Antonio Maria Valsalva

Antonio Maria Valsalva was born in Imola to a distinguished and well-to-do family. He was the third of eight children born to the goldsmith Pompeo Pini, who adopted the name Valsalva from the location of the family home, and Catarina Tosi. He was educated by the Jesuits in the humanities, mathematics, and natural sciences, the latter arousing his interest in animal morphology and entomology. He subsequently moved to Bologna, where he studied philosophy with Lelio Trionfetti (Giovanni Battista Trionfetti, 1656-1708???), mathematics with Pietro Mengoli (1625-1686), and geometry with Rodelli. Valsalva may be considered a Galilean through Giovanni Alfonso Borelli (1608-1679) and thence through Malpighi (1628-1694), founder of microscopic anatomy and Valsalva’s teacher at Bologna University. Malpighi deeply respected Valsalva, who was his favourite pupil and who greatly admired Malpighi.

On June 10, 1687, Valsalva became a doctor of medicine and philosophy, defending the dissertation Sulla superiorità delle dottrine sperimentali. Immediately afterwards, Valsalva was appointed Inspector of Public Health in Bologna, on the occasion of an epidemic. About twelve years later, when there was an epidemic among cattle, the senate of Bologna set him in charge of containing it.

His name was now entered on the roll of Bolognese doctors and, with Santi Giorgio, Domenico Guglielmini (1655-1710), Ippolito Francesco Albertini (1662-1746), and Giacomo Beccari (1682-1766), he attended scientific meetings at Eustachio Manfredi’s (1674-1739) house that led to the founding of the Academia degli Inquiti.

Valsalva was devoted to teaching and scientific research, as well as to the practice of medicine. He spent much time in the anatomical amphitheatre, the unhealthy air of which affected his health. Seized by such a furur studendi that he even made an organoleptic evaluation of exudates, Valsalva observed that the serum produced by gangrene was so acrid that, after tasting it, its extreme sourness irritated the papillae of his tongue for an entire day.

Because of his achievements, in 1694 he was elected professor for dissecting and demonstrating anatomy, while also receiving a position in the Ospedale degli Incurabili, where he practised for twenty-five years. He remained in Bologna until his death. In 1704 he published his magnum opus, De aure humana tractatus, which he dedicated to the Senate. In 1705, despite the fact that he was not a native born Bolognese, the senate appointed Valsalva lecturer and demonstrator in anatomy at the University, a post he held for the rest of his life.

Valsalva’s scientific integrity was noteworthy. When he was elected, with Vittorio Francesco Stancari (1678-1709) (kan være feil, Vittorio var fysiker og matematiker. Broren, Gian Antonio Stancari var lege, 1670-1748) by the Bologna Academy as censor of the first volume of Morgagni’s Adversaria anatomica (Bologna, 1706), he asked for time in order to be able to give a considered and precise opinion. When the objection was raised that this would delay publication of the book, Valsalva replied, “That’s how I am . . . I love Morgagni, but I love the truth more.”

His most famous work, De aure humana tractatus appeared in 1704 in Bologna, with subsequent editions in Dutch and Italian university cities. This remarkable book, which became a standard on the subject for over a century, contains his anatomical, physiological, and pathological observations of the organ. In it he described and depicted even the smallest muscles and nerves of the ear, subdividing the ear into its internal, middle, and external parts, and he showed an original method of inflating the middle ear (Valsalva's manoeuvre) which is still practiced today. He also described the tympanic antrum. An interesting aspect of this work, seen from whonamedit.com, is that Valsalva coined the term Eustachian tube, one of the earliest eponyms known.

Valsalva noted that motor paralysis is on the opposite side to the cerebral lesion both in stroke and in cases of cranial injury.

On April 22, 1709, at the age of forty three, Valsalva married Elena Lisi, the seventeen-year old daughter of a noble Bolognese senatorial family; they had six children, three of whom died young. In 1721, during a consultation with Morgagni in Venice, he suffered a temporary dyslalia, a symptom of the fatal apoplexy that struck him two years later.

Valsalva was an extremely skilled anatomist and pathologist, a fine physician, and an excellent surgeon for a quarter-century in the Bolognese hospitals. As a surgeon he anticipated the importance of nephrectomy, and did work in ophthalmology, rhinology, and vasal and tumor surgery. He is particularly remembered for his handling of aneurysms. He also invented surgical instruments that were of great use.

Valsalva has a place in the history of psychiatry for having been among the first to call for, and in part to implement, humanitarian treatment of the insane, preceding Vincenzo Chiarugi (1759-1820) and Philippe Pinel (1745-1826). He considered madness to be analogous to organic disease.

Valsalva indirectly made important contributions to Morgagni’s great work De sedibus et causis morborum, as this work contains a large number of his casuistic contributions.

• Sulla superiorità delle dottrine sperimentali.
  Doctoral dissertation; Bologna, June 10, 1687.
• De aure humana tractatus : in quo integra ejusdem auris fabrica, multis novis inventis, & iconismis illustrata, describitur; omniumque ejus partium usus indagantur : quibus interposita est musculorum uvulae, atque pharyngis nova descriptio, et delineatio / auctore Antonio Maria Valsalva Imolensi.
  Bononiae, typis Constantini Pisari, ad S. Michaelem, 1704. Utrecht 1717.
  Leiden: Apud Gisbertum Langerak & Johannes Hasebroek, 1735.
  Geneva (Ginevra), 1737; Venice.
  1740 (published by Morgagni with a biography of Valsalva); Leiden, 1742. Bologna, 1794.
  The preparation of the drawings was probably influenced by Eustachi’s plates, which Valsalva greatly admired. Second edition:
  
• De aure humana tractatus : in quo integra auris fabrica, multis novis inventis & iconismis illustrata, describitur; omniumque ejus partium usus indagantur : quibus interposita est musculorum uvulae, atque pharyngis nova descriptio, et delineatio / auctore Antonio Maria Valsalva Imolensi.
  Trajecti ad Rhenum [Utrecht] : ex officina Guilielmi vande Water, 1707.
• Opera. 3 volumes in 1. Venetiis, apud Franciscum Pitteri, 1740.
• G. B. Morgagni:
  De vita et scriptis Antonii Mariae Valsalvae commentariolum. Venice, 1740.
  Valsalva was deeply interested in pathology throughout his life, and Morgagni's great work, De sedibus, contains much material collected by Valsalva. In this work his beloved pupil, Morgagni, assembled and published posthumously his teachers anatomical works. Biographical etc.
  
• Terzo centenario della nascita di Antonio Maria Valsalva.
  Imola, 1966. A collection of Valsalva’s work.
• G. Bilancioni:
  La figura e l’opera di Valsalva. In his Sulle rive de Lete. Rome, 1930: 77-100.
• P. Capparoni:
  Antonio Maria Valsalva. Profili bio-bibliografici di medici e naturalissti celebri italiani dal secolo XV al secolo XVIII. Rome, 1932: 92-94.
• P. Ravanelli:
  M. Valsalva (1666-1723) anatomico-medico-chirurgo-primo psichiatra. Imola, 1966.
• B. Bugyi:
  Antonio Maria Valsalva, der vergessene Begründer der klinischen Pathologie.
  Grünenthal Waage, 1968, 7: 103-108
• L. di Florio:
  I presupposti del metodo morgagnano (clinico-anatomopatologico) in Valsalva.
  Medicina nei Secoli, Roma, 1966, 3, H.3: 17-20.