Andreas Vesalius

• 1. Introduction

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  Andreas Vesalius was born on the 31st of December 1514 in Brussels, and by the time he was 28 years old, he had produced a book that would upend more than a thousand years of medical tradition. The work was called De Humani Corporis Fabrica Libri Septem, meaning On the Fabric of the Human Body in Seven Books, and it did something that no anatomist of sufficient authority had dared to do before: it proved that Galen, the revered ancient physician whose writings had governed medicine for fourteen centuries, had been largely describing the insides of animals, not people.

  Vesalius came from a family of physicians and apothecaries stretching back generations, and he trained at some of the finest universities in Europe. As a student he was already so captivated by bones that he would seek out charnel houses and gibbets to examine what he could find there. By the time he held a professorship at Padua, he was performing dissections himself rather than delegating to a barber-surgeon, insisting that direct observation was the only reliable method of learning anatomy.

  What drove him to tear apart Galen's authority? How did a young man from Brussels end up dedicating his masterwork to Emperor Charles V? And what brought him, near the end of his life, onto a ship sailing for the Holy Land, from which he would never return?

• 2. A Family Made for Medicine

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  Jan van Wesel, Vesalius's great-grandfather, earned a medical degree from the University of Pavia and taught medicine at the University of Leuven, seeding a dynasty of physicians that would shape the generations that followed. His grandfather Everard van Wesel served as Royal Physician to Emperor Maximilian, and his father Anders van Wesel worked first as apothecary to Maximilian and then as valet de chambre to Maximilian's successor, Charles V.

  Growing up inside that professional lineage, Vesalius was enrolled by his father in the Brethren of the Common Life in Brussels, where he learned Greek and Latin before approaching medicine. This was the standard path of the era, and it was essential training for anyone who needed to read Galen's texts in the original.

  When he entered the University of Leuven in 1528, he began with the arts. A shift in family circumstances in 1532 redirected him: his father's appointment as Valet de Chambre to Charles V opened a path to Paris, and Vesalius moved there in 1533 to study medicine formally. In Paris he studied under Johann Winter von Andernach, Jacques Dubois (known as Jacobus Sylvius), and Jean Fernel, three men who would later figure in very different ways in the unfolding of his career. Sylvius in particular would become one of his most bitter opponents.

  It was during those Paris years that Vesalius developed the obsessive habit that would define him: he was often found examining excavated bones in the charnel houses at the Cemetery of the Innocents. He is also said to have constructed his first skeleton by stealing a body from a gibbet outside the city.

• 3. Padua and the Cadaver Supply

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  On the very day he received his doctorate from the University of Leuven in 1537, Vesalius was offered the chair of surgery and anatomy at the University of Padua. The offer was immediate, a sign of how visibly his talents had announced themselves during his student years.

  Before taking up the post, he traveled through Italy and assisted the future Pope Paul IV and Ignatius of Loyola in tending to people afflicted by leprosy. In Venice he encountered Johan van Calcar, a student of Titian, with whom he would collaborate on his first anatomical publication. That work, the Tabulae Anatomicae Sex, appeared in 1538 as six large woodcut posters designed for students. When Vesalius discovered that pirated copies were already circulating, he gathered all six and published them formally under that title.

  At Padua, Vesalius changed the nature of anatomy teaching in a fundamental way. The established method was to read aloud from Galen while a barber-surgeon performed the dissection and a lecturer directed operations from a distance. Vesalius rejected that entirely. He handled the dissections himself, stood beside the cadaver, and urged his students to do the same. He held that hands-on direct observation was the only trustworthy path to knowledge.

  The steady supply of human bodies he needed came through an unusual alliance. In 1539, a judge at the Padua criminal court became sufficiently interested in the work to agree to supply Vesalius with the cadavers of executed criminals on a regular basis. Without that arrangement, the research behind the Fabrica would have been far harder to pursue. Guest lectures at the University of Bologna and the University of Pisa extended his influence beyond Padua while he accumulated the material and evidence he needed.

• 4. Dismantling Galen

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  In Bologna, Vesalius made a discovery with long consequences: every piece of Galen's research had been conducted on animals, because Roman tradition forbade dissecting the human body. Galen had worked most extensively on Barbary macaques, which he considered the animal most similar in structure to humans. That substitution had generated a cascade of errors that fourteen centuries of anatomists had dutifully repeated, partly because no one had seriously checked.

  The interventricular septum of the heart was one of the most important cases. Galen's theory required that blood pass from the right ventricle to the left through small holes in the partition between them. So commanding was Galen's authority that for 1,400 years, anatomists had claimed to find those holes. Vesalius was the first of standing to admit he could not locate them. He initially supposed the blood diffused through the solid partition rather than risk directly contradicting Galen, but in his revised second edition he published that the septum was waterproof, and he identified and named the mitral valve to account for blood flow.

  Other Galenic errors fell in turn. Galen had recorded, from his macaque dissections, that the human mandible consists of two bones; Vesalius demonstrated it was one. Galen had described a structure called the rete mirabile at the base of the brain, a network of blood vessels found in sheep; Vesalius showed that humans simply do not have it. Galen had assumed, again from apes, that the human sternum has seven parts; Vesalius found three. He also disproved the long-standing belief that men have one rib fewer than women, and refuted the claim that men have more teeth than women than women do.

