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Iulius Casserius (1552‐1616): The self‐made anatomist of Padua's golden age

2001; Wiley; Volume: 265; Issue: 4 Linguagem: Inglês

10.1002/ar.1151

1097-0185

Alessandro Riva, Beniamino Orrù, Alessio Pirino, Francesca Riva,

Medical History and Innovations

Giulio Cesare Casseri (1552–1616), whose name was Latinized into Iulius Casserius, was born in Piacenza; therefore, the nickname Piacentino (Placentinus) was often used. According to Sterzi (1910), who based his claim on a statement contained in Casserius's will, his date of birth was around 1552. It should be noted, however, that although most modern authors accept this date (Roberts and Tomlinson, 1992; Premuda, 1993), some (Singer, 1957) still report 1561 as his birth date on the basis of the inscription (Fig. 1) appearing on the portrait published in Casserius's work De Vocis Auditusque organis that ascribes to the author the age of 39 years. According to most of his early biographers (Tomasini, 1630; Ghilini, 1647; Papadopoli, 1726), Casserius's family was very poor and the young Iulius, perhaps as the servant of some student (Sterzi, 1910), moved to Padua, the city that shared with Bologna the reputation of being the seat of Italy's most illustrious university. He soon assumed the job of servant in the house of the famed Gerolamo Fabrici d'Acquapendente (Fabricius, 1533–1619) (Fig. 2), Public Lecturer of Anatomy and Surgery (Tomasini, 1630; Ghilini, 1647). As Tomasini (1630) reports, “from a servant he became first Fabricius's auditor, then instructor and brilliant disciple.” Early historians of Anatomy did not give full justice to Casserius's scientific achievements. Portrait of Casserius at 39 years of age. Frontispiece of De Vocis Auditusque organis. Courtesy of Ministero dei Beni e Attività Culturali, Biblioteca Universitaria, Cagliari. Detail of the “Miracle of the miser's heart” painted (1621 ?) by Pietro Damini in the church of San Canziano, Padua. Fabricius is portrayed while dissecting the body of the miser whose heart is seen in the jewel case. This painting is very likely not only the first representation of a cardiac explant, but also that of a dissected human heart in colors. We do not know when Casserius matriculated in the School of Medicine of the Università Artista. As mentioned several times in his works, Casserius, in addition to Fabricius, had the well-known physician Gerolamo Mercuriale (Mercurialis) as a teacher and mentor, who held the chair of Clinical Medicine of Padua in the years 1569–1587. The precise date he obtained his degree in medicine and philosophy is unknown, because the official records are missing from 1580 to 1587; a likely date is ca.1580 (Sterzi, 1910; De Ferrari, 1978; Premuda, 1993). After the award of his degree, Casserius, in addition to giving private lectures on anatomy to the students of the Università Artista and working as Fabricius's preparator, started a practice as physician and surgeon in Padua that was very successful (Tomasini, 1630). In 1584, Casserius's reputation was already so great that he took Fabricius's place as member of the board of examiners for the finals in surgery. These examinations, held in private houses in the presence of the Rector of the University, conferred the license to practice surgery. The profession of surgery was considered in those days as a minor branch of Medicine and the surgeon had to take an oath that he would not involve himself in the treatment of serious diseases, but would call a licensed physician whenever the patient was in real danger. Casserius acted as examiner until 1598 when the job was reassumed by Fabricius, possibly because of the fierce rivalry between the two concerning their professional practices and the teaching of Anatomy. According to Sterzi (1910), who bases his report on the proceedings of the Natio Germanica (the most important and powerful of Padua's national corporations of students), the first hint of the quarrel became public in 1595 when Fabricius, after his temporary leave for illness, resented the enthusiasm with which the students, particularly the Germans, thanked Casserius for his teaching as substitute lecturer of Anatomy. Things worsened in the academic year of 1597–1598 when Fabricius had to shorten his public course for lack of cadavers, while, at the same time, Casserius was able to give, in his house, a private course of 5 weeks, during which he dissected one monkey, several dogs, and nine cadavers. Again, the praise of the students, who sent Casserius a letter of gratitude and presented him with an expensive silver chandelier, served to further increase the jealousy of the old master (Sterzi, 1910). As recorded in the proceedings of both the Università Artista and of the Natio Germanica, Fabricius