Bartolomeo Eustachi

Born 1510
Died 1574

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Italian anatomist, born ca. 1500-1513, San Severino, Ancona; died August 27, 1574, in Umbria, on the Via Flamina en route to Fossombrone.

Biography of Bartolomeo Eustachi

Relatively little is known about the life of this great anatomist Bartolomeo Eustachi. He was born in San Severino, most probably in the district of Ancona, but some authors maintain that it may have been San Severino in Calabria. His year of birth has been given as 1500, 1510, 1513 (most probable), 1520, and even 1524 (improbable).

Bartolomeo was the son of Mariano Eustachi, a celebrated physician said to be of noble family, and Francesca (Benvenuti) Eustachi. Mariano insisted upon a well-rounded humanistic education, in the course of which Eustachi acquired such an excellent knowledge of Greek, Hebrew, and Arabic that he was able to edit an edition of the Hippocratic glossary of Erotian (1566) and is said to have made his own translations of Avicenna (Ibn Sïnã) from the Arabic. He appears to have studied medicine at the Archiginnsio della Sapenza (Philosophical Institute) in Rome, but it is not known precisely when. He began to practice medicine in his native land about 1540.

Eustachi's talents were soon noticed by the duke of Urbino, who requested Eustachi his personal physician. Then in 1547, Eustachi accepted the invitation to serve as physician to the duke’s brother, Cardinal Giulio della Rovere, whom Eustachi followed to Rome in 1549.

There he became protomedico and was invited to join the medical faculty of the Collegia della Sapienza as the equivalent of professor of anatomy. This academic position granted him permission to obtain cadavers for dissection from the hospitals of Santo Spirito and Consolazione.

With advancing years Eustachi was so severely afflicted by gout that he was compelled to resign his post at the Sapienza. He continued, however, to serve Cardinal della Rovere, and it was in response to the cardinal’s summons to Fossombrone in 1574 that he set forth, only to die on the way. Judging from what he writes in his own works, he must have lived under rather humble circumstances.

Eustachi was also physician to S. Carlo Borromeo and S. Filippo Neri.

In his investigations Eustachi sought not only a corroboration of Galen’s teaching. Otherwise, however, his researches had a more unbiased scientific purpose and, unlike Jakobus Sylvius, he did not attempt to fight all innovative thinking - something Sylvius did with even the most ridiculous means. In high age, in his paper Libell de multitudine (Leiden, 1746) he admits having overlooked many of Galen’s mistakes.

On his (assumed) 400th birthday in 1913 a memorial was erected in his honour at the Sapienza in Rome.

Only a few lesser works were published in his lifetime.

Works by Bartolomeo Eustachi
Eustachi’s first works were Ossium examen and De motu capitis, both written in 1561.

In 1562 and 1563 Eustachi produced a remarkable series of treatises on the kidney, the auditory organ, the venous system, and the teeth. These were published, together with the two earlier defences of Galen, in Opuscula anatomica (1564).

The treatise on the kidney was the first work specifically dedicated to that organ - it displays a detailed knowledge of the kidney which shows that he possessed knowledge of the organ that surpasses that of his predecessors, and contains the first account of the adrenal gland (suprarenal gland) and a correct determination of the relative levels of the kidneys. It was also in this treatise that Eustachi for the first time emphasized the problem of anatomical variation, which had been previously touched upon briefly by Andreas Vesalius (1514-1564).

In Opuscula anatomica, Eustachi, basing his work on the dissection of foetuses and newborn children, was also the first to make a study of the teeth in considerable detail. His treatise contains an early description of the first and second dentitions as well as the tooth's basic composition of enamel and dentin, in some respects preceded by the account of Falloppio. He further attempted an explanation of the problem, not yet completely solved, of the sensitivity of the tooth’s hard structure.

