J a m e s Ta i t GOODRICH ( N e w York, U.S.A.)

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ANDREAS VESALIUS AND ANATOMY : A RE-EVALUATION OF HIS EFFORTS

One of t h e g r e a t e s t f igures in t h e h i s to ry of a n a t o m y is Andreas Vesal ius . I n 1543, h is m a s s i v e book, De Humani Corporis Fabrica, appea red ; i t a l t e r e d t h e h i s to ry of a n a t o m y a n d sc ience in m a n y w a y s . The Fabrica is of ten p r e s e n t e d by h i s t o r i a n s a s t h e or ig in poin t of m o d e r n a n a t o m y . Analysis of a n a t o m i c a l s tud ie s j u s t p r io r to Vesa l ius sugges t s t h i s m i g h t no t be t h e case . F r o m s t u d i e s of t hese ea r l i e r pre-Vesal ian w o r k s it wil l be d e m o n s t r a t e d h e r e t h a t a h igh level of a n a t o m i c a l soph i s t i ca t ion exis ted. I t wil l be a r g u e d t h a t Vesa l ius w a s n o t a n ind iv idua l w h o o n e day a r r i v e d on the scene a n d comple te ly revolu t ion ized ana­t o m y : R a t h e r , m u c h as sc ien t i s t s h a v e done h is tor ica l ly , h e bu i l t upon a s t ead i ly g rowing founda t ion of a n a t o m y la id a n d developed by t h e a n a t o m i s t s before h i m . T h e e n d r e su l t of today ' s t a lk provides a novel scient i f ic p r e s e n t a t i o n of Vesa l ius ' con t r ibu t ions in f o r m i n g t h e Fabrica, as we l l a s a d i f ferent i n t e r p r e t a t i o n of h is to­r i ca l c u r r e n t s t h a t affected a n a t o m y in t h e s ix t een th cen tu ry .

Mos t m o d e r n wr i t i ngs on h i s to r i ca l a n a t o m y a s s e r t t h a t l i t t le a n a t o m i c a l s t u d y o c c u r r e d in t h e f i f teenth cen tu ry . A c loser e x a m i n a t i o n shows th i s no t b e t h e case a n d t h a t a t i n s t i t u t i ons l ike t h e Univers i ty of P a d u a a n a t o m i e s w e r e c o n d u c t e d f r o m 1404 o n w a r d w i t h a f o r m a l dec ree i s s u e d in 1429 ; in fac t P a d u a a t t a i n e d f a m e as a g rea t a n a t o m i c a l cen te r . I t shou ld be n o t e d t h e r e p u t a t i o n of P a d u a b e c a m e w i d e s p r e a d long before Vesa l ius accep ted t h e c h a i r of a n a t o m y a t P a d u a in 1536. M o n t a g n a n a (d. 1460), a n ear ly a n a t o m i s t a t P a d u a , w h o w r o t e h i s Consilia i n 1444, m e n t i o n e d wi tnes s ing four teen a n a t o m i e s . By 1945 a s t a t u e w a s passed requ i r ing t h a t one m a l e a n d one female pe r y e a r be del ivered to t h e school of a n a t o m y . B y the 16th c e n t u r y i t w a s a n o r d i n a r y o c c u r r e n c e for bodies of execu ted c r i m i n a l s t o be p rov ided to schools l ike P a d u a f r o m a n a t o m i e s .

An i m p o r t a n t I t a l i an f igure of th i s pe r iod w h o c o n t r i b u t e d m u c h to a n a t o m i c a l s tud ie s w a s Leona rdo d a Vinci (1452-1519). I n t h e ear ly 1900's t h e h i s to r i ca l l i t e r a t u r e w a s filled w i t h c o n t r o v e r s y over w h e t h e r Vesa l ius s a w o r w a s inf luenced for Leona rdo ' s w o r k . The a r g u m e n t w a s first p r e s e n t e d by E . J a c k c h a t h in 1902 a n d Holl in 1905 t h a t Vesa l ius ' book, t h e Fabrica, w a s n o t h i n g m o r e t h a n a p l ag ia r i sm of Leona rdo ' s folios. Opposing a r g u m e n t s w e r e p u t fo r th by G a r r i s o n a n d M c M u r r i c h a n d o t h e r s . They a r g u e d t h a t Vesa l ius cou ld no t h a v e seen th i s w o r k because it w a s s e q u e s t e r e d by a f r iend of L e o n a r d o a t h i s d e a t h a n d n e v e r publ ished. Th i s al leged s e q u e s t r a t i o n of L e o n a r d o ' folios h a d led m a n y scho la r s t o ques t ion h i s inf luence on s ix teen th c e n t u r y a n a t o m y . Most w o u l d h a v e u s bel ieve t h a t w i t h Leona rdo ' s d e a t h h i s m a n u s c r i p t d i sappeared .

