

[Illustration: COLOPHON OF THE ANATOMY OF MONDINO, 1513] So numerous are the abbreviations in Mondino’s book, so barbarous is his style, that the making of a translation is a difficult task.

His reasons for writing are these:—“A work upon any science or art—as saith Galen—is issued for three reasons; _First_, that one may help his friends.

_Second_, that he may exercise his best mental powers.

_Third_, that he may be saved from the oblivion incident to old age”.

CHAPTER THIRD

Mondino’s Successors