SALERNITAN ANATOMISTS

(fl. eleventh to thirteenth centuries, Salerno, Italy)

anatomy.

In order to assess the contribution made by the school of anatomists at Salerno to the revival of their science in the West, it is essential to review briefly the arid millennium in the history of anatomy that began after the death of Galen (A.D. 199/200). Even during the latter’s lifetime, dissection of the human body was no longer permitted at Alexandria: and the early Christian aversion to such studies is clearly shown by the opprobrium heaped on the memory of Herophilus by Tertullian, who castigated the great anatomist as “more of a butcher than a physician.” Although Galen based many of his studies on the Barbary ape and rhesus monkey, he frequently made use of the pig (among other domestic animals), not only because of its ready availability but also because the internal organs were thought to show a remarkable similarity to those of show are markable similarity to those of man. Indeed, it was while vivisecting a pig that Galen discovered the function of the recurrent laryngeal nerve in voice production.

Although the written records do not say so, there is reason to believe that during the Dark Ages an occasional intrepid soul investigated the interior of the human body. A recent find in a fourth-century Roman catacomb shows a rather apathetic-looking group of master and pupils observing the dissection of a male corpse. Cassiodorus (sixth century) stated that human dissection was strictly forbidden by law and added a warning —presumably for the more intrepid—about cemetery guards and the harsh penalties for grave desecration. The various barbarian legal codes also contained section on the violation of sepulchers. Some three centuries later George Teofano (d, 818) related that some Greek soldiers stationed in Bulgaria turned over a condemned prisoner to the physicians before consigning his body to the flames.

It is generally held that none of the anatomical works of Hippocrates, Aristotle, or Galen were in use in Europe before the end of the eleventh century. The meager anatomical literature available at Salerno before the arrival of the Constantinian translations included the Scheme anatomica of Vindicianus (late fourth century), which survives in a solitary fragment written in the Benedictine script used at Salerno; the book on anatomical terminology in the Differentiae and the Origines of Isidore of Seville (ca.560–636): and the anatomical chapters— derived ultimately from Celsus and Galen — in the Epitome of Paul of Aegina (seventh century). This situation changed radically with the arrival at Salerno of Constantine the African (d.1087), translator of numerous works from the Arabic. Most important from an anatomical viewpoint was the Kitāb al-Mālikī of Haly Abbas (^cAlīibn al-^c Abbās, d. 994), titles Pantechne by Constantine, who rendered parts of its into Latin and claimed it as his own original work. TheKitāb al-Mālikī was later (1127) translated in its entirety by stephen of Antioch as theLiber regalis. The two chapters on anatomy in this book, although derived entirely from Galen and showing no evidence of direct observation, exerted a strong influence on the later anatomical writings produced at Salerno.

By the mid-eleventh century Salerno was rapidly approaching its zenith as the undisputed center of medical teaching in the Western world. The earliest writings of the school, such as the Passionarius of Gariopontus and the Practica petrocelli, were compiled for students and practitioners from late Greek and Byzantine works and contain little of anatomical interest. Yet there is every reason to believe that before the end of the century an annual public demonstration of porcine anatomy had become a traditional occurrence in the civitas Hippocratica, as Salerno came to be known.

The text that is considered to give the earliest account of such a dissection has for many centuries been attributed— although without any definite proof— to a Master Copho (fl. ca. 1080–1115), the author of De mode medemdi and other writings. The most primitive version of the Anatomia porci, as it is now called, treats only the neck, chest, and abdomen; the brief sections on the uterus and brain seem to have been added later, possibly by Stephen of Antioch, who called himself a pupil of Copho. In the cervical region the author identified the larynx, trachea, esophagus, epiglottis, and thyroid, and demonstrated to his pupils the function of the recurrent laryngeal nerve. He then proceeded to the contents of the thorax, identifying the pleura, pericardium, heart, and diaphragm as well as demonstrating the hollowness of the lung. He also described the course of the vena concava from the liver (as he thought) through the diaphragm into the inferior (right) auricle, where it becomes the artery “from which all other arteries arise”. In the abdomen he enumerated eight subdivisions of the gastrointestinal tract, described the five-lobed liver, spleen, chylous vein, kidneys, ureters, omentum, and peritoneum. In the description of the uterus, allusion is made to seven cells or chambers that accommodate the fetuses, and to the palcenta and membranes (secundines).

