Santorio Santorio
Prominent Istrians


antorio Santorio (as known as Santorio Santorii, Sanctorius of Padua, and various combinations of these names), was born on March 26, 1561 in Justinopolis, Istria (later Capodistria, now Koper, Slovenia).

His father, Antonio Santorio, was a nobleman from Friuli and a high official of the Venetian Republic who was sent to Justinopolis as Bombardier and Chief Steward of Munitions. His mother, Elisabetta Cordona, was the heiress of a  local noble family.

medical scientist

born in
Justinopolis
1561

Santorio was educated in Justinopolis and then Venice. He shared the same tutors as the patrician Morosini's sons and received a thorough knowledge of classical languages and literature.

In 1575, Santorio entered the University of Padua where he studied philosophy and medicine. He received his medical  degree in 1582 at the age of 21. Two of his biographers, Caparroni and Castiglioni say that immediately after completing his medical degree Santorio went to Poland as the personal physician to the King and the upper aristocracy. It is now generally agreed that this could not be correct, and that rather he was in Croatia (where?) between 1587 and 1599 as the personal physician of a leading local nobleman, probably Count Zrinski.

© Istituto e Museo di Storia della Scienza

In 1599 he set up a medical practice in Venice where he spent the rest of his life. He quickly became part of the circle of learned men (the circle) that met in Andrea (?) Morosini's home, a meeting place for the proponents of the new science. He became friends with Galileo (1564-1642), fra Paolo Sarpi (1552-1623), Girolamo Fabrici, Giambattista Della Porta (1535-1615), and Giovanfrancesco Sagredo (1571-1620), among others. In 1607, together with Fabrizio (or Fabrici?), he treated and cured Sarpi after an attempted assasination.

His adaptation of the pendulum to medical practice was probably inspired by discussions with Galileo on the latter's experiments with pendulums in 1602. Santorio described the medical use of the pendulum in a book, Methodi vitandorum errorum [...] in arte medica [Methods to avoid errors in medical practice], published in late 1602 or early 1603. He was a pioneer in the use of physical measurements in medicine; his most famous apparatus was a large balance to study metabolic transformations.

His own great achievement was the introduction of quantitative experimentation into biological science. In his Methodus vitandorum errorum [...] in arte medica [Methods to avoid errors in medical practice] which he published in late 1602 or early 1603. In his comprehensive study on the method of healing which he dedicated to Ferdinand of Austria, he mentioned a few measuring  instruments, including the medical use of the pendulum, a large balance to study metabolic transformations - his most famous apparatus.

Among those who volunteered for Santorio's experiments was Galileo who in 1593 had invented a "pulsilogium" (pulsiometer), a rudimentary water thermometer which, for the first time, allowed for the measuring of temperature variations. It was a device that consisted of a long glass tube inverted in a sealed jar that containing both air and water. When the jar was heated, the air expanded and pushed the liquid up the tube. The water level in the tube could be compared at different temperatures to show relative changes as heat was added or removed. The predecessor to the thermometer, the thermoscope is a thermometer without a scale, indicates differences in temperature only ie it can show if the temperature is higher, lower or the same, but unlike a thermometer it cannot measure the difference nor can the result be recorded for future reference. The thermoscope was widely used by a group of scientists in Venice that included and was attributed to Galileo. It was only a small step from the thermoscope to the thermometer.

Santorio's passion for describing phenomena in terms of numbers led him to invent  his own "pulsilogium" (a pulse clock), and then also the thermoscope to which he was the first to add a scale, thereby transforming it into a thermometer. Both of these instruments are also mentioned by Galileo, and, especially in the case of the thermoscope, so there has been controversy as to who was the actual inventor of both the "pulsilogium" and the thermoscope. Both may best be described as products of the circle. However, it was Santorio who first used the thermometer for medical purposes. He applied a numerical scale to his thermoscope which had previously only been used to measure air temperature, to measuring human body temperature, thereby adapting it into the first thermometer - in his Commentaria in artem medicinalem Galeni (1612) which he dedicated to Andrea Morosini, he makes the first printed mention of an air thermometer.  He is thus given credit as being the inventor of the thermometer. "The patient grasps the bulb" of the thermometer, he wrote, "or breathes upon it into a hood, or takes the bulb into his mouth, so that we can tell if the patient be better or worse."  Unfortunately, the accuracy of Santorio's air thermometer was poor since the effects of varying air pressure on the thermometer were not understood at that time. It was not until precisely one hundred years after Santorio's documentation of his precurser thermoscope, however, that Daniel Gabriel Fahrenheit (1686-1736) - a German physicist who had invented the alcohol thermometer in 1709 - then invented the modern (mercury) thermometer in 1714.

