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History

 

A brief historical profile of Pavia medicine

 

The teaching of medicine in Pavia is closely tied to the history of the University through an evolution dating back to the Middle Ages.  Already in 825 the Holy Roman Emperor Lothario, grandson of Charlemagne, founded a school of rhetoric and law in Pavia, which attracted students from the north-west of the Italian peninsula.Since the end of the XI century it maintained a significant presence, we lose then the tracks though probably continued to exist as a local school

Higher education in Pavia entered a new phase in 1361 with the official foundation of the Studium Generale by the King of Bohemia and Holy Roman Emperor Charles IV. Sponsored by the Visconti of Milan, the Studium became the largest center of higher education in Lombardy

It was composed of two "universities", that it to say corporations of students and teachers (only after, this word will indicate the whole of the academic education), the one of the "Human Rights" for the teaching of civil and canonic law and that of " artists ", which taught medicine, philosophy, and liberal arts.

Medicine was therefore present from the beginning of the history of the university and subsequently found a practical link with the largest hospital of Pavia, Ospedale di San Matteo, whose foundation stone was laid in 1449. During the Renaissance prominent names began to emerge with the anatomist Marcantonio della Torre who collaborated with Leonardo da Vinci in the exploration of the internal structure of the human body. A few years later Gabriele Cuneo, who built the first anatomical theater (1552), taught anatomy. He was succeeded by Giovanni Battista Carcano Leone (1536-1606), who described the foramen ovale and the arteriosus ductus in the fetal heart. In the middle of the sixteenth century, the teaching of medicine was given to Gerolamo Cardano (1501-1576), versatile and unique personality, famous throughout Europe for the vastness of his knowledge and importance of his works, the true archetype of genius and  licentiousness.

During the Renaissance the Borromeo (1561) and the Ghislieri (1567) were founded, the two historic colleges still existing, which in the following years have been accompanied by new residences, in recent years grown in number under the direction of private foundations and the “ Ente per il Diritto allo Studio Universitario”. In the seventeenth century and the first half of the following century the University of Pavia experienced a period of decline, although teachers were still of great scientific value, as the anatomist Gaspare Aselli (1581-1625) (Fig. 1), universally known for the discovery of the lymphatic vessels (Fig. 2).

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Fig. 1 Portrait of Gaspare Aselli. Source: Gaspare Aselli, De Lactibus sive lacteis venis, Mediolani, 1627 – Courtesy of University Library of Pavia

Fig. 2 One of the tables of Gaspare Aselli detailing the chylous vessels (white color) in the mesentery an the intestine. Source: Gaspare Aselli, De Lactibus sive lacteis venis, Mediolani, 1627 – Courtesy of University Library of Pavia

A clear reversal trend and the entry into a gold phase in the history of the university occurred through the work of Empress Maria Theresa of Austria (1717-1780) anxious "to promote the application in science, and convinced that public happiness of inhabitants grows according to the progress of science in the state”. The reforms of the sovereign, set in 1771 and further developed by her son Joseph II, gave great impetus to the medical and naturalistic studies at the University of Pavia. Overall, these measures produced a profound renewal of curricula with the introduction of lessons in line with the scientific progress of the age that responded to the need to combine theory with clinical and experimental practice. Furthermore, the flowering of teaching and research is carried out with the call of big names in the various fields of medical sciences (clinics, anatomy, physiology, obstetrics, surgery), with the founding of new laboratories and adequate scientific teaching spaces, the expansion of the library, the creation of a large botanical garden. Medical - naturalistic studies then reached heights never touched previously and the teaching at the University of Pavia became an example in the academic landscape of Europe.

Fig. 3 The thoracic organs and the innervation of the heart from the neurological tables by Antonio Scarpa.  Source: Antonio Scarpa, Tabulae neurologicae, Ticini, 1794 – Museum for the History, University of Pavia

Fig. 4 Drill for skull trepanation, used by Antonio Scarpa. Period: 18^th century (end), maker: Maliar, Wienn (Austria) - Museum for the History, University of Pavia

Thanks to these reforms the second half of the eighteenth century was an extraordinary period for Pavia science, a true Golden Age for the University of Pavia. In addition to the teaching of Alessandro Volta (hysics) (1745-1827) and Lazzaro Spallanzani (natural history) (1729-1799) who taught in the philosophy faculty, students followed the lessons of some of the most important names of European medicine. Not to mention  Antonio Scarpa (1752-1832), professor of anatomy and surgery, which made many anatomical discoveries (Fig. 3) and innovations in surgical techniques (Fig. 4) and Giovanni Antonio Scopoli (1723-1788), professor of chemistry and botany (his name was linked to gender Scopolia, and the scopolamina alkaloid extracted from these plants)
Of great importance is also the teaching of clinical medicine with the Swiss Samuel August Tissot (1781 to 1783) and the German Johann Peter Frank (in the years between 1785 and 1795) proponent of the idea, innovative for his time, that the state power were responsible for public health. Many were the doctors and other naturalists linked to the University of Pavia who between the end of the eighteenth century and the first half of the following century, left indelible imprints in the history of medicine. Among these one can mention, for example, Mauro Rusconi who, with his work on the  early stages of the frog evolution,  discovered and designed, with great precision, the reproduction for cell division (at a time when the cell theory was not yet formulated), Luigi Porta (1809-1875) pioneer of vascular surgery and Bartolomeo Panizza (1785-1867), professor of anatomy who discovered the occipital visual area, an epochal discovery because, six years before the identification of the cortical center of articulated language by Paul Broca (1824-1880), the cerebral localization of mental function was proved. Student of Rusconi and Panizza was the Marquis Alfonso Corti (1822-1876) universally known for his studies on inner ear, which will shed light on the anatomical basis of the reception and transduction of sound stimuli later called  Corti organ.

