Mondino de Liuzzi

Mondino de Liuzzi

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Mondino de Luzzi, or de Liuzzi or de Lucci, (ca. 1270 – 1326), also known as Mundinus, was an Italian physician, anatomist, and professor of surgery who lived and worked in Bologna
Bologna
Bologna is the capital city of Emilia-Romagna, in the Po Valley of Northern Italy. The city lies between the Po River and the Apennine Mountains, more specifically, between the Reno River and the Savena River. Bologna is a lively and cosmopolitan Italian college city, with spectacular history,...

. He is often credited as the “restorer of anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

” because he made seminal contributions to the field by reintroducing the practice of public dissection
Dissection
Dissection is usually the process of disassembling and observing something to determine its internal structure and as an aid to discerning the functions and relationships of its components....

 of human cadavers and writing the first modern anatomical text.

Biography


Mondino de Luzzi was born around 1270 into the prominent Florentine
Florence
Florence is the capital city of the Italian region of Tuscany and of the province of Florence. It is the most populous city in Tuscany, with approximately 370,000 inhabitants, expanding to over 1.5 million in the metropolitan area....

 de Luzzi family with loyalties to the Ghibellines and inscribed to the Società dei Toschi; his father, Nerino, and grandfather Albizzio were both pharmacists in Bologna, his uncle Luzio (also Liuzzo or Lucio) was a professor of Medicine. Mondino studied at the University of Bologna
University of Bologna
The Alma Mater Studiorum - University of Bologna is the oldest continually operating university in the world, the word 'universitas' being first used by this institution at its foundation. The true date of its founding is uncertain, but believed by most accounts to have been 1088...

 in the College of Medicine and the College of Philosophy, graduated around 1290, and was employed as a public lecturer in practical medicine and surgery at the university from 1306–1324. During his schooling, Mondino was a pupil of Thaddeus of Florence (Taddeo Alderotti), who made significant contributions to the development of medicine at Bologna, and a fellow student of Henri de Monteville
Henri de Monteville
Henri de Mondeville , a medieval Frenchmen, has been claimed as the "Father of French Surgery". There is some doubt about his birth place, but it was most likely to have been either the village of Mandeville or Edmondeville, both in Normandy. He was the surgeon to Philippe Le Bel of France and...

. In addition to his achievements as an anatomist, Mondino was highly regarded as a diplomat. He was involved in city government and served as an Ambassador of Bologna to John, the son of King Robert of Naples
Robert of Naples
Robert of Anjou , known as Robert the Wise was King of Naples, titular King of Jerusalem and Count of Provence and Forcalquier from 1309 to 1343, the central figure of Italian politics of his time. He was the third but eldest surviving son of King Charles II of Naples the Lame and Maria of Hungary...

. Mondino died in Bologna in 1326 and was buried in the parochial church of San Vitale e Agricola along with his uncle Leuzzo, who was also a lecturer in medicine. His granite tomb is adorned with a bas-relief
Relief
Relief is a sculptural technique. The term relief is from the Latin verb levo, to raise. To create a sculpture in relief is thus to give the impression that the sculpted material has been raised above the background plane...

, sculpted by Boso of Parma, which depicts an instructor seated in a large chair lecturing to students.

Teaching Practices


Mondino was the first to incorporate a systematic study of anatomy and dissection into a medical curriculum. The dissection of human cadavers was a hallmark of the Alexandrian school
Alexandrian school
The Alexandrian school is a collective designation for certain tendencies in literature, philosophy, medicine, and the sciences that developed in the Hellenistic cultural center of Alexandria, Egypt during the Hellenistic and Roman periods....

, but declined after 200 A.D. due to legal and religious proscriptions. These bans were eventually lifted, allowing Mondino to perform his first public dissection in Bologna in January 1315 in the presence of medical students and other spectators. The proceedings were formally sanctioned by the Vatican, and the subject was mostly likely a female executed criminal. It was common practice for the professor of anatomy to sit in a large, ornate chair elevated above the dissection proceedings, reading from an anatomical text and providing commentary, while a demonstrator, or surgeon, physically performed the dissection. Additionally, an ostensor was present to point out the specific parts of the body that were being examined. Mondino's teaching methods were unique because he often performed dissections in person and served the role of demonstrator himself, carefully studying the cadaver and incorporating this personal experience into his text and teaching.

Dissection Theory


Mondino's dissection practices were guided by his adherence to a tripartite division of the human body. He theorized that the body was composed of three distinct containers: the skull
Human skull
The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...

