What have the Romans really done for us?
Thursday, 03 November 2016
Suttie Centre Conference Room
Dr Martin Pucci, Retired GP/VTS Trainer, Clinical Senior Lecturer, University of Aberdeen & Author
“What have the Romans really done for us?”
Martin was born Montrose 1949 and bought up in Chesterfield, Derbyshire where he spectacularly failed his 11+. He attended medical school in Aberdeen from 1973 to 1979. After GP training, he worked at Ellon from 1981 to 2009 and was a founding member of G-DOCS (later G-MEDS) in 1996. Martin was the GPVTS trainer at Ellon for 12 years and always involved with teaching there. In 2009 he joined the Centre of Academic Primary Care at the University of Aberdeen, as a member of the teaching team and retired fully in 2016. He wrote a newspaper column on medical matters in the 1990’s and is currently writing for the Leopard Magazine on medical history which has always fascinated him along with scientific history and scientific biography. He has been involved in cruise ship lecturing (history of medicine) since 2014 which fits in with his love of travel. Martin is very interested in sport - has played football and golf (has had six holes in one) and run several marathons, London twice.
The President welcomed another large company. She reported on two successful events since the last meeting: the Electives Evening and the Founders’ Dinner on 20th and 29th October respectively. She reminded us of the annual Burns Supper held jointly with the Students’ Medical Society at the Douglas Hotel on 20th January. A cheque was presented to medical student Alanna Bruce, winner of this year’s Strachan Bursary competition.
The speaker for the evening, Dr Martin Pucci, was introduced and gave his presentation entitled ‘What Have the Romans Really Done for Us?’ Dr Pucci, an Aberdeen medical graduate and retired local General Practitioner has a long-established interest in the history of medicine and had previously addressed the Society on the work of Dr Alexander Gordon on puerperal fever. The present talk was an interesting and entertaining overview of the central role of the Italian medical schools and their numerous talented teachers and scholars from around Europe and the Mediterranean in the development of our understanding of the human body and its diseases throughout much of the last millennium.
After brief reference to the ancient Greek and Roman medical forefathers, the story from around 9th – 14th centuries AD focussed initially on the early Italian medical centres of Salerno, Bologna, Padua, and slightly later Naples, Pisa and Rome from around 1300 AD. By comparison, Paris (ca 1200) and Montpellier (ca 1300) were also emergent centres of medical education; Oxford (estd. 11th C) and Cambridge (13th C) Universities came into being, but medicine was not taught for some considerable time thereafter and, indeed, Aberdeen University was one of the first in the UK with a ‘Mediciner’ or Professor of Medicine on the staff from its inception around 1500.
Some coming together of primitive medical cultures was consequent on the work of Constantine the African who went from Salerno to the monastery at Montecasino where he spent the rest of his life translating Arabic and Greek medical texts into Latin. Another seminal group of three texts on women’s health, the Trotula, was produced in Salerno in the 12th C, perhaps written in part by women. The Salerno texts were used for several hundred years – despite including references to such putative therapeutic principles as hawk dung and weasel testicles!
In late 11th C, medicine was being taught among many other subjects to the students in Bologna who attended from various countries and, indeed, were organised in ‘nations of students’ who, though initially separate and partisan, eventually came to work together collaboratively in a state of ‘universitas’ – the origin of the word university.
From a little later, Padua attracted a sequence of talented medical scientists, mainly engaged in studies of anatomy. The long held and largely incontestable ‘facts’ on human anatomy were very largely based on the work of Galen who had dissected a variety of apes in the 2nd C AD. The Paduan anatomists progressively corrected many of the mistaken beliefs by ever more meticulous dissection of human cadavers. Many of their names retain eponymous recognition today including Fallopia, Oddi, Wirsung and Eustachio. By early 16th C, the Professor of Anatomy, one Girolamo Fracastro was going beyond morbid anatomy by suggesting the presence of transmissible particles (seminaria) passing contagion between bodies long before microbiology came to be accepted and understood. A little later, Andreas Vesalius (1514-64) came to the fore as revered professor of anatomy who excelled in his demonstration and explanation of human cadaveric dissection to large audiences. A native of Brussels, and fluent in Latin, Greek and Hebrew, he was very much ‘hands-on’ in his anatomical studies and is consequently attributed with the origins of the term ‘autopsy’ – I see for myself. He published his major work on human anatomy ‘De Humani Corporis Fabrica’ in Basel in 1543 and it proved to be a major advance in detail and accuracy.
The talk next moved to Englishman, William Harvey (1578 – 1657) who went from Caius College, Cambridge in 1600 to study in Padua for 2 years where he worked with Fabricius on valves and veins. His major work, De Motu Cordis (Frankfurt, 1628) described how the systemic and pulmonary circulations worked with the heart as a single, four-chambered pump. The confirmation of the presence of a capillary circulation, anticipated by Harvey, followed in the 1660s when Malpighi, who had moved from Bologna to Pisa, used the recently developed hand-held microscope to study alveolar capillaries in frogs. In due course, following further work on subjects as diverse as caterpillars and chicken embryos Malpighi was to become one of the first foreign Fellows of the Royal Society.
The Italian dominance continued with the appointment of Morgagni moved from Bologna in 1715 to take up the chair of anatomy in Padua and further developed his fascination in the link between symptoms reported in life and the morbid anatomy after death. His assertion that “symptoms are the cries of the suffering organ” led to his publication of ‘De sedibus et causis morborum’ in 1766 (when he was 79), which included many new pathophysiological insights. The book contained detailed accounts of some 700 cases including aortic dissection in what would later be recognised as Marfan’s syndrome, and peritonitis due to rupture of the appendix. This novel view of a physician as one who performed examination, determined diagnosis, offered treatment and prognosis was quite radical at the time. The list of heroes went on to include Galvani, Volta and Golgi and could have been longer.
A run through seven or eight centuries of evolving medical history in one talk was necessarily complex and often superficial. Nevertheless the speaker treated us to a fascinating series of insights on how understanding of res medica had evolved – and on many occasions had been prevented from evolving – by reminding those (relatively!) modern practitioners present about how the contemporary authenticity of anatomy, physiology and pathology, that is largely taken for granted, had grown from obscure, speculative and often inaccurate beginnings. The frequency with which ‘establishment dogma’ thwarted progress, and indeed, led to those investigators involved in more scientific approaches to revealing medical truth being disparaged, ostracised and even killed for daring to challenge, will have been of particular interest to modern students of medicine, politics and society alike.
During a short question and answer session, Dr Pucci recommended Roy Porter’s book, ‘ The Greatest Benefit to Mankind: A History of Humanity’ as a source for further reading on the evolution of medicine. The President thanked the speaker for his excellent lecture and reminded the company that the next meeting in her programme would take place on the evening of 1st December.