Andreas Vesalius, often referred to as the founder of modern anatomy, was born in Brussels,

Belgium in 1514. His name is the Latinized version of Andreas van Wesel. In 1529, he

undertook a liberal arts curriculum at the University of Louvain, where he studied Latin and

classical Greek. In 1533, he enrolled in medical school at the University of Paris, but he

transferred back to Louvain in 1536 when war broke out between the Holy Roman Emperor and

France. The following year, in order to complete his medical education at a highly ranked and

prestigious medical center, he enrolled at the University of Padua, where he received his

doctorate degree in medicine. Upon graduation on December 5, 1537, he was appointed to two

professorships in Surgery. The following day he began his first of many anatomy demonstrations

("public anatomy"), first in Padua and later in other major Italian cities. In July, 1543 his epic De

Humani Corporis Fabrica (on the Fabric of the Human Body) was published and dedicated to

Charles V., who immediately appointed Vesalius to the imperial court. For the rest of his career,

Vesalius served as a medical advisor/consultant to Charles V and then to his son Philip I. On

his return from a pilgrimage to the Holy Land in 1564, his ship was beset by a prolonged storm.

He became il, possibly due to an infectious disease, and died soon after the ship landed on the

island of Zakynthos, Greece. Details of his final illness have been lost to history.

According to the author of this book, Sachiko Kusukawa, Vesalius was nearly obsessed with

humanism, the Renaissance effort of studying and reviving the writings and achievements of

classical, ancient Greeks and Romans. He was particularly interested in Galen, the Greek

physician and philosopher who had advocated hands on dissection as the best means of

demonstrating anatomy. Vesalius strove to revive this tradition of anatomy throughout his career.

One unintended consequence, however, was Vesalius' discovery of more than 200 errors by

Galen, a problem which Vesalius attributed to Galen's use of mostly monkeys and dogs rather

than humans in his dissections. Vesalius did not hesitate to point out these errors in diplomatic

fashion in his writings.

In addition, as stated by Kusukawa, "Vesalius...considered anatomy a part of natural

philosophy. This meant identifying a purpose for each part of the body." By this concept, the

body was structured to fulfill specific functions. Understanding the function ("purpose") helped to

explain the structure, a message that, in the spirit of Galen and Aristotle, Vesalius always strove

to impart. He wanted to elevate the study of anatomy to a status above a straightforward

mechanical craft practiced by barbers and surgeons.

One theme that runs throughout Andreas Vesalius is the importance of a published book for

an author and his career. A book is very often referred to as "the hallmark of a learned

physician" or "a symbol of learned medicine", an idea that, in modern day terms, roughly

equates with academic achievement through publication. In a Renaissance center of learning

like Padua, published books not only bolstered the authority of their authors and enhanced their

professional careers, but also served as a means of social advancement.

Vesalius, whom the author portrays as clever, opportunistic, and highly ambitious, was

well-aware of these considerations. He had transferred to the University of Padua for his final

year of medical studies in order to get his medical degree from the most prestigious medical

center in Europe. His first published book, The Paraphrase of the Ninth Book of Rhazes..., was

written just before he received his doctorate degree, at a time when a medical doctorate

dissertation was uncommon and not required. Cognizant of the tendency in Padua at that time

to favor humanist scholars, in Paraphrase he modified a medieval writing (a traditional university

text) by the 10th century Arabic physician Rhazes to conform to classical Greek style and

quoted numerous ancient Greek and Roman luminaries along the way. The book was dedicated

to a physician in the court of Charles V.

Vesalius' method of teaching anatomy involved dissecting a cadaver to demonstrate what he

was discussing. Previously, dissections were performed by a barber surgeon while a medical

doctor was lecturing. In public dissections, Vesalius often found students annoying and vice

versa. They tended to be rowdy, paid little attention and disliked the order of his presentations,

which started with the bones and muscles rather than the internal organs. Their questions on

different anatomic issues were often answered by Vesalius urging them to find the answers for

themselves by doing their own dissections. He frequently employed animal parts to supplement

his discussions, and acknowledged that Galen appears to have done the same. One amusing

anecdote that the author recounts involved a public demonstration by Vesalius in Bologna. In

the audience was Professor Mateo Corti, a foremost expert on Galen.

"On entering the theatre, Vesalius declared that 'we must leave Galen and look at the body.' Corti

replied no, 'we must not leave Galen because he always well understood everything, and

consequently we will follow him'".

A war of words escalated from there, and when challenged by Vesalius to come and

demonstrate a particular point, Corti condescendingly stated that he himself was no anatomist

and that Vesalius did not have the "authority or learning to disagree with Galen - or himself." As

one observer concluded, "this clash in the theatre..accomplished nothing."

