Roseanne F. Zhao
Chicago, Illinois, United States

The Brabantian physician and anatomist, Andreas Vesalius, is widely celebrated for breaking with Galenic tradition to revolutionize the study of anatomy, changing the practice of medicine, surgery, and education in the process. Born in 1514 in Brussels, Belgium (at that time, part of the Holy Roman Empire) to a long line of scholarly physicians in the imperial service, Vesalius was exposed to medicine from an early age. Matriculating at the University of Louvain to pursue an arts and humanistic curriculum, he quickly became interested in anatomy and left for the medical university at Paris in 1533. Here, Vesalius was discontented with passively listening to professors reading poorly translated texts of Galen from a platform while barber surgeons dissected below.

Thus, the young, inquisitive, and impetuous Vesalius began his own studies of anatomy with a single-minded determination, frequently raiding the Cemetery of the Innocents and the gibbits of Montfaucon and storing the bodies in his bedroom. When news arrived of impending war between France and the Holy Roman Empire, Vesalius relocated to Padua, where he received his medical degree in 1537 and was appointed Professor of Surgery at the university.

Vesalius’ dissections of human bodies revealed numerous inconsistencies with Galenic doctrine, which was based primarily on animal dissections. In 1542, Vesalius published his anatomical masterpiece, De humani corporis fabrica, libri septum, a systematic study of the human body that has been credited with revolutionizing human anatomy, medicine, and education. In contrast to previous anatomical texts, Vesalius included copious and detailed illustrations of bodies in active poses superior to any that had been previously produced, made possible by technological advances in mass-printing woodcuts. While critics bitterly and vociferously attacked his publication, it was well-received by others and disseminated throughout Europe to influence countless future generations.

However, Vesalius’ work was not without precedent. Many of his contemporaries had previously pointed out inaccuracies, though not in such a systematic way. Indeed, more than 50 years earlier, the preeminent polymath of the Renaissance, Leonardo da Vinci, had already begun his own investigations on the anatomy and physiology of the human body. Had they been published, they would have introduced Europe to the new anatomical paradigm a generation earlier and dramatically influenced the study of medicine.

As court artist to Ludovico Maria Sforza of Milan in the 1480s, da Vinci initially studied anatomy in an effort to portray his subjects as true to nature as possible. Nevertheless, he became so captivated with his discoveries that he devoted many of his later years to producing a comprehensive treatise on anatomy. Drawing from his experience in engineering and other disciplines, da Vinci developed techniques and graphics rivaling the accuracy and depth of today’s best medical illustrations.

In fact, da Vinci was the first to accurately depict the curvature of the human spine, trace the intricacies of the blood vessels, and propose the principle of pronation/supination of the forearm. He established the heart (rather than the liver) as the center of the vascular system, and his preliminary studies on the heart and valves were even cited centuries later in a 1968 Nature paper by two engineers at the University of Oxford. Da Vinci also remarked upon the “increasing tortuosity and constriction of vessels in the elderly” where “the coat thickens so much that it closes up and prevents movement of the blood . . .  from which arises the death of the elderly without disease.”¹ His notes on the 1508 death and post-mortem of a “centenarian” were undoubtedly ahead of their time and provided the first known diagnosis of arteriolosclerosis, coronary vascular occlusion, liver cirrhosis, and associated portal hypertension.

Although da Vinci had intended to publish a comprehensive anatomical treatise, the unexpected death of his collaborator Marcantonio della Torre from the plague in 1511, combined with political instability in Milan, put this endeavor on hold. He retired to the villa of his pupil, Francesco Melzi, and his manuscripts, lost amongst his papers upon his death in 1519, were never published.

A man who combined his artistic genius and inquisitive mind with sharp observational prowess and pursuit for excellence, da Vinci was undoubtedly a forerunner of the new anatomical paradigm. Nevertheless, Vesalius deserves due credit for its founding. Despite dying penniless in 1564, after being shipwrecked returning from a penitential pilgrimage (possibly to escape the Inquisition), Vesalius’ legacy lives on in the Fabrica and in the perpetuation of his school of thought, which emphasized the empirical approach to medical teaching and research.

Then, as now, groundbreaking discoveries arose from the collective contribution of countless individuals. Da Vinci and Vesalius, along with many of their contemporaries, were all products of their time, shaped by the essential and unquenchable spirit of curiosity, creativity, and pursuit of excellence—this was the Zeitgeist that drove the Renaissance and the spirit that continues to propel our advances today.

References

1. Clayton M, Philo R. Leonardo da Vinci: Anatomist. China: Royal Collection Enterprises Limited; 2012.
2. Friedman M, Friedland GW. Andreas Vesalius and Modern Human Anatomy. In: Medicine’s 10 Greatest Discoveries. United States of America: Yale University Press; 1998.
3. O’Malley CD. Andreas Vesalius of Brussels, 1514-1564. Berkeley and Los Angeles, CA: University of California Press; 1964.