THE STORY OF ANATOMY DOWN TO THE RENAISSANCE.
We have seen that the supposed prohibition of anatomy by the Popes has no existence in reality. In spite of this fact, which it was easy for anyone to ascertain who wished to consult the documents asserted to forbid, a number of historical writers have insisted on finding religious or ecclesiastical, or theological, opposition to anatomical studies. Professor White has been most emphatic in his assertions in this regard. He admits that the supposed bull of prohibition had quite a different purport, yet he still continued to assert its connection with the failure of anatomy to develop during the Middle Ages. This presumed failure of anatomy during the Middle Ages is a myth. It continues to secure credence only in the minds of those who know nothing of the history of medical science during the thirteenth, fourteenth, and fifteenth centuries and who have not consulted the serious histories of medicine that treat of this time, but flourishes vigorously in the minds of those who have a definite purpose in making out a story of theological or Church opposition to science in general.
To counteract the false impression that has gained such wide acceptance in this matter, it has seemed advisable, in order to settle the question definitely once and for all, to trace the history of anatomical science from its beginning in the Middle Ages down to modern [{62}] times. It will not be hard to show that there was a constant development and an unfailing interest in this subject. This can be understood even more clearly from the story of the development of surgery in the Middle Ages and its relations to anatomy than from the history of anatomy itself. As is well known, materials with regard to practical and applied science interest men more at all times, and documents with regard to them are more likely to be preserved, and so the history of surgery is very full, while the history of anatomy may prove not quite so satisfactory. It is true of all sciences, that there are periods when they have much less attraction than at other times, and the success of investigators and original workers is not always the same. As in nearly everything else, the real advances in all science come when genius makes its mark, and not merely because a large number of men happen to be interested in the subject. This will be found as true in anatomy as in other sciences, and so there are periods when not much is doing, but nowhere is there a trace of ecclesiastical opposition to account for these variations of interest.
There is no doubt at all that there was much popular opposition to the practice of dissection in the Middle Ages; that has existed at all times in the world's history. It was very pronounced among the old Pagans in Rome as well as in Greece, and it prevented anatomical study to a very great degree. It continued to exist in modern times until almost the present generation. Indeed, it has not yet entirely disappeared, as any physician who has tried to secure autopsies on interesting cases knows very well. The New York Academy of Medicine is only a little over a half century old, and yet nearly every one of its early presidents had thrilling [{63}] experiences in body-snatching as a young man, because no proper provision for the supplying of anatomical material had as yet been made by law, and bodies had to be obtained. The feeling of objection to having the bodies of friends anatomized is natural and not due to religion. It exists quite as strongly among the ignorant who have no religion as among the religiously inclined. It has not disappeared among the educated classes of our own time, religious or irreligious. If this is borne in mind, the history of the development of anatomy will be easier to understand.
The first definite evidence in modern history for the existence of the practice of dissection is a famous law of the German Emperor, Frederick II., from the first half of the thirteenth century. This law was promulgated for the two Sicilies, that is, for Southern Italy and Sicily proper, very probably in the year 1240. It has often been vaguely referred to, but its actual significance can only be understood from the terms of the law itself, which has been literally translated by Von Töply in his Studien Zur Geschichte der Anatomie in Im Mittelalter. [Footnote 5]
[Footnote 5: Deuticke Leipzig und Wien, 1893]
The paragraph with regard to dissection runs as follows:
"As an enactment that will surely prove beneficial to health, we decree that no surgeon will be allowed to practice, in case he has not a written testimonial, which he must present to the teachers in the medical faculty, that he has for at least a year applied himself to that department of medicine which is concerned with the teaching and practice of surgery, and that he has, above all, learned the anatomy of the human body in this manner, and that he is fully competent in this department [{64}] of medicine, without which neither surgery can be undertaken with success nor sufferers cured." [Footnote 6]
[Footnote 6: The complete text of this law, which is a marvelous anticipation of all our efforts for the regulation of the practice of medicine down even to the present day, will be found in the appendix.]
Such a regulation, as pointed out by Professor Pilcher in an article on the early history of dissection, [Footnote 7] and as we know by modern experience, does not come into force as a rule before the actual practice of what is prescribed, has been for some time the custom and its usefulness proved by the results attained. It seems very probable, then, that even at this early day the Emperor Frederick was only making into a law what had been at least a custom before this time. Lest anyone should think that this is a far-fetched assumption, certain other paragraphs of this law, which show very definitely the high degree to which the development of medical teaching had reached, must be recalled. Frederick declared that medicine could only be learned if there was a proper groundwork of logic. Only after three years devoted to logic, then, under which term is included the grammar and philosophy of an ordinary undergraduate course, could a man take up the study of medicine. After three years devoted to medicine, to which it is again specifically declared another year must be added if surgery were to be practiced, a man might be given his degree in medicine, but must spend a subsequent full year in the practical study of medicine under the supervision of an experienced physician.
[Footnote 7: The Mondino Myth, Medical Library and Historical Journal, 1906]
The law further decreed definite punishments for the practice of medicine without due warrant and violation of its regulations, and also regulated the practice of apothecaries. It is rather interesting to find that these [{65}] were forbidden to share their profits with physicians, and the physicians themselves were not allowed to distribute their own medicines. In a word, practically every one of the problems in the practice of medicine which medical societies are trying to solve at the present moment, were also occupying the attention of the civil authorities about seven centuries ago. Anyone who reads this law will not be loath to believe that it represents the culmination of a series of efforts to regulate medical practice, and especially medical education, and that it was not merely a chance legal utterance that happened to touch a single important question for the first time. One of the paragraphs of the law even contains some clauses that would prevent fake medical schools and that establishes a board of medical examiners. This consisted of certain state officials and some professors of the art of medicine. In a word, medical education had reached a high grade of development, and medical practice was legally established on a high plane of professional dignity.
Salerno had already enjoyed a high reputation as a medical school for more than two centuries when Frederick's law was promulgated. It is true that we have no definite records of dissections done in the school. If these were not an uncommon occurrence, however, but came as did dissections later on, quite as a matter of course, the absence of such records, when we recall how liable to destruction were the meagre accounts of the university transactions of the time during the long period that has intervened and because of the many vicissitudes they were liable to, is not surprising. During the century following this decree there seems to be no doubt that dissections were done regularly, though [{66}] perhaps not very frequently from our modern standpoint, at Salerno. Salerno, as we shall see in the chapter on The Papal Medical School, was always closely in touch with the ecclesiastical authorities, and especially with the Papacy. There was no hint of friction of any kind, either before or after this law of Frederick's. The question of ecclesiastical interference with dissection does not seem to have arisen at all, much less to have proved an obstacle to the development of medical science.
At the beginning of the fourteenth century the center of interest in anatomy and the matter of dissections shifts to Bologna. We have already discussed the question whether Mondino was the first to do public anatomies, and as to whether he performed only the few that by a narrow misunderstanding of certain of his own words have sometimes been ascribed to him. Professor Pilcher, in the article The Mondino Myth, already cited, is of the opinion, and gives excellent reasons for it, that Taddeo, the great Bolognese physician of the thirteenth century, who was Mondino's master, had done at least some dissections in Bologna. Personally I have long felt sure that Taddeo or Thaddeus, as he is sometimes called in the Latin form of his name, did not a few, but a number of dissections.
Professor Pilcher's account of him does not exaggerate his merits. I may say that he was one of the great Papal physicians of whom we shall have more to tell hereafter.
