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Home , Andreas Vesalius, History of anatomy

A Course in the History of : II

By RICHARDP. AULIE Downloaded from http://online.ucpress.edu/abt/article-pdf/32/5/271/26915/4443048.pdf by guest on 01 October 2021

* Second part of a two-part article. An explanation of the provements in medical curricula, and the advent of author's course for high school teachers, human ; (ii) the European tradition in together with abstracts of two of the course topics-"The Greek View of Biology" and "What Biology Owes the Arabs" , which was influenced by Greek and Arab -was presented in last month's issue. sources and produced an indigenous anatomic liter- ature before Vesalius; and (iii) Vesalius' critical The Revolution in Anatomy examination of , with his introduction of peda- urely a landmark in gogic innovations in the Fabrica. This landmark thus shows the coalescing of these several trends, all - 1- q -thei history of biology is De Humani Corpo- expressed by the Renaissance artistic temperament, and all rendered possible by the new , - 1 P risi tFabrica Libri Sep- engraving, and improvements in textual analysis. - - ~~~tern("Seven Books on the Workings of By contrast with Arab , which flourished the "), in an extensive hospital system, Renaissance anatomy published in 1543 by was associated from the start with European univer- sities, which were peculiarly a product of the 12th- Vesalius of -- ~~~~~Andreas E U I (1514-1564). century West. As a preface to Vesalius, the lectures In our course in the on this topic gave attention to the founding of the of Bologna (1158), Oxford (c. 1167), (See footnote) history of biology we sought to examine not only the internal evidence as Paris (1200), and (1222) -archetypes of our to why the Fabrica is considered such a landmark, own colleges and universities-and examined the but also the antecedent forces responsible for the succeeding eight centuries' record of student life and emergence of so noble a work and the extent to migrations ("cessations"), faculty credentials, the which Vesalius may therefore be considered a part of granting of degrees, trends in medical curricula, and the "." (See, in references, Ve- -as a matter of particular interest today-student salius, 1543; O'Malley, 1965.) rebellions and campus unrest. Three influences on this revolution were identified: Of great importance to Renaissance anatomy was (i) the rise of the European universities, with im- the assimilation, by the faculties of medicine, of the "new science" from the Arab world. Latin transla- Author's address: Department of Biology, Washington Uni- tions of Arab medical works rapidly expanded and versity, St. Louis, Mo. 63130 modified the medieval quadrivium and trivium and An initial capital from the Fabrica. This letter "S" shows eventually rendered them obsolete (Rashdall, 1936; several cherubic children getting ready to dissect a dog. Thus Haskins, 1964). An important step forward was the the unknown engraver whom Vesalius employed displayed beginning of the of first both talent and humor-and perhaps also allowed Vesalius to (the per- poke a little fun at his students. (From the 1543 edition, haps in 1275), probably to verify the cause of death courtesy John Crerar Library.) by (see fig. 1). Soon physicians began to give

