Summary

Andrea Vesàlio, italianized form of Andreas van Wesel; his name is also given as Andrea Vesalius, André Vésale, André Vesalio, Andreas Vesal and Andre Vesalepo (Brussels, December 31, 1514 - Zakynthos, October 15, 1564), was a Flemish anatomist and physician.

He is considered the founder of modern anatomy.

He was court physician to Emperor Charles V of Habsburg and later to his son Philip, and the first to become an advocate for overcoming ancient Galenic medicine (which he rejected outright) and for a complete rewriting of anatomical and medical knowledge, through the autopsy study of the human body and the practice of corpse dissection, which he pursued with methodical intent.

He was the author of De humani corporis fabrica libri septem (often referred to elliptically as Fabrica), the first scientific work on anatomy, published in 1543 in Venice, enriched by a varied survey of drawings and illustrations of the human body. The work, the summa of post-Galenic Vesalian thought, was taken up for the most part, in the iconographic set, in the Historia de la composición del cuerpo humano (1552) by the Spaniard Giovanni Valverde, who helped spread Vesalius' work to Hispanic-cultured countries.

He was a pupil and friend of John Baptist Monte.

Origins

He was born in Brussels on December 31, 1514, into a wealthy family traditionally associated with the medical profession. His great-grandfather had been a physician to Mary of Burgundy and a lecturer at the University of Louvain, his grandfather also worked as a physician for Mary of Burgundy and wrote a series of commentaries on the Aphorisms of Hippocrates, and finally his father, also named Andrea, was a physician and pharmacist for Emperor Charles V. With this background, it was quite natural that when Vesalius became one of Europe's best known physicians and anatomists, he was offered the position of personal physician to the emperor at the Spanish court.

Training

His origins, certainly not humble, enabled him to obtain an excellent education: his advanced training began in the Paedagogium Castri, a preparatory school connected to the University of Louvain, and later in the Collegium Trilingue. He studied Latin, Greek and Hebrew. His knowledge of Latin became so profound that, using this language, at the age of twenty-three he was able to teach anatomy in Italy. As for Greek, tradition has it that he was able to translate Galen by sight.

In 1530 he entered the University of Leuven, which at the time was one of the largest universities in Europe, probably second only to Paris and Bologna. He studied philosophy and philology, but independently of his university courses, he began to take an interest in anatomy and even practiced some dissections on mice, dogs, and cats.

In 1533 he moved to Paris to study medicine, thus following the family tradition. His main teachers were Jacobus Sylvius and Ioannes Guinterius Andernacus. Vesalius admired his professors (he praised Sylvius in De Humani Corporis Fabrica of 1543), but he was later dissatisfied with the teaching he received during this period; in fact, in Paris anatomy was taught in the traditional way, with anatomists sitting in an elevated position above the septal table,-on which in the meantime a barber proceeded to dissect the cadaver-reading Galen's texts to the students and not caring about the tissues and organs laid bare at their feet. Vesalius, on the other hand, was much more inclined to the direct study of the human body: he thus used, as many students did, the Cemetery of the Innocents to procure material for studying bones. In this regard, in De Humani Corporis Fabrica, he relates how in this cemetery it was possible to find a very large quantity of bones; how he had become so expert that he could bet on recognizing them by keeping his eyes blindfolded and using only touch; how this experience in the cemetery was necessary in the absence of any real teaching on this part of medicine. However, already at this time he was demonstrating good skills in dissection.

Some autobiographical notes, written at the age of 32, are particularly significant about his personal motivations and the crude manner of his work:

In 1536, following the resurgence of the conflict between France and Spain, he had to return to Leuven where he continued his medical studies and dissection practice. In September 1537 he went to Basel and shortly thereafter moved to Padua. On December 5, after undergoing an examination, the university awarded him the title of Doctor of Medicine.

