|Leonardo Fioravanti. Via Wikimedia.|
The first part of Leonardo Fioravanti’s life was uneventful; the second was tumultuous.1 Born in Bologna in 1517,1-4 he was fortunate in 1527 to survive a violent epidemic that may have been typhus. At age sixteen he began to study medicine, probably as an indentured apprentice to a barber-surgeon. At twenty-two he began practicing medicine himself. As barber-surgeon he was restricted by law to treat only afflictions of the outside of the body, not prescribe “by mouth,” and was essentially limited to bloodletting and performing minor surgical operations.
At age thirty Fioravanti seems to have had some “sort of an epiphany”2 and left Bologna. As he described in his autobiography, he “began to walk the world and plow the sea, seeing many cities and provinces, practicing with various kinds of persons, medicating many men and women with all sorts of infirmities.”2 He went to Sicily, hoping to meet the famous alchemist Akron of Agrigentum.2 Arriving in Palermo at Carnival time, he was mistaken for a physician of great knowledge from Bologna.3 He was asked to see in consultation a Spanish nobleman suffering from malaria, recommended violent purging and vomiting, and the man recovered. His fame spread and he was asked to see many difficult cases. Not being licensed to practice as a physician, he became increasingly involved with the alchemists, “always practicing the art [of medicine and surgery] wherever I found myself, never tiring of studying and looking for the finest experiments, whether from learned physicians or from simple empirics and all sorts of people, even peasants, shepherds, soldiers.”5
He became famous and in great demand. He used his own secret remedies, treating patients suffering from a wide variety of illnesses, some internal, some of the skin, including a variety of sores, some caused by syphilis. When asked to see a woman who had an enormous malarial spleen, he cut the abdomen open with a razor blade, the spleen just popped out, and the woman recovered. Then the wife of the Spanish viceroy summoned him to treat a large number of hospital patients afflicted by “hideous sores,” and he treated many of them successfully with his concocted preparations of arsenic, ammonia, and vinegar. When the viceroy moved his court to Messina, Fioravanti was ordered to follow, and again practiced successfully.
In Messina, Fioravanti found himself relieved of many official duties and had time to delve deeply into the works of the then increasingly popular practice of alchemy.3 From then onwards, throughout his career and wherever he went, whether in Naples, Rome, or Venice, his career followed a predictable pattern. He represented himself as the exponent of a “new way” of therapeutics,2 quite different from the old galenical ministrations used by the local physicians. He made useful contacts, some serendipitous, others through patients he had treated and supposedly cured, often wealthy and important members of the nobility. He prescribed his own secretly concocted alchemical preparations, to which he gave impressive names such as Precipitatio, Lignum Sanctum, Mighty Elixir, Blessed Oil, Artificial Balsam, or Grand Liquor.1,4 These variously contained salts of arsenic or mercury, guiacum, ammonia, or vinegar—some inducing sweating and the ability to sweat the disease out. He treated external ailments with relatively mild agents, often allowing natural healing to occur and then claiming success. Internal illnesses he would treat more aggressively, inducing severe vomiting and purging, again claiming success if the patient recovered.
Whether any of his remedies actually did any good is doubtful, except for the unusual case when a patient obtained relief by the bringing up a large worm that had lodged in his stomach. He practiced mostly without a license, this at a time when most cities regulated medical care quite strictly, and accordingly frequently found himself in trouble with the authorities. He would begin by building up a successful practice and achieve a brilliant reputation, provoke the resentment and envy of the local doctors, and then experience a precipitous humiliating fall, sometimes leading to prosecution in the courts and having to flee the city.
Before leaving Messina in 1549, he visited a small village where a family of Sicilian surgeons was practicing rhinoplasty as a trade secret.1-3 Posing as a nobleman seeking information for a friend, he was allowed to witness an operation. This consisted of raising a flap of skin from the upper arm and stitching it to the face for several weeks, then refashioning a new nose. Thus stealing their secret, he later brought it to the attention of the Bologna surgeons Giulio Aranzi and in particular his pupil Gasparo Tagliacozzi, who used the technique widely in order to reconstruct noses lost from dueling, syphilis, or amputation as punishment for the crimes. The technique remained popular for several decades and represents the beginnings of the discipline of reconstructive plastic surgery.2,3
From Messina, Fioravanti moved to Naples, then the most important city in the Spanish Empire, the first ever empire on which the sun would never set.1 He purchased a house, bought distillation vessels, and set up an alchemical laboratory, attracting other alchemists and founding what he called an academy. His residence became the center of experimental activity, where “alchemists from various nations began to practice,” seeking medical remedies and also trying to transmute base metals into twenty-four carat gold.1,2 Using one of his splendid secret medicines, he treated successfully a prominent Spanish nobleman with probable syphilis. As a result of that success he was put in charge of a hospital for the “incurables,” apparently syphilitics.
