Vesalius and the New Anatomy

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LECTURE

Vesalius and the New Anatomy.

I. Galenic Anatomy.

II. Andreas Vesalius and the New Anatomy.

A. Early Life and Education.

B. De Fabrica and the Reformation of Anatomy.

III. Anatomy after Vesalius

[Eidelstein 1943; Lind 1975; O'Malley 1964; O'Malley 1965; Saunders & O'Malley 1973; Wear 1990; Webster 1982]

I. GALENIC ANATOMY.

I WANT NOW TO TURN TO ANOTHER -- AND VERY DIFFERENT -- ATTACK ON GALENIC MEDICINE; NAMELY, THE NEW FOUNDATIONS GIVEN TO HUMAN ANATOMY BY THE WORK OF ANDREAS VESALIUS.

ONE COULD SCARSELY IMAGINE A GREATER CONTRAST THAN THE ONE BETWEEN THE CAREER -- IF THAT'S WHAT IT IS TO BE CALLED -- OF PARACELSUS AND THE CAREER OF VESALIUS.

THE ONE WILD, VOLATILE, AND UNCOMPROMISING; THE OTHER CONTROLED, DISCIPLINED, AND PREDICTABLE.

YET VESALIUS, THE BRIGHT YOUNG MEDICAL PROFESSOR WORKING WITHIN THE ESTABLISHED ACADEMIC COMMUNITY, PRODUCED A CRITICISM OF GALENIC ANATOMY AS PROFOUND AS PARACELSUS' REJECTION OF GALENIC MEDICAL THEORY.

SINCE VESALIUS' ACCOMPLISHMENTS ARE INSEPARABLY BOUND TO HISMASTERY OF HUMAN DISSECTION, I WANT TO TAKE A MOMENT TO REVIEW BRIEFLY THE HISTORY OF DISSECTION.

THE HISTORY OF HUMAN ANATOMY IS OF COURSE CLOSELY RELATED TOCULTURAL ATTITUDES TOWARD THE DEAD AND SPECIFICALLY THE CUTTING UP OF DEAD BODIES.

AT LEAST IN THE WEST, THERE SEEMS TO HAVE BEEN A STRONG AVERSION TO SUCH PRACTICES IN MOST PLACES AND AT MOST TIMES, FROM THE 4TH CENTURY B.C. TO THE EARLY MODERN PERIOD.

IN ORDER TO GAIN ACCESS TO CADAVERS FOR DISSECTIONS, ANATOMISTS HAD TO OVER COME MORAL, LEGAL, AND RELIGIOUS OBJECTIONS TO THE DESECRATION OF THE DEAD.

THE EARLIEST MEDICAL TREATISES FROM ANCIENT GREEK SUGGEST THAT KNOWLEDGE DERIVED FROM HUMAN DISSECTION DATE FROM THE 4TH B.C..

BUT IT IS ENTIRELY POSSIBLE THAT SUCH ANATOMICAL OBSERVATIONS COULD HAVE BEEN MADE THROUGH THE CHANCE INJURIES OF WAR AND ACCIDENT THAT MIGHT HAVE LAID BARE SOME PARTICULAR MUSCLE MASS OR JOINT.

IRONICALLY, BY EMPHASIZING THE IMPORTANCE OF THE SOUL AND CONSIDERING THE BODY MERELY AS A TEMPORARY SHELTER FOR THE SOUL, PLATO INDIRECTLY CONTRIBUTED TO AN ATTITUDE ACCEPTING OF DISSECTION.

YET HIS STUDENT, ARISTOTLE SEEMS NEVER TO HAVE ENGAGED IN HUMAN DISSECTION; THOUGH HE DID UNDERTAKE EXTENSIVE ANATOMICAL RESEARCH ON ANIMALS.

EMPLOYING A METHOD THAT WAS TO BECOME THE NORM FOR THE NEXT2000 YEARS, ARISTOTLE'S OBSERVATIONS ON ANIMAL DISSECTIONS WEREPROJECTED ONTO THE HUMAN BODY WITHOUT ANY CORROBORATING EVIDENCE.

CONSEQUENTLY, NOT ONLY DID HIS DESCRIPTIVE ANATOMY SUFFER BUTALSO HIS THEORY OF PHYSIOLOGY.