Career

Vesalius' actual career began in Padua. As early as the day after graduation he gave his first public lecture, dissecting a cadaver and explaining both the composition of the organs and the technique used. The senate of Venice (which ruled Padua) immediately assigned him the chair of anatomy and surgery.

In his lectures Vesalius also used large fly sheets consisting of schematic drawings and concise captions as visual aids. Six of these plates were given to the press under the title Tabulae anatomicae sex (Venice 1538), thus beginning Vesalius' personal didactic-scientific anatomical production, which reached its zenith with De humani corporis fabrica (Basel 1543), a perfect synthesis of scientific rigor and artistic beauty.

In January 1540 Vesalius visited Bologna as a guest lecturer. During this stay he reconstructed the complete skeleton of a monkey and a man, and from comparing the two he realized that Galenic anatomical descriptions were based on dissections of animals, not humans. The refutation of many Galenic theories later became one of the key points of De humani corporis fabrica, which he probably began writing in Bologna itself.

In 1542, having finished writing De humani corporis fabrica, he abandoned his chair in Padua to follow its printing process and was succeeded by Realdo Colombo. The work was published in June 1543, the same year as another masterpiece in the history of science Copernicus's De revolutionibus orbium coelestium in which the heliocentric theory was first expounded. In disseminating it, Vesalius was well aware of the controversy that would ensue: it was in fact the first time that anyone dared to refute the theories of Galen, until then considered, almost dogmatically, the absolute authority of medical science. Many physicians in fact criticized Vesalius' work, particularly his past master Jacobus Sylvius. But there were also many supporters, among whom the most influential was Gabriele Falloppio.

An Epitome, or summary of the work in six chapters, was also printed of the Fabrica, mainly for the use of students. On August 4 of the same year in Speyer, Vesalius presented the work to Emperor Charles V, who immediately hired him as court physician. The reasons for his abandonment of scientific research in favor of this new position are not clear; some argue that this new work was necessary to recover the large expenses incurred in printing the Fabrica, while others claim that Vesalius wanted to abandon academia because he now had too many enemies in it. But the most likely reason is what he himself explains in the preface to the Fabrica: according to Vesalius, in fact, anatomy was only the foundation of medicine, while he aspired instead to become a complete physician. Work in the service of the emperor offered many opportunities to practice as a physician and as a surgeon.

In January 1544 he returned to Italy to take care of final business at the University of Padua, but he also traveled and lectured in Bologna and Pisa. In the latter, in the presence of Cosimo I dei Medici, he inaugurated the anatomical theater in Via della Sapienza.

He returned to Belgium to marry Anne van Hamme and then began a period of intense activity, mainly as a military surgeon, carrying out many assignments in various European countries on behalf of the emperor. Between 1553 and 1556 he lived almost permanently in Brussels, where he practiced privately and pursued his studies. In 1555 he published a revised and augmented version of the Fabrica. In particular he had had the opportunity to study female bodies, including those of pregnant women, and this enabled him to delve especially into the anatomy of the uterus and fetuses.

From this edition of the Fabrica, however, the earlier praise of his old master Jacobus Sylvius was removed. In the meantime, in fact, clashes with the Galenists had never ceased, to whom Vesalius continued to forcefully oppose his reasons, derived from the continuous and meticulous practice of dissection. His opponents, Sylvius in the lead, tried in every way to attack his reputation with the emperor, even going so far as to brand the practice of dissection as impiety. In this regard Charles V scrupulously asked the theologians of the University of Salamanca for their opinion on the admissibility of dissections: they responded by saying that they were useful and licit.

In 1556, when Charles V abdicated he granted him a life pension and appointed him count. In 1559 he returned to the Spanish court in the service of Philip II. In May 1562 he succeeded in curing Prince Don Carlos, son of Philip, of a bad head wound that had reduced him to death. This case put Vesalius to the test, both because of the severity of the wound, the responsibilities involved in treating the prince, and the hostility he encountered from other court physicians.