He traveled widely, enlisted in 1550 as surgeon in the Spanish army in Tunisia, and there used his secret medicines to treat gunshot wounds.3 During the war he witnessed a duel between two officers, one of whom had his nose sliced off; Fioravanti picked it up, brushed off the sand, urinated on it to apparently sterilize it, and stitched it back, thus acquiring a reputation in the nascent field of reconstructive plastic surgery.3
In 1556 Fioravanti moved to Rome. He stayed there for three years but fell into disfavor with “a powerful and invidious cabal of physicians”4 and relocated to Venice, where he lived for about fifteen years.1,2 He became a publisher of popular scientific and medical books designed to enhance his growing fame and promote his business.1-4 As in Naples, he set up an alchemical laboratory in his home, concocting and selling his distilled drugs, this time on a larger scale. He operated at least two pharmacies, the Bear and the Phoenix,4 where he practiced without a license, again treating patients with various illnesses. In his writings he claimed that physicians should be making their own drugs2 and promoted his own with the above-mentioned catchy tradenames. He prescribed these drugs as initial treatment for almost every ailment he encountered. In his writings he propounded a new approach to medicine, claiming that all diseases arose from a single cause, an “indisposition” of the stomach, and that these could be cured by driving out the “bad humors” corrupting the stomach. He continued to prescribe powerful emetics and purgatives that he distilled himself, and in one of his writings postulated that syphilis was actually caused by cannibalism.5
In 1568 the physicians in Venice accused him of endangering people with his treatments and also of being a vagabond.1 He went to Bologna and impressively passed the examinations to become a credentialled physician with a University MD degree.1-4 He briefly returned to Venice but did not stay there long and moved to Milan, where, in 1570, he was briefly imprisoned for “not medicating in the canonical way.”1,3
In 1576 he went to Madrid to the court of Philip II, again practicing alchemy. He had an elaborate alchemical laboratory built at the Escorial to further his research. After a time he ran into difficulties with the local medical establishment and was charged with murdering one of his patients.3 Disappointed, he returned to Italy, where he again gathered around him several physicians who became his alchemic disciples. He died around 1588.
During his peripatetic life, he published many books and tracts, proclaiming his view on therapeutics and on what he claimed was a new approach to therapeutics. He belongs to the new generation of physicians, such as notably Paracelsus,2 who promoted drugs, often metals and often toxic, to treat diseases. This practice spread across Europe in his time and continued well into the nineteenth century.
Fioravanti has now been largely forgotten, sometimes mentioned in articles for his part in introducing the Bologna surgeons to the technique of rhinoplasty and thus perhaps being one of the fathers of plastic surgery. He was a dubious character, an innovator, an inveterate experimenter, a globetrotter, and a maverick surgeon. He has also been described as “a man of ridiculous vanity, always speaking grandiloquently, lying in the most impudent manner and shamelessly spewing out pompous panegyrics about his arcane secrets,” one of the most reckless charlatans of his age.1
|La cirurgia by Leonardo Fioravanti||Del compendio de i secreti rationali by Leonardo Fioravanti. Source.|
- William Eamon: The Professor of Secrets, National Geographic, Washington DC, 20036
- Eamon, W: Alchemy in Popular Culture: Leonardo Fioravanti and the Search for the Philosopher’s Stone. Alchemy and Hermeticism. Early Science and Medicine 2000, 5 (2), 196-213.
- Douglas Biow. Constructing a Maverick Physician in Print: Leonardo Fioravanti, the Medical Examination of Odors, and the Reconstructed Nose Modern Language Notes 2014; 12 (Vol. 9): S60-72 (April).
- Eamon, W: Pharmaceutical Self-Fashioning or How to Get Rich and Famous in the Renaissance Medical Marketplace. Pharmacy in History 2003; 45 (No. 3): 123-129
- Eamon William: Cannibalism and Contagion, Framing Syphilis in Counter-Reformation Italy.Early Science and Medicine 1998; 3 (No. 1):1-31
GEORGE DUNEA, MD, Editor-in-Chief