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    [Illustration: _And. Vesalius_]




                                ANDREAS
                                VESALIUS
                                  THE
                          Reformer of Anatomy


                                   BY
                        JAMES MOORES BALL, M. D.

    [Illustration: Ornamental block]

                              SAINT LOUIS
                         MEDICAL SCIENCE PRESS
                                MDCCCCX

                           Copyrighted, 1910
                          By James Moores Ball
                         _All rights reserved_

                             TO THE MEMORY
                        OF THOSE ILLUSTRIOUS MEN
                                  WHO
                   OFTEN UNDER ADVERSE CIRCUMSTANCES
                                  AND
                      SOMETIMES IN DANGER OF DEATH
                 SUCCEEDED IN UNRAVELLING THE MYSTERIES
                  OF THE STRUCTURE OF THE HUMAN BODY,
                       TO THE FATHERS OF ANATOMY
                                  AND
                        TO THE ARTIST-ANATOMISTS
                               THIS BOOK
                              IS DEDICATED

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                                PREFACE


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In the annals of the medical profession the name of Andreas Vesalius of
Brussels holds a place second to none. Every physician has heard of him,
yet few know the details of his life, the circumstances under which his
labors were carried out, the extent of those labors, or their
far-reaching influence upon the progress of anatomy, physiology and
surgery. Comparatively few physicians have seen his works; and fewer
still have read them. The reformation which he inaugurated in anatomy,
and incidentally in other branches of medical science, has left only a
dim impress upon the minds of the busy, science-loving physicians of the
nineteenth and twentieth centuries. That so little should be known about
him is not surprising, since his writings were in Latin and were
published prior to the middle of the sixteenth century. His books, which
at one time were in the hands of all the scientific physicians of
Europe, are now rarely encountered beyond the walls of the great medical
libraries of the world. They are among the _incunabula_ of the medical
literature. That English-speaking physicians know little of Vesalian
literature is due to the fact that no extensive biography of the great
anatomist has appeared in our language. Most of the Vesalian literature
which has been written by English and American authors has been in the
form of brief articles for the medical press; these oftentimes have been
incorrect and unillustrated. Perhaps the best example of this class is
the article by Mr. Henry Morley which appeared originally in _Fraser’s
Magazine_, in 1853, and later was published in his _Clement Marot and
Other Studies_, in 1871. The chief data for Vesalius’s biography are to
be found in his own writings, in the archives of the Universities in
which he taught, and in the controversial literature of the period.
Extensive as are these sources they leave much to be desired. A vast
mass of Vesalian literature was printed, chiefly in the Latin language,
during the seventeenth and eighteenth centuries. Much of it is based on
insufficient evidence or on national prejudice. The Germans, the French,
the Dutch and the Italians have all taken a turn at it. In modern times
the monumental work of Roth, _Andreas Vesalius Bruxellensis_, Berlin,
1892, has served to epitomize this literature and to make clear many
points which formerly were not understood. I have taken Roth’s book as a
basis for this monograph, without using the voluminous references which
are found in the work of this thorough historian.

The man who overthrew the authority of Galen; revolutionized the
teaching of the structure of the human body; started anatomical,
physiological, and surgical investigation in the right channels; first
correctly illustrated his dissections; destroyed ancient dogmas, and
made many new discoveries—this man, Andreas Vesalius of Brussels,
deserves the name which Morley has given him, “the Luther of Anatomy.”

At long intervals a bright particular star appears in the intellectual
horizon, endowed with genius of such a superlative order as seemingly to
comprise within itself the whole domain of an entire science. These men
do not belong to any particular epoch in the development of the human
mind. They are the eternal symbols of progress, and their history is the
history of the science which they profess. Such men were Bacon, Galileo,
Descartes, Newton, Lavoisier, and Bichat; and such also was Andreas
Vesalius the anatomist. Young, enthusiastic, courageous and diligent,
Vesalius dared to contradict the authority of Galen, corrected the
anatomical mistakes of thirteen centuries and before his thirtieth year
published the most accurate, complete, and best illustrated treatise on
anatomy that the world had ever seen. His industry, the success which
crowned his efforts, the jealousies which his discoveries aroused in the
breasts of his contemporaries, the honors which were conferred upon him
by Charles the Fifth and Philip the Second, his pilgrimage to the Holy
Land, and his tragic death—these are events which deserve to be
chronicled by an abler pen than mine.

The year 1543 marks the date of a revolution which was won, not by force
of arms but by the scalpel of an anatomist and the hand of an artist.
The whole of human anatomy, as a study involving correct descriptions of
the component parts of the body and accurate delineations thereof, may
be said to have been founded by Andreas Vesalius and Jan Stephan van
Calcar. As light pouring into a prism attracts little notice until it
emerges in iridescent hues, so it was with anatomy: after passing
through the brain of Vesalius it bore rich fruit which has been gathered
by many hands. To turn from the writings of Galen, Mondino, Hundt,
Peyligk, Phryesen, and Berengario da Carpi to the beauties of Vesalius’s
_De Humani Corporis Fabrica_ is like passing from darkness into
sunlight. To both anatomists and artists this book was a revelation. For
more than a century after its appearance the anatomists of Europe did
little more than make additions to, and compose commentaries upon the
conjoint triumph of Vesalius and van Calcar. For more than two centuries
the osteologic and myologic figures of the _Fabrica_ formed the basis of
all treatises on Art-Anatomy.

                                                      JAMES MOORES BALL.

  Saint Louis,
  MDCCCCX.

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                           TABLE OF CONTENTS


                                                                    PAGE
  INTRODUCTION                                                      1-16
      The Study of Medical History—The General Renaissance—The
          Anatomical Renaissance.
  ANATOMY IN ANCIENT TIMES                                         17-28
      Anatomy in Egypt and in Greece—Hippocrates and the
          Asclepiadae—Alcmaeon, Empedocles and Aristotle—Early Roman
          Medicine—The Alexandrian University—Herophilus and
          Erasistratus—Claudius Galenus—The School of
          Salernum—Frederick II.
  MONDINO, THE RESTORER OF ANATOMY                                 29-36
      Life of Mondino—He restores the Study of Practical Anatomy—His
          Book on Anatomy.
  MONDINO’S SUCCESSORS                                             37-51
      Gabriel de Zerbi—John Peyligk—Magnus Hundt—Laurentius
          Phryesen—Alexander Achillinus—Berengario da Carpi—John
          Dryander—Charles Estienne.
  VESALIUS’S EARLY LIFE                                            52-55
      Origin of the Vesalius Family—Early Life of the
          Anatomist—Vesalius enters the University of Louvain.
  SOJOURN IN PARIS                                                 56-69
      Vesalius goes to Paris to study Medicine—Celebrated Parisian
          Physicians of the Sixteenth Century—Jacobus
          Sylvius—Joannes Guinterius—Jean Fernel—Philosophy of
          Pierre de la Rameé—State of Anatomy at this Period.
  VESALIUS RETURNS TO LOUVAIN                                      70-72
      Vesalius returns to Louvain—He conducts a Course in
          Anatomy—Secures a Skeleton.
  PROFESSOR OF ANATOMY IN PADUA                                    73-80
      Vesalius goes to Venice, thence to Padua—Receives the Degree
          of Doctor of Medicine—He is appointed Professor of
          Anatomy—His method of Teaching—Lectures also in Bologna.
  FIRST CONTRIBUTION TO ANATOMY                                    81-83
      Vesalius issues a Series of Anatomical Plates under the title
          “Tabulae Anatomicae”—His Plates are extensively pirated.
  PUBLICATION OF THE FABRICA                                       84-94
      The Manuscript and Illustrations for the Fabrica are
          transported to Basel—Joannes Oporinus, the noted Printer
          and Greek Scholar—Publication of the Fabrica—Beauty of the
          Illustrations—Who was the unnamed Artist?—The Plates were
          erroneously ascribed to Titian—Christoforo Coriolano—Jan
          Stephan van Calcar—Popularity of the Illustrations among
          Artists and Anatomists.
  PUBLICATION OF THE EPITOME                                       95-97
      Publication of the Epitome—Reasons for its
          Publication—Character of the Work.
  CONTENTS OF THE FABRICA                                         99-113
      General Plan of the Book—A brief Review of its Contents—The
          First Book, on Osteology—Vesalius’s Contributions to the
          Anatomy of the Bones—The Second Book, on Ligaments and
          Muscles—Excellence of this Part of the “Fabrica”—The Third
          Book, on the Veins and Arteries—The Fourth Book, on the
          Nerves—The Fifth Book, on the Organs of Nutrition—The
          Sixth Book, on the Heart—Vesalius’s Idea of the
          Circulation—Quotation from his Book—The Seventh Book, on
          the Brain and the Organs of Sense—Conclusion.
  CONTEMPORARY ANATOMISTS                                        114-125
      The publication of the Fabrica is followed by great activity
          among Anatomists—Bartholomeus Eustachius—Realdus
          Columbus—Gabriel Fallopius—John Philip Ingrassias.
  COMMENTATORS AND PLAGIARISTS                                   126-129
      Plagiarism in Medicine—William Cowper and Bidloo’s
          Plates—Pirated editions of the “Tabulae Anatomicae”—Thomas
          Geminus’s editions of the “Fabrica”—The Microcosmographia
          of Helkiah Crooke—John Banister’s Book—Juan Valverde di
          Hamusco’s work on Anatomy—Best editions of the “Fabrica”.
  THE COURT PHYSICIAN                                            130-132
      Vesalius is appointed Archiatrus to Charles the Fifth—He
          follows the Emperor in his Journeys—Abdication of
          Charles—Vesalius is appointed Archiatrus to Philip the
          Second.
  PILGRIMAGE AND DEATH                                           133-136
      Vesalius leaves Madrid—He visits Venice, then goes to Cyprus,
          and passes on to Jerusalem—Reason for the Pilgrimage—Death
          of Vesalius.

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                         LIST OF ILLUSTRATIONS


  Andreas Vesalius—from the “Epitome”, 1543                 Frontispiece
                                                                    PAGE
  Andreas Vesalius—van Kalker p.; I. Troijen s.—from an old
          copperplate engraving                                   XVIII.
  Initial Letter—from the “Fabrica”, 1543                             16
  Hippocrates                                                         17
  Aristotle                                                           19
  Alexander the Great                                                 20
  Ptolemy Soter                                                       21
  Galen                                                               24
  Mondino’s Diagram of the Heart                                      31
  Anatomical Demonstration in 1493                                    33
  Title-page of Mondino’s Anatomy by Melerstat                        34
  Colophon of the Anatomy of Mondino                                  36
  Anatomical Plate by Ricardus Hela, 1493                             38
  Peyligk’s Diagram of the Heart, 1499                                39
  Anatomical Figure from Magnus Hundt, 1501                           40
  Anatomical Figure from Laurentius Phryesen, 1518                    41
  Alexander Achillinus                                                42
  Dissection by Berengario, 1535                                      43
  Skeleton by Berengario, 1523                                        44
  Muscles by Berengario, 1521                                         45
  Muscles by Berengario, 1521                                         46
  Dryander                                                            47
  Anatomical Figure by Estienne, 1545                                 48
  Skeleton by Estienne, 1545                                          49
  Skull by Dryander, 1541                                             51
  The Old University of Louvain                                       54
  Sylvius                                                             57
  Winter of Andernach                                                 62
  Jean Fernel                                                         64
  Ramus                                                               66
  Vivisection of a Pig—from the “Fabrica”, 1543                       69
  Instruments used in Dissection—from the “Fabrica”, 1543             74
  Initial Letter—from the “Fabrica”, 1543                             80
  View of the City of Basel in the Sixteenth Century                  83
  Joannes Oporinus                                                    85
  Mark of Oporinus—from the “Fabrica”, 1543                           86
  Jan Stephan van Calcar—from Sandrart’s “Teutsche Academie”, 1685    88
  Second Vesalian Plate of the Muscles—from the “Fabrica”, 1543       90
  Ninth Vesalian Plate of the Muscles—from the “Fabrica”, 1543        92
  A Human Skull resting on the Skull of a Dog—from the “Fabrica”,
          1543                                                        94
  Title-page of Vesalius’s “Epitome”, 1543                            96
  Skeleton by Vesalius—from the “Fabrica”, 1543                       98
  Fifth Vesalian Plate of the Muscles—from the “Fabrica”, 1543       100
  Deep Muscles of the Back by Vesalius—from the “Fabrica”, 1543      102
  Part of the First Text-page of the “Fabrica”, 1543                 103
  Plate of the Arterial Tree by Vesalius—from the “Fabrica”, 1543    104
  Dissection of the Abdomen by Vesalius—from the “Fabrica”, 1543     106
  Dissection of the Heart by Vesalius—from the “Fabrica”, 1543       107
  Initial Letter—from the “Fabrica”, 1543                            113
  Brain and Nerves by Eustachius                                     116
  Muscles by Eustachius                                              117
  Title-page of Columbus’s Anatomy                                   120
  Gabriel Fallopius                                                  122
  Ingrassias                                                         125
  Charles the Fifth                                                  131
  Philip the Second                                                  133

    [Illustration: Ornamental block]

    [Illustration: _I. van Kalker p.    I. Troÿen s._
    ANDREAS VESALIUS
    (From an old copperplate engraving)]

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                              INTRODUCTION


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The intelligent student of medical history has at his command an
unfailing source of pleasure. To learn the successive steps by which
Medicine has advanced from a priest-ridden and secret art practiced with
mysterious rites in the Greek temples, passing through the schools of
Greek philosophy into the light of publicity, is his privilege. To hunt
through musty and worm-eaten volumes for facts regarding the great
physicians of antiquity is his delight; and to communicate the knowledge
thus obtained to others, who have not the time or the facilities for
such research, is his duty. In every period are events and incidents of
interest, but to the Middle Ages a peculiar fascination attaches; for it
was during this period that Europe, emerging from an intellectual
darkness of ten centuries’ duration, awoke to the Renaissance, and
Medicine, as ever has been the case, kept pace with the general advance
of knowledge.

The present book deals with the life of a master whose work was an
essential factor in the evolution of the Anatomical Renaissance. In
order to understand the New Birth of Anatomy it is necessary to know
something of the scope and influence of the General Renaissance.


The General Renaissance

This, the Revival of Learning, includes an indefinite time in European
history. The seeds of the new movement were planted in the Middle Ages,
but they bore no fruit until the time had arrived for an apparently
“spontaneous outburst of intelligence”. Definitions of the Renaissance
will vary with the point of view. Artists and sculptors will say it was
a revolution which was created by the recovery of ancient statues;
littérateurs and philosophers look upon it as a radical change due to
the discovery of the writings of the classical authors; astronomers and
physicists will cite the names of Copernicus, Galileo, and Torricelli;
geographers will point to the discovery of a New Continent; historians
will name the extinction of feudalism and the capture of Constantinople
by the Turks; inventors will recall the changed conditions of warfare
brought about by gunpowder, the multiplication of books by the invention
of printing, and the advent of new methods of engraving; and anatomists
will sound the praises of Leonardo da Vinci and of Andreas Vesalius. All
will agree that the Renaissance meant Revolution—revolution in thought,
in conduct, in creed, and in conditions of existence. To no one fact can
the Renaissance be attributed; nor can its scope be limited to any one
field of human endeavor. The Renaissance was, and is, and will continue
to be, as long as the race progresses.

The new movement began in Italy and grew rapidly. When, toward the end
of the sixteenth century, the lamp of learning began to get dim in
Italy, it was relighted by the nations of northern Europe—the Germans,
the Hollanders, and the English—and by them was transferred to us. The
Revival consisted largely in the recovery of the buried writings of the
ancient Greek and Roman authors, together with comments on what they had
written, and the production of books which were modeled after their
works. But it was broader than this. It included all branches of
learning, although more progress was made in some lines than in others.

Italy, a country divided into numerous small States, and so-called
Republics, offered great opportunities for individual development and
became famous in those paths in which individualism has gained its
greatest triumphs. Thus in literature, in law, in medicine, in painting
and in sculpture, the Italians were preëminent. In architecture and in
the drama they reached no such heights as were attained by the French,
the Germans and the English. It was in the northwest part of Italy, in
the province of Tuscany, that the Renaissance gained its greatest
victories. Among the earliest of the leaders of the New Learning was the
Florentine poet, Dante Alighieri (1265-1321). “To Dante”, says Symonds,
“in a truer sense than to any other poet, belongs the double glory of
immortalising in verse the centuries behind him, while he inaugurated
the new age”. His _Vita Nuova_ (New Life) and _Divina Commedia_ (Divine
Comedy) are essentially modern in thought, but ancient in the manner in
which the thought is expressed.

Petrarch may be said to fairly open the new era. Like Dante, he was a
Florentine. He was the apostle of Humanism, that system of philosophy
which regarded man “as a rational being apart from theological
determinations” and perceived that “classic literature alone displayed
human nature in the plenitude of intellectual and moral freedom”. To a
revolt against the despotism of the Church, it added the attempt to
unify all that had been taught and done by man. Petrarch was a poet, a
lawyer, an orator, a priest, and a philosopher. He lived between the
years 1304-1374. He was a great traveler, and visited the leading
continental cities in order to converse with learned men. Petrarch
delighted in the study of Cicero, in collecting manuscripts, and in
accumulating coins and inscriptions for historic purposes. He advocated
public libraries and preached the duty of preserving ancient monuments.
He opposed the physicians and astrologers of his day, and ridiculed the
followers of Averröes.

Boccaccio, who has been called the Father of Italian Prose, and is most
widely known as the author of the _Decameron_, did not spend all of his
time in describing the escapades of the knights and ladies of old.
Influenced potently by Petrarch, Boccaccio regretted the years he had
wasted in law and trade, when he should have been reading the classics.
Late in life he began the study of Greek that he might read the _Iliad_
and the _Odyssey_. What he lacked in genuine scholarship he made up in
industry. He continued the work begun by Petrarch of hunting for lost
manuscripts of the ancient Greek and Roman authors. Many of these
precious documents were stored in the conventual libraries, where, too
often, they were either wantonly destroyed or were mutilated, the words
of the author being erased from the parchment to make way for new
prayers. Boccaccio tells of a visit which he made to the Benedictine
Monastery of Monte Cassino near the city of Salernum. He wished to see
the books and found them in a room without door or key. Many of them
were mutilated. On making inquiry as to the cause, the monks answered
that they had sold some of the sheets, having first erased the original
words, replacing them with psalters. The margins of the old pages were
made into charms and were sold to women.

It was owing to the unselfish labors of such men as Petrarch and
Boccaccio that the works of Livy, Cicero, Quintilian, Terence, and
others of the ancient authors, were preserved. In this enterprise they
were encouraged by the rulers. Thus Cosimo de’ Medici in Florence,
Alfonso the Magnanimous in Naples, and Nicholas V. in Rome, to say
nothing of the despots of the smaller cities, rivaled one another in
their zeal in unearthing and multiplying the manuscripts of the ancient
writers. They spared neither time nor money to increase their store of
manuscript books. They surrounded themselves with learned men who lived
in high esteem, and who were supported by salaries paid by the State or
by private pensions.

The fifteenth century, which was one of the most remarkable epochs in
history, was rich in accomplishment. Almost all of the great events
which have influenced European commercial and intellectual development
can be traced to that period. The invention of printing, the discovery
of America, the fall of the Roman Empire in the East, the birth of the
Reformation, and the rise of art in Italy, all belong to this wonderful
century. In this period, when almost every city in Italy was a new
Athens, the Italian poets, historians, and artists vied with the eminent
men of the ancient world in carrying the lamp of learning. The Italian
cities—Florence, Bologna, Milan, Venice, Rome and Ferrara—fought with
one another, not for the spoils of the battlefield but for the victories
of science and of art; not so much for the profits of commerce as for
the wealth of genius and of learning. The intellectual development which
occurred in northern Italy under the rule of the house of Medici, and
particularly under the auspices of Lorenzo the Magnificent, forms one of
the most interesting periods in European history.

It is impossible in the present work to trace the steps by which the
exquisite taste of the ancients in works of art was revived in modern
times. Nevertheless, a few words may be devoted to this subject. While
much must be credited to those Greek artists who had left their country
and had settled in the Italian peninsula, it must be conceded that many
of the works of art of the native Italians were not the less
meritorious. The same circumstances which favored the revival of
letters, operated to further the cause of art; and the same individuals,
who were interested in the preservation of the manuscripts of the older
authors, also busied themselves with the collection of ancient statues,
paintings, gems and tapestry. The freedom of the Italian Republics
permitted the minds of men to expand to full fruition; and the
encouragement which was given by its rulers to artists, sculptors and
artisans, made the city of Florence, in the fifteenth century, a not
less renowned centre of culture than Athens had been in ancient times.

The revival of art dates from the time of Cimabue (1240-1300) and Giotto
(1276-1336). The former is known as the Father of Modern Painters; the
latter constructed the Campanile at Florence. To Giovanni Cimabue, scion
of a noble Florentine family, is usually given the credit of being the
restorer of art in Italy. He is thought to have been the first painter
to throw expression into the human countenance. His work, if judged by
present standards, would be called crude, rude and incomplete. Much of
the fame of this painter is to be attributed to his being the first
person whom Vasari chronicled in his _Lives of the Painters_. For more
than a century after the time of Cimabue and Giotto, painters displayed
only a smattering of anatomical knowledge.

