ANTONIO SCARPA - A GREAT ITALIAN OPHTHALMOLOGIST

Antonio Scarpa was born on 9 May 1752 into an impoverished family in Motta di Livenza, near Venice. At the age of 15, he started his medical studies at the University of Padua, under Leopoldo Caldani (1725-1813) and Giovanni Morgagni (1682-1771). His academic performance impressed Morgagni, who invited him to work as his assistant and personal secretary. In 1770, at the age of 18, he graduated this medical school and obtained his doctorate. Within the next two years he wrote an important treatise titled De structura fenestrae rotundae auris (Mutinae, 1772), in which he firstly described the structure and functions of the inner ear. In 1772, he was offered a professorship in anatomy and theoretical surgery at the University of Modena, where he spent the next 10 years. In 1783 Scarpa joined the medical faculty at Pavia, where he became chair of anatomy in 1785, and head of the Surgical Clinic in 1787. He ordered a new anatomical theatre, which was opened in 1785 as an architectural jewel. His teaching model was based on anatomical dissection and surgery performed before students. In the time when the cadaver ‘trade’ was the only way to possess corpses in many other universities, Scarpa suggested to the authorities that bodies of the deceased from the state hospital were to be transferred to the medical school. In 1813 Scarpa retired because of his vision problems. However, he continued to preserve his influence and power as director of medical faculty. During his long stay in Pavia, Scarpa achieved a prominent and powerful position at the University as a long-time chair of both Surgery and Anatomy Department, rector of the university and a permanent director of the Faculty of Medicine; he controlled nearly every aspect of the faculty’s life and often behaved in a despotic and absolute manner. Achille Monti described Scarpa based on the stories of his grandparents, who were medical students in Pavia between 1825 and 1836: “That grand old man with a serious face and a magnetic stare, who was familiar with no one, who taught and conversed in Latin with confidence, eloquence and an imperious tone and manner, who worked rapidly, regardless of patients’ cries, who enjoyed slicing up the corpses of illustrious colleagues such as Spallanzani, Brunacci and Brugnatelli, who appeared as impenetrable as the sphinx, as cold as death, and as merciless as fate.†On the other hand, Scarpa managed to obtain the greatest development of the University of Pavia and succeeded in reforming anatomy and surgery at the University to the most advanced scientific research level. He had only a few friends, including Alessandro Volta (1745-1827) but his enemies were numerous. At the end of his life, he was alone and blind living in his palatial villa outside the city walls (today named “via Scarpaâ€), where he died. After burial ceremonies his body was disinterred and became the subject of dissection. His urogenital apparatus, both forefingers and first pahalanxes of thumbs and head were removed and placed in an anatomy museum for years. At present they are exhibited at the Museum of History of the University of Pavia.

Scarpa's medical achievements

The list of anatomical eponyms related to his name includes Scarpa’s fascia, Scarpa’s fluid, Scarpa’s sheath and Scarpa’s triangle. His legacy includes works in otolaryngology, orthopedics, ophthalmology, neuroanatomy and surgery. Scarpa’ anatomical research was closely related with physiology, pathology and surgery, which was quite rare at his time and made him both an ingenious researcher and a very skilled and effective surgeon. His textbook, The Principal Diseases of the Eye (Saggio di osservazioni e d’esperienze sulle principali malattie degli occhi. Pavia: Baldassare Comino, 1801) was one of the most popular ophthalmology books in the 19th century. Scarpa was not an ophthalmologist, and as an anatomist and surgeon was rather critical of those arguing in favor of eye surgery not belonging to general surgery. In the introduction of his book he declared: “professed oculists whom have entirely devoted themselves to this department [ophthalmology], and from whom great and important improvements might justly have been expected, have only contributed new theories, which, for the most part, have been disproved by a minute anatomical investigation of the eye, or have merely furnished histories of cures little less than miraculousâ€.

Andrzej Grzybowski MD, PhD, professor of ophthalmology, Poznan City Hospital, Poznan, Poland; Dept. of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland

Acknowledgements: Prof Alberto Calligaro and Prof Paolo Mazzarello, director of the Museum of History of the University of Pavia for his help in supplying images related to Scarpa.