AU&tUT JR. MANN LIBRARY AT CORNELL IJNTVnERSTTY Cornell University Library R 524.V5B2 Andreas Vesalius, the reformer of anatom 3 1924 003 440 751 Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924003440751 ANDREAS VESALIUS BALL ANDREAS VESALIUS THE Reformer of Anatomy BV JAMES MOORES BALL, M. D. SAINT LOUIS MEDICAL SCIENCE PRESS MDCCCCX 1' 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 PREFACE N 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, physi- ology and surgery. Comparatively few physicians have seen his works; and fewer still have read them. The reformation which he inaugurated in anatomy, and inci- dentally 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 surpris- ing, since his writings were in Latin and were published prior to the middle of the sixteenth century. His books, X PREFACE 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 liter- ature 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 orig- inally in Fr user's Magazine, in 1853, and later was pub- lished in his Clement Marot and Other Studies y 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 seven- teenth 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. PREFACE XI The man who overthrew the authority of Galen ; revo- lutionized the teaching of the structure of the human body; started anatomical, physiological, and surgical in- vestigation 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 super- lative 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, New- ton, Lavoisier, and Bichat; and such also was Andreas Vesalius the anatomist. Young, enthusiastic, courageous and dihgent, VesaHus dared to contradict the authority of Galen, corrected the anatomical mistakes of thirteen cen- turies and before his thirtieth year published the most ac- curate, 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 dis- coveries 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 XII PREFACE was won, not by force of arms but by the scalpel of an a- natomist 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 iri- descent hues, so it was with anatomy: after passing through the brain of VesaHus it bore rich fruit which has been gathered by many hands. To turn from the writings of Galen, Mondino, Hundt, Peyligk, Phryesen, and Beren- gario da Carpi to the beauties of Vesalius's De Humani Corporis Fahrica is like passing from darkness into sun- light. 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 addi- tions 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. TABLE OF CONTENTS 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 Eiasistiatus — Claudius Galenus — The School of Salemum — 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 Femel — Philosophy of Pierre de la Ramee — State of Anatomy at this Period. VESALIUS RETURNS TO LOUVAIN . . ... 70-72 Vesalius returns to Louvain — He conducts a Course in Anatomy — iiecures a Skeleton. XIV ANDREAS VESALIUS Table of Contents— Continued PAGE 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 vfas the uimamed 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 Biain and the Organs of Sense — Conclusion. CONTEMPORARY ANATOMISTS 114-125 The publication of the Fabrica is followed by great activity among Anatomisti Bartholomeus Eustachius — Realdus Columbus — Gabriel Fallopius — John Philip Ingrassias. ANDREAS VESALIUS XV Table of Contents— Concluded PACE 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. LIST OF ILLUSTRATIONS Andreas Vesalius — ^from the "Epitome", 1543 . . . Frontispiece 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 c 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 LIST OF ILLUSTRATIONS XVII PAGE 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 Acad- emie", 1685 88 Second Vesalian Plate of the Muscles — from the "Fabrica", 1543 90 Ninth Vesalian Plate of the Muscles— from the ' 'Fabrica' ',1 543 92 A Human Skull resting on the Skull of a Dog — ^from the "Fabrica", 1543 94 Title-^page of VesaUus's "Epitome", 1543 96 Skeleton by Vesalius— from the "Fabrica", 1543 98 Fifth Vesalian Plate of the Muscles— from the ' 'Fabrica' ' , 1 543 .100 Deep Muscles of the Back by Vesalius — ^f rom the ' 'Fabrica' ' , 1 543 1 02 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 o ... 131 Philip the Second . . , . , 133 /. vm Talker f. I.'Troj/en jp ANDREAS VESALIUS (From an old copperplate engraving) INTRODUCTION ,,,,,-, -,,.,-,,,....^l mi 1 ■':' 'x.df^L-ii^i:'-:^^ ^ . . .. ;::--J.- :..'/T^'-il I ^ HE INTELLIGENT STUDENT OF medical history has at his command an unfaiHng 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 com- municate 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 inter- est, 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. ANDREAS VESALIUS The General Renaissance This, the Revival of Learning, includes an indefinite time in European history. The seeds of the new move- ment were planted in the Middle Ages, but they bore no fruit until the time had arrived for an apparently "spon- taneous 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 ; litterateurs and philos- ophers look upon it as a radical change due to the discov- ery 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 meth- ods 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 attrib- uted ; nor can its scope be limited to any one field of hu- man 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 INTRODUCTION the nations of northern Europe— the Germans, the Hol- landers, 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 preeminent. 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 Corn- media (Divine Comedy) are essentially modern in thought, but ancient in the manner in which the thought is ex- pressed. Petrarch may be said to fairly open the new era. Like Dante, he was a Florentine. He was the apostle of ANDREAS VESALIUS Humanism, that system of philosophy which regarded man "as a rational being apart from theological deter- minations" 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 con- verse with learned men. Petrarch delighted in the study of Cicero, in collecting manuscripts, and in accumulating coins and inscriptions for historic purposes. He advoca- ted public libraries and preached the duty of preserving ancient monuments. He opposed the physicians and astrologers of his day, and ridiculed the followers of Averroes. 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. Influenc- ed 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. INTRODUCTION 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 multi- plying 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 accompHsh-i ment. Almost all of the great events which have influ-^ enced European commercial and intellectual development can be traced to that period. The invention of printing. ANDREAS VESALIUS 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 em- inent men of the ancient world in carrying th6 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 com- merce 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 partic- ularly 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 cred- ited 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 INTRODUCTION 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 un- heard-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 ItaHans 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 8 ANDREAS VESALIUS muscles and flesh. This was an important step in ad- vance, since it shows that the Florentine artists were pro- ,gressing towards realism and were breaking away from i 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 sur- passed all of the artists of his day ; and as a result of his labors he may justly be named the founder of the scien- tific 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 INTRODUCTION on human anatomy. Leonardo's anatomical sketches, if they had been pubHshed 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 ac- curate 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 dissec- tions. 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\ which was published one hundred and thirty-three years after his death, shows with what care he had studied human anatomy. Albrecht Diirer's Treatise on the Pro- portions of the Human Body is also worthy of mention. In the number and fame of her Universities, Italy show- ed 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 * Theorie de la figure humaine. Paris, 1773. 10 ANDREAS VESALIUS Bracciolini, who discovered the manuscript of the Institu- tions of Quintihan and the writings of Vitruvius; Polizia- no, the first poet of the fifteenth century, and the transla- tor of the works of Hippocrates and Galen; Pontanus, whose De StelUs and Urania were much admired by Italian scholars; Sannazzaro, whose epic on the birth of Christ cost him twenty years of labor ; Vida, whose Chris- tiad and other poems were much admired; and Fracas- toro, whose Syphilis was hailed as a divine poem. From the viewpoint of the medical historian an im- portant 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 cen- turies, 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 trans- lation. 