Thursday, March 28, 2013

1543: Andreas Vesalius resurrects medicine

After Galen wrote his books in the second century there were few advancement in medicine, and this -- as we decided earlier, was one of the reasons Galen's works were worshiped as the Bible of medicine, as though Galen himself were a medical god, throughout the Dark Ages and long after.

Jacobus Sylvius (1478-1555)
John Hudson Tiner, in his book "Exploring the History of Medicine," wrote about Jacobus Sylvius  (1478-1555), who was a professor at the University of Paris.  He'd open up one of Galen's books and begin reading, and usually an animal was dissected to go along with the lecture.  Once a year Sylvius dissected a human.  While he read, an assistant did the cutting, and another pointed to each part of the body as the professor read aloud. (3, pages..

Hudson explained:
"Often, what Sylvius reads and what the assistant points to don't agree.  Sylvius steadfastly refuses to see any errors in Galen. Galen taught that the liver was five-lobed, that the breastbone had seven segments, that a network of blood vessels could be found under the brain.  Sylvius believes every word of it, although those features couldn't be found in the body right under his eyes.  He saw exactly what Galen told him he would see! 
"If the corpse and book don't agree, then the error is in the corpse!  No one would dream of doubting Galen." (3, pages...)
Yet one of his students would question Sylvius.  His name was Andreas Vesalius.  He was born in 1514....

Hudson explained that Vesalius wasn't content to just believe everything Galen wrote.  Vesalius believed that the best teacher of the human body was not Galen but the human body.  He stole a skeleton and studied it.  He learned the human breastbone did not have eight segments as Galen described, it had only three parts.  How could a teacher as magnificent as Galen have gotten it wrong?

Andreas Vesalius (1514-1564)
Then by chance one day Vesalius dissected an Ape.  Then it occurred to him:  Galen never even dissected a human body, otherwise he would have known the human sternum has only three parts.  For thousands of years doctors treated diseases based on the anatomy of apes not of humans.

To Galen's defense we must remember in the ancient world dissection was forbidden by severe punishment.  In ancient Egypt the punishment of stoning and blows was incentive enough for embalmers to stick to the task of embalming. Greeks and Romans stuck to the task of preparing the body for burial.  (4, page 9)

Tiner notes that Vesalius became a professor in 1537 and decided to dissect the bodies himself. His colleagues wondered why he would waste his time considering Galen had described the human body so perfectly.  Learning from dissecting was a waste of time, and what was needed could be learned from Galen's books.

Despite the outcries by his fellow professors, Vesalius became popular.  Because his bodies decomposed quickly, he hired jan Stephen van Calcar (1499-1546) to draw the human body, and he published in 1543 the first accurate book of the human anatomy called De Humani Corporuis Fabrica.  From this point on the human anatomy could be taught based on accurate pictures and descriptions, as opposed to Galen's ignorant descriptions.

I thought it was interesting that Tiney writes that artists like Michelangelo knew more about the human anatomy that doctors, because artists needed to have an accurate description of the body, they studied it up and down, so that they could accurately draw and paint.  Doctors merely studied Galen.

So, Tiney wrote, "Experts often date the start of the scientific revolution from the year, 1543."  It was also here that the dark ages of medicine came to a halt.

Yet the new observations came with a fierce fight amid the dogmatic medical profession.  Doctors were stuck in a paradigm that Hippocrates and Galen new everything there was to know about medicine.  All other knowledge was frivolous.

Fellow physicians of Vesaleas "fiercely" opposed him because they felt he was ruining their reputation.  They accused him of crimes.  Many wrote books against Vesalius, including his old instructor Sylvius.  He "wrote furious letters, and later spoke of him as a madman (vaesanus)."  (2, page 159)

Instead of completing more medical work, Vesaleas spent the next 20 years fighting to get others to recognize the importance of his book.  Vesalius never lived to see his book accepted by the medical profession.  His travels took him out of Europe, and how he ended his life and how he died remains a mystery.

There is one theory, however, as was told by William Osler:
"The story is that he had obtained permission to perform a post-mortem examination on the body of a young Spanish nobleman, whom he had attended.  When the body was opened, the spectators to their horror saw the heart beating, and there were signs of life!  Accused, so it is said, by the Inquisition of murder and also of genral impiety he only escaped through the intervention of the King, with the condition thta he make a pilgrimage to the Holy Land.  In carrying this out in 1564 he was wrecked on teh island of Zante, where he died of a fever or of exhaustion, in the fiftieth year of his life." (2, page 160).
The Fabric is now considered as one of the top ten most important medical discoveries of all time by Tiner.

This post was rewritten here.

Click here for more asthma history.

References:
  1. The John Hopkins Hospital bulleton," (volume XV 1904), "from the epoch of the Alexandria School (300 B.C.)"
  2. Osler, William, "The Evolution of Modern Medicine: A series of lectures at Yale University on the Silliman Foundation in April, 1913," New Have, Yale University Press, 1921,
  3. Tiner, John Hudson, "Exploring the History of Medicine,"
  4. Meryon, Edward, "The History of medicine comprising a narrative of its progress fromthe...
Originally published 9/13/2011

No comments:

Post a Comment