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Biomedical subjects

Carmela Bisaccia

Publications and source records attributed to Carmela Bisaccia.

6 recordsLinked to original sources

Constructing clinical science.

Clinical practice became clinical science in the years 1720-1820. There were many reasons for this transformation. The discoveries by Santorio Santorio, William Harvey, Marcello Malpighi, Giovanni Alfonso Borelli, Lorenzo Bellini, Thomas Sydenham, Giovanni Maria Lancisi, were perceived by students who asked for changes in the medical curriculum. In 1761 Morgagni centered the study of diseases on morbid anatomy, a way to control at autopsy the validity of diagnosis. J.P. Frank who worked on public health and John Locke who supported a method of scientific reasoning based on asking questions were also instrumental for changes. Hospitals, formerly hospices for the poor, became places for curing and healing. Military hospitals represented models to be followed. In Vienna Marie Therese inaugurated the Allegemein Krankenhaus in 1785. In revolutionary France Fourcroy with the law Frimaire An III, 1794 gave a new rationale. Medicine and surgery were unified in the curriculum. Basic sciences were introduced. Dissection became compulsory, practical teaching became the rule. But it was with John Hunter, Domenico Cotugno and P. Joseph Desault that the great advancement was achieved. They were anatomists and therefore they made the knowledge of human body the core of medical curriculum. However experimentation on animals, as well as practical bedside teaching at the hospital also became important. Through their work hospitals and universities were associated in a common goal.

Anatomy↗

The pre-Vesalian kidney: Gabriele Zerbi, 1445-1505.

Gabriel Zerbi was born in Verona in 1445 and died in Dalmatia in 1505. He was professor of philosophy in Padua at the age of 22, and moved to Bologna where he became professor of medicine and philosophy. In Rome at the time of Sixtus V and Innocentius VIII, he was archiater and professor of medicine. He completed his academic career in Padua where he worked from 1494 to 1505 with a salary of 600 florins a month. A man of vast culture, a philosopher, physician and professor of medicine, he wrote many books: (1) Questiones Metaphysicae; (2) Gerentocomia; (3) De Cautelis Medicorum; (4) Liber anatomiae corporis humani et singulorum membrorum illius; (5) De anatomia infantiis et porci ex traditione Cophonis, and (6) Libellus de preservatione corporum a passione calculosa. His contribution to anatomy was superb. Through him the discipline became the basis of modern medicine. The core of this article deals with some passages of Zerbi's chapters on the anatomy of the kidneys and bladder.

Anatomy↗

Pierre-Joseph Desault (1738-1795)--a forerunner of modern medical teaching.

Pierre-Joseph Desault (1738-1795) was the first French professor of clinical surgery. He was chief surgeon at La Charité and Hôtel-Dieu in Paris, where he developed a new method for teaching anatomy and modified the teaching of surgery. His fame was due to his dedication and to the number and quality of fellows, who included Bichat, Louis, Corvisart, Dupuytren, Percy, Richerand, Petit, Chopart, and Gavard. He taught while performing surgery, and his school included up to six hundred fellows at a time, practicing in the 1200-bed Hôtel-Dieu. He "imprinted" his pupils with his professional teaching, his surgical procedures and his personal charm.

Anatomy↗

P.J. Desault and the birth of nephrology (between 1785 and 1795).

Desault's genius and methods opened up a field: the medical diseases of the urinary tract. Though he was a surgeon and therefore an anatomically based clinician, his most important contributions were in renal pathophysiology: separation of diseases regarding the formation of urine from those regarding the excretion; comparison of anuria with urine retention; polyuria of atrophic kidney; fatal dehydration due to polyuria in diabetic patients; oligo anuria following excess waterloss from the gut, the lungs...etc. In the last two conditions the kidneys might look normal and therefore might be presumed healthy. If Desault's work had survived this physiological eruption into renal disorders would have been a definitive step of modern nephrology. From a historical point of view, one could suspect that Bichat shifted from anatomy and surgery to medicine and physiology after having posthumously compiled and edited the Desault's book, "Traité des Maladies des voies urinaires".

France↗

The build-up of clinical science.

In the years 1720-1820 medicine changed from an art into a science. The slow construction of clinical science, a process still to be completed, has many founding fathers. Here the transition is analyzed through the biographic studies of John Hunter (1728-1793), Domenico Cotugno (1736-1824) and Pierre Joseph Desault (1738-1795) who respectively taught in London, Naples and Paris. Because of their scientific stature they were able to plan, build and foresee the impact of these changes.

Education, Medical↗

Mariano Semmola (1831-1895): the effect of low protein diet in primary albuminuria.

Mariano Semmola (1831-1895), the first Italian professor of pharmacology and clinical pharmacology, was born into a family of illustrious intellectuals and trained as a fellow of Claude Bernard, Trousseau and Rayer in Paris. His scientific activity included both animal investigations and clinical research. He is credited with important contributions to several areas of clinical medicine, from infectious diseases (cholera, and tuberculosis) to renal, cardiovascular and liver diseases. He had a lifelong interest in chronic Bright's disease. His seminal papers in that field were published in international journals and presented at international congresses and the most important European academies. As a scientist of great charisma and international reputation, he received many academic and governmental awards and even served in the Italian Parliament. His name is linked in particular with the hematogenous-dyscrasic theory of Bright's disease. He made important contributions to the pathogenesis of 'large white kidneys', as well as to the albuminuria-dependent lesion in renal disease. He also described in Bright's disease the effects of nitrogen-poor diets on specific gravity, albuminuria and urea excretion. It is evident from the renal literature from 1850 to 1908 that he achieved fame as a scientist, and that his theories on kidney disease were adopted in clinical practice.

Albuminuria↗