Hieronymus Fabricius ab Aquapendente

Italian physician

• Born: May 20, 1537
• Birthplace: Aquapendente, near Orvieto (now in Italy)
• Died: May 21, 1619
• Place of death: Padua, Republic of Venice (now in Italy)

Fabricius is most famous for his discovery of valves in veins and for teaching William Harvey, who used Fabricius’s findings in his proof of blood circulation. Fabricius also made numerous contributions to anatomy, physiology, embryology, and surgery.

Early Life

Girolamo Fabrici, later known in Latin as Hieronymus Fabricius (hi-ur-AWN-ih-muhs fah-BRIHSH-ee-uhs) was born in Aquapendente, a village near Orvieto in Umbria, about sixty miles north of Rome. Named after his paternal grandfather, he received the classical education common for the eldest sons of noble families. The adolescent Fabrici was sent north to Padua to continue his studies in Latin, Greek, logic, and philosophy. While living with a patrician family, he successfully pursued Humanistic studies while also becoming interested in medicine.

The University of Padua’s medical school was one of the finest in Europe and was particularly strong in human and comparative anatomy. This tradition began with Alessandro Benedetti who published a book on human anatomy in 1502 and continued with Andreas Vesalius who graduated from Padua in 1537 and wrote De humani corporis fabrica libri septem (1543; On the Fabric of the Human Body, books I-IV, 1998; better known as De fabrica). Vesalius’s pupil and successor was Gabriel Fallopius, another excellent Paduan anatomist, who then taught Fabricius surgery and anatomy.

After receiving his degree in medicine in 1559, Fabricius taught and did research in anatomy and surgery until he achieved sufficient recognition to take over as professor in these fields at Padua. Fabricius would remain at Padua for the rest of his long and distinguished career.

Life’s Work

Fabricius lived and worked during the scientific revolution, a time when foundational ideas about the universe and human beings were being revised from what they had been in ancient and medieval times. Vesalius, like Fabricius after him, was a scientist who straddled the medieval and modern worlds. Though Vesalius challenged many of great ancient physician Galen’s ideas on anatomy, he accepted most of Galen’s ideas on physiology. Similarly, Fabricius began a revolution in medicine by his accurate and detailed description of the valves in the veins, but he continued to accept Galen’s ideas of the blood’s creation in the liver and its fundamentally unidirectional flow in the human body.

As a young professor of surgery, Fabricius exhibited the conservative tendencies that had characterized most of the history of medicine. In both his writings and practices, he heavily depended on the works of his predecessors. In describing and diagnosing such ills as fractures and dislocations, tumors and fistulas, and in the surgical techniques and therapies he used to remedy them, he followed such classical authorities as Hippocrates and Galen. He wrote popular books on surgery and made many of his own instruments; his fame as a surgeon became so great that nobles from all over Italy came to him for their operations.

Concurrently with his work in surgery, Fabricius continued the Paduan tradition in anatomy but with some important differences. Vesalius had been interested in the structure of the human body, but Fabricius went beyond descriptive anatomy to study the actions and functions of bones, muscles, nerves, and other body parts. Furthermore, he studied the anatomies and physiologies of many different species. According to some scholars, he was the first to establish the field of comparative anatomy, since he dissected many animals not just because of their relevance to humans but because this knowledge was valuable in itself.

He also designed and used his own funds to build an anatomical theater at the university, where, for more than 275 years, first Fabricius and then many other professors instructed thousands of students in the art of surgery and dissection.

Fabricius’s greatest anatomical work was his precise descriptions of the structure and action of the valves in the veins. Although others had previously observed them, Fabricius studied valves in great detail and published a seminal work about his researches. He first noticed the valves in the 1570’s in the course of his dissections. In one of his famous experiments, he wrapped a tourniquet around a subject’s arm, causing the valves to appear as periodically spaced protuberances. He could then illustrate the one-way direction of blood flow by using the pressure of one of his fingers to force the blood out of the vessel between the valves, which would refill when his finger was lifted.

In this way, Fabricius recognized that the venous valves blocked blood flow away from the heart and directed blood flow back toward the heart. Influenced by Galen’s physiological ideas, however, he erroneously interpreted the valves functions as regulating blood flow into the arms and legs for the purpose of nourishing tissues and vital organs.

