Part 2

The fifteenth century, which was one of the most remarkable epochs in history, was rich in accomplishment. Almost all of the great events which have influenced European commercial and intellectual development can be traced to that period. The invention of printing, the discovery of America, the fall of the Roman Empire in the East, the birth of the Reformation, and the rise of art in Italy, all belong to this wonderful century. In this period, when almost every city in Italy was a new Athens, the Italian poets, historians, and artists vied with the eminent men of the ancient world in carrying the lamp of learning. The Italian cities—Florence, Bologna, Milan, Venice, Rome and Ferrara—fought with one another, not for the spoils of the battlefield but for the victories of science and of art; not so much for the profits of commerce as for the wealth of genius and of learning. The intellectual development which occurred in northern Italy under the rule of the house of Medici, and particularly under the auspices of Lorenzo the Magnificent, forms one of the most interesting periods in European history.

It is impossible in the present work to trace the steps by which the exquisite taste of the ancients in works of art was revived in modern times. Nevertheless, a few words may be devoted to this subject. While much must be credited to those Greek artists who had left their country and had settled in the Italian peninsula, it must be conceded that many of the works of art of the native Italians were not the less meritorious. The same circumstances which favored the revival of letters, operated to further the cause of art; and the same individuals, who were interested in the preservation of the manuscripts of the older authors, also busied themselves with the collection of ancient statues, paintings, gems and tapestry. The freedom of the Italian Republics permitted the minds of men to expand to full fruition; and the encouragement which was given by its rulers to artists, sculptors and artisans, made the city of Florence, in the fifteenth century, a not less renowned centre of culture than Athens had been in ancient times.

The revival of art dates from the time of Cimabue (1240-1300) and Giotto (1276-1336). The former is known as the Father of Modern Painters; the latter constructed the Campanile at Florence. To Giovanni Cimabue, scion of a noble Florentine family, is usually given the credit of being the restorer of art in Italy. He is thought to have been the first painter to throw expression into the human countenance. His work, if judged by present standards, would be called crude, rude and incomplete. Much of the fame of this painter is to be attributed to his being the first person whom Vasari chronicled in his _Lives of the Painters_. For more than a century after the time of Cimabue and Giotto, painters displayed only a smattering of anatomical knowledge.

Early in the fifteenth century two Flemish artists, Hubert van Eyck (1365-1426) and his brother John (1385-1441), in their polyptych of the Adoration of the Lamb, boldly struck out along new lines and committed the unheard-of deed of painting nude figures. Italy, however, was the real birthplace of Art-Anatomy. While the Flemings and others of the North painted everything that they saw, including the nude, the Italians were the first men of the Renaissance who thought of painting the nude figure before draping it. Leo Battista Alberti (1404-1472), in his works on painting, insists that the bony skeleton must first be drawn and then clothed with its muscles and flesh. This was an important step in advance, since it shows that the Florentine artists were progressing towards realism and were breaking away from the symbolism of the early Christian painters and mosaic-workers. The new movement in art found a worthy champion in Antonio Pollaiuolo (1432-1498). In his knowledge of the anatomy of the human figure he surpassed all of the artists of his day; and as a result of his labors he may justly be named the founder of the scientific study of the nude. His knowledge of anatomy was so accurate, and so extensive, that it could have been gained only in the dissecting room.

Under the patronage of Lorenzo de’ Medici and the guiding mind of Pollaiuolo, there occurred a revival of pseudo-paganism in Art. The old Church subjects were largely neglected; mythological subjects again became the fashion; draperies were either modified or were laid aside; and the scientific study of anatomy, both as regards the nude figure and the dissection of the individual parts, became the necessary training of the student. Of all the masters of this period, the palm for excellence in drawing the naked figure must be awarded to Luca Signorelli (1442-1524), from whose work Michael Angelo is known to have profited.

The alliance between skilled anatomists and master artists was of reciprocal benefit. The anatomical studies which were made conjointly by Leonardo da Vinci and the celebrated teacher of anatomy, Marc Antonio della Torre, were lost to the world by the untimely death of the latter, before he had finished a magnificent treatise on human anatomy. Leonardo’s anatomical sketches, if they had been published during his lifetime, would have revolutionized anatomy both as regards discoveries in the body and the teaching of the structure of man. These masterpieces of anatomical illustration long remained hidden from the world; they were published only in the year 1902. Even now their cost is so great that only a few wealthy libraries can possess them. Leonardo’s long unpublished drawings show him to have been a most accurate anatomist. At the same time, he constantly kept in view the aim of fine art, which, in so far as practical anatomy is concerned, needs a knowledge of only the bones and the muscles.

