Scavenging the Dead: Vesalius and Modern Medicine

It has already been established that I’ve got a thing for the history of medicine, mostly by reason of the macabre. Combine medicine macabre with a world-changing book, and you’ve got my attention. I’m talking about Vesalius, of course.

 

Vesalius is justly famous for his immense contributions to our understanding of human anatomy, particularly as he was one of the first to break from the tradition of blindly following Galen. Don’t get me wrong: Galen is important and great and all that, but he’s the Aristotle of medicine. Scholars took his words as TRUTH and refused to deviate from or build upon them. As Daniel Boorstin puts it, “Galen was always right.” Vesalius is the first major break from that tradition.

 

Vesalius produced his great work De Humanis Corporis Fabrica (or just Fabrica) during the annus mirabilis that was 1543—the same year Copernicus’s De revolutionibus was published. He was 28.

 

A portrait of Vesalius in the first edition Fabrica
A portrait of Vesalius in the first edition Fabrica. He appears to be in the act of flaying.

 

Vesalius understood from his own studies that it was crucial for the illustrations in his book to be as exact as possible, so he employed and supervised the best available artists, and sent the book to Basel where it would be printed according to his exacting instructions. The result was one of the most important books in history—from both a scholarly and aesthetic standpoint. Sherwin Nuland says:

 

The typography, the illustrations, the correlation of the text with the pictorial material—all of these factors made its publication a turning point not only in medicine, but in the history of education and the history of the printed book as well.

 

The 1543 title page of the Fabrica
The 1543 title page of the Fabrica

 

Why was this work so important for medicine? This becomes obvious when you take a look at the cultural context under which human dissections were performed. At this time anatomy (literally Greek for “cutting up”) was studied almost exclusively through prose descriptions of previous authorities—notably Galen. A couple problems with that.

 

  1. Galen mostly dissected animals, not humans. This meant that Galen mistakenly placed certain parts into humans that existed only in animals. (The rete mirabile is a good example: found only in hoofed animals, Galen puts it at the base of the human brain.)
  2. Galen’s text was adhered to at the expense of actual evidence. About once or twice a year, an executed criminal would be dissected for the benefit of medical students. A barber-surgeon would dissect the cadaver, while above him the professor would read the Galenic text—without ever looking at the body to see how it matched up!

 

Galen. Allegedly. (An early woodcut with no basis in fact.)
Galen. Allegedly. (An early woodcut with no basis in fact.)

 

Poor Galen. He doesn’t deserve such a bad rap. He himself believed one should gain this knowledge directly by dissection. And there were others in the Renaissance who broke from tradition, experimenting by themselves: Mantegna, Michelangelo, Da Vinci…but Vesalius is the one who first shared this information with the rest of us.

From the fully digitized copy at the Universitätsbibliothek Basel
From the fully digitized copy at the Universitätsbibliothek Basel

Nevertheless, if you wanted to study anatomy off the beaten path, you really had to commit yourself. Since for the most part only certain kinds of criminal cadavers could be lawfully used for dissection, getting ahold of your very own cadaver required some ingenuity.

 

Mostly, this meant grave robbing.

 

Professors would take advantage of any opportunity to pick up even bits and pieces. Here’s a description of Vesalius’s teacher by one of his students:

 

I have seen him bring in his sleeve, because he lived all his life without a servant, sometimes a thigh or sometimes the arm of some one hanged, in order to dissect and anatomize it.

 

Poor guy, didn’t even have a servant to carry his limbs.

 

Detail of the Fabrica title page.
Detail of the Fabrica title page.

 

Furthermore, finding a single cadaver would never do. Cadavers rot. You have about four days to look around in there before it’s mostly just mush. So for any in-depth inspection, multiple bodies were required. Here is an account of one of Vesalius’s lucky days:

 

While out walking…I came upon a dried cadaver…I took advantage of this unexpected but welcome opportunity and…I climbed the stake and pulled the femur away from the hipbone. Upon my tugging, the scapulae with the arms and hands also came away…After I surreptitiously brought the legs and arms home in successive trips—leaving the head and trunk behind—I allowed myself to be shut out of the city in the evening so that I might obtain the thorax…So great was my desire to possess those bones that in the middle of the night, alone and in the midst of all those corpses, I climbed the stake with considerable effort and did not hesitate to snatch away that which I so desired.

Vesalius631
From the fully digitized copy at the Universitätsbibliothek Basel

Even after Vesalius, for hundreds of years cadavers were extremely hard to obtain. Well into the 19th century, the Edinburgh Medical College paid handsomely under the table for cadavers. A pair of inn owners, Burke and Hare, supplied them with a cadaver when one of their tenants passed. They found they made so much money that they decided to make their own cadavers. They murdered up to 16 people before they were caught. After the trial, Burke was hanged. His body was then dissected at the Medical College, where his blood was used for writing ink, his skin made into various calling cards and wallets, and his bones are even now on display.

 

Which brings us back to the importance of accurate charts and illustrations to assist with learning anatomy. Not only was Vesalius’s work landmark in printing and medicine, but it continued to be extremely valuable when cadavers were not available. So begins modern medicine.

Vesalius491
From the fully digitized copy at the Universitätsbibliothek Basel

For further reading, check out one of my favorite books: The Discoverers by Daniel Boorstin; as well as Doctors by Sherwin Nuland, and The Anatomy Murders by Lisa Rosner.

 

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8 Comments Add yours

  1. vanbraman says:

    Great, keep the books about Medical History coming.

    Also, am I a book nerd for getting excited about getting three empty dust jackets in the mail today?

  2. privatepop says:

    Love your writing. Love the pictures . I thought, “Oh no not medicine.”, but I was quickly drawn into such a fascinating description for the professing of truth.
    It truly reminds me of the theologians who refuse to see a greater understanding of scripture and lean strictly upon what past leaders had believed.

    1. Thanks! Medicine can indeed be boring. But it can also be insanely interesting. A lot like history in general. I think it greatly depends on the teacher…

  3. Dr. C.S. Howell says:

    Loved reading this post. I also enjoy the historical and often macabre applications that medicine has undergone. I have many odd volumes addressing the subject. Thank you for the further reading section, I will certainly look for these works.

    A tear is shed knowing that the push for evidence based medicine and on the spot informatics is accelerating the medical community away from written text to electronic mediums. Knowing new knowledge will likely not be found in the printed form, sends a jolt to my core. Mrs. Romney, do you have an opinion on this change in the world?

    1. Thank you for your comments. I understand the feeling about new knowledge in a new medium. Though, I would say, my opinion is that it is inevitable. That said, written texts won’t disappear entirely, in my perspective. But that’s for another post…too big and nuanced to cover in a small comment.

  4. Justin says:

    Science can be a dirty subject and few seem to exemplify this better than Versalius. I imagine his contemporarys had as much trouble with accepting his findings as they did his methods… that is quite the grizzly excerpt you’ve posted. Do you think Versalius aimed to be considered controversial? It is clear that his work benefited medical science, but I can’t help but think that maybe he revelled just a little in letting others know the gruesome details of his trailblazing. Gunther Von Hagens reminds me of Versalius in this way- where Versalius had De Fabrica, Von Hagens had Body Worlds or the public autopsy. Both benefiting medical science, both involved in macabre controversy. No denying Versalius was an interesting Fella, thanks for the education.

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