Throughout this brief tract (it contains less than a thousand words) the demonstrator speaks with assurance and clarity: his terminology has been described as transitional but is, in fact, almost entirely Greco- Latin or late Latin: and the three words of Arabic derivation may well have been interpolated during a revision. One recent student, noting that the order of dissection differs from the de capite ad calcem of Vindicianus and Isidore, suggests the influence of Celsus and Aristotle, although the means of transmission of the latter remains unclear. Certainly there is an agreement between the description of the large vessels of the heart in the Historia animalium and the Anatoimia porci. The author seems to have been unfamiliar with the Galenic concept of blood passing from right to left ventricle through pores in the interventricular septum and depended on the earlier tradition (common to all twelfth-century Salernitan anatomies) that had the superior vena cava entering directly into the aorta.

Summing up the evidence for dating the earliest version of the Anatomia porci, I would suggest a year between 1080 and 1090, the decade just before the Constantinian translations had begun to circulate freely in Salerno.

Regardless of its antecedents and meagerness of content, the value of the Anatomia porci to the historian of science cannot be denied. Any eleventh-century investigation at which students from all over Europe could observe their master verify or criticize statements of other authorities must have had more than ordinary significance as marking the beginning of a new era. The text itself has survived in at least five manuscripts: it also has a remarkable printing history, having served as a working tool in book form from 1502 to 1655. Few works in the history of medicine can claim use over more than five centuries: long after the works of Mondino de’ Luzzi and Vesalius were freely available, students continued to memorize the ancient text “as a preparatory exercise to the noble art of anatomy” Indeed, Mondino himself must have known and relied on this earlier work, since he continued to describe the human liver as five-lobed and the human uterus as bicronuate and multichambered.

The exact number of anatomies attributed to Salerno has varied with authorities. but Sudhoff and Corner agree on four. The second pig disseaction, the Demonstratio anatomica, is related to the first as far as basic anatomica facts are concerned but differs greatly in style, methodology, and terminology. This work is approximately five times as long as the Anatomia porci and can best be described as an elaborate, polemic, early Scholastic commentary on the short primitive text. The author frequently wandered from descriptive anatomy to elaborate discussions of humoral physiology and made repeated reference to the teleological concepts of Galen. Apparently this master had fallen completely under Arabic influence, and he made no attempt to conceal his indebtedness to Constantine. Indeed, he mentioned the latter by name on eight occasions, but only in reference to the terminology of various subdivisions of the gastrointestinal tract. Corner has clearly shown that vocabulary, phrases, and even entire paragraphs have been lifted almost verbatim from the Pantechne.

This second demonstration lacks the spontaneity of the first, and because of its prolixity never gained a student following. Since the author referred, somewhat pompously, to his own commentaries on several texts of the still-growing Articella, I have tentatively identified him with Master Bartholomaeus (fl, first half of the twelfth century), who is now known to have written precisely such commentaries as well as an Anatomia (all still unpublished). In his occasionally critical side remarks, the author confirmed the tradition of an annual dissection at Salerno: emphasized to his students the importance of committing his remarks to memory: and described th professional rivalry and competition for students in the still loosely organized school. He refused flatly to accept the lateralia “described in a recent booklet” — probably a revision of the Anatomia porci— because he “had never discovered these in animals”, nor would he admit the usage of the term faringes proposed by a predecessor, because he had “not found it written in any book or hears it form any teacher”. One the other hand, he did not hesitate to describe the human liver (which he obviously had never studied) as being five-lobed, “since certainly the same number [as in the pig] occurs in man”.

