Salvatore Mangione, MD
Thomas Jefferson University, Philadelphia, Pennsylvania, United States

The Foetus in the Womb, c. 1511; Royal Collection, The Windsor CastleWhen Vesalius started his life journey five hundred years ago, Leonardo Da Vinci’s own journey into the human body was symbolically coming to an end. Denounced by a German collaborator for necromancy, he would eventually be barred by the Church from even entering the Ospedale di Santo Spirito under accusations of “heresy and cynical dissection of cadavers.”1 Soon thereafter he would accept the invitation of Francis I and move to France, one of the first in a long line of bright Italians forced to die on foreign soil. He would never dissect again.

Leonardo's exploration of the “meravigliosa macchina umana"2 spanned forty years, entailed the study of more than thirty men, women, and children3, and left us with hundreds of breathtakingly beautiful drawings. They are the congealed thoughts of a brain that always thought in pictures, but also show us that the boundaries between art and science are illusory. In fact, Leonardo would have laughed at C.P. Snow's idea of the "two cultures," since he considered himself a humanist who happened to be both a scientist and an artist. Or, as he put it in his notebooks, someone adept at “the science of art and the art of science."2

Besides being beautiful, Leonardo’s anatomical drawings were also groundbreaking. From pioneering the injection of molten wax into cerebral ventricles, to multiple views of various specimens, to the recurrent use of cross-sections and cutouts, Leonardo consistently blessed us with his unique visual-spatial perception of reality. He also relied on “exploded” views, as well as the use of guidelines to show the three-dimensional location of various parts. And he made great use of strings and wires to mimic the function and position of muscles. In fact, he was the first to describe (and draw) many previously unseen structures, since to him mankind came in three flavors: "those who see, those who only see when shown, and those who just can't see."2

Leonardo could definitely see, but he could also draw. As art historian Kenneth Clark later put it, “It is often said that Leonardo drew so well because he knew about things; it is truer to say that he knew about things because he drew so well."4

In fact, Leonardo was the ultimate pathfinder, preceding Michelangelo’s dissections by twenty years, Vesalius’ by sixty, and Nicolaes Tulp’s of Rembrandt’s fame by one hundred fifty. Leonardo’s work in anatomy might have even been known to Vesalius himself, considering that Da Vinci’s heir, Francesco Melzi, kept all of his master’s notebooks not too far from Padua, and was eager to show them to anyone interested. They might have actually served as inspiration for Vesalius’ scenic styles of the Fabrica plates.5 As Leonardo advised in his Treatise on Painting, “figures ought to be in an attitude suitable to the subject they represent, so that in viewing them one may easily know what they think and what they would say.”6

The latter part of Leonardo’s research was aimed at understanding when, where, and if the soul enters the body. This, in turn, led him to dissect fetuses, which quite understandably put him at odds with the Church. As Clark wrote, “of all the great Renaissance artists, Da Vinci alone was destined to fall from Papal grace … in a larger sense he was a graver menace to medieval society than any Borgia. Cesare merely killed men, Da Vinci, like Copernicus, threatened the certitude that knowledge had been forever fixed by God, the rigid mindset that left no role for curiosity or innovation. Leonardo’s cosmology was, in effect, a blunt instrument assaulting the fatuity which had, among other things, permitted a mafia of profane Popes to desecrate Christianity.”4    

Ironically, it was exactly this kind of work, especially his depiction of a five-month fetus in the womb of his mother, which William Hunter gazed at when in 1784 he opened a long-forgotten and locked chest in Windsor Castle. It is hard to imagine the amazement the great obstetrician must have felt in discovering drawings that precisely showed those very placental vessels he had been laboring so hard to study. There they were, in “a miracle of intense presentation”7 made three hundred years before by an unlettered artist with no medical training. Yet, his drawings were so thorough and accurate that Joseph Needham eventually called DaVinci “the father of embryology as an exact science."8

Leonardo’s anatomical drawings are indeed bold, courageous, amazingly beautiful, and scientifically sound. They are probably his greatest achievement as a human being. In fact, they make us proud of belonging to the same animal species - even though Leonardo might not have returned the compliment, since he was famous to quip that "most human beings are only good for filling toilets."2

Still, they are the first serious step towards modern medicine and definitely worth revisiting half a millennium later.


  1. Robinson V. The Story of Medicine. Tudor Publishing, New York, 1936
  2. Richter, JP. The Notebooks of Leonardo Da Vinci. Dover Books, New York, 1970
  3. Keele KD. Leonardo Da Vinci and Anatomical Illustration. Medical and Biographical Illustration; 2: 226, 1952.
  4. Clark K. Leonardo Da Vinci. Penguin Books, London, 1989.
  5. Goodrich JT. "Andreas Vesalius and anatomy: a re-evaluation of his efforts." Hist Sci Med. 1982; 17(Spec 2):13-
  6. Leonardo Da Vinci. A Treatise on Painting. Dover Books, New York, 2005
  7. Kemp M. "Vincian Velcro." Nature 1998; 396 (6706): 25. 
  8. Needham J. A History of Embryology. The University Press, Cambridge, 1934.


SALVATORE MANGIONE, MD, is a clinician-educator with a long interest in physical diagnosis, medical history, and community service. His innovative programs and engaging teaching style have been recognized by multiple awards for clinical teaching, and his work has been featured in the New York Times, the Los Angeles Times, the Wall Street Journal, the BBC, CNN, NPR, and Forbes. Dr. Mangione has been an invited speaker at many national and international meetings, especially in regard to using visual arts to teach bedside observation. He is the author of the book Secrets in Physical Diagnosis.