  When Vesalius published his Venesection Epistle in 1539 on the practice of bloodletting, he used it to pose a hypothesis that was striking for its time: that anatomical dissection could be used to test speculation. That methodological idea would prove as consequential as any individual finding.

• 5. The Fabrica

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  In 1543, Vesalius traveled to Basel and worked alongside the printer Johannes Oporinus to produce De Humani Corporis Fabrica Libri Septem. He was 28 years old when the first editions appeared. The book was dedicated to Charles V, and an abridged student edition called the Epitome was dedicated to Charles's son, Philip II of Spain.

  The Fabrica contained 273 illustrations. Whether Jan Stephen van Calcar, Titian's pupil who had worked with Vesalius on the Tabulae, created all of them is uncertain; the source notes that evidence is lacking and it is unlikely one artist produced the full set in so short a period. What is agreed is that the artists who made the plates were present at the dissections themselves, which gave the images a quality of direct witness that set them apart.

  Among the specific anatomical contributions in the book: the first accurate description of the sphenoid bone; the finding that the sacrum consists of five or six portions; a description of the vestibule inside the temporal bone; verification of earlier observations on the valves of the hepatic veins; a description of the vena azygos; and the discovery of the canal that runs in the fetus between the umbilical vein and the vena cava, a structure later named the ductus venosus. Vesalius also gave the first correct account of the pylorus's structure, the first thorough description of the mediastinum and pleura, and the most complete account of the brain's anatomy produced to that point.

  The book also made Vesalius the first person to describe mechanical ventilation. That achievement was recognized much later when he was incorporated into the arms and crest of the Australian and New Zealand College of Anaesthetists.

  Pirated editions began circulating almost immediately after publication, which Vesalius had anticipated and acknowledged in a printer's note. In 1543, he also conducted a public dissection of Jakob Karrer von Gebweiler, a notorious felon from Basel, assembled the skeleton afterward, and donated it to the University of Basel. That preparation, known as the Basel Skeleton, is his only well-preserved skeletal work still in existence and remains on display at the Anatomical Museum of the University of Basel as the world's oldest surviving anatomical preparation.

• 6. Imperial Court and Enemies

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  Shortly after the Fabrica's publication, Vesalius accepted an invitation to become imperial physician to Charles V, informing the Venetian Senate that he would vacate his chair at Padua. Duke Cosimo I de' Medici responded by offering him a position at the university in Pisa, which Vesalius declined.

  At the imperial court, hostility greeted him. Fellow physicians mocked him as a mere barber-surgeon rather than a proper academic, a characterization that inverted the genuine innovation behind his methods. In the 1540s he married Anne van Hamme, from Vilvorde in Belgium, and the couple had one daughter, also named Anne, who died in 1588.

  For the next eleven years, Vesalius traveled with the court across Europe, treating battle and tournament injuries, conducting postmortems, and corresponding on specific medical questions. He also wrote the Epistle on the China Root in 1546, a text that doubted the efficacy of a popular medicinal plant used for gout, syphilis, and stones; the work served equally as a polemic against Galenism and a reply to his critics, particularly Jacobus Sylvius.

  The attacks did not subside. In 1551, Charles V commissioned an inquiry in Salamanca into the religious implications of Vesalius's methods. The board cleared him, but Sylvius, his former professor and now an obsessive opponent, published a piece in 1555 claiming that the human body had actually changed since Galen's time, which Sylvius offered as an explanation for why Vesalius's findings disagreed with Galen's. That same year, Vesalius published a revised edition of the Fabrica and transferred his position to serve Philip II.

  In February 1561, Gabriele Fallopio sent Vesalius a copy of his Observationes anatomicae, a set of friendly additions and corrections to the Fabrica. Vesalius composed a warm reply, which he called the Examen, recognizing Fallopio as a true equal in the science of dissection. That reply was published in May 1564, one month after Vesalius had already died.

• 7. Pilgrimage and Death

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  In 1564, Vesalius departed for a pilgrimage to the Holy Land. The reasons have long been disputed. One account, spread from 1565 onward by the diplomat Hubert Languet, held that Vesalius had performed an autopsy on a Spanish aristocrat and discovered the heart still beating, that the Inquisition had condemned him to death for it, and that Philip II commuted the sentence to a pilgrimage. Modern biographers have generally dismissed this story as unfounded.

  The more plausible reading is that the pilgrimage was a pretext. The lifestyle of the Spanish court did not suit him, and he wanted to return to research. Unable to resign his royal appointment directly, he obtained permission to travel to Jerusalem as a way of escaping the position.

  He sailed with the Venetian fleet under James Malatesta, stopping at Cyprus. When he reached Jerusalem, a message arrived from the Venetian Senate offering him the professorship at Padua, which had opened on the death of Fallopio. On the return voyage, his ship was caught by adverse winds in the Ionian Sea for many days before being wrecked on the island of Zakynthos, also known as Zante. He died there shortly afterward, in debt severe enough that a benefactor had to cover the cost of his funeral. He was 49 years old. He was buried somewhere on the island of Zakynthos, with no surviving marker to locate the spot.