Italy in the sixteenth century was the fount from which issued a
ceaseless stream of anatomical discoveries. The ancient and illustrious
Universities of Bologna, Pavia, Padua, Pisa and Rome, eclipsed the
schools of Paris and Montpellier, of Toulouse and Salamanca; and the
Italian peninsula, which, in early mediaeval times, had gloried in the
skill of the physicians of Salernum, a second time became the medical
centre of Europe. Vesalius and his pupil, Fallopius, taught at Padua;
the ancient fame of Bologna was supported by Arantius and Varolius;
Vidius, returned from establishing the anatomical school at Paris,
taught at Pisa; Eustachius was at Rome, Ingrassias lectured at Naples,
and the fame of the New Anatomy spread throughout the world. The Italian
cities were filled with students from foreign lands. Padua had more than
one thousand new students every year, salaries were paid to her one
hundred professors, and medicine was looked upon as a noble profession.
While the Italians were the leaders in progress, the Germans were still
lecturing on Galen and Avicenna, the English had done almost nothing,
and the Collége de France was not established until 1530.
Legalized by imperial authority and sanctioned by the Church, dissection
was no longer regarded as a crime. A bull by Pope Boniface VIII., issued
in the year 1300, forbidding the evisceration of the dead and the
boiling of their bodies to secure the bones for consecrated ground, as
was done by the Crusaders, was wrongly interpreted as forbidding
anatomical dissection. Two centuries later the Popes, standing in the
vanguard of science, permitted dissections to be made in all the Italian
medical schools, and paved the way for the Anatomical Renaissance.
Great things were done in the sixteenth century. Under the scalpel and
pen of Vesalius, anatomy was revolutionized. Surgery was guided into new
paths by Ambroise Paré; and obstetrics, thanks to the labors of
Eucharius Rhodion and Jacques Guillemeau, began to assume its legitimate
place among the medical sciences. Servetus, visionary and argumentative,
correctly described the pulmonary circulation in a theological work
which was burned with its author. Eustachius, Columbus and Fallopius
widened the path which had been blazed by Vesalius. Arantius,
Caesalpinus and Fabricius added materially to anatomical science. The
labors of all these great masters prepared the way for the greatest
event occurring in the seventeenth century, namely, William Harvey’s
discovery of the circulatory movement of the blood.
[Illustration: INITIAL LETTER BY VESALIUS
(From the “Fabrica”, 1543)]
CHAPTER FIRST
Anatomy in Ancient Times
[Illustration: Illuminated capital]
Egypt and Greece were the sources of the medical learning of the ancient
world. Although the Egyptians and early Greeks possessed a certain
amount of anatomical knowledge, which was gained in the one instance by
the practice of embalming and in the other by an examination of the
bones, no real progress could be made because of the laws, customs and
prejudices of those ancient peoples. Thus we find the Egyptians stoning
the operator who opened the abdomen in order that the body might be
embalmed; and the Greeks inflicted the death penalty on those of their
generals who, after a battle, neglected to bury or burn the remains of
the slain.
[Illustration: HIPPOCRATES]
In the time of Hippocrates, whose life extended approximately over the
period between 460-377 B.C., Greek medicine emerged from the domination
of the Asclepiadae, or priests of Aesculapius, who had followed it as an
hereditary and secret art. Prior to this time in the numerous Asclepia,
or Temples of Aesculapius, votive offerings had been accepted, some of
which were of anatomical interest. Thus the Temple at Athens received a
silver heart and gold eyes. Pausanias states that Hippocrates gave to
the Temple of Apollo, at Delphos, a skeleton which was made of brass.
Possibly, as Moehsen[2] believes, this was a metallic figure
representing a man who was much emaciated by the ravages of disease. In
the Hippocratic writings, some of which are undoubtedly spurious, are
few references to the opening of a dead body; and these examinations
concern the investigation of the thorax and abdomen in order to
determine the cause of death. While the Greek physicians knew little of
the human muscles, of the nervous system and of the organs of sense,
they were well acquainted with the anatomy of the bones. Their
dissections were held upon the lower animals.
It is impossible to determine whether or not the Greek physicians of the
Hippocratic period dissected the human body. “It has long been a matter
of debate”, says John Bell[3], “whether the ancients were, or were not,
acquainted with anatomy, and the subject, with its various bearings, has
been much and keenly agitated by the learned. If anatomy had been much
known to the ancients, their knowledge would not have remained a subject
of speculation. We should have had evidence of it in their works; but,
on the contrary, we find Hippocrates spending his time in idle
prognostics, and dissecting apes, to discover the seat of the bile.”
