The authority of Galen, at once a
despotism and a religion, was scarcely ever called
in question until the sixteenth century. No attempt
worth recording was made during thirteen hundred years
to extend the boundary of scientific knowledge in
anatomy and physiology. It is true that the scholastic
philosopher, Albertus Magnus, who was for a short time
(1260-1262) Bishop of Ratisbon, in the middle of the
thirteenth century wrote a “History of Animals,”
which was a remarkable production for the age in which
he lived; although Sir Thomas Browne, in his famous
“Enquiries into Common Errors,” speaks
of these “Tractates” as requiring to be
received with caution, adding as regards Albertus that
“he was a man who much advanced these opinions
by the authoritie of his name, and delivered most
conceits, with strickt enquirie into few.”
As regards human anatomy, it was considered,
during the Middle Ages, to be impiety to touch with
a scalpel “the dead image of God,” as man’s
body was called. Mundinus, the professor of medicine
at Bologna from 1315 to 1318, was the first to attempt
any such thing. He exhibited the public dissection
of three bodies, but by this created so great a scandal
that he gave up the practice, and contented himself
with publishing a work, “De Anatome,”
which formed a sort of commentary on Galen. This
work, with additions, continued to be the text-book
of the schools until the time of Vesalius, who founded
the study of anatomy as nowadays pursued.
Andreas Vesalius was born at Brussels,
on the last day of the year 1514, of a family which
for several generations had been eminent for medical
attainments. He was sent as a boy to Louvain,
where he spent the greater part of his leisure in
researches into the mechanism of the lower animals.
He was a born dissector, who, after careful examination,
in his early days, of rats, moles, dogs, cats, monkeys,
and the like, came, in after-life, to be dissatisfied
with any less knowledge of the anatomy of man.
He acquired great proficiency in the
scholarship of the day. Indeed the Latin, in
which he afterwards wrote his great work, is so singularly
pure that one of his detractors pretended that Vesalius
must have got some good scholar to write the Latin
for him. Latin was not the only language in which
he was proficient; he added Greek and Arabic to his
other accomplishments, and this for the purpose of
reading the great biological works in the languages
in which they were originally written. From Louvain
the youth went to Paris, where he studied anatomy under
a most distinguished physician, Sylvius. It was
the practice of that illustrious professor to read
to his class Galen on the “Use of Parts,”
omitting nearly all the sections where exact knowledge
of anatomical detail was necessary. Sometimes
an attempt was made to illustrate the lecture by the
dissection of a dog, but such illustration more often
exposed the professor’s ignorance than it added
to the student’s knowledge. Indirectly,
however, it did good, for whenever Sylvius, after
having tried in vain to demonstrate some muscle, or
nerve, or vein, left the room, his pupil Vesalius
slipped down to the table, dissected out the part
with great neatness, and triumphantly called the professor’s
attention to it on his return.
Besides studying under Sylvius, Vesalius
had for his teacher at Paris the famous Winter, of
Andernach, who was physician to Francis I. This learned
man, in a work published three years after this period,
speaks of Vesalius as a youth of great promise.
At the age of nineteen Vesalius returned to Louvain;
and here for the first time he openly demonstrated
from the human subject. In this connection a somewhat
ghastly story is told, which serves to show the intensity
of the enthusiasm with which our anatomist was inspired.
On a certain evening it chanced that Vesalius, in
company with a friend, had rambled out of the gates
of Louvain to a spot where the bodies of executed
criminals were wont to be exposed. A noted robber
had been executed. His body had been chained
to a stake and slowly roasted; and the birds had so
entirely stripped the bones of every vestige of flesh,
that a perfect skeleton, complete and clean, was suspended
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.
Mounting upon the shoulder of his friend, Vesalius
ascended the charred stake and forcibly tore away
the limbs, leaving only the trunk, which was securely
bound by iron chains. With these stolen bones
under their clothes the two youths returned to Louvain.
