The Popes and Science

"In my own investigations and reflections upon the conditions which led up to this happy renewal of scientific search into the composition of the body of man, it has seemed to me that writers have hitherto fallen short of tracing through to its ultimate source, the earlier spirit of enthusiasm for knowledge, of insight into the problems of disease, and of contempt for traditionary shackles, to the influence of which, as shown by the master, Taddeo, the latter work of the pupil, Mondino, was in great measure due."

Medici, in his History of the School of Anatomy at Bologna, [Footnote 8] quotes Sarti on The Distinguished Professors of the University of Bologna for proof of Taddeo's familiarity with dissection. Von Töply does not think that this quotation is enough absolutely to prove that Taddeo had done dissections, yet it would be hard to understand it unless some such interpretation is made. Taddeo was asked to decide a medico-legal question with regard to a pregnant woman. He refused, however, with a modesty that might well be commended to medico-legal experts of more modern times, to answer the question decisively, because he had never made a dissection of a pregnant woman. Sarti argues that it is evident from this that he had dissected other bodies more easy to obtain than those of pregnant women, or else that he had had the opportunity to make observations on them when dissected by others.

[Footnote 8: Medici Compendio Storico Della Scuola Anatomica de Bologna, Bologna, 1857. ]

Certain of Taddeo's contemporaries must have had the incentive of his example to help them to a knowledge of human anatomy, for they surely could not have accomplished all that they did in surgery without experience in dissection, yet Taddeo was looked up to as a master by all of them.

Anyone who has read the contributions to surgery of William of Salicet and his great pupil Lanfranc, even if only what we give with regard to them in our chapter on Surgery during the Middle Ages, cannot but be impressed with the idea that they must have done human dissections. They do not mention this fact explicitly, but portions of their surgical works are taken up with the consideration of applied anatomy. They discuss the relations of various structures to one another, especially with reference to the surgery of them. Von Töply, in his Studies on the History of Anatomy in the Middle Ages, says that the anatomies written before William's chapters on applied anatomy, were most of them purely theoretic discussions meant to be guides for internal medicine, or else they were very short directions for those who undertook the practical work of the dismemberment of bodies, usually, however, with reference to animals rather than to human bodies. In William of Salicet we encounter, he says, for the first time a treatise on anatomy made with the deliberate purpose of its application to practical surgery. Everywhere William gives hints for surgical operations with special reference to the anatomical relations.

Puccinotti quotes from William of Salicet's surgery, written about 1270, a passage that shows how familiar this surgeon must have been with dissection. The nephew of Count Pallavicini received an arrow wound in the jugular vein and died within an hour. During his death agony he suffered from a peculiar form of rattle in his throat. It was thought that this might be due to the fact that the arrow had been poisoned. William was called in to decide this question, and found that there was nothing responsible for his death except the wound itself. He describes how he found the blood in the lungs and in the heart, and considers that the conditions that were present were due to the wound. Von Töply has suggested that William would have given more details had he actually examined these organs, but when the autopsy report is negative, such descriptive details are not usual even at the present time. If he had found reason for thinking that there was poison in the case, a careful description of the other organs would be necessary. The fact, however, that he was asked to decide such a question, would seem to indicate that he was supposed to have a knowledge of the normal appearances of human tissues when examined by dissection.

In everything else Lanfranc went farther than his master William, and he did so also in anatomy. Some of the details of his work will be found in our chapter on Surgery in the Middle Ages. He could not have been able to give the detailed instructions that he has for the treatment of every portion of the body only that he knew them by actual contact in the cadaver as well as the patient. His outlook upon scientific medicine and surgery would satisfy even the most exacting of modern experimental scientists. The famous aphorism of his runs as follows: "Every science which depends on operation is greatly strengthened by experience." More than anything else, however, surgery owes to Lanfranc the distinct advantage that he carried into the West as far as Paris, the methods which had come into existence in Italy, and were ever after to prove a precious heritage in the great French University. As Salicet's work was carried on by Lanfranc, at least as well was Lanfranc's work further advanced by his pupil and successor in the chair of surgery, Henri de Mondeville. This subject of surgical development will be treated in the chapter on Surgery in the Middle Ages. Here it is introduced only to emphasize the opportunity there must have been for anatomical study through dissection in the thirteenth century, or these men would not have made the marvelous progress they actually accomplished in this department.