Thus began to mature in Vesalius the desire to leave the court and return to work in Italy. This desire was probably already born when in 1561 Gabriele Falloppio sent him from Padua, as a tribute, a copy of his work Observationes Anatomicae, which contained some observations and criticisms of the Fabrica. Vesalius wrote a letter of reply that was entrusted for delivery to the Venetian ambassador to the court of Philip II. However, the latter was detained in Spain for several months due to other commitments, and when he finally returned to the Venetian Republic in October 1562, Falloppio was dead.

Vesalius learned of his colleague's death only in the spring of 1564, when, for reasons that have never been fully clarified, he left on a pilgrimage to the Holy Land. In fact, departing from Spain, he stopped in Venice and found his letter there. Some doctors asked him to give it to the press; he agreed and the letter was published in Venice on May 24, 1564 under the title Andree Vesalii Anatomicarum Gabrielis Fallopii Observationum Examen. Vesalius never saw this publication, in fact by April he had already embarked for the Holy Land. Most likely, when he returned, he would have regained his old chair of medicine in Padua, left vacant by Falloppio; but on the return voyage he fell ill and was landed on the island of Zakynthos, where he died on October 15, 1564. He was buried at an unspecified spot on the island of Corfu.

Hypotheses on the reasons for the pilgrimage to the Holy Land

For many years it was believed that Vesalius' departure to the Holy Land was due to problems with justice and in particular with the Inquisition. There are several sources on this subject: the famous French physician and surgeon Ambroise Paré reports the story of a Spanish anatomist who performed the dissection of a noblewoman who died from "strangulation of the uterus." At the time of the second incision, the woman, not really dead, suddenly awoke; this caused such horror in the eyes of those present that the previously very famous anatomist became hateful and detestable to all and so decided to leave the country.

Edward Jorden, an English physician, tells more or less the same story, but explicitly mentions Vesalius' name and says that he used the pilgrimage as an excuse to leave Spain. The French diplomat Hubert Languet, in one of his letters, tells instead that the victim of the dissection was a man and that Vesalius realized the false death when, after opening the chest and uncovering the heart, he noticed that it was still beating: for this he was tried and sentenced to death by the Inquisition; however, through the direct and unofficial interest of Emperor Philip II, the sentence was commuted to the obligation of pilgrimage to the Holy Land. Other sources of the time completely ignore this story; in particular, there is no document or record of Vesalius' alleged trial.

Some historians say that it is very unlikely, though not impossible, that Vesalius made such a mistake. What is much more likely instead is that he, after his death, was the victim of a perfidious slander put about by his opponent physicians. In fact, Languet's letter may be a forgery, for although it bears the date of January 1, 1565, it was first published only in 1620 in Melchior Adam's Vitae Germanorum Medicorum, and does not appear instead in the published collections of Languet's correspondence.

For modern historiography, the story of Vesalius' condemnation is to be considered baseless.

The most likely hypothesis as to the reason for his departure is that he was simply tired of court life and the hostility of Spanish physicians, and that the pilgrimage was merely a pretext for leaving the country. It also seems that the jealousies and clashes with other court physicians, especially regarding medical care for Prince Don Carlos, were so bitter that Vesalius became ill: in fact, the Flemish botanist Carolus Clusius, who arrived in Madrid on the same day as Vesalius' departure, testifies that Vesalius had obtained permission to leave on pilgrimage precisely for health reasons. Moreover, as already explained, Vesalius' desire to return to Padua to devote himself exclusively to scientific research was certainly instrumental in his decision to leave the court.

Another widespread anecdote told about Vesalius' condemnation says that he was condemned by the Inquisition for claiming that, contrary to the common belief of biblical memory, man and woman have the same number of ribs, as shown by the dissections he performed. In Genesis, in fact, it is said that Eve was created from one of Adam's ribs, so the latter should have had one less rib: hence the belief that men all have one missing rib. It is reported that this belief was at the time an accepted and established scientific thesis derived from the biblical account and imposed as de facto dogma by religious authorities.

