Fabio Zampieri

MEDICINE, EVOLUTION, AND NATURAL SELECTION: AN HISTORICAL OVERVIEW

Contemporary Darwinian medicine is a still‐expanding new discipline, one of whose principal aims is to arrive at an evolutionary understanding of those aspects of the body that leave it vulnerable to disease. Historically, there was a precedent for this research; between 1880 and 1940, several scientists tried to develop some general evolutionary theories of disease as arising from deleterious traits that escape elimination by natural selection. In contrast, contemporary Darwinian medicine uses evolutionary theory to consider all the possible reasons why selection has left humans vulnerable to disease.

An etymological "autopsy" of Morgagni's title: De sedibus et causis morborum per anatomen indagatis (1761).

For the Morgagnian anniversaries of 2011 to 2012, the University of Padua organized a wide research project, trying to understand Morgagnis contribution in his historical context and why he is still considered the father of a new way of thinking in medicine, based on anatomoclinical correlations. Calling his masterpiece De sedibus et causis morborum per anatomen indagatis, Morgagni placed his research in a specific tradition of medical studies: the mechanistic approach to medicine, considered new in different European contexts. This approach gave Morgagni the theoretical structure to find his anatomopathologic research and the revolutionary idea for his time: post mortem dissections could be useful to understand pathophysiologic mechanisms and clinical symptoms in the living.

The clinico-pathological conference, based upon Giovanni Battista Morgagni’s legacy, remains of fundamental importance even in the era of the vanishing autopsy

Walter Cannon and Richard Cabot inaugurated the clinico-pathological conference (CPC) at Harvard Medical School at the beginning of the twentieth century, but this approach to anatomo-clinical correlation was first introduced by Giovanni Battista Morgagni at the University of Padua in the eighteenth century. The CPC consists of the presentation of a clinical case, in which past and recent medical histories of the patient, with all relevant information about laboratory tests including biopsy results, therapy and, eventually in a fatal case, the autopsy, are discussed. This is done for an audience of trainees and all physicians involved in the care for the patient. The CPC is still in use in many academic hospitals, as a teaching tool not only for undergraduate and graduate medical trainees, but also for postgraduate continuous medical education, in spite of the progressively declining autopsy rate. CPCs represent the ideal occasion for fruitful discussion between the two “souls” of medicine, i.e., the clinical, with its focus on the patient, and the pathological, with its focus on understanding disease. To discontinue using them would be equal to denying that modern medicine originated in Morgagni’s method.

The discovery of pulmonary circulation: From Imhotep to William Harvey

In his quest to comprehend his existence, Man has long been exploring his outer world (macro-cosmos), as well as his inner world (micro-cosmos). In modern times, monmental advances in the fields of physics, chemistry, and other natural sciences have reflected on how we understand the anatomy and physiology of the human body and circulation. Yet, humanity took a long and winding road to reach what we acknowledge today as solid facts of cardiovascular physiology. In this article, we will review some of the milestones along this road.

The prehistory of the cytoskeleton concept

Here we discuss how the concept and the name of cytoskeleton were generated and started to evolve over the last two centuries into what is presently a basic topic of modern biology. We also attempt to describe some facets of the emergence of cytoskeleton component characterization in which our laboratory was in part involved.

Phrenology between anthropology and neurology in a nineteenth-century collection of skulls.

The University of Padua has many legends about its cultural heritage. One of these concerns a collection of eight skulls still preserved in the Hall of Medicine at Bo Palace, near the old anatomy theatre built in 1545. It is said that some famous professors of the University donated their bodies to medical science, and the skulls were from these bodies. From multidisciplinary research, both historical and anthropological, we have discovered that Francesco Cortese, Professor of Medicine and Rector of the University, started this personal collection of colleagues’ skulls, although they had not donated their bodies to science, so that he could make his own detailed phrenology study.

Andreas Vesalius’ Tabulae anatomicae sex (1538) and the Seal of the American College of Cardiology

To the Editor: The seal of the American College of Cardiology (ACC) reproduces the Vesalian heart from the Tabulae anatomicae sex (Venice, 1538) [(1)][1]. First registered in January 1965, it was selected by Professor Franz Maximilian Groedel (1881 to 1951), who—after having been among the

Origin and development of modern medicine at the University of Padua and the role of the “Serenissima” Republic of Venice

[first paragraph of article] The University of Padua Medical School played a fundamental role in the history of medicine. Padua is a very old town, probably one of the oldest in North Italy. Traditional legend tells that the Trojan prince Antenore founded Padua in 1183 BC. At the beginning of the Roman Empire, Padua was an important town, both for its strategic position as an ultimate defence point against barbarian populations of North Europe and for its famous horse breeding, which made it the main supplier of horses to the Roman army. In the late Middle Ages, even before the rule of Venice, Padua was a prosperous city state adhering to the values of tolerance, civilization and democracy. During that era, Padua was particularly famous for its school of civil and religious law, which was the cornerstone for the upcoming university.

Cardiovascular medicine in Morgagni's De sedibus: dawn of cardiovascular pathology.

The most significant cardiovascular anatomoclinical observations from Morgagnis masterpiece De sedibus et causis morborum per anatomen indagatis (1761) are herein reported, divided into the current taxonomy according to cardiac structure: (a) aorta and pulmonary artery, (b) pericardium, (c) coronary arteries, (d) myocardium, (e) endocardium, (f) congenital heart defects, and (g) heart rhythm disorders. Morgagnis interpretations in cardiovascular pathology were strictly related with the most advanced theories of his time, such as those of blood circulation and iatromechanics; nevertheless, he remained close to the empirical description of clinical and pathological anatomy phenomena with their individual specificity. Through a systematic review of the literature, he compared the data from his own observations and experiments with those from physicians he considered reliable by applying the method of literature review which is still valid nowadays.

Should the annular tendon of the eye be named 'annulus of Zinn' or 'of Valsalva'?

The annular tendon is commonly named ‘annulus of Zinn’, from the German anatomist and botanist Johann Gottfried Zinn (1727–1759) who described this structure in his Descriptio anatomica oculi humani (Anatomical Description of the Human Eye, 1755). This structure, however, had been previously discovered not by Zinn, but by Antonio Maria Valsalva (1666–1723) some decades before the publication of Zinn, in his Dissertatio anatomica prima and Dissertatio anatomica altera (First and Second Anatomical Dissertations), inside Valsalvas Opera omnia published in 1740. We advance that this structure could be re‐named such as ‘annulus of Valsalva‐Zinn’ because Valsalva, even making a mistake in its functional interpretation, first described this anatomical structure. Likewise, Valsalva, with his discovery, advanced a revolutionary idea for that time on the usefulness of anatomy for clinic and pathology.