Early in the fifteenth century two Flemish artists, Hubert van Eyck
(1365-1426) and his brother John (1385-1441), in their polyptych of the
Adoration of the Lamb, boldly struck out along new lines and committed
the unheard-of deed of painting nude figures. Italy, however, was the
real birthplace of Art-Anatomy. While the Flemings and others of the
North painted everything that they saw, including the nude, the Italians
were the first men of the Renaissance who thought of painting the nude
figure before draping it. Leo Battista Alberti (1404-1472), in his works
on painting, insists that the bony skeleton must first be drawn and then
clothed with its muscles and flesh. This was an important step in
advance, since it shows that the Florentine artists were progressing
towards realism and were breaking away from the symbolism of the early
Christian painters and mosaic-workers. The new movement in art found a
worthy champion in Antonio Pollaiuolo (1432-1498). In his knowledge of
the anatomy of the human figure he surpassed all of the artists of his
day; and as a result of his labors he may justly be named the founder of
the scientific study of the nude. His knowledge of anatomy was so
accurate, and so extensive, that it could have been gained only in the
dissecting room.

Under the patronage of Lorenzo de’ Medici and the guiding mind of
Pollaiuolo, there occurred a revival of pseudo-paganism in Art. The old
Church subjects were largely neglected; mythological subjects again
became the fashion; draperies were either modified or were laid aside;
and the scientific study of anatomy, both as regards the nude figure and
the dissection of the individual parts, became the necessary training of
the student. Of all the masters of this period, the palm for excellence
in drawing the naked figure must be awarded to Luca Signorelli
(1442-1524), from whose work Michael Angelo is known to have profited.

The alliance between skilled anatomists and master artists was of
reciprocal benefit. The anatomical studies which were made conjointly by
Leonardo da Vinci and the celebrated teacher of anatomy, Marc Antonio
della Torre, were lost to the world by the untimely death of the latter,
before he had finished a magnificent treatise on human anatomy.
Leonardo’s anatomical sketches, if they had been published during his
lifetime, would have revolutionized anatomy both as regards discoveries
in the body and the teaching of the structure of man. These masterpieces
of anatomical illustration long remained hidden from the world; they
were published only in the year 1902. Even now their cost is so great
that only a few wealthy libraries can possess them. Leonardo’s long
unpublished drawings show him to have been a most accurate anatomist. At
the same time, he constantly kept in view the aim of fine art, which, in
so far as practical anatomy is concerned, needs a knowledge of only the
bones and the muscles.

Nor was Leonardo the only artist who made dissections. Raffaello Santi,
Michael Angelo, Bartholomaus Torre, Luigi Cardi or Civoli, Jan Stephan
van Calcar, Giuseppe Ribera, Arnold Myntens, and Pietro da Cortona
studied practical anatomy. Rubens’s long-lost sketch-book[1], which was
published one hundred and thirty-three years after his death, shows with
what care he had studied human anatomy. Albrecht Dürer’s _Treatise on
the Proportions of the Human Body_ is also worthy of mention.

In the number and fame of her Universities, Italy showed supremacy. At
the end of the fifteenth century she could boast of sixteen seats of
learning, a number equal to that of the combined institutions of
Britain, France, Germany, Hungary, Bohemia and Bavaria.

This digression has led us away from the Humanists. Their list is a long
one. Among them were Poggio Bracciolini, who discovered the manuscript
of the _Institutions_ of Quintilian and the writings of Vitruvius;
Poliziano, the first poet of the fifteenth century, and the translator
of the works of Hippocrates and Galen; Pontanus, whose _De Stellis_ and
_Urania_ were much admired by Italian scholars; Sannazzaro, whose epic
on the birth of Christ cost him twenty years of labor; Vida, whose
_Christiad_ and other poems were much admired; and Fracastoro, whose
_Syphilis_ was hailed as a divine poem.

From the viewpoint of the medical historian an important event occurred
in the year 1443, when Thomas of Sarzana, later known as Pope Nicholas
V., discovered a manuscript copy of the _De Medicina_ of Aulus Cornelius
Celsus. This classic, which had been lost for many centuries, was one of
the first medical books to pass through the press. It gave physicians an
insight into Hippocratic medicine without the disadvantage of an
imperfect translation. Physicians took an active part in the
Renaissance. Thus Nicholas Leonicenus, of Ferrara, translated the
_Aphorisms_ of Hippocrates and the _Natural History_ of Pliny; and
Winter of Andernach did similar labor for the writings of Galen,
Alexander, and Paulus Aegineta. Their efforts seem insignificant in
comparison with those of Anutius Foesius, a humble practitioner of Metz,
who spent forty years of his life in preparing a complete Greek edition
of the works of Hippocrates. The New Learning was brought to England by
two physicians, Thomas Linacre and John Kaye (Caius).

Some of the Humanists were printers. The history of printing in Italy
naturally forms a part of the history of the Renaissance. In 1462,
Maintz was pillaged by Adolph of Nassau and its printers were scattered
over Europe. Two of them wandered into Italy, living in a village in the
Sabine mountains, where, in October, 1465, the first book was printed
from an Italian press. It was a Latin edition of Lactantius. Six years
later a press was established in Florence. In 1478, Mondino’s
_Anathomia_ was printed in Pavia. It has been estimated that before the
first year of the sixteenth century, five thousand books had been
printed in Italy. In those days the editions were small, 265 copies
being considered one edition. An immense amount of labor was required to
get out a new edition. First, the manuscripts of the ancient author had
to be collected, compared and corrected, this work being done by learned
men who resided in the home of the publisher. The corrections were made
without the aid of dictionaries, grammars, or book-helps of any kind.
The proof was read aloud to the assembled scholars and the final
corrections were added. In time, Venice came to be the most noted of the
Italian cities in the publishing business, owing chiefly to the family
of Aldo. This family of printers became famous for finely printed Greek
and Latin books, which are still called Aldine editions. Nine years
after the printing of the first book in Italy, the art was practiced in
England by Caxton.

Humanism in Italy began to decline toward the close of the fifteenth
century. Long before this time it had degenerated into Paganism. The
scholars influenced all life, customs and thought. Although the nation
remained Catholic, it was such only in name. Everyone bowed before the
shrine of classical literature. Even in the christening of children the
Christian name was sacrificed to paganism. The saints were forgotten,
and the names most frequently chosen were those from heathen mythology.
The polite authors described scenes, events and actions in their
writings in terms which long since have been banished from good society.
A spade was called by its true name. Bembo, the secretary of Leo X.,
could write a hymn to Saint Stephen or a monologue for Priapus with
equal ease and elegance. The amours of the high and the low were
flaunted in print. The nation degenerated into an intellectual and
sensual state which involved even the Popes. Scholars and rich men alike
vied with one another in returning to those pursuits, habits, and
methods of thought which had ruled ancient Rome in her most corrupt
days.

Such a condition could not exist forever. The turning-point came in
1527, when Charles the Fifth, engaging in war with Pope Clement VII.,
captured and sacked the city of Rome. After that event everything was
changed. Not only had the scholars lost their influence, but many of
them had lost their lives. Valeriano, who returned to Rome after the
siege, pathetically exclaims: “Good God! when first I began to enquire
for the philosophers, orators, poets and professors of Greek and Latin
literature, whose names were written on my tablets, how great, how
horrible a tragedy was offered to me! Of all those lettered men whom I
had hoped to see, how many had perished miserably, carried off by the
most cruel of all fates, overwhelmed by undeserved calamities; some dead
of plague, some brought to a slow end by penury in exile, others
slaughtered by a foeman’s sword, others worn out by daily tortures;
some, again, and these of all the most unhappy, driven by anguish to
self-murder”. Such was the end of the men who made the Italian
Renaissance. The Spaniards, the Inquisition, and the changed policy of
the Church prevented a second revival of Humanism.

While the sack of Rome marks the end of the Humanists, the Revival in
Medicine continued to grow in vigor and extent. Many of the greatest
discoveries in anatomy were made, and most of the important books on
this subject were written, in the middle and latter part of the
sixteenth century. Italian history is rich in contradictions. While
peace, ease and comfort are generally considered to be necessary to the
development of science and culture, Italy offers the strange spectacle
of the steady increase in medical knowledge in spite of wars and alarms.
The Inquisition, which had been introduced from Spain in 1224, was given
a new and horrible impetus when, in 1540, Paul III. appointed six
cardinals to add to its tortures. One of them, Caraffa, became Pope Paul
IV. in 1555, and four years later originated the _Index Expurgatorius_.
Torn by civil and foreign wars, and terrorized by the Inquisition, which
was not abolished until late in the eighteenth century, Italy gradually
lost her commercial and intellectual supremacy. That she should have
accomplished so much under such unfavorable circumstances, is now a
matter of wonderment.

The origin of the Renaissance in Italy was due to many causes. The early
Roman civilization was not entirely blotted out by the invasion of the
barbarians of the North. And in the matter of language the Italians
possessed an advantage, since the transition from Latin to Italian was
easier than from Latin to Spanish, French, English or German. The
fertility of the country; the mildness of the climate; the division into
semi-independent states; the infusion of new northern blood into the
veins of the Italians; the removal of the papal court to Avignon in
1309; and the gradual rise of a powerful middle class, whose members
included the devotees of the professions of law and medicine, were
factors which determined that Italy, rather than France or Spain, should
be the field for the Revival of Letters.

To Italy, then, belongs the glory of having been the first to free
herself from the trammels of ancient scholasticism and the fetters of
mediaeval theology. She abandoned the wordy dialectics and metaphysical
gymnastics of the philosophers of old. In place of mortification,
penance and solitary confinement in cloistered monasteries and convents,
she began to have a proper conception of the dignity of man and his
relation to nature.

Italy, in the time of her freedom, received the torch of learning from
Greece; Italy revived its brilliancy, and, when her time of adversity
and ruin arrived, she passed it on to the nations of Northern Europe.
They in turn have transferred it to America, to Australia, to India, and
to the uttermost parts of the earth.


The Anatomical Renaissance

Italy in the sixteenth century was the fount from which issued a
ceaseless stream of anatomical discoveries. The ancient and illustrious
Universities of Bologna, Pavia, Padua, Pisa and Rome, eclipsed the
schools of Paris and Montpellier, of Toulouse and Salamanca; and the
Italian peninsula, which, in early mediaeval times, had gloried in the
skill of the physicians of Salernum, a second time became the medical
centre of Europe. Vesalius and his pupil, Fallopius, taught at Padua;
the ancient fame of Bologna was supported by Arantius and Varolius;
Vidius, returned from establishing the anatomical school at Paris,
taught at Pisa; Eustachius was at Rome, Ingrassias lectured at Naples,
and the fame of the New Anatomy spread throughout the world. The Italian
cities were filled with students from foreign lands. Padua had more than
one thousand new students every year, salaries were paid to her one
hundred professors, and medicine was looked upon as a noble profession.

While the Italians were the leaders in progress, the Germans were still
lecturing on Galen and Avicenna, the English had done almost nothing,
and the Collége de France was not established until 1530.

Legalized by imperial authority and sanctioned by the Church, dissection
was no longer regarded as a crime. A bull by Pope Boniface VIII., issued
in the year 1300, forbidding the evisceration of the dead and the
boiling of their bodies to secure the bones for consecrated ground, as
was done by the Crusaders, was wrongly interpreted as forbidding
anatomical dissection. Two centuries later the Popes, standing in the
vanguard of science, permitted dissections to be made in all the Italian
medical schools, and paved the way for the Anatomical Renaissance.

Great things were done in the sixteenth century. Under the scalpel and
pen of Vesalius, anatomy was revolutionized. Surgery was guided into new
paths by Ambroise Paré; and obstetrics, thanks to the labors of
Eucharius Rhodion and Jacques Guillemeau, began to assume its legitimate
place among the medical sciences. Servetus, visionary and argumentative,
correctly described the pulmonary circulation in a theological work
which was burned with its author. Eustachius, Columbus and Fallopius
widened the path which had been blazed by Vesalius. Arantius,
Caesalpinus and Fabricius added materially to anatomical science. The
labors of all these great masters prepared the way for the greatest
event occurring in the seventeenth century, namely, William Harvey’s
discovery of the circulatory movement of the blood.

    [Illustration: INITIAL LETTER BY VESALIUS
    (From the “Fabrica”, 1543)]




                             CHAPTER FIRST
                        Anatomy in Ancient Times


    [Illustration: Illuminated capital]

Egypt and Greece were the sources of the medical learning of the ancient
world. Although the Egyptians and early Greeks possessed a certain
amount of anatomical knowledge, which was gained in the one instance by
the practice of embalming and in the other by an examination of the
bones, no real progress could be made because of the laws, customs and
prejudices of those ancient peoples. Thus we find the Egyptians stoning
the operator who opened the abdomen in order that the body might be
embalmed; and the Greeks inflicted the death penalty on those of their
generals who, after a battle, neglected to bury or burn the remains of
the slain.

    [Illustration: HIPPOCRATES]

In the time of Hippocrates, whose life extended approximately over the
period between 460-377 B.C., Greek medicine emerged from the domination
of the Asclepiadae, or priests of Aesculapius, who had followed it as an
hereditary and secret art. Prior to this time in the numerous Asclepia,
or Temples of Aesculapius, votive offerings had been accepted, some of
which were of anatomical interest. Thus the Temple at Athens received a
silver heart and gold eyes. Pausanias states that Hippocrates gave to
the Temple of Apollo, at Delphos, a skeleton which was made of brass.
Possibly, as Moehsen[2] believes, this was a metallic figure
representing a man who was much emaciated by the ravages of disease. In
the Hippocratic writings, some of which are undoubtedly spurious, are
few references to the opening of a dead body; and these examinations
concern the investigation of the thorax and abdomen in order to
determine the cause of death. While the Greek physicians knew little of
the human muscles, of the nervous system and of the organs of sense,
they were well acquainted with the anatomy of the bones. Their
dissections were held upon the lower animals.

It is impossible to determine whether or not the Greek physicians of the
Hippocratic period dissected the human body. “It has long been a matter
of debate”, says John Bell[3], “whether the ancients were, or were not,
acquainted with anatomy, and the subject, with its various bearings, has
been much and keenly agitated by the learned. If anatomy had been much
known to the ancients, their knowledge would not have remained a subject
of speculation. We should have had evidence of it in their works; but,
on the contrary, we find Hippocrates spending his time in idle
prognostics, and dissecting apes, to discover the seat of the bile.”

Galen[4] states that the ancient physicians did not write works on
anatomy; that such treatises were at that time unnecessary, because the
Asclepiadae—to which family Hippocrates belonged—secretly instructed
their young men in this subject; and that opportunities were given for
such study in the temples of Aesculapius.

    [Illustration: ARISTOTLE]

The first systematic dissections seem to have been made by the
Pythagorean philosopher Alcmaeon, who lived in the sixth century B. C.,
but it is uncertain whether he dissected brutes or men. The cochlea of
the ear and the amnios of the foetus were named by Empedocles of
Agrigentum, in the fifth century B. C. The nerves were first
distinguished from the tendons by Aristotle, (384-322 B. C.), the most
celebrated zoötomist of antiquity, who has been called the Father of
Comparative Anatomy. For twenty centuries his views of natural phenomena
were held in high esteem.

For a long period the early inhabitants of Rome were practically without
physicians. During severe epidemics they had recourse to oracles, to the
health deities of the Greeks, and to their native gods. As early as the
fifth century B. C., during a pestilence, a temple was erected to Apollo
as Healer. The worship of Aesculapius was introduced into Rome in the
year 291 B. C. Livy relates that the god of medicine in the guise of a
serpent was transported from Epidaurus, in Greece, to the Isle of the
Tiber where a temple was built in his honor.

The Romans, like the Greeks, were accustomed to leave votive offerings,
or donaria, in their temples. Such gifts included surgical instruments,
pharmaceutical appliances, painted tablets representing miraculous
cures, and great numbers of images of various parts of the human frame
shaped in metal, stone or terra-cotta. Among the remains of Roman
anatomical art is the marble figure which was unearthed in the villa of
Antonius Musa, the favorite physician of the Emperor Augustus. It is a
human torso; the front of the chest and abdomen has been removed so as
to expose the viscera. The heart is placed vertically in the middle of
the thorax, thus corresponding to the position of this organ as
described by Galen who made his dissections on apes. It is a human
thorax with simian contents. The figure is supposed to have been
constructed for the purposes of a teacher of anatomy.

    [Illustration: ALEXANDER THE GREAT]

It was in the famous Alexandrian University that human anatomy was first
studied systematically and legally.

Alexander the Great, after the fall of Tyre (332 B. C.) and the siege of
Gaza, ordered his fleet to sail up the Nile as far as Memphis while he
proceeded overland with the army. It was probably on this march, while
viewing the pyramids and other marvelous works of the ancient Egyptians,
that he conceived the grand idea of founding a city upon the banks of
the Nile, which should be a model of architectural beauty, a centre of
intellectual life and a lasting monument of his own greatness and
magnificence. The foundation of Alexandria was laid by the warrior whose
name it bears; but the credit of instituting the Library belongs to one
of his lieutenants, Ptolemy Soter.

    [Illustration: PTOLEMY SOTER]

The new city which for centuries was the intellectual and commercial
storehouse of Europe, Africa and India, was of oblong form. Lake
Mareotis washed its walls on the south, while the Mediterranean bathed
its ramparts on the north. Provided with broad streets, it was adorned
with magnificent houses, temples and public buildings. At the centre of
the city was the Mausoleum in which was deposited the body of Alexander,
embalmed after the manner of the Egyptians. Alexandria was divided into
three parts: the _Regio Judaeorum_ or Jews’ quarter, in the northwest;
the _Rhacotis_, or Egyptian section, on the west, containing the
Serapeum with a large part of the Library; and on the north, the
_Bruchaeum_, or Greek portion, containing the greater part of the
Library, the Museum, the Temple of the Caesars and the Court of Justice.
The population was cosmopolitan in character; the statues of the Greek
gods stood by the side of those of Osiris and of Isis; the Jews forgot
their language and spoke Greek; and under the Ptolemies, who were of
Greek descent, Alexandria became a centre of intellectual life and
culture.

To the medical historian the most interesting feature of Alexandria was
the Museum or University. Here were assembled the intellectual giants of
the earth: Archimedes and Hero, the philosophers; Apelles, the painter;
Hipparchus and Ptolemy, the astronomers; Euclid, the geometer;
Eratosthenes and Strabo, the geographers; Manetho, the historian;
Aristophanes, the rhetorician; Theocritus and Callimichus, the poets;
and Erasistratus and Herophilus, the anatomists, all of whom labored in
quiet upon the peaceful banks of the Nile. The early Christian church
drew from “the divine school at Alexandria” such eminent teachers as
Origen and Athanasius. Here were a chemical laboratory, a botanical and
zoölogical garden, an astronomical observatory, a great library, and a
room for the dissection of the dead.

In the Alexandrian school of medicine Erasistratus and Herophilus taught
the science of organization from actual dissections. The generosity of
the Ptolemies not only furnished them with an abundance of dead
material, but condemned malefactors were used for human vivisection.
Celsus[5] states that the Alexandrian anatomists obtained criminals,
“for dissection alive, and contemplated, even while they breathed, those
parts which nature had before concealed.”

Herophilus made many anatomical discoveries. He traced the delicate
arachnoid membrane into the ventricles of the brain, which he held to be
the seat of the soul; and first described that junction of the six
cerebral sinuses opposite the occipital protuberance, which to this day
is called the _torcular Herophili_. He saw the lacteals, but knew not
their use, and regarded the nerves as organs of sensation arising from
the brain; he described the different tunics of the eye, giving them
names which are still retained; and first named the duodenum and
discovered the epididymis. He attributed the pulsation of arteries to
the action of the heart; the paralysis of muscles to an affection of the
nerves; and first named the furrow in the fourth cerebral ventricle,
calling it _calamus scriptorius_.

Erasistratus gave names to the auricles of the heart; declared that the
veins were blood-vessels; and the arteries, from being found empty after
death, were air-vessels. He believed that the purpose of respiration was
to fill the arteries with air; the air distended the arteries, made them
beat, and in this manner the pulse was produced. When once the air
gained entrance to the left ventricle, it became the vital spirits. The
function of the veins was to carry blood to the extremities. He is said
to have had a vague idea of the division of nerves into nerves of
sensation and of motion; to the former he assigned an origin in the
membranes of the brain, while the latter proceeded from the cerebral
substance itself. He recognized the use of the trachea as the tube which
conveys air to the lungs. A catheter, the first invented, which was
figured in ancient surgical works, bore the name of the catheter of
Erasistratus. He gravely tells us, as the result of his anatomical
studies, that the soul is located in the membranes of the brain.

The practice of human dissection did not long exist in the city of its
origin, and after the second century was unknown. Then science underwent
a retrogression; observations and experiments were replaced by useless
discussions and subtle theories. The decline of the Alexandrian
University was due to a series of disasters which began with the Roman
domination and reached their climax with the capture of the city by the
Arabs.

    [Illustration: GALEN]

Claudius Galenus, the celebrated Roman physician whose writings were for
centuries accepted as authority and whose reputation was second only to
that of Hippocrates, was obliged to base his anatomical treatises
largely upon the dissection of the lower animals. He advised his pupils
to visit Alexandria, where he had studied, in order that they might
examine the human skeleton. He complained that the physicians of his
time—in the reign of Marcus Aurelius—had entirely neglected anatomical
knowledge and had degenerated into mere sophists. He appreciated the
importance of anatomy, particularly to a surgeon who is called upon to
treat wounds and injuries. Hence he has endeavored in the four books,
_De Anatomicis Administrationibus_, to cover this part of anatomy as
exhaustively as possible.

