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November 18, 2017
16th Century Andreas Vesalius

Andreas Vesalius (1514-1564)

De humani corporis fabrica libri septem. Basileae (ex off, Ioannis Oporini, 1543).

Andreas Vesalius
Portrait of Andreas Vesalius
Portrait of Andreas Vesalius


During the early phase of the European Renaissance, the modification of laws and the removal of restrictions by Roman Catholic Church eased the dissection of the human body and this practice became a part of the science of anatomy. In the 16th and 17th centuries, the great popularity of human dissection led to the creation of anatomic theaters in Europe that not only attracted medical students and physicians but also the general public who assisted these sessions with great curiosity, interest and even fear.

One of the greatest anatomists of Renaissance was Andreas Vesalius. He initially studied at the University of Paris under the mentorship of Guinter and the famous French anatomist Jacobus Sylvius. In 1536, he left Paris and after a brief stay in the University of Louvain, he joined the famous University of Padua, the center of medical education in Europe. In 1537, he became Professor of Surgery and Anatomy at this very prestigious institution at the age of twenty-three. Throughout his career, Vesalius performed extensive anatomic studies using human and animal dissections as well as vivisections. His observations were published in several important books and because of his numerous outstanding contributions; he is regarded as the founder of descriptive anatomy.

The principal work of Vesalius, "De Humani Corporis Fabrica" (On the structure of the Human Body), which is considered one of the most important texts in the history of medicine, was published in 1543. The importance of De Fabrica is its insistence on the fact that anatomic study should be based on findings verified by human observations and not on the teaching of Galen. Vesalius reinvented anatomical illustration. More than 200 woodcuts of great quality and precision accompany the text. They were made under the direction of Vesalius by Jan van Calcar (1499-1546), a pupil of Titien, the great painter of Italian Renaissance. The anatomical work of Vesalius predominated in Europe for the next three centuries. Vesalius' historic De Fabrica is divided into 7 sections. The third section mainly focuses on the vascular system whereas the sixth section describes the cardiac and pulmonary anatomy.

 Vesalius corrected many mistakes of Galen which were due to either inaccurate observation or reliance upon animal dissection for his anatomical description. In the first edition of De Fabrica , he questioned the communication between the right and left ventricle via invisible pores in the septum and in the 1555 revised second edition he rejected the existence of these pores. On the section concerning the cardiac valves, the left atrio-ventricular valve was named mitral valve by Vesalius because of the similarity between the shape of the valve and a bishop's mitre. In fact, the mitral valve turned upside down has a similar shape to a bishop's two-flapped angled hat. In his text, Vesalius wrote: "...mitrae episcopali non admodum inepte contuleris...." . Vesalius gave an accurate description of the structural anatomy of cardiac valves.


Andreas Vesalius Andreas Vesalius Andreas Vesalius

Vesalius' descriptions, however, carried some of the mistakes inherited from Galen's era. He also considered the heart a two-chambered structure. The right atrium was the prolongation of the superior and inferior vena cava whereas the left atrium was an expansion of the pulmonary veins. From physiologic point of view, he described an erroneous system of blood circulation inherited from Galen. From pathologic point of view, he is credited with the first description of thoracic and abdominal aortic aneurysms in 1555.

Other important anatomists of this period were Berengario, Canano, Estienne, Servetus, Colombo, Cesalpino, Falloppio, and Fabrizzi. Colombo, Cesalpino and Fabrizzi  contributed significantly to our knowledge of cardiovascular anatomy and we will study their work further in detail. The understanding of the anatomy of the heart and the vascular system and the determination of the relationship between these different structures laid the foundation for major physiologic advances which would take place in the 17th century.

REFERENCES

O'Malley CD. Andreas Vesalius of Brussels. Berkeley, University of California Press, 1964

Ball JM. Andreas Vesalius, the reformer of anatomy. St Louis,  Medical Science Press, 1910

Cushing HW. A bio-bibliography of Andreas Vesalius. New York, Schuman, 1943

Saunders JB de CM, O'Malley CD. The Illustrations from the works of Andreas Vesalius of Brussels. Cleveland, The World Publishing Co., 1950

Silverman ME. Profiles in Cardiology: Andreas Vesalius and De Humani Corporis Fabrica. Clin Cardiol 1991; 14:276-279


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