reacted by applying to the academic authorities to enforce the old (1586) statutory rule that private lectures were forbidden. As a consequence, there is no record of private lectures given by Casserius until 1604, a prohibition that must have greatly embittered Casserius. Although no names were aired, the conflict was echoed in the relevant dedications to the Duke of Parma (Ranuccio Farnese) and to three Venetian noblemen (Jacopo Foscarini, Leonardo Donati, and Giovanni Dolfin) appearing in the preface of two books on very similar topics and printed almost at the same time by Casserius (De Vocis Auditusque Organis Historia Anatomica, Ferrariae 1600–1601, Fig. 3) and by Fabricius (De Visione Vocis Auditus, Venetiis, 1600). The handling of the material in both treatises is much the same, each book being organized into three sections: Anatomy, Physiology, and Philosophy. However, whereas Casserius, although not mentioning Fabricius, scrupulously reports the discoveries made by previous authors, no citations are present in Fabricius's work. Both authors state, Casserius in the preface and Fabricius in the dedication to Foscarini, that they were preparing a collection of anatomical tables (Theatrum Anatomicum) illustrating the entire human body. Fabricius maintains that there were more than 300 of these, each of them in a colored and in a black and white version, whereas Casserius, in a letter dated 1613, asserts that he had ready for publication 150 figures all engraved in copper (Sterzi, 1910). It is impossible to ascertain who—the old teacher or his younger rival—first had the idea for the atlas, which had been required by the medical students themselves (Sterzi, 1910). Ironically, neither Casserius nor Fabricius lived to see their respective tables published (Riva et al., 2000). Title page of De Vocis Auditusque organis. Note that even the crowned eagle appearing in Casserius's self-appointed coat of arm depicted in the frontispiece (Fig. 2) is here reduced to a skeleton. Courtesy of Ministero dei Beni e Attività Culturali, Biblioteca Universitaria, Cagliari. Curiously, this academic fight between the old master and the younger rival who wanted the Chair of Anatomy is not mentioned in the English literature, where Casserius is depicted as the successor of Fabricius (Cole, 1944; Singer, 1957; Roberts and Tomlinson, 1992). This becomes even stranger if one considers that the rivalry between the two was clearly reported even in classic textbooks (Bartholin, 1665; Haller, 1774). However, the enmity between the two, did not prevent both of them (Fabricius as Professor of Anatomy and Surgery; Casserius as Teacher of Anatomy, Physiology, and Surgery) from signing Harvey's doctoral diploma on April 28, 1602 (Roberts and Tomlinson, 1992). Because of Fabricius's unavailability due to illness, the Rector of the Università Artista, after a specific request made by the medical students, asked Casserius in the winter of 1604 to present the Anatomy course. Although Fabricius gave his formal assent to this, Casserius refused to teach in the public theatre (Fig. 4) opened by Fabricius in 1594 and gave the lectures in the private theatre he had built at his home. The great success that Casserius's teaching received among the medical students is attested to by an official document (Sterzi, 1910) drawn by Marco Antonio Coradino Stella, notary of the Università Artista, on April 23, 1604, at the closure of the Anatomy course (Sterzi, 1910). From 1605–1608, Casserius, who was preparing his second great work, the Pentaestheseion, went on to give well-attended private lectures on Anatomy and Surgery, while, at the same time, the teaching activity of Fabricius as public lecturer was reduced to a minimum. Such a situation led the Venetian authorities to intervene by a Dogal decree dated August 25, 1609, and, for the first time in the history of the University of Padua (Tosoni, 1844), the teaching of Anatomy was separated from that of Surgery, the latter being officially given to Casserius, whereas Fabricius continued to hold the chair of Anatomy as Professore Supraordinario. An anatomic lecture in Padua public theatre in the seventeenth century. Detail from the title page of Veslingius's (1647) Syntagma Anatomicus. Courtesy of Biblioteca Medica Pinali. Sezione Antica, Padova. Shortly after the nomination of Casserius to the public lectorship of Surgery, the well-known Danish anatomist Caspar Bartholin (Bartolinus) visited Padua. As reported in the preface of his Institutiones Anatomicae (1632), Bartholin held Casserius in the highest esteem. In 1613, Fabricius, having reached the fiftieth year of public lectorship, was given official permission to reduce his teaching burden and, although he tried to have Giulio Cesare Sala appointed as his