Galen’s voluminous writings form a precious monument of ancient
medicine. The works of the Alexandrian anatomists having been destroyed,
we know of their labors chiefly from what Galen has said of them. His
treatises show a remarkable familiarity with practical anatomy, although
his dissections were made upon the lower animals. Galen’s knowledge of
osteology was extensive. He described the bones of the skull, the
cranial sutures, and the essential features of the malar, maxillary,
ethmoid and sphenoid bones. He divided the vertebrae into cervical,
dorsal and lumbar classes. He knew that both arteries and veins were
blood-carrying vessels; he described the valves of the heart, and
recognized this organ as the source of pulsation. He erroneously taught
that the interventricular septum presents foramina through which the two
kinds of blood become mixed.

In myology Galen made numerous advances. “Previous to his
investigations”, says Fisher[6] “much confusion existed as to what
constituted a single muscle; he adopted the general rule of considering
each bundle of fibers that terminates in an independent tendon to be one
muscle. He was the first to describe and give names to the platysma
myoides, the sterno- and thyro-hyoides, and the popliteal. He described
the six muscles of the eye, two muscles of the eyelids, and four pairs
of muscles of the lower jaw—the temporal to raise, the masseter to draw
to one side, and two depressors, corresponding to the digastric and
internal pterygoid muscles. He described also the brachialis anticus,
the biceps flexor cubiti, the sphincter and levator ani, and the
straight and oblique muscles of the abdomen. In short, he described the
greater portion of the muscles of the body, his treatise differing
chiefly from a modern one in the minute account of these organs and in
the omission of some of the smaller muscles.” Galen studied the brain
and named the corpus callosum, the septum lucidum, the corpora
quadrigemina and the fornix; but erroneously stated that the nerves of
sensation arise from the brain, and those of motion from the spinal
cord. He denied the decussation of the optic nerves. He described the
pneumogastric and sympathetic nerves; seven pairs of cerebral and thirty
pairs of spinal nerves; and claimed the discovery of the ganglia of the
nervous system. He located the seat of the soul in the brain, which also
is the source of the rational mind; the heart to him was the source of
courage and of anger, and the liver was the seat of desire. Many of
Galen’s anatomical statements show that he derived his knowledge from
comparative dissections.

The Galenic era was followed by that long period of ignorance, of
slumber and of inaction which is justly known as the Dark Ages. While a
few Greek and Arab writers, who came after Galen, contributed to the
literature of medicine and surgery, they did nothing for anatomy. After
the end of the fifth century even the works of Galen were forgotten. At
this period, when medicine was chiefly in the hands of the Jews, the
Arabs and the bigoted clergy, nothing was done for science or for art.
The whole influence of Christianity was exerted against the schools of
philosophy. Illustrious apostles of the Church pronounced anathemas
against the reading of the ancient classics;[7] and eminent
ecclesiastics regarded disease as a divine penalty or as an invaluable
aid to saintly advancement. Art and anatomy were practically forgotten.
Their Renaissance occurred almost simultaneously.

During the period from the seventh to the fourteenth centuries the
school of Salernum was for medicine what Bologna became for law and
Paris for philosophy. Here, for eight hundred years, medicine was taught
to thousands of students and the impress of the profession was so potent
that the city called itself _Civitas Hippocratica_, and thus its seals
were stamped. Here medical diplomas were first issued to waiting
students who took a sacred oath to serve the poor without pay. Here with
a book in his hand, a ring on his finger and a laurel wreath on his
head, the candidate was kissed by each professor and was told to start
upon his way. Here women were professors and vied with men in spreading
the doctrines of our art.

For a period of several hundred years anatomy was taught at Salernum
from dissections made upon pigs. Copho, one of the Salernian professors
of the early part of the twelfth century, wrote a treatise, _Anatomia
Porci_, which gives minute directions regarding the manner in which the
animal is to be dissected. Another anatomical work of later date,
written by a member of the Salernian faculty, is entitled _Demonstratio
Anatomica_; it also deals only with comparative anatomy. In the
thirteenth century (A. D. 1231) Frederick II., Emperor of Germany and
King of the Two Sicilies, and the author of a treatise which contained a
complete anatomy of the falcon, decreed that a human body should be
anatomized at Salernum at least once in five years. Physicians and
surgeons of the kingdom were required to be present at the dissection.
So far as is known, no record has been kept of these demonstrations.
Creditable as was this anatomic decree, the great Hohenstaufen in other
respects was not free from the errors of his age. A firm believer in
_Medicina Astrologica_, he did not decide upon any undertaking until the
stars had been consulted.

It was not alone at Salernum that dissection was legalized in the
thirteenth century. A document of the year 1308, of the Maggiore
Consiglio of Venice, shows that a medical college located in that city
was authorized to dissect a body once a year. This, and other isolated
examples, indicate that the time was approaching when anatomy should be
taught from human dissections. The credit of reinaugurating the teaching
of this useful department of science belongs to Mondino dei Luzzi of
Bologna.

    [Illustration: Ornamental block]




                             CHAPTER SECOND
                    Mondino, the Restorer of Anatomy


    [Illustration: Illuminated capital]

In the year 1315, in the old Italian city of Bologna, an event occurred
which marks an important epoch in the history of medicine. A wondering
crowd of medical students witnessed the dissection of a human
cadaver—one of the few procedures of the kind that had occurred since
the fall of the Alexandrian University. Acting under royal authority
Mondino, a man far in advance of the age, placed the body of a female
upon a table where for many centuries before only the cadavera of apes,
of swine and of dogs had been studied.

Mondino, known also as Mundinus, Mundini, Raimondino, or Mondino dei
Luzzi, was descended from a prominent Italian family. Little is known of
his life. The year of his birth is disputed; probably 1276 was near the
time. He was graduated in medicine in 1290 and in 1306 he became a
professor in the University of Bologna, holding his chair with credit
until his death in 1326. Like that of the illustrious Homer, Mondino’s
nativity has been claimed by several rival cities. Guy de Chauliac,
writing in 1363, states that Mondino was a Bolognese: _Mundinus
Bononiensis_ is Chauliac’s expression.

Mondino’s method of teaching anatomy is known from Chauliac’s
testimony:—“Mundinus of Bologna, wrote on anatomy, and my master,
Bertruccius, demonstrated it many times in this manner:—The body having
been placed on a table, he would make from it four readings; in the
first the digestive organs were treated, because more prone to rapid
decomposition; in the second, the organs of respiration; in the third,
the organs of circulation; in the fourth the extremities were treated.”
The innovation so auspiciously begun was not continued, and after the
death of Mondino human dissections were made only at long intervals. The
few instances in which, in the fourteenth and fifteenth centuries, the
ecclesiastical and civil authorities granted the right to make
dissections only prove the contention, that the practical study of human
anatomy did not gain recognition until the sixteenth century.

When Mondino began his dissections the epoch of Saracen learning had
ended, but the influence of Arab medicine exerted by the writings of
Albucasis, Avicenna and Rhazes had not declined. The Arabian physicians
had accomplished little for anatomy. In this line the influence of Galen
was still potent, and was rarely questioned until the publication of the
_Fabrica_ of Vesalius in 1543. During a long period the little treatise
of Mondino held full sway in the mediaeval schools. Medicine was taught
in the University of Bologna, which as early as the twelfth century was
celebrated for its departments of literature and of law. These studies
were free of the difficulties which beset medicine. The prejudice
against dissection was so great that for nearly a century after his
death few men dared to repeat the acts of Mondino.

In 1316 Mondino issued his book which remained in manuscript form for
more than one hundred and fifty years, the first printed edition bearing
the date 1478. Small and imperfect as it was, it marks an era in the
history of science. By command of the authorities this book was read in
all the Italian Universities. The work of Mondino contained no new
facts; it was compiled largely from the writings of Galen and of
Avicenna. The descriptions, to use the words of Turner, “are corrupted
by the barbarous leaven of the Arabian schools, and his Latin is defaced
by the exotic nomenclature of Ibn-Sina and Al-Rasi”. Mondino divided the
body into three cavities, of which the upper contains the animal
members, the lower the natural members, and the middle the spiritual
members. Many of his names are borrowed from the Arab writers. Thus, he
calls the peritoneum _siphac_, the omentum _zyrbi_, and the mesentery
_eucharus_. His description of the heart is much nearer accuracy than
would be expected. He resorted to vivisection, and tells us that when
the recurrent nerves of the larynx are cut the animal’s voice is lost.
In his book we find the rudiments of phrenology. He states that the
brain is divided into compartments, each of which holds one of the
faculties of the intellect.

    [Illustration: MONDINO’S DIAGRAM OF THE HEART, 1513]

Mondino did not himself make the dissections which are credited to him.
According to an ancient custom which lasted until the time of Vesalius,
the actual cutting was done by a barber who wielded a knife as large as
a cleaver. The professor of anatomy sat upon an elevated seat and
discoursed concerning the parts, while a demonstrator, who also did not
soil his fingers, pointed to the different structures with a staff.
Originally Mondino’s book contained no figures; when the art of wood
engraving was introduced in the latter part of the fifteenth century, a
few rude woodcuts appeared which represent Mondino and his method of
teaching. In the _Fasciculus Medicinae_ of Joannes de Ketham, published
at Venice in 1493, Mondino’s book is printed with an illustration
showing a demonstration in anatomy.

According to Mondino the heart is placed in the centre of the body. The
valves he considers “wonderful works of nature”. He describes a right,
left and middle ventricle. The right ventricle has thinner walls than
the left, because it contains blood; the left one contains the vital
spirit, which passes through the arteries to the body; and the middle
ventricle consists of many small cavities “broader on the right side
than on the left, to the end that the blood, which comes to the left
ventricle from the right, be refined, because its refinement is the
preparation for the generation of vital spirit, which should be
continually formed”. Mondino describes five bones of the head, separated
by three sutures—coronal, sagittal and occipital. The brain has two
membranes: dura and pia. There are three cerebral ventricles—anterior,
posterior and middle—and in these he locates the various intellectual
qualities. He describes the cerebral nerves: olfactory, optic, motor
oculi, facial, vagus, trigeminal, auditory and hypoglossal. He calls the
innominate bone _os femoris_: the femur, _canna coxae_; the humerus, _os
adjutori_; while the bones of both leg and forearm are named _focilia_
major and minus.

    [Illustration: ANATOMICAL DEMONSTRATION IN 1493
    (Joannes de Ketham)]

    [Illustration: TITLE-PAGE OF MONDINO’S ANATOMY BY MELERSTAT
    (Printed before 1500)]

Like many anatomists who succeeded him, Mondino mingled surgical ideas
with his anatomical statements. A break in the _siphac_ causes hernia
and a swelling in the _mirach_. He treated ascites by puncture and
evacuation, making a valve-like opening. Wounds of the large intestines
must be sutured; if the wound be in the small intestines he advises that
“you should have large ants, and, making them bite the conjoined lips of
the wound, decapitate them instantly, and continue until the lips remain
in apposition and then reduce the gut as before”. He gives an
explanation of the length and convolution of the intestines; “for if it
were not convoluted the animals would have to be continuously ingesting
food and continuously defecating, which would impede engagement in the
higher occupations”. Digestion is aided by black bile from the spleen
and by red bile from the liver. The kidneys he regards as glands in
which urine is extracted from the blood. The renal veins expand and form
a fine membrane like a sieve through which the urine is filtered but
blood cannot pass. He mentions renal calculi: if small they pass through
the ureter; if large they are incurable except by incision, and this is
to be avoided. The uterus and breasts are connected by veins, hence the
sympathy between these organs. Inguinal hernia is to be operated upon;
the spermatic cord and testicle may or may not be dissected out, or the
hernia may be treated by the application of a caustic. An incision in
the neck of the bladder will heal, because this part is muscular; but a
cut in the body of the organ will not heal. He describes the operation
for stone:—The patient being in proper position, the stone is conducted
to the neck of the bladder by the finger in the rectum; an incision is
made and the stone is pulled out with an instrument called
_trajectorium_.

Mondino’s book passed through not less than twenty-three editions
between the years 1478-1580. The only manuscript extant is in the
National Library at Paris.

The first printed edition of the _Anathomia Mundini_, Pavia, 1478, is a
folio of twenty-two leaves. The Strassburg edition, 1513, is a small
octavo volume of forty leaves. It contains a diagram of the heart and an
astrological figure, a cadaver with the thorax and abdomen opened,
surrounded by the signs of the zodiac. Such was the volume which for
more than two hundred years was supposed to contain all that was to be
said of human anatomy!

    [Illustration: COLOPHON OF THE ANATOMY OF MONDINO, 1513]

So numerous are the abbreviations in Mondino’s book, so barbarous is his
style, that the making of a translation is a difficult task. His reasons
for writing are these:—“A work upon any science or art—as saith Galen—is
issued for three reasons; _First_, that one may help his friends.
_Second_, that he may exercise his best mental powers. _Third_, that he
may be saved from the oblivion incident to old age”.




                             CHAPTER THIRD
                          Mondino’s Successors


    [Illustration: Illuminated capital]

For two hundred years anatomists used Mondino’s book as a text for their
lectures and for the same period anatomical writers did little more than
comment upon this treatise. The new art of wood engraving was turned to
anatomical use and crude illustrations of the various parts of the body
were put into circulation. Some of these pictures were in the form of
_Fliegende Blätter_, or flying leaves. A set of anatomical plates of
this type was issued by a certain Ricardus Hela, a physician of Paris,
as early as the year 1493. They were printed at Nuremberg. Their
character may be judged by the accompanying illustration of the osseous
system.


Gabriel de Zerbi

One of Mondino’s commentators was Gabriel de Zerbi (1468-1505), of
Verona, who taught medicine, logic and philosophy in the Universities of
Padua, Bologna and Rome. His book, _Anatomia Corporis Humani_, appeared
at Venice in 1502. Zerbi imitated Mondino in style, abbreviations and
language. The work, however, contains some original observations
regarding the Fallopian tubes, the puncta lachrymalia and the lachrymal
gland. From the fact that Zerbi describes two lachrymal glands in each
orbit, it is known that many of his dissections were made upon brutes.

    [Illustration: ANATOMICAL PLATE BY RICARDUS HELA, 1493]

Zerbi’s reputation, which extended to all parts of Europe, was the cause
of his death. The Venetians received from Constantinople the request for
a skillful physician who should treat one of the principal Seigniors of
Turkey. The Republic turned its eyes to Zerbi who went to
Constantinople, apparently cured the Seignior, and, loaded with
presents, started on the return voyage for Venice, Unfortunately the
patient suddenly died after a debauch. The infuriated Turks overtook the
ship on which Zerbi and his son were passengers and carried them back to
Constantinople, where both the anatomist and his son were quartered
alive.

    [Illustration: PEYLIGK’S DIAGRAM OF THE HEART, 1499]


John Peyligk

Among the German anatomists of this period was John Peyligk, a Leipsic
jurist, whose _Philosophiae Naturalis Compendium_, printed at Leipsic in
1499, contains crude anatomical illustrations.


Magnus Hundt

Far more important was the _Antropologium_ of Magnus Hundt (1449-1519),
of Magdeburg, which appeared at Leipsic in 1501. It contains four large
and several small woodcuts which are among the earliest of anatomical
illustrations. One of these shows the trachea on the right side of the
neck, passing downward to the lungs; on the left side the oesophagus is
represented. In the thorax are seen the lungs and the heart, the latter
resembling the figure of this organ as presented on old playing cards.
The pericardium has been opened, and the stomach and intestines are
crudely figured. The diaphragm is absent.

    [Illustration: ANATOMICAL FIGURE FROM MAGNUS HUNDT, 1501]


Laurentius Phryesen

Early in the sixteenth century a Holland physician, Laurentius Phryesen
(_Phries_, _Friesen_), residing in the German city of Colmar and later
at Metz, wrote a popular book on medicine, _Spiegel der Artzny_, which
was published at Strassburg in 1518. It contains two anatomical
illustrations cut in wood, dated 1517, and supposedly made after the
drawings of Waechtlin, a pupil of the Elder Holbein. These pictures tell
their own story; they show a marked improvement over the figures which
Hundt published in 1501. The other anatomical plate in Phryesen’s book
is devoted to the skeleton.

    [Illustration: ANATOMICAL FIGURE FROM LAURENTIUS PHRYESEN, 1518]


Alexander Achillinus

The Italian physician Alexander Achillinus (1463-1525), professor of
philosophy and medicine in Bologna, is deserving of mention for his
anatomical knowledge. Zealously devoted to the Arab medical authors,
Achillinus made numerous discoveries which are set forth in his general
anatomy, _De Humani Corporis Anatomica_, Venice, 1516; and in a
commentary upon Mondino’s book, _In Mundini Anatomiam Annotationes_,
Venice, 1522. He discovered the duct of the sublingual gland, usually
credited to Wharton; two of the auditory ossicles, the malleus and
incus; the labyrinth; the vermiform appendix; the caecum and ileo-caecal
valve; and the patheticus nerve. Portal credits him with a better
knowledge of the bones and of the brain than was possessed by his
predecessors.

    [Illustration: ALEXANDER ACHILLINUS]


Berengario da Carpi

    [Illustration: DISSECTION BY BERENGARIO, 1535]

Giacomo Berengario, Jacobus Berengarius Carpensis, also known as Carpus,
was born in the small town of Carpi, in the Duchy of Modena, in the year
1470. His father, who was a surgeon, directed his studies, and for a
time he was placed under the instruction of the learned Aldus Manutius.
Graduating in medicine from the University of Bologna, Berengario became
noted for his skill in surgery and anatomy. He taught these branches in
Pavia, and was a member of the Bologna faculty from 1502 to 1527. Then
he practiced for a time in Rome, where he amassed a fortune by the
treatment of the victims of syphilis. The last twenty years of his life
were spent in Ferrara, where he died in 1550. Berengario was one of the
restorers of anatomy. His first dissection is said to have been made in
the house of Albert Pion, Seigneur de Carpi. This demonstration was
given publicly upon the body of a pig. Soon the anatomist turned his
attention to human subjects, of which it is said that more than a
hundred passed beneath his scalpel.

Berengario’s later years are said by Brambilla to have been made
miserable by the machinations of the agents of the Inquisition, who
objected to some of his opinions regarding the organs of generation. He
was unjustly accused of dissecting living men—an accusation which arose
from his statement that the surgeon should observe the anatomy of the
living body whenever it was opened by wounds or accidents.

    [Illustration: SKELETON BY BERENGARIO, 1523]

Berengario determined to improve Mondino’s book by making corrections in
the text, and by adding suitable illustrations. No illustrations were to
be found in the early editions of Mondino, and those which were added by
later editors of the work were untrue to nature. To Berengario must be
given the credit of furnishing some of the first anatomical
illustrations that were published, and that were made from actual human
dissections. These appeared in his “Commentaries of Carpus upon the
Anatomy of Mundinus”, (_Carpi Commentaria super_ _Anatomia Mundini_),
which was published at Bologna in 1521. The volume contains twenty-one
plates which were cut in wood. They have been credited to the celebrated
artist, Hugo da Carpi. While the drawing is somewhat coarse, the
illustrations are true to nature and show a distinct advance over
preceding pictures of this class. Berengario states that his plates will
be of value not only to physicians and surgeons but also to artists (_et
istae figurae etiam juvant pictores in lineandis membris_). Some of his
figures are schematic; for example, those showing the abdominal muscles.
So much better are his illustrations than those of his predecessors that
it may fairly be claimed that Berengario was the first author to produce
an illustrated anatomy.

    [Illustration: MUSCLES BY BERENGARIO, 1521]

Berengario also wrote a “Short Introduction to the Anatomy of the Human
Body”, _Isagogae Breves in Anatomiam Humani Corporis_; and a work on
Fracture of the Skull.

He was the first anatomist who described the basilar part of the
occipital bone, the sphenoidal sinus and the tympanic membrane.
Meryon[8] credits him with the “first correct description of the great
omentum (gastrocolic) and transverse mesocolon; of the caecal appendix
vermiformis, of the valvulae conniventes of the intestines; of the
relative proportions of the thorax and pelvis in man and woman; of the
flexor-brevis-pollicis; of the vesiculae seminales; of the separate
cartilages of the larynx; of the membranous pellicle in front of the
retina (attributed to Albinus); of the tricuspid valve, between the
right auricle and ventricle of the heart; of the semilunar valves at the
commencement of the pulmonary artery; of the inosculation between the
epigastric and mammary arteries, and an imperfect account of the cochlea
of the ear”. He was the first of the mediaeval anatomists to deviate
from the Galenic teaching in regard to the structure of the heart. He
diplomatically states that in the human subject the foramina in the
cardiac septum are seen only with great difficulty (_sed in homine cum
maxima difficultate videnter_).

    [Illustration: MUSCLES BY BERENGARIO, 1521]


John Dryander

John Dryander, a German physician, whose true name was Eichmann, called
himself Dryander in accordance with the custom of adopting names derived
from the Latin or Greek languages. He was born about the year 1500 in
the Wetterau in Hesse. After obtaining proficiency in mathematics and
astronomy, he went to Paris where he studied medicine for several years.
Returning to Germany, he engaged in the study of practical anatomy and
became a professor in Marburg, in which city he died in the year 1560.
He is said to have conducted the first dissections that were made in
Marburg, where he taught anatomy for twenty-four years, or from 1536 to
1560.

    [Illustration: DRYANDER]

Dryander, although he was a partisan of Mondino and da Carpi, and was a
fierce and sometimes an unfair opponent of Vesalius, deserves to be
regarded as one of the restorers of anatomy. He made several
observations upon the distinction between the cortical and the medullary
portions of the brain; and was one of the earliest practical anatomists
of the sixteenth century to furnish anatomical illustrations. He made
important astronomical observations and was the inventor of several
useful instruments. He was the author of three medical works of which
two were upon anatomy. His _Anatomia Mundini_, which was published at
Marburg in 1541, contains forty-six plates, many of which have been
copied from Berengario’s work.