Galen[4] states that the ancient physicians did not write works on
anatomy; that such treatises were at that time unnecessary, because the
Asclepiadae—to which family Hippocrates belonged—secretly instructed
their young men in this subject; and that opportunities were given for
such study in the temples of Aesculapius.
[Illustration: ARISTOTLE]
The first systematic dissections seem to have been made by the
Pythagorean philosopher Alcmaeon, who lived in the sixth century B. C.,
but it is uncertain whether he dissected brutes or men. The cochlea of
the ear and the amnios of the foetus were named by Empedocles of
Agrigentum, in the fifth century B. C. The nerves were first
distinguished from the tendons by Aristotle, (384-322 B. C.), the most
celebrated zoötomist of antiquity, who has been called the Father of
Comparative Anatomy. For twenty centuries his views of natural phenomena
were held in high esteem.
For a long period the early inhabitants of Rome were practically without
physicians. During severe epidemics they had recourse to oracles, to the
health deities of the Greeks, and to their native gods. As early as the
fifth century B. C., during a pestilence, a temple was erected to Apollo
as Healer. The worship of Aesculapius was introduced into Rome in the
year 291 B. C. Livy relates that the god of medicine in the guise of a
serpent was transported from Epidaurus, in Greece, to the Isle of the
Tiber where a temple was built in his honor.
The Romans, like the Greeks, were accustomed to leave votive offerings,
or donaria, in their temples. Such gifts included surgical instruments,
pharmaceutical appliances, painted tablets representing miraculous
cures, and great numbers of images of various parts of the human frame
shaped in metal, stone or terra-cotta. Among the remains of Roman
anatomical art is the marble figure which was unearthed in the villa of
Antonius Musa, the favorite physician of the Emperor Augustus. It is a
human torso; the front of the chest and abdomen has been removed so as
to expose the viscera. The heart is placed vertically in the middle of
the thorax, thus corresponding to the position of this organ as
described by Galen who made his dissections on apes. It is a human
thorax with simian contents. The figure is supposed to have been
constructed for the purposes of a teacher of anatomy.
[Illustration: ALEXANDER THE GREAT]
It was in the famous Alexandrian University that human anatomy was first
studied systematically and legally.
Alexander the Great, after the fall of Tyre (332 B. C.) and the siege of
Gaza, ordered his fleet to sail up the Nile as far as Memphis while he
proceeded overland with the army. It was probably on this march, while
viewing the pyramids and other marvelous works of the ancient Egyptians,
that he conceived the grand idea of founding a city upon the banks of
the Nile, which should be a model of architectural beauty, a centre of
intellectual life and a lasting monument of his own greatness and
magnificence. The foundation of Alexandria was laid by the warrior whose
name it bears; but the credit of instituting the Library belongs to one
of his lieutenants, Ptolemy Soter.
[Illustration: PTOLEMY SOTER]
The new city which for centuries was the intellectual and commercial
storehouse of Europe, Africa and India, was of oblong form. Lake
Mareotis washed its walls on the south, while the Mediterranean bathed
its ramparts on the north. Provided with broad streets, it was adorned
with magnificent houses, temples and public buildings. At the centre of
the city was the Mausoleum in which was deposited the body of Alexander,
embalmed after the manner of the Egyptians. Alexandria was divided into
three parts: the _Regio Judaeorum_ or Jews’ quarter, in the northwest;
the _Rhacotis_, or Egyptian section, on the west, containing the
Serapeum with a large part of the Library; and on the north, the
_Bruchaeum_, or Greek portion, containing the greater part of the
Library, the Museum, the Temple of the Caesars and the Court of Justice.
The population was cosmopolitan in character; the statues of the Greek
gods stood by the side of those of Osiris and of Isis; the Jews forgot
their language and spoke Greek; and under the Ptolemies, who were of
Greek descent, Alexandria became a centre of intellectual life and
culture.