Deeply linked to Pavia, where he studied law as a student of the College Ghislieri and then in relationship with the professors of the medical faculty, was Agostino Bassi (1773-1856) who first demonstrated the transmission of a parasite of the silkworm responsible for the disease  called illness of the mortar or dormouse. He saw that other diseases were due to "organic living beings who come into other organic living beings, in which they find grazing, their appropriate food, and they grow and reproduce”. Thus the microbial theory of infectious diseases was born; it will be fully developed with the research of Louis Pasteur and Robert Koch.

In the second half of the nineteenth century the University of Pavia is still at the heart of the medical world with the research of Cesare Lombroso (1835-1909), the founder of criminal anthropology, Giulio Bizzozero (1846-1901), discoverer of phagocytosis, of the hematopoietic function of bone marrow (after, at the University of Turin, he will discover the third morphological element of blood) and most of all of his pupil Camillo Golgi (1843-1926).

Fig. 5 Original drawing by Camillo Golgi of a nerve cell with the “black reaction”.

With an apparently simple experimental procedure, which soon became known as the “black reaction”, Golgi found the key to  penetrating the nervous system’s innermost morphological secrets and made a substantial contribution to the foundation of modern neuroscience. Period: ca. 1880, author: Camillo Golgi - Museum for the History, University of Pavia

Histologically studying the nervous system of animals and man, he began to develop the black reaction, a precise method for displaying single nerve cell, whose contours, coloured in black (Fig. 5), with all their extensions, could be followed in the microscopic field up to great distances. What appeared to be a chaotic structure,  suddenly revealed, in the hands of Golgi, its structural regularity, the true prerequisite for a subsequent anatomo-functional investigation and clinical nervous activities. Research for which he obtained the Nobel prize for medicine in 1906. Golgi did fundamental studies in many other areas, but his cytological discoveries were immortal. They enabled him to identify a new cytoplasmic organelles, the apparatus or Golgi complex, and microbiological tests that led him to describe the development cycle of malaria in the human blood (Golgi cycle). His great merit was to build one of the few Italian scientific schools in the last two centuries that had great reputation worldwide. One need only think of the names of Adelchi Negri (1876-1912), who discovered the bodies of rabies that bear his name, and Emilio Veratti (1872-1967) and Romeo Fusari (1857-1920), who described the sarcoplasmic reticulum, Aldo Perroncito (1882-1929), author of important research on regeneration of peripheral nerve, Carlo Martinotti (1859-1918), whose name remained bound to axons ascending cells of the cerebral cortex, Battista Grassi (1854-1925), Darwin medal of the Royal London Society  and discoverer of the Anopheles mosquito that transmits the human malaria, Casimiro Mondino (1859-1924), author of neuroanatomy studies and founder of Neurologico Institute which then took his name, Antonio Carini (1872-1950), discoverer of Pneumocystis carinii, the microrganism responsible for frequent infections in situation of  acquired immunodeficiency, Father Agostino Gemelli (Edoardo) (1878-1959), founder of the Catholic University.

Among the other great scientists of this period relating to Pavia at least it should be remembered Carlo Forlanini (1947-1918), inventor of therapeutic pneumothorax for the treatment of pulmonary tuberculosis, his pupil Scipione Riva Rocci (1863-1937), inventor of the sphygmomanometer (the instrument became universally symbol of medicine at patinent’s bed), Edoardo Porro (1842-1902), author of the first ovarian-uterus amputation during caesarean section, Enrico Bottini (1835-1902), precursor of surgical antisepsi, Edoardo Bassini (1844-1924) who introduced the technique for the surgical treatment of hernia, Iginio Tansini, innovator of surgical techniques, Peter Grocco (1856-1916) refined scholar of medical semeiotics, Enrico Sertoli (1842-1910), discoverer of the homonymous testis cells, Louis Magiagalli (1850-1928), founder of the University of Milan (1924).

 

Even in the XX century the University of Pavia has distinguished itself in importance and originality of the research, just to mention a few fields of the first half of the century: the studies of Maffo Vittorio Vialli (1897-1983) and Vittorio Erspamer (1909-1999) that led to the identification of serotonin (5-hydroxy tryptamine-or enteramina), haematological investigations of Adolfo Ferrata (1880-1936) and his students, the research of neurological and neurohistological of Ottorino Rossi (1877-1936) following Golgi tradition, the pioneering studies on genetics started by Adriano Buzzati Traverso (1913-1983) and continued by Luigi Luca Cavalli Sforza (1922-living) and his school .

The University of Pavia is one of the privileged scientific places in our country, where in different ages there were major transitions of knowledge along the path that led to modern medicine.

Paolo Mazzarello

Professor of the History of Medicine