CLASIFICADOR POR OBJETO DEL GASTO Versión Descriptiva
30000 MATERIALES Y SUMINISTROS
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eginning in the 16th century, the study of anatomy became an important foundation for Western medicine. As noted pre- viously, the dire number of fatalities from the Black Death in the 14th century began to set the tone for a change in attitude about dissections. Initially, the church permitted autopsies to be done on plague victims solely to try to assess the cause of death, but later strictures against autopsies began to loosen. After the laws changed in 1537 and autopsies were permitted on an as-needed basis, the physicians of the day were able to study the human anatomy more regularly.Eventually, the study of anatomy became a part of the medical school curriculum, but even then it was still diffi cult to obtain cadavers to dissect. The church regulated the numbers of bodies that could be made available, and since there was no refrigeration it was diffi cult to study a body thoroughly before it began to decay. (Even when the dissection was done within three days—fast for that time—the stench became unpleasant for both students and teachers.)
This chapter will introduce the scientists and the physicians who worked to better understand the human body. Andreas
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Vesalius was the first to see that Galen’s understanding of anat- omy was in large measure wrong, and he was joined by several others who helped clarify the understanding of anatomy. Miguel Serveto, a theologist and physician, correctly explained pulmo- nary circulation, but his work was never widely acknowledged. Realdo Colombo drew needed attention to pulmonary circula- tion. Gabriele Falloppio (Falopius), one of Vesalius’s students, succeeded him as a professor of anatomy at Padua, where he continued to explore the body’s structure and made notable advances in the study of the skull, the ear, and the female geni- talia. Vesalius also inspired others to more closely study the organs and how the body worked. Another who did so was Bar- tolomeo Eustachio (1520–74), who discovered the eustachian tube, the suprarenals, the thoracic duct, and the abducens nerve. Also, Santorio Santorio helped bring about an understanding of metabolism.
The Anatomy Lesson of Dr. Nicolaes Tulp by Rembrandt, 1632 (The Yorck Project)
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Andreas Vesalius (1514–64) was born into a family of physicians in Brussels, Belgium, and he took an early interest in how living things worked. While still a boy, he was said to have done dissec- tions on small animals on his mother’s kitchen table, which may have helped prepare him for a world where dissections were finally becoming an accepted part of medical studies.
His medical education began at the University of Louvain, fol- lowed by a move to the University of Paris in 1533 where he stud- ied under the well-respected teacher Jacob Sylvius (1478–1555). Sylvius used dissection to study Galen, but, like his contempo- raries, he saw only what Galen wanted him to see, ignoring the discrepancies between Galen’s conclusions and the actual dissec- tions. Vesalius noted the differences, and he began to speak openly about his disagreements with Galen’s theories and those who taught them unquestioningly. According to the historian Lois N. Magner, author of A History of Medicine, Vesalius was said to have told students that they “could learn more at a butcher shop” than at a lecture by a particular professor, meaning Sylvius. Vesalius’s disdain for Galen greatly angered Sylvius and other members of the faculty.
Vesalius eventually moved on to the University of Padua to com- plete his studies (he received a degree in December 1537) and was offered a professorship there. Vesalius continued to perform more and more animal and human dissections, and he began to notice that some of Galen’s notes were true for apes and monkeys but that human skeletons did not have the same features. Galen wrote of locating a “small projection of bone upon one vertebrae of its spine.” Vesalius found the additional bone mass on an ape’s skel- eton but could not find it on a human. He realized that Galen must have been dissecting monkeys and assumed that what he found on an ape or a monkey would hold true for humans, too. Over time, Vesalius began a full-scale assault on Galen. Vesalius arranged to conduct a side-by-side comparison for the public in Padua, dissect- ing an ape on one table and a human on the other. (There was no
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shortage of audiences for this type of thing.) He pointed out more than 200 differences between the two skeletons. The “small projec- tion” on the vertebrae described by Galen was found only on the ape. As Vesalius had promised, the human skeleton had none.
After a brief stint in the military, Vesalius took a teaching posi- tion at the University of Venice. He ran afoul of this faculty, too, by breaking with traditional teaching methods. At this time, medical classes employed three instructors. The professor was a physician who taught the class from a raised platform, a barber-surgeon was there to perform the dissection, and an “ostensor” (meaning one who shows; from medieval Latin, ostendere, “to show”) was there to point out the parts of the body. Vesalius preferred to fulfill all three roles, performing the dissection himself while also lecturing and pointing out what he was discussing.
Vesalius’s lectures aroused high interest, and to investigate in more depth he began to take longer to perform dissections, which gave him time to inves- tigate organs and muscula- ture that normally had been rushed through. His work came to the attention of a judge in the Padua court sys- tem, and the judge began to award the bodies of executed criminals to Vesalius. Winter was the best time to study bodies as the cold weather slowed the pace of decay, so the judge established more executions during the colder weather, and he spread out the timing of them so that the gifted anatomist would have a steady flow of bodies to study.
Folio 8r showing the first and second layers of muscles from the Epitome of Vesalius, Basel, 1543 (University of Glasgow Library)
In 1543, Vesalius published De humani corporis fabrica in an effort to inform a wider audience of his findings. At the time, this was the most accurate book on human anatomy, and it is still highly respected for both its beauty and its high level of accuracy. Further discussion of this book can be found in the following sidebar.