    [Illustration: ANATOMICAL FIGURE BY ESTIENNE, 1545]


Charles Estienne

    [Illustration: SKELETON BY ESTIENNE, 1545
    (Reduced one-half)]

Charles Estienne, better known by the name of _Carolus Stephanus_, was a
French anatomist whose work is worthy of remembrance. Born in the early
part of the sixteenth century, he was given an excellent education. He
belonged to a noted Huguenot family of scholars and printers who have
made the Estienne name famous. Robert Estienne, the brother of Charles,
became the victim of religious persecution; he was obliged to flee to
save his life, and for a time the publishing business was conducted by
Charles Estienne. The latter also suffered for his faith; he was thrown
into a dungeon, where he died in the year 1564. Charles Estienne wrote
numerous books on literature, history, forestry and botany. His
anatomical treatise, _De Dissectione Partium Corporis Humani_, appeared
at Paris in 1545 with sixty-two full page plates which combine
anatomical clearness, beauty of form, and artistic representation. A
French translation of Estienne’s Anatomy was published in 1546. This
work was printed as far as the middle of the third book as early as the
year 1539: some of the plates are dated as early as 1530. The
illustrations have been excellently cut in wood; many of them show the
entire body, with much ornamentation, so that the proper anatomical part
seems small and irrelevant. Some of the plates show the subject in
picturesque and even loathsome attitudes. The text of this work is
especially valuable for the history of anatomical discovery. Although he
was an ardent Galenist, Estienne made numerous original observations in
anatomy. He described the synovial glands, a discovery which has been
credited to Clopton Havers. Estienne was the first anatomist to discover
the canal in the spinal cord; he described the capsule of the liver, a
tissue which bears Glisson’s name; and differentiated the eight pair
from the sympathetic nerves. He was the first anatomist to see and
describe the valves in the veins, which he called _apophyses venarum_—
discovery which has been claimed for Jacobus Sylvius, Cannanus, Amatus
and Fabricius.

The question of priority in the discovery of the valves of the veins
gave rise to much controversy. It is reasonable to assume that these
structures were noticed independently by all of the anatomists whose
names are mentioned above.

    [Illustration: SKULL BY DRYANDER, 1541]




                             CHAPTER FOURTH
                         Vesalius’s Early Life


    [Illustration: Illuminated capital]

Andreas Vesalius, or Wesalius as the family name was inscribed prior to
the year 1537, was born in Brussels on the last day of the year 1514.
From astrological observations made by Jerome Cardan we learn that this
event occurred about six o’clock in the morning, and under favorable
stellar auspices. The placenta and caul, to which popular belief
ascribed remarkable powers, were carefully preserved by the mother.

The Vesalius family originally was named Witing, (_Witting_, _Wytinck_,
_Wytings_, according to various authorities) and adopted the name
Wesalius from the town of Wesel, (_Wesele_, _Vesel_), in the Duchy of
Cleves, which the family claimed as their native place. The three
weasels (_Flemish_—“Wesel”), found in the Vesalian coat of arms, testify
to this origin.

It may be said with truth that medical learning ran in the blood of the
Vesalius family. Andreas’s great-great-grandfather, Peter Wesalius,
wrote a treatise on some of the works of Avicenna and at great cost
restored the manuscripts of several medical authors. Peter’s son, John
Wesalius, held the responsible position of physician to Mary of
Burgundy, the first wife of Maximilian the First; in his old age John
taught medicine in the University of Louvain. From that time the
Vesalius family was closely associated with the Austro-Burgundian
dynasty. Eberhard, son of John Wesalius, served as physician to Mary of
Burgundy; he died before attaining his thirty-sixth year, and was long
survived by his father. Eberhard, who was the grandfather of Andreas,
wrote commentaries upon the books of Rhazes and on the _Aphorisms_ of
Hippocrates. He was also noted as a mathematician. Eberhard’s son
Andreas, the father of the anatomist, was apothecary to Charles the
Fifth and to Margaret of Austria. He accompanied the great Emperor upon
his numerous journeys and military expeditions. In 1538 he presented
Andreas’s first anatomical plates to the Emperor, and thus opened the
way to the court to his son. The father remained in the imperial service
until the day of his death, which occurred in 1546. Andreas’s mother,
Isabella Crabbe, exercised a great influence upon the youth whom she
believed to be destined to accomplish great things. She it was who
preserved the manuscripts and books of the Vesalian ancestors. Isabella
happily lived long enough to see the _Fabrica_, to witness the
intellectual triumph of her son, and to know of his activity at the
Spanish court.

    [Illustration: THE OLD UNIVERSITY OF LOUVAIN
    (Erected early in the Fourteenth Century. The New Building dates
    from 1680)]

Little is known of the youth of Vesalius. The traditions of his
ancestors, their accomplishments in the field of letters and in
medicine, and their loyalty to their sovereigns, were themes which his
mother must have recounted with pleasure. At an early age Andreas was
sent to the neighboring city of Louvain, whose University, founded in
the year 1424, in the early part of the sixteenth century eclipsed many
institutions of greater age, and in the number of its students ranked
second only to the University of Paris. The theologians of Louvain were
noted for their orthodox Catholicism; from the very first days of
religious controversy they had battled strongly against the rising tide
of the Reformation. Her professors of jurisprudence and of philosophy
were men of eminent talents. Within the University were four literary
schools which were named _Paedagogium Castri_, _Porci_, _Lilii_, and
_Falconis_, from their insignia:—a fort, a pig, a lily, and a falcon.
Here also was the _Collegium trilingue Buslidianum_, which was founded
by Hieronymus Busleiden (+1517) for teaching the Greek, Hebrew and Latin
languages. Vesalius selected the _Paedagogium Castri_ which he fondly
mentions in laudatory terms in his _Fabrica_. Here, and in the
Busleidinian College, he obtained that thorough knowledge of ancient
languages which, in later years, astonished his hearers and served him
well in numerous literary controversies. The names of Vesalius’s
teachers are unknown, although Adam[9] states that John Winter of
Andernach was his professor of Greek. Vesalius speaks scornfully of one
of his teachers, a theologian, who, in trying to explain Aristotle’s _De
Anima_, used a picture of the _Margarita Philosophica_ to show the
structure of the brain. Among Vesalius’s school companions were
Gisbertus Carbo, to whom the anatomist presented the first skeleton
which he articulated (_Fabrica_, 1543, page 162); and the younger
Granvella, who later was Chancellor to Charles the Fifth.

At an early age Vesalius possessed a desire to study the structure of
the human body. His powers of observation were precociously developed.
When a boy, learning to swim by the aid of bladders filled with air, he
noted the elasticity of these organs, and he referred to the incident in
his _Fabrica_ (1543, page 518). When little more than a child, he tired
of dialectics and tried to learn anatomy from the scholastic writings of
Albertus Magnus and of Michael Scotus. He soon discovered that the true
road to anatomical science led, not through books but through the actual
handling of the dead tissues. He began the practical study of anatomy by
dissecting the bodies of mice, moles, rats, dogs and cats.[10]




                             CHAPTER FIFTH
                            Sojourn in Paris


    [Illustration: Illuminated capital]

One thought was uppermost in the mind of Vesalius, and that was to
follow the profession of his ancestors, just as in ancient Greece the
sons of the Asclepiadae naturally adopted the vocation of their fathers.
Andreas possessed an excellent preliminary education and was especially
proficient in the Greek and Latin languages; he also knew something of
Hebrew and much of Arabic. It was in the year 1533 that the young
Belgian travelled to Paris for the purpose of obtaining a medical
education. At that time the French capital was the Mecca of the medical
world—Paris, that city where classical medicine first secured support
(_ubi primum medicinam prospere renasci vidimus_)[11]. In Paris, under
the leadership of Budaeus, Humanism had enjoyed a rapid growth; and here
Petrus Brissotus, after gaining the doctor’s cap in the year 1514,
produced a revolution by delivering his lectures from the books of Galen
in place of the treatises of Averröes and of Avicenna. At his own
expense Brissotus published Leonicenus’s translation of Galen’s _Ars
Curativa_, in order that his pupils might not be misled by the incorrect
text of the Arab authors. It will be recalled that, long before this
time, classical Greek and Latin medical literature had passed through
the distorting crucible of Saracenic translations. At this period
medical science, purified from Arabic dross, was taught in a splendid
manner in Paris by such eminent professors as Jacobus Sylvius, Jean
Fernel, and Winter of Andernach. At their feet sat young men from the
remotest parts of Europe.

The most popular of the Paris teachers was Jacobus Sylvius, or Jacques
Dubois, whose Latinized name is perpetuated in anatomical nomenclature.
He was born at Louville, near Amiens, in 1478. In his early years he was
noted for his scholarly attainments in the Greek, Latin and Hebrew
languages and was the author of a French grammar. His anatomical
knowledge was gained under Jean Tagault, a famous Parisian practitioner
and surgical author.

    [Illustration: SYLVIUS]

Sylvius was noted for his industry, for his eloquence, and above all for
his avarice. It was the inordinate desire for money which led him to
abandon philology for medicine. While studying under Tagault he began a
course of medical lectures, explanatory of the works of Hippocrates and
Galen, with such success that the Faculty of the University of Paris
protested on the score that Sylvius was not a graduate. He then went to
Montpellier, whose medical professors had long held a high position,
where, according to Astruc, he received the doctor’s cap at the end of
November, 1529. He was then above fifty years of age. Armed with this
degree, he returned to Paris and immediately entered the lists as an
independent medical teacher, but was again halted by the Faculty who
ruled that he must first receive the Bachelor’s degree. This he gained
on June 28, 1531. Sylvius then resumed his lectures with such success
that his classes in the Collége de Tréguier numbered from four to five
hundred, while Fernel, who was a professor in the Collége de
Cornouailles, lectured to almost empty benches. In 1550, Henry the
Second named Sylvius Professor of Medicine, as the successor of Vidus
Vidius, in the recently established Collége de France. Sylvius died
January 13, 1555, and was interred in the paupers’ cemetery as he had
wished.

Sylvius was not only an eloquent lecturer but he was also a
demonstrative teacher. He was the first professor in France who taught
anatomy from the human cadaver. In his lectures on botany he used a
collection of plants to elucidate the subject. His chief fault was a
blind reverence for ancient authors. He regarded Galen’s writings as
gospel; if the cadaver presented structures unlike Galen’s description,
the fault was not in the book but in the dead body, or, perchance, human
structure had changed since Galen’s time! In one of his early books[12],
Sylvius declared that Galen’s anatomy was infallible; that Galen’s
treatise, _De Usu Partium_, was divine; and that further progress was
impossible!

The character of Sylvius was contemptible. He was a man of vast learning
and at the same time was rough, coarse and brutal. His avarice led him
to endure the cold winters of Paris without the benefit of a fire; in
severe weather he would play at football, or engage in other violent
exercise in his room, to save the cost of fuel. Once, and once only, did
his friends find him hilarious; they wondered and asked the cause.
Sylvius said he was happy because he had dismissed his “three beasts,
his mule, his cat and his maid”. He was notoriously rigid in exacting
his fees from students, and on one occasion he threatened to stop his
lectures until two delinquents should pay their dues. Although he was
supposed to have amassed great wealth, little of it was found after his
death, and these sums were secreted in secluded places. In 1616, when
his former residence in the _rue Saint-Jacques_ was demolished, numerous
gold pieces were found. His reputation for miserliness followed him
beyond the grave, as witness his epitaph:

  _Sylbius hic situs est, gratis qui nil dedit unquàm,_
  _Mortuus et gratis quod legis ista dolet._

  “Sylvius lies here, who never gave anything for nothing:
  Being dead, he even grieves that you read these lines for nothing.”

In controversies he was violent and vindictive—a pastmaster in the use
of bitter language. Jealous of the fame of other anatomists, he was
particularly enraged when, in later years, he was opposed by Vesalius.
Sylvius spoke of him not as Vesalius, but as _Vesanus_, a madman, who
poisoned Europe by his impiety and clouded knowledge by his blunders.
Such was the man who, in the mid-part of the sixteenth century, filled
the position of highest honor in the Medical Faculty of the Collége de
France[13].

Sylvius rendered valuable service in naming the muscles which, prior to
his time, were designated by numbers. These, says Northcote[14] “were
differently applied by almost every author; so that it was the
description, and not the name, that must lead one to know what part was
meant by such authors; and this required a previous thorough knowledge
of anatomy”. He is the first writer who mentions colored injections and
is supposed to have discovered this useful adjunct of anatomical study.
He was the first anatomist who published satisfactory descriptions of
the pterygoid and clinoid processes of the sphenoid bone, and of the os
unguis. He gave a good account of the sphenoidal sinus in the adult but
denied its existence in the child, as had been affirmed by
Fallopius[15]. Sylvius also wrote intelligently concerning the vertebrae
but incorrectly described the sternum. His observation concerning the
valves in the veins gave rise to much discussion; the honor of priority
in the discovery, however, belongs to other anatomists—Estienne and
Cannanus. His discoveries in cerebral anatomy have caused his name to be
attached to the _aqueduct_, the _fissure_ and the _artery of Sylvius_.

The manner in which Sylvius conducted his anatomical course is known to
us by his own writings, by the testimony of Moreau[16], and by that of
Vesalius[17]. Thus the course for the year 1535 began with the reading,
by Sylvius, of Galen’s treatise _De Usu Partium_. When the middle of the
first book was reached, Sylvius remarked that the subject was too
difficult for his students to understand and that he would not plague
his class with it. He then jumped to the fourth book, read all to the
tenth book, discussed a part of the tenth and omitting the eleventh,
twelfth and thirteenth, he took up the fourteenth and the remaining
three books. Thus he omitted all that Galen had said concerning the
extremities. A second Galenic work which Sylvius used was the
anatomico-physiologic treatise, _De Musculorum Motu_. Not infrequently
the professor was unable to demonstrate in dissection the parts on which
he had lectured. Thus, on one occasion, the students succeeded in
finding the pulmonary and aortic valves which Sylvius had failed to find
on the preceding day.


Joannes Guinterius of Andernach

Another famous member of the Paris Faculty of this period, and a man
whose life-story reads like a romance, was Joannes Guinterius, the
beggar of Deventer. Guinterius (Gonthier, Guinther, Guinter, Winter, or
Winther), who is often called John Winter of Andernach, from the name of
the town in which he was born, lived between the years 1487-1574, and
rose to eminence in both the literary and the medical worlds. Born of
humble parents, he was sent at an early age to the University of
Utrecht. Leaving this institution because of his poverty, he went to
Deventer where he was reduced to the necessity of begging in the
streets. He drifted to the University of Marburg, and here displayed
such brilliant talents that he soon obtained employment as a teacher in
the small town of Goslar, in Brunswick. His growing reputation for
learning led to his appointment to the chair of Greek in the noted
University of Louvain.

    [Illustration: WINTER OF ANDERNACH]

Desiring to study medicine, Guinterius went to Paris in 1525; he
received the Bachelor’s degree in 1528, and the full medical title two
years later. He passed a brilliant examination which won for him the
commendation of the most eminent professors. Remaining in Paris, he
engaged in practice and in teaching, and rapidly rose to eminence. In
addition to conducting courses in anatomy, he translated into Latin the
writings of the most noted Greek medical authors of antiquity—the books
of Galen, of Oribasius, of Paul of Aegina, of Caelius Aurelianus, and of
Alexander of Tralles—all of which were held in high esteem in the
sixteenth century. His fame reached far beyond the boundaries of France.
Christian III., the enlightened king of Denmark, who was noted for his
love of literature, sought to attach him to the Danish court, but the
honor was refused. Having become a convert to the religious views of
Luther, Guinterius found that his life was in danger; he left Paris and
resided for a time in Metz. He soon removed to Strassburg, where he was
received with distinguished honors and was appointed to a professorship
in the University. Owing to the activity of his enemies, his position
became insecure; accordingly, he resigned his chair and spent a
considerable time in travelling throughout Germany and Italy. In the
year 1562, Ferdinand I., in appreciation of the great merits of
Guinterius, raised him to the highest distinction by placing him among
the nobles of the land; and thus the beggar of Deventer became a
nobleman of Strassburg. His life ended October 4, 1574.

Like Sylvius, Guinterius was a teacher of men who became greater than
himself—Vesalius, Servetus and Rondelet sat upon his benches. Like
Sylvius, he placed his faith in Galen and failed to grasp the great
truth that anatomical science is based, not on the writings of the
Fathers but on dissection of the dead body.


Jean Fernel

    [Illustration: JEAN FERNEL]

The third bright star of the Paris constellation was Jean Fernel
(1485-1558), of Amiens, who was regarded as the ablest physiologist of
his time and was physician-in-ordinary to Henry the Second. Fernel
dipped deeply into philosophy, geometry and mathematics. Before entering
the medical profession he issued three books on mathematic and geometric
subjects. He received the medical degree in 1530, but continued his
study of mathematics with such ardor that he was almost ruined
financially. On the advice of his friends he entered upon the practice
of medicine in Paris and met with remarkable success. He was skilled in
anatomy and surgery and accompanied his sovereign upon numerous military
expeditions. His medical writings are contained in many volumes and
concern a variety of subjects, such as physiology, therapeutics,
surgery, pathology, the treatment of fevers and the venereal diseases.

Fernel’s medical views were powerfully influenced by the teachings of an
unfortunate French philosopher, Pierre de la Rameé, or Ramus, who, like
many other Protestants, lost his life on Saint Bartholomew’s Night.
Brutally assassinated, his body was dragged through the streets of Paris
and then was thrown into the Seine; but his system of philosophy
survived and exercised a potent influence until it was eclipsed by the
doctrines of Descartes.

Ramus, who was an uncompromising opponent of the Aristotelian
philosophy, pointed out the defects and suggested the reforms in the
system of University education. He compared the teaching of medicine
with that of theology, much to the disparagement of the latter:—“The
reason”, said he, “why medicine is better taught, and the lectures are
better attended than in theology is, that those who teach it know it,
and practice it, and their disputations are chiefly on the books of
Hippocrates and Galen; whilst the theologians observe a strict reticence
on questions of the Old Testament, which they read in Hebrew, as well as
of the New, which they read in Greek, but display their learning in
subtle questions respecting the pagan philosophy of Plato and
Aristotle”.[18] Ramus endeavored to withdraw the minds of both
physicians and medical students from the authoritative dogmas of the
ancient physicians and to substitute therefor the intelligent study of
Nature. The practical trend of his mind is shown in his suggestion that
institutions should be arranged for clinical teaching.

    [Illustration: RAMUS]

Just as Ramus had become an Eclectic in philosophy, so Fernel sought the
best from various sources and different medical systems. Like Ramus, he
cast off the yoke which authority had placed upon him; and proposed
carefully planned principles which should lead to the discovery of
truth. Like Ramus, Fernel presented his views in a clear style and in
better order than was to be found in the writings of his predecessors.
Like Ramus, he adopted the good and rejected the bad, regardless of
whether it had been said by Aristotle, or by Galen, or by Hippocrates.
Fernel was a reformer who stood for freedom of thought, which, up to his
time, had suffered from the despotism of the scholastics. Although many
of Fernel’s physiologic and pathologic ideas seem ridiculous when viewed
in the light of modern knowledge, yet he deserves praise for daring to
oppose ancient dogmas, and for pointing the road to progress. In breadth
of view, Fernel was far superior to Sylvius and Guinterius.

The anatomical teaching in Paris in the early part of the sixteenth
century was far from satisfactory. There was too much lecturing and
theorizing from Galen’s texts, and too little of actual dissection.
Vesalius, who was not backward in his criticisms, says that the
dissections were made by ignorant barbers, and during the whole time
that he was in Paris he never saw Guinterius use a knife upon a cadaver.
Only at rare intervals was a human body brought into the amphitheatre,
and then the dissection lasted less than three days. It comprised only a
superficial study of the intestines and abdominal muscles; no other
muscles were studied. The bones, veins, arteries and nerves were almost
wholly ignored. The great lights of the Paris profession were totally
unfit to give to the young Belgian what was his heart’s desire. They
were ignorant and knew it not. It is not surprising that, on more than
one occasion, Vesalius brushed the ignorant prosectors aside, took the
knife into his own hands, and carried out the dissection in a systematic
manner. His zeal and learning won the admiration of Guinterius who spoke
of Vesalius and Servetus in loving terms;—“first Andreas Vesalius, a
young man, by Hercules! of singular zeal in the study of anatomy; and
second, Michael Villanovanus (Servetus), deeply imbued with learning of
every kind, and behind none in his knowledge of the Galenic doctrine.
With the aid of these two, I have examined the muscles, veins, arteries
and nerves of the whole body, and demonstrated them to the
students”.[19]

Vesalius must have had many blue days in Paris—days when he longed to
have a free hand in dissection. A weaker character than his would have
fitted peacefully into the established order of things, but not of such
stuff was Andreas made. The difficulties which beset his path only
stimulated him to work the harder; he firmly resolved to devote his
energy, his talents and his life to anatomical study and teaching. He
decided to secure the opportunity to dissect the human body and to rival
the ancient Alexandrian professors who taught the subject. “Never”, he
says, “would I have been able to accomplish my purpose in Paris, if I
had not taken the work into my own hands”. The Book of Nature which
Sylvius lauded, but kept his pupils from studying, was now opened by
Vesalius. He dissected numerous dogs and studied the only part of human
anatomy that was available, namely, the bones. In his search for
materials for a skeleton he haunted the Cemetery of the Innocents. On
one occasion, when he went to Montfauçon, the place where the bodies of
executed criminals were deposited and bones were plentiful, Vesalius and
his fellow-student were attacked by fierce dogs. For a time the young
anatomist was in danger of leaving his own bones to the hungry
scavengers. By such dangers he gained what the Paris professors could
not supply. He became a master of the osseous system, so much so that,
when blindfolded, he was able to name and describe any part of the
skeleton which was placed in his hands. His talents were recognized by
both professors and students; and at the third anatomy which he attended
in Paris he was requested to take charge of the dissection. To the
satisfaction of the students, as well as to the astonishment of the
barbers, he made an elaborate dissection of the abdominal organs and of
the muscles of the arm.