With regard to Mondino, Taddeo's successor at Bologna, enough has been said already in the preceding chapter. About this time, however, very definite evidence begins to accumulate of the frequent practice of dissection. Roth, whose life of Vesalius is a standard work in the history of anatomy, has summed up most of what we know with regard to dissections in the early part of the fourteenth century, in his chapter on Dissection Before Vesalius's Time. Roth's work is well known and is frequently referred to in Dr. White's History of the Warfare of Science with Theology. There can be no question, then, but that in taking what Roth has to say I shall be quoting from a work with regard to which there can be no hint even of partiality. Roth himself was a Swiss, with no leaning toward the Church. There are certain portions of his book, indeed, in which he is inclined not to allow that the Church did as much for education in these times as she actually did. His study of the rise of anatomy can be accepted with absolute assurance, that it is at least not written from the standpoint of one who wants to make the situation with regard to anatomy more favorable than it actually was during the fourteenth century, for the sake of showing any lack of opposition on the part of ecclesiastics.

Some of the material that Roth has made use of has already been referred to in the preceding chapter, but it has seemed proper to repeat it here because this gives a connected account from a definite authority in the history of medicine, and especially of anatomy, with regard to the century immediately following the promulgation of Boniface's bull. Besides, it gives an opportunity for such comments on various features of the history of anatomy, as he details it, as will bring out the significance of his remarks. His account will make it very clear that, far from the Papal bull in question having been universally construed as prohibiting dissections, as Dr. White says it was, it never entered into the minds of medieval anatomists to consider it as having any such signification. The bull was never thought of in that sense at all. It does not refer to anatomy or dissection and it never had any place in the history of anatomy until dragged into it without warrant by Daunou and other nineteenth century writers. Roth says:

"In the pre-Vesalian period the dissection of the human body was practiced, according to the terms of Frederick's law, for the instruction of those about to become physicians and surgeons. The natural place for this school anatomy–for a dissection was called anatomia, or, erroneously, anatomia publica–was at the universities and the medical schools. Apart from teaching institutions, however, public anatomies were held in Strasburg and in Venice. Their purpose was the instruction of the practicing medical personnel of these towns. Dissections which were not made for general instruction were called private anatomies. They were performed for the benefit of a few physicians, or students, or magistrates, or artists. Private anatomies began to have special importance only toward the end of the pre-Vesalian period (this would be about the end of the fifteenth and the first quarter of the sixteenth century). It is a play of chance that the first historical reference to a dissection concerns a private anatomy, one undertaken for the purpose of making a legal autopsy. This was made in Bologna in the year 1302 (two years after the decretal supposed to forbid dissection). A certain Azzelino died with unexpected suddenness, after his physicians had visited him once. A magistrate suspected poison and commissioned two physicians and three surgeons to determine the cause of death. It was found that death resulted from natural causes. (As I have said, it would appear that this was not an unusual procedure, for unless medical autopsies had been done before, it does not seem probable that this method of determining the cause of death would have been so readily taken up.)

"Thirteen years later there is an account of the dissection of two female bodies, in January and March of the year 1315, performed by Mundinus." (We have already seen that the fact that the two female bodies should be especially mentioned, though taken by some historians of medicine to indicate that Mundinus had done but few dissections, will not stand such an interpretation, in the light of the evidence that he had dissected many male bodies at least, as his text-book of anatomy indeed makes very clear. These two dissections of females happened only to have special features that made them noteworthy.) "A few years later (1319) there is a remarkable document which tells the story of body-snatching for dissecting purposes." (This would seem to be sufficient of itself to show that a number of dissections were being done, and, indeed, as I have already said, Rashdall, in his History of the Universities, states that, according to the University statutes teachers were bound to dissect such bodies as students brought to them.) Roth concludes with the words (italics are mine): "These are a few, but weighty testimonies for the zeal with which Bologna pursued anatomy in the fourteenth century." (I may add that all of these concern the twenty years immediately following Pope Boniface's supposed prohibition.)

Nor was the custom of making dissections any less active during the rest of the half century after the time when, if we are to believe Professor White, the decree of Boniface had been universally interpreted to forbid it. In a note to his history of dissection during this period in Bologna, Roth says: "Without doubt the passage in Guy de Chauliac which tells of having very often (multitoties, many times, is the exact word) seen dissections must be considered as referring to Bologna." This passage runs as follows: "My master, Bertruccius, conducted the dissection very often after the following manner: The dead body having been placed upon a bench, he used to make four lessons on it. First, the nutritional portions were treated, because they are so likely to become putrified. In the second, he demonstrated the spiritual members; in the third, the animate members; in the fourth, the extremities." (Guy de Chauliac was at Bologna studying under Bertruccius just before the middle of the fourteenth century. It is evident beyond all doubt, from what he says, that dissections were quite common. This is during the first fifty years after the decree. I shall show a little later that there are records of dissections during the second half of this century. Roth, however, goes on to tell next of the fifteenth century.)

