Author: Stephen N. Joffe
The author of this biography portrays his subject, Andreas Vesalius, as a physician whose ‘disciplined and detailed’ dissection of the human body made him ‘the most influential anatomist of the sixteenth century’. The book chronicles how Vesalius, believing that ‘comprehensive studies of the anatomy of the human body‘ were essential for ‘the conscientious and effective practice of therapeutic medicine‘, set out to ‘break new ground‘ and achieve his ‘desire to unite the study and practice of medicine’. Whilst his discoveries were momentous, the book argued that Vesalius himself considered his method of ‘observation through dissection‘ to be greater than his findings – a view the author justified by showing that Vesalius’s approach eventually became ‘the foundation of all modern medical discoveries’. The author also inevitably explored De Humani Corporis Fabrica, Vesalius’s exceptional book which the author referred to as his abiding legacy, and as ‘a text unlike anything previously seen…both in substance and in form‘. The biography also celebrates his wider attainments which earned him the high status of ‘physician to the emperor for more than thirteen years’ (pages x, 90, 100, 154 and 160-161).
Vesalius’s medical training formed a most revealing theme of the book as it highlighted the rigorous education he received, and the academic influences that determined the course of his career. For example, the biography noted that as a prerequisite to study medicine, he first studied art at the University of Louvain, a school which the author said ‘held a coveted position as a progressive institution‘, and where such scholars such as Desiderius Erasmus ‘were active in challenging the interpretations of standard academic readings and worked to develop new methodological approaches to their study’. Whilst at Louvain, the author said Vesalius kept the company of ‘an influential group of individuals’ who later became ‘central actors in a changing world’. Similarly, at the University of Paris where Vesalius studied medicine, the author related how he came under the influence of leading scholars such as Jacobus Sylvius who taught him the skilled techniques of dissection and attention to nomenclature, and Jean Sturm, a reformer who belonged to ‘a network of progressive thinkers and medical scholars‘. Unable to complete his medical training in Paris due to the threat of war, the book chronicled his return to Louvain where he had ample opportunities for dissection, and where he quickly became the university’s informal anatomy instructor. It was however as a qualified physician at the University of Padua that the author said Vesalius built the foundation of his future work; this was because Padua had a large medical school and it placed emphasis on anatomical study, medical botany and clinical practice. Indeed it was as a professor of surgery in Padua that the author said Vesalius ‘became increasingly vocal in his challenges to accepted medical doctrines’ (pages 19, 24-28, 34-41, 47, 51-57 and 62-65).
In tracing the factors that contributed to Vesalius making his groundbreaking discoveries, the biography particularly emphasised his personality which it said was characterised by ‘bold ambition, impudent confidence, and an exhaustive desire to achieve excellence‘. The book also noted ‘his dedication to scholarship‘, and his advocacy for ‘knowledge that was grounded in verifiable empirical evidence‘. But beyond ‘his genius, his vision, and his courage‘, the author also argued that the historical developments of the time favoured him; for example, the author referred to his access to ‘medical and scholastic manuscripts‘ by virtue of being ‘born within an age where the printed word would change the world forever’. Similarly, his revolutionary ideas were encouraged by the emerging intellectual reforms which the author said gave priority to ‘critical thought, reason, and classical scholarship‘, and by the changing social order which led to the ‘uprising and religious dissidence of the Protestant Reformation’. Another factor which aided him was growing up in close proximity to the site of public hangings which, the book argued, enabled the young Vesalius to ‘study…the bodies of the criminals that had been left to hang and rot’ (pages ix, 1-2, 9-13, 61 and 99).
One of the strengths of this biography is its detailed portrayal of the practical ways in which Vesalius made his discoveries – what the author metaphorically referred to as ‘creating a clearing in the dense and obscurant growth of centuries of traditional and speculative anatomical theory’. For example, the author described how Vesalius demonstrated that the human jaw was a single bone, and that it was not made of two bones as posited by Galen. In similar ways, the book detailed his dissections, his teachings, and his research interests such as in venesection. It is relevant that the book also narrated the extreme lengths to which he and other anatomists went to source bodies for dissection, including grave robbing. With regard to how he came about the extraordinary images he used in his book, the author pointed out that Vesalius ‘understood early in his education the utility of illustration’, and he used these in his Fabrica to create ‘a new pedagogical mode of anatomical education in which images ‘function both as mnemonic aids and as explanatory tools‘ (pages 45, 66-75, 109, 111 and 135-139).