    [Illustration: VIVISECTION OF A PIG
    (From the “Fabrica”, 1543)]




                             CHAPTER SIXTH
                      Vesalius Returns to Louvain


    [Illustration: Illuminated capital]

In the latter part of the year 1536, owing to the outbreak of the third
Franco-German war, Vesalius returned to the University of Louvain.
During this period he secured a human skeleton by secret means.
Accompanied by his faithful friend, Regnier Gemma, known as a
mathematician as well as a physician, Vesalius visited the gallows
outside the walls of Louvain in order to search for bones. Here he found
a skeleton which was held together simply by the ligaments and still
possessed the origins and insertions of the muscles. Morley states that
the body was that of “a noted robber, who, since he deserved more than
ordinary hanging, had been chained to the top of a high stake and
roasted alive. He had been roasted by a slow fire made of straw, that
was kept burning at some distance below his feet. In that way there had
been a dish cooked for the fowls of heaven, which was regarded by them
as a special dainty. The sweet flesh of the delicately roasted thief
they had preferred to any other; his bones, therefore, had been
elaborately picked and there was left suspended on the stake a skeleton
dissected out and cleaned by many beaks with rare precision. The
dazzling skeleton, complete and clean, was lifted up on high before the
eyes of the anatomist, who had been striving hitherto to piece together
such a thing out of the bones of many people, gathered as occasion
offered”.

Such a prize could not be lost. With Gemma’s assistance Vesalius climbed
the gallows and secured the skeleton which he secretly conveyed to his
home. The treasure, however, was not complete; one finger, a patella and
a foot were missing. To this extent was Vesalius the owner of a human
skeleton. In supplying the missing parts Vesalius was obliged to incur
new dangers. He stole out of the city in the nighttime, climbed the
gallows unaided, searched through the mass of decaying bodies, and,
having found the coveted bones, he stole into the city by another gate.
These secret expeditions, however, soon became unnecessary, for the
Burgomaster of Louvain generously furnished an abundance of material for
Vesalius’s students.

It was at this period—late in the year 1536 or early in 1537—that
Vesalius conducted the first public anatomy that had been held in
Louvain in eighteen years. He performed the dissection and lectured at
the same time, which was an innovation. Some remarks he made concerning
the seat of the soul caused him to be critised by the theologians. A
further cause for suspicion was his association with such firm
Protestants as Guinterius and Sturm of Paris; and his friendly relations
with the publisher Rescius, and the physician Velsius. Fortunately the
suspicion of heresy did not lead to any formal charges, but the affair
seems to have rankled in his memory and some years later, in his
_Fabrica_, he sought to clear his name of even the appearance of heresy.

Vesalius began his career as an author by issuing a paraphrase, or free
translation, of the ninth book of the _Almansor_ of the celebrated
Rhazes[20]. This book, _liber ad Almansorem_, or work dedicated to the
Caliph Al-Mansûr, was written by a learned Arab physician who lived
between the years 860-932. The _Almansor_ consists of ten books and was
designed by the author for a complete body or compendium of Physic. The
first book treats of anatomy and physiology; the second, of
temperaments; the third, of food and simple medicines; the fourth, of
means for preserving health; the fifth, of skin diseases and cosmetics;
the sixth, of diet; the seventh, of surgery; the eighth, of poisons; the
ninth, of treatment of all parts of the body; the tenth, or last book,
deals with the treatment of fevers. The ninth book, which Vesalius
translated from the barbarous version into a readable form, was so
highly prized in mediaeval times that it was read publicly in the
schools and was commentated by learned professors for more than a
hundred years. By this publication Vesalius furnished a valuable
contribution to medical literature. The numerous marginal and
interlinear notes, which he supplied, show his intimate acquaintance
with classical literature as well as with materia medica. Vesalius
emphasizes the fact that the book of Rhazes contains many remedies which
were unknown to the Greeks. The value of his edition was increased by
the presence of original drawings of the plants mentioned in the text.




                            CHAPTER SEVENTH
                     Professor of Anatomy in Padua


    [Illustration: Illuminated capital]

Shortly after the publication of his _Paraphrasis in nonum librum
Rhazae_, Vesalius journeyed into Italy. It was in the year 1537 that he
entered the prosperous and enlightened city of Venice. Here the study of
anatomy not only was not tabooed, but was encouraged, particularly by
the Theatin monks who devoted themselves to the care of the sick. At the
head of this order stood two remarkable men: J. Peter Caraffa, who later
ascended the papal throne as Paul IV.; and Ignatius Loyola, the founder
of the Jesuits. It is a strange circumstance that two strong characters
so dissimilar as were Vesalius and Loyola should meet as co-workers in
the same field. The one was filled with a thirst for anatomical
knowledge, and was dreaming of the day when his _opus magnum_ should
revolutionize an important science; the other was enthused with visions
of the world-wide acceptance of the doctrines of Catholicism. They met
again, in 1543—the year which marks two important events, namely, the
publication of the _Fabrica_, and the full recognition of the Jesuits by
the Pope.

In Venice the young anatomist entered into various lines of activity. He
experimented with a new remedy, the China root, and besought his
acquaintances to observe its effects in cases of pleurisy. He solicited
anatomical material and possibly may have conducted a public
demonstration in anatomy, although this is uncertain. He practiced minor
surgery; he leeched and opened veins, particularly the popliteal vein
which the barbers of that day did not venture to touch. In Venice he
fortunately met his countryman, Jan Stephan van Calcar, who was soon to
furnish the drawings for Vesalius’s first anatomical plates.

    [Illustration: INSTRUMENTS USED IN DISSECTION
    (From the “Fabrica”, 1543)]

In order to gain all the rights and privileges of a full-fledged
physician, Vesalius settled in Padua. On the 6th day of December, 1537,
shortly after having received his degree as Doctor of Medicine, Andreas
Vesalius of Brussels was appointed Professor of Surgery with the right
to teach Anatomy in the famous University of Padua. This, says Fisher,
“was the first purely anatomical chair ever instituted”.

From his own writings and from the manuscript notes of his loyal
student, Vitus Tritonius, a fairly good idea of Vesalius’s teaching can
be given. The first act of the young Paduan professor was to improve the
course in anatomy. Here, as he had done previously at Louvain, Vesalius
discharged the entire duties of the professorship. He acted as lecturer,
demonstrator and dissector. Dissatisfied with the ignorant barbers, he
ignored them and employed his students as assistants. He resorted to all
possible means to obtain anatomical material, much of which was secured
by stealth.

The aula in which Vesalius conducted his course was built of wood and
was capable of holding five hundred persons. In the centre of the room
was a table under which was a receptacle containing bones and joints. An
articulated skeleton was placed in an upright position at one end of the
table. In this elegantly appointed room, before an audience of
distinguished laymen and students, the instruction in anatomy was given.
The course was a strenuous one, occupying practically the entire day for
a period of three weeks, and comprising not only human but also much
comparative anatomy. The vivisection of dogs, pigs, and rarely of cats,
was a regular part of the course. Drawings were used to elucidate the
relations between the skeleton and the soft parts; and frequently
Vesalius marked the outlines of the joints upon the skin of the subject.
He also marked the cranial sutures with ink. His anatomical charts were
the work of his own hand; at times he drew the pictures in the presence
of his audience. His dissections were made with extreme neatness and
dexterity. He used but few instruments and these were of the simplest
kind: knives of different shapes, hooks, cannula, catheter, sounds,
bristles, hammer, saw, needles, thread and a sponge. Forceps and
injection apparatus were not used; he rarely used scissors. Much of the
actual separation of tissues was done by the aid of the finger-nails. A
vivisection board completed the list _de instrumentis quae anatomes
studioso debent esse ad manum_.

Let us now follow one Vesalius’s public courses in anatomy. It is the
month of December, in the year 1537. The report has spread that the
young Belgian professor will begin his course. Long before the hour set
for the lecture, every available seat has been taken and many persons
are standing. An audience comprising the professors of the University,
the students of medicine, officials of the city of Padua, and learned
persons of all ranks, including members of the clergy, numbering more
than five hundred persons, has assembled to do honor to the professor of
anatomy.

Vesalius comes into the arena and walks to the table which is closely
surrounded by his auditors. He wastes no time; after a few preliminary
remarks on the importance of anatomy and the methods of acquiring a
knowledge of this science, he launches into the practical demonstration.
After rapidly pointing out the divisions of the body, and demonstrating
the skin, joints, cartilages, ligaments, glands, fat and muscles, he
passes to the more complex parts, all of which are shown upon the
skinned body of a dog or of a lamb, in order to conserve the human
material. Now the human cadaver is placed on the table; all eyes are
turned upon it, for such a demonstration occurs only at long intervals.
Vesalius speaks first of the difference in the structure of joints at
different ages and in different sexes, illustrating his remarks by means
of drawings and by an abundant supply of bones of man and of the lower
animals.

Now comes the dissection. This is made rapidly and in regular order. Its
course depends upon the amount of material at hand; if the professor
resorts to two bodies, as in the year 1538, the demonstration is handled
in grand style. Vesalius uses the first body for a comprehensive
examination of the muscles, ligaments and viscera; whilst the second
cadaver is devoted to the relations of the veins, arteries, nerves and
viscera. The text of the _Fabrica_ is written according to this plan of
public dissection.

At times Vesalius attempted to teach the whole of anatomy on one
cadaver. In this event, osteology was followed by the dissection of the
abdominal muscles layer by layer, the demonstration closing with an
examination of the entire contents of the abdomen. The pelvic organs
were reached by incision and separation of the symphysis pubis. If the
cadaver was that of a female, the dissection began with the mammary
glands and then passed to the inferior venter. In pregnancy the foetal
membranes were removed intact, and were placed in a vessel filled with
water. The foetus was opened and its anastomosing vessels were found.
For demonstrating the cotyledons, the uterus of a sheep or goat was
used. After the thorax had been raised by means of a log or brick,
Vesalius passed to the face and the anterior part of the neck, freely
exposing the muscles on one side and the vessels and nerves on the
other. Then followed the unilateral preparation of the muscles of the
shoulder and back, then those of the mouth, which were approached by
means of division of the lower jaw; and, finally, the pharynx and the
larynx were exposed. The rectus anticus muscle was next brought into
view, whereupon Vesalius detached the head from the vertebral column.
Decapitation was followed by an examination of the cranium; the
skull-cap was sawed and the brain was dissected in its natural position.
Then came the examination of the eye, which Vesalius dissected in two
ways: either by a complete section, or layer by layer from without
inwards.

The ear and the cavities of the frontal and sphenoidal bones were next
opened, provided these bones were not needed for the setting up of a
skeleton. Finally he took up the extremities, demonstrating the muscles
of an arm and a leg on one side, and the nerves and vessels on the
other. The anatomy lesson ended with the introduction of numerous
vivisections.

Vesalius could not entirely escape disputations, but he gave to them a
close anatomic basis. Theoretical physiology was repugnant to him; for
him physiology was not speculation but the sequel of anatomic research.
If he at times gave free reign to his views, he indicated them as mere
theories. He did not ignore pathologic conditions, but he handled them
as briefly as possible. Fearing to tire his audience with too much
variety, he confined his students closely to the structure of the human
body.

The merit of Vesalius’s public dissections, and the impression which
they made upon his auditors, can be appreciated only by comparison with
similar demonstrations made by his predecessors. The large and
enlightened audience remained day by day for a period of three or four
weeks. He says not a word about the physical and mental strain incident
to such a strenuous course, in which his entire time was employed. The
courses brought great financial profit to the professor.

On two occasions, probably in the years 1539 and 1540, Vesalius was
called from Padua to Bologna to conduct public dissections. This was a
great honor, for Bologna was the city in which Mondino had revived the
practical teaching of anatomy. These courses were conducted by Vesalius
in a wooden building erected for that particular purpose. Here, as in
Padua, the professor acted as demonstrator and lecturer, remaining in
this ancient city for a period of several weeks. On the first occasion
he was supplied with three human bodies and was enabled to handle the
subject in grand style. At the first séance he engaged with the
celebrated Professor Matthaeus Curtius, whose acquaintance he had made
in 1538 while on a vacation trip, in a deep study of the question of
venesection. Before a large and select assembly he demonstrated in all
three bodies that Galen’s description of the vena azygos was incorrect.
On the second convocation Vesalius seems to have disposed of more
bodies. He reviewed Galen’s work on the joints, and by numerous
specimens, which were prepared by the students, he demonstrated the
difference in the ancient knowledge of the skeleton. On this occasion he
undertook the complete dissection of an ape and presented its skeleton,
as well as that of a man, to Professor John Andreas Albius, who held the
chair of Hippocratic medicine in Bologna.

Little is known of the way in which Vesalius taught surgery. The first
year he was in Padua, he began with Avicenna’s treatise on tumors.
According to the fragmentary notes in the college book of his ardent
pupil, Vitus Tritonius, Vesalius compared Avicenna’s teachings with the
classical works of Hippocrates, Galen, Paul of Aegina, and Aetius,
explaining and correcting them.

    [Illustration: INITIAL LETTER BY VESALIUS
    (From the “Fabrica”, 1543)]




                             CHAPTER EIGHTH
                     First Contribution to Anatomy


    [Illustration: Illuminated capital]

Like all great teachers, Vesalius was ever mindful of the interests of
his students. Soon after accepting the chair of Anatomy in Padua, he
articulated a human skeleton for use in his class room. His next work
was the preparation of a set of anatomical plates, _Tabulae Anatomicae_,
which were intended to pave the way to anatomy for beginners. For the
further benefit of his class, he edited an edition of Guinterius’s
_Institutionuin Anatomicarum_, which was issued in April, 1538.


Tabulae Anatomicae

The _Tabulae Anatomicae_ were in the form of _Fliegende Blätter_, or
loose leaves, and consisted of six plates which are now among the rarest
of medical works. They bore the following title:

        _Tabulae Anatomicae. Imprimebat Venetiis B(ernardinus).
               Vitalis Venetus sumptibus Joannis Stephani
                 Calcarensis Prostrant verò in officina
                        D. Bernardini. a. 1538._

In the preface Vesalius says that no one can learn either botany or
anatomy from figures alone, but illustrations are a valuable means
toward the imparting of knowledge. In publishing these plates he hopes
to benefit those persons who had attended his public dissections. Not a
line in these pictures is unnatural; all has been reproduced just as he
had shown in his demonstrations. He gives due credit to van Calcar, the
artist who made the drawings of the three skeletons. The other pictures
were made by the author himself.

The _Tabulae Anatomicae_ were arranged in the following order:—

  I.—The Portal System and the Organs of Generation;
  II.—The Venae Cavae and Chief Veins;
  III.—The Great Artery—Arteria Magna—and the Heart;
  IV.—The Skeleton in its Anterior View;
  V.—The Skeleton in its Side View;
  VI.—The Skeleton in its Posterior View.

The plates are of large dimensions, measuring over sixteen inches in
length, and were cut in wood. Like those in the _Fabrica_, they were
made in Italy. Owing to their transient use by medical students, the
_Tabulae_ were soon destroyed, although unauthorized editions were
printed in several cities. The book was dedicated to Narcissus of
Parthenope (Narciso Verdunno, or Vertuneo) who, in 1520, was first
physician to the crown of Naples, and later, in 1524, was physician and
councilor to Charles the Fifth. It is noteworthy that three of these
plates deal with the skeleton, a subject to which Vesalius had given
much attention. The absence of a plate showing the nervous system is
also to be noted. Vesalius had such a plate prepared, and it appeared in
a pirated edition of the _Tabulae_ which was published at Cologne in
1539. The large size of these plates, their fidelity to nature, and the
skill with which they were cut in wood, were features which showed to
the world that a real master of anatomy had been born. The original
drawings were made by Jan Stephan van Calcar, who probably also was the
engraver.

Only two copies of the _Tabulae Anatomicae_ are known. A fine edition of
these plates, reproduced by photography, was privately issued in 1874 by
Sir William Stirling-Maxwell, the talented author of the _Annals of the
Artists of Spain_.

    [Illustration: VIEW OF THE CITY OF BASEL IN THE SIXTEENTH CENTURY]




                             CHAPTER NINTH
                       Publication of the Fabrica


    [Illustration: Illuminated capital]

On the first day of August, 1542, after three years of strenuous labor,
Vesalius completed the _Fabrica_, and twelve days later he wrote the
last word of the _Epitome_. The blocks for the _Fabrica_, and also those
for the _Epitome_, were made in Italy. In the summer of 1542 they were
conveyed to Basel by a merchant named Danoni and were safely delivered
to the printer, Oporinus. They were accompanied by a long Latin letter,
written by Vesalius to his friend, “Joannes Oporinus, professor of Greek
letters in Basel”. He begs Oporinus to take the greatest care that the
printed illustrations shall correspond with the proofs which accompany
the blocks. “Every detail must be distinctly visible, so that each cut
shall have the effect of a picture”. Early in the following year
Vesalius went to Basel to superintend the printing of his books. While
there, he conducted a demonstration in anatomy—the first which had
occurred in that city since 1531—and presented the articulated skeleton
of the subject to the University. Part of this skeleton exists today. It
is thought to be the oldest anatomical preparation in existence.


The Fabrica

The heart of Vesalius must have filled with joy when he saw the final
page of his book turned from the press. The treatise which founded
modern anatomy bears this title:—

            _Andreae Desalii Brurellensis, Scholae medicorum
               Patabinae professoris, de humani corporis
                    fabrica Libri septem. Basileae._
                                MDXLIII

A fortune was lavished upon the illustration and publication of this
grand work. To use the words of Fisher, “it was and is a glorious book,
a rare and precious monument of genius, industry and liberality”. It
abounds with curious initial letters bearing quaint and interesting
anatomical conceits, each one teaching its lesson. One of these, reduced
in size, introduces the present chapter; and it was this letter that
Vesalius used in his opening sentence: _Os caeterarum hominis partium
est durissimum & ardissimum, maximaque terrestre & frigidum, & sensus
denique praeter solos dentes expers._

    [Illustration: JOANNES OPORINUS]

The first edition of the _Fabrica_ is a folio volume with magnificent
illustrations on wood, all carefully printed by Joannes Oporinus
(1507-1568) of Basel.

The title-page is a beautiful engraving which represents Vesalius at
work dissecting a female subject. He is surrounded by interested
spectators who crowd the amphitheatre. The abdomen of the subject is
opened. Vesalius has raised his left hand; his right hand grasps a small
rod which rests on the viscera. The great teacher is talking to his
pupils. Placed at the head of the dissecting table is an upright
skeleton which grasps a long staff with its right hand. In the audience
are many persons of different rank. To the left a naked man is climbing
a pillar, while to the right, and below, a dog is being brought into the
arena. To the left, and below, is a monkey which appears to enjoy the
demonstration. Above, in the architecture, we see the monogram of the
publisher, Oporinus; in the centre, on a shield, are the three weasels
of the Vesalius family, and below, is a shield which bears the
privilegium. This old engraving is one of the most spirited and
elaborate to be found in the whole range of medical literature. In the
1725 edition, for which Jan Wandelaar made copperplate reproductions of
the original figures, the title-page is altered:—the monogram of
Oporinus is absent and the architecture is slightly changed.

    [Illustration: MARK OF OPORINUS]

Who was the unnamed artist? It is noteworthy that Vesalius does not
state who drew the illustrations, or who cut them in wood, for his
_Fabrica_. He only states that this book has cost him a monstrous amount
of labor in the preparation of the dissections, and in the directing of
the eye, the hand, and the intelligence of the artist. He complains
bitterly of the obstinacy of the artist, who, at times so tormented him
that he—Vesalius—considered himself more unfortunate than the criminal
whose body had been dissected[21]. It was probably owing to this
unpleasant experience that Vesalius omitted the artist’s name. The great
anatomist speaks regretfully of the large sums which he was obliged to
pay, in order to induce skilled artists to undertake this class of work.
He states that they were much more interested in painting Venus and The
Graces than in drawing pictures of skinned and foul smelling bodies.
Moehsen[22] assumes that Vesalius had Titian in mind when he penned
these thoughts, but this is questionable. It is not surprising that
eminent artists should have disliked anatomical drawing, at a time when
antiseptic injections and preserving fluids were not known. Foul odors
had no terrors for the great Belgian, who haunted cemeteries for
anatomical material and often kept parts of cadavers in his bedchamber
for weeks at a time.

For a period of two centuries the Vesalian pictures were ascribed to
Titian, but on insufficient grounds. The famous Venetian painter was
over sixty years of age at the time of the publication of the _Fabrica_;
his services were much in demand, and he was signally honored by the
Spanish emperor, Charles the Fifth. His powers remained undiminished
until shortly before his death, which occurred in 1576. He had the
ability to make the Vesalian illustrations, but it is doubtful if he had
the time. Although Titian may have taken an interest in these anatomical
plates, it is not now believed that he drew them.

