Banti, Guido

(b. Montebicchieri, Italy, 8 June 1852; d. Florence, Italy, 8 January 1925)

pathology.

Banti, the most eminent Italian pathologist of the early twentieth century, was born in a typical village of Tuscany, in the lower valley of the Arno River. He was the son of Dr. Scipione Banti, a physician, and Virginia Bruni. He studied medicine at the University of Pisa, but was graduated in 1877 from the Medical School of Florence. He was then appointed assistant at the Archihospital of Santa Maria Nuova in Florence and, at the same time, assistant at the Laboratory of Pathological Anatomy. Banti was tireless worker. Chief of the hospital medical service from 1882, in 1890 he became temporary professor and, in 1895, ordinary professor of pathological anatomy at the Medical School of Florence. His medical service at the hospital ended in 1924, after forty-seven years; he died the following year, his thirty fifth year, his thirty-fifth year of teaching.

As a result of then existing arrangements, Banti could observe patients in bed and later study their corpses through autopsy as well as through laboratory tests: he wrote that clinical observation, anatomical report, and laboratory examination are three links in the same chain. Banti’s numerous writings are original, and few men of science have spoken or written with such conciseness and clarity.

Banti was a perspicacious clinician, as evidenced by his study on heart enlargement(1886) and his notes for the surgical treatment of hyperplastic gastritis (1898) and acute appendicitis (1905). He was also a precise histologist who studied cancer cells (1890–1893) and a capable bacteriologist who published the first Italian textbook of bacteriological technique, Manuale di Tecnica Batteriologica(Florence 1885). Thus, he contributed decisively to the advancement of the study of human pathology.

As a bacteriologist, Banti integrated bacteriology with the pathogenesis of infectious diseases. His works on typhoid fever (1887, 1891) and his paper Le setticemie tifiche (1894) contained the first observations of typhoid without intestinal localizations. Of fundamental importance were his studies (1886–1890) on Diplococcus pneumoniae Fraenkelii. In particular, Banit analyzed the Characteristics of the types hemolytic and viridans. In 1890 he affirmed the hematogenic pathogenesis of acute pneumonia. In his remarkable experimental work on the destruction of bacteria in organisms (1888), Banti contributed to the development of Metchnik off’s views on the phagocytic defense of the organism against bacterial invasion.

As a histologist, Banit wrote his Endocorditi e nefriti (Florence, 1895), in which he illustrated several forms of endocarditis and described arteriosclerosis of the kidney. He also anticipated the modern view of nephrosis. Opposing Ludwig Pfeiffer, who in Die protozoen also Krankheiserreger (1890) interpreted as parasites some cytoplasmatic corpuscles in the cancerous cells, Banti denied the parasitic nature of these a pathology of the mytosis (see his su i Parassiti de carcinoma, 1893). At that time, when every pathological process anatomically characterized by fibrinous exudation was attributed to an infectious agent, Banti illustrated the existence of a fibrinous pericarditis as caused by a dismetabolic etiopathogenesis (1894).

As an anatomist, Banti contributed to the understanding of aphasia (1886); and in his paper of 1907, A proposito dei recenti studi sulle afasie, he confuted Pierre Marie’s views on the motor type of aphasia.

Banti is especially remembered, however, for his contributions to knowledge of pathology of the spleen and the leukemia. In 1913, he gave his nosographic definition of the leukemias and demonstrated the relationship of the spleen to hemolysis in vivo

From 1882 to 1914 Banti studied the so-called primitive splenomegalies—enlargements of the spleen that are neither degenerative nor infectious. In his first work on the spleen (“Dell’anemia splenica,” in the second volume of Archivio di anatomia patologica [1882]), Banti had already directed attention to the relation between some splenomegalies and a peculiar form of hypochromic progressive anemia in adults. From further observations he was able by 1894 to describe a new morbid entity, later known as Banti’s disease, characterized by anemia with splenomegaly, and, in the terminal stage, by cirrhosis of the liver with ascites. This disease, of unknown cause and of several years’ duration, is histologically defined by a peculiar picture of the spleen (fibroadenia). A timely splenectomy, performed when the spleen is enlarged, leads to permanent recovery, because this procedure prevents or halts the development of cirrhosis of the liver. Discussion of Banti’s disease has resulted in an improved knowledge of the spleen’s physiopathology and anatomy.

Banti also developed knowledge of the spleen in relation he hemolysis. He demonstrated (1895–1912) that the spleen in the principal site for the destruction of red blood cells, and that this normal functions is exaggerated when the spleen become enlarged pathologically. Banti stated that only splenectomy can stop the hemolytic process, and the first splenectomy for hemolytic jaundice was performed in Florence, on his advice, on 20 February 1903.