To the medical historian the most interesting feature of Alexandria was
the Museum or University. Here were assembled the intellectual giants of
the earth: Archimedes and Hero, the philosophers; Apelles, the painter;
Hipparchus and Ptolemy, the astronomers; Euclid, the geometer;
Eratosthenes and Strabo, the geographers; Manetho, the historian;
Aristophanes, the rhetorician; Theocritus and Callimichus, the poets;
and Erasistratus and Herophilus, the anatomists, all of whom labored in
quiet upon the peaceful banks of the Nile. The early Christian church
drew from “the divine school at Alexandria” such eminent teachers as
Origen and Athanasius. Here were a chemical laboratory, a botanical and
zoölogical garden, an astronomical observatory, a great library, and a
room for the dissection of the dead.
In the Alexandrian school of medicine Erasistratus and Herophilus taught
the science of organization from actual dissections. The generosity of
the Ptolemies not only furnished them with an abundance of dead
material, but condemned malefactors were used for human vivisection.
Celsus[5] states that the Alexandrian anatomists obtained criminals,
“for dissection alive, and contemplated, even while they breathed, those
parts which nature had before concealed.”
Herophilus made many anatomical discoveries. He traced the delicate
arachnoid membrane into the ventricles of the brain, which he held to be
the seat of the soul; and first described that junction of the six
cerebral sinuses opposite the occipital protuberance, which to this day
is called the _torcular Herophili_. He saw the lacteals, but knew not
their use, and regarded the nerves as organs of sensation arising from
the brain; he described the different tunics of the eye, giving them
names which are still retained; and first named the duodenum and
discovered the epididymis. He attributed the pulsation of arteries to
the action of the heart; the paralysis of muscles to an affection of the
nerves; and first named the furrow in the fourth cerebral ventricle,
calling it _calamus scriptorius_.
Erasistratus gave names to the auricles of the heart; declared that the
veins were blood-vessels; and the arteries, from being found empty after
death, were air-vessels. He believed that the purpose of respiration was
to fill the arteries with air; the air distended the arteries, made them
beat, and in this manner the pulse was produced. When once the air
gained entrance to the left ventricle, it became the vital spirits. The
function of the veins was to carry blood to the extremities. He is said
to have had a vague idea of the division of nerves into nerves of
sensation and of motion; to the former he assigned an origin in the
membranes of the brain, while the latter proceeded from the cerebral
substance itself. He recognized the use of the trachea as the tube which
conveys air to the lungs. A catheter, the first invented, which was
figured in ancient surgical works, bore the name of the catheter of
Erasistratus. He gravely tells us, as the result of his anatomical
studies, that the soul is located in the membranes of the brain.
The practice of human dissection did not long exist in the city of its
origin, and after the second century was unknown. Then science underwent
a retrogression; observations and experiments were replaced by useless
discussions and subtle theories. The decline of the Alexandrian
University was due to a series of disasters which began with the Roman
domination and reached their climax with the capture of the city by the
Arabs.
[Illustration: GALEN]
Claudius Galenus, the celebrated Roman physician whose writings were for
centuries accepted as authority and whose reputation was second only to
that of Hippocrates, was obliged to base his anatomical treatises
largely upon the dissection of the lower animals. He advised his pupils
to visit Alexandria, where he had studied, in order that they might
examine the human skeleton. He complained that the physicians of his
time—in the reign of Marcus Aurelius—had entirely neglected anatomical
knowledge and had degenerated into mere sophists. He appreciated the
importance of anatomy, particularly to a surgeon who is called upon to
treat wounds and injuries. Hence he has endeavored in the four books,
_De Anatomicis Administrationibus_, to cover this part of anatomy as
exhaustively as possible.
Galen’s voluminous writings form a precious monument of ancient
medicine. The works of the Alexandrian anatomists having been destroyed,
we know of their labors chiefly from what Galen has said of them. His
treatises show a remarkable familiarity with practical anatomy, although
his dissections were made upon the lower animals. Galen’s knowledge of
osteology was extensive. He described the bones of the skull, the
cranial sutures, and the essential features of the malar, maxillary,
ethmoid and sphenoid bones. He divided the vertebrae into cervical,
dorsal and lumbar classes. He knew that both arteries and veins were
blood-carrying vessels; he described the valves of the heart, and
recognized this organ as the source of pulsation. He erroneously taught
that the interventricular septum presents foramina through which the two
kinds of blood become mixed.