    [Illustration: JAN STEPHAN VAN CALCAR]

The Vesalian pictures have been attributed to Christoforo Coriolano; but
he could not have been the artist, since his earliest work dates from
1568. He is known to have furnished the drawings for Jerome
Mercurialis’s _De Arte Gymnastica_, and for Vasari’s _Lives of the
Painters_. Roth is of the opinion that Vesalius himself made most of the
illustrations; but such a view would credit the comparatively short and
busy life of the great anatomist with too much accomplishment.

I conclude that the illustrations for the _Fabrica_, like the osseous
figures in the _Tabulae Anatomicae_, which Vesalius issued in 1538, were
made by Jan Stephan van Calcar (+1546), the favorite pupil of Titian.
Sandrart[23] states that van Calcar made the drawings for the _Fabrica_;
that he went to Venice in 1536 or 1537; that he studied under Titian;
and that his paintings were of such merit that they were often mistaken
for those of Titian, Raphael, and Rubens.

Van Calcar was a Fleming, a native of Kalcker in the Duchy of Cleves.
The date of his birth is not known. His death occurred at Naples in
1546. He was highly esteemed by Vesalius who speaks of him as ranking
“with the divine and happy wits of Italy”. The anatomical plates which
Vesalius issued in 1538 were made, he states, by van Calcar:—_sumptibus
Joannis Stephani Calcarensis_. These plates, which appeared in the form
of pictorial broad sheets, or _Fliegende Blätter_, may be likened to the
Herald who goes in advance to announce the coming of the King. They were
engraved on wood, and, like their companion pictures in the _Fabrica_,
they were unprecedented in magnitude and in minuteness.

    [Illustration: SECOND VESALIAN PLATE OF THE MUSCLES
    (From the “Fabrica”, 1543. Reduced one-half)]

The Vesalian plates vary greatly in merit. The most satisfactory ones
are those depicting the undissected body and the bones and muscles. The
artist was not at his best in drawing the nervous system, although it is
claimed that Vesalius had prepared his neurologic specimens with great
care. For the use of artists, the best plates are the three skeletons
and the four entire myologic figures in the _Fabrica_. The first
myologic figure, showing a man who has been divested of all skin, fat,
and superficial fascia, presents the muscles of the anterior portion of
the body beautifully delineated. Vesalius took much pride in this plate,
and directed the attention of artists to it. The second plate, which is
constructed along similar lines, shows the body in its lateral aspect.
The head is thrown slightly backward, the right hand pointing to the
earth and the left raised towards the horizon, and the whole attitude of
the subject calls to mind the position which an orator would assume when
addressing an audience. The third myologic plate is similar to the first
one, but the muscles of the face are exhibited to better advantage and
the aponeuroses, absent in the first plate, are here present. The fourth
plate, which is the ninth in Vesalius’s work (_nona musculorum tabula_),
presents the muscles of the posterior part of the body. The other
myologic figures show the deeper muscles, layer by layer, and are of
value to an artist who wishes to study the effect of their action upon
the superficial parts of the body. Hence many of these figures have been
reproduced in works on art-anatomy. The artist who studies these plates
should remember that the figures in question are divested of skin, fat,
and superficial veins—all of which must be supplied, in order to avoid
giving too great prominence to the muscles. The two naked figures
contained in the _Epitome_ are properly clothed in skin and are of great
artistic merit. They also are to be seen in numerous works on
art-anatomy. Thus, in one of the earliest books on anatomy for the use
of artists (_Abrégé d’anatomie accommodé aux arts de peinture et de
sculpture._ Paris, 1667, 1668), Rogers de Piles and François Tortebat
have used the three skeletons and seven myologic figures taken from the
_Fabrica_ and the _Epitome_. In the preface of his book, de Piles says
that he does not think it is possible to produce better figures than
those found in the works of Vesalius. That he was not alone in this
opinion is shown by the fact that many other artists, who have composed
treatises on art-anatomy, have drawn freely from the Vesalian
storehouse. An Italian, Giacomo Moro, in his anatomy for the use of
artists, (_Anatomia ridotta ad uso de’ pittori e scultore._ Venice
1679), reproduced nineteen of Vesalius’s figures in copperplate.

    [Illustration: NINTH VESALIAN PLATE, OF THE MUSCLES
    (From the “Fabrica”, 1543. Reduced one-half)]

The popularity of Vesalius’s anatomical figures among painters was due,
not only to the intrinsic worth of these illustrations, but also to the
erroneous belief that the original drawings were the work of Titian.
This opinion found expression on the title-pages of several works on
art-anatomy. For example, in 1706, Moschenbauer, of Augsburg, issued a
folio volume illustrated with Vesalian figures cut in wood, with this
title:—_Andreae Vesalii, Bruxellensis, des ersten besten Anatomici,
Zergliederung des menschlichen Körpers auf Mahlerey, and Bildhauer-Kunst
gerichtet, die Figuren von Titian gezeichnet_. An anonymous book,
_Notomia di Titanio_, appeared in Italy about the year 1670.

The Vesalian figures of the skeleton were also issued in single sheets
with moralistic verses appended. Moehsen cites one of these with the
inscription printed in French:

  “De cet objet affreux tu parois rebutté,
  Est c’est ce que dans peu cependant tu dois étre:
  Apprens, mortel, a te connoître
  Ce miroir est le seul, ou tu n’est point flatté”.

Another legend reminds the reader that he is only dust, and to dust he
must return:—“_Vous estes poudre, & vous retournéres en poudre_”.

    [Illustration: A HUMAN SKULL RESTING ON THE SKULL OF A DOG
    (From the “Fabrica”, 1543)]




                             CHAPTER TENTH
                       Publication of the Epitome


    [Illustration: Illuminated capital]

Upon the thirteenth day of August, 1542, Vesalius finished the _Epitome_
of his great book. The text and illustrations for it were forwarded to
Basel by the same merchant who conveyed the manuscript and drawings of
the _Fabrica_. The title of the lesser work is as follows:—

            _Andreae Vesalii Bruxellensis, Scholae medicorum
            Patavinae professoris, suorum de Humani corporis
             fabrica librorum Epitome. Basil., et officina
               Joannis Oporini, Anno, 1543, mense Junio._

This work is extremely rare. It belonged to the class of _Fliegende
Blätter_ and was issued unbound. Perfect copies of it are rarely found.
The first twelve sheets are printed on both sides; the two last leaves
are printed on one side only, in order that they might be cut out and
pasted together to show two complete figures. Hence these sheets are
often lacking. The _Epitome_ appeared in the same year and in the same
month as the _Fabrica_, but the latter work was printed first.

The _Epitome_ is dedicated to Philip, the son of Charles the Fifth, who,
after his father’s abdication, was known as Philip the Second of Spain.
The title-page is printed from the same plate as the larger work; and
Vesalius’s portrait also is present. From the fact that the dedication
bears the inscription: _Patavii, idibus Augusti 1542_, the erroneous
opinion arose that this work preceded the _Fabrica_.

    [Illustration: TITLE-PAGE OF VESALIUS’S “EPITOME”, 1543]

Among the illustrations found in the _Epitome_ are seven that are not in
the large book; namely, five myologic plates, and the figure of a naked
man and one of a woman. The myologic figures in the _Epitome_ differ
from those in the _Fabrica_ in this respect: the muscles are drawn in
their natural position, group, and order, so that the surgeon, in
treating wounds and in performing operations, may have the correct
relations of the parts in mind. Also, the one side of the figure differs
from the other: the one showing the superficial muscles, while the other
exhibits the deeper musculature. The muscles in the _Fabrica_, with the
exception of four complete myologic figures, are represented as they
appear in anatomical demonstrations, particular attention being given to
their origins and insertions. For the purpose of the artist, the best
figures are the three skeletons and the four complete myologic figures
which are found in the _Fabrica_.

Two beautiful copies of the _Epitome_, printed on vellum, are in
existence. One is in the British Museum and is thought to be the copy
which was owned by the celebrated Dr. Richard Mead; the other one is in
the possession of the University of Louvain.

Vesalius speaks modestly of the _Epitome_, which he regards as an index
or appendix of the _Fabrica_, and is for the use of beginners in
anatomy.

    [Illustration: SKELETON BY VESALIUS
    (From the “Fabrica”, 1543. Reduced one-half)]




                            CHAPTER ELEVENTH
                        Contents of the Fabrica


    [Illustration: Illuminated capital]

The reputation of Vesalius rests securely upon the _Fabrica_. This grand
book, which is dedicated to Charles the Fifth, consists of six hundred
and fifty-nine folio pages of text; thirty-four pages of index, disposed
in three columns to the page; six pages of preface; and two pages of a
letter which is addressed to “Joannes Oporinus, the renowned professor
of Greek letters in Basel”. The work is printed in excellent style. The
printed page measures 8 by 12½ inches, including the marginal notes.
There are fifty-seven lines to a page, averaging twelve words to a line,
or approximately seven hundred words to a page. This was written, amid
many duties and distractions, in the short period of three years. It is
truly a monument of diligence.

The text of the _Fabrica_ is clear and concise; it describes what has to
be described and does it well. The errors which Vesalius rectified, and
the improvements which he made in anatomy, are so numerous that
references can be made to only a few of them. His anatomical writings
are of such bulk that they cannot be reviewed adequately within the
limits of the present chapter. As regards the _Fabrica_, we may say,
with Richardson, that “The dissections and the plates are the book”.

    [Illustration: FIFTH VESALIAN PLATE OF THE MUSCLES
    (From the “Fabrica”, 1543. Reduced one-half)]

The _Fabrica_ contains the rudiments of anthropology as well as the
first illustrations of comparative anatomy. Vesalius portrays a human
skull resting upon the skull of a dog. He also shows a simian and a
canine sacrum and coccyx, to prove his contention that Galen’s anatomy
was derived from dissection of the lower animals. The _Fabrica_ is more
than an anatomy. Throughout the work physiology goes hand in hand with
the anatomical description. The use and function of each part of the
body is given in short, clear sentences.

The _Fabrica_ is built upon a practical plan. It treats of anatomy in a
logical manner and is composed of seven books, which deal with the
following subjects: (1)—Bones and Cartilages; (2)—Ligaments and Muscles;
(3)—Veins and Arteries; (4)—Nerves; (5)—Organs of Nutrition and
Generation; (6)—Heart and Lungs; and (7)—Brain and Organs of Sense.


The First Book

Vesalius devotes one hundred and sixty-eight pages to the bones and
cartilages, treating these structures with a thoroughness that amazed
his contemporaries. He was the first author who correctly described the
osseous system as a whole. In numerous instances Vesalius places himself
in direct opposition to the opinions of Galen. He denied the existence
of the intermaxillary bone in adults, and showed that the inferior
maxilla does not consist of two pieces, as has been asserted by Galen.
The seven bones of the sternum were reduced to three by Vesalius. He
denied Galen’s statement that the bones of the symphysis pubis separate
during parturition. He was the first anatomist to give an accurate
description of the sphenoid bone. A small aperture at the root of the
pterygoid process of the sphenoid bone is called _foramen Vesalii_.
Vesalius proved the existence of marrow in the bones of the hand, which
had been denied by Galen. In all respects, he wrote more intelligently
of the bones than any anatomist who had preceded him.

    [Illustration: DEEP MUSCLES OF THE BACK BY VESALIUS
    (From the “Fabrica”, 1543. Reduced one-half)]

    [Illustration: PART OF THE FIRST TEXT-PAGE OF THE “FABRICA”]


The Second Book

Vesalius devotes one hundred and eighty-eight pages to a description of
the ligaments and the muscles. This part of his treatise, while it
contains a few errors and does not reach the high plane of the first
book, is superior to any work of its kind that had preceded it. Vesalius
was the first writer to describe the internal pterygoid muscle. He
denied the existence of a general muscle of the skin, and stated that
the intercostal muscles merely separate the ribs without expanding or
contracting the thorax. He held the view that nerves and muscles do not
stand in any relation of proportionate strength to one another, large
nerves often being distributed to small muscles. He also held that the
tendons are similar in structure to the ligaments.

    [Illustration: PLATE OF THE ARTERIAL TREE BY VESALIUS
    (From the “Fabrica”, 1543. Reduced one-half)]

Vesalius’s plates of the superficial muscles are among the most
beautiful that have ever appeared. They have been copied in practically
all later treatises on anatomy, and have been used extensively by
art-anatomists. His plates of the deeper muscles, while naturally not so
pleasing to the eye, are wonderfully near accuracy. The different
muscles are drawn to show function as well as structure.


The Third Book

The third part of the _Fabrica_, comprising sixty pages, is devoted to
the veins and arteries. Vesalius begins with the definition of a vein,
and describes the structure of these vessels in general. The term
“artery” is treated in like manner. He introduces several small
illustrations which serve to elucidate this part of the text. His first
large plate in this section is devoted to the venae portae. This is
followed by a full-page picture of the entire venous system. The
arterial system is fully described and elaborately illustrated. To these
is added another plate, in which both arteries and veins are represented
in their natural order. In other plates he shows the special
circulations—cerebral, portal, and pulmonary.

    [Illustration: DISSECTION OF THE ABDOMEN BY VESALIUS
    (From the “Fabrica”, 1543)]

Vesalius described the valve which guards the foramen ovale in the
foetus, and also noticed the valve-like fold which guards the entrance
of each hepatic vein into the inferior vena cava. He also gave an
admirable description of the vena azygos. Blinded by the ancient theory
of the movement of the blood—a sort of flux and reflux in the veins, he
overlooked the function of the venous valves. He described them as
eminences, or projections, or accidental rugosities, which in no way
interfere with the flux and reflux of the blood.

    [Illustration: DISSECTION OF THE HEART BY VESALIUS
    (From the “Fabrica”, 1543)]


The Fourth Book

Vesalius devotes forty pages to the cerebral and spinal nerves. The
anatomy of the brain is treated in the seventh book. His representations
of the nerves are very creditable. He mentions eleven pairs of cranial
nerves: the olfactory, the optic, the motores oculorum, the trifacial,
the abducens, the portio dura, the portio mollis, the glosso-pharyngeal,
the pneumogastric, and the spinal accessory.

His account of the brain—contained in the seventh book—is elaborately
minute considering the time when it was written. His illustrations and
description of this organ surpass those of scores of later authors.
Vesalius fully describes the position of the brain; the membranes which
cover it; the cavities, or ventricles, within it; the divisions of
cerebrum, cerebellum, and medulla; the anatomy of the base, and the
origins of the cerebral nerves. These structures are illustrated from
different points of view.


The Fifth Book

The fifth book, comprising more than one hundred pages, is devoted to
the organs of nutrition. Here we find an admirable account of the
peritoneum, the mesentery, the omentum, the stomach and intestines, the
liver, the spleen, and the genito-urinary tract—all of which structures
are described and fully illustrated. In this book Vesalius also
describes the foetus in utero.


The Sixth Book

In less than fifty pages Vesalius describes the contents of the thorax.
He writes intelligently of the membrane lining the thorax, and then
gives an account of the arteria aspera, as the trachea was formerly
named. Passing on to the lungs, he next takes up the anatomy of the
heart. He describes its position, form, and structure in better terms
than had been done by preceding anatomists. The auricles, ventricles,
and valves are carefully examined. His illustrations of both lungs and
heart are excellent.

In the 1543 edition of the _Fabrica_, Vesalius adopts the erroneous view
of Galen that openings exist in the septum of the heart. In the second
edition of his book, published in 1555, he says that influenced by the
views of Galen, he believed that the blood passes from the right to the
left ventricle of the heart, through the septum, by means of the pores.
Vesalius immediately adds that the septum of the heart is as dense and
compact as the rest of this organ, and that not the smallest quantity of
blood passes through the septum.

His account of this subject is best given in his own words:—“In
recounting as above the structure of the heart, and the use of its
different parts, I have followed in the main the doctrines of Galen; not
that I regard them in all particulars as consonant with the truth, but
because, in attributing new functions and uses to a number of parts, I
am still distrustful of myself, and not long ago should hardly have
ventured to differ from that Prince of Physicians by so much as a
finger’s breadth. As for the dividing wall, or septum, between the
ventricles forming the right side of the left cavity, the student of
anatomy should consider carefully that it is equally thick, compact, and
dense, with all the rest of the cardiac substance enclosing the left
ventricle. And accordingly, notwithstanding what I have said about the
pits in this situation, and at the same time not forgetting the
absorption by the portal vein from the stomach and intestines, I still
do not see how even the smallest quantity of blood can be transfused,
through the substance of the septum, from the right ventricle to the
left”.

Vesalius and other anatomists knew of the hepatic circulation, or at
least believed in some communication between the portal and hepatic
veins:—“The branches of this vein”—vena cava—“distributed through the
body of the liver, come in contact with those of the portal vein; and
the extreme ramifications of these veins inosculate with each other, and
in many places appear to unite and be continuous”.

Vesalius knew that in several particulars the accepted physiology of the
vascular system was wrong. If he could have lived a few years longer, it
is possible that he might have solved the great problem which was made
clear by William Harvey. In the light of our present knowledge some of
Vesalius’s words are suggestive:

“When these matters are taken into account, many things at once present
themselves in regard to the arterial system, which deserve careful
consideration; especially the fact that there is hardly a single vein
going to the stomach, the intestines, or even the spleen, without its
accompanying artery, and that nearly every member of the portal system
has a companion artery associated with it in its course. Again, the
arteries going to the kidneys are of such size that they can by no means
be affirmed to serve merely for regulating the heat of these organs; and
still less can we assert that so many arteries are distributed to the
stomach, intestines and spleen for that purpose alone. And there is,
furthermore, the fact, which we must for many reasons admit, that there
is through the arteries and veins a mutual flux and reflux of materials,
and that within these vessels the weight and gravitation of their
contents has no effect”.


The Seventh Book.

In the seventh book, consisting of less than sixty pages, Vesalius fully
describes the anatomy of the brain, of the cranial nerves, and of the
organs of sense. His description of the eye is not as near accuracy as
might be expected. He places the crystalline lens in the centre of the
globe. His description of the organ of vision was only slightly better
than that which was given by Galen. Vesalius showed, however, that the
optic nerve is not a hollow tube, and that it does not enter the eyeball
exactly in the antero-posterior axis.


Conclusion

Considering the time in which he lived, Vesalius was remarkably free
from errors. Although to him the arteries were carriers of vital
spirits, the veins were the true blood vessels, and, according to the
first edition of his great book, the septum of the heart was filled with
foramina; yet, we must say with Baas, “these are all mere shadows
necessary to the brilliancy of the picture”.

Vesalius was more than an anatomist. As a practical physician he had the
highest reputation among his contemporaries. He was an accomplished
scholar and was thoroughly conversant with the weaknesses of human
nature, as is evident from many satirical touches in his writings.
Although his great work contains many errors that a tyro of the present
day would laugh at, it laid the foundations of our knowledge. Vesalius
overthrew the idol of authority in anatomy and taught us to look at
Nature with our own eyes.

Portal[24] has paid a splendid tribute to Vesalius. “Vesalius”, he says,
“appears to me one of the greatest men who ever existed. Let the
astronomers vaunt their Copernicus, the natural philosophers their
Galileo and Torricelli, the mathematicians their Pascal, the geographers
their Columbus, I shall always place Vesalius above all their heroes.
The first study of man is man. Vesalius has this noble object in view,
and has admirably attained it; he has made on himself and his fellows
such discoveries as Columbus could make only by travelling to the
extremity of the world. The discoveries of Vesalius are of direct
importance to man; by acquiring fresh knowledge of his own structure,
man seems to enlarge his existence; while discoveries in geography or
astronomy affect him but in a very indirect manner”.

Like Harvey, Vesalius was obliged to defend his writings from fierce
attacks. The most desperate of his opponents was his old master, Jacobus
Sylvius, who was so wedded to the Galenic teachings that he asserted
that since Galen’s time the thigh bones had changed their shape. He
spoke of Vesalius as a “madman, Vesanus, whose pestilential breath
poisons Europe”. Ponderous discussions were carried on between the
friends and opponents of the great anatomist. The complete overthrow of
the Galenists resulted.

If Vesalius had remained professor of anatomy in Padua, instead of being
appointed physician to Charles the Fifth, at Madrid, in 1544, it is
probable that the circulation of the blood would have been discovered by
him.

In recent years attempts have been made to show that it was not
Vesalius, but Leonardo da Vinci, who was the founder of modern anatomy.
A considerable amount of controversial literature has accumulated on
this subject. For our purpose it may suffice to quote the conclusions of
McMurrich[25]:—“Leonardo was the first to create a new anatomy, but he
created it for himself alone; Vesalius demonstrated a new anatomy to the
world. It was the publication of Vesalius’s _Fabrica_ that
revolutionized anatomy, while Leonardo’s drawings were lying
unpublished, at first the cherished possessions of his favorite pupil
Melzi, later in the Ambrosian Library in Milan, and still later
forgotten in the Royal Library at Windsor. We must credit Leonardo as
being the forerunner of the new anatomy, but Vesalius must be recognized
as its founder”.

    [Illustration: INITIAL LETTER BY VESALIUS
    (From the “Fabrica”, 1543)]




                            CHAPTER TWELFTH
                        Contemporary Anatomists


    [Illustration: Illuminated capital]

Shortly after the publication of the _Fabrica_, great activity was
manifested in anatomic research, and numerous opponents and critics of
Vesalius appeared in the arena of science. The criticism of such men as
Jacobus Sylvius and John Dryander, while it was of a violent type, was
of much less importance than was that of Eustachius, Columbus and
Fallopius. Vesalius was not without his partisans, of whom Ingrassias
and Cannanus are worthy of mention.


