Young man digging graves and stealing corpses at midnight: I am here to bury Caesar |

Modern historiography seems to have become a convention, assuming that there is really no "lone genius" in the world, and there are almost no moments of shouting "eureka!" But this is not the case in the field of surgery. There are many famous masters whose genius perspectives are underestimated, but they see further, challenge the times, and contribute more to improving the fate of mankind than experts in any other field.

This article is authorized to be excerpted from Chapter 3 of The Birth of Surgery: From the Renaissance to the Transplantation Revolution (CITIC Publishing Group). The title is added by the editor.

Written by David Schneider

Translation | Zhang Ning

A series of developments in the mid-15th century set the stage for a sociological revolution. In these decades, Lucretius’s long poem On the Nature of Things was discovered in German monasteries, clear crystal glass and high-grade mirrors were made in Venice, Constantinople fell to the Ottoman Turks and ancient Greek manuscripts flowed to Italy, and movable type printing presses were invented. It is generally believed that “individualism” was born in 1500 AD, and it is no coincidence that the refined mirror and the first self-portraits appeared at the same time. Lewis Mumford wrote in Technics and Civilization: “Self-consciousness, introspection, dialogue with the mirror image developed together with the new object.” For the first time, man was able to see himself, and when man himself became the focus of attention, property rights and legal conventions began to develop around the individual rather than around collective units such as the family, tribe, city or kingdom as before. The new individualism and humanism of the mid-15th century prompted elite wizards to look within themselves, to explore the motivations of the mind and the human body, or to “discover” the structure of the human body, in Columbus terms. As the Dark Ages faded, our inner minds and bodies became fertile ground for exploration. The explorers who focused their attention on the human body had no idea of ​​the "new world" that was opening up before them.

Around 150 BC, the time of Herophilus and Erasistratus, the decline of human dissection in Alexandria heralded the demise of the medical school, once the world’s most advanced scientific research center. After Alexandria was incorporated into the Roman Empire in 30 BC, the Empire further codified laws against human dissection, which was opposed both by law and popular religious sentiment. As we have seen, Galen became the unquestioned authority on anatomy, even though he never performed a dissection or autopsy on a human corpse. His investigations were based on animals, including farm animals and Mediterranean macaques.

The prohibition on human dissection persisted even during the Muslim intellectual leadership of the 8th to 13th centuries, with only a few original anatomical studies. "Islamic anatomical knowledge merely gave Galen a Muslim veneer," and the great Arab translators merely restated Galen's ideas. There is a curious idea that the practice of boiling and dismembering bodies and cleaning the bones to facilitate the transport of dead Crusaders back home in the Far East may have laid the foundation for the revival of human dissection. In the Apennines, interest in studying medicine was rekindled, first in Salerno, then in Bologna and Padua, leading young researchers to perform the first human dissections in defiance of the ban of Boniface VIII in 1299. The ban "was not directed against human dissection, but against boiling the bodies of those who died in a foreign land [for burial at home]... Although the pope never issued any specific statement against dissection, it seems that some overly enthusiastic local church clergy were consciously or unconsciously opposed to the practice of dissection." It is a mistake to think that the Church banned dissection; ironically, these bans were actually enacted by pagans in the Roman Empire, remained in effect until the 14th century, and it was their Italian descendants who most vigorously challenged and overturned these laws.

Mondinode Luzzi, a physician from Bologna, Italy, became the first important anatomist of the Middle Ages. He published his classic Anatomy in 1316, the first modern book devoted entirely to anatomy. Mondinode Luzzi seemed to rely heavily on Galen’s work, but much of the book was clearly based on his own anatomical practice. Accessible, concise, and clearly organized, Anatomy would guide anatomists for the next 200 years and ignite a thirst for medical knowledge across Europe. The University of Bologna thus became the first home of a renaissance in anatomical practice and study of the human body that soon spread to Padua, Venice, and Florence in the 14th century, and by 1501 to Siena, Perugia, Genoa, and Pisa. Again, despite the sins of the Catholic Church in the 14th and 15th centuries, it did not prohibit human dissection as we often assume.