Santorio's use of the thermometer and other devices for measuring and quantifying the body's workings helped to take much of the mysticism out of medicine, but he did not stop there. He also invented a pendulum for measuring the pulse rate, a special syringe for extracting bladder stones, a bathing bed. Beyond medicine he invented a hygrometer to measure humidity, a wind gauge and a device to measure the force of water currents. Ever inventive, Santorio studied digestion by constructing a wooden frame that supported a chair, bed, and work table - his most famous experiment.

The study of bodily weight

In 1614, Santori published De statica medicina et de responsione ad staticomasticem. Aphorismorum sectionibus septem comprehensa, [Concerning Static Medicine], the first systematic study of basal metabolism and the work that 'introduced quantitative experimentation into biological science'.

"In a letter to Galileo he (Santorio) explained that his work De medicina was based on two principles: first, Hippocrates' view that medicine is essentially the addition of what is lacking and the removal of what is superfluous; and second, experimentation. The origin of "static medicine" was, in fact, the Hippocratic conception that health consists in the harmony of the humors. One expression of this harmony is the equilibrium between the substances consumed by the organism and those rejected by it. According to this view, pathological conditions should be accompanied by a quantitave disequilibrium of the exchanges between the living body and its surroundings. To verify this suppodition, Santorio turned to quantitative experimentation.

With the aid of a chair scale, he systematically observed the daily variations in the weight of his body and showed that a large part of excretion takes place in the skin and lungs (perspiratio insensibilis). Moreover, he sought to determine the magnitude of this invisible excretion; its relationship to visible excretion; and its dependence on various factors, including the state of the atmosphere, diet, sleep, exercise, sexual activity, and age. Thus he invented instruments to measure ambient humidity and temperature. From this research he concluded that perspiration insensibilis, which had been known since Erasistratus but which was considered imponderable, could be determined by systematic weighing; that it is, in itself, greater than all forms of sensible bodily excretions combined; and that it is not constant but varies considerably as a function of several internal and external factors, for example, cold and sleep lessen it and fever increases it" (Dictionary of Scientific Biography).

The 4th Edition in Italian translation.

The 5th Edition in English translantion.

In this book, Santori briefly describes the results of a his most famous experiment, actually a long series of experiments, that he conducted on himself with a scale and other measuring instruments. This research into metabolism was then known as perspiratio insensibilis or 'insensible perspiration', a term that Santorio invented to account for differences in body weight. He believed that weight was gained or lost through the pores or during respiration, and through a long series of experiments and careful record-keeping he established that a large part of excretion occurs invisibly through the skin.

He devised an elaborate weighing chair - a platform suspended from the ceiling with an enormous (steelyard) balance - and with this recorded changes in his weight. The device is operated in a negative feedback mode, employs the concept of transduction, and measures pulse through another dimension--length. More than 100 years after its invention, the pulsilogium found useful application by de la Croix in measurements of cardiac function during "electrification."

"For thirty years, Santorio slept, ate, worked, and made love in the weighing contraption to record how much his weight changed as he ate, fasted, or excreted." [© Frank I. Katch, William D. McArdle, Victor L. Katch. 1997.] Often depriving himself of food and drink, Santorio determined that the daily change in body mass approached 1.25 kg.

From this research Santorio concluded that perspiration insensibilis, which had been known since Erasistratus but which was considered imponderable, could be determined by systematic weighing; that it is, in itself, greater than all forms of sensible bodily excretions combined; and that it is not constant but varies considerably as a function of several internal and external factors, for example, cold and sleep lessen it and fever increases it" (Dictionary of Scientific Biography).

This little book of aphorisms drew worldwide attention, made Santorio Santorio famous throughout Europe, and is today considered a medical classic. There is only one copy of the first edition listed in NUC (Yale) and only one of the second edition (NLM). A third copy was published in Venice by Marc'antonio Brogiollo in 1634. In 1728, the fourth edition, in full leather binding, was translated to English and published in London by J. Osborn and T. Longman and J. Newton with the title Medicina Statica: Being the Aphorisms of Sanctorius. The translantion included large explanations to which was added Dr. Keil's Medicina Statica Britannica, with Comparative Remarks and Explanations. A fifth edition was published in 1737.

