only the beginning of the development that it was destined to reach
during the sixteenth century, it would be a serious mistake to think
that the study of anatomy, having died in the old classical days, was
not re-born until the sixteenth century. This would be to commit the
error that many ardent devotees of the Renaissance make with regard to
all the accomplishments of this period. In spite of the contrary
almost universal impression, the Renaissance was not original {92} to
any marked degree. With the touch of the Greek spirit that had come
again into the world, it only carried the preceding work of great
original thinkers to a high order of perfection. This happened as well
in anatomy as in art and architecture and literature. Anatomical
science was a lusty infant of great promise when Vesalius, the Father
of Anatomy, came on the scene. The great painters, Raphael and
Lionardo and Michael Angelo, owed much to Giotto and Fra Angelico, who
had preceded them, but not more than Vesalius and his contemporaries,
who did such magnificent work in original anatomical investigation,
owed to Mondino, Bertrucci, Zerbi, Achillini, and above all to
Berengar of Carpi and Benivieni, who did their work before and just
after the sixteenth century opened. There is never a sudden
development in the history of any department of man's knowledge or
achievement, as there is nothing absolutely new under the sun, though
it is still the custom of the young man in his graduation essay to
talk of such things, and older men sometimes fail to realize the truth
that in history as in biology, life always comes from preceding
life--_omne vivum ex vivo_--and there is no such thing as spontaneous
generation.
If the achievements of this earlier period of scientific work, which
affected anatomy even more than any of the other sciences, be kept in
mind, the discussion of the Golden Age of Anatomy will find its proper
place in the history of the relation of the Popes to science. Though
the date of the Golden Age in Anatomy follows that of the so-called
reformation, there is absolutely no connection between the two series
of events, for the one took place in Germany and the other in Italy.
The Golden Age of Anatomy was indeed a perfectly {93} legitimate and
quite to be expected culmination of the anatomical interest which had
been gradually rising to a climax in the Italian universities during
the preceding century. It has a definite place in the evolution of
science, and is not a sudden or unlooked for phenomenon.
If there was any place in the world at the beginning of the sixteenth
century in which the ecclesiastical authorities had much to say with
regard to what should not be taught and what should not be studied in
the universities, it was Italy. In spite of this fact, all medical men
who wanted to do post-graduate work in medicine went down into Italy.
This was especially true for those who desired to obtain ampler
opportunities for anatomical study than were afforded by the rest of
Europe. In his maturer years as a student of medicine, Vesalius went
down to Italy in order to avail himself of the magnificent field for
investigation that was provided there. This favorable state of affairs
as regards research in anatomy had existed for more than a century
before his time. It continued to be true for at least two centuries
after his time. As a matter of fact, Italy was to the rest of the
world of the fifteenth and sixteenth and seventeenth centuries the
home of post-graduate opportunities in all sciences as well as in
medicine.
These are not idle words, but are fully substantiated by the lives of
the men who stand at the head of our modern medicine. More than a
decade before Vesalius was born, Linacre, the distinguished English
physician and founder of the Royal College of Physicians, went to
Italy to complete his medical studies and incidentally also to round
out his education in the midst of the new learning which was so
thoroughly cultivated there. When Linacre was leaving Italy, with true
classic spirit {94} he set up a little altar on the top of the Alps
whence he could get his last view of the Italian plains, and greeted
the charming country that he was leaving so reluctantly with the
beautiful name of Alma Mater Studiorum. To him, after his return to
England, English-speaking medical men owe the establishment of the
institution which above all others has helped to uplift the dignity of
the medical profession and make the practice of the healing art
something more than a mere trade--the Royal College of Physicians.
One of Vesalius's most distinguished fellow students at Padua was Dr.
John Caius, who was later to become the worthy president of the Royal
College of Physicians of England and the author of certain important
medical works. Dr. Caius was the first to introduce the practice of
public dissections into England. Caius and Vesalius were roommates,
though at the time Vesalius was an instructor at the University, and
the inspiration of his originality seems to have had a great effect
upon young Caius. They were nearly of the same age, though Vesalius
was a precocious genius, and Caius's greatness only showed itself in
maturity. Caius was studying in Italy partly because the religious
disturbances in England had made it uncomfortable for him to remain in
his native country, for he was a firm adherent of the old Church and
he hoped they would pass over, but mainly because he coveted the
opportunities afforded by that country. Later in life, out of the
revenues of his position as Royal Physician to Queen Mary and
subsequently for some time to Queen Elizabeth, he founded the famous
Caius College at Cambridge, usually called Key's College by
Cantabrigians.
Before either of these men there had been a third {95} distinguished
English physician who had gone down to Italy for his education. This
was the celebrated and learned John Phreas, who was born about the
commencement of the fifteenth century. Very little is known of his
career, but what we do know is of great interest. He was educated at
Oxford and obtained a fellowship on the foundation of Balliol College.
