Berengario da Carpi: Renaissace Anatomist1
Plinio PRIORESCHI*
*MD, PhD, Department of Pharmacology, Section of History of Medicine, Creighton
University, Omaba, Nebraska 68178, USA
e-mail: plinio@creighton.edu
Summary
The author reviews briefly the life and work of Berengario da Carpi and
discusses his contribution to the study of anatomy. It is concluded that his main merit was
to have emphasized the importance of observation over reliance on authority. In addition,
Berengario was the first anatomist to recognize the significance and value of anatomical
illustrations in clarifying the text. Although he was not immune to prejudices and did not
reject all the errors of the ancients (e.g., he accepted the notion of the presence of
foramina in the interventricular septum), his work represents a milestone in the
development of scientific anatomy.
Key words: Renaissance anatomy; anatomical illustrations; history of anatomy;
Renaissance science.
It is generally accepted that the publication of Vesalius’ De humani corporis
fabrica (“On the Structure of the Human Body”) in 1543 represents a milestone in the
history of anatomy. Among several anatomists who preceded Vesalius and who started to
study the discipline by dissecting the human body, Berengario da Carpi (Jacopo or
Iacopo2 Berengario da Carpi, Jacopo da Carpi – c.1460-c.1530) was one of the most
important.
The real name of Berengario da Carpi was Jacopo Barigazzi.3 Berengario’s father,
Faustino, was a barber-surgeon from whom his son learned some anatomy and surgery
before his graduation in medicine from the University of Bologna in 1489 where his
teachers included Girolamo Manfredi, Gabriele Zerbi, and Alessandro Achillini.4 He
spent his youth at Carpi with his family at the service of Lionello Pio, Lord of Carpi. The
famous printer, Aldus Manutius,5 was the teacher of both Berengario and Alberto Pio, the
son of Lionello.
1
In 1499, Ercole I, Duke of Ferrara, managed to acquire possession of Carpi.
Berengario opposed him and, as a result, in 1500, was condemned to pay a fine or have
his nose cut off. His father paid the fine and Berengario saved his nose but found it wise
to live Carpi.6 In 1502 he was made Lecturer in Surgery at Bologna. His medical success
was probably due to his skill in surgery and practical medicine (at the time he had not yet
published any books).
There are episodes in the life of Berengario that suggest a fierce, greedy and
ruthless nature. It has been said that “Avarice and cupidity stir in the mind of this great
man greater passions than glory and virtue.”7 While in Bologna, he was involved in
violent quarrels and assaults and was even convicted of robbery although, because of
powerful friends, he escaped punishment.8
In 1525-1526, Berengario spent a few months in Rome, where he attended
Cardinal Pompeo Colonna, who was afflicted with what was believed to be cancer. 9 In
Rome he treated people for syphilis. The following are the comments of Benvenuto
Cellini:
At that time [in 1526], a very great surgeon came to Rome, he was called
Maestro Iacomo da Carpi. This capable man, among others, treated some desperate cases
of French disease [syphilis]. In Roma, the disease was common among priests, especially
the richest among them and he became well known as he declared that he could cure the
disease in the most marvelous fashion with the use of certain perfumes. He wanted to
agree on the fee before the treatment, however, and those fees were not in the tens but in
the hundreds... He was very learned and spoke marvelously on the subject of medicine.
The pope wanted him to remain in his service but the man said that he did not want to be
in the service of anyone in the world and that whoever needed him could seek him. He
was indeed shrewd and it was good for him to leave Rome because, a few months later,
all those whom he had treated were doing very badly and many were worse than before.
Had he remained in Rome, he would have been killed.10
For syphilis, Berengario probably used ointments of mercury; a common
treatment at the time.11
On his return to Bologna, he lost his position as Lecturer in Surgery, which he had
held for twenty-four years, and he suddenly left the city. The reason for this turn of
events is unclear. Falloppio in his De morbo gallico, to explain the abrupt departure,
wrote that Berengario had been charged with human vivisection:
2
This man so hated Spaniards that, when he was at Bologna, he took twin
Spaniards suffering from syphilis and determined to practice vivisection on them: being
ruined for this reason, he went to Ferrara.12
This, however, is probably an interpolation in Falloppio’s book and there may be
no truth to the accusation of human vivisection.13
Subsequently he went to Modena and then to Ferrara, where, by 1529, he had
become court surgeon to Alfonso D’Este, duke of the city. There is no evidence that
Berengario ever taught at Pavia, as has been often asserted. 14 The exact date of his death
is unknown.15
The main works of Berengario da Carpi are:16
1. Tractatus de fractura calve sive cranei (“Treatise about fractures of the skull or
cranium” – Bologna, Hieronymus de Benedictis, 1518).