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 Learn- ing 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 INTRODUCTION 11 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* sAnathomia was printed in Pavia. It has been estimated that before the first year of the sixteenth century, five thousand books had been print- ed 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 cor- rections were made without the aid of dictionaries, gram- mars, 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 be- came 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 prac- ticed 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 re- mained Catholic, it was such only in name. Everyone 12 ANDREAS VESALIUS bowed before the shrine of classical literature. Even in the christening of children the Christian name was sacri- ficed 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 de- generated into an intellectual and sensual state which in- volved 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 horri- ble a tragedy was offered to mel 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, over- whelmed by undeserved calamities ; some dead of plague. INTRODUCTION 13 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 Span- iards, 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 Human- ists, 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 cen- tury. Italian history is rich in contradictions. While peace, ease and comfort are generally considered to be neces- sary 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. ap- pointed 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 su- premacy. 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 en- 14 ANDREAS VESALIUS tirely blotted out by the invasion of the barbarians of the North. And in the matter of language the Italians pos- sessed 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-independ- ent 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 mid- dle class, whose members included the devotees of the professions of law and medicine, were factors which de- termined 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 scholas- ticism and the fetters of mediaeval theology. She aban- doned the wordy dialectics and metaphysical gymnastics of the philosophers of old. In place of mortification, penance and solitary confinement in cloistered monaster- ies 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 INTRODUCTION 15 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 be- came 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 lec- tured 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 College 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, for- bidding 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 disr sections to be made in all the Italian medical schools, and paved the way for the Anatomical Renaissance. 16 ANDREAS VESALIUS Great things were done in the sixteenth century. Un- der the scalpel and pen of Vesalius, anatomy was revolu- tionized. Surgery was guided into new paths by Ambroise Pare; 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 pul- monary circulation in a theological work which was burn- ed 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. INITIAL LETTER BY VESALIUS (From the "Fabrica", 1543) CHAPTER FIRST Anatomy in Ancient Times IGYPT AND GREECE WERE THE sources of the medical learning of the ancient world. Although the Egyp- tians and early Greeks possessed a cer- tain 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 preju- dices of those ancient peoples. Thus we find the Egyp- tians stoning the operator who opened the abdomen in order- that the body might be embalmed ; and the Greeks inflicted, the death penalty oh those of their generals who, after a battle, neglected to, bury or burn the remains of the slain. . In the time of Hippo- crates, whose life extended approximately over the pe- riod between 460-377 B.C., Greek medicine emerged from the domination of the Asclepiadae, or priests of Aesculapius, who had fol- lowed it as- an hereditary . and secret.art. Prior to this" time in the numerous As- hippocrates 18 ANDREAS VESALIUS clepia, 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* believes, this was a metallic figure representing a man who was much ema- ciated 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 ex- aminations 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! BelP, "whether the ancients were, or were not, acquaint- ed with anatomy, and the subject, with its various bear- ings, 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 specula- tion. 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." ! Moehsen: Verzeichnls einer Sammlung von Bildnissen. Berlin. 1771- oaM 59 2 Bell: Observations on Italy. Edinburgh, 1825; page 257. ANATOMY IN ANCIENT TIMES 19 Galen ^ 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. The first systematic dis- sections seem to have been made by the Pythagorean philosopher Alcmaeon, who lived in the sixth cen- aristotle tury 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 zootomist of antiquity, who has been called the Father of Comparative Anatomy. For twenty centu- ries 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 ^ Galen: De Anatomicis Administratlonibus. Lib. II. 20 ANDREAS VESALIUS 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 appli- ances, 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 hu- man torso; the front of the chest and abdomen has been removed so as to expose the viscera. The heart is plac- ed vertically in the middle of the thorax, thus corres- ponding to the position of this organ as described by Galen who made his dis- sections on apes. It is a human thorax with simian contents. The figure is supposed to have been con- structed for the purposes of a teacher of anatomy. It was in the famous Alexandrian University that hu- man 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 ALEXANDER THE GREAT ANATOMY IN ANCIENT TIMES 21 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 mod- el of architectural beauty, a centre of intellectual life and a lasting monument of his own greatness and magnifi- cence. 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. 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. Pro- vided with broad streets, it was adorned with mag- nificient houses, temples and pubHc 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 Rhacoiis, or Egyptian section, on the west, containing the Serapeum with a large part of the Library ; and on the north, the Bruchaeum, or Greek por- PTOLEMY SOTER 22 ANDREAS VESALIUS tion, containing the greater part of the Library, the Mu- seum, the Temple of the Caesars and the Court of Justice. The population was cosmopoHtan in character; the stat- ues 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 de- scent, 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 : Archime- des 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 CaUimichus, 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 Alex- andria" such eminent teachers as Origen and Athanasius. Here were a chemical laboratory, a botanical and zoolog- ical 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 vivisec- tion. Celsus* states that the Alexandrian anatomists ob- 1 Celsus : De Medicina. Lib. I. ANATOMY IN ANCIENT TIMES 23 tained 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 op- posite 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 differ- ent 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 scripiorius. , Erasistratus gave names to the auricles of the heart; declared^ that the veins were blood-vessels; and the arter- ies, 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 be- came 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 sensa- tion 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 24 ANDREAS VESALIUS 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 Alex- andrian University was due to a series of disasters whicli began with the Roman domination and reached their clir max with the capture of the city by the Arabs. Claudius Galenus, the cele- brated Roman physician whose writings were for centuries ac- cepted as authority and whose reputation was second only to ^ that of Hippocrates, was oblig- ed to base his anatomical treat- ises largely upon the dissection of the lower animals. He ad- vised his pupils to visit Alexan- dria, 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 GALEN ANATOMY IN ANCIENT TIMES 25 surgeon who is called upon to treat wounds and injuries. Hence he has endeavored in the four books, De Anato- micis AdminisiraiionibuSj to cover this part of anatomy as exhaustively as possible. Galen's voluminous writings form a precious monu- ment 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, al- though his dissections were made upon the lower animals. Galen's knowledge of osteology was extensive. He de- scribed 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 interventric- ular septum presents foramina through which the two kinds of blood become mixed. In myology Galen made numerous advances. "Pre- vious to his investigations", says Fishery "much confusion existed as to what constituted a single muscle ; he adopt- ed the general rule of considering each bundle of fibers that terminates in an independent tendon to be one mus-i cle. 