The second treatise on the auditory organ provides a correct account of the tube (tuba auditiva) that is still referred to eponymously by Eustachi’s name, and contains a description of the tensor tympani and stapedius muscles. Eustachi’s claim to discovery of the stapes is inadmissible, however, since it had been mentioned orally by the Italian physician and anatomist Giovanni Filippo Ingrassia (1510-1580) in 1546 and in print by the Spanish physcian and anatomist Pedro Jimeno (Gimeno) in 1549, Louis Collado (Ludovigo Collado) in 1555 and the Italian anatomist Gabriello Falloppio (1523-1562) in 1561. Since Ingrassia's description did not appear in print until 1603, priority must be given Jimeno.

Although Eustachi is rightfully credited the first accurate description of the tuba auditiva, the first description of the structure is attributed to Almaceon of Sparta in 400 BC. It was his belief that the eustachian tube allowed goats to breath through their ears as well as their noses.

A theory exists that the Eustachius discovery of the connection between the middle ear and the pharynx later inspired Shakespeare to write his play Hamlet – whose father was killed by poison poured into his ear. Another explanation for the possibility of a murder via auris, which was known to occur in 16th century Italy, is based on the knowledge of that time about the possibilities of direct absorption of some substances from the ear.

In his work on the azygos vein and its ramifications Eustachi described the thoracic duct and the Eustachian valve - the valvula venae cava inferioris in the right ventricle of the heart, indicating a careful and relatively advanced knowledge of the heart’s structure.

Eustachi is considered the first comparative anatomist, as he was the first to refer to conditions in the animal realm for comparison and elucidation, and his treatises contain a developmental history of the kidneys and the teeth. Several of the discoveries ascribed to Lorenzo Bellini (1643-1704) were made by Eustachi.

Riders of the lost masterpiece
In 1552 Eustachi, with the help of Pier Matteo Pini, a relative and an artist from Urbino, prepared a series of forty-seven anatomical illustrations for a medical treatise; these were engraved, two on the obverse and reverse of a single copper plate, by Giulio de’ Musi of Rome. The illustrations were prepared for a book entitled De dissensionibus ac controversiis anatomicis but were never published. The first eight large octavo plates, labelled Tabula Prima-Octava, were used in the Opuscula anatomica.

Since Eustachi mentioned forty-seven plates in the Opuscula anatomica but actually made use of only eight of them in that work, the remaining 39 seem to have been lost after his death and were sought for long and unsuccessfully - by Marcello Malpighi, among others. Ultimately the missing thirty-nine engravings were discovered in the early eighteenth century - after 162 years - in the possession of a descendant of Pier Matteo Pini, to whom Eustachi had, as it was learned, bequeathed them They were purchased by Pope Clement XI for 600 scudi and presented to Giovanni Maria Lancisi, his physician and a successor to Eustachi in the chair of anatomy at the Sapienza.

Lancisi, on the advice of Morgagni, published the plates, together with the eight smaller ones that had already appeared in 1564, under the title Tabulae anatomicae Bartholomaei Eustachi quas a tenebris tandem vindicatas (Anatomical Illustrations of Bartholomeo Eustachi Rescued from Obscurity) in 1714. Although devoid of Eustachi’s planned text, the plates alone assure him a distinguished position in the history of anatomy.

The series of plates contains depictions of muscles, bones, the abdominal structure, the thorax and the vascular system. Particularly notable is Tabula XVIII, displaying the base of the brain and the sympathetic nervous system. Sometimes, as in the instance of the «musclemen», they display both sides of the body in juxtaposition, with a numbered rule on three sides of the figures to which numbered references are made in the text for identification of detail. Despite such finesse, oddly enough, the plates are arranged in a way that suggests the pattern of dissection that had been followed from medieval times up to that of Vesalius, that is, beginning with the most corruptible parts and continuing thence to the least corruptible. Thus the Eustachian plates begin with the abdominal structures, then those of the thorax, followed by the nervous system, vascular system, muscles, and finally the bones.

Although from an artistic point of view they are not as well done as the anatomical plates of Vesalius, from the point of view of anatomy they are sometimes more accurate than Vesalius'. Had the plates been published at the time they were executed, Eustachi would undoubtedly have ranked with Vesalius as founder of modern anatomy, and anatomical studies would have reached maturity in the seventeenth rather than in the eighteenth century.

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