ARISTOTLE BELIEVED THE BRAIN WAS A RELATIVELY INSIGNIFICANT ORGAN, THE CHIEF FUNCTION OF WHICH WAS TO COOL THE HEART THROUGH THE SECRETION OF PHLEGM, WHICH, AS YOU RECALL FROM HUMORAL THEORY, IS WATER-LIKE AND POSSESSES THE QUALITIES OF MOISTNESS AND COOLNESS.

THE HEART, ON THE OTHER HAND, IS OF PREMIER IMPORTANCE, BEING NOT ONLY THE SEAT OF SENSATION AND INTELLIGENCE, IT IS ALSO THE FIRST ORGAN TO LIVE (THIS ARISTOTLE HAD OBSERVED DURING HIS EMBRYOLOGICAL EXPERIMENTS), THE LAST TO DIE, AND CENTRAL FOR THE LIFE OF THE REST OF THE BODY.

ARISTOTLE ALSO BELIEVED THE HEART HAD THREE VENTRICLES -- AN ASSERTION THAT WAS TO CAUSE MUCH DEBATE AND CONSTERNATION UNTIL WELL INTO THE 16TH CENTURY.

WITHOUT DISTINGUISHING VEINS FROM ARTIES, HE DECLARED THAT TWO LARGE VESSELS ORIGINATE IN THE HEART, AS DID ALL NERVES.

IN PREPARING ANIMALS FOR DISSECTION, ARISTOTLE REASONED THAT ITWOULD BE BETTER TO HAVE THE ANIMAL STRANGLED SO AS TO PRESERVE THE NATURAL DISTRIBUTION OF THE BLOOD.

AS A RESULT OF THIS METHOD OF PREPARATION, THE LEFT CHAMBERS OF THE HEART AND ARTERIES WERE DEPLETED OF BLOOD.

CONSEQUENTLY, THE FUNCTION OF THE HEART WAS NOT AT ALL OBVIOUS AND THE ARTERIES WERE LONG THOUGHT TO BE FILLED NOT WITH ARTERIAL BLOOD BUT WITH AIR.

SPORADIC EVIDENCE OF HUMAN DISSECTION EMERGES IN MEDICAL TREATISE WRITTEN IN THE YEARS AFTER ARISTOTLE (WHO DIED IN 322 B.C.).

YET SYSTEMATIC HUMAN DISSECTION SEEMS TO HAVE OCCURRED FOR THE FIRST TIME IN ALEXANDRIA IN THE 3RD CENTURY B.C..

INDEED THE EVIDENCE SUGGESTS THAT SOME PHYSICIANS ACTUALLY PERFORMED VIVISECTIONS ON HUMANS, THESE POOR VICTIMS FOR MEDICAL RESEARCH TYPICALLY BEING CONDEMNED CRIMINALS SUPPLIED BY STATE AUTHORITIES.

FOR APPROXIMATELY THE NEXT 150 YEARS, UNTIL ABOUT 150 B.C., ANATOMICAL KNOWLEDGE INCREASED GREATLY AS A CONSEQUENCE OF THE RESEARCH DONE IN ALEXANDRIA.

MANY OF THE BASIC STRUCTURES OF THE BODY CAME UNDER INVESTIGATION FOR THE FIRST TIME:.

ARTERIES WERE DISTINGUISHED FROM VEINS;.

THE VEIN-LIKE ARTERIES AND ARTERY-LIKE VEINS OF WHAT WE WOULD CALL THE PULMONAYRY CIRCULATION WERE IDENTIFIED -- THOUGH NOT PROPERLY UNDERSTOOD;.

AND IT WAS DISCOVERED THAT THE BRAIN IS THE SEAT OF INTELLIGENCEAND SENSATION AS WELL AS MOTOR FUNCTIONS AND THAT THE SIZE AND COMPLEXITY OF THE BRAIN HAS SOMETHING TO DO WITH THE SUPERIORITY OF HUMAN INTELLIGENCE.

HOWEVER, THE PRACTICE OF HUMAN DISSECTION -- AND CERTANLY VIVISECTION -- DECLINED BY THE BEGINNING OF THE 1ST CENTURY B.C..