When the English student William Harvey arrived at Padua in 1599, Fabricius had already done most of his research on the venous valves and was preparing a book on his findings. Harvey became his devoted pupil and resided for a time in his teacher’s house. After spending three years at Padua, Harvey received his medical degree in 1602 and then returned to England, where he became a successful and famous physician and medical researcher in his own right. He once claimed that Fabricius’s discovery of the one-way function of the venous valves was the most important factor that led to his own great discovery of blood circulation. A short time after Harvey left Padua, Fabricius published De venarum ostiolis (1603; De venarum ostiolis, 1603, of Hieronymus Fabricius of Aquapendente, 1933), in which he summarized his nearly thirty years of research on this subject.

Harvey was also impressed by Fabricius’s work in embryology, and in the early seventeenth century, Fabricius began to publish the results of his studies. As with his other medical contributions, his embryological work looked both backward and forward. He was familiar with Aristotle’s studies of the development of the chick embryo and with his ideas about how creatures such as insects can be spontaneously generated from decomposing materials. Unlike Aristotle, Fabricius believed that most insects, as well as many other animals, are born from eggs. Since the mammalian egg could not be seen with the unaided eye, Fabricius did not think that mammals originated from eggs. He also had a deficient understanding of the structure and function of eggs and sperm. He believed that the yolk and albumen in the egg simply nourished the embryo and that the spiral threads that held the yolk in position were responsible for the chick’s origin. Furthermore, Fabricius thought that semen never entered the egg but stimulated the generative process from a distance. Despite the faultiness of these views, his studies of the morphological details of the developing fetuses of a variety of animals, including humans, greatly advanced the knowledge of how these creatures originate, mature, and are nourished in the early stages of development.

Because of his accomplishments as a teacher and researcher, the university kept increasing his salary, thus enabling him to purchase an estate at Bugazzi. Early in the seventeenth century, he was honored with the title of Professor Supraordinarius and given tenure for the rest of his life. Failing health caused him to retire from the university in 1613. His wife died in 1618, and he did not long survive her. He fell ill on May 13, 1619, and died about a week later at his house in Padua. Though he had had an illegitimate son, he left his fortune of more than 200,000 ducats to a niece.

Significance

Some consider Fabricius’s greatest significance to be his teaching rather than his originating new ideas. Fabricius was the product of excellent teaching, and he in turn trained outstanding medical researchers such as William Harvey. Although his insensitivity alienated some of his German students early in his academic career, he matured into Padua’s most popular professor. Padua had an excellent reputation when Fabricius arrived, and his more than sixty years of service further enhanced its preeminence. Fabricius was part of a distinguished and innovative faculty that attracted students from all over Europe. Just as Galileo enhanced Padua’s prestige in physics, astronomy, and mathematics, so Fabricius made its medical program matchless in comparative anatomy and embryology.

Though he remained faithful to many traditional medical ideas, Fabricius was an excellent researcher whose empirical results led him to criticize both ancient authorities and his immediate predecessors. His skill as a physician and surgeon brought him many patients, including such knowledgeable individuals as Galileo. They obviously shared the view of most of his students and fellow professors that Fabricius was the most talented and erudite physician of his time.

Bibliography

Adelman, Howard B. The Embryological Treatises of Hieronymus Fabricius of Aquapendente. Ithaca, N.Y.: Cornell University Press, 1942. In addition to translating some of Fabricius’s most important works into English, Adelman also provides useful information on his subject’s life and work.

Doby, T. Discoverers of Blood Circulation: From Aristotle to the Times of Da Vinci and Harvey. New York: Abelard-Schumann, 1963. This work, written for the general reader, contains accounts of the forerunners and contemporaries of William Harvey, including Fabricius. Nine-page bibliography and name and subject indexes.

Kemp, Martin, “Medicine in View: Art and Visual Representation.” In Western Medicine: An Illustrated History, edited by Irvine Loudon. New York: Oxford University Press, 1997. Written by a team of twenty distinguished medical historians, this book’s material spans medicine in Europe and America from its beginnings to the end of the twentieth century. The article by Kemp contains an analysis of Fabricius’s work on surgery, which was superbly illustrated. Glossary, chronology, and an extensive index.

Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: Norton, 1997. Porter, a social historian of medicine, emphasizes medical theory and practice in this book that blends “erudition and entertainment.” He discusses Fabricius as a great comparative anatomist and an important precursor of William Harvey. Forty-five-page section on further readings and a comprehensive index.