Bartholomeus Eustachius

Eustachius was born at San Severino, a small city near Salernum, about
the year 1520. He studied anatomy in Rome and made remarkable progress
in this science. In the year 1562, as he informs us in his _Opuscula
Anatomica_, he was professor of medicine in the Collegio della Sapienza
at Rome. Like many other men of genius, Eustachius died in poverty. In
August, 1574, having been called by the illness of Cardinal Rovere to
Fossombrone, Eustachius died upon the journey.

To Eustachius posterity is indebted for a series of splendid copperplate
engravings which were designed to illustrate the anatomy of the human
body. These plates, the handiwork of Eustachius, and the first
anatomical illustrations wrought in copper, were completed in 1552, only
nine years after the first impression of the book of Vesalius.
Unfortunately for himself, and worse for medical science, Eustachius was
unable to publish them. If this magnificent atlas of anatomy could have
been published when completed, the anatomical discoveries of the
eighteenth century would have come two hundred years earlier.
Unfortunately the entire text of the work is lost. For one hundred and
thirty-eight years the Eustachian plates remained either in the family
of Pinus, an intimate friend of the anatomist, or were buried in the
Papal Library at Rome. When discovered they were presented by Pope
Clement XI. to his physician, Lancisi, who published them with notes of
his own, at Rome, in 1714. In 1740 they were issued under the direction
of Cajetan Petrioli. Four years later the edition by Albinus appeared,
which was republished in 1761. The anatomical writings of Eustachius
were published during his lifetime, in 1564. It is upon his _Tabulae
Anatomicae_ that the fame of this wonderful man is founded. If this work
had been published in 1552, Eustachius would have divided with Vesalius
the honor of founding human anatomy. The victim of circumstances, his
name has been overshadowed by that of Vesalius, to whom in some respects
he was superior. Deprived during life of his merited honors, Eustachius
has been awarded a goodly share of posthumous fame.

    [Illustration: BRAIN AND NERVES BY EUSTACHIUS
    (Reduced one-half)]

    [Illustration: MUSCLES BY EUSTACHIUS
    (Reduced one-half)]

Eustachius was the first anatomist to describe, with any degree of
accuracy, the tube which bears his name. We can truly say he discovered
it, since Alcmaeon dissected only the lower animals, and was not an
accurate observer, as his view that goats breathe through the ears,
amply testifies. Eustachius discovered the tensor tympani and stapedius
muscles, the modiolus and membranous cochlea, and the stapes. The honor
of the discovery of the stapes is claimed for no less than five renowned
anatomists, namely, Fallopius, Ingrassias, Columbus, Colladus, and
Eustachius. It is unnecessary to discuss this disputed claim to
priority. The truth seems to be that the stapes was discovered by both
Ingrassias and Eustachius, each independently of the other. In 1546
Ingrassias publicly demonstrated the little bone of the ear in his
lectures at Naples. Fallopius, after learning from an eyewitness that
Ingrassias had actually discovered and named the ossicle, relinquished
his claim to the discovery. Columbus and Colladus filed their
information at too late a date. Eustachius, as previously stated,
finished his anatomical plates in 1552. His seventh plate shows, among
other subjects, the auditory ossicles—malleus, incus and stapes—and
tensor tympani muscle. These objects are delineated as taken from a
human subject, and also from a dog.

Eustachius discovered the origin of the optic nerves, and the sixth
cerebral nerves. He gives excellent pictures of the corpora olivaria and
corpora pyramidalia; of the stylo-hyoid muscle; of the deep muscles of
the neck and throat; of the suprarenal capsules, and of the thoracic
duct. He also described the ciliary muscle. Eustachius was the first
anatomist who accurately studied the teeth and the phenomena of the
first and second dentition. In his researches he employed magnifying
glasses, maceration, exsiccation, and various methods of injection.


Realdus Columbus

The first anatomical treatise containing an account of the lesser, or
pulmonary circulation, was the monumental work, _De Re Anatomica, libri
xv._, written by Realdus Columbus and sumptuously published at Venice in
the year 1559. This, however, was not the first printed account of the
lesser circulation. Six years prior to the publication of the book of
Columbus, the unfortunate Servetus, in a theological treatise, described
correctly the course of the blood in its transit through the lungs.
Tried for heresy, Servetus was burned, together with all obtainable
copies of his book. Although it had been printed, the work was
suppressed; hence it follows that Columbus was the first to publish the
great discovery. Of the life of this anatomist we know but little. Born
at Cremona, a small Milanese village, the year of his birth is unknown.
He died in 1559, while his book was being printed. A few copies were
finished before his demise, since a copy belonging to the late Dr.
George Jackson Fisher, of Sing Sing, N.Y., contains the author’s own
dedication to Pope Paul IV., while in other exemplars, the dedication
has been written by the two sons of Columbus, and is addressed to “_Pio
IIII., Pont. Max_”. This prelate, on the death of Paul IV., on August
18, 1559, became the head of the Church.

Some writers have held that the discovery of the lesser circulation was
not made by Columbus independently of Servetus, but that a copy of the
book of Servetus had drifted into Italy and had been read by Columbus.
There is no direct evidence to support this view. When Vesalius was
called to Madrid as physician to Charles the Fifth, Columbus, in 1544,
succeeded him in the University of Padua; two years later he filled the
anatomical chair at Pisa, and in 1546, Pope Paul IV. called him to Rome.
Here he spent the later years of his life, engaged in teaching anatomy
and in writing his book. For forty years Columbus pursued his anatomical
studies, and in that period he dissected an unusually large number of
bodies. Fourteen subjects passed under his scalpel in a single year.

    [Illustration: TITLE-PAGE OF COLUMBUS’S ANATOMY
    (Reduced one-half)]

Columbus frequently made experiments upon living animals. He was the
first to use dogs for such purposes, preferring them to swine. Book
XIIII. of the work of Columbus is upon the subject of vivisection, _De
viva sectione_. In this he tells us how to employ living dogs in
demonstrating the movements of the heart and brain, the action of the
lungs, etc. Columbus was the first anatomist who demonstrated
experimentally that the blood passes from the lungs into the pulmonary
veins. “When the heart dilates”, says Columbus, “it draws natural blood
from the vena cava into the right ventricle, and prepared blood from the
pulmonary vein into the left; the valves being so disposed that they
collapse and permit its ingress; but when the heart contracts, they
become tense, and close the apertures, so that nothing can return by the
way it came. The valves of the aorta and pulmonary artery opening, on
the contrary, at the same moment, give passage to the spirituous blood
for distribution to the body at large, and to the natural blood for
transference to the lungs”.

Like Servetus, Columbus held to the idea of “spiritus”. Harvey was the
first physiologist who recognized the circulation as purely a movement
of blood. All before him assumed the existence of a mixture of air and
blood. Columbus, pupil and prosector of Vesalius, like his great master,
denied the existence of foramina in the cardiac septum.


Gabriel Fallopius

    [Illustration: GABRIEL FALLOPIUS]

Gabriel Fallopius (1523-1562), of Modena, was a noted Italian anatomist.
In his twenty-fifth year he was made professor of anatomy at Pisa.
Although the span of his life was short, he will be remembered always as
the discoverer of the tubes which bear his name. According to Fisher,
Fallopius “described the ear more minutely than had ever before been
done. He discovered the little canal along which the facial nerve passes
after leaving the auditory; it is still called the _aquaeductus
Fallopii_. He demonstrated the fact of the communication of the mastoid
cells with the cavity of the tympanum; and also described the fenestrae
rotunda and ovalis. In the treatment of diseases of the ear, he used an
aural speculum, and employed sulphuric acid for the removal of polypi
from the meatus. In some of his supposed discoveries he had long been
anticipated; for example, the tubes which bear his name were known and
accurately described by Herophilus, over three hundred years before the
Christian era, and also by Rufus of Ephesus, of whom Galen speaks as the
best anatomist of the second century. Rufus refers to two varicose and
tortuous vessels passing from the testes (as the ovaries were called) to
the cavity of the uterus. Fallopius, however, gave a full account of
their course, position, size and structure. He cut into them and found
them hollow, gave them the name of tubae seminales, and posterity
attached his name to them, and in time came to a better comprehension of
their true function. This is not the only instance in the history of
anatomical discovery where the name of a person, not its discoverer, has
been given to an organ. Allusion has been made to Fallopius as a
botanist; a genus of plants, _Fallopia_, has been named in honor of
him”.

Fallopius was appointed professor of anatomy at Pisa, in the year 1548;
and later, at the instance of the Grand Duke of Tuscany, Cosimo I., he
received a professorship at Padua, as successor to Vesalius. Besides the
chair of anatomy and surgery and of botany, he also held the office of
superintendent of the new botanic garden in that city. Fallopius
remained in Padua to the day of his death, which occurred in 1562. He
was very properly succeeded by his favorite pupil, Fabricius ab
Aquapendente, who had been for some time previously his anatomical
demonstrator. His collected works, as published in Venice, 1606, embrace
twenty-four treatises distributed in three folio volumes. Only one of
his works was published during his lifetime, namely, his _Observationes
Anatomicae_, Venice, 1561, which is considered one of his most valuable
books, containing, as it does, most of his discoveries and his
animadversions on the works of other anatomists.

This was written as a supplement to the anatomy of Vesalius, for it
follows the same order, passes upon the same subjects, corrects the
inaccuracies of the Vesalian treatise, and supplies what is wanting.
Throughout the work Fallopius treats Vesalius with great respect, and
never mentions him without an honorable title. Vesalius wrote an answer
to this work, entitled, _Observationum Fallopii examen_, in which he
acknowledges the courtesy of Fallopius, but, as argument progresses,
appears to be out of temper.

After the death of Fallopius it was thought that no successor except
Vesalius could be found competent to fill his place. Accordingly
Vesalius was chosen. The news of his appointment reached him while he
was returning from a pilgrimage to Jerusalem. Unfortunately he was
shipwrecked and perished, otherwise history would have afforded an
example of the master filling the chair of the pupil.


John Philip Ingrassias

Ingrassias, who lived between the years 1510-1580, was a graduate of the
celebrated Paduan School. He described minutely the anatomy of the ear,
including the tympanum, fenestrae rotunda and ovalis, the cochlea, the
semi-circular canals, and the tensor tympani muscle. His admiring pupils
caused his portrait to be painted and placed in the Neapolitan School,
with this inscription:—“To Philip Ingrassias, of Sicily, who, by his
lectures, restored the science of true Medicine and Anatomy in Naples,
his pupils have suspended this portrait as a mark of grateful
remembrance”. Ingrassias was a voluminous writer, his chief work being a
treatise on osteology, which was published twenty-three years after his
death. When the plague depopulated Palermo, in 1575, his devotion was
such as to earn for him the title of the Sicilian Hippocrates. Few men
have been more earnest workers in medical science. If his fame as an
anatomist has not equalled that of others, the cause is to be sought in
the multiplicity of competitors, not in lack of zeal and ability.

    [Illustration: INGRASSIAS]




                           CHAPTER THIRTEENTH
                      Commentators and Plagiarists


    [Illustration: Illuminated capital]

Medical history furnishes numerous examples of literary theft. In many
instances an entire set of anatomical plates has been pirated by
unscrupulous publishers. In a few cases both text and plates have been
appropriated by medical authors. The most notorious example of this form
of theft was furnished by William Cowper (1666-1709), an English surgeon
and anatomist, who, having secured three hundred copies of Bidloo’s set
of one hundred and five anatomical plates, in 1697 issued the work[26]
as his own. Cowper added a few original illustrations to the book.

Vesalius suffered severely at the hands of the plagiarists. Pirated
editions of the _Tabulae Anatomicae_ were printed in several cities,
chiefly in Germany. As regards the _Fabrica_, we may say that it has
been the fountain from which many anatomical writers have derived
practically all of their illustrations and much of their text.

The fame of the _Fabrica_ soon spread throughout Europe. It was
published in Germany, in Holland and in England. An epitome of its
contents was issued in Latin, in 1545, by Thomas Geminus, or Gemini,
under the title:—_Compendiosa totius Anatomiae delineatio, aere exaratum
per Thomam. Geminum._ It contained forty of the Vesalian plates, cut in
copper, and was the first book issued in England in which the roller
printing process was employed. It was dedicated to Henry the Eighth, and
was embellished with “one of the earliest and most curious of all extant
engraved title-pages”.

In 1553, Geminus issued a second edition, in which the text was
translated into English. This edition was dedicated to Edward the Sixth,
with a commendatory note, “To the gentill readers and Surgeons of
Englande”. Six years later the third English edition appeared, which was
inscribed to Queen Elizabeth. It contains the first published portrait
of the Queen. She is shown upon the engraved title-page, and, strange to
say, above her is another queenly figure, with a pen in her right hand,
a wreath on her left, her foot resting on the globe, and styled
_Victoria_.

Another English work on anatomy, which is filled with poor imitations of
Vesalius’s illustrations, is the _Microcosmographia_ of Helkiah Crooke,
or Crocus, who was “Professor in Anatomy and Chirurgery”. Its chief
value rests in an elaborately engraved title-page, a part of which shows
Crooke giving a demonstration in anatomy in the presence of the
“Worshipfull Company of Barber-Chirurgeons”, in London, early in the
seventeenth century.

John Banister of Nottingham, in 1578, borrowed a few Vesalian woodcuts
for use in _The Historie of Man, sucked from the sappe of the most
approved Anatomists and published for the Utilitie of all Godly
Chirurgians within this Realme_.

Most of the host of translators, epitomizers, commentators and imitators
of Vesalius have passed into oblivion. A few of these persons have
possessed enough of individuality to deserve recognition.

Juan Valverde di Hamusco, a Spaniard who was born about the year 1500,
studied anatomy at Padua and later at Rome. His book, _Historia de la
Composicion del Cuerpo Humano_, was published at Rome in 1556. It
contains forty-two copperplates and an engraved title-page. Although the
author says he has used only the Vesalian plates, his work contains
several plates which are not to be found in Vesalius’s writings. For
example, Valverde shows a _muskelmann_ with his skin held in his right
hand, the left grasping a dagger which may have been used in the
skinning process. Other original drawings show the abdomen and
intestines, a pregnant woman with the abdomen opened, and illustrations
of the superficial veins.

Valverde was physician to Cardinal Juan de Toledo, Archbishop of
Santiago, to whom the work is dedicated. The illustrations were drawn by
Gaspar Becerra and were engraved by Nicholas Beatrizet. Valverde’s book
went through several editions. It forms a landmark in the medical
history of Spain—a country which, for many years, was behind other
states of Europe in matters of science.

To name the list of anatomical writers who have derived their artistic
inspiration from the _Fabrica_ would require much more space than is at
our disposal. It must suffice to say, that, for a period of two
centuries, nearly all treatises on anatomy contained illustrations which
were taken from the writings of Vesalius. With few exceptions, these
reproductions were little better than caricatures of the original
figures.

Of the numerous editions of the _Fabrica_ there are three which are
highly prized, namely, the first one, 1543; the second, issued in 1555,
containing eight hundred and twenty-four pages, with many changes in the
text; and the 1725 edition of the collected writings of Vesalius. The
last named is a huge volume which was published at Leyden under the
supervision of Boerhaave and Albinus, with the illustrations cut in
copper by Jan Wandelaar[27].

It contains the _Fabrica_, the _Epitome_, the _Epistola de Radicis
Chynae_, various anatomical treatises of a controversial character, and
the _Chirurgia Magna_ which has been wrongly attributed to Vesalius.
Morley says of this book:—“After his death a great work on surgery
appeared, in seven books, signed with his name, and commonly included
among his writings. There is reason, however, to believe that his name
was stolen to give value to the book, which was compiled and published
by a Venetian, Prosper Bogarucci, a literary crow, who fed himself upon
the dead man’s reputation”.

    [Illustration: Ornamental block]




                           CHAPTER FOURTEENTH
                          The Court Physician


    [Illustration: Illuminated capital]

Vesalius, having finished the _Fabrica_, intended to write a work on the
practice of medicine which should be based on pathology. He makes
mention of this in the preface of the _Fabrica_, and in numerous places
in the body of the book he describes the pathologic appearances which he
found in dissection.

Returning to Padua after a year’s absence, he found that the University
for which he had strenuously labored was a very hotbed of opposition.
His former pupil and friend, Realdus Columbus, who was now lecturing on
anatomy at Padua, had turned against him. How deeply Vesalius was
wounded by the man whom he had made, can be appreciated only by those
who have been placed in similar circumstances. The controversy between
Columbus and Vesalius was of a bitter and personal character.

On all sides the views of Vesalius were attacked, and the defenders of
Galen joined hands with men like Columbus in an effort to besmirch the
great anatomist. Disgusted with such treatment, Vesalius, early in 1544,
went to Pisa. Here he conducted a course in anatomy. Leaving Pisa, he
went to Bologna where he made some special dissections upon two bodies.
About this time he declined a chair in the University of Pisa which was
tendered to him by direction of Cosimo de’ Medici. Tired of the
apparently useless effort to make men see the truth, sick of disputes
and arguments, persecuted by members of his own profession, in a fit of
passion Vesalius threw his manuscripts into the fire and ended his
career as a scientist. “Thus”, says Morley, “he destroyed a huge volume
of annotations upon Galen; a whole book of Medical Formulae; many
original notes upon drugs; the copy of Galen from which he lectured,
covered with marginal notes of new observations that had occurred to him
while demonstrating; and the paraphrase of the books of Rhazes, in which
the knowledge of the Arabians was collated with that of the Greeks and
others”.

    [Illustration: CHARLES THE FIFTH]

While in this frame of mind it is not surprising that he should have
accepted the appointment of Archiatrus to Charles the Fifth of Spain.

The great Emperor was now at the zenith of his fame. His kingdom, which
reached from South America to the Zuyder Zee, was well under control,
but the monarch already contemplated the abdication of the throne in
favor of his son Philip, who is known in history as Philip the Second.

Vesalius left Italy and took up his residence at Madrid. He was now in
his thirtieth year. As Archiatrus he accompanied the Emperor in the
fourth French war, in which he gained his first experience as a military
surgeon. He also acted as physician to Charles and to the members of the
imperial household. The war ended in September 1544. In January, 1545,
Charles went to Brussels, and remained in the Netherlands for many
months. Vesalius was now in his native country, and in April, 1546, he
visited the graves of his ancestors at Nymwegen and Wesel. In the same
year he published a new edition of his treatise on the China root.

On the twenty-fifth day of October, 1555, amid a scene of pomp and
splendor, in the presence of the assembled representatives of the
Netherlands, Charles formally surrendered to his son all his
territories, jurisdiction and authority in the Low-Countries. This was
the first of a series of acts by which the Emperor gradually
relinquished the reins of power, in order to spend his remaining days in
a cloister. Philip thus became the heir to a vast dominion. Vesalius was
continued in office as Archiatrus by the new Emperor. From both Charles
and Philip, Vesalius received many marks of honor. It was he who rescued
Charles from what was thought to be a mortal disease. At a later date,
when Philip’s unfortunate son, Don Carlos, received a severe injury to
the head, and after the treatment of the Spanish physicians had failed,
it was Vesalius who saved his life by an operation. These cures, and the
accurate prediction of the death-day of Maximilian d’Egmont, placed the
fame of Vesalius at high tide.




                           CHAPTER FIFTEENTH
                          Pilgrimage and Death


    [Illustration: Illuminated capital]

Suddenly, early in the year 1564, for a reason which has never been
explained satisfactorily, Vesalius left Madrid. Apparently he was at the
height of success. He was famous as a physician and surgeon; he was a
favorite at the Spanish court; he had amassed a fortune; and seemingly
he was destined to pass his remaining days under the most favorable
surroundings. As occurs to all great men, he had excited the jealous
animosity of many of the members of his profession. The efforts of the
Madrid physicians to ignore the talents of one whom they regarded as a
foreigner, long since had reacted to the advantage of the Archiatrus.

    [Illustration: PHILIP THE SECOND]

During the twenty years that he had filled the post of Archiatrus, the
scalpel of Vesalius was rusting: but the controversy concerning the
infallibility of Galen was still raging. The violent criticisms of
Sylvius upon the _Fabrica_ had been silenced by death, but others took
up the cause of Galen where Sylvius had left it. But the passing years
had brought a new coterie of professors, who, like Fallopius at Padua;
Rondelet at Montpellier; Massa at Venice; and Fuchs at Tübingen, were
boldly teaching many things that were contrary to Galen.

Life at the Spanish court was not favorable to the study of science.
“The hand of the Church”, says Foster[28], “was heavy on the land; the
dagger of the Inquisition was stabbing at all mental life, and its torch
was a sterilizing flame sweeping over all intellectual activity. The
pursuit of natural knowledge had become a crime, and to search with the
scalpel into the secrets of the body of man was accounted sacrilege. It
was for a life in priest-ridden, ignorant, superstitious Madrid that
Vesalius had forsaken the freedom of the Venetian Republic and the
bright academic circles of Padua; in Madrid, where, as he himself has
said, ‘he could not lay his hand on so much as a dried skull, much less
have the chance of making a dissection’. Moreover, he must have felt the
loss of Charles, who, whatever his faults, recognized the worth of
intellectual efforts, and in many ways had shown his sympathy with
Vesalius’s love of knowledge. Such sympathy could not be looked for in
the narrow and bigoted Philip”.

About this time Vesalius received a copy of the _Observationes
Anatomicae_ of his pupil Fallopius, who, having learned all that his
master had taught of anatomy, continued his studies with great skill and
industry. Such a book, coming at an opportune time, must have seemed
like a voice calling the Archiatrus back to the intellectual life,
bringing to his mind’s eye the recollection of his happy days in Italy.