WITH THE INCORPORATION OF ALEXANDRIA INTO THE ROMAN EMPIRE IN30 B.C., THE MEDICAL SCHOOL ITSELF WENT INTO DECLINE AND EVENTUALLY CEASED TO EXIST ALTOGETHER.

ROMAN RELIGIOUS ATTITUDES CONCERNING RESPECT FOR THE DEAD PREVENTED ANY HUMAN DISSECTIONS FROM TAKING PLACE ANYWHERE, AND ANATOMISTS HAD TO CONTENT THEMSELVES WITH ANIMAL DISSECTIONS.

OF COURSE IT MADE SENSE TO PROCUR ANIMALS AS MUCH LIKE HUMANS AS POSSIBLE; THIS UNFORTUNATE DISTINCTION FELL TO THE HAPLESS BARBARY APE, A BABOON-LIKE CREATURE STILL INHABITING THE NORTHERN COAST OF AFRICA.

BUT IF THE APE COULD NOT BE SUPPLIED, PHYSICIANS WOULD TAKE A SHEEP OR GOAT AS AN ACCEPTABLE ALTERNATIVE.

AS ONE MIGHT GUESS, THIS WAS NOT A HAPPY SITUTATION FOR APE, SHEEP, OR ANATOMIST, AND SEVERAL ANATOMICAL ERRORS WERE INTRODUCED INTO THE MEDICAL LITERATURE AS A CONSEQUENCE.

ONE OF THE LONGEST-LIVED AND STRANGEST OF ERRORS HAD TO DO WITH THE 'RETE MIRABILE' (OR 'MIRACULOUS NET') MENTION IN THE PREVIOUS LECTURE.

ALTHOUGH THIS NET-LIKE ARRAY OF BLOOD VESSELS SURROUNDING THE BRAIN IS FOUND ONLY IN UNGULATES, LIKE SHEEP AND GOATS, IT WAS ASSUMED THAT IS WAS AN ANATOMICAL DETAIL FOUND IN ALL ANIMALS, INCLUDING MAN.

IT WAS INTO THIS TRADITION THAT GALEN STEPPED IN THE 2ND CENTURYA.D..

HE HIMSELF PERFORMED EXTENSIVE ANATOMICAL INVESTIGATIONS ONANIMALS, AGAIN USING BARBARY APES AND SHEEP AS HIS SUBJECTS.

ALTHOUGH GALEN HAD SEEN THE 'RETE MIRABILE' ONLY IN SHEEP, HE ASSUMED IT EXISTED IN HUMANS AS WELL.

THUS A TENUOUS NETWORK OF VESSELS FOUND AROUND A SHEEP'S BRAIN BECAME ONE OF THE MORE IMPORTANT ORGANS IN HUMAN PHYSIOLOGY.

FOR IN GALENIC PHYSIOLOGY, THE 'RETE MIRABILE' WAS THE SITE WHERE ARTERIAL BLOOD WAS REFINED INTO ANIMAL SPIRIT, THE SUBSTANCE RESPONSIBLE FOR SENSATION, MOTOR FUNCTIONS, AND REASON IN MAN.

DESPITE SUCH OBSTACLES TO A CORRECT UNDERSTANDING OF HUMAN ANATOMNY, GALEN WAS ABLE TO CLARIFY A NUMBER OF OTHER POINTS: HE REJECTED ARISTOTLE'S CLAIM THAT THE HEART HAS THREE VENTRICLE, AND HE WAS ABLE TO DEMONSTRATE THAT THE ARTERIES ARE FILLED WITH BLOOD.

HE DID, HOWEVER, INVENT AND PERPETUATE A NUMBER OF ERRORS CONCERNING THE ORGANIZATION AND FUNCTION OF THE ABDOMINAL ORGANS.

PERHAPS THE MOST REMARKABLE ASPECT OF GALEN'S RESEARCH WAS HIS USE OF PHYSIOLOGICAL EXPERIMENT.

