Giovanni Maria Lancisi - Opera varia. In unum congesta, et in duos tomos distributa - 1793

Giovanni Maria Lancisi, Opera varia. In unum congesta, et in duos tomos distributa. Venice: Sanctes Pecori, 1739.

Folio (two parts): xxxi, 260 pages; xii, 265, (25) pages, with ten engraved anatomical plates and two large folding epidemiological plates of the marshy areas of Rome (often missing).

FIRST edition of the Opera.

Bound in contemporary soft boards, showing a few faint stains, and preserved in a slip-case. A handsome copy of an impressive book, with clean pages, untrimmed, and wide margins.

GIOVANNI MARIA LANCISI
Lancisi, a Roman doctor, was a professor of surgery and anatomy and personal physician to two popes, Innocent XI and Clement XI. Founder of the noble Academy of Medicine and Surgery, he acquired European fame with for his work on cardiology and on epidemiology. He was the first to identify the mosquito as the vehicle for spreading the malaria, and his works (collected here) laid the basis for cardiac pathology with his observation of valvular lesions and cardiac dilatation in correlation with symptoms of disease. He was the first to describe cardiac syphilis.

THE COLLECTION
This collection includes, amongst other texts:
• De Subitaneis mortibus.
• Dissertatio de nativis, deque adventitiis romani coli qualitatibus.
• De Noxiis paludum effluviis.
• Latio importata, cui accedit confilium de equorum epidemia… anno 1717.
• An acidum ex sanguine extrahi queat.
• De Motu cordis & aneurysmatibus.
• De recta medicorum studiorum ratione

The copperplates depict the cardio-vascular system, the maps relate to the Pontine Marshes near Rome.

THE HEART, THE MARSHES AND THE MOSQUITO
In De Motu Cordis et de Aneurysmatibus, in which the germ of many later notions can be found. For instance, Lancisi gave very clear descriptions of growths on valves and of dilated and strongly pulsating cervical veins in right heart dilatation (differentiating them from the pulsations in chlorosis). It should be noted that Lancisi described also correctly the genuine arterial (in particular aortic) and caridac aneurysm, as we know it. The text (first published in 1728) also classifies cardiac diseases, describes cardiac syphilis and establishes syphilis as a cause of cardiac aneurysms. Although a clear description of angina pectoris would not appear for more than half a century, Lancisi described complaints which surely represented this entity.

Still more pertinent to present day cardiology was his De subitaneis Mortibus. Of course the definition of sudden death was not so strict as it is now - much debated as this question has been in our own time - but it is interesting that Pope Clement XI, alarmed by a recent increase of the number unexpected deaths among prominent people in Rome, ordered Lancisi to inquire by autopsy the cause of every sudden or quickly occurring death in the years 1705 and 1706. The findings proved far from uniform and the epicrisis (Scholium) was often couched in vague terms of iatrochemical hypotheses. However, in some cases of rupture of an aortic aneurysm was found and in other instances an aneurysm (dilatation) of the heart which probably was due to hypertension or aortitis with aortic insufficiency. In one young patient with valvular disease and a large spleen, bacterial endocarditis may have been present.

Lancisi’s work on sudden deaths also represents one of the earliest epidemiological studies of non-communicable diseases. In De subitaneis Mortibus (originally published in 1707), Lancisi examines the pathogenesis of the unusual number of sudden deaths that occurred in Rome during 1705-1706. Pope Clement XI, whom Lancisi served as personal physician, feared poisoning but Lancisi pointed out that the fevers afflicting Rome and the surrounding countryside were closely related to the presence of swamps, which encouraged the multiplying of mosquitoes. By a brilliant intuition Lancisi attributed the spread of the disease to these insects (rather than to ‘bad air’, or mal aria), and strongly advocated the draining of the swamps – unfortunately without success – and the use of quinine.

The epidemiological work is also represented in other texts in the collection including De Noxiis Paludum Effluviis which explores the relations of stagnant water to disease and in which Lancisi argues against the destruction of forests and other vegetation. This text includes an engraved map which shows the drainage scheme for the nearby swamps. In Dissertatio de Nativis (1711), Lancisi deals with the sanitary conditions of Rome, its water supplies, climate and housing; he also describes the devastating epidemic of influenza which began in Italy in 1709 and swept through most of Europe.

Not least, Lancisi in De recta medicorum studiorum ratione (1715) pleaded for a modern medical training model. He had in mind a curriculum based on the two pillars – ‘learning in the hospital’ and ‘learning in the library’. On the one hand, the student was to attend the visit of the protomedicus to the sick and on the other hand, he was to deal with the new philosophy of nature in the library. Lancisi hoped that this would bridge the gap between theory and practice. In this, as in other subjects, Lancisi was right and ahead of his time.

REFERENCES:
Brunet, III: 14; Graesse, IV: 93-94; Garrison-Morton 71, 2731, 2973, 5232.