2. Commentaria super anatomia Mundini (Commentaria cum amplissimis
additionibus super anatomia Mundini una cum textu ejusdem in pristinum et verum
nitorem redacto, “Commentary with very many additions on the anatomy of Mondino
published with his original elegant text” – Bologna, Hieronymus de Benedictis, 1521)
3. Isagogae breves (Isagogae breves perlucide ac uberrime in anatomiam humani
corporis a communi medicorum academia usitatam, “Short introduction on the anatomy
of the human body used with great profit and clarity in medical colleges” – Bologna, B.
Hectoris, 1522).
Berengario’s primary interest is the care of the patient, and he often follows Galen
and Avicenna with frequent references to Celsus.17
The Tractatus is the first treatise devoted to head wounds. It describes several
types of skull lesions and fractures and mentions the relation between location and
neurological effects. The Tractatus was a surgical rather than anatomical work. The
following quote gives an example of the cranial operations performed at the time and of
Berengario’s cautious approach to therapy:
… I saw in my practice at Florence a boy of twelve or thereabouts, the son of a
dyer, who had been kicked by a mule. His cranium was fractured over a large area of
bone and depressed inward about the width of a knife blade and separated throughout.
Together with master Alessandro da Ripa (or Riva), a natural philosopher, and a certain
man named Tansura, a surgeon, I was called in for consultation. When we saw the
depressed bone we decided to lift it up completely with the appropriate instruments. But
in the process we saw a notable vein had been ruptured from which a considerable
amount of blood was flowing and we recognized the great danger involved. We released
the bone into its place again because it was holding back the blood, thinking we could
3
remove it when the time was right. As we did so we saw the bone was in a healthy
condition, nor were there any bad symptoms. [Later] I proceeded alone with the cure of
the patient, and I saw the bone was consolidated from the sides by means of a callus. I
released the bone to its position and the patient was perfectly cured. 18
The Commentaria super anatomia Mundini is an extensive work of almost a
thousand pages in which the author gives a commentary upon each chapter of Mondino’s
medieval text with criticism and emendations based on what he had observed in the
course of dissection.
Although modestly titled, the Commentaria is in reality an original contribution of
considerable value and it is the first illustrated anatomical textbook to be printed.19 The
importance of Berengario’s anatomical work is underlined by the following quotations in
which the prominence of observation over authority is clearly stated:
And let sense perception agree with this text and thus let those who write books
on anatomy also not trust in the authorities but in their sense perception as I do and shall
do.20
Galen with his followers whose opinion I always maintain except when senseperception disagrees with him. 21
Many, however, believe otherwise, but sense perception is the judge in this
matter.22
Berengario, in fact, often records personal observations in his attempt to arrive at
anatomical truth. He reports that he performed an experiment in which he injected the
vein of the kidney with water from a syringe to see if the water would emerge from the
ureter and found that it did not do so.23
He states his purpose for writing the Commentaria:
When I saw so many and so great altercations between those writing on
Anatomy, I resolved through means of a Commentary to draw together, by some quite
brief summary, what I have seen by long experience in dissecting the bodies both of the
living and the dead, and what I have sought in long reading. And my guide will be the
excellent Mundinus of Bologna... In this exposition I will add some noteworthy things,
not without their usefulness, from more recent writers, always with the senses and some
authorities and reasonings of the divine Galen as my guide... 24
4
The passage illustrates the transition from the uncritical repetition of ancient
notions to reliance on empirical observation. In the same work, in fact, Berengario
decries the ways of some authors who blindly follow authority and warns not to be
deceived by “some of our moderns who involve anatomy with authorities and not with
observation;” as noted above, he says that he always accepts Galen’s views except when
they disagree with observation.25 In defense of some of Mondino’s shortcomings (e.g.,
his acceptance of the notion of the multi-celled uterus), Berengario mentions the paucity
of anatomical writings in his day and uses the famous image of a dwarf standing on the
shoulder of a giant to see further 26 to illustrate his belief in the cumulative nature of
knowledge.27