HE WOULD LIGATE, OR TIE OFF, BLOOD VESSELS AND NERVES TO STUDYTHE EFFECTS ON UPON MUSCLES, LARYNX, OR MOTOR FUNCTIONS, AND STUDIED SYSTEMATICALLY THE LOSS OF SENSATION AND MOTION RESULTING FROM THE SEVERING OF THE SPINAL CORD AT DIFFERENT LEVELS.

THIS SORT OF EXPERIMENTAL PHYSIOLOGY, AS OPPOSED TO MERELY EXPLORATORY OR DESCRIPTIVE ANATOMY, WAS NOT AGAIN PRACTICED UNTIL THE 16TH AND 17TH CENTURIES, MOST IMPORTANTLY IN THE WORKOF WILLIAM HARVEY AND RENÉ DESCARTES.

UNFORTUNATELY, ATTACHED TO GALEN'S PHYSIOLOGICAL EXPERIMENTS WAS A NUMBER OF THEORETICAL SPECULATIONS NOT WELL GROUNDED IN EVIDENCE.

WHAT IS MORE, HE WOULD OCCASIONALLY MODIFY HIS ANATOMY TO FIT HIS SPECULATIVE PHYSIOLOGY AND WRITE BOTH ERROREOUS ELEMENTS OF HIS THEORY INTO HIS TREATISES.

PERHAPS GALEN'S MOST EGREGIOUS ERROR CONCERNED THE STRUCTURE AND FUNCTION OF THE HEART.

AS I MENTIONED LAST TIME, THE HEART WAS ONE OF THE THREE MAJORORGANS IN GALENIC THEORY; THE OTHER TWO BEING THE BRAIN AND LIVER.

IF YOU RECALL THE DIAGRAM I HANDED OUT ON TUESDAY, VENOUS BLOO CHARGED WITH NATURAL SPIRIT FROM THE LIVER IS ATTRACTED THROUGH THE VENA CAVA INTO THE RIGHT VENTRICLE OF THE HEART.

THERE THE IMPURITIES THE VENOUS BLOOD HAD PICKED UP FROM THE BODY DRIFT THROUGH THE ARTERY-LIKE VEIN INTO THE LUNG WHERE THEY WERE EXHALED.

MOST OF THE VENOUS BLOOD WAS THEN ATTRACTED BACK TO THE VENOUS SYSTEM.

HOWEVER, A SMALL PORTION OF VENOUS BLOOD SEEPED THROUGH THEPORES GALEN THOUGHT EXISTED IN THE INTERVENTRICULAR SEPTUM, THE THICK, FLESHY DIVISION SEPARATING THE LEFT FORM RIGHT VENTRICAL.

OF COURSE THESE PORES DO NOT EXIST, THERE ARE NO HIDDEN OR MINUTE PASSAGE-WAYS CONNECTING VENTRICAL TO VENTRICLE.

HOWEVER, THE SURFACE OF THE SEPTUM IS DEEPLY PITTED, AND IF ONEWAS REALLY DESPERATE TO FIND A MEANS OF COMMUNICATING BLOODBETWEEN THE TWO MAJOTR CHAMBERS OF THE HEART, ONE COULD WELL POSTULATE THE EXISTENCE OF SUCH UNOBSERVABLES.

AFTER ALL, HARVEY DID THE SAME THING IN THE 17TH CENTURY WHEN HE POSTULATED THE EXISTENCE OF CAPILLARIES CONNECTING THE ARTERIAL TO THE VENOUS SYSTEM; ENTITIES WHICH FOR HIM WERE EQUALLY UNOBSERVABLE.

IN ANY EVENT, ONCE THIS PORTION OF VENOUS BLOOD PASSED THROUGH TO THE LEFT VENTRICLE, IT WAS IMBUED WITH PNEUMA, WHICHTHE LUNGS HAD REFINED FROM AIR AND WHICH WAS BROUGHT TO THE LEFT CHAMBER THROUGH THE VEIN-LIKE ARTERY.

NOW SINCE THE AMOUNT OF BLOOD THAT SEEPS THROUGH THE SEPTUMIS RELATIVELY SMALL, IT MUST BE THAT THE ARTERIAL BLOOD ITSELF DOES NOT UNDERGO ANY GREAT MOTION; THAT IS, THAT IS STAYS PRETTYMUCH IN PLACE.