Roth says nothing about the decree of Boniface VIII., nor of any possible effect that it had upon anatomy. The real historian, of course, does not mention things that have not happened. Roth confesses, as I have said, that he takes the material for his sketch of anatomy before Vesalius's time from Corradi. [Footnote 9] Corradi being an Italian, and knowing of the slander with regard to the Papal decree, explicitly denies it. Surely, here is material enough to convince anyone that all that Professor White has said with regard to the supposed effect of the misinterpretation of Boniface's decree is without foundation in the history of anatomy. Within twenty years after the bull was issued dissection was practiced to such an extent, that body-snatching became so common that there were prosecutions for it, and public dissections seem to have been held every year in the universities of Italy during most of the fourteenth century.

[Footnote 9: Corradi Dello Studio e dell' Insegnamento dell' Anatomia in Italia nel Medio Evo ed in parte del Cinquecento, Padova, 1873.]

De Renzi [Footnote 10] gives an interesting account of the methods by which material was obtained for dissection purposes before governments made any special provision for this purpose. Naturally, the rifling of graves was resorted to by students intensely interested in the subject of anatomy. The first criminal prosecution for body-snatching on record is in 1319, when some students brought a body to one Master Albert, a lecturer in medicine at the University at Bologna, and he dissected it for them. At this time, according to the statutes of the university, teachers of anatomy were bound to make a dissection if the students supplied the body. The whole party were brought to trial for this offence, though they do not seem to have suffered any severe penalty for their violation of the laws. At this time, according to De Renzi, there was a rage for dissection and many bodies were yearly obtained surreptitiously for the purpose.

[Footnote 10: De Renzi Storia della Medicina in Italia, Napoli. 1845-49, Vol. II., p. 247.]

With regard to the bodies of condemned criminals, people began to countenance the procedure, and while unwilling as yet to give them freely, allowed the bodies to be taken. Corradi, quoted by Puschmann, says "that laws against the desecration of graves, without being abolished, became a dead letter. The authorities interfered only if decided violence had been used or a great scandal raised. Such consequences were likely to follow only if, in the ardor of their enthusiasm for anatomical knowledge, students rifled the graves of well-known persons or took the bodies of those whose relatives discovered the desecration and proceeded against the marauders by legal measures."

At the Italian universities after the middle of the fourteenth century there is abundant evidence for perfect freedom with regard to dissection. We have already shown by our quotation from Roth that Bertrucci was very active in dissection work and did many public dissections. He was followed by Pietro di Argelata, who died toward the end of the fourteenth century. These men followed Mondino in the chair of anatomy at Bologna, and Julius Pagel, in his chapter on Anatomy and Physiology in Puschmann's Handbuch der Geschichte der Medizin (Vol. I., p. 707), says that "the successors of Mondino were in a position, owing to the gradual enlightenment of the spirit of the time and the general realization of the importance of anatomy as well as the fostering liberality of the authorities, to make regular, systematic dissections of the human body." This would bring us down, then, to the end of the fourteenth century.

To return now to Roth, who takes up the next century. He says:

"For the fifteenth century, the university statutes of Bologna for the year 1405 furnish many sources of information. There is a special division which is concerned with the annual anatomy or dissection that had to be made and the selection of the persons to be present, the payment of the expenses and other details. An addition to the statutes, made in the year 1442, determines the arrangement of the delivery of the body from the city to the university authorities. Every year two bodies, one male and one female, must be provided for the medical school dissections. In default of a female body, a second male body was to be provided. In the presence of such detailed regulations, the absence almost entirely of details as to the actual performance of dissections can mean very little. Bologna reached its highest development as a medical school at the beginning of the sixteenth century when Alexander Achillinus and Jacob Berengarius had charge of the public dissections there. Of these I shall speak later." (All this is at the University of Bologna, where ecclesiastical influence was supreme and where the Popes exercised their jurisdiction as the ultimate authority to be appealed to in all disputed educational questions.)

Roth continues: "Padua had, like Bologna, dissection in the fourteenth century. There is the record of a dissection made in the year 1341, in which Gentilis made the discovery of a gall-stone." (It is evidently not because the dissection was unusual, but because the discovery was unusual, that this incident is mentioned. The dissections were such ordinary occurrences as not to deserve special mention except for some particular reason.)

"Much more is known about dissection at Padua in the fifteenth century, when the city had become Venetian." [Footnote 11] (It is significant to note that the previous occurrence was in pre-Venetian days, for Professor White insists that it was the Venetian authorities, in opposition to the Pope, who allowed dissection at Padua. Here is the rebuttal of any such theory.) "Bertapaglia, in his Surgery, has the record of the dissection of a criminal made under the direction of Master Hugo De Senis, on the 8th of February, 1429. On the 4th of April, 1430, the dissection of a woman was made. In 1444 Professor Montagnana speaks of fourteen dissections at which he had been present." (This would seem to indicate that dissections were quite common and that the occasional records of them give no proper idea of their actual number.)

[Footnote 11: Note that this is a full century before Vesalius's time, who, Professor White insists, reintroduced dissection.]

