Andreas Vesalius (Brussels
, December
31, 1514 - Zakynthos
, October 15, 1564) was an anatomist, physician, and
author of one of the most influential books on human anatomy, De humani corporis fabrica
(On the Workings of the Human Body). Vesalius is
often referred to as the founder of modern human anatomy.
Vesalius is the Latinized form of
Andreas van
Wesel. He is sometimes also referred to as
Andreas
Vesal.
Early life and education
Vesalius
was born in Brussels
, then in the
Habsburg Netherlands, to a
family of physicians. His great-grandfather, Jan van Wesel,
probably born in Wesel
, received
his medical degree from the University of Pavia
and taught medicine in 1428 at the then newly
founded University of
Leuven. His grandfather, Everard van Wesel, was the
Royal Physician of
Emperor Maximilian, while
his father, Andries van Wesel, went on to serve as
apothecary to Maximillian, and later a
valet de chambre to his successor
Charles V. Andries encouraged
his son to continue in the family tradition, and enrolled him in
the
Brethren of the Common
Life in Brussels to learn
Greek
and
Latin according to standards of the
era.
In 1528
Vesalius entered the University of Leuven (Pedagogium
Castrensis) taking arts, but when his father was appointed as
the Valet de Chambre in 1532, he decided to pursue a career in
medicine at the University of Paris
, where he moved in 1533. Here he studied the
theories of
Galen under the auspices of
Jacques Dubois (Jacobus Sylvius) and
Jean Fernel.
It was during this
time that he developed his interest in anatomy, and was often found
examining bones at the Cemetery of the Innocents
.
Vesalius
was forced to leave Paris in 1536 due to the opening of hostilities
between the Holy Roman Empire and France, and returned to Leuven
. Here
he completed his studies under
Johannes Winter von Andernach
and graduated the next year. His thesis,
Paraphrasis in nonum
librum Rhazae medici arabis clariss ad regem Almansorum de affectum
singularum corporis partium curatione, was a commentary on the
ninth book of
Rhazes. He remained at Leuven
only briefly before leaving after a dispute with his professor.
After
settling briefly in Venice
in 1536, he
moved to the University of Padua
(Universitas aristarum) to study for his doctorate, which
he received in 1537.
Medical career and mature works
On graduation he was immediately offered the chair of Surgery and
Anatomy (
explicator chirurgiae) at Padua.
He also guest lectured
at Bologna
and Pisa.
Previously these topics had been taught primarily from reading
classic texts, mainly
Galen, followed by an
animal dissection by a barber-surgeon whose work was directed by
the lecturer. No attempt was made to actually check Galen's claims;
these were considered unassailable. Vesalius, on the other hand,
carried out dissection as the primary teaching tool, handling the
actual work himself while his students clustered around the table.
Hands-on direct observation was considered the only reliable
resource, a huge break with medieval practice.
He kept meticulous drawings of his work for his students in the
form of six large illustrated anatomical tables. When he found that
some of these were being widely copied, he published them all in
1538 under the title
Tabulae Anatomicae Sex. He followed
this in 1539 with an updated version of Galen's anatomical
handbook,
Institutiones Anatomicae. When this reached
Paris one of his former professors published an attack on this
version.
In 1538 he also published a letter on
venesection, or
bloodletting. This was a popular treatment for
almost any illness, but there was some debate about where to take
the blood from. The classical Greek procedure, advocated by Galen,
was to let blood from a site near the location of the illness.
However, the Muslim and medieval practice was to draw a smaller
amount blood from a distant location. Vesalius' pamphlet supported
Galen's view, and supported his arguments through anatomical
diagrams.
In 1539 a Paduan judge became interested in Vesalius' work, and
made bodies of executed criminals available for dissection. He soon
built up a wealth of detailed anatomical diagrams, the first
accurate set to be produced. Many of these were produced by
commissioned artists, and were therefore of much better quality
than those produced previously.
In 1541, while in Salami, Vesalius uncovered the fact that all of
Galen's research had been based upon primate anatomy rather than
the human; since dissection had been banned in ancient Rome, Galen
had dissected
Barbary Apes instead, and
argued that they would be anatomically similar to humans. As a
result, he published a correction of Galen's
Opera omnia
and began writing his own anatomical text. Until Vesalius pointed
this out, it had gone unnoticed and had long been the basis of
studying human anatomy. However, some people still chose to follow
Galen and resented Vesalius for calling attention to such glaring
mistakes.
Vesalius, undeterred, went on to stir up more controversy, this
time disproving not just Galen but also
Mondino de Liuzzi and even
Aristotle; all three had made assumptions about
the functions and structure of the heart that were clearly wrong.
For instance, Vesalius noted that the heart had four chambers, the
liver two lobes, and that the blood vessels originated in the
heart, not the liver.