Afterward he seems to have studied medicine with a physician in
England, but was not satisfied with the medical education thus
obtained. He set the fashion for going down into Italy sometime during
the first half of the fifteenth century, and after some years spent at
Padua received the degree of doctor in medicine, which in those days
carried with it, as the name implies, the right to teach. As not
infrequently happens to the brilliant medical student, he settled down
for practice in the university town in which he graduated, to take up
both occupations, that of teacher and practitioner. He is said to have
made a large fortune in the practice of physic. [Footnote 12] The best
proof of his scholarship is to be found in some letters still
preserved in the Bodleian and in the Library of Balliol College.
Personally, I have considered that his career was interesting from
another standpoint. I have often looked in history for the cases of
appendicitis which occur so frequently in our day and with regard to
which people ask how is it they did not occur in the past. The fact
is, they did occur, but were unrecognized. People were taken suddenly
ill, not infrequently a short time after a meal, and after
considerable pain and fever, swelling and great tenderness in the
abdomen {96} developed, and they died with all the signs of poisoning.
They were actually poisoned, not by some extraneous material, but by
the putrid contents of their own intestines which found a way out
through the ruptured appendix. These cases were set down as poisoning
cases, and usually some interested person was the subject of
suspicion. Dr. Phreas's learning had obtained for him an appointment
to a bishopric in England, a curious bit of evidence of the absence of
opposition between medical science and religion in his time. He died
shortly after this, under circumstances that raised a suspicion of
poisoning in the minds of some of his contemporaries--but raises the
thought of appendicitis in mine,--and one of his rivals was blamed for
it.
[Footnote 12: Like the other distinguished physicians of this time,
John Phreas did not devote himself to medicine alone. He had a taste
for literature, and besides being an accomplished scholar he was a
poet.]
Nor did the custom for English medical students to go down to Italy to
complete their education cease with the so-called reformation. Some
two generations after Vesalius's time another distinguished
Englishman, Harvey, went down to Italy to complete the studies he had
already made and eventually to lay the foundation of that knowledge on
which he was twenty years later to construct his doctrine of the
circulation of the blood. This doctrine, however, remained merely a
theory until the distinguished Italian anatomist, Malpighi, after
another half century, demonstrated the existence of the capillaries,
the little blood vessels which connect the veins and arteries, and by
thus showing the continuity of both the blood systems, proved beyond
all doubt the certainty of the teaching that the blood does circulate.
Students came, moreover, from even the distant North of Europe to the
Italian schools of medicine during these centuries. Neil Stensen, or
as he is perhaps better known by his Latin name, Nicholas Steno, the
{97} discoverer of the duct of the parotid gland, which has been named
after him, and of many other anatomical details, especially of the
fact that the heart is a muscle, which stamp him as an original
investigator of the highest order, after having made extensive studies
in the Netherlands and in France to complete the medical education
which he had begun in his native city of Copenhagen, went down into
Italy to secure freer opportunities for original research than he
could obtain anywhere else in Europe. [Footnote 13]
[Footnote 13: It may perhaps be of interest to say that while doing
investigation in anatomy and certain other sciences allied to
medicine, Steno became a convert to the Catholic Church and after some
years became a priest. Before his ordination, however, though after
his conversion, he received the call to the chair of anatomy at
Copenhagen. He accepted this and worked for several years at the Danish
University, but was dissatisfied with the state of affairs around him
as regards religion and went back to Italy. Eventually he was made a
bishop--hence the curious picture of him in a Roman Catholic Bishop's
robes in the collection of pictures of professors of anatomy at the
University of Copenhagen. Not long after, at his own request, he was
sent up to the Northern part of Germany in order to try to bring back
to the Church as many of the Germans as might be won by his gentleness
of disposition, his saintly character, his wonderful scientific
knowledge, and his winning ways. He is the Father of Modern Geology as
well as a great anatomist, and his little book on geology was
published after he became a priest, yet did not hamper in any way his
ecclesiastical preferment nor alienate him from his friends in the
hierarchy. He was honored especially by the Popes. In a word, his
career is the best possible disproof of any Papal or ecclesiastical
opposition to science in his time.]
