Morgagni on apoplexy in De Sedibus: a historical perspective

This paper considers the historical significance of case reports on apoplexy and paralysis in Morgagni's De Sedibus et Causis Morborum. When autopsies became relatively common in the sixteenth century, Galen's speculation that apoplexy was caused by the accumulation of cold phlegm or black bile in the cerebral ventricles began to be questioned and was largely abandoned in the following century. The notion that the seats and causes of diseases are to be found in solid organs and not in the dyscrasia of humors gradually replaced many but not all humoral concepts. Morgagni's letters on apoplexy bolstered this "solidist" idea, but humoral physiology was still employed as a foundation for the treatment of apoplexy and to explain some aspects of the pathogenesis of this syndrome. Based on autopsy studies, Morgagni considered two principal forms of apoplexy, due to intracranial hemorrhage ("sanguineous apoplexy") and excessive intracranial fluid ("serous apoplexy"), to which he added a group that he judged to be separate from these two archetypes.