Vesalius

Portrait of Andreas Vesalius (1514-1564) at age twenty-eight years. C.D. O'Malley, who wrote the definitive biography of Vesalius, credits this image as the only authentic portrait of Vesalius, from Vesalius's Fabrica. Source: James Moores Ball.

Andreas Vesalius (1514-1564),      a Belgian (Flemish) Renaissance physician/surgeon, anatomist and physiologist, revolutionized the study of human anatomy and, as a consequence, the practice of medicine. He accomplished that feat (a) in virtue of the results of his dissections of human cadavers never previously performed with the quality of Vesalius's extraordinary meticulous systematic detail and eloquent extensive documentation; (b) in virtue of the fluent writing [in Latin] of lucid descriptions of his anatomical and physiological findings precisely integrated with the accompanying illustrations; and, (c) in virtue of having his anatomical findings exquisitely illustrated by his artist collaborators, notably Jan Stephan van Calcar, a protégé of the great Italian artist, Titian. 

In 1543, at the age of 28 years, Vesalius published De Humani Corporis Fabrica (On the Workings of the Human Body.) — generally referred to as the Fabrica — a work of many years of observations and illustrations of human dissections that not only laid the foundation for a realistic human anatomy but also demonstrated numerous errors in the anatomical assertions of the self-proclaimed heir of Hippocrates (460-360 BCE), Galen (129-216 CE) of Pergamum, the Greek physician/surgeon who based his description of human anatomy on extrapolations of dissections of animals and observations of the wounds of gladiators in Rome and Pergamum. Vesalius's contemporaries, having unquestionably accepted Galen's conclusions about human anatomy, found themselves in turmoil, stunned and even outraged at what eventuated as one of the most important contributions to the evolution of biology and medicine. In his book on the evolution of medicine, Sir William Osler considered it "....one of the great books of the world", asserting as follows:

The worth of a book, as of a man, must be judged by results, and, so judged, the "Fabrica" is one of the great books of the world, and would come in any century of volumes which embraced the richest harvest of the human mind. In medicine, it represents the full flower of the Renaissance. As a book it is a sumptuous tome—a worthy setting of his jewel—paper, type and illustration to match...the chef d'œuvre of any medical library.

The U.S. National Library of Medicine offers an online gray-scale reproduction of some forty pages of the Fabrica, prepared in such a way that the reader can turn the pages, pause on any page to zoom on any section, read explanatory commentaries, and print pages.

Medicine's intertwining with science began when physicians finally realized that universalizing, all-explaining theories about human biology served only to foster the misinterpretation of observed phenomena. Until then, a conflict between what was actually experienced and what the grand conceptual scheme told a physician he should be experiencing was always resolved in favor of the latter. —Sherwin B. Nuland

The year that saw publication of the Fabrica, 1543, also saw publication of Nicholas Copernicus's (1473-1543) De revolutionibus orbium coelestium libri vi (Six Books Concerning the Revolutions of the Heavenly Orbs) — the two books published a week apart. A memorable year, and a memorable pair of scholars who jump-started two revolutions, one on interpretations of the structure and function of the human body, the other on interpretations of the structure and movements of the earth and the sun. Those revolutions challenged ancient wisdom that had dominated thinking in medicine and astronomy. These new ideas met with strong opposition from the church of the time, although they represent an anno mirabile in the history of science.

The history of Western science recognizes Vesalius's century as a turning point in the progress of science, a significant transition period straddling medieval science and the scientific revolution of the 1600s. Historian C. B. Schmitt states that one of the major growth points for scientific studies during the sixteenth and early seventeenth centuries lay in developments within biological science. While many contributed to that growth, and did so in what biologists would now assign to many different disciplines of biology, Vesalius remains a key contributor, in pedagogical and scientific method, in knowledge, and in influence.

Chronology of Vesalius's life

Vesalius entered the world in Brussels, Belgium, late on the last day of 1514 or early on the first day of 1515, the newest member of a wealthy family of many generations of physicians. His father served as apothecary — preparer and dispenser of medications — in the royal court (Holy Roman Emperor Charles V (1500-1558)). Father's duties apparently forced leaving the upbringing of Vesalius and his two brothers and a sister to the mother. Vesalius had access to his family's library of books. As a child Vesalius often visited a nearby site (Gallows Hill) where the authorities left criminals hanging until they rotted. Vesalius thus could begin to teach himself aspects of human anatomy at an early age. He continued to satisfy his curiosity of anatomy with the dissection of small animals, concentrating on both structure and function at a macroscopic level — the microscope not invented until after Vesalius's death.

At age 15, Vesalius began studying at the University of Louvain, where he learned, between 1530 and 1533, the subjects of rhetoric, logic, philosophy, and Latin. The University of Louvain stressed the Latin of the ancient Romans and attempted to inculcate a high degree of literary skill in reading and writing.

