Medical Reader

Andreas Vesalius founded modern anatomy in 1543

Andreas Vesalius

Andreas Vesalius founded modern anatomy with the publication of De Humanis Corporis Fabrica (On the Structure of the Human Body) in June 1543. His book was based upon personal dissection of human bodies. This represented a remarkable departure from the zoological anatomy of Galen. The accomplishments of Vesalius were possible because of the resumption of the dissection of human bodies that began in the thirteenth century.

Human dissection was rare before the thirteenth century. The Egyptians knew the body organs, but only after extracting them through tiny incisions made for the purposes of embalming. There is continuing controversy about human dissection during the Hippocratic period. A knowledge of anatomy, except the skeleton, is scanty in the Corpus Hippocraticum. The consensus is that human dissection was not practiced during the Hippocratic period, either because of reverence for the human body or belief in a life after death that required an intact body.

Dissection for the purpose of acquiring a knowledge of the human body probably originated in Alexandria, Egypt, in the fourth century b.c., 100 years after Hippocrates. Herophilus studied the nervous system and gastrointestinal tract, describing the cerebrum, cerebellum, meninges, fourth ventricle of the brain, duodenum, and the eye. He counted the pulse with a water-clock, and analyzed the rate and rhythm. Erasistratus (ca 310–250 b.c.) described the aortic and pulmonic valves and the chordae tendineae of the heart. He clearly saw that the heart was a pump, although he had the direction of circulation backward.

The practice of human dissection in antiquity was confined largely to Alexandria. Some dissection apparently occurred in Rome until the second century a.d., but it must have been sparse. Galen (a.d. 129–200) said Alexandria, where he had studied, was the only place where anatomy could be learned. There is no good evidence that Galen himself practiced human dissection.

Human dissection began again in the thirteenth century in Bologna, one of the great medieval universities, and has continued uninterrupted through the present time. Several occurrences during the early thirteenth century set the stage for the lifting of the taboo against disturbing the human body. Emperor Frederic II issued an imperial decree in 1238 authorizing the performance of public “anatomes” on the bodies of executed criminals for teaching purposes. Legend has it that Frederick II also had the stomachs of two of his subjects opened in order to determine if digestion was enhanced by exercise or by rest. Another sign of the relaxation of the concept of the sanctity of the human body during the thirteenth century was the practice of dismembering the bodies of the Crusaders and boiling the parts so that the bones could be returned to their families in Europe for burial. A more specific reason for the resumption of human dissection probably had to do with the legal scholars at the University of Bologna, which was famous for its law school. The scholars were concerned to know the causes of deaths for legal reasons.

Mondino of Bologna

Mondino of Bologna (ca 1270–1326) was the predecessor of Vesalius in the founding of anatomy. In 1316 he wrote his Anothomia, the first text exclusively on anatomy. It was based on his own dissection of humans. This book was published at Padua in 1487 and went through 39 separate editions and translations. It was an unillustrated manual or handbook of dissection and not a formal anatomic text. His method was to begin with the abdominal viscera, then go to the chest and neck. The book ends with the opening of the skull. The manual was a student favorite and was widely used. Mondino’s anatomic work was continued by his students, and dissection became more popular. A public dissection occurred at Padua in 1341. Public dissections were decreed at the University of Montpelier in 1366, at Venice in 1368, and at Florence in 1388. In Padua an anatomic theater was erected in 1445. These events set the stage for Vesalius in the sixteenth century.

Vesalius was born in Brussels in 1514–1515, the son of a Flemish family that had been in medicine for many generations. He was said to be interested in anatomy even as a youth, dissecting mice, rats, dogs, and cats. He studied anatomy in Paris under Sylvius, a famous scholar who declared Galen was infallible. In 1537 he went to Padua, where he received his medical degree. For the next 5 years he worked prodigiously as professor of medicine and surgery, breaking tradition by personally performing all the dissections. At the end of these 5 years, he published his Fabrica. He was 28.

The Fabrica was sumptuously illustrated by Titian’s pupil Jan Kalkar, who was the first to attain what Choulant calls the true anatomic norm, that is, a picture at once scientifically exact and artistically beautiful, summing up, as in a composite photograph, the innumerable peculiarities and minor variations in structures encountered in dissection. The splendid wood-cuts representing majestic skeletons and flagged figures, dwarfing a background of landscape, set the fashion for over a century and were copied and imitated by a long line of anatomic illustrators. …

Vesalius provided the accurate anatomic base upon which physical diagnosis could be built.

“Few men in medical history have dominated their subject or their epoch as did Andreas Vesalius. The history of anatomy is divided into three periods: the pre-Vesalian Period, the Vesalian Period, and the post-Vesalian Period—a tribute to the genius of this great anatomist”.

Source: Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.