The publication of Vesalius’ De fabrica certainly marks a major change in the study and teaching of anatomy at the medieval university, but, as I hope is clear, that change did not come out of thin air but was the result of a couple of centuries of gradual developments in the discipline. It also didn’t trigger an instant revolution in the discipline throughout the university system but spread slowly, as is almost always the case with major innovations in a branch of knowledge. In the case of Vesalius’ anatomy, it was not just the normal inertia inherent in theory change, but also a long-prolonged opposition by neo-Galenists.
The beginnings of the acceptance of Vesalius anatomy took place, naturally, in his own university of Padua and other North Italian universities resulting in a dynasty of excellent professors at those universities, leading to a major influx of eager students from all over Europe.
Following Vesalius, the first of the significant Paduan anatomists was Gabriele Falloppio (1523–1562). Born in Modena, the son of an impoverished noble family. Lacking money, he joined the clergy, was appointed a canon of Modena Cathedral, and received an education in medicine at the University of Ferrara, graduating in 1548. In the same year he was appointed professor for anatomy at the university. In 1549 he was appointed professor for anatomy at the University of Pisa and in 1551 he received the same position at the University of Padua. Although, most well know today for his study of the reproductive organs leading to the naming of the Fallopian tubes after him, he made major contributions to our knowledge of bones and muscles. His major area of research was, however, the anatomy of the head where he systematically expanded our knowledge.
Earlier that Falloppio was Matteo Realdo Colombo (c. 1515 – 1559), who was a colleague of Vesalius at Padua. The son of apothecary born in Cremona he initially apprenticed to his father but then became apprentice to the surgeon Giovanni Antonio Lonigo for seven years. In 1538 he enrolled as a medical student at Padua, where he quickly acquired a reputation for the study of anatomy. He became friends with Vesalius and was appointed to teach his courses while Vesalius was in Basel overseeing the publication of De fabrica. Vesalius attributes many of the discoveries in De fabrica to Colombo. Their relationship declined, when Colombo pointed out errors in Vesalius’ work, leading to them becoming rivals.
Colombo left Padua in 1544 and went to the University of Pisa and from 1548 he worked at the papal university teaching anatomy until his death in 1459. Colombo was also involved in priority disputes with Falloppio. His only published text, De re anotomica issued posthumously in 1559 contains many discoveries also claimed by Falloppio, most notably the discovery of the clitoris and its sexual function.
Colombo made many contributions to the study of anatomy, perhaps his most important discovery was the rediscovery of the so-called pulmonary circulation, previously discovered by Ibn al-Nafis (1213–1288) and Michael Servetus (c. 1511–1553).
Bartolomeo Eustachi (c. 1510–1574), a contemporary of Vesalius, who belonged to the competition, was a dedicated supporter of Galen working at the Sapienza University of Rome.
However, he made many important anatomical discoveries. He collated his work in his Tabulae anatomicae in 1552, but unfortunately this work was first published in 1714.
Julius Caesar Aranzi (1529/30–1589) was born in Bologna and studied surgery under his uncle Bartolomeo Maggi (1477–1552), who lectured on surgery at the University of Bologna.
He studied medicine at Padua, where he made his first anatomical discovery at the age of nineteen in 1548. He finished his studies at the University of Bologna graduating in 1556. At the age of twenty-seven he was appointed lecturer for surgery at the university. Like the others he made numerous small contributions to our understanding of human anatomy, of particular importance was his study of foetuses. However, his major contribution was in the status of anatomy as a discipline. As professor for anatomy and surgery in Bologna starting in 1556, he established anatomy as a major discipline in its own right.
A very central figure in the elevation of anatomy as a discipline at the medieval university was Girolamo Fabrici d’Acquapendente (1533–1619). Fabrici studied medicine in Padua under Falloppio graduating in 1559. He went into private practice in Padua and was very successful, numbering many rich and powerful figures amongst his patients. From 1562 till 1565 he also lectured at the university on anatomy. In 1565 he succeeded Falloppi as professor for anatomy and surgery at the university, a post he retained until 1613. As an anatomist he is considered one of the founders of modern embryology and as also renowned for discovering the valves that prevent blood following backwards in the veins, an important step towards the correct description of blood circulation.
