This consistent book has several strengths. The first is Zampieri’s effort to reunite three prominent scholars of the early modern period, Marcello Malpighi (1628–94), Antonio Maria Valsalva (1666–1723), and Giovanni Battista Morgagni (1682–1771), who greatly contributed to the birth of modern anatomy and clinical pathology. The second is Zampieri’s encyclopaedic knowledge of Italian and European early modern medicine, as he also explores lesser-known medical areas and topics. The third is Zampieri’s synthesis of two centuries’ worth of discoveries, debates and scientific transformations, connecting medical knowledge to diverse disciplines, including natural history and natural philosophy. The book thus offers an outstanding and rich roadmap to medical science in the seventeenth and eighteenth centuries.
In Chapter 1, Zampieri brilliantly explores the status of medicine in the early modern period. The key to this reconstruction is the debate among neoteric, empirical and ancient medicine. He identifies two origins for this debate. The first is its efficient cause, so to speak, as medicine languished within a traditional methodology grounded in qualitative and finalistic analysis during the middle ages (p. 28). New discoveries achieved during the Renaissance put this medical approach in crisis. The second is its formal cause, as Zampieri uncovers a similar debate in ancient medicine as well. Despite Galen’s important synthesis, the contrapositions of antiquity were not solved, but covered again in the early modern period (pp. 40–1). A crucial point of novelty was the mechanical approach to medicine, mostly (though not exclusively) introduced by the work of Galilei and Descartes. This mechanical approach fuelled neoteric medicine and produced anatomical studies that helped define diseases and develop cures. Both this debate and the mechanical approach furthered Morgagni’s anatomical-clinical method, which resulted in a synthesis of the mechanical (purely anatomical) approach and empiricism or clinical medicine.
Chapters 2 and 3 deal with Malpighi and Valsalva, the predecessors of Morgagni, whose work Zampieri analyses in the light of their attempts to enhance mechanical approaches and anatomy in the debate previously described. Zampieri highlights the fact that Malpighi thought mechanical models could help one to understand organs, describe the causal chain, and comprehend both physiology and physiopathology (p. 72). From this perspective, the nature of malady was of particular help to us in understanding the normal state of the body. Both Galilei and Descartes were sources for Malpighi, though he reinterpreted Descartes’ heuristic model (p. 80). Zampieri analyses three situations to detail Malpighi’s position. The first is Domenico Guglielmini’s reception of Malpighi. The second is the debate on a number of theses written by Michele Lipari, a physician of Messina, who supported Galenic medicine against Malphighi’s innovations (pp. 99–102). The third is the debate with Giovanni Girolamo Sbaraglia, who criticised neoteric medicine and the uses of anatomy in favour of empiricism or practical medicine. Zampieri describes concisely the diverse support for these positions (even bizarre ones, like Gideon Harvey who compared anatomy to cannibalism, p. 111), which cast a shadow on Malpighi’s medicine, but also brilliantly illuminates the latter’s interpretation (pp. 137–40). The result is well known: Malpighi is one of the fathers of modern medicine.
In the analysis of the work of Valsalva, posthumously published by Morgagni, Zampieri detects the presence of several methodological features that Valsalva derived from Malpighi. These are: (1) the uses of mechanical models to explain anatomy (on p. 156, a table of measurements of the semicircular canals of the ear exemplifies this connection) and the combination of the diverse parts of the body; (2) the role of detailed anatomy; (3) the microcosm of nature; (4) the conceptualisation of disease as a natural experiment to confirm the normal structure and function of the body; and (5) the application of anatomy to clinical examination and surgery.
Chapter 4 forms a compelling section of the book, the medicine of Morgagni. Zampieri divides this chapter into four subsections, in which he connects Morgagni’s method outlined in De sedibus et causis morborum with Malpighi and Valsalva, but also shows its innovations in the debate between the mechanical and clinical approaches. Following his teachers, Morgagni reinterpreted humours as produced by glands (p. 187) and connected anatomy, clinical examination and surgery (p. 190). Yet, Morgagni combined innovative aspects with traditional features (p. 196), which gave his De sedibus enormous success in Europe. In this regard, Zampieri detects Morgagni’s connection with ancient authorities, Hippocrates, Galen, Celsus, and Aretaeus of Cappadocia (p. 204), with early modern physicians, such as William Harvey and Théophile Bonet (p. 210), and then with early modern (natural) philosophers, such as Robert Boyle (pp. 228–30), and, in the case of Morgagni’s understanding of causation, John Locke (p. 286). Within this complex matrix of references, De sedibus et causis morborum is revealed as an innovative work, in both its title (p. 234) and contents. Zampieri especially deals with the role of comparison in series (p. 238), the innovative uses of mechanical models in the discussion of diseases (p. 248), the observation of polyps in the heart, aneurisms and syphilis (p. 270), the definition of causation (pp. 281–3), and the limits to the uses of the microscope (p. 297). In the last subsection, Zampieri focuses on the role of conjectures and hypotheses developed by Morgagni. The latter’s conception of reality is more undetermined than mechanists claimed (p. 320).
Nevertheless, Morgani’s position consists of a strong connection between mechanical and empirical approaches. Indeed, while he developed a conjectural or provisory mechanical approach, he related mechanical models to clinical and anatomical phenomena. Accordingly, a new methodological synthesis of true knowledge surfaced (p. 326). Yet, this is Zampieri’s thesis: Morgagni’s success resided in a fruitful methodological combination that has its origin in the work of Malpighi and Valsava, as well as in the exceptional condition of the study of medicine at Padua during the early modern period (pp. 349–90).
Zampieri’s book, which is of paramount importance for both historians of medicine and physicians (p. 401), lays bare with rigour and exactitude a crucial juncture in early modern medical knowledge, which would otherwise be challenging to comprehend.
