Part 2

Little more can be said about Edwardes. He seems to have died about 1542,[35] and perhaps this explains why the larger work was never to be published. Perhaps, had he remained at Oxford, he might have established an anatomical tradition, and so provided the influence which his book was not to have. Today only one copy of this little treatise is known, that in the library of the British Museum, and no consideration appears to have been paid to it from Edwardes’s day to the present. However, its virtual extinction was not the result of hard usage by students such as that which determined the almost complete annihilation of Vesalius’ _Tabulae Anatomicae_. As has been said, no contemporary mentioned Edwardes, despite the fact that his book was published in London. The edition must have been a small one, and copies were not likely to have been preserved as other and better works on anatomy began to be imported from the Continent.

Meanwhile the universities continued their drowsy course so far unaffected in any way by the efforts of an alumnus of one of them. The barber-surgeons and surgeons appear to have been equally unproductive of anything new, still leaning upon earlier continental writers. Yet a few individuals recognized the need for improvement. Well before the surgeons of England received official encouragement for anatomical study the surgeons of Edinburgh had asked for and obtained bodies for dissection. On 1 July 1505 the magistrates of Edinburgh granted a Seal of Cause to the Guild of Surgeons and Barbers, and this was confirmed by James IV on 13 October 1506. Among the clauses regulating the practice of the barbers and the surgeons is one giving them the body of one felon each year for an anatomy:

... and that we may have anis [once] in the yeir ane condampnit man efter he be deid to mak antomell of, quhairthraw we may haif experience, ilk ane to instrict vtheris ... and that na barbour, maister nor seruand, within this burgh hantt [practise] vse nor exerce the craft of Surregenrie without he be expert and knaw perfytelie the thingis abouewritten.[36]

Edinburgh, therefore, was the cradle of anatomical study in the British Isles. In England Thomas Linacre had founded the College of Physicians of London in 1518 with the idea of its being a select body of physicians to raise medical standards and maintain them through its power of licensing to practice. The need of more modern surgical texts was indicated by the publication in 1525 of a translation of the work of the late fifteenth-century German surgeon, Hieronymus Brunschwig, which contained a brief section on anatomy, but there appears to have been no attempt to produce a new and up-to-date surgery in England. The fact was that the more advanced books from continental Europe proceeded to smother any continuance of independent native efforts, and in the field of anatomy this makes the early appearance of David Edwardes’s little treatise an astonishing chronological anomaly in the history of English anatomical writing. The importance of anatomy was now to be recognized, but it would be a long time before another native English treatise on the subject was published.

The introduction of the officially recognized, and even encouraged, study of human anatomy into England was the result of influences brought to bear from several sources: the desire of King Henry VIII to improve the practice of medicine and surgery in England and possibly, too, with thoughts for a higher quality of military surgery; and the desire, as well, of some of the more thoughtful surgeons, of whom Thomas Vicary was probably one. So it was that in 1540 the Company of Barbers was united with the Fraternity of Surgeons to form what was called the United Company of Barber-Surgeons of which Thomas Vicary was named Master in 1541, an event handsomely commemorated in a painting commissioned from Hans Holbein the younger.[37]

In the Charter by which the union was officially sanctioned, a statement is to be found which was to be of particular importance to the advancement of anatomical knowledge:

the sayd maysters or governours of the mistery and comminaltie of barbours and surgeons of London, and their successours yerely for ever after their sad discrecions at their free liberte and pleasure shal and maie have and take without contradiction foure persons condempned adiudged and put to deathe for feloni by the due order of the kynges lawe of thys realme for anatomies without any further sute or labour to be made to the kynges highnes his heyres or successours for the same. And to make incision of the same deade bodies or otherwyse to order the same after their said discrecions at their pleasures for their further and better knowlage instruction insight learnyng and experience in the sayd scyence or facultie of surgery.[38]

