MORGAGNI, Giovanni Battista.

A lovely unsophisticated copy, still in its publisher’s binding, of this medical masterpiece, the first edition of Morgagni’s (1682-1771) treatise on clinical medicine grounded in anatomy, containing detailed descriptions of hundreds of dissections, from the library of an unknown contemporary physician, possibly from Montecalvo in Campania.

De sedibus consists of a series of letters solicited by an unnamed patron, arranged into books on diseases of the head, torso (including the heart and arteries, which Osler describes as being of particular value), stomach, and two books of ‘surgical and universal’ diseases, including fevers, tumours, broken bones, sexual diseases, arthritis, epilepsy and paralysis, etc. ‘Published when [Morgagni] was seventy-nine years of age, [it] had been years in preparation, and constitutes a foundation of modern pathological anatomy. Vast in scope, it is one of the most fundamentally important works in the history of medicine. In it he reports in precise and exhaustive detail his findings in nearly seven hundred autopsy dissections, introducing and insisting on the concept that diagnosis, prognosis, and treatment of disease must be based on an exact understanding of the pathologic changes in the anatomic structures. It put the final rout to the old humoral pathology. Morgagni’s contribution to the understanding of disease may well rank with the contributions of Vesalius in anatomy and Harvey in physiology’ (Heirs of Hippocrates). Osler referred to it as ‘one of the great books in our literature’ and called it ‘the foundation [upon which] the morbid anatomy of modern clinical medicine was built’ (Evolution of Modern Science, pp. 185-189).

‘Morgagni, professor of anatomy at Padua, was an expert clinician and was the first to identify the symptomatic condition associated with many diseases … This book … contained reports on an extensive series of post mortems performed by himself, his teacher, [Antonio Maria] Valsalva (1666-1723), and other members of his circle. By comparing the clinical symptoms with the post mortem findings Morgagni laid the foundations of pathological anatomy’ (PMM). Rudolf Virchow, ‘one of the greatest of modern pathologists, acknowledged his indebtedness to Morgagni’ and credited this book with ‘introducing the anatomical idea into medicine’ (ibid.). ‘There can be no knowledge of morbid symptoms without the knowledge of normal organ function – physiology. Morgagni’s classification was thus one of symptoms rather than diseases. The book includes a number of brilliant descriptions of new diseases, some of which have remained classics until our own day, particularly those of the heart, blood vessels, lungs and throat. He described syphilitic tumours (gummata) in the brain, recorded a case of heart-block (Stokes Adams disease), identified the clinical features of pneumonia with consolidation of the lungs, described lesions in angina pectoris, acute yellow atrophy of the liver, tuberculosis of the kidney, etc.’ (ibid.). There are extensive indexes ‘of exceptional value’ (Osler, Evolution), including of symptoms and of observations made on the cadavers.

Printing and the Mind of Man 206. Heirs of Hippocrates 501. Osler 1178. NLM C18, p. 312. Wellcome IV, p. 178 (this is the first state, with ‘P.P.P.’ in error to t-p of second vol., and with t-p of first vol. in red and black. Wellcome calls for two portraits of Morgagni but clearly only one was provided in many cases, as in many of the copies we have checked).