Greetings from iainthepict. This blog of mine is meant to be like a 'Book of Days' or a kind of 'Scottish Year Book' if you will. The idea was to present an event for each day of the year. Somewhere in here, you can find out what happened, affecting Scotland and the Scots, on any given day of the year. Your comments and observations are very welcome.
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Sunday, 2 October 2011

Alexander ‘Secundus’ Monro

Alexander ‘Secundus’ Monro, anatomist and physician, died on the 2nd of October, 1817.

Alexander Monro the second, like his father before him and his son to follow, took for a living the practice of cutting open human cadavers and as if that wasn’t bad enough, he wrote about it. In fact, he was so good at writing about it that he became famous for just that. He became so famous that he had to be distinguished from his famous father and so the two of were given Latin nicknames; Primus and Secundus, in that order. Later, his son, unsurprisingly, got the label of Tertius. With each of them inheriting his predecessor’s role as Professor of Anatomy at the University of Edinburgh, they comprised a one hundred and twenty-six years unbroken succession of advancers of medical knowledge. Add John Monro, Primus’ father, who was Deacon of the Incorporation of Surgeons and that’s quite a dynasty. All three latinised Monros contributed toward making the medical school at Edinburgh University the best in the world, but Secundus is considered the finest anatomist and teacher of the three.

As a teacher, Secundus was considered more effective than Primus and official records of the Faculty of Medicine give Secundus 228 students in 1808. In his role as an educator, Alexander the Second wrote thirty-four volumes of anatomical case notes. Only the index remains extant, but between the Medical Libraries at the Universities of Otago and Edinburgh, there exists a collection of printed books and manuscripts that includes a set of notes taken down verbatim from Secundus’ lectures in 1773/4. According to Douglass W. Taylor, who wrote extensively about this set, all nine volumes are corrected and glossed in Monro’s hand. Monro also wrote three major anatomical treatises (all with long names), including a comparative anatomy of fishes and man, ‘A Description of All the Bursae Mucosae of the Human Body’, and ‘Observations on the Structure and Functions of the Nervous System’, which massive 1783 text was his greatest work.

A list of Monro’s contributions to medicine includes his discovering and accurately describing Monro’s cyst, Monro’s foramen, Richter’s line (on which can be found Monro’s point), Monro’s sulcus, and establishing Monro’s doctrine (a.k.a. the Monro-Kellie doctrine). Over a hundred years later, the ‘foramen of Monro’ became crucial for neurological diagnostic techniques in the 20th Century, so we can be eternally thankful. In addition to being the first to use a stomach pump to surgically drain fluid from a body cavity, Secundus is also listed as having discovered the Lymphatic System, established the function of the Nervous System, and for noting the physiological effects of drugs.

In those days, there was a war going on between anatomists and surgeons, with surgery suffering from academic prejudice as it was perceived to be a manual craft; not an intellectual discipline. In fact, surgical teaching was ‘bolted on’ to anatomy courses like the ones given by Secundus (and Tertius in his turn), but the interesting thing is that those guys were physicians who had no surgical training. Thanks to ‘rebel’ surgeons like Benjamin Bell, and John and Charles Bell (no relation), there were independent schools of surgery, but due largely to Monro’s jealous guarding of his own status as Professor of Anatomy and Surgery, it wasn’t until 1803 that an independent Chair of Clinical Surgery was established in Edinburgh University.

Monro was also a bit of an argumentative chiel and never held back from criticising his fellow anatomists. William Hewson, a former pupil, got the sharp end of his pen as did Gilbert Blane. Hewson appears to have had the temerity to suggest that his investigations preceded Monro’s, prompting Secundus to write the 1770 disertation ‘A State of Facts Concerning the First Porposal of Performing the Paracentesis of the Thorax and the Discovery of the Lymphatic Valvular absorbent System of Oviparous Animals. In Answer to Mr. Hewson’. Prior to all that, in 1757, after publishing his Berlin treatise ‘De venis lymphaticis valvulosis’, Monro fell out with William Hunter, who had made a counterclaim for priority in discovery. That spat led to tit-for-tat acrimonious exchange of pamphlets, which went on until at least 1764.

Alexander Monro was born in Edinburgh on the 22nd of May, 1733. Wee Alec went to a private school ran by James Mundell, before going on to the University of Edinburgh at the tender age of eleven. Incredibly, the name of Alexander Monro (Jnr.) appears in an account book for his father’s anatomy class in 1744. He matriculated in the Faculty of Arts in 1745 (the same year Bonnie Prince Charlie came ower frae France) and studied Latin, Greek, philosophy, mathematics, physics, and history under some of the most famous names of the Enlightenment. Monro began his formal medical studies in 1750 under the tutelage of his father, and that’s when he showed his predilection for anatomy.

By 1753, Monro Jnr. was competent enough to have been entrusted by Monro Snr. to teach the afternoon ‘overflow’ anatomy class – the classes had become so popular. It wasn’t long after that when the Primus/Secundus thing came into use, when the elder Monro successfully petitioned the Town Council to allow the two of them to conjointly hold the Chair of Anatomy. Secundus accepted the position of Professor of Anatomy on the 10th of July 1754. A year later, on the 12th of July, 1755, he received his Edinburgh M.D. Unusually for the time, unlike most dissertations, Secundus’ thesis, on the testicles and semen, contained original research – he injected the tubules with mercury. Funnily enough, Secundus appears to have taught that “these animalcules [spermatozoa] are no more essential to generation than the animals found in vinegar are to acidity.” Well?

For some years after that, apart from pitching up back in Edinburgh on a couple of occasions to cover for his father’s illnesses, Secundus studied in London, Berlin and Leiden under the likes of Hunter, Johann Friedrich Meckel and Bernhard Siegfried Albinus. By the time Primus died in 1767, Secundus had taken over all his anatomy classes and held the Chair of Anatomy for the next fifty years. Like father, like son; in 1798 Secundus persuaded Edinburgh Town Council to appoint his namesake elder son as joint Professor of Anatomy, after which Secundus and Tertius shared duties until 1808, when Secundus retired.

Alexander Secundus Monro died in Edinburgh, of apoplexy, on the 2nd of October, 1817. His collection of anatomical and pathological specimens was bequeathed to his son and successors in the Chair of Anatomy.

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