I would not wish to produce the impression, however, that Italy was the only place in Europe in which dissections were freely done during the fourteenth and fifteenth centuries. There is no doubt that anatomy and surgery and every branch of medicine was cultivated much more assiduously and with much better opportunities provided for students down in Italy, than anywhere else in the world. This of itself alone shows the utter absurdity of the declarations that the Church was opposed to medical progress in any way, since the nearer the center of Christendom, the more ardor there was for investigation and the more liberty to pursue original researches. Other countries also began to wake up to the spirit of progress in medical education that was abroad. In France there were two centers of interest in anatomy. One of these was at Montpelier, the other at Paris. It is interesting to note, however, that the men to whom anatomical progress is due at these universities obtained their training, or at least had taken advantage of the special opportunities provided for anatomical investigation to be had, in the Italian cities. Guy de Chauliac I have already mentioned. He is spoken of as the Father of Modern Surgery, and there is no doubt that he did much to set surgery on a very practical basis and to make anatomy a fundamental feature of the training for it. He declared that it was absurd to think that surgeons could do good work unless they knew their anatomy.

Under his fostering care the study of anatomy flourished to a remarkable degree at the University of Montpelier. The difficulty hitherto had been that it was very hard to procure bodies for dissecting purposes. It is easy to understand that friends of the dead would always prevent dissections as far as they could. They do so even at the present moment, and there are not many of us who find it in our hearts to blame them over much for it. Few of us are ready to make the sacrifice of our own dead. Even the poor in those days had friends who prevented the cutting up of their remains; for large alms-houses were not presided over by paid officials, but by religious, to whom their poor in their friendlessness appealed as kindred. There were not many prisons, and they were not needed because all felonies were punished by death. Guy de Chauliac realized that here was the best opportunity to procure bodies. Accordingly it was mainly through his instrumentality that a regulation was made handing over the dead bodies of malefactors to the medical school for dissecting purposes. It must be recalled that when he did this the Papal court was at Avignon, in the South of France, and exerted great influence over the University of Montpelier, situate not far away.

The reputation of the University of Paris is such that we should not expect her to be backward in this important department of education. As a matter of fact, there is abundant evidence of dissection having been carried on here at the end of the thirteenth century, and the practice was not interrupted at the beginning of the fourteenth century. Lanfranc, the famous surgeon who had studied with William of Salicet in Italy (we have already mentioned both of them and we shall have much to say of them hereafter), taught surgery from a very practical standpoint in Paris, and illustrated his teachings by means of dissections. Lanfranc was succeeded in Paris by Mondeville, whose name is also associated with the practice of dissection by most historians of medicine, and whose teaching was of such a practical character that there can be no doubt that he must have employed this valuable adjunct in his surgical training of students. In general, however, the records of dissecting work and of anatomical development are not near so satisfactory at Paris as in the Italian universities. As is the case in our own day and has always been true, universities were inclined to specialties in the Middle Ages, and the specialty of Paris was Philosophy and Theology. This was choice, however, not compulsion, any more than similar conditions in our own time. The medical school continued to be in spite of this one of the best in the world, though it was not famous for its original work, except in surgery, which is, however, the subject most nearly related to anatomy and the one whose development would seem necessarily to demand attention to anatomy.

With the Renaissance, which is usually said to begin after the fall of Constantinople in 1453, and the consequent dispersion of Greek scholars throughout Italy, a new spirit entered into anatomy as into every other department of intellectual life at this time. The reason for it is not easy to explain. Perhaps the spread of Greek texts with regard to medicine inspired students and teachers to try out their problems for themselves, and so a new impetus was given to anatomical investigation. Whatever it was that caused it, the new movement came unhampered by the Church, and Italy continued to be even to a greater degree than before the Mecca for medical students who wished to do original work in anatomy. During the last fifty years of the fifteenth century anatomy began its modern phase, and original work of a very high order was accomplished. There are five names that deserve to be mentioned in this period. They are Gabriele Zerbi, Achillini, Berengar of Carpi, Matthew of Gradi and Benivieni. Each of these men did work that was epoch-making in anatomy, and each has a place in the history of the science that will never be lost.

Zerbi, who did his work at Verona, traced the olfactory nerves and describes the nerve supply of the special senses more completely than it had ever been done before. After his time it was only a question of filling in the details of this subject. Achillini added much to our knowledge of the anatomy of the head, being the first to describe the small bones of the ear and also to recognize the orifices of Wharton's ducts. Besides this, which would have been quite enough to have given him a place in the history of anatomy, he added important details to what had been previously known with regard to the intestines, and described very clearly the ileocecal valve and suggested its function. Matthew of Gradi, or De Gradibus, was the first, according to Professor Turner in his article on Anatomy in the Encyclopaedia Britannica, who represented the ovaries in the correct light as regards their anatomical relations and their function.