It is no accident that the rise of anatomical knowledge, humanistic self-awareness, and artistic expression all occurred simultaneously during the Italian Renaissance. In the early 16th century, Botticelli, Leonardo da Vinci, Michelangelo, Raphael, Dürer, and Titian emerged simultaneously, competing with each other and occasionally collaborating. In 1502, Giacomo Berengario was appointed head of surgery and anatomy at the University of Bologna, succeeding Mondino. He wrote a nearly 1,000-page work, the Commentaria (1521), made possible only by the printing revolution. Berengario was the first physician “not constantly subject to the views of earlier authorities such as Galen or Muslim scholars” and had considerable confidence in his own views of the human body and its functions. Importantly, he also had a keen interest in art and even owned Raphael’s famous painting John the Baptist. Although the Commentaries of Mondino were still crude, they were the first anatomy book to integrate text and illustrations, and Berengario was also called "the first anatomist to better understand the true significance of anatomical illustrations."

Although surgery was still limited to opening abscesses, performing initial triage on battlefield casualties, and managing emergencies, the overall trend was toward a greater understanding of how the body worked. With improved printing, perfected woodcuts, and new methods of scientific research, the stage was set for a young anatomist-surgeon to write one of the greatest books ever written.

Andreas Vesalius was born in Brussels, Belgium in 1514. He was born into a family of high social status. His father, Andreas, was the royal pharmacist, and his grandfather was the royal physician to Maximilian I. In an era when royal family members often traveled, the travel of the royal motorcade meant that Vesalius's father was rarely at home. Vesalius benefited from an elite education, first in Brussels and then in nearby Leuven as a teenager. At the Castle School of the University of Leuven, the teenage Vesalius studied philosophy and art, including Aristotle's doctrine, and became proficient in Hebrew, Greek, and Latin. It was not surprising that Vesalius, who came from a medical family, chose medical school. In 1533, he embarked on the road to Paris.

Vesalius enrolled at the medical school in Paris, expecting to receive his degree in four years. Now it seems strange that four years of study were required to obtain a bachelor's degree in medicine. A modern surgeon might ask, what were they studying? Why did this professional course take so long? There were no instruments such as microscopes, no concepts such as physiology (the study of the dynamic function of the human body), pathology (the study of organ and cell diseases), microbiology (the study of bacteria and viruses) had not yet appeared, and surgery was still very primitive, such as we can still see in villages in Kalimantan that retain Stone Age life. We can only speculate that the medical schools at that time studied Galen's medicine and ancient Greek medicine, which was full of philosophical ideas and fallacies. Vesalius studied in Paris for three years, but as we will see later, he was forced to leave there before he received his bachelor's degree.

Before Andreas Vesalius arrived in Paris, the city of light, barbers, surgeons, and physicians were fighting for social prestige and recognition. Entrenched prohibitions against human dissection had dissuaded doctors from any interest in anatomical research. Since anatomical research was closely tied to surgery, physicians had no incentive to study the human body seriously, let alone touch a corpse. A modern reader might assume that today’s physicians and surgeons, no matter what their specialization, started out as classmates at the same medical school. But in the Middle Ages, physicians and surgeons did not train together. Surgeons were taught individually by medical teachers; barbers were far less well-educated, learning no Latin and certainly no Greek, except for occasional instruction from physicians and surgeons. Barbers first clustered around monasteries, where they shaved the heads of medieval priests who entered the monasteries. Over the past thousand years, barbers have become experts in haircuts, shaving, and Hippocratic bloodletting. In England from 1540 to 1745, barbers and surgeons were indistinguishable. Eventually, barbers became a group of people who specialized in shaving and cutting hair. Only the striped pillars in front of the barbershops remind us that they once had the job of bleeding customers.

Just as medieval clergy exercised control over their parishioners, "the use of Latin followed an ancient tradition of power and control... the mastery of Latin held the key to the secrets of the mysteries." After years of tension, Paris finally reached an agreement on the hierarchy of the medical system in 1516 - physicians continued to be at the top, while surgeons accepted a position below. Parisians were unwilling to follow the leading Bolognese and Paduans, who rolled up their sleeves and performed dissections and research themselves. French physicians refused to touch corpses, and they sat on their thrones, lecturing from a high position while surgeons performed the actual dissections from the sidelines.

By the 15th century, surgery had gained a certain degree of respect in Italian cities, but in northern European countries such as France, Germany and the United Kingdom, surgeons were far less respected than internists. Their guilds (equivalent to today's trade unions) were composed of surgeons and barbers, and strictly established rules and standards for membership. The art of "barbering and surgery" looked more like "surgery" in ancient Greece and Rome, limited to the most basic stabilization of trauma, including fractures, sword wounds and new types of trauma caused by the introduction of gunpowder from China.

