Reifler. Milestones in OPRS: Discovery of LPS & Subsequent History Supplemental Digital Content (SDC 7) SDC 7: Galenist and non-Galenist contemporaries of Colombo. In addition to the “non-Galenist” anatomists, Vesalius and Falloppio, who were contemporaries of Colombo, other anatomists — “Galenists” and “non-Galenists” — may be mentioned who were also notably active in the early 1550s as Colombo was nearing completion of his De re anatomica. The lives of each of these individuals intersected with Colombo at various points in his life. Colombo knew some of them personally; others he knew by reputation; and one — an as-yet-unknown medical student at Padua who would delineate the origin of the LPS — not at all. As mentioned elsewhere, Colombo was a classmate of the English polymath-scholar and Galenist, John Caius (1510–73) at the University of Padua.a Caius wrote that he “taught at the same hour as Realdo Colombo of Cremona, in the general schools by S. Biagio in Padua, for the schools of the Artists were still in the course of construction at the Bo’ and were not separate from the schools of the jurists.”b Caius remained a steadfast supporter of Galen and his falling out with Vesalius included disputes over Galen’s methodology. The Englishman possessed extensive philological knowledge of Greek and Latin and, in a fanciful reconstruction of a “lost” ancient text, he attempted to more systematically and directly link Galen’s anatomy to Hippocrates and human dissections.c Another Galenist was the Huguenot physician and publisher Charles Estienne (1504–64). In following Galen as Vesalius had done in both editions of the Fabrica (1543 and 1555) Estienne’s De dissectione partium corporis humani (1545)— in three separate illustrations— erroneously depicted the superior pole of the right kidney as situated more cephelad than the left, not the other way around in humans as Colombo was the first to observe.d,e Like Servetus, Estienne also suffered for his faith. He was thrown into a dungeon where he died in the year 1564.f Two additional Parisian Galenists were particularly dominant in mid-sixteenth century medicine: Jacques Dubois [Jacobus Sylvius] (1478–1555), professor of anatomy at the Paris Faculty of Medicine; and Jean François Fernel (1497–1558) a polymath astronomer, mathematician, and physician to Henri II. Reifler. Milestones in OPRS: Discovery of LPS & Subsequent History Supplemental Digital Content (SDC 7) Sylvius, like Johann Winter, was a former teacher of Vesalius and Servetus. As another example of a teacher-student relationship gone bad, Sylvius maliciously expressed a critique of Vesalius with the translated title, A refutation of the slanders of a madman against the anatomy of Hippocrates and Galen (1551).g Sylvius’ colleague, Fernel, also closely followed Galen. Like Colombo, Fernel’s writings —multiple editions of textbooksh—were extremely popular in Europe up until the time of William Harvey, a span of many decades. As Galen did in De usu partium, and as Colombo would do in his separate treatment of vivisection in De re anatomica, Fernel expounded on the functioning of the human body. Fernel’s groundbreaking De naturali parte medicinae [The Natural Part of Medicine] (1542)—the first separate treatment of the subject since Galen— appeared seventeen years before Colombo’s posthumous work. The modern neologism, “physiology,” was used for the first time in the first edition of this work. In 1554, Fernel re- edited and retitled this work as Physiologia, which was to be the first portion of his magnus opus, Universa Medicina. In the preface to Book 2 of Physiologia, Fernel attributed the founding of physiology to Aristotle. The term, physiology, was embraced by Sylvius as early as 1555; it was widely adopted and is now recognized as defining an entire discipline of science.i From a retrospective standpoint, the most notable Galenist anatomist who was a contemporary of Colombo was Bartolomeo Eustachi [Eustachius] (1513–74), a likewise a member of the faculty of the Sapienza in Rome. Like Colombo, Eustachi aspired to write a comprehensive text of anatomy. Though he outlived Colombo by fifteen years, he did not succeed in doing this during his lifetime.j While Colombo was nearing completion of his textbook, Eustachi was apparently farther along in preparing illustrations, though much farther behind in preparing an organized treatise. In 1552, with the help of his relative and assistant, Pier Matteo Pini, Eustachi prepared forty-six copperplate engravings for a comprehensively illustrated text, including one that showed the LPS. In 1564, eight of the forty-seven illustrations (concentrating on the kidneys) were published in six collected monographs known as the Opuscula. This work confirmed an important anatomical fact first published five years earlier by the now deceased Colombo, that, in humans, the left kidney is indeed more cephalad in its