WHAT DOES MOVE, OR MORE PRECISE, WHAT IS ATTRACTED BY THE RESTOF THE BODY, IS THE VITAL SPIRIT.

AFTER THIS FUNCTION HAD BEEN COMPLETED, IMPURITIES AND EXCESSHEAT WERE ATTRACTED BACK TO THE HEART AND UP THE VEIN-LIKE ARTERY AND THUS EXPELLED FROM THE BODY.

NOW, FROM OUR PERSPECTIVE, WE MAY SEE MANY PROBLEMS WITH THEANATOMY AND PHYSIOLOGY OF THE GALENIC MAN.

YET THIS WAS THE SYSTEM THAT DOMINATED MEDICAL THINKING FOR THE NEXT 1400 YEARS, FROM THE 2ND CENTURY A.D. TO THE 16TH CENTURY.

THERE WERE SEVERAL FACTORS CONTRIBUTING TO THIS DOMINANCE:.

1) FIRST AND MOST SIMPLY, THE SURVIVAL OF A LARGE PORTION OF GALEN'S ENORMOUS BODY OF MEDICAL WRITINGS;.

2) SECOND, HIS RECOGNIZED ABILITY AND REPUTATION, WHICH WAS WELL-ESTABLISHED BY THE TIME OF HIS DEATH;.

3) THIRD, GALENIC MEDICINE WAS SYSTEMATIC, COMPREHENSIVE, AND INTEGRATED; THAT IS, IT WAS CONSTRUCTED ON A SOLID FOUNDATION OFSYSTEMATIC ANATOMICAL OBSERVATION AND A PLAUSIBLE SET OF PHYSIOLOGICAL EXPERIMENTS; IT COVERED VIRTUALLY EVERY ASPECT OF THE VISIBLE BODY AND ITS FUNCTIONS; AND IT FIT IN WELL WITH OTHER FIELDS OF SCIENCE -- IT SEEMED TO BE PART OF A CONNECTED NETWORK INCLUDING ARISTOTELIAN, PLATONIC, EVEN PTOLEMAIC ELEMENTS.

IN A WORD, GALENIC MEDICINE WAS PART OF COHERENT AND INTERNALLY CONSISTENT PACKAGE.

4) AND FOURTH, THE INTELLECTUAL AND SCIENTIFIC DECLINE OF HELLENISTIC CULTURE EFFECTIVELY PREVENTED THE DEVELOPMENT OF AN POSSIBLE RIVAL SYSTEM.

IF YOU WERE TO STUDY MEDICINE AT ANY TIME FOR THE NEXT 14 CENTURIES, THE LITERATURE WAS VAST BUT YOUR CHOICES FEW.

THAT IS, THERE WAS AN ENORMOUS NUMBER OF MEDICAL TREATISES, COMMENTARIES, SUMMARIES, EPITOMES, AND GLOSSES; YET ALMOST ALLSERVED TO PRESENT OR EXPLICATE GALEN.

AND, IN THE ABSENCE OF A RIGOROUS TRADITION IN HUMAN DISSECTION, THE NON-CIRCULATION OF BLOOD, A POROUS SEPTEM IN THE HEART, THE 'RETE MIRABILE', A FIVE-LOBED LIVER, AND HOLLOW NERVES ALL SEEMED NOT MERELY PLAUSIBLE BUT POSITIVELY AUTHORITATIVE.

AS IN THE ROMAN WORLD, THE EARLY CHRISTIAN MIDDLE AGES POSSESSED AN ATTITUDE TOWARD THE DEAD THAT DID LITTLE TO ENCOURAGE HUMAN DISSECTION.

THERE ARE SCATTER REPORTS OF BRIEF EPISODES OF ANATOMICAL ACTIVITY DURING THIS PERIOD, BUT THERE APPEARS TO HAVE BEEN NO SUSTAINED TRADITION IN HUMAN DISSECTION.

FOR EXAMPLE, THE PHYSICIANS OF THE MEDICAL SCHOOL IN SALERNO IN THE 13TH CENTURY OPENLY DECLARED THAT THE DISSECTION OF THEHUMAN BODY WAS TO BE LOOKED UPON AS A HORRIBLE ACTION.