It is of interest to note that very soon after the Charter had been granted, Thomas Vicary approached the Lord Mayor and Aldermen of London to make sure that the Barber-Surgeons should receive the bodies of the felons for anatomical study. It would seem that the Court of Aldermen were not sure how they should direct their Sheriffs, for the Minutes of the Court for 14 December 1540 state:

... Item, Master Laxton & Master Bowes, Shreves of this Citye, prayed the Advyse of this howse for & concernying the Delyuerye ouer of one of the dedde bodyes of the Felons of late condempned to dethe within this Citye, And requyred of the seyd Master Shreves by Master Vycary & other the surgeons of this Citye for Annotamye, Accordyng to the fourme of an Acte of parlyament thereof lately made. And Agreyd that the same Acte be first seen & then Master Shreves to work ther after.[39]

With human dissection material assured, the United Company proceeded to appoint a Reader of Anatomy, the first perhaps being Thomas Vicary, and although the intervening records of the company are not complete, it is known that in 1546 Dr. John Caius, lately returned from Padua, where he had been acquainted with and even lived for a time with the celebrated anatomist Andreas Vesalius, was appointed and held the position of Reader of Anatomy for the next seventeen years. In his brief autobiography Caius refers to these dissections which he performed ‘for almost twenty years’, and adds, ‘By the wish of the most illustrious prince Henry VIII, King of England, I performed them in London before the surgeons; among the physicians at that time there was no dissection.’[40] It may be assumed, however, that by ‘physicians’ Caius was referring to those of London rather than to those of the universities. Nevertheless, his remark helps to explain the lack of anatomical works which might have competed with those of the Continent. The physicians, although better trained in languages than the surgeons and, we may assume, literary exposition, were as yet not interested in the subject of anatomy.

Nevertheless it does seem somewhat incredible that the physicians were so late in taking up the practice of human dissection. While it is always dangerous to exceed the limits of evidence, this peculiar situation in regard to the College of Physicians of London requires that attention be called to a statute of the college reproduced by Munk who gives it the date 1569-70.[41] According to this authority, the terms employed in the statute, reproduced below in translation, suggest that human anatomical dissection was already being employed by the physicians of the college at the time, although it seems impossible to determine whether or not the reference is to a period earlier than 1565 when Elizabeth granted them four bodies annually for anatomical purposes.[42] However, it seems unlikely that the college, which was so concerned with the enforcement of laws concerning medicine would itself perform an illegal action and therefore that Elizabeth’s grant to the college most likely introduced it to human dissection. Furthermore, one wonders just how frequently the college employed its new right, and in this respect it is interesting to note that there is no reference either to Elizabeth’s grant or to any dissection at all in the _Annals_ of the college as written by John Caius.[43]

Although the study of human anatomy was now officially recognized and regularly pursued, at least in London, it would be incorrect to believe that native English anatomical writings would be forthcoming to continue the course modestly established by David Edwardes. The apathy or even hostility of physicians toward anatomical studies was an obstacle experienced earlier on the Continent and referred to by Vesalius who contributed no small share to the growth of anatomy’s respectability in the eyes of physicians. However, the time lag between the Continent and England had resulted in a disregard of anatomical studies by English physicians at the very times when continental physicians had begun to interest themselves in the subject and publish anatomical studies. As a result it was inevitable that for such Englishmen as were interested in anatomy it was easier to import the more advanced and elaborate continental texts, and dependence on such alien works was for long to be the regular pattern. But even with these advanced, contemporary works available, the practice continued among the surgeons of republishing old and obsolete anatomico-surgical treatises of late medieval times. If such a practice was dictated by an elementary knowledge, certainly the continuance of it would not lead to any development.

In 1544 a Flemish engraver named Thomas Lambrit, better known under his pseudonym of Geminus, engraved on copper a series of anatomical figures plagiarized from the _Fabrica_ and _Epitome_ of Vesalius. Geminus displayed the plates, which are of considerable artistic merit, indeed, the first of high quality to be produced in England, to King Henry VIII. That monarch, aware of the need of anatomical books to bolster the anatomical teaching now in progress, urged Geminus to publish his engravings. Never one to scorn the chance of gain, Geminus proceeded to follow this royal advice in the succeeding year (1545) and added to his plates a dedication to the king and the text of Vesalius’ _Epitome_.[44] For some peculiar reason the completely innocent John Caius has occasionally been blamed as the impetus to this plagiarized publication despite the fact that Geminus states plainly in his preface that Henry VIII was responsible for his decision to publish.