I t appears ce r t a in Vesa l ius w a s inf luenced by Leonardo , a m a n w h o s e cont r ibu­t ions to a n a t o m y h a v e b e e n u n d e r r a t e d . Whi le proof does no t exis t t h a t Vesa l ius ac tua l ly h a n d l e d Leonardo ' s Folios, t h e inf luence of L e o n a r d o on t h e a r t i s t s , t h e

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a n a t o m i s t s , a n d t h e c o m m u n i t y t h a t p r o d u c e d t h e Fabrica m u s t h a v e b e e n consi­de rab le .

I n 1568 Giorgio Vasa r i pub l i shed h i s Lives of the Most Eminent Painters... Vasa r i w a s a p r o m i n e n t a r t i s t a n d very fami l i a r w i t h t h e I t a l i an a r t i s t s of t h i s per iod, very l ikely t h e a r t i s t s w h o p r o d u c e d t h e Fabrica's g r ea t engrav ings . To provide ev idence t h a t Leona rdo ' s w o r k w a s wel l k n o w n to t h e a r t i s t s and 1 SOS' t o m i s t s of th i s pe r iod a n d easi ly avai lable for s tudy , r e fe rence wil l b e m a d e to t h e w o r k s of V a s a r i a n d o t h e r s .

V a s a r i w r o t e abou t Leona rdo ' s in t en t ion t o publ i shed a m a j o r col lect ion of a n a t o m i c a l t r e a t i s e s in co l l abora t ion w i t h M a r c a n t o n i o Delia To r r e , a n o t h e r excel lent a n a t o m i s t of th is per iod. This co l labora t ion w a s t o yie ld a 120-volume encyc lopaedia on a n a t o m y cal led Quaderni D'Anatomia. Vasa r i w r i t e s on th i s colla­bo ra t ion :

« H e (Leona rdo ) a f t e r w a r d s gave h is a t t en t ion , a n d w i t h i nc rea sed e a r n e s t n e s s , to t h e a n a t o m y of t h e h u m a n f r ame , a s t u d y w h e r e i n Messe r M a r c a n t o n i o Delia Tor re , a n e m i n e n t phi losopher a n d himself d id m u t u a l l y ass i s t a n d ecourage each o ther .

Messe r M a r c a n t o n i o w a s a t t h a t t i m e ho ld ing l ec tu re s in Pavia , a n d w r o t e on t h e s a m e sub jec t , h e w a s one of t h e f irst , a s I h a v e h e a r d say, w h o began to apply t h e doc t r i ne s of Galen to t h e luc ida t ion of m e d i c a l sc ience , a n d to diffuse l ight over t h e sc ience of a n a t o m y , w h i c h up to t h a t t i m e , h a d been involved in t h e a l m o s t to ta l d a r k n e s s of ignorance . I n th i s a t t e m p t , M a r c a n t o n i o w a s wonder fu l ly a ided by t h e genius a n d l abou r of Leonardo , w h o filled a book w i t h d r a w i n g s in r e d c rayon , ou t l ined w i t h t h e pen, all copies m a d e w i t h t h e u t m o s t c a r e f rom t h e bodies d i s sec ted by h is o w n hand. . . » I t is obvious f r o m th is passage , t h a t L e o n a r d o ' s w o r k w a s ava i lab le to the a r t i s t , a n d t h a t it m a d e a g rea t impres s ion upon t h e m i n d s of h i s c o n t e m p o r a r i e s . T h e g e n t l e m a n to w h o Vasa r i r e fe r s , F r a n c e s c o d a Melzi, m a d e t h e paper s of L e o n a r d o avai lable to all w h o w i s h e d to see t h e m . Th is is verif ied in t h e wr i t i ngs of o t h e r a r t i s t s : — 1523 : Melzi w r i t e s h e m a d e h i s i nhe r i t ed papers of L e o n a r d o avai lable t o h i s