THE CLOSEST THINGS TO DISSECTION WERE THE PRACTICES OF EMBALMING, LEGALLY MOTIVATED AUTOPSIES (TO DETERMINE CAUSE OFDEATH), AND THE DISMEMBERMENT, BOILING, AND REMOVAL OF BONESOF CRUSADERS WHO HAD DIED IN DISTANT LANDS.

THIS LAST PRACTICE MADE IT EASIER TO TRANSPORT THE REMAINS BACKTO THE CRUSADERS' HOMELAND FOR A PROPER CHRISTIAN BURIAL.

YET EVEN THIS PRACTICE WAS FROWNED UPON BY CHURCH AUTHORITIES, AND THERE WAS EVENTUALLY A PAPAL BULL (IN 1299 BY POPE BONIFACE VIII) PROHIBITING IT.

THE FIRST WESTERN MONOGRAPH ON ANATOMY WAS WRITTEN IN 1316 BY MODINO DA LUZZI, PROFESSOR OF MEDICINE AT THE UNIVERSITY OF BOLOGNA IN ITALY.

IT SEEMS LIKELY THAT MODINO HIMSELF ENGAGED IN DISSECTION OF HUMAN BODIES, THOUGH IT APPEARS ONLY TO EXPERIENCE FOR HIMSELFWHAT HE WAS READING IN GALEN.

INDEED, THE ENTIRE WORK IS WHOLLY DEPENDENT ON GALEN AND MODINO'S RECOURSE TO DISSECTION WAS CERTAINLY NOT INTENDED ASA CHALLENGE TO GALEN'S AUTHORITY IN ANATOMY.

MODINA'S SUCCESSOR AT BOLOGNA, NICOLO BERTUCCI, CONTINUED THE TRADITION OF PEDAGOGICAL DISSECTION.

EXACTLY HOW VIGOROUS THIS TRADITION WAS IS DIFFICULT TO ASCERTAIN.

HOWEVER, THERE IS EVEIDENCE FROM OTHER ITALIAN UNIVERSITIES THAT INDICATE A GROWING INTEREST IN HUMAN DISSECTION DURING THE 14TH CENTURY.

EVIDENCE SUGGESTS THAT THE FIRST HUMAN DISSECTION AT THE UNIVERSITY OF PADUA WAS IN 1341; AT VENICE IN 1368; AT FLORENCE IN 1388, SIENA IN 1427, PERUGIA IN 1457, GENOA IN 1482, AND PISA IN 1501.

AS ENCOURAGING AS THESE DATES MIGHT BE CONCERNING THE EMERGENCE OF A TRADITION OF EXPOSING STUDENTS TO HUMAN DISSECTION, THERE IS SOME DOUBT AS TO THE PEDAGOGICAL USEFULNESS OF DISSECTIONS AS THEY WERE PERFORMED.

DISSECTIONS SEEM TO HAVE BEEN ONLY ANNUAL OR SEMI-ANNUAL EVENTS; THE AUDIENCE WAS LIMITED TO A SMALL NUMBER OF MEDICAL STUDENTS (PERHAPS ONLY ONE OR TWO DOZEN); AND THE DEMONSTRATIONS HAD TO BE PERFORMED QUICKLY AND ALMOST NON-STOP GIVEN THE RAPID RATE OF DECAY OF THE CADAVER.

STUDENTS HAD NO OPPORTUNITY TO PERFORM EVEN A PART OF THE DISSECTION THEMSELVES, AND THEY SCARCELY HAD TIME TO ASSIMILATE THE LARGE QUANTITY OF NEW MATERIAL UNFOLDING BEFORE THEIR VERY EYES.

WHAT IS MORE, SUCH ANATOMICAL DEMONSTRATIONS WERE DIRECTED -- BUT NOT PERFORMED -- BY PHYSICIANS.

THE PHYSICIAN DID NOT ACTUALLY DO THE DISSECTION HIMSELF BUT DIRECTED HIS ASSISTANTS, TYPICALLY A BARBER OR SURGEON -- MEN TECHNICALLY FROM THE SUB-PROFESSIONAL CRAFTS.