While the illustrations plagiarized from Vesalius may have been of some pedagogical value, the text of the _Epitome_ certainly was no anatomical manual, and the fact that it was in Latin, which many if not most of the surgeons could not read, gave it even less value.

It was perhaps at least partly for these reasons that Thomas Vicary appears to have issued in 1548 an anatomical text in English entitled _A Profitable Treatise of the Anatomie of Mans Body_. No copy of it is known to exist today, and its existence is realized only through mention of it on the title-page of an edition published in 1577 by the surgeons of St. Bartholomew’s Hospital and a reference to it in 1565 by another surgeon, John Halle, who refers to Vicary as ‘the firste that euer wrote a treatyse of Anatomye in English (to the profite of his brethren chirurgiens and the helpe of younge studientes) as farre as I can learne’.[45] However, to refer to the ‘profite’ and ‘helpe’ to be obtained from Vicary’s treatise is to reveal the deplorable state of anatomical studies in England at the time and to cause one to wonder if Halle had read by way of contrast the continental writings of that period. It seems very likely that what has been termed Vicary’s anatomy was nothing other than a copy of a manuscript, presently in the Wellcome Historical Medical Library in London, dated 1392 and merely a compilation of Lanfranc, Henri de Mondeville, and Gui de Chauliac, the most recent of them dead in 1367. Thus not only was Vicary’s work not based upon dissection, except for a secondhand account of crude fourteenth-century autopsy, but it represented a definite case of retrogression.

The next anatomical publication in England was a new edition in 1553 of Geminus’s plagiarized anatomical plates, but this time with an English text by Nicholas Udall, best known as the author of the first important English comedy, _Ralph Roister Doister_, and utterly lacking in knowledge of anatomy. In consequence one may correctly hazard that this work, published with commercial rather than pedagogical motives, would not contribute much to knowledge of anatomy in England, even though the text was now in English. It is true that Vesalius’ descriptions of his illustrations were put into English, the first translation into English of any portion of the _Fabrica_, but the text which now replaced the _Epitome_ of the earlier edition of 1545, like Vicary’s work, is predominantly indebted to that same fourteenth-century manuscript compiled from the writings of late medieval surgeons. Finally, the sheets of this work were reissued in 1559 with a new preface written by Richard Eden which aimed to delude the public into the belief that the publication had been revised.

About this time, too, a small series of anatomical fugitive sheets with superimposed flaps made their appearance in England. One, at least, had two leaves of English text to explain the woodcut and is nearly always discovered bound into the 1559 reissue of Geminus’s book. The fugitive sheets, like their continental predecessors and followers, added very little to anatomical knowledge and must have been for popular consumption.

If we turn now for a moment to give consideration to continental activity during the same period, there is no difficulty in observing the superiority of publications abroad. In 1543 the _Fabrica_ of Vesalius was published, in 1545 the _De Dissectione_ of Rivière and Estienne, in 1555 the revised and much improved second edition of the _Fabrica_, in 1556 _Composicion del Cuerpo Humano_ of Valverde, and in 1559 the _De Re Anatomica_ of Colombo. It is little wonder that these foreign texts overwhelmed the English market and prevented any initiative which might have led to the publication of any but the most rudimentary manuals, presuming that there was in England anyone who had pursued the study of anatomy sufficiently to be in a position to compete with the continental authorities. On the other hand, the superiority of the foreign publications owed part of that superiority to the fact that they were the work of much better educated physicians who had undertaken the study of anatomy, whereas in England the subject was yet very largely under the control of the less learned and less articulate surgeons who thought of anatomy more as a limited body of technical information required for surgery rather than a field of knowledge to be studied for itself and capable of indefinite expansion. David Edwardes had sought to set medicine on the right course, but to no avail. While in time the Faculties of Medicine in the two universities would pay some lip-service to anatomy, yet some considerable time was to pass before they became genuinely interested in the subject.

