19th Century Medical Revolution: Nature Of Disease: Pathology
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This article is from the Health Articles series.
19th Century Medical Revolution: Nature Of Disease: Pathology
The founder of pathology was Giovanni Batista Morgagni (1682-1771), professor of medicine and anatomy at Padua for 56 years. He published at the age of 79 the De Sedibus Causis Morborum containing accounts of aneurysm, acute yellow atrophy of the liver, heart block and valvular disease of the heart, pneumonia and the connection between miliary disease and cerebral abscess. He detailed the case histories and pathological appearances of no less than 700 cases.
A man who had been too much given to the exercise of tennis and the abuse of wine, was, in consequence of both these irregularities, seized with a pain of the right arm, and soon after of the left, joined with a fever. After these there appeared a tumour on the upper part of the sternum, like a large boil. The patient came into the Hospital of Incurables, at Bologna ... in the year 1704. The swelling on ...the chest wall was equal in size to a quince...and began to exsude blood in one place ... very near having broken through the skin ... He (being quite ignorant of the danger which was at hand) began to pull off the bandages, for the sake of showing his disorder. But his circumstance being observed, he was prevented going on, and ordered to keep himself still, and to think seriously and piously of his departure from this mortal life, which was very near at hand, and inevitable. On the day following, he felt the blood gushing forth, and had the presence of mind not only to commend himself to God, but to take up with his own hands a basin that lay at his bed-side; and, as if he had been receiving the blood of another person, put it beneath the gaping tumour, while the attendants immediately ran to him as fast as possible, in whose arms he soon expired.
On examining the body before I dissected it, I saw that there was no longer any tumour, inasmuch as it had subsided after the blood, by which it had been raised up externally, and had been discharged. The skin was there broken through, and the parts that lie beneath it with an aperture, which admitted two fingers at once....In both the cavities of the thorax, also, was a great quantity of water, of a yellowish colour. And there was a large aneurism, into which the anterior part of the curvature of the aorta itself being expanded, had partly consumed the upper part of the sternum, the extremities of the clavicles which lie upon it, and the neighbouring ribs, and partly had made them diseased, by bringing on a caries.
Morgagni had no microscope. Microscopes were needed for further advance in pathology. Marcello Malpighi (1628-1694) of Bologna saw capillaries in the frog's lung and completed Harvey's discovery of the circulation. He also saw the layers of the skin, white pulp of the spleen and renal glomeruli. Athanasius Kircher (1602-1680) studied the blood of plague patients and saw countless masses of small worms - red blood corpuscle. He described striations in muscle fibres, bacteria and protozoa. Rudolph Virchow (1821-92) brought the microscope to pathology and showed that cell changes were the centre of the alterations of the tissues in disease. Omnis cellula e cellula.
by Dr. Ian Carr, Professor Emeritus, Faculty of Medicine, University of Manitoba
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