Part 6

On two occasions, probably in the years 1539 and 1540, Vesalius was called from Padua to Bologna to conduct public dissections. This was a great honor, for Bologna was the city in which Mondino had revived the practical teaching of anatomy. These courses were conducted by Vesalius in a wooden building erected for that particular purpose. Here, as in Padua, the professor acted as demonstrator and lecturer, remaining in this ancient city for a period of several weeks. On the first occasion he was supplied with three human bodies and was enabled to handle the subject in grand style. At the first séance he engaged with the celebrated Professor Matthaeus Curtius, whose acquaintance he had made in 1538 while on a vacation trip, in a deep study of the question of venesection. Before a large and select assembly he demonstrated in all three bodies that Galen’s description of the vena azygos was incorrect. On the second convocation Vesalius seems to have disposed of more bodies. He reviewed Galen’s work on the joints, and by numerous specimens, which were prepared by the students, he demonstrated the difference in the ancient knowledge of the skeleton. On this occasion he undertook the complete dissection of an ape and presented its skeleton, as well as that of a man, to Professor John Andreas Albius, who held the chair of Hippocratic medicine in Bologna.

Little is known of the way in which Vesalius taught surgery. The first year he was in Padua, he began with Avicenna’s treatise on tumors. According to the fragmentary notes in the college book of his ardent pupil, Vitus Tritonius, Vesalius compared Avicenna’s teachings with the classical works of Hippocrates, Galen, Paul of Aegina, and Aetius, explaining and correcting them.

CHAPTER EIGHTH First Contribution to Anatomy

Like all great teachers, Vesalius was ever mindful of the interests of his students. Soon after accepting the chair of Anatomy in Padua, he articulated a human skeleton for use in his class room. His next work was the preparation of a set of anatomical plates, _Tabulae Anatomicae_, which were intended to pave the way to anatomy for beginners. For the further benefit of his class, he edited an edition of Guinterius’s _Institutionuin Anatomicarum_, which was issued in April, 1538.

Tabulae Anatomicae

The _Tabulae Anatomicae_ were in the form of _Fliegende Blätter_, or loose leaves, and consisted of six plates which are now among the rarest of medical works. They bore the following title:

_Tabulae Anatomicae. Imprimebat Venetiis B(ernardinus). Vitalis Venetus sumptibus Joannis Stephani Calcarensis Prostrant verò in officina D. Bernardini. a. 1538._

In the preface Vesalius says that no one can learn either botany or anatomy from figures alone, but illustrations are a valuable means toward the imparting of knowledge. In publishing these plates he hopes to benefit those persons who had attended his public dissections. Not a line in these pictures is unnatural; all has been reproduced just as he had shown in his demonstrations. He gives due credit to van Calcar, the artist who made the drawings of the three skeletons. The other pictures were made by the author himself.

The _Tabulae Anatomicae_ were arranged in the following order:—

I.—The Portal System and the Organs of Generation; II.—The Venae Cavae and Chief Veins; III.—The Great Artery—Arteria Magna—and the Heart; IV.—The Skeleton in its Anterior View; V.—The Skeleton in its Side View; VI.—The Skeleton in its Posterior View.

The plates are of large dimensions, measuring over sixteen inches in length, and were cut in wood. Like those in the _Fabrica_, they were made in Italy. Owing to their transient use by medical students, the _Tabulae_ were soon destroyed, although unauthorized editions were printed in several cities. The book was dedicated to Narcissus of Parthenope (Narciso Verdunno, or Vertuneo) who, in 1520, was first physician to the crown of Naples, and later, in 1524, was physician and councilor to Charles the Fifth. It is noteworthy that three of these plates deal with the skeleton, a subject to which Vesalius had given much attention. The absence of a plate showing the nervous system is also to be noted. Vesalius had such a plate prepared, and it appeared in a pirated edition of the _Tabulae_ which was published at Cologne in 1539. The large size of these plates, their fidelity to nature, and the skill with which they were cut in wood, were features which showed to the world that a real master of anatomy had been born. The original drawings were made by Jan Stephan van Calcar, who probably also was the engraver.

Only two copies of the _Tabulae Anatomicae_ are known. A fine edition of these plates, reproduced by photography, was privately issued in 1874 by Sir William Stirling-Maxwell, the talented author of the _Annals of the Artists of Spain_.