In 1549 a royal examination of the Oxford statutes led to a declaration that they were ‘antiquated, semi-barbarous and obscure’, and new ones were substituted. In regard to medicine it was declared that before receiving the degree of Bachelor of Medicine the student must see two anatomical dissections, and himself perform two dissections before receiving his licence to practice. Before receiving the degree of Doctor of Medicine he was required to observe two or three more dissections.[46] This, however, seems more likely to have been the ideal than the reality and echoes a similar but normally unfulfilled requirement in fifteenth-century Paris. It is more likely that the frequency with which anatomy was conducted at Oxford would have depended upon the particular interest of the Professor of Medicine, such as Walter Bayley (1529-93) who became Regius Professor of Medicine in 1561 and who at his death left his ‘skeleton of bones in Oxford’ to his successor in the chair.[47] However, no Reader in Anatomy was appointed at Oxford until 1624. Indeed, the founder of the readership, Richard Tomlins, recognized the situation in his grant by noting that the study of anatomy was

more particularly necessary for the faculties and Artes of Phisicke and Chirurgery, the perfection whereof doth much avayle to the safety health and comfort of the whole Commonwealth in the conservation of theire persons: And that there is as yet in neither of the Vniversities of this Kingdome (thoughe otherwise the most florisshing of the whole Christian world) any such Anatomy Lecture founded or established.[48]

If we may believe John Caius, writing after the middle of the century, the first early enthusiasm for Greek studies had worn off among physicians. Caius, himself a very competent Grecist, wrote in advocacy of the study of Greek medicine in the Greek language, that

as each is more capable in his own tongue so he is consistent and always remains himself which contributes much to clarity, since each tongue has its own idioms and inexpressible terms which when translated do not retain the same emphasis or a like grace. In short, translators some times do not understand certain things, elsewhere they fall asleep, do not retain exactness of diction, restrain freedom, and since we are all human and so desirous of variety, from time to time they slip so that not only may there be obscurity but even ambiguity.

Nevertheless, wrote Caius, in his day ‘everyone turns to the Latin editions and no one touches the Greek’.[49]

It is certainly true that after that first generation of men like Linacre, there was little interest in England in the original language of Galen and Hippocrates. The surgeons, certainly, knew no Greek, and the physicians were not interested in anatomy. There was to be little controversy, therefore, as to the meaning of any of Galen’s anatomical terms and less likelihood of investigating and disputing Galenic assertions. Acceptance without demur of the translation was a long step toward unquestioned acceptance of the content of the original. Hence it appears that by the middle of the sixteenth century the authority of Galen in Latin dress, or of his commentators, was not very likely to be opposed. On the Continent it had been instances of questions and opposition which had brought about anatomical advancement by resort to the only arbiter of doubts and questions, that is, the cadaver.

With conditions as they have been portrayed it is no wonder, therefore, that little initiative was displayed in England. The most popular of the foreign works in England, as on the Continent, appears to have been the _De Re Anatomica_ of Colombo which held its position until well after the opening of the seventeenth century. It was excellent for its time, not certainly the equal of the _Fabrica_, but on the other hand much cheaper to purchase, less bulky to hold, and not so detailed as to be confusing. It was probably this particular work in its several editions which more than any other prevented the appearance of a native English anatomical text.

In 1578 John Banister published a book entitled _The Historie of Man, sucked from the Sappe of the most approued Anathomistes_. The title indicates the character of the work, drawn from continental authorities, and especially from Colombo, despite the fact that Banister was Reader in Anatomy to the United Company and therefore in a position to undertake independent researches. Indeed, a contemporary painting shows Banister in his capacity as Reader standing beside an open copy of Colombo’s _De Re Anatomica_.[50]

It is clearly apparent that English anatomy in the Tudor period remained far behind that of the Continent, at least on the basis of such books as were published in England, and thereby renders that modest but early effort of David Edwardes all the more curious.