Galen assumed arteries carried the purest blood to higher organs
such as the brain from the left ventricle of the heart, while veins
carried blood to the lesser organs such as the stomach from the
right ventricle. In order that this theory could be correct some
sort of holes were needed to interconnect the ventricles, and so in
the spirit of Galen's time, he claimed to have found them,
adjusting the facts to suit his theory. So paramount was the
authority of Galen that for the next 1400 years, a succession of
anatomists claimed to find these holes until finally Vesalius
declared he could not find them. However, while Vesalius dared to
admit he could not find these holes, he did not dream of disputing
Galen on the distribution of blood, and so imagined it distilled
through the unbroken partition between the ventricles.
Other famous examples of Vesalius disproving Galen in particular
was his discovery that the lower jaw was only one bone, not two
(which Galen had assumed from animal dissection) and his proof that
blood did not pass through the
interatrial septum.
In 1543,
Vesalius conducted a public dissection of the body of Jakob Karrer von Gebweiler, a
notorious felon from the city of Basel
, Switzerland
. With the cooperation of the surgeon Franz Jeckelmann, he assembled the bones
and finally donated the skeleton to the
University
of Basel
. This preparation (“The Basel Skeleton”) is
Vesalius’ only well-preserved skeletal preparation today, and is
also the world’s oldest anatomical preparation.
It is still displayed
at the Anatomical Museum of the University of Basel
.
Later that year Vesalius asked
Johannes Oporinus to help publish the
seven-volume
De humani
corporis fabrica (
On the fabric of the human
body), a groundbreaking work of
human
anatomy he dedicated to Charles V and which most believe was
illustrated by
Titian's pupil
Jan Stephen van Calcar. A few weeks later he
published an abridged edition for students,
Andrea Vesalii
suorum de humani corporis fabrica librorum epitome, and
dedicated it to
Philip II of
Spain, son of the Emperor.
Though Vesalius' work was not the first such work based on actual
autopsy, nor even the first work of this era, the production
values, highly-detailed and intricate plates, and the fact that the
artists who produced it were clearly present at the dissections
themselves made it into an instant classic. Pirated editions were
available almost immediately, a fact Vesalius acknowledged would
happen in a printer's note. Vesalius was only 30 years old when the
first edition of
Fabrica was published.
Imperial physician and death
Soon after publication, Vesalius was invited as Imperial physician
to the court of
Emperor
Charles V. He informed the Venetian Senate that he was leaving
his post in Padua, which prompted
Duke Cosimo I de'
Medici to invite him to move to the expanding university in
Pisa, which he turned down. Vesalius took up a position in the
court, where he had to deal with the other physicians mocking him
as being a barber.
Over the next eleven years Vesalius travelled with the court,
treating injuries from battle or tournaments, performing surgeries
and postmortems, and writing private letters addressing specific
medical questions. During these years he also wrote
Radicis
Chynae, a short text on the properties of a medical plant,
whose use he defended, as well as defense for his anatomical
findings. This elicited a new round of attacks on his work that
called for him to be punished by the emperor.
In 1551, Charles V
commissioned an inquiry in Salamanca
to investigate the religious implications of his
methods. Vesalius' work was cleared by the board, but the
attacks continued. Four years later one of his main detractors
published an article that claimed that the human body itself had
changed since Galen had studied it.
After the abdication of Charles he continued at court in great
favour with his son Philip II, who rewarded him with a pension for
life and by being made a count palatine. In 1555 he published a
revised edition of
De Corporis.
In 1564 Vesalius went on a pilgrimage to the Holy Land.
He sailed
with the Venetian fleet under James
Malatesta via Cyprus
.
When he
reached Jerusalem
, he received a message from the Venetian senate
requesting him again to accept the Paduan professorship, which had
become vacant by the death of his friend and pupil Fallopius.
After
struggling for many days with the adverse winds in the Ionian Sea
, he was wrecked on the island of Zakynthos
. Here he soon died in such debt that, if a
benefactor had not paid for a funeral, his remains would have been
thrown to the animals. At the time of his death he was scarcely
fifty years of age.
For many years it was assumed that Vesalius's pilgrimage was due to
pressures of the
Inquisition. Today this
is generally considered to be without foundation (see C.D. O'Malley
Andreas Vesalius' Pilgrimage, Isis 45:2, 1954) and is
dismissed by modern biographers. It appears the story was spread by
Hubert Languet, who served as de Saxe
under Charles V and then the prince of Orange. He claimed in 1565
that Vesalius was performing an autopsy on an aristocrat in Spain
when it was found that the heart was still beating, leading to the
Inquisition condemning him to death. The story went on to claim
that Philip II had the sentence transformed into a pilgrimage. The
story re-surfaced several times over the next few years, living on
until recent times.