"Any comprehensive attempt to trace the real influences to which was due so great a step as a return to the practice of dissections of the human body, seems to me must be very defective if it failed to take into consideration the influence of such a man as Thaddeus (Italian Taddeo). [{67}] That he was able to impress himself in the way in which history records that he did, both upon the general public and upon the scholastic foundations of Bologna, shows a strength of character and a mastery of the peculiar conditions of the moment in the fields of science and philosophy which made him a master and an inspirer. If he is to be considered in his proper historical light, as one who declares that the knowledge of the structure of the human body to a most minute degree is the foundation upon which all rational medicine and surgery must be built, then it is impossible to exaggerate the importance of the pivotal moment when, in the development of science, the human body began to be anatomized. Nor is any fault to be found with the custom which has crowned with the laurels of universal appreciation the names of those men who began and who continued anatomical study, who vulgarized the practice of dissection.
"In my own investigations and reflections upon the conditions which led up to this happy renewal of scientific search into the composition of the body of man, it has seemed to me that writers have hitherto fallen short of tracing through to its ultimate source, the earlier spirit of enthusiasm for knowledge, of insight into the problems of disease, and of contempt for traditionary shackles, to the influence of which, as shown by the master, Taddeo, the latter work of the pupil, Mondino, was in great measure due."
Medici, in his History of the School of Anatomy at Bologna, [Footnote 8] quotes Sarti on The Distinguished Professors of the University of Bologna for proof of Taddeo's familiarity with dissection. Von Töply does not think that [{68}] this quotation is enough absolutely to prove that Taddeo had done dissections, yet it would be hard to understand it unless some such interpretation is made. Taddeo was asked to decide a medico-legal question with regard to a pregnant woman. He refused, however, with a modesty that might well be commended to medico-legal experts of more modern times, to answer the question decisively, because he had never made a dissection of a pregnant woman. Sarti argues that it is evident from this that he had dissected other bodies more easy to obtain than those of pregnant women, or else that he had had the opportunity to make observations on them when dissected by others.
[Footnote 8: Medici Compendio Storico Della Scuola Anatomica de Bologna, Bologna, 1857. ]
Certain of Taddeo's contemporaries must have had the incentive of his example to help them to a knowledge of human anatomy, for they surely could not have accomplished all that they did in surgery without experience in dissection, yet Taddeo was looked up to as a master by all of them.
Anyone who has read the contributions to surgery of William of Salicet and his great pupil Lanfranc, even if only what we give with regard to them in our chapter on Surgery during the Middle Ages, cannot but be impressed with the idea that they must have done human dissections. They do not mention this fact explicitly, but portions of their surgical works are taken up with the consideration of applied anatomy. They discuss the relations of various structures to one another, especially with reference to the surgery of them. Von Töply, in his Studies on the History of Anatomy in the Middle Ages, says that the anatomies written before William's chapters on applied anatomy, were most of them purely theoretic discussions meant to be guides for internal [{69}] medicine, or else they were very short directions for those who undertook the practical work of the dismemberment of bodies, usually, however, with reference to animals rather than to human bodies. In William of Salicet we encounter, he says, for the first time a treatise on anatomy made with the deliberate purpose of its application to practical surgery. Everywhere William gives hints for surgical operations with special reference to the anatomical relations.
Puccinotti quotes from William of Salicet's surgery, written about 1270, a passage that shows how familiar this surgeon must have been with dissection. The nephew of Count Pallavicini received an arrow wound in the jugular vein and died within an hour. During his death agony he suffered from a peculiar form of rattle in his throat. It was thought that this might be due to the fact that the arrow had been poisoned. William was called in to decide this question, and found that there was nothing responsible for his death except the wound itself. He describes how he found the blood in the lungs and in the heart, and considers that the conditions that were present were due to the wound. Von Töply has suggested that William would have given more details had he actually examined these organs, but when the autopsy report is negative, such descriptive details are not usual even at the present time. If he had found reason for thinking that there was poison in the case, a careful description of the other organs would be necessary. The fact, however, that he was asked to decide such a question, would seem to indicate that he was supposed to have a knowledge of the normal appearances of human tissues when examined by dissection.
In everything else Lanfranc went farther than his [{70}] master William, and he did so also in anatomy. Some of the details of his work will be found in our chapter on Surgery in the Middle Ages. He could not have been able to give the detailed instructions that he has for the treatment of every portion of the body only that he knew them by actual contact in the cadaver as well as the patient. His outlook upon scientific medicine and surgery would satisfy even the most exacting of modern experimental scientists. The famous aphorism of his runs as follows: "Every science which depends on operation is greatly strengthened by experience." More than anything else, however, surgery owes to Lanfranc the distinct advantage that he carried into the West as far as Paris, the methods which had come into existence in Italy, and were ever after to prove a precious heritage in the great French University. As Salicet's work was carried on by Lanfranc, at least as well was Lanfranc's work further advanced by his pupil and successor in the chair of surgery, Henri de Mondeville. This subject of surgical development will be treated in the chapter on Surgery in the Middle Ages. Here it is introduced only to emphasize the opportunity there must have been for anatomical study through dissection in the thirteenth century, or these men would not have made the marvelous progress they actually accomplished in this department.
With regard to Mondino, Taddeo's successor at Bologna, enough has been said already in the preceding chapter. About this time, however, very definite evidence begins to accumulate of the frequent practice of dissection. Roth, whose life of Vesalius is a standard work in the history of anatomy, has summed up most of what we know with regard to dissections in the early [{71}] part of the fourteenth century, in his chapter on Dissection Before Vesalius's Time. Roth's work is well known and is frequently referred to in Dr. White's History of the Warfare of Science with Theology. There can be no question, then, but that in taking what Roth has to say I shall be quoting from a work with regard to which there can be no hint even of partiality. Roth himself was a Swiss, with no leaning toward the Church. There are certain portions of his book, indeed, in which he is inclined not to allow that the Church did as much for education in these times as she actually did. His study of the rise of anatomy can be accepted with absolute assurance, that it is at least not written from the standpoint of one who wants to make the situation with regard to anatomy more favorable than it actually was during the fourteenth century, for the sake of showing any lack of opposition on the part of ecclesiastics.
Some of the material that Roth has made use of has already been referred to in the preceding chapter, but it has seemed proper to repeat it here because this gives a connected account from a definite authority in the history of medicine, and especially of anatomy, with regard to the century immediately following the promulgation of Boniface's bull. Besides, it gives an opportunity for such comments on various features of the history of anatomy, as he details it, as will bring out the significance of his remarks. His account will make it very clear that, far from the Papal bull in question having been universally construed as prohibiting dissections, as Dr. White says it was, it never entered into the minds of medieval anatomists to consider it as having any such signification. The bull was never thought of in that sense at all. It does not refer to anatomy or dissection and it never had [{72}] any place in the history of anatomy until dragged into it without warrant by Daunou and other nineteenth century writers. Roth says:
"In the pre-Vesalian period the dissection of the human body was practiced, according to the terms of Frederick's law, for the instruction of those about to become physicians and surgeons. The natural place for this school anatomy--for a dissection was called anatomia, or, erroneously, anatomia publica--was at the universities and the medical schools. Apart from teaching institutions, however, public anatomies were held in Strasburg and in Venice. Their purpose was the instruction of the practicing medical personnel of these towns. Dissections which were not made for general instruction were called private anatomies. They were performed for the benefit of a few physicians, or students, or magistrates, or artists. Private anatomies began to have special importance only toward the end of the pre-Vesalian period (this would be about the end of the fifteenth and the first quarter of the sixteenth century). It is a play of chance that the first historical reference to a dissection concerns a private anatomy, one undertaken for the purpose of making a legal autopsy. This was made in Bologna in the year 1302 (two years after the decretal supposed to forbid dissection). A certain Azzelino died with unexpected suddenness, after his physicians had visited him once. A magistrate suspected poison and commissioned two physicians and three surgeons to determine the cause of death. It was found that death resulted from natural causes. (As I have said, it would appear that this was not an unusual procedure, for unless medical autopsies had been done before, it does not seem probable that this method of [{73}] determining the cause of death would have been so readily taken up.)
