The University of Padua is one of the oldest in the world, founded in 1222 when a large number of scholars and lecturers left the University of Bologna looking for more academic freedom. As the city of Padua was long recognized for its cultural richness and liberal schools, the University was established spontaneously, not “ex privilegio”, which was a special decree of the Emperor or the Pope needed at that time. When Venice conquered Padua, in 1404, Venetian administrators decided to improve its University, already famous and prosperous, making this institution the principal cultural centre of the Republic. Venetians continued to guarantee the freedom of thought which was the typical characteristic of Padua, so to justify the motto Universa universis patavina libertas: “The freedom of Padua is complete and for everyone”. The administrators of the University, also called “Riformatori”, were delegated by the Great Council of Venice to rule the University and to secure freedom and tolerance for students and professors, who came from all the Europe. Leonardo Donato (1536-1612), who became later a famous Doge of Venice, was one of these Riformatori. He contributed to the call of Galileo Galilei to Padua (1592), authorized the construction of the first permanent anatomical theatre of the world under the professorship of Girolamo Fabrici d’Acquapendente (1594), and defended the autonomy of Venetian Republic. Interestingly, Donato became Doge of Venice when Galileo started to use the telescope to investigate the Moon, the Milky Way, Venus and Jupiter (1609-1610). After the Catholic Reformation, its University remained the only institution under the Catholic reign still open to Protestants, Anglicans, Jewish and Orthodox students and professors.

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The University of Padua Medical School played a fundamental role in the history of medicine. For centuries in this institution, many prominent physicians and scientists contributed in the development of study of health and disease following a scientific method. In addition to its medical school, the University hosted many eminent figures in all fields of science and humanities, such as Francesco Petrarca (1304-1374) (poet), Pietro Bembo (1470-1547) (poet and humanist), Nicolaus Copernicus (1473-1543) (astronomer), Galileo Galilei (1564-1642) (mathematician and astronomer), Giacomo Casanova (1625-1798) (humanist) and Elena Cornaro Piscopia (1646-1684) (philosopher and the first woman to have a doctorate degree in the western world).

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The ”golden age” of Padua Medical School started with the Renaissance. During this period, the most significant contributions of Padua were related to the study of Anatomy, still recognised as fundamental to all medical disciplines. Andreas Vesalius (1514-1564) marked the dawn of modern anatomy with anatomical illustration. Vesalius, Belgian scholar and teacher of Anatomy and Surgery at the University of Padua, published two seminal texts: Tabulae anatomicae sex (Six anatomical tables, 1538) and De humani corporis fabrica (The fabric of the human body, 1543). In the De humani corporis fabrica Vesalius proved that the anatomy of Galen (130-200), followed by ancient and medieval medicine, was based on animals such as ape and ox, not on humans. Vesalius was the first to deny the existence of inter-ventricular pores, by which the blood was though to pass from the right to left ventricle of the heart. Rejecting this keystone of Galenic physiology, Vesalius opened the way to a radically new understanding of cardiovascular system. Other eminent anatomists of Padua Renaissance Medical School were Realdo Colombo (1516-1559), Gabriele Falloppia (1523-1562), Girolamo Fabrici d’Acquapendente (1533-1619), Giulio Cesare Casserio (1522-1616), and Johannes Wesling (1598-1649). Realdo Colombo, scholar of Vesalius, was the first to describe the pulmonary circulation in the Western world.

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The discovery of blood circulation by William Harvey (1578-1657) marked the beginning of human physiology in the modern sense. Before this discovery, Galen theory postulated that arteries and veins were two separated systems. He thought that venous blood was generated in the liver, from where it was distributed and consumed by all organs of the body, and that a “spirit” circulated in arteries which was a mixture of blood passing trough the pores in inter-ventricular septum and air coming from the pulmonary vein. While being a scholar of Fabrici d’Acquapendente in Padua, Harvey first conceived the idea of blood circulation that was later published in his famous book: Exercitatio anatomica de motu cordis et sanguinis in animalibus (Anatomical essay on heart and blood movement in animals, 1628). Harvey supported his theory with the discovery by Fabrici of the valves of veins and with the application of Aristotelian concepts on circular movement, which he learned in Padua. It is noteworthy that Harvey used a mathematical and quantitative approach in his researches, scientific method well established in Padua thanks to the teachings of Galileo Galilei (1564-1642), who was professor of mathematics (1592-1610) at the time of Harvey stay in Padua.

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In the XVIII century, Padua witnessed a further fundamental advancement in medicine: the shift from merely studying the normal anatomy and physiology to analysing the natural history of disease and understanding sick structures and functions. Giovanni Battista Morgagni (1682-1771), professor of Anatomy in Padua Medical School, introduced the anatomo-clinical method, which still represents an up-to-date scientific approach of combining basic research and clinical practice. Celebrated as the father of physiopathology, Morgagni’s pathological anatomy was deeply clinically and physiologically oriented. The principles of Morgagni were based on the idea that altered functions cause deformities in organs, which in turn were the cause of clinical phenomena. In Morgagni’s masterpiece, De sedibus et causis morborum per anatomen indagatis (Seats and causes of diseases investigated by anatomy, 1761), cardiovascular pathology plays a prominent role. Morgagni first described the trilogy of Fallot and a rarity of the pulse which will be recognized as the Morgagni-Adams-Stokes syndrome (av block). He gave interesting descriptions and interpretations of syphilitic aortitis, dissecting aneurysm, atherosclerosis, valvulopathies and other cardiovascular diseases.