The battlefields of Europe in the 14th and 15th centuries saw the power of gunpowder, and the “blast injuries” from gunfire seemed far worse than any trauma ever seen. The son of a barber and surgeon, Ambroise Paré (1510-1590) never attended proper medical school but became surgeon to four French monarchs. The first great French surgeon, Paré revolutionized the treatment of war wounds and became an influential figure through his writings (written in French, not Latin). Early Renaissance physicians found themselves helpless against patients with severe gunshot wounds, wounds more complex than anything humans had ever faced. So these patients were left to barbers or surgeons. And before Newton’s time, it was hard to understand that it was the energy from the gunpowder propelling the shrapnel that caused such severe injuries, rather than some “poison” in the fragments. Pope Julius II’s surgeon, Giovanni da Vigo (1450-1525), in his works published in 1514 and 1517, speculated that gunshot wounds were a form of “poisoning caused by gunpowder” that should be treated with boiling oil, mimicking the ancient treatment used by gladiators for their injuries. As we can imagine, boiling oil cauterization would stop the bleeding, misleading trauma experts to assert that the treatment was effective; in fact, it only expanded the “damage area” and caused more severe injuries. Unfortunately, Vigo’s views were so influential that field surgeons obediently poured oil on these explosion wounds.

In his Oeuvres, published in 1575, Pare succinctly described a crisis he encountered during the Battle of Turin in 1536. Late in the evening after a heavy battle, when Pare’s boiling oil ran out, he recorded:

Finally, I ran out of oil and was forced to use a digestive medicine made of egg yolk, rose oil and turpentine to treat the wounded. That night, I tossed and turned, thinking that the wounded who did not receive the boiling oil cauterization would be poisoned and die. This thought urged me to visit them at dawn. To my surprise, the wounded who were treated with the digestive medicine had no redness, swelling or inflammation in their wounds, and they were basically painless, so they rested well all night. However, the wounded who used the boiling oil cauterization treatment had a fever, and the area around the wound was red and swollen, and the pain was extremely severe. From then on, I no longer used such cruel cauterization treatment to treat those poor people who were shot.

Pare had stumbled upon a better method, inadvertently conducting a controlled study. More importantly, he published his findings, going against the grain of the academic establishment. Pare would have a major influence on early surgery, as he also advocated ligating (suturing) blood vessels, using prosthetic limbs after amputations, and improving the management of childbirth. The timely advent of book printing technology helped Pare’s work to be published; and, as we will see again and again, war provided fertile ground for medical progress.

Andreas Vesalius entered medical school in 1533, the same year that Pare arrived at the Hôtel-Dieu, the oldest hospital in the world, next to Notre Dame. Vesalius’s medical training was typical of the time. Galenic theories were in full swing, and Vesalius’s instruction in anatomical techniques was at best rudimentary. It was here that Vesalius first demonstrated his intellectual curiosity, or his lifelong eccentricity. After he established his own school, he admitted that if he had only followed the instructions of his professors, “if I had not studied for myself while a student of medicine in Paris, but had accepted without question the superficial and casual presentations of organs … made by the unskilled barbers for me and my fellow students,” he would not have succeeded. As we have seen again and again in later history, surgery is made up of a combination of fine craftsmen, eccentrics, solitary geniuses, inspiring mentors, and eccentric old fogeys. Vesalius was one of them. He visited the Cemetery of the Infants of Paris many times, picking through rotting corpses and maggot-infested skeletons, and later recalled spending long hours in the cemetery, "often besieged by vicious wild dogs."

When war broke out between the Holy Roman Emperor Charles V and the King of France, Francis I, Andreas Vesalius was forced to return to Brussels, as he was seen as a Flemish enemy living in Paris. He quickly settled in at the Faculty of Medicine in Louvain, just outside Brussels, and soon began searching the local area for bodies. While searching for the remains of executed prisoners outside the city walls, Vesalius and a physician friend came across a body hanging from the gallows. He examined the body and speculated that it had originally been burned on straw, but that the flesh had been eaten clean by birds. He also observed that the bones were preserved by dry ligaments connecting them. Vesalius recalled:

I found the body dry, without any moisture or decay, and I took advantage of this opportunity. With the help of my friends, I climbed up the stake and pulled the femur from the hip. The hand and arm also fell off with the shoulder blade, but the fingers of one hand, two patellae, and one foot were gone. I went back and forth several times to smuggle these limbs home, and then only the head and torso remained. At night, I deliberately let myself be locked out of the city so that I could find a way to remove the thorax, which was firmly tied to the chain. I was so eager to get the bones that I was alone among the corpses in the middle of the night. I struggled to climb the stake and pulled down the object I was longing for.