"Thirteen years later there is an account of the dissection of two female bodies, in January and March of the year 1315, performed by Mundinus." (We have already seen that the fact that the two female bodies should be especially mentioned, though taken by some historians of medicine to indicate that Mundinus had done but few dissections, will not stand such an interpretation, in the light of the evidence that he had dissected many male bodies at least, as his text-book of anatomy indeed makes very clear. These two dissections of females happened only to have special features that made them noteworthy.) "A few years later (1319) there is a remarkable document which tells the story of body-snatching for dissecting purposes." (This would seem to be sufficient of itself to show that a number of dissections were being done, and, indeed, as I have already said, Rashdall, in his History of the Universities, states that, according to the University statutes teachers were bound to dissect such bodies as students brought to them.) Roth concludes with the words (italics are mine): "These are a few, but weighty testimonies for the zeal with which Bologna pursued anatomy in the fourteenth century." (I may add that all of these concern the twenty years immediately following Pope Boniface's supposed prohibition.)
Nor was the custom of making dissections any less active during the rest of the half century after the time when, if we are to believe Professor White, the decree of Boniface had been universally interpreted to forbid it. In a note to his history of dissection during this period in Bologna, Roth says: "Without doubt the passage in [{74}] Guy de Chauliac which tells of having very often (multitoties, many times, is the exact word) seen dissections must be considered as referring to Bologna." This passage runs as follows: "My master, Bertruccius, conducted the dissection very often after the following manner: The dead body having been placed upon a bench, he used to make four lessons on it. First, the nutritional portions were treated, because they are so likely to become putrified. In the second, he demonstrated the spiritual members; in the third, the animate members; in the fourth, the extremities." (Guy de Chauliac was at Bologna studying under Bertruccius just before the middle of the fourteenth century. It is evident beyond all doubt, from what he says, that dissections were quite common. This is during the first fifty years after the decree. I shall show a little later that there are records of dissections during the second half of this century. Roth, however, goes on to tell next of the fifteenth century.)
Roth says nothing about the decree of Boniface VIII., nor of any possible effect that it had upon anatomy. The real historian, of course, does not mention things that have not happened. Roth confesses, as I have said, that he takes the material for his sketch of anatomy before Vesalius's time from Corradi. [Footnote 9] Corradi being an Italian, and knowing of the slander with regard to the Papal decree, explicitly denies it. Surely, here is material enough to convince anyone that all that Professor White has said with regard to the supposed effect of the misinterpretation of Boniface's decree is without foundation in the history of anatomy. Within twenty years [{75}] after the bull was issued dissection was practiced to such an extent, that body-snatching became so common that there were prosecutions for it, and public dissections seem to have been held every year in the universities of Italy during most of the fourteenth century.
[Footnote 9: Corradi Dello Studio e dell' Insegnamento dell' Anatomia in Italia nel Medio Evo ed in parte del Cinquecento, Padova, 1873.]
De Renzi [Footnote 10] gives an interesting account of the methods by which material was obtained for dissection purposes before governments made any special provision for this purpose. Naturally, the rifling of graves was resorted to by students intensely interested in the subject of anatomy. The first criminal prosecution for body-snatching on record is in 1319, when some students brought a body to one Master Albert, a lecturer in medicine at the University at Bologna, and he dissected it for them. At this time, according to the statutes of the university, teachers of anatomy were bound to make a dissection if the students supplied the body. The whole party were brought to trial for this offence, though they do not seem to have suffered any severe penalty for their violation of the laws. At this time, according to De Renzi, there was a rage for dissection and many bodies were yearly obtained surreptitiously for the purpose.
[Footnote 10: De Renzi Storia della Medicina in Italia, Napoli. 1845-49, Vol. II., p. 247.]
With regard to the bodies of condemned criminals, people began to countenance the procedure, and while unwilling as yet to give them freely, allowed the bodies to be taken. Corradi, quoted by Puschmann, says "that laws against the desecration of graves, without being abolished, became a dead letter. The authorities interfered only if decided violence had been used or a great scandal raised. Such consequences were likely to follow only if, in the ardor of their enthusiasm for anatomical knowledge, students rifled the graves of well-known [{76}] persons or took the bodies of those whose relatives discovered the desecration and proceeded against the marauders by legal measures."
At the Italian universities after the middle of the fourteenth century there is abundant evidence for perfect freedom with regard to dissection. We have already shown by our quotation from Roth that Bertrucci was very active in dissection work and did many public dissections. He was followed by Pietro di Argelata, who died toward the end of the fourteenth century. These men followed Mondino in the chair of anatomy at Bologna, and Julius Pagel, in his chapter on Anatomy and Physiology in Puschmann's Handbuch der Geschichte der Medizin (Vol. I., p. 707), says that "the successors of Mondino were in a position, owing to the gradual enlightenment of the spirit of the time and the general realization of the importance of anatomy as well as the fostering liberality of the authorities, to make regular, systematic dissections of the human body." This would bring us down, then, to the end of the fourteenth century.
To return now to Roth, who takes up the next century. He says:
"For the fifteenth century, the university statutes of Bologna for the year 1405 furnish many sources of information. There is a special division which is concerned with the annual anatomy or dissection that had to be made and the selection of the persons to be present, the payment of the expenses and other details. An addition to the statutes, made in the year 1442, determines the arrangement of the delivery of the body from the city to the university authorities. Every year two bodies, one male and one female, must be provided for the [{77}] medical school dissections. In default of a female body, a second male body was to be provided. In the presence of such detailed regulations, the absence almost entirely of details as to the actual performance of dissections can mean very little. Bologna reached its highest development as a medical school at the beginning of the sixteenth century when Alexander Achillinus and Jacob Berengarius had charge of the public dissections there. Of these I shall speak later." (All this is at the University of Bologna, where ecclesiastical influence was supreme and where the Popes exercised their jurisdiction as the ultimate authority to be appealed to in all disputed educational questions.)
Roth continues: "Padua had, like Bologna, dissection in the fourteenth century. There is the record of a dissection made in the year 1341, in which Gentilis made the discovery of a gall-stone." (It is evidently not because the dissection was unusual, but because the discovery was unusual, that this incident is mentioned. The dissections were such ordinary occurrences as not to deserve special mention except for some particular reason.)
"Much more is known about dissection at Padua in the fifteenth century, when the city had become Venetian." [Footnote 11] (It is significant to note that the previous occurrence was in pre-Venetian days, for Professor White insists that it was the Venetian authorities, in opposition to the Pope, who allowed dissection at Padua. Here is the rebuttal of any such theory.) "Bertapaglia, in his Surgery, has the record of the dissection of a criminal made under the direction of Master Hugo De Senis, on [{78}] the 8th of February, 1429. On the 4th of April, 1430, the dissection of a woman was made. In 1444 Professor Montagnana speaks of fourteen dissections at which he had been present." (This would seem to indicate that dissections were quite common and that the occasional records of them give no proper idea of their actual number.)
[Footnote 11: Note that this is a full century before Vesalius's time, who, Professor White insists, reintroduced dissection.]