, or superior ventricle, which enclosed the “animal members”; the thorax
Thorax
The thorax is a division of an animal's body that lies between the head and the abdomen.-In tetrapods:...

, or middle ventricle, which contained "spiritual members" such as the heart and lungs; and finally the abdomen, or inferior ventricle, which housed "natural members" including the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

 and other visceral organs. Mondino utilized the differences between animal, spiritual, and natural members to classify distinct aspects of physiological activity. He also asserted that certain parts of the body are innately superior to others; according to this hierarchical arrangement, the abdomen should be dissected first because its organs are "the most confused and least noble", followed by the thorax, and finally the head, which contains "higher and better organized" anatomical structures. Additionally, Mondino argued that distinct dissection methods should be applied to simple structures (such as bones, muscles, nerves, veins, and arteries) as compared to more complex composite parts (for example, the eye, ear, liver, and spleen. He also suggested that, when studying the muscles of the limbs, a sun-dried body be used as an alternative to the more laborious practice of dissecting a rapidly decaying cadaver.

Contributions to Anatomy


Mondino's major work, Anathomia corporis humani, written in 1316, is considered the first example of a modern dissection manual and the first true anatomical text. The earliest edition of the work was printed in Padua
Padua
Padua is a city and comune in the Veneto, northern Italy. It is the capital of the province of Padua and the economic and communications hub of the area. Padua's population is 212,500 . The city is sometimes included, with Venice and Treviso, in the Padua-Treviso-Venice Metropolitan Area, having...

 in 1478, and more than 40 editions exist in total. By the 14th century, the practice of anatomy had come to refer to the dissection of a cadaver
Cadaver
A cadaver is a dead human body.Cadaver may also refer to:* Cadaver tomb, tomb featuring an effigy in the form of a decomposing body* Cadaver , a video game* cadaver A command-line WebDAV client for Unix....

 according to prescribed rules; Anathomia was intended as a handbook to guide this process. Mondino's Anathomia remained the most widely used anatomical text for 250 years (through the 16th century) because it clearly and concisely provided the important technical indications involved in the dissection process, including the steps involved and the reasoning behind the organization of these procedures. Unlike his predecessors, Mondino focuses specifically on anatomical descriptions rather than engaging in a larger discourse on pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

 and surgery in general.

Anathomia opens with the assertion that human beings are superior to all other creatures because of their intellect, reasoning ability, tool-making abilities, and upright stature; because he possesses these noble qualities, man is worthy to be studied. Mondino goes on to describe the organs in the order in which they present themselves during the dissection process. Dissection began with the opening of the abdominal cavity via vertical incision running from the stomach to the pectoral muscles and a horizontal cut above the navel
Navel
The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...

. First, the musculature of the intestinal tract is described in detail, followed by an extensive discussion of the form, function, and position of the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...

. According to the text, the stomach is spherical; the stomach wall has an internal lining, which is "the seat of sensation", and an external fleshy coat that is involved in digestion. In order to access the spleen
Spleen
The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...

, which was thought to secrete black bile into the stomach through imaginary canals, the dissector was required to remove the "false ribs". The liver is said to have five lobes, the gallbladder is described as the seat of yellow bile, and the cecum
Cecum
The cecum or caecum is a pouch, connecting the ileum with the ascending colon of the large intestine. It is separated from the ileum by the ileocecal valve or Bauhin's valve, and is considered to be the beginning of the large intestine. It is also separated from the colon by the cecocolic...

 is described with no mention of the vermiform appendix
Vermiform appendix
The appendix is a blind-ended tube connected to the cecum , from which it develops embryologically. The cecum is a pouchlike structure of the colon...

. Though Anathomia only vaguely describes the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

, the pancreatic duct is discussed in greater detail. He also makes new observations regarding the anatomy of the bladder and the enlargement of the uterus during both menstruation and pregnancy.

Mondino's description of the human heart
Human heart
The human heart is a muscular organ that provides a continuous blood circulation through the cardiac cycle and is one of the most vital organs in the human body...

, though inaccurate, is fairly detailed. He discusses three chambers: the right ventricle, the left ventricle, and a middle ventricle within the septum. The right ventricle is purported to contain a large opening, through which the heart draws blood originating in the liver, as well as the opening of the vena arterialis toward the lung. The left ventricle contains an orifice with three valves and the bivalvular opening of the arteria venalis, which allows the passage of a smoke-like vapor from the lungs. Despite these anatomical shortcomings, the vena chili (Mondino's name for the vena cava) is noteworthy in its accuracy. He then moves on to the lungs, describing the course of the vena arterialis (pulmonary artery
Pulmonary artery
The pulmonary arteries carry deoxygenated blood from the heart to the lungs. They are the only arteries that carry deoxygenated blood....