position than the right. Reifler. Milestones in OPRS: Discovery of LPS & Subsequent History Supplemental Digital Content (SDC 7) A cult-like devotion to the memory of Eustachi was expressed in a beautiful eulogy 425 years after his death that is undoubtedly the product of nationalistic pride and some whimsy. With the exception of a very favorable review of Colombo by Cunningham (2016),k there is no such worship of the Colombo to be found in the literature. The death of Eustachio, one of the greatest anatomists of the Renaissance, is fundamentally the death of a doctor who neglected himself and his own health to do all he could for his patients. During his lifetime Eustachio did not seek glory, but only wished, this from his own words, that his work would be recognized by his successors. He would not be disappointed: Joseph Hyrtl (1810), in fact, whose opinion is considerable, defined him as an ‘anatomical genius.’ In light of this noble and exemplary figure of a doctor and scientist, who dedicated every day of his life to the ceaseless quest for truth, we can but bow our heads and learn from his enlightened teachings.l None of the published texts or plates in the Opuscula dealt with the eyes, the orbit, or the LPS.m The rest of the plates were forgotten but rediscovered and, combined with the previous monographs, they were published in 1714 by Giovanni Maria Lancisi (1654–1720). Eustachi and Pini had illustrated the length of the LPS in a para-sagittal plane (with orbital bony structures removed and viewed from above) but they erroneously depicted the LPS and rectus muscles as having a common origin from a sheath surrounding the optic nerve, rather than having a separate origin from the bony orbit. Eustachi correctly illustrated the main insertions of the flattened tendon onto the superior tarsal plate. In supplying the missing text decades later, Lancisi almost overlooked the LPS, including its description only at the end of the volume on an unnumbered page of Emendanda, et Addenda, with the insertion, “musculum attollentem palpebram superiorum 50, 18.”n The two numbers refer to a unique, meticulous system of coordinate-mapping of each illustration (a ruled frame as employed in cartography) that Eustachi devised and named, “geometricus gnomon.” The 1714 publication of Eustachi’s illustration of the LPS and Lancisi’s emended text came 155 years after Colombo’s published description of the LPS and 140 years after Eustachi’s death. In the summer of 1555, Colombo found new incentives to finish work on the book that would feature his discoveries in the context of philosophical perspectives and lessons for Reifler. Milestones in OPRS: Discovery of LPS & Subsequent History Supplemental Digital Content (SDC 7) students and practitioners engaged in anatomizing the human body, i.e., in the tradition of the ancient Alexandrian masters. Colombo had no interest in joining the fray between supporters of Galen epitomized by Caius, Sylvius, Eustachi, and others, and he did not join supporters of Vesalius such as Renatus Henerus (1514–64) who offered point-by-point defenses for Vesalius against Sylvius’ attacks.o Even as Henerus’ work came to print in 1555, Sylvius had already died earlier that year. Sylvius’ attack upon his former student was becoming increasingly irrelevant. One younger, non-Galenist contemporary of Colombo will be mentioned for his contribution to the history of the LPS, his contributions to facial plastic surgery, and for his place in the medical history of Bologna. Giulio Cesare Aranzi [Arantius] (1530–89) was a former student of Falloppio at the University of Padua who returned to his native Bologna to receive his medical degree in 1556.p The University of Bologna was the first university to be established in Europe (1088) and was subsequently the site of many important milestones in the history of anatomy and surgery:q The reestablishment of anatomical dissections by Mondino de’ Luzzi (1270–1326) in the fourteenth century; the publication of anatomical texts by Jacapo Berengario da Carpi (1466–1530) that were updated commentaries on Mondino’s work;r and the elucidation of flap reconstructions of the nose by Gaspare Tagliacozzi (1545–99) that merited him the sobriquet, “Father of Plastic Surgery.”s Less well known is that Tagliacozzi’s teacher, Aranzi, performed such plastic reconstructions of the nose at the University of Bologna between 1565 and 1569, “precisely at the time when Tagliacozzi was his student.”t At this institution, about two decades after Colombo’s description of the LPS (and not as a nineteen-year-old student in Padua as claimed by someu), Aranzi traced the origin of the LPS to the sphenoid lesser wing. v References / SDC 7 a O’Malley CD. Andreas Vesalius of Brussels 1514–1564. Berkeley: University of California Press, 1964; 105–6. b Nutton V, ed. An Autobiography by John Caius. London and New York: Routledge, 2018; 66.