I would not wish to produce the impression, however, that Italy was the only place in Europe in which dissections were freely done during the fourteenth and fifteenth centuries. There is no doubt that anatomy and surgery and every branch of medicine was cultivated much more assiduously and with much better opportunities provided for students down in Italy, than anywhere else in the world. This of itself alone shows the utter absurdity of the declarations that the Church was opposed to medical progress in any way, since the nearer the center of Christendom, the more ardor there was for investigation and the more liberty to pursue original researches. Other countries also began to wake up to the spirit of progress in medical education that was abroad. In France there were two centers of interest in anatomy. One of these was at Montpelier, the other at Paris. It is interesting to note, however, that the men to whom anatomical progress is due at these universities obtained their training, or at least had taken advantage of the special opportunities provided for anatomical investigation to be had, in the Italian cities. Guy de Chauliac I have already mentioned. He is spoken of as the Father of Modern Surgery, and there is no doubt that he did much to set surgery on a very practical basis and to make anatomy a fundamental feature of the training for it. He declared that it was absurd to think that surgeons could do good work unless they knew their anatomy.
Under his fostering care the study of anatomy flourished to a remarkable degree at the University of Montpelier. The difficulty hitherto had been that it was very hard to procure bodies for dissecting purposes. It is easy to understand that friends of the dead would always prevent dissections as far as they could. They do so even at the present moment, and there are not many of us who find it in our hearts to blame them over much for it. Few of us are ready to make the sacrifice of our own dead. Even the poor in those days had friends who prevented the cutting up of their remains; for large alms-houses were not presided over by paid officials, but by religious, to whom their poor in their friendlessness appealed as kindred. There were not many prisons, and they were not needed because all felonies were punished by death. Guy de Chauliac realized that here was the best opportunity to procure bodies. Accordingly it was mainly through his instrumentality that a regulation was made handing over the dead bodies of malefactors to the medical school for dissecting purposes. It must be recalled that when he did this the Papal court was at Avignon, in the South of France, and exerted great influence over the University of Montpelier, situate not far away.
The reputation of the University of Paris is such that we should not expect her to be backward in this important department of education. As a matter of fact, there is abundant evidence of dissection having been carried on here at the end of the thirteenth century, and the practice was not interrupted at the beginning of the fourteenth century. Lanfranc, the famous surgeon who had studied with William of Salicet in Italy (we have already mentioned both of them and we shall have much [{80}] to say of them hereafter), taught surgery from a very practical standpoint in Paris, and illustrated his teachings by means of dissections. Lanfranc was succeeded in Paris by Mondeville, whose name is also associated with the practice of dissection by most historians of medicine, and whose teaching was of such a practical character that there can be no doubt that he must have employed this valuable adjunct in his surgical training of students. In general, however, the records of dissecting work and of anatomical development are not near so satisfactory at Paris as in the Italian universities. As is the case in our own day and has always been true, universities were inclined to specialties in the Middle Ages, and the specialty of Paris was Philosophy and Theology. This was choice, however, not compulsion, any more than similar conditions in our own time. The medical school continued to be in spite of this one of the best in the world, though it was not famous for its original work, except in surgery, which is, however, the subject most nearly related to anatomy and the one whose development would seem necessarily to demand attention to anatomy.
With the Renaissance, which is usually said to begin after the fall of Constantinople in 1453, and the consequent dispersion of Greek scholars throughout Italy, a new spirit entered into anatomy as into every other department of intellectual life at this time. The reason for it is not easy to explain. Perhaps the spread of Greek texts with regard to medicine inspired students and teachers to try out their problems for themselves, and so a new impetus was given to anatomical investigation. Whatever it was that caused it, the new movement came unhampered by the Church, and Italy [{81}] continued to be even to a greater degree than before the Mecca for medical students who wished to do original work in anatomy. During the last fifty years of the fifteenth century anatomy began its modern phase, and original work of a very high order was accomplished. There are five names that deserve to be mentioned in this period. They are Gabriele Zerbi, Achillini, Berengar of Carpi, Matthew of Gradi and Benivieni. Each of these men did work that was epoch-making in anatomy, and each has a place in the history of the science that will never be lost.
Zerbi, who did his work at Verona, traced the olfactory nerves and describes the nerve supply of the special senses more completely than it had ever been done before. After his time it was only a question of filling in the details of this subject. Achillini added much to our knowledge of the anatomy of the head, being the first to describe the small bones of the ear and also to recognize the orifices of Wharton's ducts. Besides this, which would have been quite enough to have given him a place in the history of anatomy, he added important details to what had been previously known with regard to the intestines, and described very clearly the ileocecal valve and suggested its function. Matthew of Gradi, or De Gradibus, was the first, according to Professor Turner in his article on Anatomy in the Encyclopaedia Britannica, who represented the ovaries in the correct light as regards their anatomical relations and their function.
The most important of these fifteenth century investigators in pure anatomy, however, is Berengarius or Berengar of Carpi, who did his work at Bologna at the end of the fifteenth and the beginning of the sixteenth [{82}] century. His commentaries on Mondino's work show how much he added to that great teacher's instruction. If he had no other distinction than that of having been the first to undertake a systematic view of the several textures of which the body is composed, it would have been sufficient to stamp him as a great original worker in anatomy. He treats successively of the anatomical characters and properties of fat, of membrane in general, of flesh, of nerve, of villus or fibre, of ligament, of sinew or tendon, and of muscle in general. Almost needless to say, he must have made many dissections to obtain such clear details of information, and, as we shall see, he probably did make many hundreds. If he had done nothing else but be the first to mention the vermiform appendix, it would have been quite sufficient to give him a distinction in our day. Everything that he touched, however, he illuminated. His anatomy of the fetus was excellent. He was the first to note that the chest of the male was larger than in the female, while the capacity of the female pelvis was in the opposite ratio. In the larynx he discovered the two arytenoid cartilages. He recognized the opening of the common biliary duct, and was the first to give a good description of the thymus gland. All this, it must be remembered, before the end of the second decade of the sixteenth century, that is, almost before Vesalius was born.
Berengar's work was done at Bologna. Some five years before his death Bologna became a Papal city. There is no sign, however, that this change in the political fortunes of the city made any difference in Berengar's application to his favorite studies in anatomy. As we shall see in the chapter on The Papal Medical School, already the Popes were laying the foundations [{83}] of their own great medical school in Rome, in which anatomy was to be cultivated above all the other sciences, so that there would be no reason to expect from other sources of historical knowledge any interruption of Berengar's work, and it did not come.
A fifth great student of anatomy during the fifteenth century was Benivieni, who has been neglected in the ordinary histories of anatomy because his work concerned itself almost exclusively with pathological, not with normal anatomy. In our increasing interest in pathology during the nineteenth century, he has very properly come in for his due share of attention. Professor Allbutt, in his address on the Historical Relations of Medicine and Surgery down to the Sixteenth Century, declares that Benivieni should be revered as the forerunner of Morgagni and as one of the greatest physicians of the late Middle Ages. Benivieni's life occupies almost exactly the second half of the fifteenth century, as he was born probably in 1448, and died in 1502. Allbutt says:--
"He was not a professor, but an eminent practitioner in Florence, at a period when, in spite of its Platonism, Florence on the whole was doing most for science; for as Bologna turned to law, Padua turned to humanism and philosophy. He was one of those fresh and independent observers who, like Mondeville, was oppressed by the authority neither of Arab nor Greek."
We are not interested, however, at the present time in what he accomplished for surgery, though there are a number of features of his work, including the crushing of stone in the bladder and his puncture of the hymen for retained menses, as well as his methods of division and slow extension of the cicatricial contractions [{84}] resulting from burns near the elbow, which place him among the most ingenious and original of surgical thinkers. It is his interest in dissection that commends him to us here. He must have done a very great number of autopsies.