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 * Fisher: Claudius Galenus. Annals of Anatomy and Surgery, Vol. IV., page 216. 26 ANDREAS VESALIUS lower jaw— the temporal to raise, the masseter to draw to one side, and two depressors, corresponding to the digas- tric and internal pterygoid muscles. He described also the brachialis anticus, the biceps flexor cubiti, the sphinc- ter and levator ani, and the straight and oblique muscles of the abdomen. In short, he described the greater por- tion 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 mus- cles." 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 sympathe- tic nerves ; seven pairs of cerebral and thirty pairs of spi- nal nerves ; and claimed the discovery of the ganglia of the nervous system. He located the seat of the soul in 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 Vnatomical statements show that he derived his knowledge jrom comparative dissections. The Galenic era was followed by that long period of ig- norance, 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 med- icine 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 ANATOMY IN ANCIENT TIMES 27 the hands of the Jews, the Arabs and the bigoted clergy, nothing was done for science or for art. The whole in- fluence of Christianity was exerted against the schools of philosophy. Illustrious apostles of the Church pronoun- ced anathemas against the reading of the ancient classics;' and eminent ecclesiastics regarded disease as a divine pen- alty or as an invaluable aid to saintly advancement. Art and anatomy were practically forgotten. Their Renais- sance 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, ^ Saint Basil, in his maturer years, deeply regretted that he had studied classical litera- ture in his youth. Jerome regarded the reading of the writings of antiquity as a terri- ble 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. 28 ANDREAS VESALIUS 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 cen- tury (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, de- creed that a human body should be anatomized at Saler- l|num at least once in five years. Physicians and surgeons /of the kingdom were required to be present at the dissec- tion. 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 Medi- cina Astrologicay he did not decide upon any undertaking until the stars had been consulted. It was not alone at Salernum that dissection was legal- ized 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 dis- sect a body once a year. This, and other isolated exam- ples, indicate that the time was approaching when anatomy should be taught from human dissections. The credit of reinaugu rating the teaching of this useful department of science belongs to Mondino dei Luzzi of Bologna. CHAPTER SECOND Mondino, the Restorer of Anatomy N THE YEAR 1315, IN THE OLD Italian city of Bologna, an event occur- red 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 ad- vance 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, Rai- mondino, 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 iii 1290 and in 1306 he became a professor in the University of Bologna, hold- ing 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: Mundi- nus 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 30 ANDREAS VESALIUS 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 respi- ration; in the third, the organs of circulation; in the fourth the extremities were treated." The innovation so auspicious- ly begun was not continued, and after the death of Mon- dino 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 in- fluence of Galen was still potent, and was rarely question- ed 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 MONDINO, RESTORER OF ANATOMY 31 years, the first printed edition bearing the date 1478. Small and imperfect as it was, it marks an era in the his- tory 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 de- scriptions, to use the words of Turner, "are corrupted by the barbarous leaven of the Arabian schools, and his Lat- in 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 Utt^nmcntSrrf earn intttpit tAticne 30.9^dpK 21 ^BrrancA^omi! qnSmit > «t co: fpm *b oTa^otwe wt* bwqii p(irin(tif.«i*pe|lioI« cUudunf Rfcrta dAuftSCob 2^ ^HrrancTJCpjIiepwrtttC* MONDINO'S DIAGRAM OF THE HEART, 1513 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 zyrhi, and the mesentery eucharus. His de- scription 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 ani- mal's voice is lost. In his book we find the rudiments of phrenology. He states that the brain is divided into com- partments, each of which holds one of the faculties of the intellect. 32 ANDREAS VESALIUS 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 demon- strator, 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 engrav- ing was introduced in the latter part of the fifteenth cen- tury, 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 cen- tre 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 contin- ually 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— g / ANATOMICAL DEMONSTRATION IN 1493 (Joannes de Ketham) 34 ANDREAS VESALIUS 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, can- na coxae', the humer- us, OS adjutori; while the bones of both leg and forearm are nam- ed focilia, major and minus. Like many anato- mists who succeeded him, Mondino min- gled surgical ideas with his anatomical statements. A break in the siphac causes hernia and a swell- ing in the mirach. He treated ascites by puncture and evac- uation, making a valve - like opening. Wounds of the large intestines must be sutured; if the wound be in the small intes- tines he advises that "you should have large ants, and, making them bite the conjoined lips of the wound, decapitate them instant- TITLE-PAGE OF MONDINO'S ANATOMY BY MELERSTAT (Printed before 1500) MONDINO, RESTORER OF ANATOMY 35 ly, 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 contin- uously 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 con- nected by veins, hence the sympathy between these or- gans. Inguinal hernia is to be operated upon; the sperm- atic 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 Strass- 36 ANDREAS VES ALIUS burg edition, 1513, is a small octavo volume of forty leaves. It contains a diagram of the heart and an astro- logical 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 con- /^ r^ iLsJ^N /^r\ I^^^^S ( ^^ ^^\^^\ ffi^ fBERSJ^OTaSLJ ^^^ ^Sf^Sf^m^^Y s^^ (irMM^u ^! ^re^^l ^ ^nnf*Mr¥r? ^wA^ )^^.^^^^^^ ^^ ^^^^^ SI COLOPHON OF THE ANATOMY OF MONDINO, 1513 tain all that was to be said of human anatomy I So numerous are the abbreviations in Mondino's book, so barbarous is his style, that the making of a translation is a diffi- cult task. His rea- sons for writing are these :— " A work up- on any science or art —as saith Galen — is issued for three rea- sons; Firsf, that one may help his friends. Second, that he may exercise his best men- tal powers. Third, that he may be saved from the oblivion in- cident to old age". w K ^ 1 S 1 1^^ Bl ^ ^ CHAPTER THIRD Mondino's Successors OR 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 il- lustrations of the various parts of the body were put into circulation. Some of these pictures were in the form of Fliegende Blatter, 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, Anaiomia Corporis Humani, appear- ed at Venice in 1502. Zerbi imitated Mondino in style, abbreviations and language. The work, however, con- tains 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. ANATOMICAL PLATE BY RICARDUS HELA, 1493 MONDINO'S SUCCESSORS 39 Zerbi's reputation, which extended to all parts of Eu- rope, 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 Con- stantinople, apparently cured the Seignior, and, loaded aitcrjIiiMtMlts 9en»attmiii8 £ap(aU c0Kli9 PEYLIGK'S DIAGRAM OF THE HEART, 1499 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. John PeyHgk Among the German anatomists of this period was John Peyligk, a Leipsic jurist, whose Philosophiae Nafuralis Compendium, printed at Leipsic in 1499, contains crude anatomical illustrations. Magnus Hundt Far more important was the Aniropologium of Magnus Hundt (1449-1519), of Magdeburg, which appeared at 40 ANDREAS VESALIUS Leipsic in 1501. It contains four large and several small woodcuts which are among the earliest of anatomical il- lustrations. One of these shows the tra- chea on the right side of the neck, passing downward to the lungs ; on the left side the oesophagus is rep- resented. In the thorax are seen the lungs and the heart, the latter resem- bling the figure of this organ as pre- sented on old play- ing cards. The pericardium has been opened, and the stomach and in- testines are crude- ly figured. The diaphragm is ab- sent. 