In the night, however, and alone, the sturdy Vesalius
found his way again to the place which to
most men, at any rate in those times, would have been
associated with unspeakable horrors and
there, by sheer force, wrenched away the trunk, and
buried it. Then leisurely and carefully, day
after day, he smuggled through the city gates bone
after bone. Afterwards, when he had set up the
perfect skeleton in his own house, he did not hesitate
to demonstrate from it. But such an act of daring
plunder could not escape detection, and he was banished
from Louvain for the offence. This story is here
quoted only to show the extraordinary physical and
moral courage which the anatomist possessed; which
upheld him through toils, dangers, and disgusts; and
by which he was strengthened to carry on, even in
a cruel and superstitious age, and placed, as he was,
on the very threshold of the Inquisition, a work at
all times repulsive to flesh and blood.
After serving for a short time as
a surgeon in the army of the Emperor Charles V., Vesalius
went to Italy, where he at once attracted the attention
of the most learned men, and became, at the age of
twenty-two, Professor of Anatomy at the University
of Padua. This was the first purely anatomical
professorship that had been established out of the
funds of any university. For seven years he held
the office, and he was at the same time professor
at Bologna and at Pisa. During these years his
lectures were always well attended, for they were a
striking innovation on the tameness of conventional
routine. In each university the services of the
professor were confined to a short course of demonstrations,
so that his duties were complete when he had spent,
during the winter, a few weeks at each of the three
towns in succession. He then returned to Venice,
which he appears to have made his head-quarters.
At this city, as well as at Pisa, special facilities
were offered to the professor for obtaining bodies
either of condemned criminals or others. At Padua
and Bologna the enthusiasm of the students, who became
resurrectionists on their teacher’s behalf, kept
the lecture-table supplied with specimens. They
were in the habit of watching all the symptoms in
men dying of a fatal malady, and noting where, after
death, such men were buried. The seclusion of
the graveyard was then invaded, and the corpse secretly
conveyed by Andreas to his chamber, and concealed
sometimes in his own bed. A diligent search was
at once made to determine accurately the cause of death.
This pitiless zeal for correct details in anatomy,
associated as it was with indefatigable practice in
physic, appeared to Vesalius, as it does to his successors
of to-day, to be the only satisfactory method of acquiring
that knowledge which is essential to a doctor.
Thus it was that he, who at the age of twenty-two
was able to name, with his eyes blindfolded, any human
bone put into his hand, who was deeply versed in comparative
anatomy, and had more accurate knowledge of the human
frame than any graybeard of the time, enjoyed afterwards
a reputation as a physician which was unbounded.
One illustration of his sagacity in diagnosis will
suffice. A patient of two famous court physicians
at Madrid had a big and wonderful tumour on the loins.
It would have been easily recognized in these days
as an aneurismal tumour, but it greatly puzzled the
two doctors. Vesalius was therefore consulted,
and said, “There is a blood-vessel dilated;
that tumour is full of blood.” They were
surprised at such a strange opinion; but the man died,
the tumour was opened; blood was actually found in
it, and we are told in admirationem rapti fuere
omnes.
It was not until after Vesalius had
been three years professor that he began to distrust
the infallibility of Galen’s anatomical teaching.
Constant practical experience in dissection, both human
and comparative, slowly convinced him that great
anatomist as the “divus homo”
had undoubtedly been his statements were
not only incomplete, but often wrong; further, that
Galen very rarely wrote from actual inspection of
the human subject, but based his teaching on a belief
that the structure of a monkey was exactly similar
to that of a man. With this conviction established,
Vesalius proceeded to note with great care all the
discrepancies between the text of Galen and the actual
parts which it endeavoured to describe, and in this
way a volume of considerable thickness was soon formed,
consisting entirely of annotations upon Galen.
