Santorio's Medical Method

Scientific Humanism and Corpuscularism

What Santorio, as much Alpini, accomplished was a cultural translation of ancient precepts and tenets of medicine. Theirs was a translation and an interpretation at once, which resembles a new Humanism of the sciences. In fact, Santorio referred to units of weight and properties of the physical world, of which the human body is a part responding to the same physical laws and limits (Epicurus, Letter to Menoikos: “Keep in mind that some desires are natural whereas others are groundless; that among the natural desires some are natural and necessary whereas others are merely natural; and that among the necessary desires some are necessary for happiness, some for physical health, and some for life itself. The steady contemplation of these facts enables you to understand everything that you accept or reject in terms of the health of the body and the serenity of the soul — since that is the goal of a completely happy life”). As someone who conducted empirical and numerical observations, Santorio justified the data he collected through a reading of the classics.  Santorio also used historical sources as a foundation for his numerical approach to medicine. In fact, written evidence worked as well as experimental research did. Santorio weighed himself before and after meals, before and after exercise, and before and after bodily waste for thirty years. Observation alone, however, would not be sufficient for a physician to develop a theory: reasoning becomes a necessary instrument, too. As stated in the Preface, results derive from reasoning and thirty years’ experience (“ratione et triginta annorum experientia”). In addition to that, he had ten thousand patients record their fluctuation in weight (Opere di Galileo, Volume XII, 140-42).

Connections between early modern medical theories, dating back to Hippocrates and the Roman Republic, show from medical ancient sources, as much as from early modern readings of them. The text, and the reception of such text through commentaries and aphorisms, displays a rhetorical intent when interpreting medical data through instruments. The stylistic form is a collection of aphorisms, which is superior to description (In the Preface to Ars de statica medicina, we read that Santorio preferred writing through the form of aphorisms (“Doctrina aphoristica quam diexodica describere”). The first aphorism claims to set useful definitions and parameters, too (Book I, Aphorism I). By imitating Hippocrates’s style, the Hippocratic tradition, and almost by necessity, conciseness and memorability merged into aphorisms, divided into six books. Indeed, clinical practice and medical theory seem to combine together. Aphorisms also help for organizing ideas in a structure which guides for later browsing, thus showing pedagogical intents. Rhetorical devices such as aphorisms, metaphors, and classical references serve a grander purpose within Baroque literary expression.

Santorio collected those aphorisms in a remarkable order, almost the same way bees collect honey from a number of flowers to put it into beehives later, he argued, with an order that was purposedly designed by bees themselves; in Santorio’s words, “optime inter se connexos miro hoc ordine digesserim, eo plane modo quo apes primum mel ex variis floribus delibant, et deinde in apiariis per aedicularum suarum favos elaboratum miro ordine disponunt.” That simile is a humanistic imitation of a passage from a letter by Seneca (Epistulae morales, XI, 84, 3: “Apes, ut aiunt, debemus imitari, quae vagantur et flores ad mel faciendum idoneos carpunt, deinde quidquid attulere disponunt ac per favos digerunt et, ut Vergilius noster ait, ‘liquentia mella/ stipant et dulci distendunt nectare cellas’”). If we imitate the patience and resilience of bees, we collect materials, be they honey or readings, Seneca seems to suggest; then, Santorio expands on that concept, because we do, indeed, use intellectual skills to expand and enrich our understanding of nature (Epistulae morales, XI, 84, 5 “nos quoque has apes debemus imitari et quaecumque ex diversa lectione congessimus separare . . . deinde adhibita ingenii nostri cura et facultate in unum saporem varia illa libamenta confundere, ut etiam si apparuerit unde sumptum sit, aliud tamen esse quam unde sumptum est appareat”). Extending analysis and research set forth by other scholars resembles a father-and-son connection, as Seneca put it in a letter that influenced Santorio’s critical method. Imitation only does not produce much more than a copy; however artistic that might be, it is far removed from the achievements of the original it mimicks (Epistulae morales, XI, 84, 8: “Etiam si cuius in te comparebit similitudo quem admiratio tibi altius fixerit, similem esse te volo quomodo filium, non quomodo imaginem: imago res mortua est”). Thus, a worthy writer will acknowledge those sources (deriving, as it is, from reading, “lectione,” with an intended pun arising from the verb “lego” meaning both to collect honey, in Seneca’s simile, and classical sources, in Santorio’s work respectively). Humanism is a positive asset in medical thinking, too.

