Andreas Vesalius

Flemish physician and historian

• Born: December 31, 1514
• Birthplace: Brussels (now in Belgium)
• Died: October 15, 1564
• Place of death: Zacynthus, Republic of Venice (now Zákinthos, Greece)

Vesalius published the first modern comprehensive text of human anatomy, and his accurate description of the structure of the human body, the result of firsthand dissection, is the basis of the modern scientific study of human anatomy.

Early Life

Andreas Vesalius (ahn-DRAY-ahs veh-SAY-lee-uhs) belonged to the fifth-generation family of a long line of physicians, a family line that combined scholarly and Humanistic interests (several had written medical treatises or commentaries on Arabic and Hippocratic works) with medical ability and ambition, having served the courts of Burgundy and the Habsburgs. Although the family had long lived in Flanders, it had come originally from Wesel on the lower Rhine River, hence the family’s name, of which Vesalius is the Latin form. Vesalius’s father was apothecary to the court of the Habsburg emperor Charles V.

As a boy, Vesalius dissected dogs, cats, moles, mice, and rats. He attended the University of Louvain from 1529 to 1533, where he studied Latin and Greek. He then went to the University of Paris to study medicine, remaining there from 1533 to 1536. The medical faculty at Paris was under the influence of Galen, the great second century Greek medical writer, whose authority in anatomical matters was unchallenged. Vesalius found that there was little practical teaching of anatomy. Human corpses were dissected only twice a year, and Vesalius found the procedure disappointing. The professor of anatomy never performed the dissection himself but merely read passages from Galen as an assistant dissected the cadaver. In most cases, pigs or dogs were dissected. Eager to obtain human skeletons, Vesalius sought them from cemeteries and gallows outside the city, where he obtained corpses of criminals in various states of decay. He became skilled at dissection and gained a firsthand knowledge of human anatomy. He began to acquire a reputation as an anatomist and even conducted a public dissection.

Vesalius left Paris in 1536 on the outbreak of war between France and the Holy Roman Empire. He returned to Louvain, where he completed his baccalaureate degree in the following year. Thereupon, he traveled to Italy and enrolled in the University of Padua, which enjoyed an outstanding reputation. On December 5, 1537, Vesalius received his medical degree with highest distinction. On the following day, he was appointed professor of surgery, which entailed the teaching of anatomy as well. He was only twenty-three years of age.

Life’s Work

The young professor was enormously successful at Padua, where he lectured to some five hundred students, professors, and physicians. Dispensing with an assistant, he personally descended from his academic chair to dissect cadavers. He prepared four large anatomical charts to illustrate his lectures. In 1538, he published three of them and three skeletal views, which have come to be known as Tabulae anatomicae sex (Six Anatomical Tables , 1874). The publication of these accurate and detailed plates marked a major advance in anatomical illustration. In the same year, he published a dissection manual based on Galen, Institutiones anatomicae (1538), and in the following year he published Epistola, docens venam axillarem dextri cubiti in dolore laterali secandam (1539; The Bloodletting Letter of 1539 , 1946), in which he argued for the importance of the direct observation of the body.

As a result of his publications and success in teaching, Vesalius began to acquire more than an ordinary reputation. He was reappointed to the medical faculty in 1539 at an increase in salary. In his lectures on anatomy, Vesalius had, as was then customary, expounded the views of Galen, whose authority was accepted in virtually every medical faculty in Europe. In dissections he performed, however, he began to notice discrepancies between what he observed and what Galen had described. At first, so few cadavers were available that there was only limited opportunity for dissection. Beginning in 1539, however, corpses of executed criminals were made available to him. Repeated dissections made it increasingly apparent to Vesalius that Galen’s descriptions were erroneous and that Galen had based his descriptions on the anatomy of animals, primarily apes, pigs, and dogs. He expounded his discoveries first at Padua (in his fourth public dissection, at which he ceased to use Galen as a text), then, in 1540, at Bologna, where he was invited to lecture.

As early as 1538, Vesalius had apparently contemplated a major work on anatomy. As his dissections revealed many discrepancies between Galen’s anatomy and his own discoveries, he recognized the need for a new and comprehensive text to replace Galen. After his return to Padua from Bologna, he commenced work on one in earnest. Vesalius had woodcut illustrations for the work prepared in Venice, probably in the artist Titian’s studio. To produce at least some of the illustrations, he chose a compatriot, Jan Steven van Calcar, who belonged to the school of Titian and had drawn the skeletal figures for the plates in Six Anatomical Tables. Other painters associated with the school of Titian almost certainly had a hand in the illustrations as well. Vesalius selected a firm in Basel to print the work, and the woodblocks for the illustrations were transported by donkey.