Although he often accepted the errors and prejudices of the ancients, he was not
constantly overwhelmed by earlier authorities. Because of this approach, he made a
number of contributions: he expressed disbelief in the imaginary rete mirabile of Galen
(see below); he rejected the medieval idea of a multicellular uterus; he was the first to
describe the thymus gland, the seminal vescicles, the arytenoid cartilages, the tympanic
membrane, the malleus and incus, and the vermiform appendix; and he observed that the
chest was larger in the male just as the pelvis was in the female. He denied the existence
of the third ventricle of the heart mentioned by Aristotle but believed in the pores of the
interventricular septum.28 Other original observations attributed to him are the sphenoid
sinuses and the pineal gland; he has also been hailed as a pioneer in the treatment of
gunshot wounds.29 It must be underlined however, and this applies not only to Berengario
da Carpi but to all pre-Vesalian anatomists, that no systematic study has been made to
determine who was the first to describe what and with what accuracy. Lacking such
precise information, we must be cautious in attributing “firsts” to this or that author.
The Isagogae is a concise and detailed description of the anatomy of the human
body and also a manual of dissection. Again, the errors and legends of the ancients are
frequently accepted in spite of the fact that some of the work is based on actual dissection
of the cadaver. We quote, as an example, the section of the Isagogae concerning the
heart:
For the dignity of the heart prevails over other parts since it is the chief of all the
members and is called the sun of the microcosm because it illuminates the other members
with its spirit. The heart has an especial heat. It certainly beats and has motion as if it
were a living creature…
Some men are said to be born with a shaggy heart; they are bolder and stronger
than other men, as, for example, Aristomenes the Messenian, who killed three hundred
Spartans and when wounded and captured finally escaped by fleeing into the hiding place
5
of foxes. Captured once more, he boldly fled again. Captured a third time by the use of
traps, the Spartans cut open his chest to find the cause of his virility and discovered that
his heart was bristly with hair…30
The heart possesses a triple sinus hollow or domicile or ventricle. The right one
is larger than the left. The left sinus reaches to the extremity of the point of the heart. The
right sinus terminates a little under that place.
Between these sinuses [i.e., ventricles] is a dense, thick wall called diaphragm
by Galen. In this wall there are many little foramina stretching from the right sinus to the
left sinus. They are broader at the right sinus than at the left sinus. These foramina are
dilated when the heart is shortened and opens; they are contracted when the heart is
elongated and closes. Hence the blood, made thin and prepared, passes from the right to
the left, where it is completely chanced into vital spirit.31
The above shows that Berengario agreed that the heart possessed special heat and
that it was the sun of the microcosm, and that he did not consider the tale of Aristomenes’
shaggy heart absurd. In addition, he accepted the old notions about the third ventricle and
the foramina in the interventricular septum. On the other hand, concerning the nonexistent rete mirabile under the brain described by Galen, he said:
From these arteries [internal carotids], as the authors commonly say, above the
bone immediately under the dura mater are formed many very thin branches marvelously
united together one upon the other in the shape of a net occupying a large place in front,
behind, and at the sides32…
Yet I have never seen this net… this net is not given in that place between the
aura mater and the basilar bone… I have given many… reasons [for the non-existence of
this net] in my Commentary on Mundinus, to which I refer my readers for the sake of
brevity; among these reasons the experience of the senses is my chariot-driver…33
Berengario, therefore, as other anatomists at the time, was able to reject some
incorrect classical notions but, without blinking an eye, could accept others that, to the
modern mind appear absurd (e.g. the shaggy heart of Aristomenes). Also, for example,
concerning the overlap between medicine and philosophy, he says:
The utility and necessity of anatomy needs to be known not only by the
Physician, but also by the Philosopher exploring the secrets of Nature: here, through
anatomy, Philosophers may very much marvel at the power of the Creator... 34
6
During the Middle Ages and the Renaissance, in fact, medicine and philosophy
were not as distinct as they are in modern times (Zerbi, for example, considered anatomy
to be primarily a philosophical exercise35).