Girolamo Fabrici is also renowned for several of the students, who studied under him in Padua. Giulio Cesare Casseri (1552 – 8 March 1616) not only studied under Fabrici but was also employed as his servant.
The two of them later had a major falling out, but Casseri still succeeded Fabrici as professor in Padua. His biggest contribution was his Tabulae anatomicae, containing 97 copperplate engravings, published posthumously in in Venice 1627, which became one of the most important anatomical texts in the seventeenth century.
Casseri was succeeded as professor in Padua by another of Fabrici’s students the Netherlander, Adriaan van den Spiegel (1578–1625).
Van den Spiegel was born in Brussels but studied initially in Leuven and Leiden, in 1601 he transferred to Padua, where he graduated in 1604. His main text, his De humani corporis fabrica libri decem, which he saw as an updated version of Vesalius’ book of the same title, was also published in Venice in 1627.
For English readers Girolamo Fabrici’s most well-known student was William Harvey (1578–1657). Born the eldest of nine children to the jurist Thomas Harvey and his wife Joan Halke.
He was educated at King’s School Canterbury and matriculated at Gonville & Caius College Cambridge in 1593. He graduated BA in 1597 and then set off on travels through mainland Europe. He travelled through France and Germany and matriculated as a medical student at Padua in 1599. During his time in Padua, he developed a close relationship with Fabrici graduating in 1602. Upon graduation he returned to England and having obtained a medical degree from Cambridge University, he became a fellow of Gonville & Caius. The start of a very successful career. His major contribution was, of course, his Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (An Anatomical Exercise on the Motion of the Heart and Blood in Living Beings), the first correct account of the blood circulation and the function of the heart published in Frankfurt in 1628.
He also published an important work on the development of chicken embryos in the egg, Exercitationes de generatione animalium (On Animal Generation) published in 1651.
It could be argued that Girolamo Fabrici’s most important contribution to the history of anatomy was the erection of the university’s anatomical theatre. We saw in the last episode that the universities had been erecting temporary wooden dissecting spaces in winter for a couple of centuries, as described by Alessandro Benedetti (1450?–1512) in his Anatomice: sive, de historia corporis humani libri quique (Anatomy: or, Five Books on the History of the Human Body) in 1502:
A temporary theatre should be built at a large and well-ventilated place, with seats arranged in a circle, as in the Colosseum in Rome and the Area in Verona, sufficiently large to accommodate a great number of spectators in such a manner that the teacher would not be inconvenienced by the crowd… The corpse has to be put on a table in the centre of the theatre in an elevated and clear place easily accessible to the dissector.
During the second half of the sixteenth century several institutions began to assign a permanent room for such spaces, the University of Montpellier in 1556, the Company of Barber Surgeons in London in 1557 and so on. Girolamo Fabrici raised the stakes by having the first ever purpose-built anatomical theatre designed and built in Padua in 1594. The project was the work of the Venetian polymath Paolo Sarpi (1552–1623) and the artist-architect Dario Varotari (c. 1539–1596). A closed elliptical shape with tiers of standing spaces for the observers rising steeply up the sides, giving a clear view of the dissecting table in the centre.
In Northern Italy the first to follow suit was the University of Bologna, which one year later opened its Anatomical Theatre of the Archiginnasio now situated in the Archiginnasio Palace the main building of the university.
Originally situated elsewhere, it was rebuilt in its current setting between 1636 and 1638. The Bolognese rejected the Paduan Ellipse for a rectangular room claiming it to be superior.
Of greatest interest however was the Theatrum Anatomicum built far away from Northern Italy in 1596 in the still young university of Leiden. The University of Leiden was established in 1575, in the early phases of the Eighty Years’ War, as the first university of the newly founded United Provinces.