In the summer of 1542, Vesalius went to Basel to oversee the printing of De humani corporis fabrica libri septem (On the Fabric of the Human Body, books I-IV, 1998; better known as De fabrica , which was published in August, 1543. In De fabrica, Vesalius corrected more than two hundred errors of Galenic anatomy and described certain features that either were previously unknown or had been described only partially. He was not the first to find mistakes in Galen, but he went beyond mere correction by insisting that the only reliable basis of anatomical study was dissection and personal observation. De fabrica was the first modern treatise on human anatomy that was not based on Galen or drawn from dissected animals. The most extensive and accurate description of human anatomy that had yet appeared, it surpassed all previous books on the subject. Its publication revolutionized the study of anatomy, not least of all by its outstanding use of illustrations. Vesalius was only twenty-eight years of age when the book appeared, less than a week after the publication of Nicolaus Copernicus’s De revolutionibus orbium coelestium (1543; On the Revolutions of the Heavenly Spheres, 1952; better known as De revolutionibus), which challenged the dominant geocentric theory of Ptolemy as De fabrica challenged the anatomy of Galen. Both books aroused violent controversy.

De fabrica also was one of the most outstanding examples of the bookmaker’s art in the sixteenth century. Every detail had been personally supervised by Vesalius: the paper, woodcuts, typography, and famous frontispiece. The woodcuts, showing skeletons and flayed human figures, represented the culmination of Italian painting and the scientific study of human anatomy. They were meant to be studied closely with the text and were so successful that they were frequently plagiarized; they set the standard for all subsequent anatomical illustrators.

Vesalius’s fame spread rapidly, and many Italian physicians came to accept his views. Yet Galen’s supporters reacted with strong attacks. Jacobus Sylvius, the leading authority on anatomy in Europe and Vesalius’s former teacher, published a vitriolic pamphlet against Vesalius, perhaps angered at his attacks on the deficiencies of training in anatomy. Disappointed by the opposition of the Galenists, he abandoned his anatomical studies, burned all his manuscripts, resigned his chair at Padua, and left Italy to accept the position of third court physician to the Holy Roman Emperor Charles V.

Vesalius was to spend some thirteen years in the service of the emperor, following a family tradition of service to titled houses. In 1544, his father, who had been an apothecary to Charles, died and left a substantial inheritance to Vesalius, who then was married to Anne van Hamme. About a year later, a daughter, his only child, was born. Vesalius spent much of his time traveling with the emperor, who suffered from gout and gastrointestinal disorders. He served as a military surgeon as well, during which time he introduced several new procedures, the most notable of which was the surgical drainage of the chest in empyema. Vesalius enjoyed the full confidence of the emperor, and his professional reputation continued to grow. On Charles’s abdication from the Spanish throne in 1556 (he had abdicated as Holy Roman Emperor in 1555), he granted Vesalius a pension for life.

In 1546, Vesalius found time to write a short work, Epistola, rationem modumque propinandi radicis Chynae (Vesalius on China-root , partial translation 1935), in response to a friend who sought his opinion of a fashionable remedy called the China root. In 1552, he began work on a second edition of De fabrica, which was issued a few months after Charles’s abdication in 1555, though, like the first edition, it was dedicated to the emperor. The new edition was even more sumptuous than the first. Vesalius took the opportunity to revise and correct the text and make a number of additions. In 1556, he took up residence in Madrid as one of the physicians in the service of Philip II, who had succeeded his father, Charles, as king of Spain.

Vesalius’s reputation was sufficiently outstanding that in 1559, when King Henry II of France was severely wounded in the head during a tournament, Vesalius was summoned to Paris, where he joined the distinguished French surgeon Ambroise Paré in treating the king. The wound proved fatal, however, and the king died ten days later. Vesalius’s reputation as one of the greatest physicians of the age was secure, and his opinion was repeatedly sought. In 1562, Don Carlos, heir to the throne of Spain, received a severe head injury as the result of a fall. As his condition grew worse, the king summoned Vesalius to join several Spanish physicians in attendance on the infant. Although they distrusted him from the beginning, the Spanish physicians eventually allowed Vesalius to administer a treatment that resulted in a rapid improvement of the prince, who recovered.

In the spring of 1564, Vesalius embarked on a trip to the Holy Land by way of Venice. There is reason to believe that he did not intend to return to Spain. He seems to have been regarded with hostility by the Spanish physicians at court. He was probably motivated as well by a desire to return to an academic position, inspired by reading Gabriello Fallopio’s Observationes anatomicae, which had been published in 1561. He was offered the vacant chair at Padua of his pupil Fallopio, who had died, and he signified his intention to take the position on his return. He proceeded to Palestine by way of Cyprus, but he became ill on the return journey and died on October 15, 1564. He was buried on the island of Zacynthus.