271 Vesalius, a student in 1533-1536 at the conservative of Paris, where these Greek texts and occasional dissections had only recently been in- troduced. Soon Vesalius displayed both his growing com- mand of Galen, which he had gained from his re- nowned teacher's new translation, and his skill at dissection, although he had but scant human material at his disposal (see fig. 3). Mention should be made of another renowned member of that faculty, Jacobus Sylvius (1478-1555), who always remained a faithful Galenist. Sylvius did not earn his medical degree until he was about 52 years old, but he then went on to stimulate Vesalius' interest in dissection, probably at first on lower . The strengthening of the Ga- lenic tradition, far from frustrating biology, served as a stimulus to progress. Medicine became a learned Downloaded from http://online.ucpress.edu/abt/article-pdf/32/5/271/26915/4443048.pdf by guest on 01 October 2021 Fig. 1. Perhaps the earliest known picture of the dissection profession, and anatomy, through the work of Ve- of a human : from a Norman or Anglo-Norman manu- salius, a scientific enterprise. script dated about the beginning of the 14th century or per- haps as early as 1275; courtesy Bodleian Library, Oxford Vesalius' critical use of the new Galenic texts University. The female body has been opened from xiphi- quickly bore fruit at the more progressive University to pubic symphysis, apparently by a layman, who of Padua, where he taught anatomy from 1537 to holds the , while a physician and a monk view the pro- 1542, pursued his dissections, revised the Guinter edi- ceedings, perhaps offering advice. Notice that various organs -kidneys, , stomach-are scattered about in untidy fash- tion of Galen, and pushed his Fabrica toward publica- ion. The first dissections were primarily for diagnostic tion (see cover illustration). In the course of his purposes, rather than to study anatomy (Singer, 1957, pp. 73, studies he compared his findings at the dissection 74). table with the Galenic texts: he was asking "whether the method of anatomy could corroborate specula- "" and to write down their own ideas. The tion" (Saunders and O'Malley, 1947, p. 86). He ad- Galenic influence is seen in the work of Mondino de' vanced anatomy when using books I-IX of the Ana- Luzzi (1270-1326; sometimes called the "Restorer of tomical Procedures as his dissection manual. He ad- Anatomy"), whose Anathomia (1316), while record- vanced anatomy even while continuing to support the ing his efforts to verify Avicenna, shows that he him- old Hippocratic vascular conceptions; for example, in self carried out dissections. Mondino thus reempha- attempting to improve on venesection techniques sized the study of anatomy. Also significant was the () he more accurately traced out the work of Berengario da Carpi (c. 1460-1530), whose hemorrhoidal and branches of the azygous. illustrated Short Introduction to Anatomy (1523) Gradually he became convinced that Galen, whom he formed an important link between Mondino and always revered as "the prince of physicians," had Vesalius. The practice of dissection in the medical based his Anatomical Procedures on nonhuman ma- schools, though not rigorous, and the preparing of terials. For example, he stressed Galen's error in anatomic manuscripts with simple diagrams for supposing the lower jaw to be composed of two teaching purposes, indicate a growing and continuous separate pieces. But apparently Vesalius was un- tradition of anatomy in Europe since at least the 13th aware of Abdul Latif's correct observations of three century (Ketham, 1491; Da Carpi, 1535). Eventually centuries before, when he reported (O'Malley, 1965, this tradition, by showing the need for fresh transla- p. 153-154): tions from the Greek, found expression in the "Hu- manistic Revival" in the early part of the 16th cen- The jaw of most animals is formed of two bones tury (Hall, 1956). joined together at the apex of the chin ... In man, Many new editions of Galen emerged from this however, the lower jaw is formed of a single bone ... Galen and most of the skilled dissectors after the movement. They were translated directly from Greek time of asserted that the jaw is not a sources into Latin, and thus they began to compete single bone . . . with Arab influence in Europe (see fig. 2). Among them were the Natural Faculties, prepared by Thom- The history-of-biology lectures on this topic ex- as Linacre (1460-1524) in 1523, and the all-important amined in particular Vesalius' description of the Anatomical Procedures (1531) by Jean Guinter of skeleton and musculature, where he was at his best; Andernach (1505-1574), who was one of Vesalius' his descriptions of the vascular system, where the teachers (O'Malley, 1965, p. 46-61). To repeat the influence of Galen may be noted (see fig. 4); and his observations and experiments that Galen had done experiments, described in the second edi- soon became a natural desire of medical students and tion (1555) of the Fabrica-some of them repetitions physicians who benefited from this new humanism. of Galen. Among them was the youthful and audacious ' insistence on personal dissection, integra-