substitute, the job was given to Casserius. However, the latter once again refused to teach in the public theatre and held his dissections in his own home theatre. In 1614, in recognition of his professional and academic merits, Casserius, to whom the Chair of Anatomy had previously been offered by the University of Parma, first, and the University of Turin, later, was made Knight of San Marco, the highest honor bestowed by the Republic. One year later, he was reconfirmed as public lector of Surgery with a substantial raise in salary. In January 1616, he started the Anatomy course, which, following the recommendations of the academic authorities, he presented, for the first and only time, in that public theatre where, for all his life, he had dreamed of teaching as Public Lector of Anatomy. He was now at the zenith of his fame and the course, which lasted for 3 weeks, was so successful that the students of all nations published a laudatory booklet to demonstrate their gratitude. Shortly after this applauded performance, Casserius contracted a fever and died on the evening of March 8. His body was buried in the church of the Eremitani, in front of the chapel painted by Mantegna, where his tomb was reported as existing until 1626 (Sterzi, 1910). Old Fabricius, still holding the official chair of Anatomy, outlived him by 3 years. Upon Fabricius's death (1619), the chairs of Anatomy and Surgery were once again reunited (Tosoni, 1844) and were given to Adriaan van den Spieghel (Spigelius). Casserius was the author of three anatomical works. The first two, De vocis auditusque organis Historia anatomica (Ferrariae, 1600–1601) and Pentaestheion, hoc est, De quinque sensibus liber, Organorum Fabricam…(Venetiis, 1609), were edited by Casserius himself. The third, Iulii Casseri Placentini Tabulae Anatomicae LXXIIX, omnes novae nec ante hac visa. Daniel Bucretius… XX quae deerant supplevit et omnium explicationes addidit (Venetiis, 1627), was published by Daniel Rindfleisch (Bucretius) 11 years after Casserius's death. The first work, De vocis auditusque organis, reprinted in Venice in 1607, is a large volume in folio dedicated to Ranuccio Farnese, Duke of Parma and Piacenza, whose portrait and that of the 39-year-old Casserius dissecting a human hand (Fig. 1) is reproduced on the first pages of the book. It contains two treatises: De Larynge vocis organo, printed in 1601, and the De Aure auditionis organo, printed earlier (1600). Preceding the first treatise, there are 60 unnumbered pages containing the title page (Fig. 3), drawn, according to Cazort (1987), by the famous Jacopo Ligozzi, as well as containing the dedication, the preface, and a letter by T.M. Turquet, Professor of Anatomy at the University of Paris, who urges Casserius to publish his findings by saying: “Twice gives (he) who gives at the right time (bis dat, qui tempestive dat)”. There also are 14 congratulatory poems and an author index with 163 citations, (but no mention of Fabricius), the table of contents that presents the chapters in alphabetic order, and, finally, an index of the 34 tables engraved in copper (22 from the first and 12 from the second treatise). The latter were drawn by the Swiss-German painter Joseph Murer (or Maurer) who, as stated by Casserius himself (page 79 of the II Treatise), resided at his home during the preparation of the book, according to Roberts and Tomlinson, 1992. Each treatise is divided into three parts (Libri). The first (Fabrica) describes, starting from the superficial structures inward, the anatomy of the organ concerned first in the human adult and in the fetus, then the same organ is followed through a series of animals. The second (Actione) shows how the parts function, and the third (Usu) describes what that function is. Casserius's contemporaries, with the exception only of Riolanus (Sterzi, 1910), deemed his work superior to Fabricius's De Visione, Voce, Auditu (Venezia, 1600). Furthermore, Sterzi (1910) maintains that it represents the first true treatise on the comparative anatomy of these organs, a conclusion later reached by Cole (1944), Hawkins (1988), and Finger (1994). For the first time, Casserius states that the skeleton of the human larynx is cartilaginous and not osseous, and he correctly illustrates the ventricles of the larynx, the anatomy and function of laryngeal muscles, and provides a description of laryngectomy (Fig. 5), which corresponds to the superior tracheotomy of modern times. Furthermore, he mentions, before Stensen (1661) did, the sublingual glands and their ducts (Riva and Testa Riva, 1996). The work also contains important findings on the human ear: the structure of the auricle, the difference between the adult and the infant temporal bone, the observation about the obliquity of the tympanic membrane, the