After softening the bones in boiling water and removing the ligaments and soft tissue, Vesalius continued:

Finally, I secretly boiled all the bones for my own use, and after cleaning them, I assembled them into specimens and preserved them in Louvain.

After a brief stop in Leuven, Vesalius traveled to Padua, Italy, home to one of the world’s leading medical schools. It was at the University of Padua that Vesalius took his final exams.

The nearly 400-year-old academic archives of the University of Padua tell us that he “performed with distinction in this rigorous examination… and the examiners unanimously approved him.” Amazingly, the day after graduation, Vesalius was appointed head of the Department of Surgery and Anatomy. Despite attending three schools in four years, he still stood out in the department, and it was clear that something extraordinary was brewing in Padua.

In December 1537, one day after Vesalius graduated, the new head of the Department of Surgery and Anatomy began his first anatomical practice on the corpse of an 18-year-old male. This dissection would last for 18 days. Vesalius followed the plan set by Mondino: first the abdominal cavity, then the chest cavity, head and neck, skull and brain, and then the limbs. People found that the biggest change was that Vesalius combined all the roles in one person. He was not only a lecturer, but also a demonstrator and dissector. This prestigious physician stepped down from his high throne, stood beside the corpse with a scalpel in hand, and took on the role of a surgeon. He did not have to read out the views of Mondino or Galen from the book, because their works were already familiar to him. Vesalius, who had just turned 23, also introduced a new teaching method, which was to post illustrations or diagrams for students. This was a person who was truly devoted to teaching, and in less than a year, he published his first book, Tabulae Anatomicae. The drawings, which broke with tradition, reflected Vesalius's observations, confirmed the message he wanted to convey, and had a high mnemonic value. Printed in Venice, the Atlas of Anatomy used six large woodcuts measuring 19 inches by 13.5 inches. Published in 1538, the book was the first hint that Galen's teachings were unreliable. Vesalius discovered inconsistencies in Galen's descriptions, and the young anatomist began his own research project, refusing to accept past authorities unless he could prove them correct.

Two years later, Vesalius published a revised edition of another anatomist’s work, Johann Guinter’s Institutiones Anatomicae, which became a teaching text to accompany anatomy lectures and demonstrations. In a sense, the book was largely plagiarized, with Vesalius making revisions and adding new material. Although it was a little strange that he would revise someone else’s work, there was something worse: Vesalius’s text and illustrations were later completely plagiarized verbatim by other publishers.

In the late 1530s, Vesalius began a comprehensive analysis of Galen’s work, including a Greek translation and a scholarly assessment of his anatomical descriptions. It was becoming increasingly clear to Vesalius that Galen was not always right. Encouraged by some of his professors in Paris and Louvain, he began to boldly prepare a monumental work to challenge Galen’s authority. In doing so, he took advantage of new printing technology and the widespread improvement in the aesthetic taste of northern Italy during the early Renaissance. During this period of investigation, Vesalius lived with John Caius, an Englishman who was also in his twenties and had come to Padua to study medicine. Caius had studied at Gonville College, Cambridge. He must have assisted Vesalius in his Greek translation, but he was more faithful to Galen’s original work than Vesalius was. Historian CD O'Malley said: "Although Caius and Vesalius were actually of the same generation, in their time, human specimen dissection was already being carried out and scientific treatment based on anatomy had begun; but in spirit, Caius belonged to the older generation who had a firm belief in Galen. The medical humanists at that time believed that Galen held the key to solving all medical problems, so those Latin works accurately translated from the original Greek classics were the greatest blessing they could provide to the medical community." Later, Caius returned to London and was very successful. He rescued Gonville College from financial crisis. The college was renamed after him in 1557 and became the world-famous Gonville and Caius College of the University of Cambridge today.

Vesalius was busy in Padua and nearby Bologna, attracting students with his teaching and his talent for anatomy. “It is significant that wherever Vesalius went to give extramural lectures, a wave of gravedigging and body-robbing would occur in the area.” Newly buried citizens and criminals became fodder for Vesalius and his “anatomy.” One contemporary report said: “The mistress of a certain monk [in Padua] died suddenly… The body was stolen from her grave by Paduan students and publicly dissected. They were extremely diligent in peeling off the entire skin from the body, fearing that the monk would recognize it.”

