Mondino de Luzzi, Anatomist

Successful surgery benefits from knowledge of the body's interior, and the study of anatomy was not always easy to come by. Dissecting human bodies fell out of favor after the Classical Era. One Italian physician did extensive research in anatomy and restored the study of it. His name was Mondino de Luzzi, and he lived and worked in Bologna from c.1270 - 1326.

His father and grandfather were pharmacists, and his uncle taught medicine. Mondino himself taught medicine and surgery at the University of Bologna from 1306 to 1324. In 1316 he published an illustrated manual of details of the inside of the human body (sample to the left). The Anathomia corporis humani ("Anatomy of the human body") was the first of its kind.

He theorized a hierarchy of body parts based on what he considered most important. The abdomen was the "least noble" part of the body, and so should be dissected first. The thorax came next, and last was the head with its "higher and better organized" structures (the organs of the senses: eyes, ears, mouth). He also discussed different methods of dissection between simple versus complex structures, like muscles and arteries versus eyes. When dissecting muscles, he suggested letting the cadaver desiccate, rather than mess with a decaying cadaver. The Anathomia was a manual to explain Mondino's proper methods for dissection.

That doesn't mean he was right about everything. He claims the liver has five lobes, the stomach is round and its internal lining is where sensation happens and the external layer is where digestion takes place. He apparently never found an appendix in a cavern, even though he examined many intestines. He says the heart has three chambers, not four. Still, the text became a standard in medical knowledge for 300 years.

Mondino wasn't much interested in pathology of disease, which is just as important to medicine as understanding how the physical; body works, if not more so. Fortunately, there were others—contemporaries of Mondino's, in fact—of whom we shall speak...tomorrow.

Pietro De Crescenzi

Knowledge of proper agricultural techniques waned in the thousand years following the fall of Rome, except in monasteries, where texts on soil and crop management were preserved and studied. Into this setting, in the 13th century, came a Bolognese jurist named Pietro De Crescenzi.

De Crescenzi (c.1230 - c.1320) practiced as a layer from 1274 until 1300, during which time he traveled from city to city in the Lombard League. Traveling jurists were important, due to the concern that local lawyers would not be impartial. As he traveled, he took note of farming practices, comparing them to what he observed at the Dominican monastery in Bologna (his brother and several friends were members there, and its head was his confidant).

He retired at the age of 70 in c.1300 to his own farm in a suburb of Bologna. His application of efficient farming practices earned him such a reputation that King Charles II of Sicily asked him to write a treatise on the subject.

De Crescenzi produced the Liber ruralium commodorum ("Book of rural benefits") between 1304 and 1309, dedicated to Charles. It was so well received that Charles V of France ordered a French version in 1371. It was translated into Latin in 1471; 57 editions in different languages followed.

This was the first serious work on agronomy in a millennium, and borrowed heavily from the "lost" classical works on the subject. The structure is based on the De re rustica ("About rural things") of the 1st century Roman writer Columella, and De Crescenzi was clearly able to get a copy of the agricultural work of another Roman, Taurus Palladius, but he makes his own point in the introduction about soil that is fundamental to all farming:

The power of the soil should be investigated, and when it is discovered it is like an inestimable treasure that should be conserved with humility and patience.

He argued that a field giving poor yields should be left alone for four or five years until planted again. He recognized the need for crop rotation, "green manure" by plowing under what was growing wild, and regular fertilization—practices that make sense to us today, but that had fallen out of use for centuries.

The work is in 12 parts:

1. Siting and layout of a manor, villa or farm, considering climate, winds, and water supply; also the duties of the head of the estate
2. Botanical properties of plants and horticultural techniques
3. Agriculture of cereals and building of a granary
4. Vines and winemaking
5. Arboriculture—trees useful for food and medicine
6. Horticulture—plants useful for food and medicine
7. Management of meadows and woodland
8. Pleasure gardens
9. Animal husbandry and bee keeping
10. Hunting and fishing
11. General summary
12. Monthly calendar of tasks

You can see how extensive and thorough a guide for farming on a large and a household scale it is.

One of his emphases is on the utility of a particular plant, so I thought we'd talk next about its history and about what De Crescenzi has to say about it: the misnamed lupine.