Santorio elaborated upon further arguments of Seneca’s, too: thus, plagiarism and criticism of dishonest intellectuals follows (Epistulae morales, XI, 84, 4: “Quibusdam enim placet non faciendi mellis scientiam esse illis sed colligendi”). Foundational values might be present, though inadvertently, in opponents’ literature. Santorio’s use of classical authorities as an agent of intellectual reform becomes clearer when we examine a book published by an opponent to his perspiratio insensibilis theories, Ippolito Obizzi’s Staticomastix sive staticae medicinae demolitio (1614). One cannot help but suspect that insisting on the extent of novelty and revolution in medicine hardly hides Obizzi’s concern and envy. That attitude would likely hinder the advancement of numerical considerations and significance within research practices. Just as preaching to the choir may reinforce tenets that a preacher and the choir share, it is also true that confronting a scientific theory that you do not endorse requires a certain level of mastery of the opponent’s theories. Urged by disagreement with Santorio and a love for truth, Obizzi staged a dialogue between the personifications of Galenic medicine and Static medicine respectively. One first argument of contrast is found in the modest scope of influence of Santorio’s static medicine: Obizzi warned readers, in his Preface, that there is no novelty or revolution in method, nor hope or benefit (“res novae . . . nec spes ulla, nec qualiscumque fructus,” Obizzi 1r). The lack of revolutionary perspectives diminished the impact of applicability and the value of scientific principles on which the new theory and method lay. Even though Obizzi aspired to designing a new concept of medicine, the personification of Galenic medicine was still unparalleled. Galenic medicine’s youngest rival was the unflattering personification of Santorio’s Static medicine – or, should one say, the understanding of it which Obizzi had decided to portray.

One educated reader may suspect that insisting on the extent of novelty and revolution in medicine might be a poor attempt of Obizzi to conceal his concern and envy for Santorio’s academic standing and research (In Santorio’s Preface to Ars de statica medicina, “Cum sic se ferant res humanae, ut res novas invidi opprimere potius quam studio illas promovere conentur, scio multos non solum vulgares, sed etiam ex literatorum censu, non veritatis amore ductos, sed ambition oestro, aut vana contradicendi libidine, aut invidiae stimulo impulsos, contra artem hanc novam insurrecturos eamque graviter detracturos esse”). A reference to a famous letter by Seneca would possibly remind a reader of its cautious conclusion, as well: original work stands to singers, as interpreters are to spectators (Epistulae morales, XI, 84, 10: “De choro dico quem veteres philosophi noverant: in commissionibus nostris plus cantorum est quam in theatris olim spectatorum fuit”). One way to produce original work is by a willingness in reasoning (Epistulae morales, XI, 84, 11: “Adsidua intentione . . . ratione suadente”). Seneca’s letter still has more to disclose: firstly, human bodies respond to natural laws; secondly, it is important to take care of one’s diet and digestion, as life and intellectual skills derive from digestion, 

Quod in corpore nostro videmus sine ulla opera nostra facere naturam (alimenta quae accepimus, quamdiu in sua qualitate perdurant et solida innatant stomacho, onera sunt; at cum ex eo quod erant mutata sunt, tunc demum in vires et in sanguinem transeunt), idem in his quibus aluntur ingenia praestemus, ut quaecumque hausimus non patiamur integra esse, ne aliena sint (Epistulae morales, XI, 84, 5-6).

 
In the new scientific discourse, instruments and measurements lend a rhetoric of things that is unprecedented because, as a matter of fact, the devices were as novel as the value attached to numbers was. Other than the all-present scales, other scientific instruments grounded Santorio’s medical aphorisms: for instance, the pulsilogium foreshadows observations on plague (I, CXXXV: “rarum habentes pulmonem . . . pulsus ictus”) and the hygrometer and thermoscope check air temperature and humidity  (II, IV: “aeris ponderositas”).

