Domenico Felice Antonio Cotugno

Domenico Felice Antonio Cotugno's birthplace was the small town of Ruvo di Puglia, in south-eastern Italy, on eastern slopes of the Murge plateau, west of Bari city. Born into a family of humble means Cotugno underwent physical and economic hardships to get an education. He was the son of Michele Cotugno and his second wife, Chiara Assalemme.

Cotugno early displayed such intelligence that he was sent to nearby Molfetta for training in Latin, returning to Ruvo for work in logic, metaphysics, mathematics, physics and the natural sciences, he soon found his natural bent in medicine and continued his studies, often in strained circumstances, at the University of Naples and the Ospedale degli Incurabili. To these two institutions Cotugno devoted the greater part of his life.

He studied medicine at the University of Naples from 1753. Poverty and illness plagued him during his training. After barely surviving a critical illness that he contracted while resident physician at the Neapolitan Hospital for Incurables, he received his doctorate in philosophy and physic in 1755, and became an assistant at the Ospedale degli Incurabili. In 1761 he became professor of surgery at that hospital and continued his investigations. He was subsequently for 30 years professor of anatomy at the high school of Napoli as well as director of the Ospedale degli Incurabili. In 1808 he was appointed arciater. He ceased lecturing in 1814, suffered a cerebral emboly in 1818 that recurred in 1822, and to which he succumbed on October 6 that year.

In 1765 he made trips to Rome and northern Italy to visit libraries and men of science, including Giovanni Battista Morgagni (1682-1771), and in 1789 he travelled to Austria and Germany as physician to Ferdinand IV, king of Naples. In 1794 Cotugno married Ippolita Ruffo, duchess of Bagnara. In a period of political upheaval in the kingdom of Naples he did not swerve from medicine. An outstanding example of the physician-humanist, he was devoted to books and accumulated a large library; was well versed in art, architecture, numismatics, and antiquities; and had a great facility in the Latin language.

Apart from medicine, in which his reputation was such that, the saying went, no one in Naples could die without a passport from him, Cotugno's greatest contributions to science resulted from his fusing of anatomy and physiology to uncover the secrets of the human body. They were made early in his career, when at the Osepdale degli Incurabili he had the almost constant opportunities for dissection.

Before his thirty-first year he had written two books, made numerous important contributions to anatomy and pathology, and was made professor of surgery and anatomy at the University of Naples. He was 25 years of age when he discovered the Aquaeductus Cotunii in 1760, and the next year, 1761, he described the labyrinthine system and its fluids.

In 1761 Cotugno published for distribution to friends a plate that traced the course of the nasopalatine nerve, which is responsible for sneezing. Antonio Scarpa acknowledged his priority in knowledge of this nerve. In the same year his anatomical dissertation De aquaeductibus auris humane internae, following the work of Guichard Joseph Duverney and Antonia Maria Valsalva and anticipating that of Hermann Ludwig von Helmholtz, described the vestibule, semicircular canals, and cochlea of the osseous labyrinth of the internal ear, demonstrated the existence of the labyrinthine fluid, and formulated a theory of resonance and hearing.

Cotugno also formulated a theory on hearing, discovered the Nervus nasopalatinus, and wrote a classic monograph on sciata. He is also credited the discovery of the cerebrospinal fluid in 1774.

Cotugno also investigated smallpox, was deeply concerned with controlling pulmonary tuberculosis, and exemplified to many students the true investigative and selfless spirit in anatomy and medicine.

An unselfish and generous man, and a poor man's son, Cotugno made the Incurabili his heirs as he left 100,000 ducats to the hospital for the chronically ill. The Ospedale Domenico Cotugno in Bari is named for him.

• De aquaeductibus auris humane internae anatomica dissertatio.
  Napoli and Bologna: 1761. Ex typographica Sancti Thomae Aquinatis, 1775.
  Cortugno was the first to describe the fine anatomy of the inner ear. In this, his first major work, he identifies the aqueduct of the inner ear and the columns in the osseous spinal lamina of the cochlea, which are named after him.
• Raccolta di opuscoli medico-pratici, II. Firenze, 1775.
• De ischiade nervosa commentarius. Napoli, Simoni, 1764.
  Cotugno was a keen observer and a fine clinician. In this, perhaps his most important work, he differentiates arthritis from nervous sciata, and concluded that the sciatic nerve is responsible for the latter, and in discussing it for the first time gives a detailed description of the cerebrospinal fluid, and showed that the congealed protein in the heated urine of a nephrotic patient (a person afflicted with dropsy) is a diagnostic sign.
• Novis curis auctior. Napoli, 1769.
• De sedibus variolarum syntagma.
  Napoli, 1771, 1775. Ex typographica Sancti Thomae Aquinatis.
  Extending his interests to preventive medicine and public health, Cotugno became a pioneer in epidemiology. In this work, first published in 1771, he gives a lucid description of the anatomy and pathology of smallpox pustules. It is regarded as one of the finest dermatological works of the eighteenth century. 41: Napoli, 1775.
• Della spirito della medicina. Napoli, 1783.
• Opuscula medica . . . . 2 volumes. Napoli, 1826-1827.
• Opera posthuma. 4 volumes, Napoli, 1830-1832.