« fellow p a i n t e r s ». — 1537 : Anon imo G a d d i a n o in h is De Subtilitate gives a descr ip t ion of Leonardo ' s

folios a n d no te s h e s a w t h e m a t t h e Melzi r es idence . G a d d i a n o c o m m e n t s o n t h e re la t ionsh ip of Vesa l ius t o Leona rdo .

— 1540 : Lomazzo — Idea Del Tiempo Delia Pittura. A Mi lanese p a i n t e r w h o men­t ions in th i s w o r k a visi t t o Melzi to see L e o n a r d o ' s w o r k .

— .1549 : B iondo in h is Eulogy of Painting m e n t i o n s L e o n a r d o w o r k on a n a t o m y . — 1568 : B e n v e n t o Cellini i n t e n d s to publ ish s o m e of L e o n a r d o ' s w o r k . — 1584 : Borgh in i in h i s Riposo m e n t i o n s Leona rdo ' s a n a t o m y of t h e h o r s e a n d m a n . On t h e bas is of t h e c o m m e n t s p r e sen t ed above, it is c lea r t h a t a t l eas t in t h e S ix t een th Century , L e o n a r d o ' s folios w e r e easi ly avai lable for inspect ion .

Leonardo , in h i s Treatise on Painting p rophe t ica l ly p red ic t ed t h e scenic s tyles of t h e Fabrica p l a tes w h e n h e s t a t e d : « All t h e f igures in a pa in t i ng ough t t o be in a n a t t i t u d e su i table t o t h e subjec t they r e p r e s e n t ; so t h a t in v iewing t h e m one m a y easi ly k n o w w h a t they t h i n k a n d w h a t they w o u l d say. T o ass i s t your i m a g i n a t i o n in th i s su i t ing t h e a t t i t u d e s t o the f igures , cons ide r a t ten t ive ly t h e g e s t u r e of m u t e s , w h o express t h e t h o u g h t s a n d concep t ions of t he i r m i n d by t h e m o t i o n s of t h e i r eyes, h a n d s , a n d t h e who le body... »

I t w o u l d be in t r igu ing to specu la te w e t h e r Vesa l ius p lagiar ized f rom Leona rdo ' s w o r k . This i s sue wil l be con t rove r s i a l un t i l m o r e def ini te ev idence su r faces . B u t t o say t h a t Leona rdo ' s w o r k d id no t c o n t r i b u t e s ignif icant ly to t h e Fabrica is a n incomple te ana lys i s of t h e h i s to r i ca l ev idence . The Fabrica is m a i n l y a n effort of a r t i s t i c t a l en t developed by one of t h e g rea t schools (T i t i an) of I ta ly . I t s eems fair

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t o say t h e a r t i s t s w e r e in f luenced by t h e avai lable folios of Leonardo , by Leona rdo ' s th ree -d imens iona l d i scuss ion a n d p r e sen t a t i ons , a n d by Leona rdo ' s knowledge of a n a t o m y , w h i c h w a s infini tely super io r to med ieva l a n a t o m y . T h e m o s t obvious conc lus ion is t h a t L e o n a r d o h a d a m a j o r inf luence u p o n th is per iod. This ev iden t by t h e w i d e s p r e a d d i s t r ibu t ion of h i s w o r k a m o n g t h e a r t g roups .