Qualitative descriptions were not missing in Santorio’s observations either (III, XXIII; III, XLV-XLVIII). No excess should be allowed, in what sounds like an aspiration to aurea mediocritas (VI, XLIII; VI, XLVIII; VI, XLVI, omne enim nimium naturae inimicum); consequently, if it is not a good idea to have four pounds of food at once, to share it in two or three meals (III, LXXXVIII). Similarly, Celsus recommended moderation (Celsus II, 12 and III, 4). Overall, maintaining weight is important (I, XV) and it helps for longevity (I, CXXIII; III, XLI; III, XC). Another Padua-based scholar, Alvise Cornaro, had promoted the idea of a sober lifestyle some two generations before Santorio did.
By writing Discorsi della vita sobria, Cornaro used his own knowledge deriving from experience. A frugal diet could become routine: bread, yolk, meat, and soup could weigh from twelve to fourteen ounces, and wine could be from fourteen to sixteen ounces per day. Cornaro considered the knowledge of diet to be part of experience (“proprietà occulte . . . io con la lunga osservanza, à pena le ho potute avertire, & ritrovare? Però non può alcuno essere perfetto Medico d’un’altro”).
Hidden qualities in nature, Santorio argued, could be the quantitative representation of weight and changes in weight and perspiratio insensibilis. Celsus had written about unseen properties, too, in his oft-quoted Prooemium (Celsus, Prooemium 14. Crignon 352-53 “Celsus’s Preamble 15 was often quoted by natural philosophers, Bacon and Boyle included.” Crignon 352-53 “the modern reading of ancient empiricism”). Santorio started an innovative medical method and practice along the line of the seventeenth-century Scientific Revolution in Italy; at the same time, classical texts were an authoritative presence in the shaping of early modern medical education. In a cultural translation that resembles a new Humanism of the sciences, doctors aimed at defining corpuscularism on both textual and experimental foundations. Lucretius described nature as made of corpuscles (II, 528a-29: “versibus ostendam corpuscula materiai/ ex infinito summam rerum usque tenere/ undique protelo plagarum continuato”). Their small dimensions do not limit their extension, nor the ability to change our weight (Lucretius IV, 898-900 “nec tamen illud in his rebus mirabile constat,/ tantula quod tantum corpus corpuscula possunt/ contorquere et onus totum convertere nostrum”).



Connections between early modern medical theories and ancient sources play a role that is rhetorically inclined in the new scientific discourse (Rawson wrote about Asclepiades’s rhetorical tendencies (“medicine being listened to by the fashionable development, but it is in no way a surprising to a general audience,” Rawson 364). In a strategic position as a preface can hold, Santorio states clearly the weight, i.e. the importance, of knowledge of perspiratio insensibilis in medical practice (“quantum in medendo ponderis habeat insensibilis perspirationis cognitio”). To put it in other words, instruments and measurements lend a rhetoric of things that is unprecedented because, as a matter of fact, the devices were as new as the value attached to numbers was. Furthermore, it is possible for readers to double-check the value of Santorio’s medical observations, thus validating the rhetorical value of instruments, words, and experiments through understanding, reasoning, eyes, and, so to speak, almost one’s hands (“non solum animo et intellectu… sed oculis etiam… quasi manibus palpent”). Experiments are important to start and validate one’s hypothesis. On the other hand, the process of thinking may work as an experiment, too: either as a first reasoning, or as a revisitation of the experienced fact. Santorio suggests a thought experiment for patients to understand that thirty-five ounces of food is the desirable intake (I, LXIV).

The two elements, matter and numbers for its qualities, combined in binomial terms which had rhetorical, but also epistemological value. On the other side, the connection between corpuscularism and measurement resides in observing human bodies and Galenic humours, in order to attach numerical significance. Numerical significance arises, as a matter of fact, not so much from the numbers per se, but in the rapport, variation and comparison with previous clinical cases, and with the patient’s anamnesis. In sequencing this argument in relation to established research, numerical approaches to medicine had not been common before Santorio. Aside from a quotation from the Biblical book of Ecclesiastes, stating that everything is found in weight and number (omnia in mensura et numero et pondereEcclesiastes 11:21), there was not a consistent background of numbers as signifiers capable of explaining values, combining qualitative and quantitative observations, and consequently interpreting medical signs.