His interest in the causes of disease was so great that he seems to have taken every possible opportunity to search out changes in organs which would account for symptoms that he had observed. His place in anatomy and the history of pathology has not been properly appreciated in this matter, and Professor Allbutt claims for him the title of Father of Pathology, rather than for those to whom it has been given, and demands for his work done in Florence during the second half of the fifteenth century the credit of laying the real foundation-stones of the great science of pathological anatomy. Unfortunately, he died comparatively young and without having had time properly to publish his own contributions to medical science. Professor Allbutt says:--
"The little book De abditis causis morborum (brief title), was not published in any form by Antony Benivieni himself, but posthumously by his brother Jerome, who found these precious notes in Antony's desk after his death, and with the hearty cooperation of a friend competent in the subject, published them in 1506 in a form which no doubt justly merits our admiration. Benivieni's chief fame for us is far more than all this; it is that he was the founder of pathological anatomy. So far as I know, he was the first to make the custom and to declare the need of necropsy to reveal what he called not exactly "the secret causes," but the hidden causes of diseases. Before Vesalius, before Eustachius, he opened the bodies of the dead as [{85}] deliberately and clear-sightedly as any pathologist in the spacious time of Baillie, Bright and Addison. Virchow, in his address at Rome, said Morgagni was the first pathological anatomist who, instead of asking What is disease? asked Where is it?"
But Benivieni asked this question plainly before Morgagni: "Not only," says he, "must we observe the disease, but also with more diligence search out the seat of it." The precept is so important, I will quote the original words: "Oportet igitur medicum non solum morbum cognoscere, sed et locum in quo fit, diligentius perscrutari."
Among the pathological reports are morbus coxae (two cases); biliary calculus (two cases); abscess of the mesentery, thrombosis of the mesenteric vessels; stenosis of the intestine; some remarkable cardiac cases, several of "polypus" (clot, which was a will-of-the-wisp to the elder pathologists); scirrhus of the pylorus, and probably another case in the colon; ruptured bowel (two cases); caries of ribs with exposure of the heart. He gives a good description of senile gangrene which even Paré did not discriminate. He seems to have had remarkable success in obtaining necropsies; concerning one fatal case he says plaintively, "Sed nescio qua superstitione versi negantibus cognatis," etc. Of another he says, "cadavere publicae utilitatis gratia inciso" (the case of cancer of the stomach). With this admirable and original leader, Italian medicine of the fifteenth century closes gloriously, to slumber for some fifty years, till the dayspring of the new learning. Of his work Malpighi says, and apparently with truth, "up to now it is the only work in pathology which owes nothing to anyone."
This should be enough, it seems to me, to settle the question that anatomy was permitted very freely before Versalius's time. I have said it in other places, but it may be well to recall here, that Berengar did his dissection at Bologna just before and after the time it became a Papal city and when Papal influence was very strong. In spite of the fact that in 1512 Bologna passed under the dominion of the Popes, there is no question of any interruption or hampering of Berengar's work in anatomy, and as a matter of fact, this great anatomist did not succeed to the professorship of anatomy, which had been held up to this time by Achillini, until in the very year when Bologna came under Papal sway, and had his opportunity to do his independent work only after this. Professor Turner can scarcely find words strong enough to set down his admiration for Berengar and his work. Besides what we have already quoted he says that, "the science of anatomy boasts in Berengar of one of its most distinguished founders."
The distinguished Edinburgh anatomist harbors no illusions with regard to any supposed opposition of the Church to dissection or to the development of anatomy. As a life-long student of anatomy who knew the history of his favorite science, he appreciated very well just who had been the great workers in it and where their work had been done. He says that "Italy long retained the distinction of giving birth to the first eminent anatomists in Europe, and the glory she acquired in the names of Mondino, Achillini, Berengar of Carpi, and Massa was destined to become more conspicuous in the labors of Columbus, Fallopius and Eustachius." These are the greatest names in the history of anatomy down to the beginning of the seventeenth century, with the single exception of Vesalius.
All this of anatomical development in Italy at universities that were directly under the ecclesiastical authorities would seem to settle all question of interference by the Popes or the Church with any phase of anatomical development. It does not seem sufficient for Dr. White, however. When I called attention to all these details of the history of anatomy, long before the reformation and before Vesalius, Dr. White's response was the following paragraph in which he explains how dissection came to be practiced at all, and reiterates not only his belief that Pope Boniface's bull prevented dissection, but even insists on what cannot but seem utterly absurd to any one who has read even the brief account I have given here, that except at one or two places, and then only to a very limited degree, dissection was not practiced at all. Here is how the history of dissection must be viewed according to Dr. White:--
"But Dr. Walsh elsewhere falls back on the fact that shortly after the decree of Pope Boniface VIII., which struck so severe a blow at dissection, the Venetian Senate passed a decree ordaining that a dissection of the human body should be made every year in the city of Venice, and he leaves his readers to conclude that this effectually proves that dissection had not really been discouraged by the Pope. The very opposite conclusion would be deduced by anyone familiar with the relations between the Republic of Venice and the Papacy. These two powers were always struggling against each other; again and again the Venetian Republic, in maintaining its rights, braved the Papal interdicts. The fact that it allowed dissections, so far from proving that the Pope allowed them, would seem to prove that in this case, and in so many other cases, and especially that of [{88}] Vesalius of Padua, the Venetian Senate sought to show the Vatican that it would yield none of its rights to clerical control. This very fact--that Venice refused to be bound with regard to anatomical investigation by an order from the Vatican--seems to be entirely in the line with all the other facts in the case, which show that the Roman court had committed itself, most unfortunately, against the main means of progress in anatomy and medicine."
Here then is the answer that a modern historian and educator makes to all the representations with regard to the development of anatomy and the practice of dissection during the Middle Ages. If the practice of dissection was permitted it was in spite of the Popes. The fact that there were a dozen of medical schools in Italy at which dissection was carried on is ignored. The great anatomists of the fourteenth and fifteenth centuries simply did not exist--Dr. White knows nothing about them. There must be no admission that the Popes permitted dissection or any other form of science. Dr. White makes his last stand by a really marvelous tour d'esprit. It was Venice defying the Vatican that permitted dissection. This, he supposes, may help him, for anatomy did develop very wonderfully at Padua when it was Venetian territory. But, as pointed out by Roth, dissection was practiced very successfully, and the anatomical tradition established at Padua, before it came under the dominion of Venice. At all the other important cities of Italy dissection was carried on. We have given some of the evidence for Verona, for Pisa, for Naples, for Bologna, for Florence, and, be it remembered, even for Rome. Padua was the rival of Bologna in anatomy only for a comparatively short time. Bologna [{89}] always maintained a primacy in the field of anatomy, and never more so than after she became a Papal city at the beginning of the sixteenth century. Vesalius taught and demonstrated not at Padua alone, but also at Bologna and at Pisa. For two centuries Rome was the most successful rival of Bologna, and hundreds of dissections were done in the Papal Medical School.
Of course, the appeal to Venetian opposition to the Papacy as an explanation for dissection being carried on in Italy in spite of ecclesiastical regulations to the contrary is only a subterfuge. It can only be found in histories written by those who refuse to see facts as they were, because those facts do not accord with pet theories as to Papal Opposition to Science, and the Warfare Between Theology and Science, which must be maintained at all costs, though with an air of apology always for having to tell such unpleasant truths of these old-time religious authorities.
THE GOLDEN AGE OF ANATOMY
VESALIUS.
The Golden Age of discovery in anatomy culminated during the first half of the sixteenth century. This will not be surprising if it is but recalled that this period represents the culmination also of that larger golden age of achievement in art and letters, which has been called the Renaissance. Columbus and Copernicus were giving men a new world and a new universe. Raphael, Michael Angelo, Lionardo da Vinci, the Bellinis and Titian were creating a new world of art. Most of these artists were deeply interested in anatomy. Every phase of human thought was being born anew. Unfortunately, this word Renaissance has given rise to many misunderstandings. Many people have taken its significance of re-birth to mean that art and letters, and with them education and thinking, were born again into the modern world at this time with the coming in of the New Learning, just as if there had been nothing worth while talking about in these lines of human accomplishment in the preceding centuries. Taken in this sense, the word Renaissance is entirely a misnomer. Magnificent achievements in art and letters and every form of education preceded the Renaissance by at least three or four centuries. The Gothic cathedrals and the enduring artistic development that took place in their making, the magnificent organization of technical education in the training of artist artisans by the guilds of the time (we would be glad if our technical schools could accomplish [{91}] anything like the same results, for evidently, though the name technical education is our invention, these medieval peoples had the reality to a high degree), and finally the universities, which have remained essentially the same down to our own day--all these serve to show how much was done for every form of education many centuries before the beginning of the Renaissance so-called.