In myology Galen made numerous advances. “Previous to his
investigations”, says Fisher[6] “much confusion existed as to what
constituted a single muscle; he adopted the general rule of considering
each bundle of fibers that terminates in an independent tendon to be one
muscle. He was the first to describe and give names to the platysma
myoides, the sterno- and thyro-hyoides, and the popliteal. He described
the six muscles of the eye, two muscles of the eyelids, and four pairs
of muscles of the lower jaw—the temporal to raise, the masseter to draw
to one side, and two depressors, corresponding to the digastric and
internal pterygoid muscles. He described also the brachialis anticus,
the biceps flexor cubiti, the sphincter and levator ani, and the
straight and oblique muscles of the abdomen. In short, he described the
greater portion of the muscles of the body, his treatise differing
chiefly from a modern one in the minute account of these organs and in
the omission of some of the smaller muscles.” Galen studied the brain
and named the corpus callosum, the septum lucidum, the corpora
quadrigemina and the fornix; but erroneously stated that the nerves of
sensation arise from the brain, and those of motion from the spinal
cord. He denied the decussation of the optic nerves. He described the
pneumogastric and sympathetic nerves; seven pairs of cerebral and thirty
pairs of spinal nerves; and claimed the discovery of the ganglia of the
nervous system. He located the seat of the soul in the brain, which also
is the source of the rational mind; the heart to him was the source of
courage and of anger, and the liver was the seat of desire. Many of
Galen’s anatomical statements show that he derived his knowledge from
comparative dissections.
The Galenic era was followed by that long period of ignorance, of
slumber and of inaction which is justly known as the Dark Ages. While a
few Greek and Arab writers, who came after Galen, contributed to the
literature of medicine and surgery, they did nothing for anatomy. After
the end of the fifth century even the works of Galen were forgotten. At
this period, when medicine was chiefly in the hands of the Jews, the
Arabs and the bigoted clergy, nothing was done for science or for art.
The whole influence of Christianity was exerted against the schools of
philosophy. Illustrious apostles of the Church pronounced anathemas
against the reading of the ancient classics;[7] and eminent
ecclesiastics regarded disease as a divine penalty or as an invaluable
aid to saintly advancement. Art and anatomy were practically forgotten.
Their Renaissance occurred almost simultaneously.
During the period from the seventh to the fourteenth centuries the
school of Salernum was for medicine what Bologna became for law and
Paris for philosophy. Here, for eight hundred years, medicine was taught
to thousands of students and the impress of the profession was so potent
that the city called itself _Civitas Hippocratica_, and thus its seals
were stamped. Here medical diplomas were first issued to waiting
students who took a sacred oath to serve the poor without pay. Here with
a book in his hand, a ring on his finger and a laurel wreath on his
head, the candidate was kissed by each professor and was told to start
upon his way. Here women were professors and vied with men in spreading
the doctrines of our art.
For a period of several hundred years anatomy was taught at Salernum
from dissections made upon pigs. Copho, one of the Salernian professors
of the early part of the twelfth century, wrote a treatise, _Anatomia
Porci_, which gives minute directions regarding the manner in which the
animal is to be dissected. Another anatomical work of later date,
written by a member of the Salernian faculty, is entitled _Demonstratio
Anatomica_; it also deals only with comparative anatomy. In the
thirteenth century (A. D. 1231) Frederick II., Emperor of Germany and
King of the Two Sicilies, and the author of a treatise which contained a
complete anatomy of the falcon, decreed that a human body should be
anatomized at Salernum at least once in five years. Physicians and
surgeons of the kingdom were required to be present at the dissection.
So far as is known, no record has been kept of these demonstrations.
Creditable as was this anatomic decree, the great Hohenstaufen in other
respects was not free from the errors of his age. A firm believer in
_Medicina Astrologica_, he did not decide upon any undertaking until the
stars had been consulted.
It was not alone at Salernum that dissection was legalized in the
thirteenth century. A document of the year 1308, of the Maggiore
Consiglio of Venice, shows that a medical college located in that city
was authorized to dissect a body once a year. This, and other isolated
examples, indicate that the time was approaching when anatomy should be
taught from human dissections. The credit of reinaugurating the teaching
of this useful department of science belongs to Mondino dei Luzzi of
Bologna.