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 popu- MONDINO'S SUCCESSORS 41 lar book on medicine, Spiegel der Artzny, which was pub- lished 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 ANATOMICAL FIGURE FROM LAURENTIUS PHRYESEN, 1518 42 ANDREAS VESALIUS a marked improvement over the figures which Hundt pubHshed in 1501. The other anatomical plate in Phrye- sen's book is devoted to the skeleton. Alexander Achillinus The Italian physician Alexander AchiUinus (1463-1525), professor of philosophy and medicine in Bologna, is deserv- ing of mention for his anatomical knowledge. Zealous- ly devoted to the Arab medical authors, Achillinus made numerous discoveries which are set forth in his general anatomy, De Humani Corporis Anaiomica, Venice, 1516; and in a commen- tary upon Mon- dino's book. In Mundini Ana- tomiam Annota- tioneSy Venice, 1522. He dis- covered the duct of the sublingual gland, usually credited to Whar- ton; two of the auditory ossicles, the malleus and incus; the labyrinth; the vermiform appendix; the cae- cum 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 pre- decessors. ALEXANDER ACHILLINUS MONDINO'S SUCCESSORS 43 Berengario da Carpi 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 DISSECTION BY BERENGARIO, 1535 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 vic- tims 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 pub- 44 ANDREAS VESALIUS licly 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. Berengario determined to improve Mondino's book by making corrections in the text, and by adding suitable illustrations. No illustra- tions 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 illustra- tions that were published, and that ^ye^e made from actual human dissections. These appeared in his "Com- mentaries of Carpus upon the Anatomy of Mundinus", SKELETON BY BERENGARIO, 1523 {Curpi Commentafia super MONDINO'S SUCCESSORS 45 Anatomia Mundini), which was pubHshed 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 dis- tinct advance over preceding pictures of this class. Ber- engario states that his plates will be of value not only to physicians and surgeons but also to artists (et iside 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 claim- ed that Berengario was the first author to produce an il- lustrated anatomy. Berengario also wrote a "Short Introduction to the Anatomy of the Human Body", Isagogae Breves in Anatomiam Humani Cor- poris ; and a work on Frac- ture of the Skull. He was the first anato- mist who described the basi- lar part of the occipital bone, the sphenoidal sinus and the tympanic membrane. Mer- yon* credits him with the MUSCLES BY BERENGARIO, 1521 1 Meryon: History of Medicine. London, 1861; vol. I, page 479. 46 ANDREAS VESALIUS "first correct description of the great omentum (gastro- colic) 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 vv^oman; of the flexor-brevis-pollicis; of the vesiculae seminales ; of the separate cartilages of the larynx; of the membran- ous pellicle in front of the retina (attributed to Albi- nus); 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 struc- ture of the heart. He diplomatically states that in the hu- man subject the foramina in the cardiac septum are seen only with great difficulty (sed in homine cum maxima difficuUate videnier). John Dryander John Dryander, a German physician, whose true name MUSCLES BY BERENGARIO, 1521 MONDINO'S SUCCESSORS 47 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 proficien- cy in mathematics and as- tronomy, he went to Paris where he studied medi- cine 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 con- ducted the first dissec- tions that were made in DRYANDER Marburg, where he taught anatomy for twenty-four years, or from 1536 to 1560. Dryander, although he was a partisan of Mondino and da Carpi, and was a fierce and sometimes an unfair oppo- nent 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 practi- cal anatomists of the sixteenth century to furnish anatom- ical illustrations. He made important astronomical ob- servations and was the inventor of several useful instru- ments. He was the author of three medical works of 48 ANDREAS VESALIUS 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 Beren- gario's work. ANATOMICAL FIGURE BY ESTIENNE, 1545 Charles Estienne Charles Estienne, better known by the name of Caro- his SiephanuSy was a French anatomist whose work is SKELETON BY ESTIENNE, 1545 (Reduced one-half) 50 ANDREAS VESALIUS 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 vic- tim 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 Pariium 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 transla- tion 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 anatom- ical 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 de- scribed the capsule of the liver, a tissue which bears MONDINO'S SUCCESSORS 51 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 apophy- ses venarum—3. 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 reason- able to assume that these structures were noticed inde- pendently by all of the anatomists whose names are men- tioned above. SKULL BY DRYANDER, 1541 CHAPTER FOURTH Vesalius's Early Life NDREAS VESALIUS, orWESALIUS 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 pla- centa and caul, to which popular beHef ascribed remark- able powers, were carefully preserved by the mother. The Vesalius family originally was named Witing, {Witting, Wytinck, Wytings, according to various author- ities) and adopted the name Wesalius from the town of Wesel, {Wesele, Veset), in the Duchy of Cleves, which the family claimed as their native place. The three weasels (Ffemis/i— "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 man- uscripts 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 EARLY LIFE 53 associated with the Austro-Burgundian dynasty. Eber- hard, 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 Hip- pocrates. He was also noted as a mathematician. Eber- hard'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 mihtary 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 in- tellectual triumph of her son, and to know of his activity at the Spanish court. Little is known of the youth of Vesalius. The tradi- tions 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 neigh- boring 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 num- 54 ANDREAS VESALIUS ber 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 juris- prudence and of philosophy were men of eminent talents. Within the University were four literary schools which were named Paedagogium Castriy Porci, LiUiy and Fal- conisy from their insigna : — a fort, a pig, a lily, and a fal- con. Here also was the Collegium trilingue BusUdianum, which was founded by Hieronymus Buslciden (-{-1517) THE OLD UNIVERSITY OF LOUVAIN (Erected early in the Fourteenth Century. The New BuUding dates from 1680) 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, as- tonished his hearers and served him well in numerous EARLY LIFE 55 literary controversies. The names of Vesalius's teachers are unknown, although Adam* states that John Winter of Andernach was his professor of Greek. Vesalius speaks scornfully of one of his teacher^, 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 obser- vation were precociously developed. When a boy, learn- ing to swim by the aid of bladders filled with air, he noted the elasticity of these organs, and he referred to the inci- dent in his Fabrica (1543, page 518). When little more than a child, he tired of dialectics and tried to learn anato- my 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 be- gan the practical study of anatomy by dissecting the bodies of mice, moles, rats, dogs and cats.' » Adam: Vitae Germanorum Medicorum. Haidelbergae, 1620 5 page 224. ''Zwinger: Theatrum Vitae Humanae. Basileae, 1571. CHAPTER FIFTH Sojourn in Paris NE THOUGHT WAS UPPERMOST in the mind of Vesalius, and that was to follow the profession of his ances- tors, just as in ancient Greece the sons of the Asclepiadae naturally adopted the vocation of their fathers. Andreas possessed an excellent pre- liminary 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 sup- port (iibi primum medicinam prospere renasci vidimusf. 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 Averroes and of Avicen- na. 