) and the arteria venalis (pulmonary vein
Pulmonary vein
The pulmonary veins are large blood vessels that carry blood from the lungs to the left atrium of the heart. In humans there are four pulmonary veins, two from each lung...

). This section of Anathomia also describes the pleura and notes the importance of distinguishing between pulmonary pathologies including true pleurisy
Pleurisy
Pleurisy is an inflammation of the pleura, the lining of the pleural cavity surrounding the lungs. Among other things, infections are the most common cause of pleurisy....

, false pleurisy, and pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

. His descriptions of the larynx
Larynx
The larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...

 and epiglottis
Epiglottis
The epiglottis is a flap that is made of elastic cartilage tissue covered with a mucous membrane, attached to the entrance of the larynx. It projects obliquely upwards behind the tongue and the hyoid bone, pointing dorsally. The term, like tonsils, is often incorrectly used to refer to the uvula...

 are very rudimentary.

Mondino describes the closure of an incised intestinal wound by having large ants bite on its edges and then cutting off their heads, which one scholar interprets as an anticipation of the use of staples in surgery. Anathomia also includes a detailed passage on the surgical treatment of a hernia
Hernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....

, both with and without castration, as well as a description of a type of cataract
Cataract
A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light...

 surgery.

Mondino's treatment of the skull provides only inexact directions for its dissection, suggesting that the cranial cavity was opened infrequently and with little technical skill. Nonetheless, Anathomia contains a description of the cranial nerves derived from Galen's Uses of the parts of the body of man. Furthermore, the brain is divided into three vesicles, with the anterior vesicle serving as the meeting place of the senses, the middle vesicle housing the imagination, and the posterior vesicle containing the memory. Movement of the choroid plexus
Choroid plexus
The choroid plexus is a structure in the ventricles of the brain where cerebrospinal fluid is produced...

 is said to control mental processes by opening and closing passages between the ventricles. Mondino follows Galen and the Islamic commentators in placing the lens in the center of the eye.

Much of the medical information included in Anathomia is derived from commentaries on Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...

, Aristotle
Aristotle
Aristotle was a Greek philosopher and polymath, a student of Plato and teacher of Alexander the Great. His writings cover many subjects, including physics, metaphysics, poetry, theater, music, logic, rhetoric, linguistics, politics, government, ethics, biology, and zoology...

, and Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

 written by Islamic scholars. Although Mondino makes frequent references to his personal dissection experiences, he nonetheless repeats numerous fallacies reported by these textual authorities. For example, he propagates the incorrect Galenic notion that a rete mirabile
Rete mirabile
A rete mirabile is a complex of arteries and veins lying very close to each other, found in some vertebrates. The rete mirabile utilizes countercurrent blood flow within the net...

("miraculous network") of blood vessels exists at the base of the human brain when it is in fact only present in ungulates. Other errors contained in Anathomia are the result of an attempt to reconcile the teachings of Galen and Aristotle. This is exemplified by Mondino's description of the heart: he combines Aristotle's notion of a triventricular heart with Galen's claim that a portion of the blood can flow directly from one side of the heart to the other though a permeable interventricular septum
Interventricular septum
Interventricular septum , abbreviated IVS, is the stout wall separating the lower chambers of the heart from one another....

. He also propagates information about the human reproductive system
Reproductive system
The reproductive system or genital system is a system of organs within an organism which work together for the purpose of reproduction. Many non-living substances such as fluids, hormones, and pheromones are also important accessories to the reproductive system. Unlike most organ systems, the sexes...

 that is not corroborated by anatomical evidence, including the existence of a seven-celled uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...

 with hornlike appendages.

Legacy


Mondino de Luzzi made lasting, if not entirely accurate, contributions to the fields of anatomy and physiology. Anathomia quickly became a classic text and, after his death, Mondino was regarded as a "divine master" to such an extent that anything differing from the descriptions in his book was regarded as anomalous or even monstrous. For three centuries, the statutes of many medical schools required lecturers on anatomy to use Anathomia as their textbook. Jacopo Berengario da Carpi
Jacopo Berengario da Carpi
Jacopo Berengario da Carpi was an Italian physician. His book "Anatomia Carpi" published in 1535 made him the most important anatomist before Andreas Vesalius.-Early years:Jacopo Berengario da Carpi was the son of a surgeon...

, a 16th century professor of anatomy at Bologna, wrote an extensive commentary on Mondino's work, and the text of Anathomia was incorporated into Ketham's 1493 text Fasciculus medicinae.