We have mentioned that it was while he was pursuing his special
investigations in various Italian universities that Stensen was
honored with the invitation to become professor of anatomy at the
University of Copenhagen. This was not a chance event, but a type of
the point of view in university education at the time. Just as at the
present time the prestige of research in a German university counts
for much as a recommendation for professorships in our American
universities, so in the sixteenth and seventeenth centuries was it
with regard to study in Italy. It was felt that men who had spent {98}
several years there could be reasonably expected to know all that
there was to be known in the rising sciences of anatomy and
physiology; at the same time there was a very general impression,
quite justified by the results observed, that those who did their
post-graduate work in Italy were nearly always sure to make
discoveries that would add to the prestige of their universities
later, and that would be a stimulus to students and to the other
teachers around them such as could be provided in no other way. If
read in the proper spirit, the history of the universities of those
times is quite like our own, only for influence, the name of Italy
must always be substituted for that of Germany. Yet Italy, if we were
to believe some of the writers on the history of education and
science, was at this time laboring under the incubus of ecclesiastical
intolerance with regard to anatomy and an almost complete suppression
of opportunities for dissection. Those who write thus know nothing at
all of the actual facts of the history of science, or else they are
blinding themselves for some reason to the real situation.
Fortunately students of the facts of history, especially those who
have devoted any serious attention to the history of medicine, make no
such mistake. For them it is perfectly clear that there was a
wonderful development in anatomy which took place down in Italy,
beginning about the middle of the fifteenth century or even earlier,
and which led to the provision of such opportunities for dissection
and original research in medicine, that students from all over the
world were attracted there. For instance, Professor Clifford Allbutt,
in the address on the Historical Relations of Medicine and Surgery to
the end of the Sixteenth Century, already quoted, has a passage {99}
in which, as an introduction to what he has to say about Galen, he
sums up the history of anatomy from the return of the Popes from
Avignon to Rome, which took place just about the beginning of the last
quarter of the fourteenth century, down to the time of Vesalius. This
expresses so well what I have been trying to say with regard to the
gradual development that led up to the Golden Age of Anatomy and to
Vesalius's work, that I quote it.
"Meanwhile, however, the return of the Popes to Rome (1374) and the
displacement of the Albucasis and Avicenna by the Greek texts
renewed the shriveling body of medicine, and with the help of
anatomy, Italian medicine awoke again; though until the days of
Vesalius and Harvey the renascence came rather from men of letters
than of medicine. The Arabs and Paris said: "Why dissect if you
trust Galen? _But the Italian physicians insisted on verification;
and therefore back to Italy again the earnest and clear-sighted
students flocked from all regions._ Vesalius was a young man when he
professed in Padua, yet, young or venerable, _where but in Italy
would he have won, I would not say renown, but even sufferance!_ If
normal anatomy was not directly a reformer of medicine, by way of
anatomy came morbid anatomy, as conceived by the genius of
Benivieni, of Morgagni, and of Valsalva; the galenical or humoral
doctrine of pathology was sapped, and soaring in excelsis for the
essence of disease gave place to grubbing for its roots."
A sketch of Vesalius's career will give the best possible idea of the
influences at work in science during this Golden Age of anatomical
discovery, and will at the same time serve to show better than
anything else, how {100} utterly unfounded is the opinion that there
was opposition between religion, or theology and science, and above
all medical science, at this time. On the other hand, it will
demonstrate that the educational factors at work in Vesalius's time
were not different from those of the preceding century, nor indeed
from those that had existed for two or three centuries before his
time; and though his magnificent original research introduced the new
initiative which always comes after a genius has left his mark upon a
scientific department, the spirit in which science was pursued after
his time did not differ essentially from that which had prevailed
before. He represents not a revolution in medical science, as has so
often been said, though always with the purpose of demonstrating how
much the so-called reformation accomplished in bringing about this
great progress in anatomy, but only a striking epoch in that gradual
evolution which had already advanced so far that his work was rendered
easy and some such climax of progress as came in his time was
inevitable.
Vesalius's earlier education was received entirely in his native town
of Louvain. There were certain preparatory schools in connection with
the university at Louvain, and to one of these, called Paedagogium
Castri because of the sign over the door, which was that of a fort,
Vesalius was sent. Here he learned Latin and Greek and some Hebrew.
How well he learned his Latin can be realized from the fact that at
twenty-two he was ready to lecture in that language on anatomy in
Italy. His knowledge of Greek can be estimated from the tradition that
he could translate Galen at sight, and he was known to have corrected
a number of errors in translations from that author made by preceding
{101} translators. To those who know the traditions of that time in
the teaching of the classic languages along the Rhine and in the Low
Countries, these accomplishments of Vesalius will not be surprising.
They knew how to teach in those pre-reformation days, and probably
Latin and Greek have never been better taught than by the Brethren of
the Common Life, whose schools for nearly a hundred years had been
open in the Low Countries and Rhenish Germany for the children of all
classes, but especially of the poor. Other schools in the same region
could scarcely fail to be uplifted by such educational traditions.
Altogether, Vesalius spent some nine years in the Paedagogium.