It is not surprising that with this much of education abroad in the land men succeeded in making enduring literature in every form and in every country in Europe, and in setting examples of style in prose and verse that succeeding generations have nearly always gone back to admire lovingly. Such an amount of education and development of thinking could not have come without profound attention to science, and, as a matter of fact, there was much more anticipation of even what is most modern in our scientific thinking than most scholars seem to have any idea of. Personally, I have found, in writing the history of The Thirteenth the Greatest of Centuries, more that interested me in the science of this century than in almost any other department of its wonderful educational development.
We have already seen that while anatomy had during preceding centuries only the beginning of the development that it was destined to reach during the sixteenth century, it would be a serious mistake to think that the study of anatomy, having died in the old classical days, was not re-born until the sixteenth century. This would be to commit the error that many ardent devotees of the Renaissance make with regard to all the accomplishments of this period. In spite of the contrary almost universal impression, the Renaissance was not original [{92}] to any marked degree. With the touch of the Greek spirit that had come again into the world, it only carried the preceding work of great original thinkers to a high order of perfection. This happened as well in anatomy as in art and architecture and literature. Anatomical science was a lusty infant of great promise when Vesalius, the Father of Anatomy, came on the scene. The great painters, Raphael and Lionardo and Michael Angelo, owed much to Giotto and Fra Angelico, who had preceded them, but not more than Vesalius and his contemporaries, who did such magnificent work in original anatomical investigation, owed to Mondino, Bertrucci, Zerbi, Achillini, and above all to Berengar of Carpi and Benivieni, who did their work before and just after the sixteenth century opened. There is never a sudden development in the history of any department of man's knowledge or achievement, as there is nothing absolutely new under the sun, though it is still the custom of the young man in his graduation essay to talk of such things, and older men sometimes fail to realize the truth that in history as in biology, life always comes from preceding life--omne vivum ex vivo--and there is no such thing as spontaneous generation.
If the achievements of this earlier period of scientific work, which affected anatomy even more than any of the other sciences, be kept in mind, the discussion of the Golden Age of Anatomy will find its proper place in the history of the relation of the Popes to science. Though the date of the Golden Age in Anatomy follows that of the so-called reformation, there is absolutely no connection between the two series of events, for the one took place in Germany and the other in Italy. The Golden Age of Anatomy was indeed a perfectly [{93}] legitimate and quite to be expected culmination of the anatomical interest which had been gradually rising to a climax in the Italian universities during the preceding century. It has a definite place in the evolution of science, and is not a sudden or unlooked for phenomenon.
If there was any place in the world at the beginning of the sixteenth century in which the ecclesiastical authorities had much to say with regard to what should not be taught and what should not be studied in the universities, it was Italy. In spite of this fact, all medical men who wanted to do post-graduate work in medicine went down into Italy. This was especially true for those who desired to obtain ampler opportunities for anatomical study than were afforded by the rest of Europe. In his maturer years as a student of medicine, Vesalius went down to Italy in order to avail himself of the magnificent field for investigation that was provided there. This favorable state of affairs as regards research in anatomy had existed for more than a century before his time. It continued to be true for at least two centuries after his time. As a matter of fact, Italy was to the rest of the world of the fifteenth and sixteenth and seventeenth centuries the home of post-graduate opportunities in all sciences as well as in medicine.
These are not idle words, but are fully substantiated by the lives of the men who stand at the head of our modern medicine. More than a decade before Vesalius was born, Linacre, the distinguished English physician and founder of the Royal College of Physicians, went to Italy to complete his medical studies and incidentally also to round out his education in the midst of the new learning which was so thoroughly cultivated there. When Linacre was leaving Italy, with true classic spirit [{94}] he set up a little altar on the top of the Alps whence he could get his last view of the Italian plains, and greeted the charming country that he was leaving so reluctantly with the beautiful name of Alma Mater Studiorum. To him, after his return to England, English-speaking medical men owe the establishment of the institution which above all others has helped to uplift the dignity of the medical profession and make the practice of the healing art something more than a mere trade--the Royal College of Physicians.
One of Vesalius's most distinguished fellow students at Padua was Dr. John Caius, who was later to become the worthy president of the Royal College of Physicians of England and the author of certain important medical works. Dr. Caius was the first to introduce the practice of public dissections into England. Caius and Vesalius were roommates, though at the time Vesalius was an instructor at the University, and the inspiration of his originality seems to have had a great effect upon young Caius. They were nearly of the same age, though Vesalius was a precocious genius, and Caius's greatness only showed itself in maturity. Caius was studying in Italy partly because the religious disturbances in England had made it uncomfortable for him to remain in his native country, for he was a firm adherent of the old Church and he hoped they would pass over, but mainly because he coveted the opportunities afforded by that country. Later in life, out of the revenues of his position as Royal Physician to Queen Mary and subsequently for some time to Queen Elizabeth, he founded the famous Caius College at Cambridge, usually called Key's College by Cantabrigians.
Before either of these men there had been a third [{95}] distinguished English physician who had gone down to Italy for his education. This was the celebrated and learned John Phreas, who was born about the commencement of the fifteenth century. Very little is known of his career, but what we do know is of great interest. He was educated at Oxford and obtained a fellowship on the foundation of Balliol College. Afterward he seems to have studied medicine with a physician in England, but was not satisfied with the medical education thus obtained. He set the fashion for going down into Italy sometime during the first half of the fifteenth century, and after some years spent at Padua received the degree of doctor in medicine, which in those days carried with it, as the name implies, the right to teach. As not infrequently happens to the brilliant medical student, he settled down for practice in the university town in which he graduated, to take up both occupations, that of teacher and practitioner. He is said to have made a large fortune in the practice of physic. [Footnote 12] The best proof of his scholarship is to be found in some letters still preserved in the Bodleian and in the Library of Balliol College. Personally, I have considered that his career was interesting from another standpoint. I have often looked in history for the cases of appendicitis which occur so frequently in our day and with regard to which people ask how is it they did not occur in the past. The fact is, they did occur, but were unrecognized. People were taken suddenly ill, not infrequently a short time after a meal, and after considerable pain and fever, swelling and great tenderness in the abdomen [{96}] developed, and they died with all the signs of poisoning. They were actually poisoned, not by some extraneous material, but by the putrid contents of their own intestines which found a way out through the ruptured appendix. These cases were set down as poisoning cases, and usually some interested person was the subject of suspicion. Dr. Phreas's learning had obtained for him an appointment to a bishopric in England, a curious bit of evidence of the absence of opposition between medical science and religion in his time. He died shortly after this, under circumstances that raised a suspicion of poisoning in the minds of some of his contemporaries--but raises the thought of appendicitis in mine,--and one of his rivals was blamed for it.
[Footnote 12: Like the other distinguished physicians of this time, John Phreas did not devote himself to medicine alone. He had a taste for literature, and besides being an accomplished scholar he was a poet.]