By challenging the conventional wisdom he had learned, Vesalius came to understand the human body better than anyone else. In the age of exploration and discovery, navigators had already charted the coastlines of South America, Africa, India, and East Asia; Vesalius’ subjects were similar and largely concerned with human progress, and he was eager to convey this knowledge in the best possible way.

The formal writing of the On the Fabric of the Human Body began in early 1540, just after Vesalius’ 25th birthday. He intended the On the Fabric of the Human Body to be a guide to dissection and understanding of the human body. This was not just a book about the human body, not the kind of amusement for a reclusive gentleman. It was a guide tailored for doctors, and a later, abridged version, the Summa, was designed specifically for medical students. The On the Fabric of the Human Body included descriptions of the instruments needed for each step of the dissection, as well as techniques for boiling and cleaning bones, and the dissection of all muscles, joints, organs, and nerves. Sometimes he would stay alone in his home in Padua for weeks at a time writing and reflecting. Vesalius probably spent at least a year writing the On the Fabric of the Human Body. The woodcuts in the early publications were taken from illustrations he had drawn himself, but the illustrations in the On the Fabric of the Human Body were eventually drawn by professional painters. The printing revolution gave Vesalius and his team of illustrators great reproduction capabilities, whereas his predecessors had written “disposable” books whose texts were circulated by hand copying and whose illustrations had to be redrawn each time they were reproduced. After repeated copying, the quality would be greatly reduced.

In his earlier works, Vesalius had hinted at the inconsistencies in Galen's arguments and his lack of experience in human anatomy. In On the Fabric of the Human Body, Vesalius did not go on to hint at the inconsistencies in Galen's arguments and his lack of experience in human anatomy. In On the Fabric of the Human Body, Vesalius stated affirmatively:

At Padua, the most famous university in the world ... I taught surgery, and as anatomy was connected with it, I devoted myself to the study of the structure of the human body. I therefore practiced dissection very frequently, both at Padua and at Bologna, and, abandoning the absurdities which were current in the schools, my demonstrations and teachings did not differ in any way from the ancient tradition.

He then mentions the gods of anatomy, including Galen, and criticizes their followers:

For those who really cared about dissection, they [the early anatomists] seemed to have no interest in human dissection. I do not know what made them so firmly cling to the work of their leader [Galen], and what made them, after the failure of others to dissect, reduce Galen's teaching to a summary (if they really understood Galen at all), and not dare to go beyond it.

Such powerful words came from the pen of a 28-year-old young man, but in the second half of the introduction, he became more tactful:

Now, I have no intention of criticizing the erroneous teachings of Galen, who was undoubtedly the king of professors of anatomy; still less do I wish to be thought from the outset to be a betrayer of the authority of this author who has done so much useful work.

In the words of Mark Antony, “I am here to bury Caesar, not to praise him.” Vesalius then cites more than two hundred instances in which Galen was wrong about “the structure of the human body, its uses and functions.” His message becomes clear: the old king is dead, and a new king is in place.

Figure 1. Portrait of Vesalius

Ambroise Paré, mentioned earlier in this chapter, is considered by some to be the first great surgeon. We can argue that Vesalius, by emphasizing the skill of the hands in surgery, lifted surgery from the insignificant position of the barber-surgeon and illuminated the way forward. In On the Structure of the Human Body, Vesalius lamented that humans had neglected “the most elementary instrument, the hand, and so [medicine in manual operations] fell into disdain, and was practiced by common men without professional training.” Early ancient physicians used diet, drugs, and their hands to practice medicine, but physicians in Vesalius’s time had unwittingly “degenerated greatly, leaving all the work of cooking and preparing meals for patients to nurses, the dispensing of drugs to pharmacists, and the work of the hands to barbers.” Vesalius, who came from a well-off family, advocated close contact with his patients, even though it made him filthy and smelly. Ancient physicians “specialized in the treatment of dislocations [dislocated joints], fractures, and wounds… to relieve warriors from the pains of javelins, darts, and other demons of war.” Vesalius wanted surgeons to continue to treat patients with their hands, “scorning the whispers of physicians as if it pleased the gods,” as many physicians did—many of whom disdained the art of “hands-on” dissection and treatment. Pare is recognized for his wiser approach to battlefield injuries and gentler treatment of ruptured blood vessels, but Vesalius’s renewed interest in the study of the human body and his emphasis on the importance of hands-on work make him one of the most important figures in the history of surgery.