CHAPTER NINTH Publication of the Fabrica

On the first day of August, 1542, after three years of strenuous labor, Vesalius completed the _Fabrica_, and twelve days later he wrote the last word of the _Epitome_. The blocks for the _Fabrica_, and also those for the _Epitome_, were made in Italy. In the summer of 1542 they were conveyed to Basel by a merchant named Danoni and were safely delivered to the printer, Oporinus. They were accompanied by a long Latin letter, written by Vesalius to his friend, “Joannes Oporinus, professor of Greek letters in Basel”. He begs Oporinus to take the greatest care that the printed illustrations shall correspond with the proofs which accompany the blocks. “Every detail must be distinctly visible, so that each cut shall have the effect of a picture”. Early in the following year Vesalius went to Basel to superintend the printing of his books. While there, he conducted a demonstration in anatomy—the first which had occurred in that city since 1531—and presented the articulated skeleton of the subject to the University. Part of this skeleton exists today. It is thought to be the oldest anatomical preparation in existence.

The Fabrica

The heart of Vesalius must have filled with joy when he saw the final page of his book turned from the press. The treatise which founded modern anatomy bears this title:—

_Andreae Desalii Brurellensis, Scholae medicorum Patabinae professoris, de humani corporis fabrica Libri septem. Basileae._ MDXLIII

A fortune was lavished upon the illustration and publication of this grand work. To use the words of Fisher, “it was and is a glorious book, a rare and precious monument of genius, industry and liberality”. It abounds with curious initial letters bearing quaint and interesting anatomical conceits, each one teaching its lesson. One of these, reduced in size, introduces the present chapter; and it was this letter that Vesalius used in his opening sentence: _Os caeterarum hominis partium est durissimum & ardissimum, maximaque terrestre & frigidum, & sensus denique praeter solos dentes expers._

The first edition of the _Fabrica_ is a folio volume with magnificent illustrations on wood, all carefully printed by Joannes Oporinus (1507-1568) of Basel.

The title-page is a beautiful engraving which represents Vesalius at work dissecting a female subject. He is surrounded by interested spectators who crowd the amphitheatre. The abdomen of the subject is opened. Vesalius has raised his left hand; his right hand grasps a small rod which rests on the viscera. The great teacher is talking to his pupils. Placed at the head of the dissecting table is an upright skeleton which grasps a long staff with its right hand. In the audience are many persons of different rank. To the left a naked man is climbing a pillar, while to the right, and below, a dog is being brought into the arena. To the left, and below, is a monkey which appears to enjoy the demonstration. Above, in the architecture, we see the monogram of the publisher, Oporinus; in the centre, on a shield, are the three weasels of the Vesalius family, and below, is a shield which bears the privilegium. This old engraving is one of the most spirited and elaborate to be found in the whole range of medical literature. In the 1725 edition, for which Jan Wandelaar made copperplate reproductions of the original figures, the title-page is altered:—the monogram of Oporinus is absent and the architecture is slightly changed.

Who was the unnamed artist? It is noteworthy that Vesalius does not state who drew the illustrations, or who cut them in wood, for his _Fabrica_. He only states that this book has cost him a monstrous amount of labor in the preparation of the dissections, and in the directing of the eye, the hand, and the intelligence of the artist. He complains bitterly of the obstinacy of the artist, who, at times so tormented him that he—Vesalius—considered himself more unfortunate than the criminal whose body had been dissected[21]. It was probably owing to this unpleasant experience that Vesalius omitted the artist’s name. The great anatomist speaks regretfully of the large sums which he was obliged to pay, in order to induce skilled artists to undertake this class of work. He states that they were much more interested in painting Venus and The Graces than in drawing pictures of skinned and foul smelling bodies. Moehsen[22] assumes that Vesalius had Titian in mind when he penned these thoughts, but this is questionable. It is not surprising that eminent artists should have disliked anatomical drawing, at a time when antiseptic injections and preserving fluids were not known. Foul odors had no terrors for the great Belgian, who haunted cemeteries for anatomical material and often kept parts of cadavers in his bedchamber for weeks at a time.

For a period of two centuries the Vesalian pictures were ascribed to Titian, but on insufficient grounds. The famous Venetian painter was over sixty years of age at the time of the publication of the _Fabrica_; his services were much in demand, and he was signally honored by the Spanish emperor, Charles the Fifth. His powers remained undiminished until shortly before his death, which occurred in 1576. He had the ability to make the Vesalian illustrations, but it is doubtful if he had the time. Although Titian may have taken an interest in these anatomical plates, it is not now believed that he drew them.

The Vesalian pictures have been attributed to Christoforo Coriolano; but he could not have been the artist, since his earliest work dates from 1568. He is known to have furnished the drawings for Jerome Mercurialis’s _De Arte Gymnastica_, and for Vasari’s _Lives of the Painters_. Roth is of the opinion that Vesalius himself made most of the illustrations; but such a view would credit the comparatively short and busy life of the great anatomist with too much accomplishment.