Nor was Leonardo the only artist who made dissections. Raffaello Santi, Michael Angelo, Bartholomaus Torre, Luigi Cardi or Civoli, Jan Stephan van Calcar, Giuseppe Ribera, Arnold Myntens, and Pietro da Cortona studied practical anatomy. Rubens’s long-lost sketch-book[1], which was published one hundred and thirty-three years after his death, shows with what care he had studied human anatomy. Albrecht Dürer’s _Treatise on the Proportions of the Human Body_ is also worthy of mention.

In the number and fame of her Universities, Italy showed supremacy. At the end of the fifteenth century she could boast of sixteen seats of learning, a number equal to that of the combined institutions of Britain, France, Germany, Hungary, Bohemia and Bavaria.

This digression has led us away from the Humanists. Their list is a long one. Among them were Poggio Bracciolini, who discovered the manuscript of the _Institutions_ of Quintilian and the writings of Vitruvius; Poliziano, the first poet of the fifteenth century, and the translator of the works of Hippocrates and Galen; Pontanus, whose _De Stellis_ and _Urania_ were much admired by Italian scholars; Sannazzaro, whose epic on the birth of Christ cost him twenty years of labor; Vida, whose _Christiad_ and other poems were much admired; and Fracastoro, whose _Syphilis_ was hailed as a divine poem.

From the viewpoint of the medical historian an important event occurred in the year 1443, when Thomas of Sarzana, later known as Pope Nicholas V., discovered a manuscript copy of the _De Medicina_ of Aulus Cornelius Celsus. This classic, which had been lost for many centuries, was one of the first medical books to pass through the press. It gave physicians an insight into Hippocratic medicine without the disadvantage of an imperfect translation. Physicians took an active part in the Renaissance. Thus Nicholas Leonicenus, of Ferrara, translated the _Aphorisms_ of Hippocrates and the _Natural History_ of Pliny; and Winter of Andernach did similar labor for the writings of Galen, Alexander, and Paulus Aegineta. Their efforts seem insignificant in comparison with those of Anutius Foesius, a humble practitioner of Metz, who spent forty years of his life in preparing a complete Greek edition of the works of Hippocrates. The New Learning was brought to England by two physicians, Thomas Linacre and John Kaye (Caius).

Some of the Humanists were printers. The history of printing in Italy naturally forms a part of the history of the Renaissance. In 1462, Maintz was pillaged by Adolph of Nassau and its printers were scattered over Europe. Two of them wandered into Italy, living in a village in the Sabine mountains, where, in October, 1465, the first book was printed from an Italian press. It was a Latin edition of Lactantius. Six years later a press was established in Florence. In 1478, Mondino’s _Anathomia_ was printed in Pavia. It has been estimated that before the first year of the sixteenth century, five thousand books had been printed in Italy. In those days the editions were small, 265 copies being considered one edition. An immense amount of labor was required to get out a new edition. First, the manuscripts of the ancient author had to be collected, compared and corrected, this work being done by learned men who resided in the home of the publisher. The corrections were made without the aid of dictionaries, grammars, or book-helps of any kind. The proof was read aloud to the assembled scholars and the final corrections were added. In time, Venice came to be the most noted of the Italian cities in the publishing business, owing chiefly to the family of Aldo. This family of printers became famous for finely printed Greek and Latin books, which are still called Aldine editions. Nine years after the printing of the first book in Italy, the art was practiced in England by Caxton.

Humanism in Italy began to decline toward the close of the fifteenth century. Long before this time it had degenerated into Paganism. The scholars influenced all life, customs and thought. Although the nation remained Catholic, it was such only in name. Everyone bowed before the shrine of classical literature. Even in the christening of children the Christian name was sacrificed to paganism. The saints were forgotten, and the names most frequently chosen were those from heathen mythology. The polite authors described scenes, events and actions in their writings in terms which long since have been banished from good society. A spade was called by its true name. Bembo, the secretary of Leo X., could write a hymn to Saint Stephen or a monologue for Priapus with equal ease and elegance. The amours of the high and the low were flaunted in print. The nation degenerated into an intellectual and sensual state which involved even the Popes. Scholars and rich men alike vied with one another in returning to those pursuits, habits, and methods of thought which had ruled ancient Rome in her most corrupt days.

Such a condition could not exist forever. The turning-point came in 1527, when Charles the Fifth, engaging in war with Pope Clement VII., captured and sacked the city of Rome. After that event everything was changed. Not only had the scholars lost their influence, but many of them had lost their lives. Valeriano, who returned to Rome after the siege, pathetically exclaims: “Good God! when first I began to enquire for the philosophers, orators, poets and professors of Greek and Latin literature, whose names were written on my tablets, how great, how horrible a tragedy was offered to me! Of all those lettered men whom I had hoped to see, how many had perished miserably, carried off by the most cruel of all fates, overwhelmed by undeserved calamities; some dead of plague, some brought to a slow end by penury in exile, others slaughtered by a foeman’s sword, others worn out by daily tortures; some, again, and these of all the most unhappy, driven by anguish to self-murder”. Such was the end of the men who made the Italian Renaissance. The Spaniards, the Inquisition, and the changed policy of the Church prevented a second revival of Humanism.