The works of Berengario were not very widely read and it has been suggested that
one reason may have been that, at a time when form was considered important in
technical writings, his Latin is far from elegant.36
On of the great merits of Berengario is that he was the first anatomist to recognize
the significance and value of anatomical illustrations in clarifying the text. If one
observes earlier anatomical illustrations it becomes apparent that they are only very loose
representations of anatomical structures and are of little help in understanding the true
shape of organs. Berengario’s contribution, even if in a rather crude fashion, was to
integrate text and illustration so that the latter assisted in the description. Although his
success was limited, it prepared the way for Vesalius who was to develop the value of
illustrations to a degree far beyond his predecessors.37
Berengario paved the way for Vesalius. As Fallopius put it, what Carpi had begun
Vesalius perfected.38
REFERENCES
1
The material discussed in this paper will be found in: Plinio Prioreschi, A History of Medicine,
Vol. VI, Renaissance Medicine, Omaha, Horatius Press, scheduled to be published in 2006.
2
Both spellings are common in Italian.
3
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 3 (the name Berengario may be a corruption
of Barigazzi). See also: Berengario da Carpi On Fractures of the Skull or Cranium, translated by L.R.
Lind, Philadelphia, The American Philosophical Society, 1990, p. ix.
4
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 4.
5
Manutius lived and taught at Carpi from 1469 to 1477. Jacopo Berengario da Carpi, A Short
Introduction to Anatomy (Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago
Press, 1959, p. 4.
6
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 4.
7
Vittorio Putti, Berengario da Carpi: Saggio biografico e bibliografico seguito dalla traduzione
del “De fractura calvae sive cranei.” Bologna, L Cappelli, 1937. Translated and quoted by Lind in: Jacopo
7
Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by L.R. Lind, Chicago,
The University of Chicago Press, 1959, p. 8.
8
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, pp. 6-7, 8.
As the Cardinal lived for six years after Berengario’s visit to Rome, the cancer was probably a
9
benign tumor. See: Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves),
translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 9.
10
Benvenuto Cellini, La vita, Milano, Fratelli Fabbri, 2 Vols., 1970, I, pp. 71, 72.
11
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, pp. 9-10.
12
Quoted by Lind in: Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae
breves), translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 10.
13
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 10.
14
Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated by
L.R. Lind, Chicago, The University of Chicago Press, 1959, pp. 6.
15
For more details about his biography, see: Jacopo Berengario da Carpi, A Short Introduction to
Anatomy (Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, pp.
3-14.
For a complete list of Berengario’s works, see: Jacopo Berengario da Carpi, A Short
Introduction to Anatomy (Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago
16
Press, 1959, pp. 217-218.
17
Berengario da Carpi On Fractures of the Skull or Cranium, translated by L.R. Lind,
Philadelphia, The American Philosophical Society, 1990, pp. xxi-xxiii.
18
Berengario da Carpi, Tractatus de fractura calve sive cranei, II, x. Berengario da Carpi On
Fractures of the Skull or Cranium, translated by L.R. Lind, Philadelphia, The American Philosophical
Society, 1990, p. 37.
19
Charles Singer, The Evolution of Anatomy, London, Kegan, Trench, Trubner & Co., 1925, p. 97.
20
Et cum isto textu [of Galen] concordat sensus: sic ergo sint cauti componentes libros de
anatomia et non credant auctoritatibus sed sensui sicut nos facimus et faciemus (for. 153v). Translated an
quoted by Lind in: L.R. Lind, Studies in Pre-Vesalian Anatomy: Biography, Translations, Documents,
Philadelphia, The American Philosophical Society, 1975, p. 10.
21
G. cum suis sequacibus cuius opinionem semper tenemus nisi ubi discordat ab ipso sensus (for.
412v). Translated an quoted by Lind in: L.R. Lind, Studies in Pre-Vesalian Anatomy: Biography,
Translations, Documents, Philadelphia, The American Philosophical Society, 1975, p. 10.
22
Multi tamen aliter sentiunt, sed sensus in hoc est iudex (for. 443r). Translated an quoted by Lind
in: L.R. Lind, Studies in Pre-Vesalian Anatomy: Biography, Translations, Documents, Philadelphia, The
American Philosophical Society, 1975, p. 10.