Vesalius travelled to Venice by way of Perpignan. While in Venice he
visited the printer, Francesco Sanese, and discussed the publication of
a new book which should contain his reply to Fallopius. In a short time
he started for Cyprus in company with Jacobo Malatesta, the commander of
the Venetian forces in that island. Thence he passed to Jerusalem on a
pilgrimage to the Holy Land. Vesalius never returned from that journey.
Information of his death reached Brussels towards the end of that
year—1564.

What was the reason for this pilgrimage? Various alleged authorities
have given different versions, many of which are evidently fictitious.
The most reasonable account, which emanates from Spanish-French sources,
dates from a letter written January 1, 1565, to the physician Caspar
Peucer by Hubert Languer, or Hubertus Languetus, the Huguenot friend of
Philip Sidney, which says:—“They say that Vesalius is dead. Doubtless
you have heard that he went to Jerusalem. That journey had, as they tell
us from Spain, an odd reason. Vesalius, believing a young Spanish
nobleman whom he had attended to be dead, obtained leave of the parents
to open the body for the sake of inquiring into the cause of the
illness, which he had not rightly comprehended. This was granted; but he
had no sooner made an incision into the body than he perceived the
symptoms of life, and opening the breast, saw the heart beat. The
parents coming afterwards to the knowledge of this, were not satisfied
with prosecuting him for murder, but accused him to the Inquisition of
impiety, in hopes that he would be punished with greater rigor by the
judges of that tribunal than by those of the common law. But the King of
Spain interposed, and saved him on condition that by way of atoning for
the error he should undertake a pilgrimage to the Holy Land”.

The pilgrimage was made, the Holy Sepulcher was visited, and the weary
wanderer had started for Padua to take the chair which was made vacant
by the death of Fallopius. A violent storm swept the Ionian Sea.
Vesalius’s ship was wrecked upon the island of Zakynthos, where, on the
fifteenth day of October, 1564, the Archiatrus died of exhaustion.

Such was the miserable end of Andreas Vesalius of Brussels, a man, who,
before he had attained his thirtieth year, had become the greatest
anatomist that the world has ever seen.

    [Illustration: Ornamental block]




                               FOOTNOTES


[1]Théorie de la figure humaine. Paris, 1773.

[2]Moehsen: Verzeichnis einer Sammlung von Bildnissen. Berlin, 1771;
    page 59.

[3]Bell: Observations on Italy. Edinburgh, 1825; page 257.

[4]Galen: De Anatomicis Adininistrationibus. Lib. II.

[5]Celsus: De Medicina. Lib. I.

[6]Fisher: Claudius Galenus. Annals of Anatomy and Surgery, Vol. IV.,
    page 216.

[7]Saint Basil, in his maturer years, deeply regretted that he had
    studied classical literature in his youth. Jerome regarded the
    reading of the writings of antiquity as a terrible crime. Gregory
    the Great declared a knowledge of grammar even for a layman to be
    indelicate.—Fort: Medical Economy during the Middle Ages. N. Y.,
    1883; pages 102, 103.

[8]Meryon: History of Medicine. London, 1861; vol. I, page 479.

[9]Adam; Vitae Germanorum Medicorum. Haidelbergae, 1620: page 224.

[10]Zwinger: Theatrum Vitae Humanae. Basileae, 1571.

[11]Vesalius: Fabrica, 1543, preface.

[12]Sylvius: Ordo et Ordinis Ratio in Legendis Hippocratis et Galeni
    Libris, 1539.

[13]The Collége Royal de France was founded by Francis the First. This
    enlightened patron of the sciences and arts recognized the merits of
    scientific men and rewarded them with his money and his friendship.
    He established the Collége de France with twelve richly-endowed
    professorships, one of which was devoted to medicine. The lectures
    were free to all who desired to attend. The first incumbent of the
    chair of medicine was Vidus Vidius, Guido Guidi, of Florence, who
    filled this position from 1542 to 1548. Such success followed his
    labors that, on his return to Italy, his experience in Paris was the
    subject of this witticism: _Vidus venit, Vidius vidit, Vidus vicit_.

[14]Northcote: History of Anatomy. London, 1772; page 56.

[15]Portal: Histoire de l’Anatomie et de la Chirurgie. Paris, 1770; vol.
    I, page 365.

[16]Moreau: Vita Sylvii, in Sylvii Opera Medica. Geneva, 1635.

[17]Vesalius: De radice Chinae epistola, 1546; pages 151, 152.

[18]Archives Curieuses de l’Histoire de France.

[19]Guinterius: Anatomicarum Institutionum, 1539.

[20]Paraphrasis in nonum librum Rhazae medici Arabis clariss. ad Regem
    Almansorem, de singularum corporis partium affectuum curatione,
    autore Andrea Wesalio Bruxellensi Medicinae candidato. Lovanii ex
    officina Rutgeri Resii. mense Februar. 1537.

[21]Radicis Chinae usus, Andrea Vesalio autore. Lugd., 1547; page 278.

[22]Moehsen: Verzeichnis einer Sammlung von Bildnissen. Berlin, 1771;
    page 82.

[23]Sandrart: Teutsche Academie. Nürnberg, 1685: vol. II., page 243.

[24]Portal: Histoire de l’anatomie et de la chirurgie. Paris, 1770; vol.
    I., page 399.

[25]McMurrich: Medical Library and Historical Journal, December, 1906.

[26]Cowper: The Anatomy of Human Bodies. Oxford, 1697.

[27]Andreae Vesalii Opera Omnia Anatomica et Chirurgica in duos tomos
    distributa cura Hermanni Boerhaave et Bernhardi Siegfried Albini.
    Lugduni Batavorum, 1725.

[28]Foster: Lectures on the History of Physiology. Cambridge, 1901, page
    17.




                                 INDEX


    [Illustration: Ornamental block]




                                 INDEX


                                   A
  Abrégé d’anatomie                                                   93
  Achillinus, Alexander                                               42
  Adam, M.                                                            55
  Adolph of Nassau                                                    11
  Aegina, Paul of                                                 63, 80
  Aesculapius                                                         17
  Aetius                                                              80
  Alberti, Leo Battista                                                7
  Albertus Magnus                                                     55
  Albius, John Andreas                                                80
  Albinus, B. S.                                            46, 115, 129
  Albucasis                                                           30
  Alcmaeon                                                       19, 115
  Aldo                                                                11
  Aldus Manutius                                                      43
  Alexander of Tralles                                                63
  Alexander the Great                                                 20
  Alexandria                                                      20, 22
  Alexandrian Anatomists                                          22, 23
  Alexandrian Library                                                 23
  Alexandrian University                                          22, 29
  Alfonso the Magnificent                                              5
  Almansor, the                                                       72
  Al-Rasi                                                             31
  Amatus                                                              51
  Ambrosian Library                                                  113
  Anatomy in Ancient Times                                         17-28
  Anathomia Mundini                                           11, 35, 48
  Anatomia Corporis Humani                                            37
  Anatomia ridotta                                                    93
  Anatomia Porci                                                      27
  Anatomical Renaissance                                              14
  Andernach, John Winter of                                           61
  Antonius Musa                                                       20
  Antropologium of Magnus Hundt                                       39
  Apelles                                                             22
  Aphorisms of Hippocrates                                            53
  Apollo                                                              19
  Apophyses venarum                                                   51
  Aquaeductus Fallopii                                               122
  Aqueduct of Sylvius                                                 60
  Arabs                                                       27, 30, 56
  Arantius                                                        15, 16
  Archimedes                                                          22
  Archiatrus                                          131, 132, 135, 136
  Aristophanes                                                        22
  Aristotle                                           19, 55, 65, 66, 67
  Ars Curativa of Galen                                               56
  Art-Anatomy                                                      7, 91
  Artery of Sylvius                                                   60
  Asclepiadae                                                 17, 19, 56
  Astruc                                                              57
  Athanasius                                                          22
  Augustus                                                            20
  Aurelius, Marcus                                                    24
  Averröes                                                         4, 56
  Avicenna                                                15, 31, 56, 80


                                   B
  Banister, John                                                     127
  Basel, view of                                                      83
  Beatrizet, Nicholas                                                128
  Becerra, Caspar                                                    128
  Bell, John                                                          18
  Bembo                                                               12
  Benedictine Monastery                                                5
  Berengario da Carpi                                              43-46
  Bertruccius                                                         29
  Boccaccio                                                         4, 5
  Bogarucci, Prosper                                                 129
  Boerhaave                                                          129
  Bologna                                 6, 15, 27, 29, 30, 37, 43, 130
  Boniface VIII                                                       15
  Bracciolini, Poggio                                                 10
  Brambilla                                                           44
  Brissotus, Petrus                                                   56
  Bruchaeum                                                           21
  Budaeus                                                             56
  Busleiden, Hieronymus                                               54


                                   C
  Caelius Aurelianus                                                  63
  Caesalpinus                                                         16
  Caius                                                               10
  Cajetan Petrioli                                                   115
  Calamus scriptorius                                                 23
  Callimichus                                                         22
  Calcar, Jan Stephan van                              9, 74, 82, 83, 89
  Canna coxae                                                         34
  Cannanus                                                        51, 60
  Caraffa                                                         13, 73
  Carbo, Gisbertus                                                    55
  Cardan, Jerome                                                      52
  Cardi, Luigi                                                         9
  Carpi, Seigneur de                                                  43
  Carpus                                                           43-46
  Carolus Stephanus                                                   48
  Caxton                                                              11
  Celsus, Aulus Cornelius                                         10, 22
  Charles the Fifth                    53, 55, 82, 87, 95, 112, 119, 131
  Chauliac, Guy de                                                    29
  China root                                                 73, 87, 132
  Christian III                                                       63
  Cicero                                                            4, 5
  Cimabue                                                              7
  Civitas Hippocratica                                                27
  Clement VII                                                         12
  Clement XI                                                         115
  Colladus                                                      117, 118
  Collegium trilingue                                                 54
  Collége de Tréguier                                                 58
  Collége de Cornouailles                                             58
  Collége de France                                           15, 58, 60
  Columbus                                    16, 114, 117, 118-121, 130
  Copernicus                                                           2
  Copho                                                               27
  Coriolano, Christoforo                                              88
  Cortona, Pietro da                                                   9
  Cosimo de’ Medici                                               5, 131
  Cosimo I                                                           123
  Cowper, William                                                    126
  Crabbe, Isabella                                                    53
  Crooke, Helkiah                                                    127
  Crusaders                                                           15
  Curtius, Matthaeus                                                  79


                                   D
  da Carpi, Berengario                                         43-46, 47
  da Carpi, Hugo                                                      45
  Danoni                                                              84
  Dante, Alighieri                                                     3
  Dark Ages, Anatomy in the                                           26
  da Vinci, Leonardo                                        2, 8, 9, 113
  de Ketham, Joannes                                              32, 33
  Della Torre, Marc Antonio                                            8
  Descartes                                                           65
  Deventer, the Beggar of                                         61, 64
  de Zerbi, Gabriel                                               37, 39
  Donaria of Anatomical Interest                                      20
  Don Carlos                                                         132
  Dryander, John                                          46-48, 51, 114
  Dubois, Jacques                                                     57
  Dürer, Albrecht                                                      9


                                   E
  Eclectic Philosophy                                                 66
  Egyptian Anatomy                                                    17
  Eichmann                                                            47
  Elizabeth, Queen                                                   127
  Empedocles of Agrigentum                                            19
  Epidaurus                                                           20
  Epitome, the                                    84, 91, 93, 95-97, 129
  Erasistratus                                                22, 23, 24
  Eratosthenes                                                        22
  Estienne, Charles                                            48-51, 60
  Estienne, Robert                                                    50
  Eucharus                                                            31
  Eucharius Rhodion                                                   16
  Euclid                                                              22
  Eustachius, Bartholomeus                               15, 16, 114-118
  Eyck, Hubert and John van                                            7


                                   F
  Fabrica, the       30, 54, 55, 71, 82, 84, 94, 126, 128, 129, 130, 133
      contents of                                                 93-113
  Fabricius ab Aquapendente                                       16, 51
  Fallopia                                                           123
  Fallopius, Gabriel                16, 114, 117, 118, 121-124, 134, 135
  Ferdinand I                                                         63
  Fernel, Jean                                             57, 58, 64-67
  Fisher, G. J.                                             25, 119, 121
  Fliegende Blätter                                           37, 89, 95
  Foesius, Anutius                                                    10
  Foramen Vesalii                                                    103
  Fort, George F.                                                     27
  Fracastoro                                                          10
  Francis the First                                                   60
  Frederick II                                                        28
  Friesen                                                             40


                                   G
  Gabriel de Zerbi                                                37, 39
  Galen   10, 15, 19, 20, 24-26, 30, 36, 56, 57, 58, 61, 63, 64, 66, 67,
            68, 79, 80, 101, 103, 109, 111, 112, 123, 130, 131, 133, 134
  Galileo                                                         2, 112
  Geminus, Thomas                                               126, 127
  Gemma, Regnier                                                  70, 71
  Giacomo Berengario                                               43-46
  Giacomo Moro                                                        93
  Giotto                                                               7
  Giuseppe Ribera                                                      9
  Glisson                                                             51
  Granvella                                                           55
  Greece, Anatomy in                                          17, 18, 20
  Gregory the Great                                                   27
  Guido Guidi                                                         60
  Guillemeau, Jacques                                                 16
  Guinterius, Joannes                              61-64, 67, 68, 71, 81


                                   H
  Hamusco, Juan Valverde di                                          128
  Harvey, William                                      16, 110, 112, 121
  Havers, Clopton                                                     50
  Hela, Ricardus                                                  37, 38
  Henry the Second                                                    65
  Hero                                                                22
  Herophilus                                                 22, 23, 122
  Historie of Man                                                    127
  Hippocrates                    10, 17, 18, 19, 24, 57, 66, 67, 80, 125
  Holbein, the Elder                                                  41
  Homer                                                               29
  Hubert van Eyck                                                      7
  Hugo da Carpi                                                       45
  Humanists and Humanism                            4, 9, 10, 11, 13, 56
  Hundt, Magnus                                                39-40, 42


                                   I
  Ignatius Loyola                                                     73
  Index Expurgatorius                                                 13
  Ingrassias, John Philip                         15, 117, 118, 124, 125
  Inquisition                                                13, 44, 136
  Isagogae Breves                                                     45
  Institutionum Anatomicarum                                          81
  Italy and the Renaissance                                         2-14


                                   J
  Jan Stephan van Calcar                               9, 74, 82, 83, 89
  Jan Wandelaar                                                  86, 129
  Jerome                                                              27
  Jerome Mercurialis                                                  88
  Jesuits                                                             73
  Joannes de Ketham                                               32, 33


                                   K
  Kalcker                                                             89
  Ketham, Joannes de                                              32, 33


                                   L
  Lactantius                                                          11
  Lancisi                                                            115
  Languer, Hubert                                                    135
  Laurentius Phryesen                                             40, 41
  Leonardo da Vinci                                         2, 8, 9, 113
  Leonicenus, Nicholas                                            10, 56
  Linacre, Thomas                                                     10
  Livy                                                             5, 20
  Lorenzo de’ Medici                                                   8
  Louvain, University of                                  53, 54, 71, 75
  Loyola, Ignatius                                                    73
  Luca Signorelli                                                      8
  Luigi Cardi                                                          9
  Luther                                                              63
  Luzzi, Mondino dei                                                  29


                                   M
  Maggiore Consiglio of Venice                                        28
  Magnus, Albertus                                                    55
  Malatesta, Jacobo                                                  135
  Manetho                                                             22
  Marc Antonio della Torre                                             8
  Margarita Philosophica                                              55
  Massa                                                              134
  Maximilian d’Egmont                                                132
  Mead, Dr. Richard                                                   97
  Medicina Astrologica                                                28
  Melzi                                                              113
  Mercurialis, Jerome                                                 88
  Meryon, Edward                                                      45
  Michael Angelo                                                    8, 9
  Mirach                                                              34
  Moehsen, J. C. W.                                               18, 87
  Mondino dei Luzzi                                                29-36
  Mondino’s Anathomia                                             11, 35
  Mondino’s Successors                                             37-51
  Monte Cassino                                                        5
  Moreau                                                              61
  Morley, Henry                                             70, 129, 131
  Moro, Giacomo                                                       93
  Moschenbauer                                                        93
  Musa, Antonius                                                      20
  Museum, Alexandrian                                                 22
  Myntens, Arnold                                                      9


                                   Mc
  McMurrich                                                          113


                                   N
  Narcissus of Parthenope                                             82
  Nicholas V                                                       5, 10
  Northcote, W.                                                       60


                                   O
  Oporinus, Joannes                                   84, 85, 86, 95, 99
  Oribasius                                                           63
  Origen                                                              22
  Osiris                                                              22


                                   P
  Padua, University of         15, 74, 75, 76, 79, 80, 81, 112, 123, 136
      Vesalius’s Sojourn in                                        56-69
  Paedagogium Castri                                                  54
  Paganism                                                        11, 12
  Paraphrase of Rhazes                                           72, 131
  Paré, Ambroise                                                      16
  Paris, Anatomical teaching at                                   56, 69
  Parthenope, Narcissus of                                            82
  Pascal                                                             112
  Paulus Aegineta                                             10, 63, 80
  Pausanias                                                           18
  Petrarch                                                       3, 4, 5
  Peucer, Caspar                                                     135
  Peyligk, John                                                       39
  Philip the Second                                    95, 131, 132, 134
  Phryesen, Laurentius                                        40, 41, 42
  Pierre de la Rameé                                          65, 66, 67
  Pietro da Cortona                                                    9
  Piles, Rogers de                                                    93
  Pinus                                                              115
  Pion, Albert                                                        43
  Poggio Bracciolini                                                   9
  Pollaiuolo, Antonio                                                  8
  Poliziano                                                           10
  Pontanus                                                            10
  Pope Boniface VIII                                                  15
  Pope Clement VII                                                    12
  Pope Clement XI                                                    115
  Pope Leo X                                                          12
  Pope Nicholas V                                                     10
  Pope Paul III                                                       13
  Pope Paul IV                                                   13, 119
  Pope Pius IIII                                                     119
  Portal                                                         60, 112
  Ptolemies, the                                                      22


                                   Q
  Quintilian                                                           5


                                   R
  Raffaello Santi                                                      9
  Raimondino                                                          28
  Ramus                                                       65, 66, 67
  Regio Judaeorum                                                     21
  Renaissance, the Anatomical                                      14-16
  Renaissance, the General                                          1-14
  Rescius                                                             71
  Rhacotis                                                            21
  Rhazes                                                  31, 53, 72, 73
  Rhodion, Eucharius                                                  16
  Ribera, Giuseppe                                                     9
  Richardson, B. W.                                                   99
  Rogers de Piles                                                     93
  Rome, Anatomy in                                                19, 20
  Rubens                                                               9
  Rufus of Ephesus                                              122, 123


                                   S
  Saint Basil                                                         27
  Saint Stephen                                                       12
  Salernum                                                     5, 27, 28
  Sandrart                                                            89
  Sannazzaro                                                          10
  Santi, Raffaello                                                     9
  Scotus, Michael                                                     55
  Servetus                                         64, 68, 118, 119, 121
  Sicilian Hippocrates                                               125
  Sidney, Philip                                                     135
  Signorelli, Luca                                                     8
  Siphac                                                              34
  Spiegel der Artzny                                                  41
  Stephanas, Carolus                                               48-51
  Stirling-Maxwell, Sir William                                       83
  Sturm                                                               71
  Sylvius, Jacobus                               57-61, 67, 68, 112, 113
  Symonds, J. A.                                                       3


                                   T
  Tabulae Anatomicae                                         81, 83, 126
  Tagault, Jean                                                       57
  Temples of Aesculapius                                              18
  Terence                                                              5
  Theatin Monks                                                       73
  Theocritus                                                          22
  Thomas of Sarzana                                                   10
  Titian                                                  87, 88, 89, 93
  Torcular Herophili                                                  23
  Torre, Marc Antonio della                                            8
  Torricelli                                                      2, 112
  Tortebat, François                                                  93
  Trajectorium                                                        35
  Tralles, Alexander of                                               63
  Tritonius, Vitus                                                75, 80


                                   V
  Valeriano                                                           12
  Valverde, Juan di Hamusco                                          128
  van Eyck, Hubert and John                                            7
  Varolius                                                            15
  Vasari                                                              88
  Velsius                                                             71
  Venice                            6, 11, 37, 73, 89, 93, 118, 123, 135
  Venice, Maggiore Consiglio of                                       28
  Verdunno, Narciso                                                   82
  Vesalius, birth of                                                  52
      death of                                                       136
      education of                                     53-55, 56, 67, 68
  Vesanus                                                        59, 112
  Vida                                                                10
  Vidius, Vidus                                                   15, 60
  Villanovanus, Michael                                               68
  Vinci, Leonardo da                                        2, 8, 9, 113
  Vitruvius                                                           10
  Vitus Tritonius                                                 75, 80


                                   W
  Waechtlin                                                           41
  Wandelaar, Jan                                                 86, 129
  Wesalius Family                                                 52, 53
  Wharton                                                             42
  Winter of Andernach                                              61-64


                                   Z
  Zakynthos, island of                                               136
  Zerbi, Gabriel de                                               37, 39
  Zyrbi                                                               31

    [Illustration: Ornamental block]




                          Transcriber’s Notes


—Silently corrected a few typos.

—Retained publication information from the printed edition: this eBook
  is public-domain in the country of publication.

—In the text versions only, text in italics is delimited by
  _underscores_.