I conclude that the illustrations for the _Fabrica_, like the osseous figures in the _Tabulae Anatomicae_, which Vesalius issued in 1538, were made by Jan Stephan van Calcar (+1546), the favorite pupil of Titian. Sandrart[23] states that van Calcar made the drawings for the _Fabrica_; that he went to Venice in 1536 or 1537; that he studied under Titian; and that his paintings were of such merit that they were often mistaken for those of Titian, Raphael, and Rubens.

Van Calcar was a Fleming, a native of Kalcker in the Duchy of Cleves. The date of his birth is not known. His death occurred at Naples in 1546. He was highly esteemed by Vesalius who speaks of him as ranking “with the divine and happy wits of Italy”. The anatomical plates which Vesalius issued in 1538 were made, he states, by van Calcar:—_sumptibus Joannis Stephani Calcarensis_. These plates, which appeared in the form of pictorial broad sheets, or _Fliegende Blätter_, may be likened to the Herald who goes in advance to announce the coming of the King. They were engraved on wood, and, like their companion pictures in the _Fabrica_, they were unprecedented in magnitude and in minuteness.

The Vesalian plates vary greatly in merit. The most satisfactory ones are those depicting the undissected body and the bones and muscles. The artist was not at his best in drawing the nervous system, although it is claimed that Vesalius had prepared his neurologic specimens with great care. For the use of artists, the best plates are the three skeletons and the four entire myologic figures in the _Fabrica_. The first myologic figure, showing a man who has been divested of all skin, fat, and superficial fascia, presents the muscles of the anterior portion of the body beautifully delineated. Vesalius took much pride in this plate, and directed the attention of artists to it. The second plate, which is constructed along similar lines, shows the body in its lateral aspect. The head is thrown slightly backward, the right hand pointing to the earth and the left raised towards the horizon, and the whole attitude of the subject calls to mind the position which an orator would assume when addressing an audience. The third myologic plate is similar to the first one, but the muscles of the face are exhibited to better advantage and the aponeuroses, absent in the first plate, are here present. The fourth plate, which is the ninth in Vesalius’s work (_nona musculorum tabula_), presents the muscles of the posterior part of the body. The other myologic figures show the deeper muscles, layer by layer, and are of value to an artist who wishes to study the effect of their action upon the superficial parts of the body. Hence many of these figures have been reproduced in works on art-anatomy. The artist who studies these plates should remember that the figures in question are divested of skin, fat, and superficial veins—all of which must be supplied, in order to avoid giving too great prominence to the muscles. The two naked figures contained in the _Epitome_ are properly clothed in skin and are of great artistic merit. They also are to be seen in numerous works on art-anatomy. Thus, in one of the earliest books on anatomy for the use of artists (_Abrégé d’anatomie accommodé aux arts de peinture et de sculpture._ Paris, 1667, 1668), Rogers de Piles and François Tortebat have used the three skeletons and seven myologic figures taken from the _Fabrica_ and the _Epitome_. In the preface of his book, de Piles says that he does not think it is possible to produce better figures than those found in the works of Vesalius. That he was not alone in this opinion is shown by the fact that many other artists, who have composed treatises on art-anatomy, have drawn freely from the Vesalian storehouse. An Italian, Giacomo Moro, in his anatomy for the use of artists, (_Anatomia ridotta ad uso de’ pittori e scultore._ Venice 1679), reproduced nineteen of Vesalius’s figures in copperplate.

The popularity of Vesalius’s anatomical figures among painters was due, not only to the intrinsic worth of these illustrations, but also to the erroneous belief that the original drawings were the work of Titian. This opinion found expression on the title-pages of several works on art-anatomy. For example, in 1706, Moschenbauer, of Augsburg, issued a folio volume illustrated with Vesalian figures cut in wood, with this title:—_Andreae Vesalii, Bruxellensis, des ersten besten Anatomici, Zergliederung des menschlichen Körpers auf Mahlerey, and Bildhauer-Kunst gerichtet, die Figuren von Titian gezeichnet_. An anonymous book, _Notomia di Titanio_, appeared in Italy about the year 1670.

The Vesalian figures of the skeleton were also issued in single sheets with moralistic verses appended. Moehsen cites one of these with the inscription printed in French:

“De cet objet affreux tu parois rebutté, Est c’est ce que dans peu cependant tu dois étre: Apprens, mortel, a te connoître Ce miroir est le seul, ou tu n’est point flatté”.

Another legend reminds the reader that he is only dust, and to dust he must return:—“_Vous estes poudre, & vous retournéres en poudre_”.