The generally received authorities being thus found
to be unreliable, it became necessary in the next
place to collect and arrange the fundamental facts
of anatomy upon a new and sounder basis. To this
task Vesalius, at the age of twenty-five, devoted himself,
and began his famous work on the “Fabric of
the Human Body.” Owing possibly to the
good fortune of his family, and to the income which
he derived from his professorships, Andreas was able
to secure for his work the aid of some of the best
artists of the day. To Jean Calcar, one of the
ablest of the pupils of Titian, are due the splendid
anatomical plates which illustrate the “Corporis
Humani Fabrica,” and which are incomparably
better than those of any work which preceded it.
To him most likely is due also the woodcut which adorns
the first page, and which represents the young Vesalius,
wearing professor’s robes, standing at a lecture-table
and pointing out, from a robust subject that lies before
him, the inner secrets of the human body; while the
tiers of benches that surround the professor are completely
crowded with grave doctors struggling to see, even
climbing upon the railings to do so.
But throughout the work the plates
are used simply to illustrate and elucidate the text,
and the information furnished in the latter is minute
and accurate, and stated in well-polished Latin.
As the author proceeds, he finds it necessary to disagree
with Galen, and the reasons for this disagreement
are given. The inevitable result follows that
Vesalius is placed at issue not only with “the
divine man,” but also with all those who for
thirteen centuries had unquestioningly followed him.
Such a result Vesalius must have foreseen. It
was not, therefore, a great surprise to him, perhaps,
to receive, soon after the publication of his work,
a violent onslaught from his old master Sylvius.
He simply replied to it by a letter full of respect
and friendly feeling, inquiring wherein he had been
guilty of error. The answer he got was that he
must show proper respect for Galen, if he wished to
be regarded as a friend of Sylvius.
In 1546, three years after the publication
of his great work, Andreas was summoned to Ratisbon
to exercise his skill upon the emperor, and from that
date he was ranked among the court physicians.
In the same year, 1546, in a long letter, entitled
“De usu Radicis Chinae,” he not only
treats of the medicine by which the emperor’s
health had been restored, but he vindicates his teaching
against his assailants, and again gives cumulative
proof of the fact that Galen had dissected only brutes.
It was the practice of Vesalius, while
he was professor in Italy, to issue a public notice
the day before each demonstration, stating the time
at which it would take place, and inviting all who
decried his errors to attend and make their own dissections
from his subject, and confound him openly. It
does not appear that any one was rash enough ever
to accept the challenge; yet, although the majority
of the young men were on the side of Vesalius, the
older teachers continued to regard him as a heretic,
and in 1551 Sylvius published a bitterly personal
attack. It was nothing to him that the results
of actual dissection were against him he
even went so far as to assert that the men of his time
were constructed somewhat differently to those of the
time of Galen! Thus, to the proof that Vesalius
gave that the carpal bones were not absolutely without
marrow, as Galen had asserted, Sylvius replied that
the bones were harder and more solid among the ancients,
and were, in consequence, destitute of medullary substance.
Again, when Vesalius showed that Galen was wrong in
describing the human femur and humerus as greatly
curved, Sylvius explained the discrepancy by saying
that the wearing of narrow garments by the moderns
had straightened the limbs.
Through these attacks, however, the
writings of Vesalius fell into somewhat bad odour
in the court; for in that very superstitious age there
was a kind of vague dread felt of reading the works
of a man against whom such serious charges of arrogance
and impiety were brought. And so it came about
that when he received the summons to take up his residence
permanently at Madrid, and the orthodoxy of the day
seemed for the moment to triumph, in a fit of proud
indignation, he burned all his manuscripts; destroying
a huge volume of annotations upon Galen; a whole book
of medical formulae; many original notes on drugs;
the copy of Galen from which he lectured, and which
was covered with marginal notes of new observations
that had occurred to him while demonstrating; and the
paraphrases of the books of Rhases, in which the knowledge
of the Arabian was collated with that of the Greeks
and others. The produce of the labour of many
years was thus reduced to ashes in a short fit of
passion, and from this time Vesalius lived no more
for controversy or study. He gave himself up
to pleasure and the pursuit of wealth, resting on
his reputation and degenerating into a mere courtier.
As a practitioner he was held in high esteem.