[Illustration: Ornamental block]
CHAPTER SECOND
Mondino, the Restorer of Anatomy
[Illustration: Illuminated capital]
In the year 1315, in the old Italian city of Bologna, an event occurred
which marks an important epoch in the history of medicine. A wondering
crowd of medical students witnessed the dissection of a human
cadaver—one of the few procedures of the kind that had occurred since
the fall of the Alexandrian University. Acting under royal authority
Mondino, a man far in advance of the age, placed the body of a female
upon a table where for many centuries before only the cadavera of apes,
of swine and of dogs had been studied.
Mondino, known also as Mundinus, Mundini, Raimondino, or Mondino dei
Luzzi, was descended from a prominent Italian family. Little is known of
his life. The year of his birth is disputed; probably 1276 was near the
time. He was graduated in medicine in 1290 and in 1306 he became a
professor in the University of Bologna, holding his chair with credit
until his death in 1326. Like that of the illustrious Homer, Mondino’s
nativity has been claimed by several rival cities. Guy de Chauliac,
writing in 1363, states that Mondino was a Bolognese: _Mundinus
Bononiensis_ is Chauliac’s expression.
Mondino’s method of teaching anatomy is known from Chauliac’s
testimony:—“Mundinus of Bologna, wrote on anatomy, and my master,
Bertruccius, demonstrated it many times in this manner:—The body having
been placed on a table, he would make from it four readings; in the
first the digestive organs were treated, because more prone to rapid
decomposition; in the second, the organs of respiration; in the third,
the organs of circulation; in the fourth the extremities were treated.”
The innovation so auspiciously begun was not continued, and after the
death of Mondino human dissections were made only at long intervals. The
few instances in which, in the fourteenth and fifteenth centuries, the
ecclesiastical and civil authorities granted the right to make
dissections only prove the contention, that the practical study of human
anatomy did not gain recognition until the sixteenth century.
When Mondino began his dissections the epoch of Saracen learning had
ended, but the influence of Arab medicine exerted by the writings of
Albucasis, Avicenna and Rhazes had not declined. The Arabian physicians
had accomplished little for anatomy. In this line the influence of Galen
was still potent, and was rarely questioned until the publication of the
_Fabrica_ of Vesalius in 1543. During a long period the little treatise
of Mondino held full sway in the mediaeval schools. Medicine was taught
in the University of Bologna, which as early as the twelfth century was
celebrated for its departments of literature and of law. These studies
were free of the difficulties which beset medicine. The prejudice
against dissection was so great that for nearly a century after his
death few men dared to repeat the acts of Mondino.
In 1316 Mondino issued his book which remained in manuscript form for
more than one hundred and fifty years, the first printed edition bearing
the date 1478. Small and imperfect as it was, it marks an era in the
history of science. By command of the authorities this book was read in
all the Italian Universities. The work of Mondino contained no new
facts; it was compiled largely from the writings of Galen and of
Avicenna. The descriptions, to use the words of Turner, “are corrupted
by the barbarous leaven of the Arabian schools, and his Latin is defaced
by the exotic nomenclature of Ibn-Sina and Al-Rasi”. Mondino divided the
body into three cavities, of which the upper contains the animal
members, the lower the natural members, and the middle the spiritual
members. Many of his names are borrowed from the Arab writers. Thus, he
calls the peritoneum _siphac_, the omentum _zyrbi_, and the mesentery
_eucharus_. His description of the heart is much nearer accuracy than
would be expected. He resorted to vivisection, and tells us that when
the recurrent nerves of the larynx are cut the animal’s voice is lost.
In his book we find the rudiments of phrenology. He states that the
brain is divided into compartments, each of which holds one of the
faculties of the intellect.
[Illustration: MONDINO’S DIAGRAM OF THE HEART, 1513]
Mondino did not himself make the dissections which are credited to him.
According to an ancient custom which lasted until the time of Vesalius,
the actual cutting was done by a barber who wielded a knife as large as
a cleaver. The professor of anatomy sat upon an elevated seat and
discoursed concerning the parts, while a demonstrator, who also did not
soil his fingers, pointed to the different structures with a staff.
Originally Mondino’s book contained no figures; when the art of wood
engraving was introduced in the latter part of the fifteenth century, a
few rude woodcuts appeared which represent Mondino and his method of
teaching. In the _Fasciculus Medicinae_ of Joannes de Ketham, published
at Venice in 1493, Mondino’s book is printed with an illustration
showing a demonstration in anatomy.