To c o n t i n u e th i s d i scuss ion of a n a t o m i c a l s t ud i e s of t h i s e r a t h e n e x t i m p o r t a n t f igure is J acopo B e r e n g a r i o d a Carpi (1470-1530). I n 1521, shor t ly a f te r L e o n a r d o died, a th ick oc tavo b o o k appea red w r i t t e n by B e r e n g a r i o comple te w i t h a n a t o m i c a l i l lu s t r a t ions a n d f ront i sp iece w i t h a d i ssec t ion scene . This book, a c o m m e n t a r y on M o n d i n u s ' a n a t o m y , w a s w r i t t e n b y one of t h e leading a n a t o m i s t s of t h e R e n a i s s a n c e a n d professor a t Bologna. T h a t h e w a s ac t ive in a n a t o m y is ev iden t f rom his o w n wr i t i ngs w h e r e h e no te s t h a t h e d i s sec ted over o n e h u n d r e d bodies . Be renga r io ' s w o o d c u t s , t h o u g h t no t offering t h e e legance of Vesa l ius , c o n t a i n surpr i s ing ly a c c u r a t e r e p r e s e n t a t i o n s w h e n c o m p a r e d to the ea r l i e r w o r k s . Th i s book ca r r i e s on a n I t a l i an t r a d i t i o n of r e d u c i n g t h e inf luence of Galen a n d o t h e r « a u t h o r i t i e s » . Be renga r io in h i s t ex t on M o n d i n u s decr ies t h e hab i t of a n a t o m i c w r i t e r s w h o follow a u t h o r i t i e s l ike ca t t l e a n d w a r n s t h e r e a d e r n o t to be deceived by s o m e of o u r m o d e r n s w h o involve a n a t o m y w i t h a u t h o r i t i e s a n d no t w i t h observa t ion . H e says a lso t h a t h e a lways accep t s Galen ' s v iews except w h e r e obse rva t ion is a t d i scord w i t h t h e m . Be renga r io w a s n o t subse rv ien t to t each ings of t h e anc i en t s , bu t w a s capab le of obse rva t ion a n d i n t e rp r e t a t i on — skil ls he ld by s o m e h i s t o r i a n s to h a v e developed f i rs t w i t h Vesa l ius s o m e t w e n t y y ea r s l a t e r .

I n 1545 t h e r e appea red f rom t h e p resses of S i m o n de Colines t h e m o s t cos t ly book done by th is shop, a u t h o r e d by Char l e s E s t i e n n e (1503-1564). I t w a s to h a v e b e e n publ i shed or iginal ly in 1539, b u t legal ac t ions de layed i t s publ ica t ion un t i l 1545. T h e book con ta in s t h e f i rs t examples of whol ly i l l u s t r a t ed ex t e rna l venous a n d ne rvous s y s t e m s . The book excells pa r t i cu l a r ly in neuro log ica l i l lus t ra t ion . E s t i e n n e se lec ted a m o t t o of Galen for h i s book : « An obse rvor of n a t u r e shal l n o t t r u s t a n a t o m i c a l books b u t only h i s o w n vision. » E s t i e n n e w a s a m o n g those a n a t o m i s t s of th i s e ra w h o s t r e s s e d the i m p o r t a n c e of p i c tu re s for c o m m u n i c a t i o n ; o n e cou ld t h e n deal w i t h vision a n d image i n s t e a d of re ly ing solely on t h e w r i t t e n w o r d . I n h i s w o r k s t h e r e a d e r sees a n open c r i t i c i sm of Galen, c r i t i c i sm w h i c h h e in t u r n suppor t ed w i t h his o w n obse rva t ions . Again w e see a n or ig ina l inves t iga to r w h o w a s n o t a servi le fol lower of Galen.