When the life of Don Carlos, Philip’s son, was
despaired of, it was Vesalius who was called in, and
who, seeing that the surgeons had bound up the wound
in the head so tightly that an abscess had formed,
promptly brought relief to the patient by cutting
into the pericranium. The cure of the prince,
however, was attributed by the court to the intercession
of St. Diego, and it is possible that on the subject
of this alleged miraculous recovery Vesalius may have
expressed his opinion rather more strongly than it
was safe for a Netherlander to do. At any rate,
the priests always looked upon him with dislike and
suspicion, and at length they and the other enemies
of the great anatomist had their revenge.
A young Spanish nobleman had died,
and Vesalius, who had attended him, obtained permission
to ascertain, if possible, by a post-mortem examination,
the cause of death. On opening the body, the heart
was said by the bystanders to
beat; and a charge, not merely of murder, but of impiety
also, was brought against Vesalius. It was hoped
by his persecutors that the latter charge would be
brought before the Inquisition, and result in more
rigorous punishment than any that would be inflicted
by the judges of the common law. The King of Spain,
however, interfered and saved him, on condition that
he should make a pilgrimage to the Holy Land.
Accordingly he set out from Madrid for Venice, and
thence to Cyprus, from which place he went on to Jerusalem,
and was returning, not to Madrid, but to Padua, where
the professorship of physic had been offered him,
when he suffered shipwreck on the island of Zante,
and there perished miserably of hunger and grief, on
October 15, 1564, before he had reached the age of
fifty. His body was found by a travelling goldsmith,
who recognized, notwithstanding their starved outlines,
the features of the renowned anatomist, and respectfully
buried his remains and raised a statue to his memory.
Two of the works of this great man
have been already referred to, namely: “De
Corporis Humani Fabrica;” “De
usu Radicis Chinae.” Besides these
the following have appeared: “Examen Observationum
Gabrielis Fallopii;” “Gabrielis Cunei
Examen, Apologiae Francisci Putei pro
Galeno in Anatome;” a great work on Surgery
in seven books.
With respect to the last of these,
it may be sufficient to remark that there is every
reason to believe that the name of the famous anatomist
was stolen after his death to give value to the production,
which was compiled and published by a Venetian named
Bogarucci; and that Vesalius is not responsible for
the contents.
The other works are undoubtedly genuine.
In 1562 Andreas seems to have been roused for a short
time from the lethargy into which he had sunk, by
an attack from Franciscus Puteus; for to this
attack a reply appeared from a writer calling
himself Gabriel Cuneus which has always
been attributed by the most competent authorities to
Vesalius himself. In this rather long work, covering
as it does more than fifty pages in the folio edition,
the views of Vesalius, which are at variance with
Galen, are gone through seriatim and defended.
In 1561 Fallopius, who had studied
under Vesalius, published his “Anatomical Observations,”
containing several points in which he had extended
the knowledge of anatomy beyond the limits reached
by his master. He had taught publicly for thirteen
years at Ferrara, and had presided for eight years
over an anatomical school, so that he was no novice
in the field of biology. Yet so completely had
Vesalius lost the philosophic temperament that he
regarded this publication as an infringement of his
rights, and in this spirit wrote an “Examen
Observationum Fallopii,” in which he decried
the friend who had made improvements on himself, as
he had been decried for his improvements on Galen.
The manuscript of this work, finished at the end of
December, 1561, was committed by the author to the
care of Paulus Teupulus of Venice, orator to the King
of Spain, who was to give it to Fallopius. The
orator, however, did not reach Padua until after the
death of Fallopius, and he consequently retained the
document until Vesalius, on his way to Jerusalem,
took possession of it, and caused it to be published
without delay. It appeared at Venice in 1564.
The letter on the China root a
plant we know nowadays as sarsaparilla by
the use of which the emperor’s recovery was effected,
has been already referred to. It was addressed
to the anatomist’s friend, Joachim Roelants.
Very little space, however, is taken up with a description
of the medicine which gives title to the letter.