description of the middle ear with the oval and round windows, the statement that there are only three semicircular canals, and the first description of the spiral lamina. However, Sterzi (1910) states that Casserius erroneously considered the thyroid as a gland lubricating the larynx and that he did not consider the role of the eustachian tube in the aeration of the middle ear. Concerning deafness, Casserius supports the theory, originated by Aristotle, that it is due to the putrefaction of cerumen, which he calls excrementum auris. Another omission, noted by Cole (1944), is the fact that Casserius, although illustrating the orifice of the ductus parotideus in one of his plates, fails to describe it. The laryngectomy as illustrated in De Vocis Auditusque organis; Courtesy of Ministero dei Beni e Attività Culturali, Biblioteca Universitaria, Cagliari. As far as comparative anatomy is concerned, Cole (1944) devotes more than 10 pages of his classic History of Comparative Anatomy to a critical review of the many original observations made by Casserius in this field. The most important discoveries are that fishes lack an external ear, which is present in cetaceans, and the description of the membranous labyrinth in fishes and of sound-producing organs of insects (Fig. 6). Curiously, Casserius, who describes and correctly illustrates the auditory ossicles and their muscles in many mammals, did not find them in monkeys. As stated by Cole (1944), Casserius breaks entirely new ground and the presence of errors and omissions, therefore, is fully understandable. The sound-producing organs of insects. De Vocis Auditusque organis; Courtesy of Ministero dei Beni e Attività Culturali, Biblioteca Universitaria, Cagliari. The second book, the Pentaestheseion, had great success among contemporaries as shown by the many reprints (Francofurti, 1609, 1610, 1612, 1622; Venetiis, 1627). All editions were in folio, with the exception of the one published in 1612 that was in reduced format; in addition, the 1622 edition, at variance with the others, was under heading “De Nova Anatomia … Authore Iulio Placentino”. It is a 360-page volume dedicated to the Duke of Bavaria, Prince Maximilian. The introductory part consists of a letter to the reader in which Casserius reports that he was prompted to publication, despite a few malevolent critics, by the favorable reception of his first work. There is also a short laudatory poem by Caspar Bartholin, who had been Casserius's friend and student. The book contains five treatises devoted to each sense organ: touch (with 2 tables), taste (6 tables), smell (7 tables), hearing (12 tables), sight (6 tables). The treatise on hearing is a reprint of the one published on the same subject in De Vocis Auditusque. Before the treatises, there is a long philosophical discussion on the nature and role of sense organs in which Casserius maintains that touch is the fundamental sense from which all the other derive, and that all sensations go to the brain, a statement fully in line with the inscription appearing in the frontispiece (Fig. 2) of De Vocis Auditusque where Casserius is portrayed while dissecting a human hand: “Rimatur manus apta manum: Mens erue mentem” (the trained hand dissects the hand: Mind, do disclose the mind!). At variance with the prevailing opinion, Casserius was the first to state that the touch organ resides in the dermis and not in the epidermis. He describes the palm of the hand and the sole of the foot with their aponeuroses, muscles, and nerves, also providing the first illustrations of these regions. Casserius, unlike his contemporaries, does not consider the tongue as made up by a single muscle. He describes and illustrates the extrinsic muscles of the tongue and the suprahyoid and infrahyoid muscles, but he considers as a single nerve, at their exit from the skull, the vagus and the glossopharyngeal nerves. Furthermore, he mistakes for a nerve the main excretory duct of the submandibular gland, later discovered by Wharton in 1656. Concerning the sense of smell, he puts forward the strange idea that the olfactory mucosa is continuous with the brain dura mater through the foramina of the cribrous lamina. He describes fairly well the muscles of the nose and the paranasal sinuses and gives an accurate description of the skeleton of the nose, stating that there are three nasal conchae and that the lower one is a separate bone. According to Hyrtl (1880), Casserius is the first to use the term nasal concha, still retained in the modern anatomical terminology (FICAT, 1998). Sterzi (1910) credits Casserius with having provided the first correct description of the eye and of its accessory organs; he gives a detailed account of the orbit and of the six eye muscles (Fig. 7), correcting a mistake by both