Andreas Vesalius founded modern anatomy. His remarkable 1543 book De humini corporus fabrica was a fully illustrated anatomy of the human body. Based on observations he made during dissections, the book overthrew misconceptions in anatomy that had persisted for over a thousand years.
Vesalius was an anatomy professor at the University of Padua and a physician to Holy Roman Emperor, Charles V.
Beginnings
Andreas Vesalius was born on December 31, 1514 in the city of Brussels. The city was then part of the Holy Roman Empire. Today it is the capital of Belgium. Vesalius was one of four children – he had two brothers and a sister.
His father, Andries van Wesele, was personal pharmacist to the court of Margaret of Austria.
His mother, Isabel Crabbe, raised her children in a prosperous home situated in a respectable neighborhood near the Coudenberg Palace, convenient for her husband’s work.
Vesalius started school aged six, possibly attending the Catholic Brothers of Common Life School in Brussels for nine years. He learned arithmetic, Latin, and other languages, and was given a thorough grounding in the tenets of the Catholic religion. His father was often absent from Brussels on imperial business. His mother, hoping her son would become a pharmacist like his father, encouraged the young Vesalius to make full use of his family’s well-stocked library.
College
At the age of 15 Vesalius enrolled at Louvain University, 20 miles (30 km) east of Brussels. This was a moment of family pride: Vesalius’s father had been forbidden a university education because he was born to unmarried parents.
Typical of the time, Vesalius studied the arts and Latin. He also learned Hebrew and Greek. Graduating with an arts degree in 1532, he was accepted into the University of Paris’s prestigious medical school.
Paris Medical School
Vesalius began his medical degree course in 1533, aged 19.
His education was dominated by the works of Galen of Pergamon, an Ancient Greek physician who had been dead for 1,300 years. Galen’s teachings were considered to be the absolute, unimpeachable truth. Most of Galen’s anatomical observations had come from animal dissections – mainly apes – as it was taboo to dissect humans in his era.
Vesalius was taught anatomy by Johann Guinter von Andernach. Guinter had made himself an expert translator of Galen’s Ancient Greek texts into Latin. Like Galen he believed personal experiences and observations were the best way to gain anatomical knowledge – he believed in getting his hands dirty!
Most human dissections took place solely to teach students that everything Galen and Hippocrates had written was true. During a typical dissection a butcher/surgeon would carry out the cutting work, while the instructor sat high above proceedings, reading a relevant ancient passage aloud. An assistant would help the students by pointing to the body part being discussed. Since the ancient texts could not possibly contain any errors, students were not allowed to ask questions or discuss the dissection.
Academic disputes tended to be about whether translations of ancient works were correct rather than about the science of anatomy.
Guinter von Andernach was a rarity in those times. He allowed his students to perform their own dissections – a practice deplored in most universities. Dissections were generally performed on executed criminals, and it was considered degrading for educated people to handle these contemptible specimens.
Vesalius’s talents impressed Guinter so much that he asked for his assistance with a Galenic anatomy book he was writing, Institutiones anatomicae. The book was published in 1536. In it Guinter heaped praise on his 21-year-old student’s abilities:
“[Vesalius is] a young man… of great promise, possessing an extraordinary knowledge of medicine, proficient in Latin and Greek, and very skilled in dissection of bodies.”
Louvain Medical School
Vesalius was forced to leave Paris in 1536 because war had broken out between France and the Holy Roman Empire. He returned to Louvain University to complete his medical studies.
His expertise in anatomy was quickly recognized. Soon he was asked to observe and comment on an autopsy of an 18-year-old noblewoman who had died suddenly. Dissections of young females were rare. Vesalius was outraged by the surgeon’s lack of skill and took over the autopsy himself.
Despite an acute self-awareness of his growing expertise, he was still dissatisfied with his command of human anatomy. He realized that the ancient texts had taught him as much as they ever could.
Now he needed to demolish the barriers to knowledge built by the professors happy to worship Galen and Hippocrates. To do this he needed cadavers for dissection and bones to examine.
Soon after his return to Louvain, he and a friend found an almost complete cadaver of an executed criminal left exposed to the elements. This was too good an opportunity to miss. That night Vesalius crept back and stole the cadaver, then prepared it as a skeleton for display. He covered his tracks with a tale that he had brought the skeleton with him from Paris.
He became Louvain’s anatomy instructor on an informal basis, demonstrating dissections to his fellow students. In 1537, aged 22, he received his bachelor’s degree in medicine.
Professor of Anatomy and Surgery
Vesalius wanted to become a physician. To do this he needed to qualify as a doctor. With this in mind, he was accepted into the University of Padua, a renowned seat of learning in Northern Italy. Padua’s professors quickly realized that Vesalius was an exceptional student.