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 * Vesalius: Fabrica, 1543, preface. SOJOURN IN PARIS 57 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, Lat- in and Hebrew languages and was the author of a French grammar. His anatomical knowledge was gain- ed under Jean Tagault, a famous Parisian practitioner and surgical author. Sylvius was noted for his indus- try, for his eloquence, and above all for his avarice. It was the in- ordinate desire for money which led him to abandon philology for medicine. While studying under Tagault he began a course of med- ical 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, accord- ing to Astruc, he received the doctor's cap at the end of SYLVIUS 58 ANDREAS VESALIUS November, 1529. He was then above fifty years of age. Armed with this degree, he returned to Paris and imme- diately 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 College de Treguier numbered from four to five hundred, while Fernel, who was a professor in the College 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 College 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 rever- ence for ancient authors. He regarded Galen's writings as gospel ; if the cadaver presented structures unlike Ga- len'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\ Sylvius declared that Galen's anatomy was infallible; that Ga- len's treatise, De Usu Partium, was divine; and that further progress was impossible I The character of Sylvius was contemptible. He was a man of vast learning and at the same time was rough, * Sylvius : Ordo et Ordinis Ratio in Legendis Hippocratis et Galeni Libris, 1539. SOJOURN IN PARIS 59 coarse and brutal. His avarice led him to endure the cold winters of Paris without the benefit of a fire ; in se- vere 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: %plt)iu0 bic 9itm m, 0tatl0 qui nil DeDit unquam, Q^ottuuis et 0tatiiB! quoD legis iiSta 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 knowl- edge by his blunders. Such was the man who, in the mid-part of the sixteenth century, filled the position of 60 ANDREAS VESALIUS highest honor in the Medical Faculty of the College de France\ Sylvius rendered valuable service in naming the mus- cles which, prior to his time, v^^ere designated by numbers. These, says Northcote' 'Vere differently applied by al- most every author; so that it w^as 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 de- scriptions 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 Fal- lopius'. 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 discov- ery, however, belongs to other anatomists— Estienne and Cannanus. His discoveries in cerebral anatomy have caused his name to be attached to the aqueduct, the fis- sure and the artery of Sylvius. * The College 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 College 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 venity Vidius vidity Vidus vicit. ^Northcote: History of Anatomy. London, 1772; page 56. ' Portal: Histoire de 1' Anatomie et de la Chirurgie. Paris, 1770; vol. I, page 365. SOJOURN IN PARIS 61 The manner in which Sylvius conducted his anatom- ical course is known to us by his own writings, by the testimony of Moreau\ and by that of Vesalius^ Thus the course for the year 1535 began with the reading, by Sylvius, of Galen's treatise De Usu Pariium. When the middle of the first book was reached, Sylvius remarked that the subject was too difficult for his students to under- stand 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 infre- quently the professor was unable to demonstrate in dis- section the parts on which he had lectured. Thus, on one occasion, the students succeeded in finding the pul- monary 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. Guin- terius (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 » Moreau : Vita Sylvii, in Sylvii Opera Mcdica. Geneva, 1635. « Vesalius : De radice Chinae epistola, 1546 ; pages 151, liZ. 62 ANDREAS VESALIUS the years 1487-1574, and rose to eminence iii both the liter- ary and the medical worlds. Born of humble parents, he was sent at an early age to the University of Utrecht. Leav- MiniiiiiiiiiuiyiiIiiiiiiiii!)iiniiiiiiiHi|i||iiiriiiiy!iiiliiii'ii'iiiyrniiiiLHiiiiiiiirp^ -r Tuaaftt icihuTn ■mcdtciv clarijsi'rnus attc, [^^- Professor of Anatomy in Padua HORTLY AFTER THE PUBLICA- tion 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 Fahrica, 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 74 ANDREAS VESALIUS material and possibly may have conducted a public de- monstration 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 anatomic- al plates. ANATOMICORVM INSTRVMEN> TOR.yM I3BX.INEATIO. 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 Brus- sels was appointed Professor of Surgery with the right to PROFESSOR IN PADUA 75 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. Dissat- isfied 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 76 ANDREAS VESALIUS 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 ap- paratus 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 dehent esse ad manum. Let us now follow one Vesalius's public courses in anat- omy. 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 lec- ture, 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 hun- dred 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 impor- tance of anatomy and the methods of acquiring a knowl- edge of this science, he launches into the practical de- monstration. After rapidly pointing out the divisions of the body, and demonstrating the skin, joints, cartilages, PROFESSOR IN PADUA 77 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 hu- man material. Now the human cadaver is placed on the table ; all eyes are turned upon it, for such a demonstra- tion 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 fol- lowed 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 78 ANDREAS VESALIUS 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 prepara- tion of the muscles of the shoulder and back, then those of the mouth, which were approached by means of divis- ion 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 fol- lowed by an examination of the cranium; the skull-cap was sawed and the brain was dissected in its natural po- sition. Then came the examination of the eye, which Vesalius dissected in two ways : either by a complete sec- tion, 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 physi- ology 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. PROFESSOR IN PADUA 79 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 im- pression which they made upon his auditors, can be ap- preciated 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 con- duct 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 seance 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 ques- tion of venesection. Before a large and select assembly he demonstrated in all three bodies that Galen's descrip- tion of the vena azygos was incorrect. On the second convocation Vesalius seems to have disposed of more 80 ANDREAS VESALIUS 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 under- took 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 med- icine 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 frag- mentary 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. INITIAL LETTER BY VESALIUS (From the "Fabrica", 1543) CHAPTER EIGHTH First Contribution to Anatomy IKE ALL GREAT TEACHERS, Vesalius was ever mindful of the inter- ests of his students. Soon after ac- cepting the chair of Anatomy in Pad- ua, 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 in- tended to pave the way to anatomy for beginners. For the further benefit of his class, he edited an edition of Guin- terius's Institutionum Anatomicarum, which was issued in April, 1538. Tabulae Anatomicae The Tabulae Anatomicae were in the form of Flieg- ende Blatter, or loose leaves, and consisted of six plates which are now among the rarest of medical works. They bore the following title : Cafiulae anatomicae. amprimeftat mnttiislS(ttmtninm), mtalis l^enctus 0umpti6u0 3foannis ©tepfiani Calcaten0i$pro0ttant ueto in officina D. 15etnatDini. 9. 1538. In the preface Vesalius says that no one can learn either botany or anatomy from figures alone, but illustra- tions are a ■ valuable means toward the imparting of 82 ANDREAS VESALIUS knowledge. In publishing these plates he hopes to bene- fit 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 fol- lowing 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 Fahrica, 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 nerv- ous system is also to be noted. VesaHus* had such a FIRST CONTRIBUTION TO ANATOMY 83 plate prepared, and it appeared in a pirated edition of the Tabulae which was pubHshed 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. VIEW OF THE CITY OF BASEL IN THE SIXTEENTH CENTURY CHAPTER NINTH Publication of the Fabrica N 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 mer- chant named Danoni and were safely delivered to the print- er, Oporinus. They were accompanied by a long Latin letter, written by Vesalius to his friend, "Joannes Opori- nus, professor of Greek letters in Basel". He begs Opori- nus^ 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 de- monstration in anatomy — the first which had occurred in that city since 1531 — and presented the articulated skele- ton 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 PUBLICATION OF THE FABRICA 85 press. The treatise which founded modern anatomy bears this title: — anDteae l^esalii TBtujellensig, ^cfiolae meDicorum PatatJinae profeg0oris, De ^umani corpori? faljrica Mibti septem. IBasileae, MDXLIII A fortune was lavished upon the illustration and pub- lication of this grand work. To use the words of Fisher, "it was and is a glorious book, a rare and precious mon- ument 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, maxi- maque terrestre & frig- idum, & sensus denique praeter solos denies expers. The first edition of the Fahrica is a folio volume with magnifi- cent illustrations on wood, all carefully print- ed by Joannes Oporinus (1507-1568) of Basel. inmHl^Tl^i'.liliiMir.iiiimH iiN'miiM'"']""!' ■"■; ; ,-■■ , S>ari ilhi mcrccdis Jtc ah utraf -vrmf ^ . i'- i -i ri;.x;i:..:f -'-^ -^'r^-i.