Something certainly is said of the history and nature
of the plant, the preparation of the decoction and
its effects; but the writer soon introduces the subject
which was at that time of very vital importance to
him, namely, his position with regard to the statements
of Galen and his followers. He collects together
various assertions of the Greek anatomist, on the
bones, the muscles and ligaments, the relations of
veins and arteries, the nerves, the character of the
peritoneum, the organs of the thorax, the skull and
its contents, etc., and shows from each and all
of these that reference had not been made to the human
subject, and that therefore the statements were unreliable.
To the work on the “Fabric of
the Human Body” we have already alluded, as
well as to the causes which led to its being written.
More than half of this great treatise is occupied
with a minute description of the build of the human
body its bones, cartilages, ligaments,
and muscles. It may have been owing to the thorough
acquaintance which Vesalius showed with these parts
that his detractors pretended afterwards that he only
understood superficial injuries. But other branches
of anatomy are fully dealt with. The veins and
arteries are described in the third book, and the
nerves in the fourth; the organs of nutrition and
reproduction are treated of in the next; while the
remaining two books are devoted to descriptions of
the heart and brain.
Vesalius gives a good account of the
sphenoid bone, with its large and small wings and
its pterygoid processes; and he accurately describes
the vestibule in the interior of the temporal bone.
He shows the sternum to consist, in the adult, of
three parts and the sacrum of five or six. He
discovered the valve which guards the foramen ovale
in the f[oe]tus; and he not only verified the
observation of Etienne as to the valve-like fold guarding
the entrance of each hepatic vein into the inferior
vena cava, but he also fully described the
vena azygos. He observed, too, the canal
which passes in the f[oe]tus between the umbilical
vein and vena cava, and which has since
been known as the ductus venosus. He was
the first to study and describe the mediastinum, correcting
the error of the ancients, who believed that this
duplicature of the pleura contained a portion of the
lungs. He described the omentum and its connections
with the stomach, the spleen, and the colon; and he
enunciated the first correct views of the structure
of the pylorus, noticing at the same time the small
size of the caecal appendix in man. His account
of the anatomy of the brain is fuller than that of
any of his predecessors, but he does not appear to
have well understood the inferior recesses, and his
description of the nerves is confused by regarding
the optic as the first pair, the third as the fifth,
and the fifth as the seventh. The ancients believed
the optic nerve to be hollow for the conveyance of
the visual spirit, but Vesalius showed that no such
tube existed. He observed the elevation and depression
of the brain during respiration, but being ignorant
of the circulation of the blood, he wrongly explained
the phenomenon.
Exclusively an anatomist, he makes
but brief references in his great work to the functions
of the organs which he describes. Where he differs
from Galen on these matters he does so apologetically.
He follows him in regarding the heart as the seat
of the emotions and passions the hottest
of all the viscera and source of heat of the whole
body; although he does not, as Aristotle did, look
upon the heart as giving rise to the nerves.
He considers the heart to be in ceaseless motion,
alternately dilating and contracting, but the diastole
is in his opinion the influential act of the organ.
He knows that éminences or projections are present
in the veins, and indeed speaks of them as being analogous
to the valves of the heart, but he denies to them the
office of valves. To him the motion of the blood
was of a to-and-fro kind, and valves in the veins
acting as such would have interfered with anything
of the sort. He expresses clearly the idea, that
was entertained in the old physiology, of the attractions
exerted by the various parts of the body for the blood;
and especially that of the veins and heart for the
blood itself. “The right sinus of the heart,”
he says, “attracts blood from the vena
cava, and the left attracts air from the lungs
through the arteria venalis (pulmonary vein),
the blood itself being attracted by the veins in general,
the vital spirit by the arteries.” Again,
he speaks of the blood filtering through the septum
between the ventricles as if through a sieve, although
he knows perfectly well from his dissection that the
septum is quite impervious.
It will thus be seen that the physiological
teaching of Galen was left undisturbed by Vesalius.