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Fig. i\"n ancmfwicntiftl"tmU.61i fflile abbas tf Fig. 2. Part of the title page of the Liber Totius Medicinae ("Comprehensive Work on Medicine") by the 10th-century Arab physician Haly Abbas; courtesy John Crerar Library. This European edition in Latin was published in Lyons, France, in 1523. The engraver has Hippocrates, Haly Abbas, and Galen reading from ancient medical works, to show the respect held for the Greek and Arab heritage during the 16th century. But during this time Latin translations of Greek works were also beginning to appear-they were prepared directly from the Greek, not from Arabic: thus Arab works were to have less influence. tion of illustrations with the text, improvement of century ideas of inheritance and species change, as terminology, and critical evaluation of textual represented by the work of Pierre Louis Maupertuis sources, combined to make his work a major contri- (1698-1759) and of Georges Buffon (1707-1788); and bution to the teaching of anatomy, with strong in- 19th-century trends in the study of the role of min- fluences on biology as a whole. For Vesalius, the hu- erals and nitrogen in plant nutrition. man body was a fabrica ("artist's workshop"), Early in the course the students were asked to wherein wrought the divine Creator-Artist. In Ve- prepare a research paper, using materials in Chicago salius was the fusion of the Renaissance artist and libraries. Some of the papers were "The Great Plague naturalist. His achievement at Padua opened fruit- of London in 1665" (John R. Steele), "Sir Peter Med- ful channels of discovery in human anatomy, com- awar, Nobel Laureate" (Mrs. Gary Baker), "Fox- parative studies, and (Hall, 1956). glove (Digitalis): a Short History of Use and Mis- use" (Lucille D. Brown), "The Origin of Osteopathy" From Harvey to Darwin and Beyond (Mrs. Gail Cuneo), "Moses Maimonides and the The three other topics in the major portion of the Study of Asthma" (Nathan N. Levin), "Leonardo da course were "The place of in the Vinci as a Biologist" (Mrs. Willie J. Wilkerson), and History of Biology," "The Problem of Differentiation "William Beaumont and the Chemistry of Digestion" in the 18th Century," and "An American Contribu- (Lawrence R. Radtke). In addition, the students also tion to Darwin's Origin of Species." (For the last- reported informally to their colleagues on what they named, see American Biology Teacher 32 [2]: 85-87.) had found in their research. An ample coffee break Shorter reviews in the time remaining included the each session further encouraged this exchange of rise of scientific societies in the 17th century; 18th- views.

A COURSE IN THE HISTORYOF BIOLOGY:11 273 Fig. 3. Before there were laboratory supply houses and be- fore dissections for study purposes were widely performed and accepted, enterprising students often obtained specimens where they could. This is a 19th-century lithograph showing Vesalius helping himself to a body hanging from a gibbet (Altmeyer et al., vol. 3, p. 47; courtesy State University of Iowa Library). Displaying initiative and dedication, he is standing on the shoulders of his friend in order to perform the acquisition. Notice the vultures. The theft of this male- factor occurred in 1536 when Vesalius was a 22-year-old student in Louvain, . He later confided that "while out walking . . . and looking for bones where the executed criminals are usually placed along the country roads-to the advantage of students-I came upon a dried cadaver. . . . I took advantage of this unexpected but welcome opportunity and, with the help of Gemma [his friend], I climbed the stake and pulled the femur away from the hipbone.... So great

was my desire to possess these bones that in the middle of Downloaded from http://online.ucpress.edu/abt/article-pdf/32/5/271/26915/4443048.pdf by guest on 01 October 2021 the night, alone [later] and in the midst of all those corpses, I climbed the stake with considerable effort and did not hesi- tate to snatch away that which I so desired . . . and prepared this skeleton with such speed that I was able to convince everyone that I had brought it from Paris." (O'Malley, 1965, p. 64, 112-113.) In those days, postmortem examinations for diagnostic purposes were common, but cadavers for study were generally scarce-preservation was impossible. How- ever, the practice of dissecting cadavers, while often facing public disapproval, was probably never expressly forbidden by church or civil law. Later, Vesalius obtained his specimens more easily. He performed public dissections, and a coopera- tive judge even scheduled the time of civic executions in order to provide him with fresh laboratory materials.

Appraisal of the First Course of selected literature, which might be from Harvey's There will be changes, of course, the next time the On the Motion of the Heart and or perhaps course is given. Other topics may be substituted, such something engaging from the writings of Georges as the problem of botanic classification in the 18th- Cuvier (1769-1832) on paleontology. But this first century, as shown in the work of Michel Adanson course at least provided an explanation of what is (1727-1806) and (1707-1778), and an meant by the history of biology: it was a hopeful analysis of French anatomic studies in the early 19th beginning. century and their effect on evolutionary thought, as It is sometimes thought that the history of biology in the work of Geoffroy Saint-Hilaire (1772-1844). is an interesting collection of anecdotes and facts Perhaps there will be a further review of l9th-cen- about the personal lives and discoveries of famous tury views of plant nutrition, with emphasis on the men. This view is erroneous. To perceive the flow of nitrogen cycle. Perhaps there should also be less thought across the ages is to see the sources of our "teacher talk" and more student participation; this own views of organic nature and to begin to learn could be accomplished by means of panel discussions who we are.