--''..'^..J^g -r-nr.L,.;.:!.:.!.!. JOANNES OPORINUS 86 ANDREAS VESALIUS VIR-TP-TI The title-page is a beautiful engraving which repre- sents Vesalius at work dissecting a female subject. He is surrounded by interested spectators who crowd the amphi- theatre. The abdomen of the subject is opened. Vesa- lius has j-aised 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 dis- secting table is an upright skeleton which grasps a long staff with its right hand. In the audience are many per- sons of different rank. To the left a naked man is climb- ing 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 pub- lisher, Oporinus ; in the cen- tre, 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. Who was the unnamed artist? It is noteworthy that Vesalius does not state who drew the illustrations, or who MARK OF OPORINUS PUBLICATION OF THE FABRICA 87 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\ It was probably owing to this un- pleasant 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' 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 hkd 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 1 Radicis Chinae usus. Andrea Vesalio autore. Lugd-. 1547; Page 278 2 Moehsen: Verzeichnis einer Sammlung von Bildnissen. Berlin, 1//1; page si. 88 ANDREAS VESALIUS 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. JAN STEPIIAN VAN CALCAR The Vesalian pictures have been attributed to Christo- foro Coriolano; but he could not have been the artist, since his earliest work dates from 1568. He is known to have furnished the drawings ior 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; hut such a view would credit the PUBLICATION OF THE FABRICA 89 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^ 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 Ca.\c2iv :—sumptibus Joannis Stephani Calcaren- sis. These plates, which appeared in the form of pictor- ial broad sheets, or Fliegende Blatter, 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 un- precedented in magnitude and in minuteness. 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 claim- ed that Vesalius had prepared his neurologic specimens »Sandrart: Teutsche Academic. Nurnberg, 1685 : vol. II., page 243. ^K^ SECOND VESALIAN PLATE OF THE MUSCLES (From the "Fabrica", 1543. Reduced one-half) PUBLICATION OF THE FABRICA 91 with great care. For the use of artists, the best plates are the three skeletons and the four entire myologic fig- ures in the Fabrica. The first myologic figure, showing a man who has been divested of all skin, fat, and super- ficial 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 audi- ence. The third myologic plate is similar to the first one, but the muscles of the face are exhibited to better advan- tage 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 repro- duced 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 con- tained in the Epitome are properly clothed in skin and are of great artistic merit. They also are to be seen in NONA Mvscy. bORVH TV BTV«> ANDBEAfi VESAt-It p R VXBttBNS IS NINTH VESALIAN PLATE OF THE MUSCLES (From the "Fabrica", 1543. Reduced one-half) PUBLICATION OF THE FABRICA 93 numerous works on art-anatomy. Thus, in one of the earhest books on anatomy for the use of artists {Abrege (Vanatomie accommode aux arts de peinture et de sculp- ture. Paris, 1667, 1668), Rogers de Piles and Francois Tortebat have used the three skeletons and seven myolog- ic 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 rldottd ad uso de' pittori e scultori. Venice, 1679), reproduced nineteen of Vesalius's figures in copperplate. ■ 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 orig- inal drawings were the work of Titian. This opinion f^und 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 mk:—Andreae Vesalii, Bruxellensis, des ersten besten Anatomici, Zergliederung des menschlicken Korpers auf Mahlerey, und 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 94 ANDREAS VESALIUS cites one of these with the inscription printed in French : "De cet objet affreux tu parois rebutte, Est c'est ce que dans peu cependant tu dois etre : Apprens, mortel, a te connoitre Ce miroir est le seul, ou tu n'est point flatt^". Another legend reminds the reader that he is only dust, and to dust he must return: — ''Vous estes poudre,& vous retourneres en poudre". A HUMAN SKULL RESTING ON THE SKULL OF A DOG (From the "Fabrica", 1543) CHAPTER TENTH Publication of the Epitome PON 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 draw- ings of the Fabrica. The title of the lesser work is as follows:— t anDteae mmu 'Bruiellenisis, ^cbolae meDicotum Patatiinaeptofe$$ori8, quorum De ^umani corporis falirica lifirorum (Epitome. T5a$iL, ei officina 3foanni$ Dporini, anno, 1543, men$e 3funio. This work is extremely rare. It belonged to the class of Fliegende Blatter 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 TITLE-PAGE OF VESALIUS'S "EPITOME", 1543 PUBLICATION OF THE EPITOME 97 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. Among the illustrations found in the Epitome are seven that are not in the large book; namely, fivemyolog- ic 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 myolog- ic 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 vel- lum, are in existence. One is in the British Museum and is thought to be the copy which was owned by the cele- brated Dr. Richard Mead ; the other one is in the pos- session 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. SKELETON BY VESALIUS (From the "Fabrica", 1543. Reduced one-half) CHAPTER ELEVENTH Contents of the Fabrica HE REPUTATION OF VESALIUS rests securely upon the Fabrica. This grand book, which is dedicated to Charles the Fifth, consists of six hun- dred 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 12J4 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 de- scribes 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 refer- ences can be made to only a few of them. His anatomic- al 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". The Fabrica contains the rudiments of anthropology it4 ANDREM VeSALIl B R V X B I.I.BII BII QVINTA Mvs'cy LO. BVM TABV' I. At FIFTH VESALIAN PLATE OF THE MUSCLES (From the "Fabrica", 1543. Reduced one-half) CONTENTS OF THE FABRICA 101 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 Fab- rica is more than an anatomy. Throughout the work physiology goes hand in hand with the anatomical de- scription. The use and function of each part of the body is given in short, clear sentences. The Fahrica 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 sys- tem 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 sym- physis pubis separate during parturition. He was the first anatomist to give an accurate description of the «B HVBANi OORPORll FASRICA LIBBS tU s^ DVOD£CF DEEP MUSCLES OF THE BACK BY VESALIUS (From the "Fabrica", 1543. Reduced one-half) CONTENTS OF THE FABRICA 103 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, hq wrote more intelligently of the bones than any anatomist who had preceded him. ANDREAE VESALII BRVXELLENSIS. DE HVMANi CORPO^ RIS PABRICA tIBBR PRIMVS, IIS Q.VAB uniuerfum corpus fufUnent ac (u(RiIciunt,quibu$qp omnia fiabiliuntur 5C adiiatcuiitur dedicatus. Q^JD 5, Qyis-Q^B ipsj^s ys^s ty differentia. Caput /. S CAETERARVM Kominispartiumeftdurifsi OfStum*. muiTi,8daridi(simS,inaHme%terreftre8£fr^idum, ti. (etifus deniquepnccer folos dentes expers. Huius enim temperamenti liinunus rerum opifex Deus Ofimifms. fubAantia merito effbrriliauit, corpori uiiiuerfo fun damenti inftar (ubtjckrtdam.Nam quod parietes bC trabes in domibus, iC in tentorijs pali , & in nauibus carina; fimul cum coftispta:ftant,id in hominis fiu brica ofsium pncbet fubftantia . Offium (iquidem OfiSiffhS. alia roboris nomine tanquam corporis ftdcra pro* ««*«»/». creantur, e 4uor um numcro funt tibiarum & femo* rumona,8^^-^v TIVS MAGNAE tiias libera dclitiutia . tiwiiit M^Ra W^ proxlaic/e^ucKiillt C'fUU / liucomiatiii. PLATE OF THE ARTERIAL TREE BY VESALIUS (From the "Fabrica", 1543. Reduced one-half) CONTENTS OF THE FABRICA 105 He denied the existence of a general muscle of tlie skin, and stated that the intercostal muscles merely separate the ribs without expanding or contracting the thorax. He held the view that the 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. 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 ven- ous 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 cir- culations—cerebral, portal, and pulmonary. DISSECTION OF THE ABDOMEN BY VESALIUS (From the ''Fabrica", 1543) CONTENTS OF THE FABRICA 107 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 descrip- tion 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. 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 credit- able. 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. 