The authorship of the third dissection, or Anatomia mauri, which has survived in four manuscripts (two of which explicitly name the author) has been attributed to Master Maurus, the optimus physicus of the school, who flourished in the latter half of the twelfth century and is known to have died in 1214. Although this brief tract shows familiarity with Arabic terminology, the descriptions are not so obviously dependent on the Pantechne as those of the second demonstration: and the author seems deliberately to have followed the Anatomia porci in format and method. In addition to the two hypochondria below the diaphragm mentioned by earlier authors. Maurus postulated, for teaching purposes. the existence of two superior hypochondria, one containing the lung and the other the heart. In his description of the circulation Maurus was somewhat more explicit than his predecessors: “Then you will see the cover of the heart and the heart itself and that vena concava which rises from the convexity of the liver through the diaphragm to the right auricle of the heart and then emerges through the left. Where from the substance of the heart it acquires another coat and is thus transformed into an artery which is called the aorta, the name given to the Chief of all arteries” Again there is no mention of the interventricular pores. For the Latin term peritoneum Maurus also used the Arabic siphacand the Greek epigasunta hymenon, thus recalling the multilingual character of the Salernitan medical milieu. Nevertheless, the text in general is rather unoriginal and, aside from some changes in terminology, offers little improvement on its predecessors.

The fourth and last surviving porcine anatomy that can definitely be related to Salerno was discovered by Sudhoff and attributed by him to Urso of Calabria, a contemporary of Maurus, who fell entirely under the spell of the “new” Aristotelian logic. Basically a theoretician and philosopher rather than a physician, Urso was concerned only vaguely with morphological data: and the Scholastic method and terminology that dominated his work exclude any practical approach to the subject. Urso provided one historical note: he recalled that in his youth he had witnessed several dissections performed by his master. Matthaeus Platearius (d. ca. 1150).

In 1224 Frederick II issued a decree that surgeons must study anatomy for a year and be examined in that subject before they could practice; whether this involved actual dissection of the human body or simple observation is not known, nor has it ever been definitely proved whether a further edict of 1231, ordering that a human cadaver be publicly dissected at least once every five years in the presence of all practicing physicians and surgeons, was ever carries out. The political turmoil that threatened the latter years of Frederick’s reign makes this unlikely.

For the sake of completeness we mention briefly an anatomy attributed to a Ricardus Salernitanus (d. 1252). He had undoubtedly studied at Salerno, for the mentioned many of its masters and reverentially compared Bartholomaeus with Hippocrates. He seems, however, to have taught at Montpellier; and his anatomy, not of the pig but of the human body, is thoroughly pseudo-Galenic and unoriginal. The work of Ricardus was edited and enlarged by a pupil, and the Anatomia nicolai is simply an elaboration of his master’s text. Neither of these works can be considered as directly related to Salerno.

The earliest Salernitan anatomical demonstration had some influence on disciplines other than medicine. This is particularly evident in the writings of the philosopher-mystic Hugh of St. Victor (d. 1141), the great rival of Abelard at Paris. Three of Hugh’s writings— “De bestiis et aliis rebus”, “De natura hominis” — bear witness to the pervasive influence of the small but provocative Anatomia porci on the intellectual life of Europe.

BIBLIOGRAPHY

See George W. Corner, Anatomical Texts of the Earlier Middle Ages (Washington. D.C., 1927): Salvatore De Renzi, Storia documentata della scuola di medicina di Salerno, 2nd ed. (Naples, 1857), 254–255, 334–335: Thomas Haviland. “‘Anatomia porci,’, a Twelfth Century Anatomy of the Pig Used in Teaching Human Anatomy”, in Wiener tierärztliche Monatsschrift, Festschrift (1960). 246–265: Ynez violé O’Neill. “William of Conches and the Cerebral Membranes”, in Clio Medica, 2 (1967), 13–21 and “Another Look at the ‘Anatomia porci’” in Viator, 1 (1970), 115–124; Werner L.H. Ploss, ed., Anatomia mauri (Leipzig, 1921); Morris H. Saffron. Maurus of Salerno (Philadelphia, 1972), 13, 62; and karl Sudhoff, “Die erste Tieranatomie von Salerno und ein neuer Salernitanischer Anatomietext”, in Archiv für Geschichte der Mathematik. der Naturwissenschften und der Technik, 10 (1927), 137–154; “Die vierte Salernitaner Anatomie”, in Archiv für Geschichte der Medizin, 20 (1928), 33–50: and “Codex Fritz Paneth”, in Archiv für Geschichte der Mathematik der Naturawissenschaften und der Technik, 12 (1929), 2.

Morris H. Saffron