All of this is, of course, a historical fallacy, first of all because, as already exposed, Vesalius never had any condemnation, and also because, historically, there has never been any dogma about the missing rib, but rather it has only ever been a popular belief.

Vesalius published in Venice in 1538 the Tabulae Anatomicae Sex, six silographies on the subject of anatomo-physiology, where he began to use modern medical terminology (although the work still appears to be linked to Galenic anatomy), and the more important De humani corporis fabrica in 1543 in Basel, which is considered one of the basic texts of modern anatomy, with its 663 folio pages divided into seven books and more than 300 anatomical silographies masterfully illustrated by Flemish engraver and painter Jan Stephan van Calcar (1499-1546), who had trained under Titian.

Independence from Galen

Andrea Vesalius' training and research initially moved within the theoretical framework sedimented in the Galenic tradition. But it was the revival of investigative techniques dating back to Galen that led him to lay the experimental foundations that decreed the obsolescence of the theoretical framework.

An example of Vesalius' process of maturation and gradual liberation from the uncritical acceptance of Galenic theories during the Paduan period is the problem of the rete mirabile: this anatomical structure was one of the fundamental elements on which Galenic physiology rested; according to it, the vital spirit, formed in the heart by refinement of the natural spirit originating in the liver, was carried to the base of the brain by the carotid arteries, which here unraveled into an intricate network of vessels, the rete mirabile precisely. There, the natural spirit was further refined, transforming into animal spirit, which, distributed through the peripheral nerves, considered hollow, endowed the body with sensitivity and movement.

The admirable network constitutes a proof of how Galenic observation was based on the study of other animal species: this anatomical formation, in fact is very evident in ungulates while it does not exist in humans. Vesalius admitted its existence in Tabulae anatomicae sex (1538), while in the Fabrica of 1543 he vividly acknowledges the error made and critically analyzes its cause:

In Fabrica Vesalius rejected other important aspects of Galen's neurology, for example, the notion that nerves were hollow. Let us read what he himself asserts in this regard:

He also described the corpus callosum as a commisural structure of the two hemispheres.

On the level of the physiology of the nervous system Vesalius expresses an agnostic position, clearly drawing boundaries between anatomical observation and philosophical speculation:

Vesalian treatment of female genitalia leaves something to be desired. It is typical of a 16th-century man, however brilliant and innovative. Vesalius shares the prejudice, dating back to Aristotle, that it is the man's semen that has the fertilizing function, while the woman lends exclusively the uterine site for fetal development, as the etymology of the term "vagina" (sheath, sheath) also indicates. Indeed, the very depiction of the uterus in the work is that of an inverted penis, intended to comfortably accommodate the male organ. We will have to wait until Fallopian tube for the discovery of the eponymous tubes, which connect the uterus with the ovary.

Vesalius' firm and inescapable conviction was the importance of anatomical sections in order to be able to understand the structure and physiology of the human body; a theory this in stark contrast to Galenic beliefs, based on an organicistic idea of the human body, that "there can be no functional lesions of the body unless these are associated with actual lesions of the internal organs."

Sources

1. Andreas Vesalius
2. Andrea Vesalio
3. ^ It was a common practice among European scholars in his time to latinize their names. His name is also given as Andrea Vesalius, André Vésale, Andrea Vesalio, Andreas Vesal, Andrés Vesalio and Andre Vesale.
4. ^ a b Attualmente i riferimenti più completi e precisi sulla vita di Vesalio sono: C.D. O'Malley, Andreas Vesalius of Brussels, University of California Press 1964 e W. Cushing, A Bio-Bibliography of Andreas Vesalius, Archon Books, 1962
5. Aujourd’hui Place Poelaert
6. The Early Superstitions of Medicine, The Popular Science Monthly, May 1872, Volume 1, 95-100. o.