According to the author of Andreas Vesalius, the above episode actually may have

accomplished something very important, namely a resolve on the part of Vesalius to transition

from the theater, where his authority was questioned, to a book where he might be the

unchallenged authority on anatomy. His efforts turned in that direction, and in July, 1543, at the

age of 28, his magnum opus- Fabrica - was published. Fabrica was 600+ pages long and was

based on Vesalius' anatomic lectures. It consisted of a set of 7 richly illustrated tall books

(chapters), each describing the form and function of a different part of the body, followed by

dissection techniques for that part. Fabrica immediately stood out among anatomy texts

because of the high quality of its artwork and the finely detailed woodcuts. Vesalius exercised

extremely tight control over the production of Fabrica: he chose the illustrators), the publisher

(in Basel rather than nearby Venice "for better distribution throughout the Holy Roman Empire"),

the woodcuts, layout, fronticepiece, fonts, etc. Fabrica was usually sold together with its less

cumbersome condensed version - Epitome - that was smaller in size and contained fewer than

a dozen illustrations. According to the author of Andreas Vesalius, the two sold for the price that

bought 34 meals in a publick house in Basel (by a rough approximation, this calculates to

approximately $1,000-$1,500 in U.S.dollars in 2024). Vesalius often used anecdotes and short

stories to illustrate his points in ways that were more reader-friendly than Galen. As noted

previously, Vesalius' findings were sometimes at a variance with Galen's. Examples include the

demonstration that the heart has no bones and that nerves are not hollow structures. Vesalius is

credited with applying names to several previously unnamed structures in the human body. His

likening of the valve between the left atrium and left ventricle to a bishop's mitre has resulted in

its present designation as the mitral valve. He also applied the names malleus and incus to 2

minute bones of the middle ear. Fabrica did not immediately change the minds of Galen

devotees, but it catapulted Vesalius into the spotlight of the scientific world, earned him an

appointment as imperial physician to Charles V (Vesalius had started the book with a letter

addressed to "the divine, the mightiest, and the most unvanquished" Holy Roman Emperor,

Charles V) and cemented his reputation in anatomy for all time.

The eighth chapter of this book, titled "Vesalius: Surgeon, Anatomist, Physician?"

is perhaps the most interesting. Vesalius looked down on surgeons, who traditionally had done

the manual work in anatomic dissections, were poorly paid, and had no

familiarity with humanist scholarship. There is only very rare mention of surgery or surgical

procedures in Fabrica. As regards physicians, he was clearly affected by the harsh criticism he

continually received from physicians who were ignorant of dissection and blindly devoted to

Galen. He referred to physicians as a bunch of hypocrites, pretenders, and windbags. What did

the father of modern anatomy feel about the designation of anatomist? Ironically, Vesalius never

identified himself as an anatomist. In his writings, he often referred to careless mistakes made

by inattentive anatomists. He appears to have been very status-conscious, and worked at a time

when "an anatomist was too closely linked to the manual aspect of dissection and remained

inferior in status to the professor of medicine." More specifically, he had been referred to as

"Corti's anatomist", and Corti had introduced him as "our dissector," two epithets which must

have rankled him years after the two had had their run-in at the dissection in Bologna. In the

end, there was no specific medical designation with which Vesalius was willing to self-identify.

Andreas Vesalius is an extensively referenced and enormously detailed scholarly work,

written in a pleasant, clear-cut style. It is well-organized, with the author often stating at the

beginning of a chapter exactly what she plans to show later in the chapter. Unlike many books

whose Introduction is best appreciated after the book is read, the Introduction to this book is a

"must read" at the outset, containing concepts like Renaissance humanism that are crucial to

understanding the rest of the book.

However, there are problems with this book. My initial impression was that its size is too small

for its subject matter. Each page is less than 8 ½ " high, in a book focused on Fabrica, whose

pages are twice that height. I needed to use a magnifying glass each time details of an

illustration were discussed. More importantly, some concepts that require explanation are not

adequately dealt with. Renaissance humanism is satisfactorily explained early on, but the term

"natural philosophy", a complex issue involving the study of nature outside of humans, is never

adequately discussed despite its appearance multiple times in the book.

I would have preferred to see something about Vesalius the person beyond Vesalius the

anatomist. It is clear that he was brilliant, cunning, ambitious, and a status-seeker. If he had any

kind traits, the author has kept them out of sight. We see that he married and had a daughter

only in the list of major life events at the end of the book.

Probably the major objection I have with this book is the overwhelming amount of detail

present. It is very easy to miss the forest for the trees. In Vesalius' Paraphrase, when recounting

the numerous contributions from classical Greek physicians in the book's margins, must the

author burden us with each and every name ("Galen, Paul of Aegina, Aetius, Theophrastus,

Pliny the Elder, and Celsus")? In a description of what is involved in the articulation of a

skeleton, is it necessary to spend several pages recounting every step from the ground up?

Details are obviously necessary in a scholarly work such as this, but I cannot avoid the

impression that there is too much "filler" present.

Despite the pleasant style of writing in Andreas Vesalius, it is not an easy read. I believe that

it is more suited for Renaissance history scholars than for the average reader. In view of the

problems noted above, I would give this book a rating of no more than three stars out of five.

 

From De Humani Corporis Fabrica - Libri Septem