Significance

The product of a long line of distinguished physicians and Humanists, Vesalius received a fine Renaissance education, had an excellent Latin style, and excelled in philological scholarship. He was trained in the Galenic system, which was taught in all European medical faculties. Only gradually did he come to see why Galen’s anatomical descriptions, based on the dissection of animals, needed correction. Even then he was not wholly able to escape Galen’s influence, for he sometimes reproduced his errors. His great contribution to medicine was his insistence that anatomical study be based on repeated dissection and firsthand observation of the human body.

The personality of Vesalius remains somewhat enigmatic. He appears to have had considerable dynastic and personal ambition, and he possessed great energy and desire to succeed. A genius, he enjoyed an enviable reputation in his own time but was nevertheless sensitive; he resented the attacks that were made on him by former teachers and jealous colleagues. Independent, unafraid of challenging authority, and confident of his own opinions, he combined great powers of observation with a reputation for remarkably accurate prognosis. He defended himself and his opinions when attacked but was willing to accept correction of his own errors.

Vesalius may be called the founder of modern anatomy. The importance that he placed on the systematic investigation of the human body led to dissection becoming a routine part of the medical curriculum. His De fabrica revolutionized the study of anatomy, and its anatomical illustrations became the model for subsequent medical illustrators. Its publication marked the beginning of modern observational science and encouraged the work of other anatomists. Vesalius’s ideas spread rapidly throughout Italy and Europe and came to be widely accepted within a half century, in spite of the continuing influence of Galen. In his remarkable genius and his influence, Vesalius deserves to be ranked among the most distinguished contributors to medical science.

Bibliography

Cockx-Indestege, Elly. Andreas Veselius A Belgian Census: Contribution Towards a New Edition of H. W. Cushing’s Bibliography. Brussels, Belgium: Royal Library Albert I, 1994. An update and emendation of the Cushing volume. Includes illustrations and indexes.

Cunningham, Andrew. The Anatomical Renaissance: The Resurrection of the Anatomical Projects of the Ancients. Brookfield, Vt.: Ashgate, 1997. This important study of the history of anatomy emphasizes Vesalius’s indebtedness to Galenic anatomy, as well as the importance of ancient science to Renaissance thinkers generally. Includes illustrations, bibliographic references, and index.

Cushing, Harvey. A Bio-Bibliography of Andreas Vesalius. 2d ed. Hamden, Conn.: Archon Books, 1962. Contains an excellent bibliography of the various editions of Vesalius’s writings and secondary literature about him.

Friedman, Meyer, and Gerald W. Friedland. Medicine’s Ten Greatest Discoveries. New Haven, Conn.: Yale University Press, 2000. Vesalius’s invention of the modern science of anatomy is the first of the ten discoveries discussed in this book. Includes illustrations, bibliographic references, and index.

Lambert, Samuel W., Willy Wiegand, and William M. Ivins, Jr. Three Vesalian Essays. New York: Macmillan, 1952. These essays deal with aspects of the printing and illustrations of De fabrica.

O’Malley, C. D. Andreas Vesalius of Brussels, 1514-1564. Berkeley: University of California Press, 1964. The definitive biography of Vesalius, which replaces that of Moritz Roth (1892).

Persaud, T. V. N. A History of Anatomy: The Post-Vesalian Era. Springfield, Ill.: Charles C Thomas, 1997. Study of Vesalius’s legacy and the development of the science of anatomy. Includes illustrations, bibliographic references, and index.

Simmons, John. The Scientific Hundred: A Ranking of the Most Influential Scientists, Past and Present. Secaucus, N.J.: Carol, 1996. Simmons ranks Vesalius as the twenty-first most important scientist in world history and explains how he has influenced anatomical science up to the present day. Includes illustrations, bibliographic references, and index.

Singer, Charles, and C. Rabin. A Prelude to Modern Science. Cambridge, England: Cambridge University Press, 1946. A discussion of the history of Six Anatomical Tables and its sources.

Vesalius, Andreas. The Illustrations from the Works of Andreas Vesalius of Brussels. Introduction and annotations by J. B. de C. M. Saunders and Charles D. O’Malley. Cleveland, Ohio: World, 1950. Contains a lengthy introduction describing the life and career of Vesalius and reproduces the woodcuts from De fabrica and other works of Vesalius.