Publications
De Corporis Fabrica
Vesalius's
Fabrica contained many intricately detailed
drawings of human dissections, often in allegorical poses.
In 1543, Vesalius asked
Johannes
Oporinus to help publish the seven-volume
De humani corporis fabrica
(
On the fabric of the human body), a groundbreaking work
of
human anatomy he dedicated to
Charles V and which most believe was illustrated by
Titian's pupil
Jan Stephen
van Calcar, though others believe was illustrated by different
artists working in the studio of Titian, and not from Van Calcar
himself.
A few weeks later he published another version of his opera,
entitled
De humani corporis fabrica librorum epitome
(
Abridgement of the Structure of the Human Body) more
commonly known as
Epitome, with a stronger focus on
illustrations than text, so as to help readers easily understand
his findings. The actual text of
Epitome was an abridged
form of his work in
De fabrica, and the organization of
the two books were quite varied. He dedicated it to
Philip II of Spain, son of the
Emperor.
The
Fabrica emphasized the priority of dissection and what
has come to be called the "anatomical" view of the body, seeing
human internal functioning as an essentially corporeal structure
filled with organs arranged in three-dimensional space. This was in
stark contrast to many of the anatomical models used previously,
which had strong Galenic/Aristotelean elements, as well as elements
of
astrology. Although modern anatomical
texts had been published by
Mondino and
Berenger, much of their work was
clouded by their reverence for Galen and Arabian doctrines.
Besides the first good description of the
sphenoid bone, he showed that the
sternum consists of three portions and the
sacrum of five or six; and described accurately the
vestibule in the interior of
the temporal bone. He not only verified the observation of Etienne
on the valves of the hepatic veins, but he described the
vena azygos, and discovered the canal which
passes in the fetus between the umbilical vein and the vena cava,
since named
ductus venosus. He
described the
omentum, and its connections
with the stomach, the
spleen and the
colon; gave the first correct views of the
structure of the
pylorus; observed the small
size of the caecal appendix in man; gave the first good account of
the
mediastinum and
pleura and the fullest description of the anatomy of
the brain yet advanced. He did not understand the inferior
recesses; and his account of the nerves is confused by regarding
the optic as the first pair, the third as the fifth and the fifth
as the seventh.
In this work, Vesalius also becomes the first person to describe
mechanical ventilation.
Quote
- "When I undertake the dissection of a human cadaver I pass a
stout rope tied like a noose beneath the lower jaw and through the
zygomas up to the top of the head... The lower end of the noose I
run through a pulley fixed to a beam in the room so that I may
raise or lower the cadaver as it hangs there or turn around in any
direction to suit my purpose; ... You must take care not to put the
noose around the neck, unless some of the muscles connected to the
occipital bone have already been cut away. ..." --Andreas Vesalius,
595:2 of Bynum & Porter,
Oxford Dictionary of Scientific Quotations 2005
Other publications
In 1538, Vesalius wrote
Epistola, docens venam axillarem dextri
cubiti in dolore laterali secundam (A letter, teaching that in
cases of pain in the side, the axillary vein of the right elbow be
cut) which demonstrated a revived
venesection, a classical procedure in which
blood was drawn near the site of the ailment. He sought to locate
the precise site for venesection in
pleurisy within the framework of the classical
method. The real significance of the book attempt to support his
arguments by the location and continuity of the
venous system from his observations rather
than appeal to earlier published works. With this novel approach to
the problem of venesection, Vesalius posed the then striking
hypothesis that anatomical dissection might be used to test
speculation.
Scientific Findings
Skeletal System
- Vesalius believed the skeletal
system to be the framework of the human body. It was in this
opening chapter, or book, of De fabrica that Vesalius
made several of his strongest claims against Galen's theories and writings which he had put in his
anatomy books. In his extensive study of the skull, Vesalius
claimed that the mandible consisted of one
bone, whereas Galen had thought it was two
separate bones. He accurately described the vestibule in the interior of the temporal bone of the skull.
- In Galen's observation of the ape, he had
discovered that their sternum consisted of
seven parts which he assumed held true for humans. Vesalius
discovered that the human sternum only
consisted of three parts.
- He also disproved the common belief that men had one rib fewer
than women and noted that fibula and tibia bones of the leg were indeed larger than the
humerus bone of the arm, unlike Galen’s original findings.
Muscular System
- Vesalius’ most impressive contribution to the study of the
muscular system may be the
incredible illustrations that accompany the text in De
fabrica, which would become known as the "muscle men". He
beautifully describes the source and position of each muscle of the
body as well as providing information on their respective
operations.
Vascular and Circulatory systems
Nervous System
- Vesalius defined a nerve as the mode of transmitting sensation
and motion and thus refuted his contemporaries’ claims that
ligaments, tendons and aponeuroses were three types of nerve units.