Academic and medical career

In 1611 Santori was appointed to the chair of theoretical medicine at the University of Padua with an initial salary of 800 ducats, later raised to 1500 (though this information may be in error, as Padua stated salaries in florins, not ducats). Originally he was supposed to have held the chair for six years; but at the end of that period, in 1617, the Venetian Senate extended his contract for six more years and granted him an exceptionally high salary. He continued to teach there until his retirement in 1624.

While teaching in Padua, Santorio carried on a busy practice with the Venetian aristocracy. When he retired, the Senate awarded him both the continuation of his salary and the permanent title of professor which he held until his death. Santorio spent the remainder of his life in Venice devoting himself wholly to the practice of medicine and there amassed a large fortune. In 1630 the Venetian government put him in charge of dealing with the plague.

Although in treating his patients Santorio did not stray far from Hippocratic and Galenic practice (based on the notion of a balance of the fluids, or "humors"), in his theory and method of investigation he differed a great deal from the classical authors. Rather than relying on authority in the first instance, as so many of his colleagues still did, Santorio argued that one should first rely on sense experience, then on reasoning, and only lastly on authority.

Rather than describing the body and its functions in terms of Aristotelian (and Galenic) elements and qualities, Santorio argued throughout his career that the fundamental properties were mathematical ones, such as number, position, and form. The body was like a clock, the workings of which were determined by the shapes and positions of its interlocking parts. Although he did not explain the role of nutrition in weight gain or loss, Santorio nevertheless inspired later researchers in metabolism. 'Through most of the 17th and 18th centuries Santorio's name was linked with that of physiologist William Harvey (1578-1657) as the greatest figure in physiology and experimental medicine because of his introduction of precision instruments for quantitative studies. He was also the founder of modern metabolic research' (Garrison and Morton n. 572.1).

Santorio Santorio died in Venice on February 22 (or March 6?), 1636.

Further readings:

  1. Antorio Santorio. by Ralph Hermon Major, New York, Hoeber, 1938.
  2. Santorio Santorio; o, Della dermatologia funzionale. by E Leban, [Firenze] Santoriana, 1952.
  3. Santorio Santorio. La vita ele opere. by Lieta Stella Ettari; Procopio Mario. Publisher: Roma, Istituto nazionale della nutrizione; Cittą universitaria, 1968.
  4. Santorio Santorio i njegovi aparati i instrumenti. by Mirko Drazen Grmek, Zagreb [Jugoslavenska akademija znanosti i umjetnosti, 1952]
  5. La vita e l'opera di Santorio Santorio Capodistriano, MDLXI-MDCXXXVI. by Arturo Castiglioni. Bologna, Cappelli, 1920.
  6. La vita e l'opera di Santorio Santorio, Capodistriano, 1561-1636. by Arturo Castiglioni, Bologna : L. Cappelli, 1920.
  7. [Santorio Santorio, biographical materials] by Santorio Santorio [19--]-
  8. Santorio Santorio (1561-1636). by Albert Van Helden, Albert Van Helden.
  9. Ricerche storiche intorno a Santorio Santorio, ed alla medicina statica ... by Modestino del Gaizo, Napoli, A. Tocco, 1889.
  10. Life and work of Sanctorius. by Arturo Castiglioni, [New York] Medical Life Press [1931] [Collection of printed and manuscript copies of materials relating to Sanctorius Sanctorius; with English translations and notes. by S Weir Mitchell; 
  11. Santorio Santorio; Arcadio Capello; Modestino Del Gaizo; Joannes Hieronymus Zanetti; Mario Girardi; John S Billings; Girolamo Gravisi, Marchese de, Philadelphia? before 1892?]
  12. De vita cl. viri Sanctorii Sanctorii olim in Patavino Gymnasio medicinam theoricam primo loco prositentis sermo : habitus Venetiis in Almo Physicorum Collegio XV. Kal. Novemb. anno sal. MDCCXLIX pro annua studiorum instauratione by Arcadio Capello; Santorio Santorio, Venetiis : Apud Jacobum Thomasinum, 1750.
  13. De impedimento perspirationis insensibilis ex immodico alimentorum usu secundum aphorismos Sanctorii ... by Knud Lund; Jakob Jersin Mathiesen, [Hafniae], Augusti Friderici Steinii [1774]
  14. De laudibus Sanctorii Sanctorii : oratio habita in collegio medicorum ven. IV. Kal by Joannes Hieronymus Fanetti; S Weir Mitchell; John S Billings [Thesis/dissertation/manuscript.
  15. Positiones medicae de insensibili perspiratione Sanctoriana et structura cutis ... by Claude Passavant, Basileae, Joh. Henrici Deckeri, [1733]
  16. De laudibus Sanctorii oratio ... by Jacopo Grandi, [Venetiis] Apud Joannem Franciscum Valvasensem [1671?]
  17. De laudibus Sanctorii oratio ... by Jacobo Grandi, [Venetiis] Apud Joannem Franciscum Valvasensem [1671?]
  18. A rational account of the causes of chronic diseases ... by John Morland, London, S. Hooper [1780?].
  19. [Santorio Santorio seated in weighing chair in front of table, part of his quantitative approach to medicine, and title page of De statica medicina aphorismorum], [published 1703].
  20. La medicina statica ... Divisa in sette sezioni: co' comentarii di Martin Lister ... e i Canoni della medicina de' solidi di Giorgio Baglivi ... Aggiuntivi gli Aforismi d'Ippocrate e i suoi Prasagi nelle due lingue Latina ed Italiana ... Idea, e fatica dell'Abbate Chiari da Pisa. by Santorio Santorio; Giorgio Baglivi; Francesco Raniero Chiari; Luigi Cornaro; Martin Lister; Hippocrates. Publisher: Venezia, Appresso l'erede di Domenico Occhi, 1784.
  21. Memoir of Santorio by Girolamo De Gravisi, Marchese [Thesis/dissertation/manuscript].
  22. Alle de medicinale, chirurgicale en philosophische werken Eerste deel. Bestaande in de nieuwe beginzelen tot de genees- en heel-konst ... Nevens een verklaring over de doorwazeming van Sanctorius, en nader onderzoek over 't II. deel der wysbegeerte, van R. des Cartes. by Heydentryk Overkamp, Amsterdam, Jan teen Hoorn, 1694.
  23. Sanctorii Sanctorii ... Commentaria, in artem Medicinalem Galeni : libri tres. by Galen, Lugduni : Pillehotte, Caffin et Plaignard, 1631.
  24. A vindicatory schedule concerning the cure of fevers containing a disquisition theoretical and practical, of the new and most effectual method of curing continual fevers, first invented and delivered by the sagacious Dr. Tho. Sydenham : also shewing by way of preliminary, the indispensible charge lying on physicians to improve themselves and the art ... : with an appendix of Sanctorius his Medicina statica ... by Andrew Brown, Edinburgh : Printed by John Reid ... to be sold be [sic] John Mathis ..., 1691.
  25. A vindication of Dr. Sydenham's nevv method of curing continual fevers in which a new hypothesis of fevers in laid down, and all their phenomena are explain'd, after a new method : together, vvith an appendix of the doctrine of insensible transpiration, advanc'd by Sanctorius, in his Medicina Statica : to which is prefix'd an essay, offering some reasons for the small progress of physical improvements by Andrew Brown, London: Printed for John Hepburn ..., 1700.
  26. Dr. Carr's medicinal epistles upon several occasions : done into English, as a supplement to the explanations of Sanctorius's Aphorisms by Richard Carr; John Quincy, London: Printed for William Newton, and J. Phillips, 1714.
  27. Dissertatio medica inauguralis, De perspiratione Sanctoriana : quam, annuente summo numine ex auctoritate reverendi admodum viri D. Gulielmi Wishart ... pro gradu doctoratus ... by Robert Mercer; William Wishart, Edinburgi: Apud T.W. & T. Ruddimannos, 1742.
  28. Lecture notes of a science student [Thesis/dissertation/manuscript].
  29. A vindicatory schedule concerning the cure of fevers containing a disquisition theoretical and practical, of the new and most effectual method of curing continual fevers, first invented and delivered by the sagacious Dr. Tho. Sydenham : also shewing by way of preliminary, the indispensible charge lying on physicians to improve themselves and the art ... : with an appendix of Sanctorius his Medicina statica ... by Andrew Brown, Edinburgh: Printed by John Reid ... to be sold be [sic] John Mathis ..., 1691.

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