Noting the Bern

The Smithfield Decretals have been mentioned recently. They are a book of decrees drawn from 1,971 letters from Pope Gregory IX, with glosses (detailed commentaries) and lavish illustrations. About 700 copies of these decretals exist—most of them created after the advent of mass printing technology; this particular one was made in France in about 1300, but found in Smithfield in the UK, hence its name. It is thought that the owner in England had the illustrations added in about 1340.

Apes fighting as knights, from page 75

Thanks to the British Library's plan to digitize all of its manuscripts, you can actually flip through the pages if you go here. You will see all the illustrations, including depictions of daily life as well as fanciful portrayals of animals acting like humans.

But those are just the side show. The reason 700 copies exist of the writings are because of the importance of the papal letters, and the explicating of the important statements within. The editor of the decretals was one Bernard of Botone (d.1263), also called Bernard of Parma because of his birthplace. He studied at the University of Bologna, where (according to his gravestone) he became Chancellor in his later years. An expert at canon law, he was an ideal commentator for the decrees.

Bernard drew from multiple sources for the commentaries. Many medieval manuscripts give no hint as to authorship, or editor-ship. In the case of the Decretals, however, attribution is always given to the other authors and commentators whom he quoted. Whenever the notes and commentaries were his own, he signed with a simple "Bern" at the end.

The whole thing is finished; give the guy who wrote it a drink.

Bernard died in 1263, and the copies that exist were all made years later. In the case of the Smithfield decretals copy, we do not know who the copyist was, nor who the illustrators were. The copyist, however, did leave a "personal stamp" on the manuscript. On the very last page, after the last line, he added the following:

The whole thing is finished; give the guy who wrote it a drink.

Great Surgeon

The history of medicine includes many brave and progressive thinkers who were not willing to follow the herd or be content with what was already known. One such in the Middle Ages was Guy de Chauliac. Born about 1300, he studied at a university in Montpellier known for its expertise in medicine. After becoming a Master of Medicine and Surgery around 1325, he went to Bologna for further study. His reputation became such that he was invited to Avignon to be personal physician to Pope Clement VI, then Pope Innocent VI and Pope Urban V. The papal connection gave him access to a library that included the texts of the Greek physician Galen in their original; most of Europe knew Galen through less accurate Latin translations.

He possibly saved Clement's life during the spread of the Black Death, when he advised the pope to stay near blazing fires. Although many physicians fled Avignon at the arrival of the Plague, Chauliac stayed to study the disease and treat people. He determined that it was contagious, but couldn't figure out the method of contagion. Still, he advised bloodletting, a healthy diet, and exposure to pure air (hence the fires, which would have serendipitously served to keep fleas away). He also realized that there were two diseases involved because of different sets of symptoms: the initial Bubonic Plague, and the follow-up Pneumonic Plague which found its foothold in the weakened population and killed much more swiftly. Chauliac spoke out strongly against those who blamed the Jews for the Plague, explaining that scientifically it made no sense to consider them at fault.

Tools for withdrawing an arrow.

His value to the rest of the world and history was the writing of Chirurgia magna (Great [book of] Surgery) in 1363. Its seven volumes covered every imaginable medical topic of the day: intubation, surgery, disease, anesthesia, hernia, cataracts, ulcers, bloodletting, cauterization of wounds, and the use of special instruments (some of which he designed himself, such as an elaborate contraption for withdrawing an arrow from flesh). Chauliac drew on the past, quoting Galen (129-c.200) and Avicenna (Abu Ali al-Husayn ibn Abd Allah ibn Sina, c.980-1037). He placed great emphasis on learning anatomy, saying that "A surgeon who does not know his anatomy is like a blind man carving a log."

Chauliac was not always accurate. He believed, for instance, that pus was an important part of the healing process and should be left alone. Nevertheless, his Chirurgia became a standard text for the next three centuries, translated into several European languages. Unfortunately for future generations, anti-Islam sentiment caused many translators to leave out knowledge from Islamic scholars, resulting in a less complete and less accurate work. Still, he has been labeled the "Father of Modern Surgery," and his great work was the standard text until the 17th century.