After preparing the text on anatomy, Vesalius began finalizing the illustrations. The outstanding drawings he commissioned were transferred to paper on a large scale via woodcuts, making them accessible to most of us. The great painter Titian (1490-1576) lived his entire life in the Republic of Venice. During his most productive years, Titian had a studio in Venice. It is thought that the most exquisite illustrations in the Human Fabric were probably created by a young talent in that studio. The illustrations fall into four categories: introductory illustrations, muscle diagrams, initials, and wonderful anatomical drawings. All of these delicate works of art were first drawn on paper and then mirror-engraved onto woodcuts of the same size, a difficult task. The woodcuts were made of pear wood, which was sawn along the grain, rubbed with hot linseed oil, and then engraved with great precision and care. After the woodcuts were completed, Vesalius wrote a letter to a printer in Basel, Switzerland. His choice was Johannes Oporinus, a professor of Greek in Basel who was known among scholars for his attention to detail and high-quality production. In September 1542, the letter and all the woodcuts were transported across the Alps to Basel in a wagon from Venice. Oporinus and his team, assisted by Vesalius, spent several months arranging the manuscript and woodcuts, and by the summer of 1543, the book was ready. Although most woodcuts used for printing were either recycled or discarded, the plates of On the Fabric of the Human Body survived for centuries, with several decades missing in between. Rumor has it that the plates were hidden in the library of the University of Munich, and after some investigation, they were discovered in 1936 in a large box in the library's attic, and the plates were well preserved. Sadly, during World War II, all of the plates were destroyed by bombs and are now gone.

Figure 2. Title page of Vesalius’ On the Structure of the Human Body

There are two large introductory images in the De humani fische Fracture. The first is the title page, the second is of Vesalius himself. The title page image is one of the greatest woodcuts ever made; its perspective, clarity, composition, and command of painterly technique are breathtaking, even if it were a hand-drawn work. And the fact that the image was engraved as a relief on the plate by the master engraver is even more incredible. The image depicts a public dissection, with a crowd (I counted at least 85 people, not counting the corpse, a dog, and a monkey) crowded around the dissecting table, and Vesalius is showing the entrails of a corpse (see above). It is reminiscent of Raphael’s The School of Athens, completed in 1511, and indeed there is a figure on the right side of that image who looks a lot like Plato in The School, who is traditionally attributed to Leonardo da Vinci, who died in 1519. But here he is not pointing to the sky, as Plato did, but to the corpse. Is this Vesalius’s ideal? If astronomers are measuring the starry sky, are our anatomists measuring the human body?

The muscle diagrams fill an entire page; in fact, in the few original copies of the Human Fabric that have survived, each sheet is larger than the normal folio size and, when unfolded, is one-third larger than the original page. These large drawings depict moving corpses, skinless but not lifeless, with faces twisted in extreme pain, which is horrifying. The illustrations are continuous, indicating that the levels of dissection are getting deeper and deeper; as the levels of dissection go deeper, there are fewer and fewer muscles attached to the body. The muscle diagrams are set against a backdrop of the bucolic countryside of Venice, with the human body perched high on a hill, and churches and rural buildings dotting the horizon (see Figure 3).

Figure 3. The muscular human body diagram from On the Structure of the Human Body.

The first letters of the book are interspersed throughout the book, becoming eerie and even terrifying interludes between paragraphs. The capital letters that open new paragraphs are large, and were previously hand-painted decorations, but after the advent of printing, woodcut printing blocks made printing more efficient. The first letters of the book in On the Structure of the Human Body use two-thirds of the letters of the alphabet, and each of them includes naked boys or angels who participate in mischievous grave digging, corpse robbing, bone boiling, bone setting, and even more terrifying, experiments on live pigs. All of this reminds people of the terrible times that our ancestors once endured, but future generations have benefited greatly from that era. As the saying goes, those who plant trees will enjoy the shade.

