The history of medicine began with stealing corpses and performing dissections in public

In the Middle Ages, Western medicine was largely based on Hippocrates’ theory of “four humors” or Galenus’ theory of “spiritual energy”, and relied on taking herbs, applying ointments, bloodletting, and even performing shaman dances to treat illnesses. In the process of Western medicine’s transformation into modern medicine, the empirical anatomy pioneered by Andreas Vesalius was one of the most important milestones.

Portrait of Vesalius | Wellcome Collection

Communicate with the anatomy teacher in person

Vesalius was born into a family of doctors in Brussels under the rule of the Habsburgs. Under the influence of his family, Vesalius was full of interest in medicine. At a young age, he went to the execution ground to observe corpses and dissected animals. In 1528, Vesalius entered the Pedagogium Castrense of the University of Leuven to study fine arts, a skill that played an interesting role in his later academic career.

In 1533, Vesalius "gave up art to pursue medicine" and entered the University of Paris to study medicine. There, he studied the medical theories of Galen (not the Galen in League of Legends, but the ancient Roman physician Claudius Galenus) under the guidance of Jacobus Sylvius and Guenther von Andernach, and served as the executor of dissection. Due to the shortage of corpses available for dissection, he often went to the Saint-Innocent Cemetery in Paris to study bones, leaving behind some horrific rumors.

In 1537, Vesalius went to the University of Padua to study for a doctorate. After graduation, he stayed in Padua as an internist and taught surgery and anatomy.

In order to understand the structure of the human body, students at that time also had to take human anatomy classes. The public dissection demonstration at that time was pioneered by Mondino de'Liuzzi of the University of Bologna. This was a bold initiative, but Mondino did not do the dissection himself. Instead, he sat on a high chair and read Galen's works, while a surgeon (who was usually a part-time barber at that time) cut the body. In other words, Mondino treated the dissection of the body as a presentation of a PowerPoint.

Vesalius said that it was better to make a PPT than to show it, so he revolutionized the way of teaching anatomy. He used anatomical tools to demonstrate the operation himself, while students gathered around the table to observe and learn.

This teaching method later developed into the "Anatomical Theatre", which is a circular tiered classroom with a dissection table in the middle and students sitting in the outer circle to watch. For the sake of popular science, the anatomical theatre sells tickets to the public. As a result, in addition to enthusiastic medical students, curious citizens also flock to it...

If you can't draw, you're not a good doctor.

Vesalius was definitely a good teacher: although the mainstream medical community at the time believed that illustrations lowered the style of books, for the convenience of students, he published six anatomical atlases, Tabulae anatomicae sex, in 1538. Three of the six pictures were sketches of the vascular system drawn by him (with his artistic skills), and the other three were skeletal structure pictures drawn by Jan Stefan van Kalkar, a student of the famous painter Tiziano Vecelli.

Skeleton diagram from Six Plates of Anatomy | Wellcome Collection

Influenced by Galen's authority, this book had some omissions, such as writing the liver as five lobes instead of four. But Vesalius was by no means a blind follower of the past. In the same year, he wrote a textbook written by his teacher Andernach, and revised many erroneous statements by comparing his own anatomical observations. Since Andernach's work was an interpretation of Galen's theory, Vesalius embarked on the path of challenging Galen, the academic authority for thousands of years.

In ancient Rome, human dissection was generally prohibited. Galen himself was a doctor who treated gladiators. His understanding of the human body depended on observing wounds. Most of his dissections were actually done on pigs, and the closest dissection object to humans was the Mediterranean macaque (Macaca sylvanus). No wonder Galen's treatise contained such bizarre ideas as blood vessels originating from the liver and the human jaw having two bones.

C. Singer's drawing explaining Galen's medical ideas | Wellcome Collection

In 1543, Vesalius published the book De Humani Corporis Fabrica. The book is divided into 7 volumes (skeleton, muscle, blood vessel, nerve, abdominal viscera, thoracic viscera, brain), with a total of 663 pages and 278 exquisite woodcuts. These pictures come from many artists, including Vesalius's old partner Calca. However, Vesalius felt that it was troublesome to cooperate with artists. He complained that "the bad temper of artists and engravers is more difficult for me than the corpses I have to dissect." When he was compiling the manuscript, he often gave suggestions to the painter like Mr. Fujino: "Look, you moved this blood vessel a little bit..."

A few weeks later, Vesalius republished a cheap version of the Human Fabric for students with limited funds, titled Epitome, which also had 11 beautiful woodcut illustrations, most of which were individually drawn. He dedicated the book to the king's son, Philip II.

The road of science is tortuous

In the book "On the Structure of the Human Body", Vesalius listed many of his new discoveries. He was the first to correctly describe the sphenoid bone, the azygos vein, the greater omentum of the abdominal cavity, the mediastinum and the pleura, and was the first to point out that the sternum is composed of three parts. He also made the most comprehensive description of brain anatomy at that time. Of course, he also had great limitations. His description of nerves was vague, and he regarded the optic nerve as the first pair of cranial nerves (the first pair of cranial nerves is the olfactory nerve, known as the "smart smell"). Moreover, he only understood the structure and could not describe it from the perspective of function.

However, Vesalius was definitely a person who could correct his mistakes. For example, in the first edition of "The Fabric of the Human Body" in 1543, he inherited Galen's statement that there was an invisible hole between the left and right ventricles, but in the second edition of 1555, he denied the existence of the hole. In 1561, Gabriele Falloppia, who succeeded Vesalius as professor of anatomy at the University of Padua, pointed out some of Vesalius's mistakes. After reading it, Vesalius wrote a 260-page private letter to Falloppia, which contained both gratitude and encouragement, as well as serious academic discussions.

Since the book "On the Structure of the Human Body" corrected many errors, it naturally criticized Galen and other great figures in the academic world. As a result, Vesalius attracted a lot of opposition and even abuse. The most regrettable thing is that Vesalius's two teachers, Sylvius and Andernach, were the most fierce opponents, and their methods were relatively vulgar, mainly abusing (using homophonic puns to call Vesalius Vaesanus, which means "madman" in Latin), slandering Vesalius's character, and reporting to the Holy Roman Emperor. Vesalius was sad and complained about these old people who only knew how to recite: "My teacher never touched a knife except at the dinner table."

Tools used in dissection, from The Structure of the Human Body | Wellcome Collection

After publishing "The Structure of the Human Body", Vesalius decided to apply the knowledge gained from the dissection of corpses to the treatment of living people. He was invited to serve as the royal physician of the court of Charles V and continued his research. In 1555, Vesalius moved to Spain with his successor Philip II. Unfortunately, the superstition of the emperor, the ignorance of Spain under Catholic control, and the jealousy of his colleagues made it difficult for the scientific Vesalius to move forward. In 1564, he resigned and left Madrid, preparing to return to the University of Padua as a professor, but died on the way.

Vesalius dissecting a cadaver by Edouard Hamman | Wellcome Collection

Let's go back to 1543. Two great scientific works were published in this year - Copernicus's On the Revolutions of the Celestial Spheres and Vesalius's On the Fabric of the Human Body. From then on, the priests, saints and authorities' words of God were gradually defeated by scientific research based on evidence. In the same year, Vesalius presided over a public dissection and donated the skeleton to the University of Basel. This is the only specimen that Vesalius dissected personally that has survived to this day, and it is now on display in the Anatomy Museum of the University of Basel.