Fig. 4 (opposite). This is Vesalius' conception, in Fabrica (courtesy John Crerar Library), of the "venous system," with major emphasis on the vena cava. Of course, he did not think of the veins as connected with the to form a closed "system" of tubes. He gave much more attention to the veins than he did to the arteries, because during the 16th century (and later) physicians placed prime importance on the veins as the basis for phlebotomy, or blood-letting procedures, which Vesalius fully endorsed. This " man" illustrates Vesalius' rapid progress as an anatomy student in his evaluation of Galen by means of dis- section: never before had so much venous detail been recorded by graphic technique. The difference between this picture and a modern diagram of the venous system should not be interpreted as errors on Vesalius' part; rather, they reflect the difficulty he had in quickly observing accurate anatomic relationships in rapidly putrefying materials-formaldehyde was unknown-and the continuing though declining influence of Galen. The Galenic conception is seen in the vena cava as a single, continuous, almost perpendicular trunk; in the brachiocephalic vessels (at the base of the neck), which are nonhuman; in the pronounced cubital veins; and in the quite large external jugular as compared with the internal. Vesalius also has a rather too large azygous vein (just visible in the curve); just above the curve in the vena cava would really be part of the heart (right ); he was unsure of the cranial venous sinuses; and the epigastrics are not quite right. Vesalius denied Galen's view that the vena cava arises from the liver, and so in his picture he has the vessel seem to pass right through where the liver would be located. William Harvey's idea of the circulation, though in a sense made possible by Vesalian anatomy, was to throw considerable light on it and greatly assist further accurate anatomic observations.

274 THE AMERICANBIOLOGY TEACHER, MAY 1970 ,AieND. VESLll 2COPS X C0 OIS INTEGRA ET AB OMNIBVS Downloaded from http://online.ucpress.edu/abt/article-pdf/32/5/271/26915/4443048.pdf by guest on 01 October 2021