The anatomical illustrations themselves are the most striking. In a letter to Oprinus, Vesalius instructed him to make all printing as "beautiful and light" as possible and to use woodcuts as "accurate and beautiful" as possible. For the first time, the illustrations are labeled with letters to link to the corresponding text. These letters guide readers to specific body parts in the illustrations as they read Vesalius's text. In addition, numbers and letters in the margins help readers to cross-reference other illustrations. Vesalius's breakthroughs are many, and he has presented a visually stunning teaching masterpiece that frequently challenges 1,500 years of authority. These hundreds of pages of text and illustrations present the human body and its functions in a clear, easy-to-understand and beautiful way; Vesalius's sections on physiology and organ function occasionally challenge Galen's views. Of course, the obvious flaw in the book is the discussion of gods, evil spirits, and where the soul exists - after all, it would take hundreds of years for advanced microscopes to reveal the secrets of cells and their functions.

Vesalius said: "I realize that because of my age - I am now 28 years old - my work has little authority, and because I often hint at the fallacies in Galen's teaching, people who have not seen my dissection demonstrations will naturally attack me, and this book will have no place to survive in the attacks." But the opposite was true. Vesalius's masterpiece was very popular as soon as it was published, and he became a world-famous anatomist and surgeon, unrivaled for about two hundred years.

I admit that I am an inveterate book lover. To hold a priceless book in my hands is a truly extraordinary feeling. After months of contacting archivists at the Wellcome Library in London, building a trusting relationship, and filling out a series of required forms to gain access to a special archive, I finally got to study the 1543 copy of the Human Fabric. This is one of the greatest medical libraries in the world. Since pens are not allowed in the rare book archive, I locked my backpack and pen in a locker, scanned my scholar's card, passed through security, and went to the top floor of the building. I was indeed a little nervous. Despite my preparation, I was still worried that I had come all the way to London and still came back with nothing. The last archivist I had ever corresponded with, a man named Ross, approached me as soon as I passed through the last security door and entered the inner room. "Dr. Schneider? Welcome to the Wellcome Library. Would you like to take a look at the Human Fabric?"

I sat down, realizing that he had done his homework, researching online, to make sure I wasn’t some imposter who had come to the Holy of Holies to abuse these priceless treasures. When Ross reappeared, he was holding a 16-inch by 11-inch rich green tome. I was stunned by the size of the book, which really looked like a mythical beast of a book. The green leather was smooth and moist, and it must be no more than a hundred years old. I wondered what the original binding looked like. Ross placed the book on the filing table, and before opening it, I felt a sense of ritual—cleansing, solemnity, and respect. Since Ross and I had never looked through rare books together before, I felt that he wanted to make sure I took proper care of this treasure. There are only about 100 copies of On the Structure of the Human Body in the world, and this one was in perfect condition.

The Human Ontology lay unopened next to me. Ross and I began to build a hill of foam blocks and white canvas bean bags. The archival document’s tenet required us to be careful when turning individual pages, to be careful with the spines, to minimize handling, and to avoid accidents. Ross tried again and again to place the book in the grooves in the middle of the diagonal black foam wedges, allowing the book to open naturally. Feeling that the right side was not strong enough, the librarian added a bean bag to the wedge. After a few minutes of fiddling, the Human Ontology was finally readable.

I was struck by the faint colored lines that outlined the edges of the pages and stared at them for a long time. They seemed to be hand-painted, and they were on almost every page. The copy of On the Structure of the Human Body in my hands was a first edition printed in 1543, which means that Vesalius himself may have touched the book with his own hands. The 400-year-old paper was in perfect condition, with no repairs and no wear on the edges.

I wanted to see a large illustration, so I flipped to the back of the book and came across a folded leaf. I was stunned by the sheer size of the page. The entire page was a detailed diagram of the veins and arteries of the human body. I unfolded it halfway and then fully along the bottom. This diagram of the arteries and veins throughout the body was printed from a woodcut, and it was truly breathtaking. The structures were labeled with dozens of letters and numbers, and the rest of the page was filled with the names of the blood vessels, all in Latin. I was mesmerized.

Back at the front of the book, the muscular human figure came into view, showing me the progression of dissection page by page, with decreasing numbers of attached muscles, much like the transparent plastic illustrations in my beloved World Book Encyclopedia. It all began here, when Vesalius, with this masterpiece of teaching, art, and daring criticism of Galen, threw down the gauntlet and declared, "I will observe for myself, and by investigation and research prove to myself what is right." Over the next hundred years, this resolution took root and ignited a scientific revolution.

About the Author

David Schneider is a well-known American joint replacement surgery expert. He leads a professional shoulder and elbow total transplant surgery team. He is also the team doctor for the Los Angeles professional baseball team and the American football team and has more than 20 years of experience in sports medicine.