According to Mondino the heart is placed in the centre of the body. The
valves he considers “wonderful works of nature”. He describes a right,
left and middle ventricle. The right ventricle has thinner walls than
the left, because it contains blood; the left one contains the vital
spirit, which passes through the arteries to the body; and the middle
ventricle consists of many small cavities “broader on the right side
than on the left, to the end that the blood, which comes to the left
ventricle from the right, be refined, because its refinement is the
preparation for the generation of vital spirit, which should be
continually formed”. Mondino describes five bones of the head, separated
by three sutures—coronal, sagittal and occipital. The brain has two
membranes: dura and pia. There are three cerebral ventricles—anterior,
posterior and middle—and in these he locates the various intellectual
qualities. He describes the cerebral nerves: olfactory, optic, motor
oculi, facial, vagus, trigeminal, auditory and hypoglossal. He calls the
innominate bone _os femoris_: the femur, _canna coxae_; the humerus, _os
adjutori_; while the bones of both leg and forearm are named _focilia_
major and minus.
[Illustration: ANATOMICAL DEMONSTRATION IN 1493
(Joannes de Ketham)]
[Illustration: TITLE-PAGE OF MONDINO’S ANATOMY BY MELERSTAT
(Printed before 1500)]
Like many anatomists who succeeded him, Mondino mingled surgical ideas
with his anatomical statements. A break in the _siphac_ causes hernia
and a swelling in the _mirach_. He treated ascites by puncture and
evacuation, making a valve-like opening. Wounds of the large intestines
must be sutured; if the wound be in the small intestines he advises that
“you should have large ants, and, making them bite the conjoined lips of
the wound, decapitate them instantly, and continue until the lips remain
in apposition and then reduce the gut as before”. He gives an
explanation of the length and convolution of the intestines; “for if it
were not convoluted the animals would have to be continuously ingesting
food and continuously defecating, which would impede engagement in the
higher occupations”. Digestion is aided by black bile from the spleen
and by red bile from the liver. The kidneys he regards as glands in
which urine is extracted from the blood. The renal veins expand and form
a fine membrane like a sieve through which the urine is filtered but
blood cannot pass. He mentions renal calculi: if small they pass through
the ureter; if large they are incurable except by incision, and this is
to be avoided. The uterus and breasts are connected by veins, hence the
sympathy between these organs. Inguinal hernia is to be operated upon;
the spermatic cord and testicle may or may not be dissected out, or the
hernia may be treated by the application of a caustic. An incision in
the neck of the bladder will heal, because this part is muscular; but a
cut in the body of the organ will not heal. He describes the operation
for stone:—The patient being in proper position, the stone is conducted
to the neck of the bladder by the finger in the rectum; an incision is
made and the stone is pulled out with an instrument called
_trajectorium_.
Mondino’s book passed through not less than twenty-three editions
between the years 1478-1580. The only manuscript extant is in the
National Library at Paris.
The first printed edition of the _Anathomia Mundini_, Pavia, 1478, is a
folio of twenty-two leaves. The Strassburg edition, 1513, is a small
octavo volume of forty leaves. It contains a diagram of the heart and an
astrological figure, a cadaver with the thorax and abdomen opened,
surrounded by the signs of the zodiac. Such was the volume which for
more than two hundred years was supposed to contain all that was to be
said of human anatomy!
[Illustration: COLOPHON OF THE ANATOMY OF MONDINO, 1513]
So numerous are the abbreviations in Mondino’s book, so barbarous is his
style, that the making of a translation is a difficult task. His reasons
for writing are these:—“A work upon any science or art—as saith Galen—is
issued for three reasons; _First_, that one may help his friends.
_Second_, that he may exercise his best mental powers. _Third_, that he
may be saved from the oblivion incident to old age”.
CHAPTER THIRD
Mondino’s Successors
[Illustration: Illuminated capital]
For two hundred years anatomists used Mondino’s book as a text for their
lectures and for the same period anatomical writers did little more than
comment upon this treatise. The new art of wood engraving was turned to
anatomical use and crude illustrations of the various parts of the body
were put into circulation. Some of these pictures were in the form of
_Fliegende Blätter_, or flying leaves. A set of anatomical plates of
this type was issued by a certain Ricardus Hela, a physician of Paris,
as early as the year 1493. They were printed at Nuremberg. Their
character may be judged by the accompanying illustration of the osseous
system.