While the sack of Rome marks the end of the Humanists, the Revival in Medicine continued to grow in vigor and extent. Many of the greatest discoveries in anatomy were made, and most of the important books on this subject were written, in the middle and latter part of the sixteenth century. Italian history is rich in contradictions. While peace, ease and comfort are generally considered to be necessary to the development of science and culture, Italy offers the strange spectacle of the steady increase in medical knowledge in spite of wars and alarms. The Inquisition, which had been introduced from Spain in 1224, was given a new and horrible impetus when, in 1540, Paul III. appointed six cardinals to add to its tortures. One of them, Caraffa, became Pope Paul IV. in 1555, and four years later originated the _Index Expurgatorius_. Torn by civil and foreign wars, and terrorized by the Inquisition, which was not abolished until late in the eighteenth century, Italy gradually lost her commercial and intellectual supremacy. That she should have accomplished so much under such unfavorable circumstances, is now a matter of wonderment.

The origin of the Renaissance in Italy was due to many causes. The early Roman civilization was not entirely blotted out by the invasion of the barbarians of the North. And in the matter of language the Italians possessed an advantage, since the transition from Latin to Italian was easier than from Latin to Spanish, French, English or German. The fertility of the country; the mildness of the climate; the division into semi-independent states; the infusion of new northern blood into the veins of the Italians; the removal of the papal court to Avignon in 1309; and the gradual rise of a powerful middle class, whose members included the devotees of the professions of law and medicine, were factors which determined that Italy, rather than France or Spain, should be the field for the Revival of Letters.

To Italy, then, belongs the glory of having been the first to free herself from the trammels of ancient scholasticism and the fetters of mediaeval theology. She abandoned the wordy dialectics and metaphysical gymnastics of the philosophers of old. In place of mortification, penance and solitary confinement in cloistered monasteries and convents, she began to have a proper conception of the dignity of man and his relation to nature.

Italy, in the time of her freedom, received the torch of learning from Greece; Italy revived its brilliancy, and, when her time of adversity and ruin arrived, she passed it on to the nations of Northern Europe. They in turn have transferred it to America, to Australia, to India, and to the uttermost parts of the earth.

The Anatomical Renaissance

Italy in the sixteenth century was the fount from which issued a ceaseless stream of anatomical discoveries. The ancient and illustrious Universities of Bologna, Pavia, Padua, Pisa and Rome, eclipsed the schools of Paris and Montpellier, of Toulouse and Salamanca; and the Italian peninsula, which, in early mediaeval times, had gloried in the skill of the physicians of Salernum, a second time became the medical centre of Europe. Vesalius and his pupil, Fallopius, taught at Padua; the ancient fame of Bologna was supported by Arantius and Varolius; Vidius, returned from establishing the anatomical school at Paris, taught at Pisa; Eustachius was at Rome, Ingrassias lectured at Naples, and the fame of the New Anatomy spread throughout the world. The Italian cities were filled with students from foreign lands. Padua had more than one thousand new students every year, salaries were paid to her one hundred professors, and medicine was looked upon as a noble profession.

While the Italians were the leaders in progress, the Germans were still lecturing on Galen and Avicenna, the English had done almost nothing, and the Collége de France was not established until 1530.

Legalized by imperial authority and sanctioned by the Church, dissection was no longer regarded as a crime. A bull by Pope Boniface VIII., issued in the year 1300, forbidding the evisceration of the dead and the boiling of their bodies to secure the bones for consecrated ground, as was done by the Crusaders, was wrongly interpreted as forbidding anatomical dissection. Two centuries later the Popes, standing in the vanguard of science, permitted dissections to be made in all the Italian medical schools, and paved the way for the Anatomical Renaissance.

Great things were done in the sixteenth century. Under the scalpel and pen of Vesalius, anatomy was revolutionized. Surgery was guided into new paths by Ambroise Paré; and obstetrics, thanks to the labors of Eucharius Rhodion and Jacques Guillemeau, began to assume its legitimate place among the medical sciences. Servetus, visionary and argumentative, correctly described the pulmonary circulation in a theological work which was burned with its author. Eustachius, Columbus and Fallopius widened the path which had been blazed by Vesalius. Arantius, Caesalpinus and Fabricius added materially to anatomical science. The labors of all these great masters prepared the way for the greatest event occurring in the seventeenth century, namely, William Harvey’s discovery of the circulatory movement of the blood.