As illustrating how men will find what interests them in spite of
supposed lack of opportunities, it may be said that from his earliest
years Vesalius was noted for his tendency to be inquisitive with
regard to natural objects, and while still a mere boy his anatomical
curiosity manifested itself in a very practical way. He recalls
himself in later years, that the bladders with which he learned to
swim, and which were also used by the children of the time as
play-toys for making all sorts of noises, became in his hands objects
of anatomical investigation. Anatomy means the cutting up of things,
and this Vesalius literally did with the bladders. He noted
particularly that they were composed of layers and fibres of various
kinds, and later on when he was studying the veins in human and animal
bodies he was reminded of these early observations, and pointed out
that the vein walls were made up of structures not unlike those,
though more delicate, of which the bladders of his childhood days had
proven to be composed.
His preparatory studies over, Vesalius entered the {102} University of
Louvain, at that time one of the most important universities of
Europe. At the end of the fifteenth and the beginning of the sixteenth
century, Louvain probably had more students than any other university
in Europe except that of Paris, and possibly Bologna. There are good
grounds for saying that the number in attendance here during the first
half of the sixteenth century was always in excess of 5,000. The
university was especially famous for its teaching of jurisprudence and
philology. The faculty of theology, however, was considered to be one
of the strongest in Europe, and Louvain, as might be expected from its
position in the heart of Catholic Belgium, was generally acknowledged
to be one of the great intellectual bulwarks of Catholicity against
the progress of Lutheranism in the Teutonic countries at this time.
Vesalius's parents were, and his family always had been, ardent
Catholics, so that, quite apart from his dwelling not far away, it was
very natural that he should have been sent here. He seems to have
spent five years in the university mainly engaged in the study of
philosophy and philology, but also of the classics and languages so
far as they were taught at that time.
It may be noted as another instance in his life of how a student will
find that which appeals to him even in the most unexpected sources,
that Vesalius took special interest in certain treatises of Albertus
Magnus and Michael Scotus, which treated of the human body in the
vague, curious way of the medieval scholars, and yet with a precious
amount of information, that this inquisitive youth eagerly drank in.
More interesting for Vesalius himself were certain studies undertaken
entirely independently of his university course. One of his {103}
biographers tells that he dissected small animals, rats and mice, and
occasionally even dogs and cats, in his eagerness to learn the details
of anatomy for himself and at first hand.
After graduating at Louvain in philosophy and philology, Vesalius went
to Paris to study medicine. At this time at Paris, Sylvius, after whom
one of the most important fissures of the brain, the sylvian, is
named, was not only teaching anatomy in a very interesting way, but
was also providing opportunities for original research in anatomy in
connection with his own investigations. The interest that his teaching
excited may be gathered from the fact that over 400 students were in
attendance at his lectures. Besides Sylvius, Guenther of Andernach in
Switzerland was also teaching in Paris, and with both of these
distinguished professors Vesalius became intimately associated. His
deep interest in the subject of anatomy would of itself be quite
sufficient to attract the attention of professors, but he had besides
the added advantage of being known as the descendant of a family which
had occupied prominent posts as medical attendants to the greatest
ruling family of Europe.
It was at Paris, then, that Vesalius first was able to devote himself
with the intense ardor of his character to the study of anatomy.
Nothing less than original research at first hand would satisfy his
ardent desire for information and his thirst for accurate knowledge.
His practical temper of mind was demonstrated by a revolution that he
worked in the method of doing dissections at the time. The dissections
in Paris used to be performed by the barber-surgeons, as a rule rather
ignorant men, who knew little of their work beyond the barest outline
of the technics of dissection. Teachers in {104} anatomy used to stand
by and direct the operation and demonstrate the various parts. These
teachers, however, considered it quite beneath them to use the knife
themselves. The faultiness of this method can be readily understood.
Vesalius began a new era in the history of anatomy by insisting on
doing the dissections himself. It was not long, however, before he
realized that Paris could not afford him such opportunities as he
desired. Altogether he did not remain there more than a year, and then
returned to the Low Countries.
At Louvain he continued his anatomical work, finding it difficult
enough to procure human material, but using such as might come to
hand. The story is told of his first attempt to get a complete
skeleton. A felon had been executed just outside the walls of Louvain,
and his remains were, as was the custom at that time, allowed to swing
on the gibbet until the birds of the air had eaten his flesh and the
wind and rain had bleached his bones. As might be thought, these bones
were a great temptation to Vesalius. Finally, one night he and a
fellow student stole out of the town and robbed the gibbet of its
treasure. In order to accomplish their task--no easy one, because the
skeleton was fastened to the beams of the scaffold by iron
shackles--they had to remain out all night. They buried it and later
removed it piecemeal, and when they had finally assembled the parts
again it was exhibited as a skeleton brought from Paris.