After Louvain, Vesalius moved to study at the most prestigious center of medical science at the time, the University of Paris, attending from 1533 to 1536. As little information has emerged of Vesalius's activities during those three years, his biographer, C. D. O'Malley, offers an educated argument from information on the workings of medical education at that time there. Near concluding, he writes:

It would be incorrect to liken the Vesalius of Paris to the later author of the Fabrica, and it is important to remember that although Vesalius in Paris may have been extraordinarily inquisitive, and he had acquired unusual skill in the technique of dissection, his vision was still considerably clouded by Galenism if, indeed, he was not a completely devoted Galenist.

Subsequently Vesalius moved to Italy, to the central hub of Renaissance culture and learning, Padua, where at the University there he quickly earned his medical degree (1537) and soon after a professorship in anatomy.

Timeline

This image show the timeline of Vesalius's life in relation to that of William Harvey, who advanced physiology as Vesalius did anatomy, and Marcello Malpighi, who completed the circuit of Harvey's circulation of the blood by his discovery of the capillaries.

(CC) Image: Anthony Sebastian (adapted from data from Wolfram Alpha)

Vesalius's work

(PD) Image: Andreas Vesalius, Fabrica (1543)
The Fabrica illustration of the human cortex. Top panel: Figure 2 of Book 7; Bottom panel: Figure 3 of Book 7.

(PD) Image: Andreas Vesalius, Fabrica (1543)
Figure accompanying Table 2 in Book 2 of the Fabrica. An image in color can be found here.

Vesalius’ major work was the Fabrica, printed by Johannes Oporinus of Basel in 1543. The letter of instructions submitting this work to the printer is available in English translation.

As samples of the Fabrica, two gray-tone versions of Fabrica illustrations are shown. The figure at left provides two figures from Book 7: The brain and organs of sense that display the human cortex. Vesalius describes in his figure captions the procedures used to obtain these views, and provides detailed observations upon the brain's construction. The figure at right shows one of many depictions of human musculature in Book 2: Ligaments and muscles. Although not obvious in the figure at this size, tiny labels identify individual muscles and are elaborated upon in the table accompanying the figure. As the figures progress, layers of muscle are peeled away to show structure at all levels.

Nuland summarizes Vesalius and his work in the following outline, presented verbatim:

“A.  Fabrica has been interpreted to mean not just "structure" but "workings." Vesalius was as interested in the functions of the human body as he was in the anatomy itself.

B.  Published in 1543, Fabrica gave the world its first accurate knowledge of anatomy and a method by which it could be studied.

C.  Vesalius provided directions by which anyone with appropriate instruments and access to cadavers could perform dissections.

D.  Vesalius's book began the process of debunking Galen, though this would take centuries.

E.  Although Vesalius's text brought about the change, the work of its artist, Jan van Calcar, a protege of Titian, is what is most commented on today.

F.  The story of this book and of Vesalius himself is also the story of a series of events representative of the Renaissance, including:

1.  A return to interest in the human body

2.  A return to Greek learning

G.  The rise of the universities, which were the focus of Renaissance thought.”

In regard to point D, the influence of Galen on the description of human anatomy before and during Vesalius's time cannot be underestimated: to quote Magner,

Indeed, when the young Vesalius began his study of human anatomy, the authority of the ancient anatomist had grown so weighty that anatomists tended to explain away discrepancies between his descriptions and their own observations in terms of individual abnormalities or changes in the human body that had occurred since the time of Galen. For example, Jacobus Sylvius (1478-1555) defended Galen's description of the human sternum as made up of seven bones on the grounds that human beings in a more heroic age might have had more bones than their degenerate descendants.

Point E seems a bit exaggerated, possibly undervaluing historical and other scholarly commentary. The suggested involvement of Jan Steven van Calcar is supported by Guerra, but is admittedly not iron clad. Guerra also points out the importance of the wood engraver and well-known publisher, Francesco Marcolini da Forlí. O'Malley, in his exhaustive biography of Vesalius, devotes seven pages specifically to a consideration of the illustrator(s) of the Fabrica, interpreting the documentary evidence as providing no definitive conclusion as to who prepared the illustrations, and no evidence with certainty that Calcar participated. O'Malley suggests that some of the illustrations were prepared by Vesalius himself and others by students of the studio of Titian. In any case, the art work is extraordinary: to quote Nutton,

"...its artwork, the co-production of anatomist, artist, block-cutter and printer, solved at a stroke many of the difficulties involved in representing a three-dimensional object on the printed page." –from the Conclusion of Nutton's Introduction to Fabrica.

The universal assessment of Fabrica today is summarized as:

"The result is, without question, the finest medical book ever published and one of the most beautiful books of all time." –Chauncey D. Leake.

References

Many citations here include blue links that open variously to full-text or to a publisher's description of the work. Links to Google books often offer an extensive preview of the text.

Notes

Annotations to several references are in the Notes below.