CHAPTER TENTH Publication of the Epitome

Upon the thirteenth day of August, 1542, Vesalius finished the _Epitome_ of his great book. The text and illustrations for it were forwarded to Basel by the same merchant who conveyed the manuscript and drawings of the _Fabrica_. The title of the lesser work is as follows:—

_Andreae Vesalii Bruxellensis, Scholae medicorum Patavinae professoris, suorum de Humani corporis fabrica librorum Epitome. Basil., et officina Joannis Oporini, Anno, 1543, mense Junio._

This work is extremely rare. It belonged to the class of _Fliegende Blätter_ and was issued unbound. Perfect copies of it are rarely found. The first twelve sheets are printed on both sides; the two last leaves are printed on one side only, in order that they might be cut out and pasted together to show two complete figures. Hence these sheets are often lacking. The _Epitome_ appeared in the same year and in the same month as the _Fabrica_, but the latter work was printed first.

The _Epitome_ is dedicated to Philip, the son of Charles the Fifth, who, after his father’s abdication, was known as Philip the Second of Spain. The title-page is printed from the same plate as the larger work; and Vesalius’s portrait also is present. From the fact that the dedication bears the inscription: _Patavii, idibus Augusti 1542_, the erroneous opinion arose that this work preceded the _Fabrica_.

Among the illustrations found in the _Epitome_ are seven that are not in the large book; namely, five myologic plates, and the figure of a naked man and one of a woman. The myologic figures in the _Epitome_ differ from those in the _Fabrica_ in this respect: the muscles are drawn in their natural position, group, and order, so that the surgeon, in treating wounds and in performing operations, may have the correct relations of the parts in mind. Also, the one side of the figure differs from the other: the one showing the superficial muscles, while the other exhibits the deeper musculature. The muscles in the _Fabrica_, with the exception of four complete myologic figures, are represented as they appear in anatomical demonstrations, particular attention being given to their origins and insertions. For the purpose of the artist, the best figures are the three skeletons and the four complete myologic figures which are found in the _Fabrica_.

Two beautiful copies of the _Epitome_, printed on vellum, are in existence. One is in the British Museum and is thought to be the copy which was owned by the celebrated Dr. Richard Mead; the other one is in the possession of the University of Louvain.

Vesalius speaks modestly of the _Epitome_, which he regards as an index or appendix of the _Fabrica_, and is for the use of beginners in anatomy.

CHAPTER ELEVENTH Contents of the Fabrica

The reputation of Vesalius rests securely upon the _Fabrica_. This grand book, which is dedicated to Charles the Fifth, consists of six hundred and fifty-nine folio pages of text; thirty-four pages of index, disposed in three columns to the page; six pages of preface; and two pages of a letter which is addressed to “Joannes Oporinus, the renowned professor of Greek letters in Basel”. The work is printed in excellent style. The printed page measures 8 by 12½ inches, including the marginal notes. There are fifty-seven lines to a page, averaging twelve words to a line, or approximately seven hundred words to a page. This was written, amid many duties and distractions, in the short period of three years. It is truly a monument of diligence.

The text of the _Fabrica_ is clear and concise; it describes what has to be described and does it well. The errors which Vesalius rectified, and the improvements which he made in anatomy, are so numerous that references can be made to only a few of them. His anatomical writings are of such bulk that they cannot be reviewed adequately within the limits of the present chapter. As regards the _Fabrica_, we may say, with Richardson, that “The dissections and the plates are the book”.

The _Fabrica_ contains the rudiments of anthropology as well as the first illustrations of comparative anatomy. Vesalius portrays a human skull resting upon the skull of a dog. He also shows a simian and a canine sacrum and coccyx, to prove his contention that Galen’s anatomy was derived from dissection of the lower animals. The _Fabrica_ is more than an anatomy. Throughout the work physiology goes hand in hand with the anatomical description. The use and function of each part of the body is given in short, clear sentences.

The _Fabrica_ is built upon a practical plan. It treats of anatomy in a logical manner and is composed of seven books, which deal with the following subjects: (1)—Bones and Cartilages; (2)—Ligaments and Muscles; (3)—Veins and Arteries; (4)—Nerves; (5)—Organs of Nutrition and Generation; (6)—Heart and Lungs; and (7)—Brain and Organs of Sense.

The First Book

Vesalius devotes one hundred and sixty-eight pages to the bones and cartilages, treating these structures with a thoroughness that amazed his contemporaries. He was the first author who correctly described the osseous system as a whole. In numerous instances Vesalius places himself in direct opposition to the opinions of Galen. He denied the existence of the intermaxillary bone in adults, and showed that the inferior maxilla does not consist of two pieces, as has been asserted by Galen. The seven bones of the sternum were reduced to three by Vesalius. He denied Galen’s statement that the bones of the symphysis pubis separate during parturition. He was the first anatomist to give an accurate description of the sphenoid bone. A small aperture at the root of the pterygoid process of the sphenoid bone is called _foramen Vesalii_. Vesalius proved the existence of marrow in the bones of the hand, which had been denied by Galen. In all respects, he wrote more intelligently of the bones than any anatomist who had preceded him.

The Second Book