They permitted him to sit his final exams almost immediately, and Vesalius was awarded his doctorate just before his twenty-third birthday.
Padua’s senior academics then promptly elected Vesalius to be the university’s professor of anatomy and surgery!
An illustration from Tabulae anatomicae sex showing the body’s veins.
A year into his professorship, in 1538, he published Tabulae anatomicae sex – The Six Anatomical Tables. These were anatomical illustrations with notes compiled from the first public dissection he performed at Padua.
The illustrations presented the liver, the venous system, the arterial system and skeleton.
The book was an immediate success and was plagiarized mercilessly.
Skeleton diagrams and text from Tabulae anatomicae sex.
In 1539 Vesalius’s anatomical research was given a boost by a judge in Padua. The judge had become interested in Vesalius’s work and started supplying him with the bodies of executed criminals for dissection.
By now it had become blindingly obvious to Vesalius that Galen’s anatomy was wrong. However, overthrowing existing ideas can be difficult and sometimes dangerous.
Even in more recent times it has all too often been an uphill battle for new ideas, even when supported by strong evidence, to be accepted. Vesalius had to overthrow the orthodoxy of 1,300 years!
In Tabulae anatomicae sex, rather than show exactly what he had observed in his dissections, he made concessions to tradition. He presented the liver in medieval form as a five lobed flower-like shape. He presented the heart and aorta as Galen had described them – those of apes rather than humans. In the skeleton however, he sneaked in a revolutionary change – albeit a subtle one – presenting a single-boned human jaw rather than the two bones Galen had incorrectly insisted upon.
In addition to this miniature mutiny, Vesalius also became involved in a dispute about venesection – blood letting. Blood letting was routinely inflicted upon unwitting patients in the belief that it could cure them or relieve their symptoms. Physicians were now arguing about where the cut in the vein should take place – near the injury or far from it.
The dispute had flared up because physicians had relied on Arabic translations of Galen’s works – his original works in Greek had not been available in Europe since the days of the Roman Empire. However, the fall of Constantinople had changed that, and Galen’s works could again be studied in the original Greek. Physicians were now discovering that what Galen had said in Greek was sometimes at odds with the Arabic translations they had been using for so long!
In 1539, aged 24, Vesalius wrote a letter about venesection. Although not advocating any revolutionary change, again he broke away from the usual practice: he discussed his own observations of veins rather than second-hand knowledge from the classical texts. Vesalius was now determined to seek the truth through his own original efforts rather than in the works of others.
The Fabrica – A New Anatomy is Unleashed
A muscle man from The Epitome. Courtesy of the University of Cambridge.
Vesalius took sabbatical leave from Padua in 1543, traveling to Basel in Switzerland to finalize the book for publication.
The Fabrica as it is now known was a spellbinding work of about 700 pages in seven volumes. Its visual impact alone – there were over 270 breathtaking illustrations – was tremendous.
Volume 2, for example, presented stunningly detailed ‘muscle men’ who, in a series of illustrations, were shown with increasing amounts of muscle removed to allow the next layer underneath to be seen.
These illustrations are probably the most famous medical images in history.
In fact, the book could be considered a milestone in the history of art as well as science. Sadly, the name of the artist (or artists) who worked with Vesalius is not known.
A remarkable 3D anatomical model from The Epitome. Courtesy of the University of Cambridge.
Not surprisingly, given the richness of its illustrations and its shear bulk, The Fabrica was an expensive purchase, intended for physicians, libraries, and aristocrats.
Recognizing that others might also be interested in his work, Vesalius simultaneously released a practical, more affordable text with fewer illustrations entitled The Epitome.
Many more illustrations were included of male bodies than female, probably because executed male criminals were much more common than similar females.
The Fabrica was the founding work of modern human anatomy. It made a decisive break with Galen and Hippocrates. Vesalius reported what he actually saw in dissections rather than what he was expected to see.
For example:
- There is no bone at the base of the heart – Galen’s description of this bone was in reality referring to cartilage found at the base of the heart in deer and other animals which hardened as the animals aged.
- The sternum has three parts, not seven as Galen claimed on the basis of ape dissections.
- The heart’s septum is not porous. It has no holes in it.
- The origin of the vena cava is the heart not the liver as Galen stated.
- There is no such thing as the rete mirabile – a series of internal arteries which supposedly led from the heart to the brain.
- Men and women have an equal number of ribs – men do not have a missing rib, as was commonly believed.
- Men and women have an equal number of teeth – men do not have more, as stated by Galen.
Most of The Fabrica’s readers were positive about it. It became the go-to book for serious anatomists and physicians. However, some physicians and academics felt threatened by its revelations: they had built their careers on Galen’s work and lashed out at Vesalius.