He believed that nerves do not originate from the heart, as was the
Aristotelian belief, but that nerves
stemmed from the brain.
- Upon studying the optic nerve,
Vesalius came to the conclusion that nerves were not hollow.
Abdominal Organs
- Although Vesalius accepted Galen’s
inaccurate claim that the liver was the locale
of blood production, he would not accept that the vena cava stems
from the liver. He also disproved Galen’s belief that the liver
consisted of five lobes, and stated that is, instead, one
lobe.
- In De fabrica, he corrected an earlier claim he made
in Tabulae about the right kidney being set higher than
the left. Vesalius claimed that the kidneys were not a filter
device for the urine to pass through but rather that the kidneys
serve to filter blood as well and that the excrement then traveled
through the ureters to the bladder.
- He described the omentum, and its
connections with the stomach, the spleen and the colon and gave the
first correct views of the structure of the pylorus.
- He also observed the small size of the caecal appendix in man and gave the first
good account of the mediastinum and
pleura.
- Vesalius admitted that due to a lack of pregnant cadavers, he
was unable to come to a significant understanding of the
reproductive organs. However, he did find that the uterus had been
falsely identified as having two distinct sections.
Heart
- Through his work with muscles, Vesalius believed that a
criterion for muscles was their voluntary motion. On this claim, he
deduced that the heart was not a true muscle due to its obvious
involuntary nature of its motion.
- He identified two chambers and two atria. The right atrium was considered a continuation of
the inferior and superior venae
cavae and the left atrium was
considered a continuation of the pulmonary vein.
- Interestingly, he also addressed the controversial issue of the
heart being the center of the soul. He wished to avoid making any
conclusions due to the inevitable onslaught from religious figures.
Brain
Miscellaneous
- Vesalius introduced the notion of induction of the extraction
of empyema through surgical means.
- Due to his impressive study of the human skull and the
variations of its features he is said to have been responsible for
the launch of the study of physical anthropology.
- Vesalius always encouraged his students to check their
findings, and even his own findings, so that they could better
understand the structure of the human body.
- In addition to his continual efforts to study anatomy he also
worked on medicinal remedies and came to such conclusions as
treating syphilis with chinaroot.
- Vesalius believed that the brain and the nervous system are
center of the mind and emotion in contrast to the common
Aristotelian belief that the heart was the center of the body.
- Claimed medicine was arranged into three parts: drugs, diet,
and 'the use of hands' - mainly suggesting surgery and the
knowledge of anatomy and physiology through dissection.
- Vesalius was a supporter of 'parallel dissections' in which an
animal cadaver and a human cadaver are dissected simultaneously in
order to demonstrate the anatomical differences and thus uncover
Galenic errors.
Scientific and Historical Impact
Modern medicine is forever in debt to the efforts put forth by
Vesalius and his ethic to provide the most accurate form of the
human body. The manner in which Vesalius tended to his work could
arguably be thought of as more significant than the work itself. By
overthrowing the Galenic tradition and relying on his own
observations, Vesalius created a new scientific method. His desire
to strive for the truth is most evident through his ability to
correct his own claims and to continually reshape his thoughts on
the human body. Through his attention to detail, he was able to
provide clear descriptions and unprecedented anatomical drawings
that set a new standard for future medical books.
The influence of Vesalius' plates representing the partial
dissections of the human figure posing in a landscape setting is
apparent in the anatomical plates prepared by the Baroque painter
Pietro da Cortona (1596-1669), who
executed anatomical plates with figures in dramatic poses, most
with architectural or landscape backdrops.
During the twentieth century, the American artist,
Jacob Lawrence created his
Vesalius
Suite based on the anatomical drawings of Andreas
Vesalius.
See also
References
- Dear, Peter. Revolutionizing the Sciences: European
Knowledge and Its Ambitions, 1500-1700. Princeton: Princeton
UP, 2001.
- Debus, Allen, ed. Vesalius. Who's Who in
the World of Science: From Antiquity to Present. 1st ed.
Hannibal: Western Co., 1968.
- O'Malley, CD. Andreas Vesalius of Brussels,
1514-1564. Berkley: University of California Press,
1964.
- Porter, Roy, ed. Vesalius. The
Biographical Dictionary of Scientists. 2nd Ed. New York:
Oxford University P, 1994.
- Saunders, JB de CM and O'Malley, Charles D. The
Illustrations from the Works of Andreas Vesalius of
Brussels. New York: Dover, 1973 [reprint].
- "Vesalius." Encyclopedia Americana. 1992.
- Williams, Trevor, ed. Vesalius. A
Biographical Dictionary of Scientists. 3rd Ed. New York: John
Wiley and Sons, 1982.
External links