The nex t i m p o r t a n t f igure in th i s s t u d y is Nicholas M a s s a (d. 1569) w h o in 1536 pub l i shed a q u a r t o size v o l u m e s e n t i t l e d Liber Introductorius Anatomiae. This book , w h i c h h a s no p la tes , shows t h e a u t h o r t o be a m a n of e n o r m o u s ego a n d a r r o g a n c e ; and , l ike so m a n y of th i s gene ra t ion , a fol lower of M o n d i n u s . I t s i m p o r t a n c e lies in the fact t h a t t he a u t h o r w a s a su rgeon w h o in s i s t ed t h a t s t u d e n t s a n d t e a c h e r s a l ike m a k e m a n y a n d v a r i e d d i s sec t ions a n d avoid t h e subse rv ience of t h e au tho r i t i e s . On t h e concep t of a d h e r e n c e to t h e au tho r i t i e s M a s s a m a k e s t h e fol lowing c o m m e n t in C h a p t e r 32 on the d i ssec t ion of t h e t o n g u e : « ... if s o m e t i m e s w r i t e r s w o u l d l i s ten t o Galen ' s advice a n d t r u s t t h e a n a t o m y books less a n d if w i t h the i r o w n h a n d s they w o u l d t ouch the b o d i e s of m e n a n d w r i t e d o w n w h a t they see a n d feel... I sha l l no t cease to des i re t h a t t h e d i s p u t a n t s i n t h e s e m a t t e r s shou ld t r u s t t h e m s e l v e s en t i re ly t o the i r senses a n d p u t a s ide soph i s t i ca ted r eason ing , as t h e anc ien t w i se m e n w e r e a c c u s t o m e d to do ; they d id n o t d i sda in t o d issec t t h e bod ies of va r ious l iving c r e a t u r e s in t he i r s e a r c h for t h e t r u t h . » L a t e r in th i s c h a p t e r h e says aga in on th i s sub jec t of a d h e r e n c e t o t h e anc i en t s « ... s ince w h a t I h a v e sa id does no t con fo rm to w h a t is sa id on t h e sub jec t by anc ien t w r i t e r s a n d wil l t h u s be a m b i g u o u s to m y r e a d e r s , I beg t h e m t o lay as ide a r g u m e n t s a n d d i scusses t h e s e difficult ies w i t h a knife t h a t c u t s by d i s sec t ing ». These quo tes s h o w us a n ind iv idua l , w h o s o m e y ea r s before Vesa l ius , a r g u e d of or ig inal a n d i n d e p e n d e n t inves t iga t ion .

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B a r t o l o m e o E u s t a c h i u s (1524-1574) w a s a t rue ly e m i n e n t scho la r ; bu t a v i c t im of c i r c u m s t a n c e s , h e neve r rece ived t h e h o n o r of d i s t inc t ion h e dese rved . A con tem­po ra ry a n d c r i t i c of Vesa l ius , h e d id m u c h in t h e w a y of or iginal inves t iga t ion . H e h a d c o m p l e t e d h i s Anatomical Engravings in 1552, b u t t hey w e r e n o t t o be publ i shed un t i l 1714.

E u s t a c h i u s w a s a severe c r i t i c of Vesa l ius , so m u c h s o h e w o u l d no t even refer to Vesa l ius by n a m e . E u s t a c h i u s w a r n e d s t u d e n t s t o r e a d Vesa l ius c r i t i ca l ly s ince h is tex t a n d i l lus t r a t ions w e r e n o t a lways a c c u r a t e . I n one sec t ion of his publ i shed wr i t i ngs h e " a t t a c k s Vesa l ius for pub l i sh ing a can ine k idney , t h i s is a t ex t on h u m a n a n a t o m y .

I t is i n t e r e s t i n g t o n o t e t h e sober s ty le of E u s t a c h i u s f igures . They lack t h e d y n a m i c s a n d appeal of Vesa l ius ' f igures yet a r e a n a t o m i c a l m o r e a c c u r a t e . I t is as if t h e w o r k is a skillful aff ront to Vesa l ius ' s w h o m E u s t a c h i u s dis l iked. I n h i s p la tes one no t e s an a l m o s t su r rea l i s t i c approach , occas ioned by t h e m a t h e m a t i c a l prec is ion E u s t a c h i u s u s e d in h i s f igures .

This , it is a p p a r e n t t h a t , c o n t r a r y t o t h e v iews of m a n y h i s to r i ans , Vesa l ius d id no t s ing lehanded ly revolu t ion ize a n a t o m y . In s t ead , t h e r e w a s a g r a d u a l ye t comple te t r a n s i t i o n f r o m med ieva l a n a t o m y in to R e n a i s s a n c e a n a t o m y . I n a span of less t h a n for ty years , a t r an s i t i on o c c u r r e d f rom scho la r s l ike Leonardo , Berengar io , a n d Es t i enne , w h o p rov ided t h e founda t ion for a n a t o m i s t s l ike Canano , Vesa l ius , a n d E u s t a c h i u s . R a t h e r t h a n being t h e sole b r igh t , innova t ive a n a t o m i s t w h o a lone s a w e d off h i s Galenic shack les , Vesa l ius w a s a n a n a t o m i s t w h o u s e d t h e w o r k of his p r edeces so r s .