Galen and Vesalius (Cole, 1944; Singer, 1957), who described as a normal human structure the coanoides, a muscle that is present only in animals. Again, Casserius states that the optic nerve is surrounded by a double sheath provided by the dura and by the pia mater, respectively. Concerning the origin of tears, he concludes that they are produced both by the brain and by the lacrimal gland. As in the previous work, the tables of the Pentaestheselon show a few morphologic details not reported in the text. In fact, Sterzi (1910) notes that, in some of the figures illustrating the eye lids, there are the tarsal glands whose discovery is ascribed to Meibom (1666). The muscles of the eye. Pentaestheseion; Courtesy of Biblioteca Comunale dell'Archiginnasio, Bologna. The Tabulae Anatomicae, his third major work, contains many famous illustrations, which were drawn by Odoardo Fialetti, a pupil of Tintoretto (Petherbridge, 1997). The images represent, as Singer (1957) notes, “the model for the copper plate illustrator as those of Vesalius and Ruini are for the woodcut operator.” They were published 11 years after Casserius's death by Bucretius (Latinized name of Jan Rindfleisch, 1600–1631). Bucretius used them as an atlas to illustrate the work, De Humani Corporis Fabrica, which was left unfinished by his teacher Spigelius, who had suddenly died in 1625 at the age of 47, and who had been successor to both Casserius and Fabricius as Professor of Anatomy and Surgery. The Tabulae Anatomicae had four further editions: two with the legends translated into German, and two in Latin. By searching through Padua's archives, Sterzi (1910) found Casserius's last will and several documents that permitted him not only to trace the way in which Casserius's tables fell into Bucretius's hands, but also to discover, in the library of the University, a codex with an inscription stating that it contained 51 unpublished Tabulae Anatomicae by Casserius plus one by a certain Petrus Hordanus. According to Premuda (1986), this codex had been privately owned by the great Morgagni, a detail apparently unknown to Sterzi (1910), who does not mention it. Eleven of these tables had labels and legends in Casserius's handwriting, 7 bear only the labels, whereas the other 33 are without either labels and legends. The Tabulae, all of outstanding quality, were fewer in number than the ones present in the edition by Bucretius, who states in the title that he had added 20 new tables and that the captions of all tables are his own work. As noted by Haller (1774), however, not all the tables added by Bucretius were originals, for many of them were repetitions of illustrations previously published by Vesalius or even by Casserius himself. By meticulously comparing the original tables and legends with those published by Bucretius, Sterzi (1910) was able to document the many variations, often erroneous, unscrupulously made by the latter both in the tables and in the legends, which, inter alia, had been plagiarized in part by Bucretius. Sterzi also points out that this is the main source, not only of many of the mistakes wrongly ascribed by later reviewers to both Casserius and Spigelius, but also of the statement first made by Haller (1774), and repeated later on (Cole, 1944; Singer, 1957), that, in many cases, features present in the tables are not properly described in the legends. Moreover, as reported by Veslingius in the preface of his Syntagma Anatomicum (1647), Spigelius's text of a mere 24 lectures was padded by Bucretius into a big volume consisting of 10 Libri. It should be emphasized that Bucretius is the true originator of most of the mistakes present in Spigelius's Opera. Although this fact was subsequently forgotten, it was clearly stated as early as 1649 by Riolan. Of the long list of the new findings present in Casserius's tables, only the ones deemed important are mentioned here. The muscles of the abdomen (Fig. 8) and those of the back are correctly represented for the first time. Again, Sterzi (1910) gives evidence that the mistakes present in the tables published by Bucretius had been introduced by the latter who altered the originals. The tables on limb musculature are very accurate and far superior to those then available. According to Sterzi (1910), Casserius was the discoverer of the lumbrical muscles of the hand and of the transverse head of the adductor hallucis. However, Sterzi notes that the coracobrachialis, although beautifully represented and known as Casserius's muscle, had already been described by both Vesalius and Columbus. For the first time, Casserius illustrated the inguinal fossae, the circular folds of the small intestine, the appendix with its vascular supply, and the adrenal glands (Hiatt and Hiatt, 1997). The abdominal muscles. Tabulae