Mondino de Liuzzi - Contributions To Anatomy

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 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 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 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. 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. 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, 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 is described with no mention of the vermiform appendix. Though Anathomia only vaguely describes the pancreas, 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, 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) and the arteria venalis (pulmonary vein). This section of Anathomia also describes the pleura and notes the importance of distinguishing between pulmonary pathologies including true pleurisy, false pleurisy, and pneumonia. His descriptions of the larynx and epiglottis 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, both with and without castration, as well as a description of a type of cataract 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 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, Aristotle, and Galen 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 ("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. He also propagates information about the human reproductive system that is not corroborated by anatomical evidence, including the existence of a seven-celled uterus with hornlike appendages.