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A Moment in History 

Title page of Anathomia Corporis Humanis by Mondino de Luzzi. Image courtesy of the National Library of Medicine
Title page of "Anathomia Corporis Humanis" by Mondino de Luzzi

Alessandra Giliani

(1307 – 1326

Italian prosector and anatomist. Alessandra Giliani is the first woman to be on record as being an anatomist and prossector. She was born on 1307 in the town of Persiceto in northern Italy.

She was admitted to the University of Bologna circa 1323. Most probably she studied philosophy and the foundations of anatomy and medicine. She studied under Mondino de Luzzi (c.1270 – 1326), one of the most famous teachers at Bologna.

Giliani was the prosector for the dissections performed at the Bolognese “studium” in the Bologna School of Anatomy. She developed a technique (now lost to history) to highlight the vascular tree in a cadaver using fluid dyes which would harden without destroying them. Giliani would later paint these structures using a small brush. This technique allowed the students to see even small veins.

Giliani died at the age of 19 on March 26, 1326, the same year that her teacher Mondino de Luzzi died.  It is said that she was buried in front of the Madonna delle Lettere in the church of San Pietro e Marcellino at the Hospital of Santa Maria del Mareto in Florence by Otto Agenius Lustrulanus, another assistant to Modino de Luzzi.

Some ascribe to Agenius a love interest in Giliani because of the wording of the plaque that is translated as follows:

"In this urn enclosed are the ashes of the body of 
Alessandra Giliani, a maiden of Persiceto. 
Skillful with her brush in anatomical demonstrations 
And a disciple equaled by few, 
Of the most noted physician, Mondino de Luzzi, 
She awaits the resurrection. 
She lived 19 years: She died consumed by her labors 
March 26, in the year of grace 1326. 
Otto Agenius Lustrulanus, by her taking away 
Deprived of his better part, inconsolable for his companion, 
Choice and deservinging of the best from himself, 
Has erected this plaque"

Sir William Osler says of Alessandra Giliani “She died, consumed by her labors, at the early age of nineteen, and her monument is still to be seen”

The teaching of anatomy in the times of Mondino de Luzzi and Alessandra Giliani required the professor to be seated on a high chair or “cathedra” from whence he would read an anatomy book by Galen or another respected author while a prosector or “ostensor” would demonstrate the structures to the student. The professor would not consider coming down from the cathedra to discuss the anatomy shown. This was changed by Andreas Vesalius.

The image in this article is a close up of the title page of Mondino’s “Anothomia Corporis Humani” written in 1316, but published in 1478. Click on the image for a complete depiction of this title page. I would like to think that the individual doing the dissection looking up to the cathedra and Mondino de Luzzi is Alessandra Giliani… we will never know.

The life and death of Alessandra Giliani has been novelized in the fiction book “A Golden Web” by Barbara Quick.

1. “Books of the Body: Anatomical Ritual and Renaissance Learning” Carlino, A. U Chicago Press, 1999 
2. “Encyclopedia of World Scientists” Oakes, EH. Infobase Publishing, 2002 
3. “The Biographical Dictionary of Women in Science”Harvey, J; Ogilvie, M. Vol1. Routledge 2000 
4. “The Evolution of Modern Medicine” Osler, W. Yale U Press 1921 
5. “The Mondino Myth” Pilcher, LS. 1906 
Original image courtesy of NLM

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The Balmis expedition

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

The Balmis Expedition (1803 -1806)  The “Royal Philanthropic Vaccine Expedition”, otherwise known as the "Balmis expedition" is a little known chapter in the history of the eradication of smallpox from this world.

One of the unintended consequences of the Spanish invasion of the New World and the work of the “Conquistadores” was the introduction of smallpox to a virgin population. Other viruses were also introduced, so that between smallpox, measles, rubella, etc. it is said that in 1520 almost 50% of the population of Mexico died because of a biological infection.

Edward Jenner (1749 – 1823) discovered in 1796 that someone infected with cowpox would be protected against smallpox. The vaccine and the expansion of its use brought some relief to Europe, but the damage caused by smallpox in the Spanish colonies was catastrophic. Smallpox in its more virulent variety carried at the time a mortality rate close to 30%, leaving those who survived the virus with skin pockmarks or blinded for life. It is estimated that towards the end of the 18th century, 400,000 people died in Europe because of smallpox, and one third of the survivors were left blind.

 Don Francisco Javier de Balmis y Berenguer

A solution was needed, so in 1803 the Spanish king Carlos IV commissioned Don Francisco Javier de Balmis i Berenguer (1753 – 1819), a Spanish phyisician, to find a solution to the smallpox problem. While planning what was later to be known as the “Royal Philanthropic Vaccine Expedition” Balmis received critical contributions from Don Antonio de Gimbernat y Arb?s (of Gimbernat’s ligament).

The main problem to this expedition was that there was no refrigeration, and the vaccine production and storage as we know it today had not been invented. The procedure was simple: Inoculate the live virus of cowpox from someone who was infected with cowpox. The solution was brilliant. A group of 10 physicians and 25 orphaned children were recruited along with nurses, and having at least one infected child on board each ship, the expedition sailed on November 30, 1803. During the long voyage, child after child were sequentially infected with the smallpox virus so that four months later, on March 19, 1804, the expedition landed in Venezuela with a child with the virus.

From here, the same method was used to distribute the vaccine North and South, to cover all of the Spanish territories until 1810. The original expedition is known as the “Balmis expedition”, and Balmis returned to Spain in 1806. Other expeditions were named after other leaders (Salvany, Justiniano, Grajales y Bola?os, etc.) but all carried the original strain brought to the Americas by Balmis. Although the original 25 children were granted the title of “special children of the Spanish nation”, no one knows how many children were used in the end, or what was their eventual fate transplanted away from their homes.

The image in this article, courtesy of Wikipedia, is a bust found at the Medical College of the Miguel Hernandez University in San Juan de Alicante, Spain

1. “La viruela, aliado oculto en la conquista espa?ola” Sanchez-Silva, DJ. INFORMED 2007; 9 (12) 581-587
2. “La expedici?n de Balmis” Laval ER Rev Chil Infect 2003; 107-108
3. “Antonio de Gimbernat, 1734-1816” Matheson NM. Proc R Soc Med 1949; 42: 407-10.
4. “La vuelta al mundo de la expedici?n de la vacuna (1803-1810)” Diaz de Yraola, G. (2003)
5. “La segunda expedicion de Balmis” Tuells, J.; Duro-Torrijos, JL G Med Mex 2013 (149) 377-84

Original image courtesy of Wikipedia