Central to this biography of Vesalius is De Humani Corporis Fabrica, the phenomenal book which symbolises his unique achievements. The author variously referred to the Fabrica as ‘an illustrated medical text unlike anything ever seen before‘, and as the work which ‘showed the human body as it had never before been imagined‘. Citing its publication in 1543 as one of the most momentous events in human history, the author further characterised the Fabrica as the product of Vesalius’s ‘overarching goal…to create a comprehensive, fully illustrated anatomy text that would build on Galen’s anatomical foundation’. The qualities of the Fabrica which the author particularly highlighted were it’s reliance on ‘evidence obtained through hands-on dissections‘, and its ‘over two hundred illustrations‘ which he said made the it ‘the material testimony to a unique collaboration in the history of art and medicine‘. The author particularly extolled the way the Fabrica’s images served as the source of ‘exhaustive information about the parts of the body’, and the way it provided ‘exact directions for the process of dissection, allowing others to confirm his findings for themselves’. The author nevertheless criticised the Fabrica’s ‘flowery language and convoluted sentence structures‘ which he said ‘drove his audience to feelings of alienation and frustration‘. The overall quality of the book however was such that it made Vesalius ‘a vanguard scholar across fields and disciplines, including medicine and science, art, printing, and the humanities‘; this, the author maintained, enabled Vesalius to ‘step out into the open and systematically articulate the errors that he had come to believe were inherent in Galen‘s original theories’ (page ix-x, 103-105, 100 117 and 128).
The significance of the Fabrica undoubtedly lay in the revolutionary ideas it advocated, and the author explored this theme in the context of the threat it posed to the established Galenic paradigm of medicine. In demonstrating the magnitude of this challenge, the author pointed out that Galen had had a ‘profound and lasting‘ impact on medicine, and his theories had ‘provided the framework for Western medical theory and practice until the late seventeenth century’. He further explained that Galen’s followers, convinced that he was ‘infallible in his observations’, were ‘irrationally committed‘ to his original texts and deplored any modifications to his theories. It was therefore not surprising when the author described their perception of the Fabrica as ‘threatening, fundamentally destabilizing, and above all, immoral‘. He also described their open hostility and resentment to Vesalius by citing the example of Jacobus Sylvius who, having become Vesalius’s ‘most vehement and disturbing critic’, waged a hate-filled and self-destructive public vendetta against him. With time however, the author said ‘the tide of anatomical study’ shifted, and more open-mindedness was directed towards his book and methods. Apart from the Fabrica, the biography also related Vesalius’s other medical contributions which established his reputation; these included his pioneering surgical treatment of osteomyelitis and empyema, and his involvement in the care and subsequent autopsy of French King Henri who fell victim to a jousting accident (25-31, 128-133, 161-162 and 167-169).
This is an exhaustive biography of one of the intellectual founders of modern medicine, and it demonstrates how his groundbreaking dissection set the foundation on which effective medical treatments emerged. The book graphically conveys the remarkably revolutionary nature of his discoveries, and it brings out the qualities and historical circumstances that enabled him to succeed in his ambitious task. With a clear and chronological narrative, the author’s objectivity shone through in his critical appraisal of Vesalius, frequently pointing out his erroneous conclusions and noting his less praiseworthy qualities. The book is marred by a rather prolonged commentary on the contribution of Vesalius to venesection, and its excessively technical depiction of the publishing process of the Fabrica. These apart, the prose is gripping and the biography comprehensive.
The accurate representation of human anatomy is the foundation for all attempts to understanding pathology. As the basis for medical and surgical treatments, the discoveries of Vesalius were remarkable not only in establishing correct human anatomy, but also in dispelling the rigidly held but erroneous Galenic teachings that had guided medical practice for centuries. The biography helpfully reveals how the work of Vesalius changed the course of medicine from one steeped in errors to one exalted in accurate observation. This is an inspirational and enlightening book and I recommend it to all doctors.
Publisher, Place, Year: Author House, Bloomington, 2009
Number of chapters: 9
Number of pages: 194
Star rating: 5