Anatomicae; Courtesy of Biblioteca Comunale Bonetta, Pavia. The particularly detailed tables on the vascularization of the liver and spleen were likely obtained by an injection method (Sterzi, 1910). Casserius depicted for the first time the urinary bladder musculature, the navicular fossa of the urethra, the septum penis, the corpus spongiosum penis as a distinct unit from the corpora cavernosa, and the prostate as a single organ. He also illustrated the corpus cavernosum of the clitoris, the interior of the uterus, the ovary with its ligaments and vessels, and the hymen. Many discoveries on the anatomy of the brain were made by Casserius: the anatomy of the dura mater (Fig. 9) and its continuation with the optic nerve sheath, the arachnoid, and the arachnoidal granulations (later described by Pacchioni, 1705), the interventricular foramen ascribed to Monro, the circle of Willis (this priority is recognized even by Cole [1944], and by McHenry [1969]), the sulci thalamostriates, the habenular trigone, the choroid membrane, and the inferior vermis with the pyramis. In recent years, an enthusiastic tribute to the artistic quality of Casserius's illustrations has come not only from anatomy historians but art critics as well. The dura mater after removal of the cranial bones. Tabulae Anatomicae. Courtesy of Biblioteca Medica Pinali; Sezione Antica, Padova. In addition to the Tabulae Anatomicae, there are nine embryological tables by Casserius illustrating the De formato foetu, a booklet by Spigelius posthumously published in 1626 in Venice by Spigelius's son-in-law, Liberale Crema. Among them, are drawings particularly admired by art critics (Kemp and Wallace, 2000) depicting a pregnant woman whose abdomen is open in a flower-like manner (Fig. 10). A tenth plate by Casserius, illustrating the external genital organs of a female newborn, was added to De formato foetu in Spigelius's Opera, published in Amsterdam in 1645 by Johannes Blaeu, edited by Johannes Antondides van der Linden, and containing all the Tabulae Anatomicae. Pregnant woman with open uterus. De formato foetu. Courtesy of Biblioteca Medica Pinali; Sezione Antica, Padova. Sterzi (1910), who wrote the most accurate and documented critical study of Casserius, asserts that historians of Anatomy did not give full justice to Casserius's scientific achievements, on the basis of their contradictory appraisals and cursory and partial evaluations (Riva et al., 2000). Further evidence of the success of Casserius's illustrations is shown by the fact that they often were reprinted in anatomy textbooks of the 17th and 18th centuries and where sometimes, as in the case of Bartholin (1677), an indication of their true origin was often omitted. Roberts and Tomlinson (1992) note that Browne's own Myographia nova (1697) contains a case of blatant plagiarism: there is no mention of the source of the tables, which were mostly taken from Casserius. It must be said, finally, that in recent years, an enthusiastic tribute to the artistic quality of Casserius's illustrations as unrivalled examples of baroque anatomy, has come not only from anatomy historians (Cole, 1944; Singer, 1957; Roberts and Tomlinson, 1992; Premuda, 1993; Zanobio and Armocida, 1997), but from art critics as well (Bucci, 1976; Cazort, 1987; Petherbridge; 1997; Kemp and Wallace, 2000). We thank Dr. Bernard Tandler for reading the manuscript. We also thank Dr. Mark Paalman for having suggested the topic of this article and for his encouragement. Mr. Alessandro Cadau helped with image processing. Dr. Riva is Professor of Anatomy and History of Medicine at the Medical School of the University of Cagliari (South Sardinia), where he also serves as Dean of the School of Nursing and Curator of the famous Collection of Susini's Anatomical Wax Models. Member of the AAA and of the Federative International Committee on Anatomical Terminology (FICAT), he is Vice President of the College of Italian Anatomists, President of the Association F.A. Boi for the promotion of History of Medicine, and Editor of the European Journal of Morphology. His main research interests, which he shares with his wife Dr. Testa Riva, Professor of Histology and Embriology, are in salivary and other exocrine glands and in the history of anatomy. Mr. Orrù is the Head Librarian of the Central Biomedical Library of the University of Cagliari at Monserrato. He is Vice President of the Sardinian Section of the Italian Library Association. His main interests are in Library Organization and History of Sciences. Dr. Pirino is Lecturer in Anatomy at the Medical School of the University of Sassari (North Sardinia), where he also is Curator of the Anatomical Museum entitled to Luigi Rolando. His research interests are in the reproductive system and in History of Anatomy.