While the reference to numbers may sound trivial with regard to weight (I, LXXIX; I, CXIV), it is through numbers, also, that a new attempt to categorize time is introduced (III, XCIV; IV, XXXIV). Establishing time as reference was an achievement in experimental research; Kepler “still considered the pulse’s record as a reliable timekeeper for astronomical observations” (Bigotti 31). Regarding the best time to take medications (IV, XXXV), both Celsus and Pliny commented that Asclepiades considered medications to be harmful for a stomach (Celsus V, 2; Pliny, XXVI, 17).
To this point, corpuscularism finds a theoretical appeal in Santorio’s analysis, though no verbatim correspondence to the theory is found in his works. Note that corpuscles are entities, as atoms are, and whirl in a godless universe. Thus, refraining from dangerous atheistic perspectives which would cause trouble to some thinkers in the seventeenth and eighteenth century, a path to corpuscularism traces back to the origins of early modern science. Asclepiades’s corpuscular theories derived from Heraclides Ponticus, according to Rawson: thus, Asclepiades “seems to have postulated indivisible particles” (Rawson 358; Fragments from Asclepiades of Bithynia, Gumpert; Cocchi V-VII, XV, XVIII, XXIV-XXV, XXVIII, XXIX-XL, LIV, LXVI, LXVIII, LXX. On Cocchi’s work, see Rawson 361 “The excellent Antonio Cocchi . . . his pure Tuscan was much admired in his own time [Discorso primo sopra Asclepiade, 1762] as a model for scientific writing”). Based on my study, Santorio fits with the paradigm of corpuscularism in quantifying units of weight and variations between contrasting qualities in them, increase, and decrease in weight. Hieronymus Mercurialis gave an interpretation of corpuscles in medicine originated by Asclepiades and mediated via Celsus:

Asclepiadem, qui Democritum secutus morbos ex atomorum in vacuos meatus ingressus, obstrusioneve gigni docuit, huiusmodi ingressum, infixionemve enstasin verosimile est vocasse: quod primo colligitur ex Celso, qui in prohemio librorum suorum tradit Asclepiadem contendisse fieri aegritudines vbi manantia corpuscula per invisibilia foramina subsistendo iter caludu(nt). Deinde ex Caelio Aureliano, qui in prohem. Lib. De acutis pass. ait Asclepiadem diffinise phrenitim esse corpuscolorum statione(m), siue obstructionem in cerebri me(m)branis (Var. lect., IV, cap. XII, p. 114).

 
Medical corpuscles act as atoms in Epicurus’s and Lucretius’s theories, without taking on the dangerous atheistic perspective which caused trouble to some thinkers in the seventeenth and eighteenth century (See Crignon 341: “Humorism and the Galenic conception of the body were still going strong, even if these traditional explanations of the origin of natural things was challenged by the rise of chemical medicine (with the work of Paracelsus and Van Helmont) and, at the same time, by the emergence of mechanism and corpuscularism. Medicine was as a battlefield during this period in which the contenders appealed to various definitions of experience”). As a consequence of the use of classical texts alongside quantification, the foundations of corpuscularism were built on a new method, combining a humanistic rediscovery of ancient sources with an intent to measure properties in clinical practice. Santorio’s medical method lines up with the Scientific Revolution precisely because he reinterpreted canonical texts by infusing them with scientific criteria of precision, reproducibility of experiments, and appreciation of trials, hypotheses, and observational records. Textual connections allow intellectual communication between early modern medical theories and their ancient sources both in the rhetoric of persuasion and the modes of scientific thinking.

As a step forward in this research project, I would like to: 1) find a tool to visualize medical data that is found diffusely in the medical aphorisms by Santorio, and 2) bring a project like Six Degrees of Francis Bacon (http://www.sixdegreesoffrancisbacon.com/?ids=10000473&min_confidence=60&type=network) into Italian Studies, by working on scholarly correspondances in the 1600s.

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