108 ANDREAS VESALIUS 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 anat- omy 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 mesen- tery, 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 CONTENTS OF THE FABRICA 109 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 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 en- closing the left ventricle. And accordingly, notwith- standing 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 trans- fused, through the substance of the septum, from the right ventricle to the left". Vesalius and other anatomists knew of the hepatic 110 ANDREAS VESALIUS 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 dis- tributed 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 mate- rials, and that within these vessels the weight and gravi- tation of their contents has no effect". CONTENTS OF THE FABRIC A 111 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 descrip- tion of the eye is not as near accuracy as might be expect- ed. He places the crystaUine 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. Vesa- lius 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 arte- ries 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 fora- mina; 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 accompHshed scholar and was thoroughly conversant with the weaknesses of hu- man 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 over- threw the idol of authority in anatomy and taught us to look at Nature with our own eyes. 112 ANDREAS VESALIUS Portar has paid a splendid tribute to Vesalius. "Vesa- lius", 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 Colum- bus, 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 impor- tance to man; by acquiring fresh knowledge of his own structure, man seems to enlarge his existence ; while dis- coveries 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 op- ponents 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. 1 Portal: Histoire de Tanatomie et de la chirurgie. Paris, 1770; vol. I., page 399. CONTENTS OF THE FABRICA 113 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^:— "Leonardo was the first to create a new anatomy, but he created it for himself alone ; Vesalius de- monstrated a new anatomy to the world. It was the pub- hcation 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 anat- omy, but Vesalius must be recognized as its founder". INITIAL LETTER BY VESALIUS (From the "Fabrica", 1543) * McMurrich: Medical Library and Historical Journal, December, 1906. CHAPTER TWELFTH Contemporary Anatomists HORTLY AFTER THE PUBLICA- tion of the Fabrica, great activity was manifested in anatomic research, and numerous opponents and critics of VesaHus 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 impor- tance than was that of Eustachius, Columbus and Fallo- pius. 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 Anatom- tea, 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 CONTEMPORARY ANATOMISTS 115 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 medi- cal science, Eustachius was unable to publish them. If this magnificent atlas of anatomy could have been pub- lished 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 Li- brary at Rome. When discovered they were presented by Pope Clement XI. to his physician, Lancisi, who pub- lished 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 appear- ed, 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 overshad- owed 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 posthu- mous fame. 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 116 ANDREAS VESALIUS 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 BRAIN AND NERVES BY EUSTACHIUS (Reduced one-half) 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, CONTEMPORARY ANATOMISTS 117 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 MUSCLES BY EUSTACHIUS (Reduced one-half) was discovered by both Ingrassias and Eustachius, each independently of the other. In 1546 Ingrassias publicly 118 ANDREAS VESALIUS 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. Colum- bus 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 deHneated 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, macera- tion, 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, Uhri xv., written by Realdus Columbus and sumptuously published at Venice in the year 1559. This, however, was not the first printed ac- count 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 CONTEMPORARY ANATOMISTS 119 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 dedi- cation to Pope Paul IV., while in other exemplars, the dedi- cation has been written by the two sons of Columbus, and is addressed to "Pio IIIL, 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 Vesa- lius was called to Madrid as physician to Charles the Fifth, Columbus, in 1544, succeeded him in the Uni- versity 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. 120 ANDREAS VESALIUS 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 VsH»Tiij,ExT)ipogftpIiiaNicolaiBeuilacqua, u p tit. CVM miviisarii. TITLE-PAGE OF COLUMBUS'S ANATOMY (Reduced one-half) Columbus is upon the subject of vivisection, De viva seciione. In this he tells us how to employ living dogs CONTEMPORARY ANATOMISTS 121 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 pas- sage 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 cir- culation 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 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 Hfe was short, he will be remembered always as the dis- coverer 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 122 ANDREAS VESALIUS canal along which the facial nerve passes after leaving the auditory; it is still called the aquaeducius 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 treat- ment of diseases of the ear, he used an aural speculum. GABRIEL FALLOPIUS 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 describ- ed by Herophilus, over three hundred years before the Christian era, and also by Rufus of Ephesus, of whom CONTEMPORARY ANATOMISTS 123 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, Fallopiay 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 pro- fessorship 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 gar- den 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 Observati- ones 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. 124 ANDREAS VESALIUS This was written as a supplement to the anatomy of VesaHus, 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 FaUopii 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 re- turning 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, re- stored 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 CONTEMPORARY ANATOMISTS 125 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 sci- ence. 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. INGRASSIAS CHAPTER THIRTEENTH Commentators and Plagiarists EDICAL HISTORY FURNISHES numerous examples of literary theft. In many instances an entire set of ana- tomical plates has been pirated by un- scrupulous publishers. In a few cases both text and plates have been appro- priated 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^ as his own. Cowper added a few original illustrations to the book. Vesalius suffered severely at the hands of the plagia- rists. Pirated editions of the Tabulae Anafomicae 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 practi- cally all of their illustrations and much of their text. The fame of the Fabrica soon spread throughout Eu- rope. 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 delineatioy aere exaraium per Thomam. Geminum . It contained forty of the Vesalian ^ Cowper: The Anatomy of Human Bodies. Oxford, 1697. COMMENTATORS AND PLAGIARISTS 127 plates, cut in copper, and was the first book issued in England in which the roller printing process was employ- ed. It was dedicated to Henry the Eighth, and was em- bellished 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 pub- lished portrait of the Queen. She is shown upon the en- graved 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, commen- tators and imitators of Vesalius have passed into oblivion. 128 ANDREAS VESALIUS A few of these persons have possessed enough of indivi- duality 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 ab- domen 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 Caspar 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 de- rived their artistic inspiration from the Fahrica would re- quire 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. COMMENTATORS AND PLAGIARISTS 129 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 VesaHus. 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'. It contains the Fabrica^ the Epitome, the Episiola de Radicis Chynae, various anatomical treatises of a contro- versial 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 appear- ed, 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". 