CHAPTER FIRST Anatomy in Ancient Times

Egypt and Greece were the sources of the medical learning of the ancient world. Although the Egyptians and early Greeks possessed a certain amount of anatomical knowledge, which was gained in the one instance by the practice of embalming and in the other by an examination of the bones, no real progress could be made because of the laws, customs and prejudices of those ancient peoples. Thus we find the Egyptians stoning the operator who opened the abdomen in order that the body might be embalmed; and the Greeks inflicted the death penalty on those of their generals who, after a battle, neglected to bury or burn the remains of the slain.

In the time of Hippocrates, whose life extended approximately over the period between 460-377 B.C., Greek medicine emerged from the domination of the Asclepiadae, or priests of Aesculapius, who had followed it as an hereditary and secret art. Prior to this time in the numerous Asclepia, or Temples of Aesculapius, votive offerings had been accepted, some of which were of anatomical interest. Thus the Temple at Athens received a silver heart and gold eyes. Pausanias states that Hippocrates gave to the Temple of Apollo, at Delphos, a skeleton which was made of brass. Possibly, as Moehsen[2] believes, this was a metallic figure representing a man who was much emaciated by the ravages of disease. In the Hippocratic writings, some of which are undoubtedly spurious, are few references to the opening of a dead body; and these examinations concern the investigation of the thorax and abdomen in order to determine the cause of death. While the Greek physicians knew little of the human muscles, of the nervous system and of the organs of sense, they were well acquainted with the anatomy of the bones. Their dissections were held upon the lower animals.

It is impossible to determine whether or not the Greek physicians of the Hippocratic period dissected the human body. “It has long been a matter of debate”, says John Bell[3], “whether the ancients were, or were not, acquainted with anatomy, and the subject, with its various bearings, has been much and keenly agitated by the learned. If anatomy had been much known to the ancients, their knowledge would not have remained a subject of speculation. We should have had evidence of it in their works; but, on the contrary, we find Hippocrates spending his time in idle prognostics, and dissecting apes, to discover the seat of the bile.”

Galen[4] states that the ancient physicians did not write works on anatomy; that such treatises were at that time unnecessary, because the Asclepiadae—to which family Hippocrates belonged—secretly instructed their young men in this subject; and that opportunities were given for such study in the temples of Aesculapius.

The first systematic dissections seem to have been made by the Pythagorean philosopher Alcmaeon, who lived in the sixth century B. C., but it is uncertain whether he dissected brutes or men. The cochlea of the ear and the amnios of the foetus were named by Empedocles of Agrigentum, in the fifth century B. C. The nerves were first distinguished from the tendons by Aristotle, (384-322 B. C.), the most celebrated zoötomist of antiquity, who has been called the Father of Comparative Anatomy. For twenty centuries his views of natural phenomena were held in high esteem.

For a long period the early inhabitants of Rome were practically without physicians. During severe epidemics they had recourse to oracles, to the health deities of the Greeks, and to their native gods. As early as the fifth century B. C., during a pestilence, a temple was erected to Apollo as Healer. The worship of Aesculapius was introduced into Rome in the year 291 B. C. Livy relates that the god of medicine in the guise of a serpent was transported from Epidaurus, in Greece, to the Isle of the Tiber where a temple was built in his honor.

The Romans, like the Greeks, were accustomed to leave votive offerings, or donaria, in their temples. Such gifts included surgical instruments, pharmaceutical appliances, painted tablets representing miraculous cures, and great numbers of images of various parts of the human frame shaped in metal, stone or terra-cotta. Among the remains of Roman anatomical art is the marble figure which was unearthed in the villa of Antonius Musa, the favorite physician of the Emperor Augustus. It is a human torso; the front of the chest and abdomen has been removed so as to expose the viscera. The heart is placed vertically in the middle of the thorax, thus corresponding to the position of this organ as described by Galen who made his dissections on apes. It is a human thorax with simian contents. The figure is supposed to have been constructed for the purposes of a teacher of anatomy.

It was in the famous Alexandrian University that human anatomy was first studied systematically and legally.

Alexander the Great, after the fall of Tyre (332 B. C.) and the siege of Gaza, ordered his fleet to sail up the Nile as far as Memphis while he proceeded overland with the army. It was probably on this march, while viewing the pyramids and other marvelous works of the ancient Egyptians, that he conceived the grand idea of founding a city upon the banks of the Nile, which should be a model of architectural beauty, a centre of intellectual life and a lasting monument of his own greatness and magnificence. The foundation of Alexandria was laid by the warrior whose name it bears; but the credit of instituting the Library belongs to one of his lieutenants, Ptolemy Soter.