IN A TYPICAL DISSECTION, THE PROFESSOR WOULD BE SEATED IN AN ELEVATED CHAIR, OR CATHEDRA, HIGH ABOVE THE FUMES AND MESS OF THE CUTTING TABLE.

HE WOULD READ ALOUD FROM GALEN, OR FROM ONE OF HIS MANY COMMENTATORS, AND DIRECT THE ACTIONS OF HIS ASSISTANTS.

THE BARBER OR SURGEON WOULD DO THE ACTUAL CUTTING OF THE CADAVER, AND ANOTHER ASSISTANT WOULD POINT OUT THE MUSCLE, ORGAN, OR BONE BEING DESCRIBED IN THE TEXT.

ALTHOUGH THIS SORT OF DIVISION OF LABOR PRESERVED THE DIGNITY AND REINFORCED THE STATUS OF THE PROFESSOR, IT WAS NOT ESPECIALLY CONDUCIVE TO A CRITICAL COMPARISION OF TEXT AND CADAVER.

NOR DID IT ENCOURAGE ORIGINAL ANATOMICAL RESEARCH.

ONE COULD WELL IMAGINE THAT THIS ARRANGEMENT WOULD MAKE ITQUITE DIFFICULT TO DISCOVER A DISCREPENCY BETWEEN TEXT AND CORPSE.

AND, GIVEN THE OVERT DISPLAY OF STATUS AND HIERARCHY, IT IS ALMOST UNIMAGINABLE THAT THE SHARP-EYED SURGEON WHO DID NOTICE SOMETHING UNUSUAL, WOULD HAVE MUCH OF A SAY.

HOW COULD HE, A MERE SURGEON, DARE TO POINT OUT AN ERROR TO THE PROFESSOR PERCHED HIGH ABOVE HIM, READING FROM A CLASSICALAND MUCH VENERATED MANUSCRIPT?.

THERE WERE, IN ADDITION, OTHER FACTORS THAT ALSO MADE THE TASKOF CHALLENGING THE AUTHORITY GALEN EVEN MORE DIFFICULT.

GALEN'S SEVERAL MEDICAL TREATISES, WHICH THEMSELVES WERE NOTPERFECTLY CONSISTENT ON MATTERS OF NOMENCLATURE, HAD BEEN TRANSLATED AT VARIOUS TIMES AND BY DIFFERNT AUTHORS.

AS A RESULT OF THE UNSYSTEMATIC WAY IN WHICH GALEN'S TEXTS PASSED INTO LATIN, THERE EXISTED CONSIDERABLE REDUNDANCY AND CONFUSION WITH REGARD TO ANATOMICAL NOMENCLATURE.

WHEN CONFRONTED WITH THE TREMENDOUS NUMBER OF ANATOMICALDETAILS OF THE DISSECTED HUMAN BODY, IT IS CRUCIAL FOR THE STUDENT TO KNOW WHICH PART IS WHICH AND WHAT IT IS CALLED.

READING FROM TEXTS THAT DESCRIBE IN DIFFERING TERMS THE IMPERFECTLY UNDERSTOOD DETAILS OF A RAPIDLY DECOMPOSING BODYMAY WELL PRODUCE MORE CONFUSION THAN UNDERSTANDING.

WHATEVER THE FLAWS OF THIS METHOD OF EXPOSITION, THE BOTTOM LINE IS THAT THERE WAS, BEGINNING IN THE 15TH CENTURY, AN INCREASING FAMILIARITY WITH HUMAN DISSECTION.

LET ME BREAK OFF THIS ACCOUNT OF LATE MEDIEVAL ANATOMY AND JUMP SLIGHTLY AHEAD TO THE LIFE AND WORK OF VESALIUS.

II. ANDREAS VESALIUS AND THE NEW ANATOMY.

A. EARLY LIFE AND EDUCATION.

AS INDICATED EARLIER, THE LIFE OF VESALIUS PROVIDES A RATHER DULL COUNTERPOINT TO THE ADVENTURES AND IDIOSYNCRASIES OF PARACELSUS.

ANDREAS VAN WESELE, THE NAME BY WHICH HE WAS BAPTIZED AND WHICH HE LATER LATINIZED TO VESALIUS, WAS BORN IN BRUSSELS BELGIUM IN 1514.