Nor did the custom for English medical students to go down to Italy to complete their education cease with the so-called reformation. Some two generations after Vesalius's time another distinguished Englishman, Harvey, went down to Italy to complete the studies he had already made and eventually to lay the foundation of that knowledge on which he was twenty years later to construct his doctrine of the circulation of the blood. This doctrine, however, remained merely a theory until the distinguished Italian anatomist, Malpighi, after another half century, demonstrated the existence of the capillaries, the little blood vessels which connect the veins and arteries, and by thus showing the continuity of both the blood systems, proved beyond all doubt the certainty of the teaching that the blood does circulate.
Students came, moreover, from even the distant North of Europe to the Italian schools of medicine during these centuries. Neil Stensen, or as he is perhaps better known by his Latin name, Nicholas Steno, the [{97}] discoverer of the duct of the parotid gland, which has been named after him, and of many other anatomical details, especially of the fact that the heart is a muscle, which stamp him as an original investigator of the highest order, after having made extensive studies in the Netherlands and in France to complete the medical education which he had begun in his native city of Copenhagen, went down into Italy to secure freer opportunities for original research than he could obtain anywhere else in Europe. [Footnote 13]
[Footnote 13: It may perhaps be of interest to say that while doing investigation in anatomy and certain other sciences allied to medicine, Steno became a convert to the Catholic Church and after some years became a priest. Before his ordination, however, though after his conversion, he received the call to the chair of anatomy at Copenhagen. He accepted this and worked for several years at the Danish University, but was dissatisfied with the state of affairs around him as regards religion and went back to Italy. Eventually he was made a bishop--hence the curious picture of him in a Roman Catholic Bishop's robes in the collection of pictures of professors of anatomy at the University of Copenhagen. Not long after, at his own request, he was sent up to the Northern part of Germany in order to try to bring back to the Church as many of the Germans as might be won by his gentleness of disposition, his saintly character, his wonderful scientific knowledge, and his winning ways. He is the Father of Modern Geology as well as a great anatomist, and his little book on geology was published after he became a priest, yet did not hamper in any way his ecclesiastical preferment nor alienate him from his friends in the hierarchy. He was honored especially by the Popes. In a word, his career is the best possible disproof of any Papal or ecclesiastical opposition to science in his time.]
We have mentioned that it was while he was pursuing his special investigations in various Italian universities that Stensen was honored with the invitation to become professor of anatomy at the University of Copenhagen. This was not a chance event, but a type of the point of view in university education at the time. Just as at the present time the prestige of research in a German university counts for much as a recommendation for professorships in our American universities, so in the sixteenth and seventeenth centuries was it with regard to study in Italy. It was felt that men who had spent [{98}] several years there could be reasonably expected to know all that there was to be known in the rising sciences of anatomy and physiology; at the same time there was a very general impression, quite justified by the results observed, that those who did their post-graduate work in Italy were nearly always sure to make discoveries that would add to the prestige of their universities later, and that would be a stimulus to students and to the other teachers around them such as could be provided in no other way. If read in the proper spirit, the history of the universities of those times is quite like our own, only for influence, the name of Italy must always be substituted for that of Germany. Yet Italy, if we were to believe some of the writers on the history of education and science, was at this time laboring under the incubus of ecclesiastical intolerance with regard to anatomy and an almost complete suppression of opportunities for dissection. Those who write thus know nothing at all of the actual facts of the history of science, or else they are blinding themselves for some reason to the real situation.
Fortunately students of the facts of history, especially those who have devoted any serious attention to the history of medicine, make no such mistake. For them it is perfectly clear that there was a wonderful development in anatomy which took place down in Italy, beginning about the middle of the fifteenth century or even earlier, and which led to the provision of such opportunities for dissection and original research in medicine, that students from all over the world were attracted there. For instance, Professor Clifford Allbutt, in the address on the Historical Relations of Medicine and Surgery to the end of the Sixteenth Century, already quoted, has a passage [{99}] in which, as an introduction to what he has to say about Galen, he sums up the history of anatomy from the return of the Popes from Avignon to Rome, which took place just about the beginning of the last quarter of the fourteenth century, down to the time of Vesalius. This expresses so well what I have been trying to say with regard to the gradual development that led up to the Golden Age of Anatomy and to Vesalius's work, that I quote it.
"Meanwhile, however, the return of the Popes to Rome (1374) and the displacement of the Albucasis and Avicenna by the Greek texts renewed the shriveling body of medicine, and with the help of anatomy, Italian medicine awoke again; though until the days of Vesalius and Harvey the renascence came rather from men of letters than of medicine. The Arabs and Paris said: "Why dissect if you trust Galen? But the Italian physicians insisted on verification; and therefore back to Italy again the earnest and clear-sighted students flocked from all regions. Vesalius was a young man when he professed in Padua, yet, young or venerable, where but in Italy would he have won, I would not say renown, but even sufferance! If normal anatomy was not directly a reformer of medicine, by way of anatomy came morbid anatomy, as conceived by the genius of Benivieni, of Morgagni, and of Valsalva; the galenical or humoral doctrine of pathology was sapped, and soaring in excelsis for the essence of disease gave place to grubbing for its roots."
A sketch of Vesalius's career will give the best possible idea of the influences at work in science during this Golden Age of anatomical discovery, and will at the same time serve to show better than anything else, how [{100}] utterly unfounded is the opinion that there was opposition between religion, or theology and science, and above all medical science, at this time. On the other hand, it will demonstrate that the educational factors at work in Vesalius's time were not different from those of the preceding century, nor indeed from those that had existed for two or three centuries before his time; and though his magnificent original research introduced the new initiative which always comes after a genius has left his mark upon a scientific department, the spirit in which science was pursued after his time did not differ essentially from that which had prevailed before. He represents not a revolution in medical science, as has so often been said, though always with the purpose of demonstrating how much the so-called reformation accomplished in bringing about this great progress in anatomy, but only a striking epoch in that gradual evolution which had already advanced so far that his work was rendered easy and some such climax of progress as came in his time was inevitable.
Vesalius's earlier education was received entirely in his native town of Louvain. There were certain preparatory schools in connection with the university at Louvain, and to one of these, called Paedagogium Castri because of the sign over the door, which was that of a fort, Vesalius was sent. Here he learned Latin and Greek and some Hebrew. How well he learned his Latin can be realized from the fact that at twenty-two he was ready to lecture in that language on anatomy in Italy. His knowledge of Greek can be estimated from the tradition that he could translate Galen at sight, and he was known to have corrected a number of errors in translations from that author made by preceding [{101}] translators. To those who know the traditions of that time in the teaching of the classic languages along the Rhine and in the Low Countries, these accomplishments of Vesalius will not be surprising. They knew how to teach in those pre-reformation days, and probably Latin and Greek have never been better taught than by the Brethren of the Common Life, whose schools for nearly a hundred years had been open in the Low Countries and Rhenish Germany for the children of all classes, but especially of the poor. Other schools in the same region could scarcely fail to be uplifted by such educational traditions. Altogether, Vesalius spent some nine years in the Paedagogium.
As illustrating how men will find what interests them in spite of supposed lack of opportunities, it may be said that from his earliest years Vesalius was noted for his tendency to be inquisitive with regard to natural objects, and while still a mere boy his anatomical curiosity manifested itself in a very practical way. He recalls himself in later years, that the bladders with which he learned to swim, and which were also used by the children of the time as play-toys for making all sorts of noises, became in his hands objects of anatomical investigation. Anatomy means the cutting up of things, and this Vesalius literally did with the bladders. He noted particularly that they were composed of layers and fibres of various kinds, and later on when he was studying the veins in human and animal bodies he was reminded of these early observations, and pointed out that the vein walls were made up of structures not unlike those, though more delicate, of which the bladders of his childhood days had proven to be composed.