Edwardes, it must be recalled, had presented his brief treatise in the same form which was being employed on the Continent, and we may assume that it represented his method. What he did was to ignore medieval writers and return directly to Galen, the supreme authority of that age, the ‘Prince of Physicians’. Coupled with this, he had begun to dissect, first, it may be assumed, for better comprehension of Galen but ultimately by Edwardes or his successors, discrepancies between the text of Galen and the observed anatomy would at once have indicated the classic error and the path to knowledge. Such was the course of continental development, but English anatomy of the period was faced by an insurmountable obstacle.

Whereas the medical faculties of continental universities came to accept anatomy, such was not to be the case with English medicine until well into the seventeenth century. As a result, anatomy was not an end in itself but rather a limited field of knowledge learned in so far as it might be usefully applied in surgery.

There were, of course, some Englishmen whose training and knowledge were superior to the quality demonstrated in English texts, men who had had Paduan training such as Caius and Harvey. But even Caius remained a Galenist when continental anatomy had become Vesalian, and Harvey, despite his thoroughly scientific attitude in respect to physiology, remained very conservative in his approach to purely anatomical problems, seeking authority not only in Galen but in the even more ancient Aristotle.

Under these conditions it seems remarkable that such great contributions were made to physiology in seventeenth-century England. The contributions of Harvey, Boyle, Hooke, and Lower form an amazing contrast to the static and even retrograde position of anatomy in the preceding century. In 1565 John Halle, a distinguished surgeon, published his _Anatomy or Dissection of the Body of Man_ which was largely a translation of the surgery of Guido Lanfranc who died in 1315, yet fifty-one years later Harvey had arrived at the circulation of the blood.[51]

NOTES TO THE INTRODUCTION

[1]Maurice Davidson, _Medicine in Oxford_, Oxford, 1953, pp. 15 ff.

[2]H. D. Rolleston, _The Cambridge Medical School_, Cambridge, 1932, pp. 1 ff.

[3]J. F. South, _Memorials of the Craft of Surgery in England_, ed. D’Arcy Power, London, 1886, pp. 14-15; Austin T. Young, _The Annals of the Barber-Surgeons of London_, London, 1890, p. 24.

[4]South, op. cit., pp. 15-18.

[5]Ibid., pp. 20 ff; Young, op. cit., pp. 40 ff.

[6]South, op. cit., pp. 81 ff.

[7]Ernest Wickersheimer, ‘Les premières dissections à la Faculté de Médecine de Paris’, _Bulletin de la Société de l’Histoire de Paris et de l’Ile-de-France_, 1910, xxxvii. 162-3.

[8]_Commentaires de la Faculté de Médecine de l’Université de Paris (1395-1516)_, Paris, 1915, p. 286.

[9]_Cronica Fratris Salimbene_ (Monumenta Germaniae Historica: Scriptores), Hanover, 1905-13, p. 613.

[10]Robert von Töply, in Puschmann, _Handbuch der Geschichte der Medizin_, Jena, 1903, ii. 199.

[11]Ibid., p. 201.

[12]Ibid., p. 209.

[13]M. Roth, _Andreas Vesalius Bruxellensis_, Berlin, 1892, p. 13.

[14]Töply, loc. cit., p. 212.

[15]Ibid.

[16]Montagu Burrow’s, ‘Memoir of William Grocyn’, _Collectanea, Second Series_ (Oxford Historical Society), Oxford, 1890, pp. 332 ff.

[17]J. N. Johnson, _The Life of Thomas Linacre_, London, 1835, pp. 1-12.

[18]G. B. Parks, _The English Traveller to Italy. The Middle Ages (to 1525)_, Stanford, Calif., 1955, pp. 457-60.

[19]R. J. Mitchell, ‘Thomas Linacre in Italy’, _English Historical Review_, 1935, l. 696.