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12 - Vesalius- and the Anatomy

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12. Vesalius- and the Anatomy

It Took Andreas Vesalius only five years only five years to underdercut the foundation stone of infallibility from beneath Galen, medieval medicine’s idol, and to raise the study of human anatomy to a science based upon the solid rock of direct observation. The work Vesalius did during this period has been called “one of the greatest treasures of Western civilization and culture.” His masterpiece, De Humani Corporis Fabrica, declared not only one of more remarkable known to science, but one of the truly noble and magnificent volumes in the history to, printing, when it came off the presses in Basel in 1543, it revealed courage and independence of thought in keeping with the resurgent spirit of the renaissance.

There had been anatomists before Vesalius, Galen had written extensively on anatomy, but his writings teemed with errors. Unable to dissect human bodies, Galen drew his opinions from anatomical structures of monkeys and of pigs. Although dissection of human bodies was begun in the thirteenth century, belief in Galen’ authority was so strong that for centuries his errors were neither discovered nor denounced, Among the pre-Vesalian anatomists who made significant contributions to man’s knowledge of man were: Mondino of Bologna, who in 1315 made the first public anatomical demonstration upon a human body, and whose students carries on his traditions; Leonardoda Vinci, whose drawings, made in the early 1500’s, lay hidden for many years, but excited admiration and praise of later generation; and Berengario da Carpi,first to make a comprehensive attempt at anatomical
Illustrations from nature (1521)

The most commanding figure in European medicine, after Galen and before Harvey, Andreas Vesalius, was born in Brussels, December 31, 1514, of long line medical men. The family originally came from Wesel in the Duchy of Cleves, and took the name Wesele or Wessale after the name of the town. Latinized, this became Vesalius. Andreas, father of the anatomist, was apothecary to Margaret of Austria and later to her nephew, Emperor Charles V. To the wife of this Andreas, Isabella Crabbe, was born Andrews Vesalius of Brussels.

Vesalius spent early years of this life in his native city. Encouraged by his mother and by the extensive family library, he early acquired the habit of reading and of studying ancient authors. In 1528, he entered the University of Lou vain. From Louvain, Vesalius went to the highly conservative University of Paris; probably in 1533 Vesalius’ teachers included Johann Guinther of Andernach (Guinterius), and Jacques du Bois of Amiens (Sylvius), both old-fashioned anatomists whose knowledge was acquired by reading Galen

Like other young students of the times, Vesalius at first accepted Galenical anatomy, since there was no other. Nevertheless, Vesalius acquired considerable knowledge of anatomy on his own initiative. By surreptitiously visiting old Parisian cemeteries and the gallows, he dared wager with fellow students that he could identify any bone blindfolded. His teachers began to request his assistance in demonstrating anatomy, and in 1536 he conducted a demonstration single handed.

After some three years in Paris, Vesalius returned to There University of Lou vain. His reputation was growing, and in 1537 he was granted permission to conduct the first demonstration of human dissection to have been seen in Lou vain in eighteen years.
Dispute over the old controversy about venesection (whether it should be conducted near the wound or far from it) ended Vesalius’ stay in Lou vain. He then went on to Italy where there were greater opportunities for study of anatomy and of medicine. He went to Venice, and from there on to the then Venetian city of Padua, founded in 1222. By the sixteenth century its medical school was noted for its progressive and critical spirit. Under tutelage of the professor of Medicine at Padua, J.B. Della Monte, who introduced a type of clinical instruction that had hardly been seen since the days of Hippo crated, Vesalius made frequent visits to the sick both in Padua and in the capital city of Venice. Probably it was on one of these trips that Vesalius become acquainted with a fellow countryman, the artist Jan Stefan van Kalkar, a student of Titian, who later was to illustrate some of Vesalius’ work.

Vesalius had not long to wait for recognition in Padua. At a solemn convocation, December 5, 1537 he was examined by the faculty and granted the degree of Doctor of Medicine “with highest distinction.” On the following day, after performing a dissection, he was nominated by the Senate of Venice to be Professor of Surgery at the University of Padua, an appointment which carried with it also responsibility for teaching of anatomy and of botany. Vesalius at this time was in his twenty-third year.

Now, with a free hand, and with characteristic energy, the ambitious young professor began serious anatomical studies and demonstrations, breaking sharply with tradition. Instead of remaining seated, as had been the custom, in a lofty chair while assistants demonstrated and Vesalius descended into the operating theater to dissect and to demonstrate personally as he lectured. Students, physicians, and other men of learning crowded his classes. To clarify his discussions, in 1538 Vesalius introduced large charts delineating various anatomical systems. Students received these so enthusiastically that Vesalius was led to publish his drawings. To his own three sketches of the vascular system were added plates of his skeleton, drawn from three standard aspects by van Kalkar. The six plates were issued in 1538; today are known as Tabulae Anatomicae Sex. They proved to be an instantaneous success.