8
23
L.R. Lind, Studies in Pre-Vesalian Anatomy: Biography, Translations, Documents,
Philadelphia, The American Philosophical Society, 1975, p. 162.
24
Berengario da Carpi, Commentaria cum amplissimis additionibus super anatomia mundini una
cum textu eiusdem in pristinum et verum nitorem redacto, Bologna, de Benedictis, 1521, f iv r. Translated
and quoted by Cunningham in: Andrew Cunningham, The Anatomical Renaissance, Aldershot, Scolar
Press, 1997, p. 75.
25
M. F. Ashley Montagu, “Vesalius and the Galenists,” in: Science, Medicine, and History, edited
by E. Ashworth Underwood, London, Oxford University Press, 1953, pp. 374-385. Montagu, for this
passage, gives the following reference: Carpi commentaria cum amplissimis additionibus super anatomia
Mundini una cum textu eiusdem in pristinum and verum nitorem redacto. Bononia, 1521, fo. 240r, 398r,
412v.
26
L.R. Lind, Studies in Pre-Vesalian Anatomy: Biography, Translations, Documents,
Philadelphia, The American Philosophical Society, 1975, p. 159.
27
Elsewhere (Plinio Ptrioreschi, A History of Medicine, Omaha, Horatius press, Volume V, 2003,
Chapter VII), we have discussed the famous figure of speech, often wrongly attributed to Newton, about
dwarfs seeing further standing on the shoulder of giants..
28
C. D. O’Malley, Andreas Vesalius of Brussels 1514-1564, Berkeley, University of California
Press, 1964, p. 19. See also: Charles Singer, The Evolution of Anatomy, London, Kegan, Trench, Trubner &
Co., 1925, p. 97.
29
See: Jacopo Berengario da Carpi, A Short Introduction to Anatomy (Isagogae breves), translated
by L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 18.
30
Translated and quoted by Lind in: Jacopo Berengario da Carpi, A Short Introduction to Anatomy
(Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 93.
31
Translated and quoted by Lind in: Jacopo Berengario da Carpi, A Short Introduction to Anatomy
(Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, p. 95.
32
Lind believes that this net is the circle of Willis (Note No. 51 in: Jacopo Berengario da Carpi, A
Short Introduction to Anatomy (Isagogae breves), translated by L.R. Lind, Chicago, The University of
Chicago Press, 1959, p. 147 – the text of the note is on p. 210). We have seen that it is instead the rete
mirabile described by Galen. Lind repeats this erroneous assertion in his discussion of the work of Niccolò
Massa (see below).
33
Translated and quoted by Lind in: Jacopo Berengario da Carpi, A Short Introduction to Anatomy
(Isagogae breves), translated by L.R. Lind, Chicago, The University of Chicago Press, 1959, pp. 146, 147.
34
Carpi commentaria cum amplissimis additionibus super anatomia mundini una cum textu
eiusdem in pristinum et verum nitorem redacto, Bologna, de Benedictis, 1521, f v r. Translated and quoted
by Cunningham in: Andrew Cunningham, The Anatomical Renaissance, Aldershot, Scolar Press, 1997, p.
77.
35
Andrew Cunningham, The Anatomical Renaissance, Aldershot, Scolar Press, 1997, p. 78.
36
Charles Singer, The Evolution of Anatomy, London, Kegan, Trench, Trubner & Co., 1925, p. 97.
Singer continues: “He is responsible for the barbarous term Vas deferens. A contemporary term, derived
9
from no language at all, is Synovia, invented by the alchemist, quack, rebel, prophet, and genius, Philip
Aureolus Theophrastus Bombastus van Hohenheim, called Paracelsus, whose work lies outside our”.
37
C. D. O’Malley, Andreas Vesalius of Brussels 1514-1564, Berkeley, University of California
Press, 1964, p. 20.
38
Gabriel Fallopius, Observationes anatomicae, Venetiis, 1561, fo. 254r. Quoted by Montagu in:
M. F. Ashley Montagu, “Vesalius and the Galenists,” in: Science, Medicine, and History, edited by E.
Ashworth Underwood, London, Oxford University Press, 1953, pp. 374-385. Check!! original if possible!!
10