A COURSE IN THE HISTORYOF BIOLOGY:I1 275 Acknowledgements.-I am grateful to the five European li- LOVEJOY,A. 0. 1960 [1936]. The , 2nd ed. braries whose staffs readily provided the reproductions Ch. 3, 6-8. from the medieval manuscripts; to Edwin E. Calverley, MEYERHOF,M. 1926. New light on Hunayn ibn Ishaq and his professor emeritus of Islamics at Hartford Seminary in Con- period. Isis 8: 685-724. necticut-missionary, Arabist, and friend, who in 1954, while . 1935. Ibn-al-Hafis (xiiith cent.) and his theory of the we were both teaching at the American University in Cairo, lesser circulation. Isis 23: 100-120 encouraged my interest in the history of biology and in the . 1944. Arabian pharmacology. Ciba symposia 6 (5, 6): culture of medieval Islam; to Fawwaz A. Tuqan of the Uni- 1848-1876. versity of Jordan and Don E. Swanjord of Washington and . 1960 [1931]. Science and medicine. In The legacy of Jefferson College for locating rare works in Arab history; to Islam, ed. by Sir T. Arnold and A. Guillaume. the staff of the John Crerar Library, in Chicago, for making O'LEARY,DE L. 1926. How Greek science passed to the Arabs. available many valuable books from their extensive histori- O'MALLEY,C. D. 1965.Andreas Vesalius of Brussels, 1514-1564. cal collections; and to Louis Szekeres of the Crerar's photo PLATO.Timaeus, trans. by F. M. Cornford (1959). department for preparing prints from these books. My thanks RASHDALL,H. 1936 [1895]. The universities of Europe in the also go to an old friend, Louise P. Olsen, for helpful sug- Middle Ages, 2nd ed. gestions in preparing this essay for publication. RAWLINSON,SIR C. R. 1839. Notes on a march from Zohab ... to Khuzistan . . . to Kirmanshah, . . . in 1836. Journal of the Royal Geographical Society 9: 26-116. (Location of Jun- * REFERENCES di-Shapur: p. 71-72.) ADAMS, F. 1849. The genuine works of Hippocrates. SARTON,G. 1927-47. Introduction to the . Vol. ALTMEYER, J., et al. 1844-45. Les Belges illustres. 1, ch. 29-34. .Generation of animals, trans. by A. L. Peck (1943). SAUNDERS,J. B. DE C. M., and C. D. O'MALLEY.1947. Andreas Downloaded from http://online.ucpress.edu/abt/article-pdf/32/5/271/26915/4443048.pdf by guest on 01 October 2021 . Historia animalium, trans. by D'A. Thompson. Vol. 4 Vesalius Bruxellensis: the bloodletting letter of 1539. of The Works of Aristotle, ed. by J. A. Smith and W. D. 1 . 1950. The illustrations from the works of An- Ross (1910; 1962). dreas Vesalius of Brussels. . Part of animals, trans. by W. Ogle. Vol. 5 of Works SCHACHT,J., and M. MEYERHOF.1937. The medico-philosophical (1912; 1965). controversy between Ibn Butlan of Baghdad and Ibn Rid- AZIZULLAH, M. 1965. Glimpses of hadith. P. 114. wan of Cairo. Egyptian Faculty of Arts pub. 13. BIRUNI. The chronology of ancient nations, trans. by E. Sachau SIASSI, A. A. 1963. L'Universite de Gondi-Shapur et 1'etendue (1879). de son rayonnement. 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On anatomical procedures, books IX-XV, trans. by W. VESALIUS.1543. De humani corporis fabrica libri septem. (Cul- L. H. Duckworth (1962). ture et Civilisation facsimile ed., 1964.) On the natural faculties, trans. by A. J. Brock (1942). On the usefulness of the parts of the body, trans. by M. T. May (1968). HALL, A. R. 1956 [1954]. The scientific revolution, 1500-1800. HAMARNEH, S. 1961. Drawings and pharmacy in Al-Zahrawi's 10th-century surgical treatise. In Contributions from the Museum of History and Technology, U. S. Natl. Mus. Bull. 228. - . 1962. Development of hospitals in Islam. Journal of the and allied sciences 17: 366-384. . and G. SONNEDECKER.1963. A pharmaceutical view of Abulcasis Al-Zahrawi in Moorish Spain. Magazine Features Science Education HARVEY, W. 1628. On the motion of the heart and blood in animals, intro. by M. Graubard (1962). HASKINS, C. H. 1960 [1924]. Studies in the history of medieval Sixteen articles on science education and educa- science, 2nd ed. tional technology are featured in the January 1970 .1964 [1927]. The Renaissance of the twelfth century. issue of the magazine Educational Technology.Some HIPPOCRATES. The theory and practice of medicine. (Citadel ed., 1964.) of the topics discussed are the psychological bases HUNAYN IBN ISHAQ. The ten treatises on the eye, trans. by M. for educationaltechnology, a systems approachto de- Meyerhof (1928). veloping scientificliteracy, individualizingscience ed- HALY ABBAS. Al Kitab al-Maliki [The Royal book]. (Cairo ed., ucation, instructional objectives, the future of re- 1877.) Vol. 1, p. 138-139. (Trans. from the Arabic by present author is basis for statement in article.) mote-access educational systems, a progress report of ISSA BEY, A. 1929. Histoire des Bimaristans (H6pitaux) a the NSTA educational technology project in science, 1'epoque Islamique. In Congres Internationale de Me'decine and a critical appraisal of the potential for educa- et d'Hygiene. Vol. 2, p. 81-209. tional technology in science education (by Stanley E. KETHAM, J. DE. 1491. Fasciculo di medicina, intro. by C. Singer, Single copies of the issue are $3.95 with trans. of the Anathomia of Mondino (1924). Williamson). LECLERC, N. L., trans. 1861. La chirurgie d'Abulcasis. (prices lower for quantity orders) from Educational . 1876. Histoire de la me'decine Arabe. Technology, 456 Sylvan Ave., Englewood Cliffs, N.J.

276 THE AMERICANBIOLOGY TEACHER, MAY 1970