But Banti’s name is primarily connected with leukemia: “All leukemias belong to the sarcomatosis,” he wrote in 1903, in opposition to the views of Arthur Pappenheim and Carl Sternberg. With further observations Banti completed his definition in 1913. He concluded that the leukemias are systematic diseases arising from hemopoietic structures, lymph glands, and bone marrow, and that they are the consequence of the limitless proliferative power of staminal blood cells (the lymphoblast and the myeloblast: Banti was always a confirmed dualist), which have lost their maturative capacity. This is still the basic definition of leukemia. Banti also was the first to demonstrate that leukemia produces erosion of the walls of the smallest blood vessels, as a result of the activity of the leukemic cells. If this erosion does not occur, then true leukemia is not present.

From 1907 to 1909 Banti was municipal adviser and also assessor of sanitation in Florence. A devout Roman Catholic, he also had a deep belief in science, which he often expounded in his lectures.

BIBLIOGRAPHY

I. Original Works. Only the first of two volumes of Trattato di anatomiapatologica was published (Milan, 1907); it covers infections, the pathology of the heart and lungs, and the leukemias. For the text of the second volume which consisted of revisions of earlier works—the chapter on the pathology of the spleen, for example—it is necessary to consult Banti’s orginal writings: Afasia e sue forme (Florence, 1886); “Sulle localizzazioni atipiche della infezione tifosa,” in La riforma medica3 (1887), 1448–1449, 1454–1455; “Sulla distruzione dei batteri nell’ organismo,” in Archivio per le scienze mediche, 12 (1888), 191–221; “Carcinoma primitivo della tiroide,” in Archivio di anatomia normale e patologica, 5 (1890), 131–142; “sopra alcune localizzazione extrapolmonari del Diplococcus pneumoniae Fraenkelii,” ibid., 71–130; “Sulla etiologia delle pneumoniti acute,” in Lo sperimentale44 (1890), 349–384, 461–474, 573–588: “L’epidemia di tifo in Firenze nei suoi rapporti con l’acqua potabile,” ibid., 45 (1891), 85–94 (See also “Adunanze Accademia Medico-Fisica Fiorentina”); “Su i parassiti del carcinoma,” in La riforma medica, 9 (1893), 361–364; “Le setticemie tifiche,” ibid., 10 (1894), 674–680; “La splenomegalia con cirrosi epatica,” in Lo sperimentale, 48 (1894), 407–420; “ueber urämiche Pericarditis,” in centralblatt für allgemenie Pathologie und pathologische Anatomie, 5 (1894), 461–468; Endocarditi e nefriti (Florence, 1895); “La milza nelle itterizie Pleiocromiche,” in Lo sperimentale, 49 , Sezione Clinica (1895) 41–42, 62–64; see also Gazzetta degli ospedali e delle cliniche, 16 (1895), 190–195, and Deutsche medizinische Worchenschrift, 31 (1895), 493–495; “Pilorostenosi e intervento chirurgico nella malattia de Reichmann,” in Lo Sperimentale, 52 (1898), 138–152; “Splenomegalie primitive,” in La riforma meidca, 17 (1901), 590–592, 605–608, 614–617, 627–631; “Le leucemie,” in Atti della Società italiana di patologia (florence, 1903), and also in Lo sperimentale, 57 (1903), 786–789; “sull’ufficio degli organi linfopoietici ed emopoietici nella genesi dei globuli bianchi del sangue,” in Archivio di firsiologia, 1 (1904), 241–247; “Sulla cura delle appendiciti acute,” in Lo Sperimentale, 59 (1905), 891–896 (see also “Adunanze Accademia Medico-Fisica Fiorentina”); “A proposito dei recenti studi sulle afasie,” in Clinica Moderna, 13 (1907), 49–65; “Ueber Morbus banti,” in Folia haematologica, 10 (1910), 33–53; “La splenomegalia emolitia,” in Lo sperimentale66 (1912), 91–122, and 67 (1913), 323–378; The Clinical Aspects of Haemolysis, report to the Seventeenth International Congress of Medicine (Oxford, 1913); “Le leucemie,” report to the eighth meeting of the Italian Society of Pathology, in Lo superimentale, 67 (1913), Suppl., 10–19; “Malattie dipolococciche,” in A. Lustig Malattie infettive dell’uomo e degli animali, I (Milan 1913), 576–610; “La splenectomia nelle anemie,” in Ricerche di biologia dedicate al Professore Alessandro Lusing nel 25°; anno del Suo insegnamento universitario (Florence, 1915), 677–680; “L’evoluzione nella materia e nella vita,” in Annuario 1902–1903 del Regio Istituto di studi pratici e di perfezionamento in Firenze.

II Secondary Literature. Works on Banti and Banti’s disease include in particular P. Franceschini, “La Malatta di Banti,” In II Sistema Istiocitario (Florence, 1954), pp. 532–561, and “In ricordo di Guido Banti,” in Rivista di storia delle scienze mediche e naturali, 43 (1952), 157–167, which has the complete inventory of his works; A. Lustig, “In memoria did Guido Banit,” in Lo sperimentale, 79 (1925), I-XXXI (with Banti’s portrait); F. Micheli, “Sul Morbo di Banti,” in Archivio per le scienze mediche33 (1909), 351–377, 46–494, 495–514; G. Patrassi, La Questione del Morbo di Banti (Bologna, 1942).

Pietro Franceschini