1 Andreae Vesalii Opera Omnia Anatomica et Chirurgica in duos t°"»os f''"*»f ^"^^ Hermanni Boerhaave et Bernhardi Siegfried Albmi. Lugduni Batavonim, 1725. CHAPTER FOURTEENTH The Court Physician ESALIUS, 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 de- scribes 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 Colum- bus in an effort to besmirch the great anatomist. Dis- gusted with such treatment, Vesalius, early in 1544, went to Pisa. Here he conducted a course in anatomy. Leav- ing Pisa, he went to Bologna where he made some special dissections upon two bodies. About this time he declined THE COURT PHYSICIAN 131 a chair in the University of Pisa which was tendered to him by direction of Cosimo de' Medici. Tired of the ap- parently 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 scien- tist. "Thus", says Morley, "he destroyed a huge volume of annotations upoil 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". While in this frame of mind it is not surprising that he should have ac- cepted 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 al- ready contemplated the abdication of the throne in favor of his son Philip, who is known in history as Philip the Second. CHARLES THE FIFTH 132 ANDREAS VESALIUS Vesalius left Italy and took up his residence at Madrid. He was now in his thirtieth year. As Archiatrus he ac- companied 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 sur- rendered to his son all his territories, jurisdiction and au- thority 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. VesaHus was continued in office as Archiatrus by the new Emperor. From both Charles and Philip, Vesalius re- ceived 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 treat- ment 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 UDDENLY, 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 Ar- chiatrus. During the twenty years that he had filled the post of Archiatrus, the scalpel of Vesalius was rusting: but the controversy con- cerning the infallibility of Galen was still raging. The violent criticisms of Sylvius upon the Fabrica had been silenced by death, but philip the second 134 ANDREAS VESALIUS others took up the cause of Galen where Sylvius had left it. But the passing years had brought a new coterie of professors, who, Hke Fallopius at Padua; Rondelet at Montpellier; Massa at Venice; and Fuchs at Tubingen, 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', "was heavy on the land ; the dagger of the Inquisition was stab- bing 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 ac- counted sacrilege. It was for a Hfe in priest-ridden, ignor- ant, superstitious Madrid that Vesalius had forsaken the freedom of the Venetian Republic and the bright aca- demic 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 VesaHus'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 Obser- vationes Anatomicae of his pupil Fallopius, who, having learned all that his master had taught of anatomy, con- tinued his studies with great skill and industry. Such a book, coming at an opportune time, must have seemed » Foster: Lectures on the History of Physiology. Cambridee, 1901, page 17 PILGRIMAGE AND DEATH 135 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 ac- count, which emanates from Spanish-French sources, dates from a letter written January 1, 1565, to the physician Caspar Feucer by Hubert Languer, or Hubertus Langue- tus, 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, behev- ing 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 grant- ed; 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 after- 136 ANDREAS VESALIUS wards to the knowledge of this, were not satisfied with prosecuting him for murder, but accused him to the In- quisition 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 in- terposed, 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. Vesa- lius's ship was wrecked upon the island of Zakynthos, where, on the fifteenth day of October, 1564, the Archiat- rus 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. INDEX ■^ INDEX Abr^g6 d'anatomie 93 Achillinus, Alexander 42 Adam, M 5S Adolph of Nassau U Aegina, Paul of , 53^ 80 Aesculapius I7 Aetius 80 Albert!, Leo Battista 7 Albertus Magnus SS Albius, John Andreas 80 Albinus, B. S 46, 115, 129 Albucasis 30 Alcmaeon 19, II5 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 5^1 Ambrosian Library 113 Anatomy in Ancient Times 17-28 Anathomia Mundini 1 1, 35, 48 Anatomia Corporis Humani 37 Anatomia ridotta 93 Anatomia Porci 27 Anatomical Renaissance 14 Andernach, John Winter of 61 140 INDEX Antonius Musa 20 Antropologium of Magnus Hundt 39 Apelles 22 Aphorisms of Hippocrates S3 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 S7 Athanasius 22 Augustus , 20 Aurelius, Marcus 24 AverrOes 4, 56 Avicenna 15, 31, 56, 80 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 Bertrucdus 29 Boccaccio 4 5 Bogarucci, Prosper 129 Boerhaave 129 Bologna b, 15, 27, 29, 30,' 37/43, 130 INDEX 141 Boniface VIII 15 Bracciolini, Poggio 10 Brambilk 44 B^ssotus, Pctrus 56 Bruchaeum 21 Budaeus 56 Buslciden, Hieronymus 54 Caelius Aurelianus 63 Caesalpinus 16 Caius 10 Cajetan Pctrioli 115 Calamus scriptorius * 23 Callimichus 22 Calcar, Jan Stephan van 9, 74, 82, 83, 89 Canna coxae • • ^^ Cannanus ^1' JJ Caraffa 1^' 73 Carbo, Gisbertus ^^ Cardan, Jerome ^^ Cardi, Luigi ^ Carpi, Seigneur de -^^ Carpus g Carolus Stephanus Caxton / * 22 Celsus, Aulus Cornelius ••::"/.;' '<\i 1,7 Charles the Fifth 53. 55. 82. 87, 95. 112, 119. 131 Chauliac. Guy de V;;;;;.;;. 73; 87.132 Chma root ' ^^ Christian III \ r Cicero ' y Cimabue 97 Civitas Hippocratica ^^ Clement VII ^^ Clement XI j-.y < jg CoUadus ' ^4 Collegium trilingue ^g College de Tr^guier 142 INDEX College de Cornouailles 58 College 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 Cuitius, Matthaeus 79 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 Delia 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 S7 Durer, Albrecht 9 Eclectic Philosophy 66 Egyptian Anatomy 17 Eichmann 47 Ehzabeth, Queen 127 Empedocles of Agrigentum 19 Epidaurus 20 INDEX 143 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 EucUd 22 Eustachius, Bartholomeus 15, 16, 114-118 Eyck, Hubert and John van 7 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 Blatter 37, 89, 95 Foesius, Anutius 10 Foramen Vesalii 10^ Fort, George F 27 Fracastoro 1" Francis the First 60 Frederick II 28 Friesen ^ 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 70 71 Gemma, Regnier ^^'^ Giacomo Berengario ^•'"^ Giacomo Moro Giotto g Giuseppe Ribera 144 INDEX 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 Hamusco, Juan Valverde di 128 Harvey, WilUam 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 Ignatius Loyola '. 73 Index Expurgatorius 13 Ingrassias, John PhiUp 15, 117, 118, 124, 125 Inquisition 13, 44, 136 Isagogae Breves 45 Institutionum Anatomicarum 81 Italy and the Renaissance 2-14 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 INDEX 145 Kalcker 89 Ketham, Joannes de 32, 33 Lactantius H 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 '3 Luca Signorelli ° Luigi Cardi ^ Luther ^^ Luzzi, Mondino dei 29 Maggiore Consiglio of Venice 28 Magnus, Albertus ^^ Malatesta, Jacobo ^^^ Manetho 22 Marc Antonio della Torre ° Margarita Philosophica 55 Massa . „^ Maximilian d'Egmont ^^Jl Mead, Dr. Richard ^^ Medicina Astrologica lU Melzi go Mercurialis, Jerome Meryon, Edward g ^ Michael Angelo '^^ Mirach ^g g^ Moehsen, J. C . W 29.36 Mondino dei Luzzi . . ^c Mondino's Anathomia * ^ Mondino's Successors 146 INDEX Monte Cassino 5 Moreau 61 Morley, Henry 70, 129, 131 Moro, Giacomo 93 Moschenbauer 93 Musa, Antonius 20 Museum, Alexandrian 22 Myntens, Arnold 9 McMurrich 113 Narcissus of Parthenope 82 Nicholas V 5, 10 Northcote, W 60 Oporinus, Joannes 84, 85, 86, 95, 99 Oribasius 63 Origen 22 Osiris 22 Padua, University of 15, 74, 7S, 76, 79, 80, 81, 112, 123, 136 Vesalius's Sojourn in 56-69 Paedagogium Castri 54 Paganism 11,12 Paraphrase of Rhazes 72, 131 Pare, 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 PhiUp the Second 95, 131, 132, 134 Phryesen, Laurcntius 40, 41, 42 Pierre de la Ramee 65, 66, 67 INDEX 147 Pietro da Cortona 9 Piles, Rogers de 93 Pinus 115 Pion, Albert 43 Poggio Bracciolini 9 PoUaiuolo, 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 1*0 Pope Paul III 13 Pope Paul IV 13, 119 Pope Pius nil 119 Portal 60, 112 Ptolemies, the 22 Quintilian . 5 Raffaello Santi 9 Raimondino 2o Ramus 65, 66, 67 Regio Judaeorum 21 Renaissance, the Anatomical 14-16 Renaissance, the General 1"^7 Rescius Rhacotis / ' '^ ' ?! Rhazes 31,53,72,73 Rhodion, Eucharius ^^ Ribera, Giuseppe • Richardson, B. W • ^^ Rogers de Piles • - Rome, Anatomy in q Rubens •"■ Rufus of Ephesus ^^^' ^^^ 148 INDEX 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, Phihp 135 Signorelli, Luca 8 Siphac 34 Spiegel der Artzny 41 Stephanus, Carolus 48-51 Stiriing-Maxwell, Sir WilUam 83 Sturm 71 Sylvius, Jacobus 57-61, 67, 68, 112, 113 Symonds, J. A 3 Tabulae Anatomicae 81, 83, 126 Tagault, Jean 5y 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, Francois 93 Trajectorium 35 TraUes, Alexander of 63 Tritonius, Vitus j^ 8q Valeriano 12 Valverde, Juan di Hamusco 128 van Eyck, Hubert and John 7 Varolius Ic INDEX 149 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 ^0 Vitus Tritonius 75, 80 WaechtUn ^J^ Wandelaar, Jan ^O ?^ Wesalius Family Jy Wharton • • ^ Winter of Andernach ^l-^""" Zakynthos, island of -J^l^ Zerbi, Gabriel dc ^^' \^ Zyrbi ^^