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Bernardino Ramazzini (1633-1714), Professor of Theoretical Medicine in the times of Morgagni, with his book De morbis Artificum diatriba (Discussion on the disease of workers, 1700) founded occupational medicine. The development of this approach can be recognized as a further step towards the concept that diseases occur due to specific causes in the setting of peculiar contexts.

As regards the period between XIX and XX century, the development of constitutional medicine occurred by Achille de Giovanni (1838-1916), Paduan clinician, Dean of the Faculty of Medicine and Magnificent Rector. This approach was the basis for the study about the hereditary of diseases and also for the development of endocrinology. The individual “constitution” was designed as a set of morphological, functional and psychological characteristics of the patient, as well as the family history, that is currently explained by genetic heritage. The different constitutional types were examined in particular with anthropometric instruments for detecting the proportions between different parts of the body, harmonies and disharmonies of the development as possible sources of “morbidity”. Constitutional medicine reserved a special attention to endocrinology, considering hormones as essential ingredients in the individual and psychological development and constitution. Nicola Pende (1880-1970), father of modern endocrinology, was student of De Giovanni.

In the last century, with the introduction of anesthesiology and surgery, Padua remained in the vanguard. Thanks to Vincenzo Gallucci (1935-1991), the late prominent cardiothoracic surgeon, the first heart transplantion in Italy took place in Padua in 1985.

All through its history, Padua adhered to the principles of intellectual liberty, proper scientific methodology and universal tolerance (libertas docendi et investigandi: freedom of teaching and searching). Today, when medicine has become a global scientific phenomenon, these principles remain the solid foundation for further scientific achievements and prosperity of humankind.

 

 

References

 

University of Padua Medical School

 

ZAMPIERI, F. – ZANATTA, A. (2014), The Origin and the Evolution of Hospitals: The Case of Padua, “European Journal of Internal Medicine”, 25, p. e1.

http://www.ejinme.com/article/S0953-6205%2813%2900088-5/abstract

 

Zampieri, F. – Zanatta, A. – Elmaghawry, M. – Rippa Bonati, M. – Thiene, G. (2013), Origin and Development of Modern Medicine at the University of Padua and the Role of the “Serenissima” Republic of Venice, “Global Cardiology Science and Practice”, 3, 21, pp. 1-14. http://www.qscience.com/doi/abs/10.5339/gcsp.2013.21

 

THIENE, G. (1996), Cardiovascular Pathology in the Land of Doges, “Cardiovascular Pathology”, 5, 5, pp. 281-283.

http://www.cardiovascularpathology.com/article/1054-8807%2896%2900023-3/abstract

 

Some protagonist of the University of Padua Medical School

 

ZANATTA, A. – ZAMPIERI, F. – ZAMPIERI, G. – GIULIODORI, A. – THIENE, G. – CAENAZZO, L. (2014), Identification of Giovanni Battista Morgagni remains following historical, anthropological and molecular studies, “Virchows Archiv” (epub ahead of print).

http://link.springer.com/article/10.1007%2Fs00428-014-1611-9

 

ZAMPIERI, F. – ZANATTA, A. – THIENE, G. (2014), An Etymological “Autopsy” of Morgagni’s Title: De Sedibus et Causis Morborum per Anatomen Indagatis (1761), “Human Pathology”, 45, 1, pp. 12-16.

http://www.humanpathol.com/article/S0046-8177%2813%2900198-6/abstract

 

ZAMPIERI, F. – ZANATTA, A. – SCATTOLIN, G. – STRAMARE, R. – THIENE, G. (2013), Diego Rivera’s Fresco and the Case taken from Morgagni’s De sedibus, “The American Journal of Cardiology”, 112, 5, pp. 735-736.

http://www.ajconline.org/article/S0002-9149%2813%2901071-0/abstract

 

ZAMPIERI, F. – BASSO, C. – THIENE, G. (2014), Andreas Vesalius’ Tabulae anatomicae sex (1538) and the seal of the American College of Cardiology, “Journal of the American College of Cardiology”, 63, 7, pp. 694-695.

http://www.sciencedirect.com/science/article/pii/S0735109713055393

 

ZAMPIERI, F. – ZANATTA, A. (2013), Surgery, Pathology and Art in Pietro Gradenigo’s Ophthalmological Waxworks, “JAMA Ophthalmology”, 131, 11, pp. 1474-1475. http://archopht.jamanetwork.com/article.aspx?articleid=1775816