Leuven, the original alma mater of Vesalius, was located in the remaining Spanish Netherlands. Home to both Rudolph Snel (1546–1613) and his son Willebrord (1580–1626) as well as Simon Stevin (1548–1629), who founded its school of engineering, the university was strong on the sciences for its early days. However, it was its school of medicine that would become most influential in the seventeenth century, and this school of medicine had deep connections to Padua and Girolamo Fabrici.
The connections start with Johannes Heurnius (Jan van Heurne) (1543–1601), born in Utrecht, he initially studied in Leuven and Paris before going to Padua to study under Fabrici, where he graduated MD in 1566. Returning to the Netherlands he became a town physician in Utrecht before being appointed professor of medicine at the new University of Leiden in 1581. He introduced anatomy in the tradition of Vesalius into the still young Dutch university, as well as the Paduan emphasis on anatomical demonstrations and practical clinical work.
The anatomical theatre was introduced by Pieter Pauw (1564–1617), born in Amsterdam the son of the politician Pieter Pauw and his wife Geertruide Spiegel, he studied medicine at the University of Leiden, under Johannes Heurnius and Gerard Bontius (c. 1537–1599), another Padua graduate, graduating in 1584.
He continued his studies in Rostock graduating MD in 1587. From here, he moved to Padua to study under Fabrici. Forced by his father’s illness he returned to Leiden in 1589, he was appointed assistant to Bontius, taking over responsibility for the medical botany. In 1592 he was appointed professor for anatomy and in 1596 he erected the permanent anatomical theatre in the same year.
Otto Heurnius (otto van Heurne) (1577–1652) was the son of Johannes Heurnius and studied medicine under his father and Pieter Pauw in Leiden. He graduated MD in 1601 and was appointed assistant to his father, whom he succeeded a year later as professor, not without criticism. In 1617 he then succeeded Pieter Pauw as professor for anatomy.
Otto’s most famous student was Franciscus Sylvius (Franz de le Boë) (1614–1672). Born into an affluent family in Hanau he studied medicine at the Protestant Academy of Sedan then from 1632 to 1634 in Leiden, where he studied under Otto Heurius and Adolphus Vorstius (Adolphe Vorst) (1597–1663), who had also studied at Padua under Adriaan van den Spiegel, graduating MD in 1622. Vorstius was appointed an assistant in Leiden in 1624 and full professor in 1625. Sylvius continued his studies in Jena and Wittenberg, graduating MD in Basel in 1637. He initial practice medicine in Hanau but returned to Leiden to lecture in 1639. From 1641 he had a successful private practice in Amsterdam. In 1658 he was appointed professor for medicine at Leiden, with twice the normal salary.
Under Sylvius it became obvious, what had been true for some time, that Leiden had, in the place of Padua, become the leading European medical school, particularly in terms of anatomy. By the middle of the seventeenth century the change that Vesalius had introduced into the study and teaching of anatomy at the medieval university had been completed. Previously a minor aspect of the medical education, anatomy had now become a prominent and central discipline in that course of studies. Sylvius produced a stream of first-class graduates, who would go on to dominate the life sciences in the next decades that included Reinier de Graaf (1641–1673), who made important contributions to the understanding of reproduction,
Jan Swammerdam (1637–1680), an early microscopist, who made important studies of insects,
Nicolas Steno (1638–1686), who made important contribution to anatomy and geology,
and Frederik Ruysch (1638–1731), an anatomist best know for his techniques for conserving anatomical specimens.
Sylvius was also one of those, who introduced chemistry into the study of medicine, which we will look at in the next episode.
For a detailed study of the work on reproduction of Harvey and many of the Leiden anatomist, I recommend Matthew Cobb’s The Egg & Sperm Race: The Seventeenth-Century Scientists Who Unravelled the Secrets of Sex, Life and Growth, The Free Press, London, 2006