Other publications followed rapidly. They were not free of Galenical errors, however, for it was not until 1539 and later that Vesalius became thoroughly convinced of errors in Galen’ anatomical writings. In serving as one of the editors of an Opera Galeni, a complete edition of the works of Glen, Vesalius encountered many puzzling questions. He intensively sought answers in human bodies under his knife. As he learned, he lectured, wrote down his findings, and made, or caused to be made, hundreds of new drawings. This work grew and grew, finally culminating in publication of masterpiece, De Humani Corporis fabrica, in 1543. An excellent blend of format, typography, and illustration, Vesalius’ Fabrica has been called: the greatest contribution ever made to human anatomy; and the beginning of modern medical science.

Along with the fabrica, Vesalius also published a smaller companion volume, known as the epitome. This book was written in simpler style intended to help orient students and other readers before attempting the more, formal and advanced fabrica-as “A pathway beside the highway” of the major work.

As might be expected, the revolutionary fabrica, which made the anatomy of the revered Galen look like a colossal collection of gruesome errors colossal collection of gruesome errors, aroused a storm of vilification and abuse, hurled at Vesalius by most of his contemporaries. Sylyius, his former teacher, turned against his brilliant pupil with a storm of coarse abuse, calling credit and to madman. Colombus, his former assistant, sought to discredit and to deride his teacher. Not insensitive to these criticisms, Vesalius in rage and disappointment was reported to have burned notes that he was preparing for another publication.


Vesalius was not without friends, however, despite the vehemence of his attackers. According to Fallopius, the great majority of Italian physicians supported Vesalius and adopted his new teachings. His dissections and lectures were in considerable demand. The anatomist spent a year or two in travel, conducting courses in anatomy at the universities of Pisa and Bologna. In Basel, he articulated a skeleton that may be seen to this day.

Insofar as his contributions to science, to medicine, and to anatomy are concerned, Vesalius’ career ended with publication of the Fabrica and the Epitome, though he was to live another twenty years. Whether his change in choice of careers resulted from disappointment over slow acceptance of his work, or from desire for more conventional living, Vesalius forsook university halls for more lucrative practice. Says Robinson: “His numerous enemies did not silence him, the Inquisition did not smite him in his prime, but the siren of aristocracy seduced him from science.”

During the winter of 1543, Vesalius’ father, the imperial apothem-Cary, died, leaving his son a substantial inheritance. War broke out in 1544, and Vesalius became court physician to Charles V of Spain. After the halt of hostilities in September, 1544, Andreas Vesalius returned to the family residence in Brussels, married Anne. His professional stature was growing, and when Emperor Charles V arrived in Brussels in 1545, Vesalius was called upon to treat his imperial employer. He continued to enjoy royal favor, though his beliefs aroused the ire of his contemporaries.

The second folio edition of De Humani Corporis Fabrica made its appearance in August, 1555. The volume was far more elegant than the earlier edition. A new title page was prepared, new material was added and corrections made.

On January 16, 1556, Charles V completed arrangements for his abdications and turned his Spanish and Sicilian kingdoms over to his son, Philip 11 of Spain. To Vesalius he gave a life pension and permission to enter the service of the new ruler.

From this point on, Vesalius’ career was neither particularly significant nor happy. He complained that, in Inquisition- ridden Spain, not even a dry skull was available. There are many stories about his last years in Spain, none of which can be verified. However, in 1564, he undertook a pilgrimage to the Holy Land. On his return trip, it is believed; he was shipwrecked on the small Greek island of Zante, and died there October 15, 1564.

Andreas Vesalius of Brussels has been called “the first man of modern science.” Certainly he was the first physician to break openly with tradition, to study anatomy and to write of it directly from observation. Vesalius’ great work, the Fabrica, after having been slandered, rapidly became a classic text in medical education; the work was pirated extensively; and, having freed anatomists of the fetters of Galenism, it stimulated other men to greater strides in anatomical research during the following centuries.

THE PICTURE

Andreas Vesalius of Brussels, the first great teacher of anatomy from natural observations, conducted many anatomical demonstrations on human bodies while Professor of Surgery and of Anatomy at the University of Padua, 1537-1543. Highly successful, these were attended by medical students, physicians, interested civic officials, sculptors, and artists. First to break with Galen’s 1400-year-old anatomical texts, Vesalius published Tabulae Anatomicae Sex in 1538 and in 1543, the monumental De Humani Corporis Fabrica, and its companion volume, the Epitome. Though reviled and ridiculed by Galenists, Vesalius’ Works, backed by anatomical demonstrations, soon overcame detractors and became classic in medical literature.