For example, Jacobus Sylvius, who had actually taught Vesalius in Paris described his former student as:
“the insolent and ignorant slanderer who… treacherously attacked his teachers with violent mendacity and time and time again distorted the truth of nature.”
In saying this, Sylvius may have been exacting revenge on Vesalius who had previously said Sylvius’s teaching methods, which consisted of studying the carcasses of cats and dogs rather than humans, were incapable of advancing the science of human anatomy.
Vesalius dedicated The Fabrica to Emperor Charles V. He also gifted him a special vellum copy of the work. He dedicated The Epitome to Charles’s son, Prince Philip.
Vesalius the Royal Physician
Having brought himself to the notice of the emperor, Vesalius was appointed physician to the imperial household. He resigned his professorship in Padua, becoming the fifth generation of the Wesele/Vesalius family to be in imperial service.
As an imperial physician, he was expected to serve the imperial army. When war broke out he was sent to the battlefield as a surgeon. Accustomed to dissecting dead bodies, at first he struggled to cope with operating on living patients. An experienced surgeon by the name of Daza Chacon helped him learn how to perform amputations quickly.
In the winter of 1543 Vesalius returned to Italy to perform anatomy demonstrations and then returned to military service in spring 1544. He became a fine surgeon.
One of his imperial duties was to embalm the bodies of wealthy noblemen who died in battle. Doing so enabled him to carry out more anatomical research, making notes and observations.
Peace was declared in mid-1544 and Vesalius then returned to caring for the emperor and his court in more comfortable surroundings.
Vesalius’s reputation continued to grow, to the extent that he received mail from physicians all over Europe asking for his advice in their most baffling cases.
In 1556 Emperor Charles V handed power over to his son, Philip.
Grateful to Vesalius, who was now 41, for his loyal service, Charles granted his physician a lifelong pension and gave him the aristocratic title of Count Palentine.
Vesalius continued working, now in the service of Philip rather than Charles.
A Pilgrimage
Vesalius accompanied Philip to live in Madrid, Spain but he did not enjoy life there. Spanish physicians relied on the movement of the planets to help cure illnesses. Dissection of human bodies was forbidden. It all seemed rather backward. Moreover, Philip preferred traditional medical treatments to Vesalius’s modern, scientific ones.
It was clear to Vesalius that he would never become Philip’s chief physician.
In 1561 Gabriele Falloppio, who now occupied Vesalius’s old chair of anatomy at Padua, sent him a copy of a book he had written entitled Observationes Anatomicae. In this book he commented on The Fabrica, pointing out in a friendly way some discrepancies between Vesalius’s work and his own more recent observations. He also let Vesalius know that he was unwell.
In 1564 Falloppio died and the chair of anatomy at Padua became available. In the same year, Vesalius left Spain on a pilgrimage to Jerusalem. This might have been a subterfuge, allowing Vesalius to leave Philip’s court in Spain without hindrance in preparation for a return to Padua.
Various sources persist with the claim that Vesalius was commanded by Philip to make the pilgrimage as an act of repentance. Philip supposedly issued this command after a nobleman’s family denounced Vesalius to the Spanish Inquisition for dissecting the nobleman while his heart was still beating. All of these claims rely a single source, a letter alleged to have been written in 1565 by Hubert Languet, a diplomat. The contents of this letter were most likely fabricated over 50 years after Vesalius’s death. There are no primary records of any accusations against Vesalius. (See O’Malley, page 304, in further reading.)
Some Personal Details and the End
In 1544 Vesalius married Anne Van Hamme. She was the daughter of a wealthy counsellor of Brussels. They had one child, a daughter, born in 1545. They named her Anne.
The family stayed together most of the time, but when Vesalius set out on his pilgrimage to Jerusalem, his wife and daughter returned to Brussels.
Vesalius reached Jerusalem, where he received a letter from Padua inviting him to accept the chair of anatomy and surgery. Unfortunately, Vesalius would never return to Padua.
His return trip from Jerusalem was marred by violent storms. By the time his ship reached port at the Greek island of Zakynthos, Vesalius was desperately ill. He died within a few days.
Andreas Vesalius died aged 49 on October 15, 1564. He was buried on Zakynthos.
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Further Reading
Charles Donald O’Malley
Andreas Vesalius of Brussels, 1514-1564
University of California Press, 1964
Stephen N. Joffe
Andreas Vesalius: The Making, The Madman, and the Myth
AuthorHouse, 2014
Marco Catani, Stefano Sandrone
Brain Renaissance: From Vesalius to Modern Neuroscience
Oxford University Press, 2015