Vesa l ius d id have a superb m i n d , a n d h e d id p re sen t m a n y convinc ing r e b u t t a l s of Galen. B u t in th i s s a m e per iod t h e r e w e r e o t h e r g rea t m i n d s a l so do ing i n t e r e s t i ng a n d or ig ina l scient if ic inqui ry . Are w e to give lesser c r e d i t t o Colombo, Es t i enne , Be renga r io , Copernicus , Ferne l , Fa l lopius , a n d o t h e r s for o r ig ina l land­m a r k inves t iga t ions ?

A final t h o u g h t : We h a v e seen h o w Vesa l ius ' scientif ic w o r k developed. O t h e r t h a n his m a j o r effort w i t h t h e Fabr ica , h i s w o r k w a s mos t l y Galenic c o m m e n t a r i e s , a n d d i scourses on b lood le t t ing a n d on t h e China Root . Wi th t h e publ ica t ion of t h e Fabrica, Vesa l ius becomes a King 's phys ic ian a n d a scient i f ic m u t e . Twelve y ea r s l a t e r (1555) t h e second ed i t ion of t he Fabrica appeared , m o r e beaut i fu l t h a n ever because of t h e improved skills of h i s p r in t e r . T h e scientif ic a d v a n c e s of t h i s v o l u m e w e r e m i n o r , except for s o m e n e w b u t m i n i m a l expe r imen ta l d a t a . On th is point J o h n F u l t o n h a s c o m m e n t e d : « As a book, t h e Fabrica h a s probably been m o r e a d m i r e d a n d less r e a d t h a n any publ ica t ion of equa l s ignif icance in t h e h i s to ry of sc ience. » I n t h e s econd ed i t ion , Fu l t on m a d e a n ana lys i s a n d no t e s t h e changes a r e compara t ive ly u n i m p o r t a n t . The l ack of scientif ic p roduc t ion h e r e leads one to a sk : W h a t h a s h a p p e n e d to th is c rea t ive m i n d over twelve y e a r s ?

I t m i g h t s eem t h a t Vesa l ius ' i m p o r t a n t con t r ibu t ion w a s b r i ng ing t o g e t h e r a g rea t p r in te r , a superb engraver , a n d a school of wel l - t ra ined a r t i s a n s u n d e r t h e d i r ec t ion of a ski l led c r a f t s m a n . His c o m m e n t a r y on t h e engrav ings , whi le provo­cat ive, a n d ce r ta in ly no t in te l lec tua l ly b a n k r u p t , p roved too obscu re t o b e useful t o t h e ave rage physic ian . If Vesa l ius ' one a c h i e v e m e n t h a d been in the idea for t h e v o l u m e a n d then t h e r e c r u i t m e n t of people to do it, t h e n th is w o u l d h a v e been t rue ly a g rea t con t r ibu t ion . B u t Vesa l ius p rov ided l i t t le r ecogn i t ion of h i s col leagues a n d apparen t ly m a d e effort no t to revea l t he iden t i ty of h i s con t r i bu t ing c o n t e m p o r a r i e s .

I w o u l d l ike t o k n o w leave w i t h a f inal t h o u g h t : T h e r ea l va lue of a m a n ' s w o r k can only b e e s t i m a t e d w i t h a n app roach to

a c c u r a c y w i t h it is seen aga ins t t he b a c k g r o u n d of t h e in te l l ec tua l life of h i s t i m e : When h is con t r i bu t ions to the wor ld ' s t h o u g h t a r e conf ron ted w i t h ideas of h is c o n t e m p o r a r i e s , w h e t h e r they r u n t o g e t h e r in h a r m o n y o r d iverge in to inde­p e n d e n t ways of deve lopmen t .

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