His preparatory studies over, Vesalius entered the [{102}] University of Louvain, at that time one of the most important universities of Europe. At the end of the fifteenth and the beginning of the sixteenth century, Louvain probably had more students than any other university in Europe except that of Paris, and possibly Bologna. There are good grounds for saying that the number in attendance here during the first half of the sixteenth century was always in excess of 5,000. The university was especially famous for its teaching of jurisprudence and philology. The faculty of theology, however, was considered to be one of the strongest in Europe, and Louvain, as might be expected from its position in the heart of Catholic Belgium, was generally acknowledged to be one of the great intellectual bulwarks of Catholicity against the progress of Lutheranism in the Teutonic countries at this time. Vesalius's parents were, and his family always had been, ardent Catholics, so that, quite apart from his dwelling not far away, it was very natural that he should have been sent here. He seems to have spent five years in the university mainly engaged in the study of philosophy and philology, but also of the classics and languages so far as they were taught at that time.
It may be noted as another instance in his life of how a student will find that which appeals to him even in the most unexpected sources, that Vesalius took special interest in certain treatises of Albertus Magnus and Michael Scotus, which treated of the human body in the vague, curious way of the medieval scholars, and yet with a precious amount of information, that this inquisitive youth eagerly drank in. More interesting for Vesalius himself were certain studies undertaken entirely independently of his university course. One of his [{103}] biographers tells that he dissected small animals, rats and mice, and occasionally even dogs and cats, in his eagerness to learn the details of anatomy for himself and at first hand.
After graduating at Louvain in philosophy and philology, Vesalius went to Paris to study medicine. At this time at Paris, Sylvius, after whom one of the most important fissures of the brain, the sylvian, is named, was not only teaching anatomy in a very interesting way, but was also providing opportunities for original research in anatomy in connection with his own investigations. The interest that his teaching excited may be gathered from the fact that over 400 students were in attendance at his lectures. Besides Sylvius, Günther of Andernach in Switzerland was also teaching in Paris, and with both of these distinguished professors Vesalius became intimately associated. His deep interest in the subject of anatomy would of itself be quite sufficient to attract the attention of professors, but he had besides the added advantage of being known as the descendant of a family which had occupied prominent posts as medical attendants to the greatest ruling family of Europe.
It was at Paris, then, that Vesalius first was able to devote himself with the intense ardor of his character to the study of anatomy. Nothing less than original research at first hand would satisfy his ardent desire for information and his thirst for accurate knowledge. His practical temper of mind was demonstrated by a revolution that he worked in the method of doing dissections at the time. The dissections in Paris used to be performed by the barber-surgeons, as a rule rather ignorant men, who knew little of their work beyond the barest outline of the technics of dissection. Teachers in [{104}] anatomy used to stand by and direct the operation and demonstrate the various parts. These teachers, however, considered it quite beneath them to use the knife themselves. The faultiness of this method can be readily understood. Vesalius began a new era in the history of anatomy by insisting on doing the dissections himself. It was not long, however, before he realized that Paris could not afford him such opportunities as he desired. Altogether he did not remain there more than a year, and then returned to the Low Countries.
At Louvain he continued his anatomical work, finding it difficult enough to procure human material, but using such as might come to hand. The story is told of his first attempt to get a complete skeleton. A felon had been executed just outside the walls of Louvain, and his remains were, as was the custom at that time, allowed to swing on the gibbet until the birds of the air had eaten his flesh and the wind and rain had bleached his bones. As might be thought, these bones were a great temptation to Vesalius. Finally, one night he and a fellow student stole out of the town and robbed the gibbet of its treasure. In order to accomplish their task--no easy one, because the skeleton was fastened to the beams of the scaffold by iron shackles--they had to remain out all night. They buried it and later removed it piecemeal, and when they had finally assembled the parts again it was exhibited as a skeleton brought from Paris.
Even this story has been made to do duty as showing the ecclesiastical opposition to dissection and the advancement of anatomical knowledge. It is hard to understand, however, why men will not look at such an incident from the standpoint of our own experience in [{105}] the modern time. There are men still alive in certain states of the Union who recall how much trouble they had to go to as medical students in order to procure a skeleton. If we go back fifty years, nearly every skeleton that physicians had in their offices was obtained in some way almost as surreptitious as that just described, or was purchased through some underhand channel. They were dug up from potter's field, or sometimes procured from complacent prison officials, or occasionally stolen from respectable cemeteries. In this respect Vesalius was not much worse off than were his medical colleagues for nearly three centuries and a half after his time in the northern countries. It was easier to procure such material in Italy.
Vesalius had that precious quality that makes the investigator desire to see and know things for himself. He could not get opportunities for definite anatomical knowledge in the western part of Europe, so he gave up his practice, though Louvain, his native town, was a most promising place, having nearly 200,000 inhabitants and business relations with all the world at the moment, and went down into Italy where he knew that he could pursue his anatomical studies to his heart's content. The tradition of the work that Zerbi and Achillini had done, and especially what Benivieni and Berengar had accomplished within a few decades before this time, was commonly known in all the medical schools of Europe, and many an ardent young anatomist in the West yearned for the opportunities and the incentive that he could obtain down there. Church influence was predominant; the ecclesiastics were the actual rulers of the universities, but medical science, and above all anatomy, was being studied very ardently. Vesalius thus prompted, [{106}] came and found what he looked for. At the end of ten short years of work down there, he had completed his text-book of anatomy which was to earn for him deservedly the title of Father of Anatomy.
At first Vesalius seems to have spent some time in Venice, where he attracted considerable attention by his thorough, practical anatomical knowledge and independent mode of thinking. After only a short period in Venice, however, he proceeded to Padua, where he spent some months in preparation for his doctor's examination. It is known that, having completed his examination in the early part of December, 1537, he was allowed within a few days to begin the teaching of anatomy, and, indeed, was given the title of professor by the university authorities.
The next six years were spent in teaching at Padua, Bologna and Pisa, and in fruitful investigation. Every opportunity to make dissections was gladly seized, and Vesalius's influence enabled him to obtain a large amount of excellent anatomical material. He began at once the preparations for the publication of an important work on the anatomy of the human body. This was published in 1543 at Basel, at a time when its author was not yet thirty years of age. It is one of the classics of anatomical literature. Even at the present day it is often consulted by those who wish to see the illustrative details of Vesalius's wonderful dissections as given in the magnificent plates that the work contains. It has become one of the most precious of medical books, and is eagerly sought for by collectors.
For ten years more Vesalius devoted himself to his favorite studies in anatomy and physiology, for it must not be forgotten that he was constantly applying his [{107}] knowledge of form and tissue to function, and came to be looked upon as the leading medical investigator of the world. It is apparently sometimes not realized, however, that Vesalius was no mere laboratory or dissecting room investigator. After the publication of his great work on anatomy he set himself seriously to the application of what he had discovered to practical medicine and surgery. He was an intensely practical man. As a consequence, it was not long before consultations began to pour in on him, and he came to be considered as one of the greatest medical practitioners of his time. Ruling princes in Italy, visitors of distinction, high ecclesiastics--all wished to have Vesalius's opinion when their cases became puzzling. This is a side of his character that many of his modern biographers have missed. Even Sir Michael Foster, whose knowledge of the history of medicine, and especially of physiology, makes one hesitate to disagree with him, seems not to have appreciated Vesalius's interest in practical medicine. A laboratory man himself, he was apparently not able to appreciate why Vesalius should have given up his scientific research in Italy to accept the post of Royal Physician to the Emperor Charles V.
Professor Foster thinks it necessary, then, to find some other reason than the temptation of the importance of the position to account for Vesalius's acceptance of it. He concludes that it was because of discouragement in his purely scientific studies as a consequence of the opposition of the Galenists. Opposition on the part of the old conservative school of medicine there was, and some of it was rather serious. This was not enough, however, to have discouraged Vesalius. Professor Foster goes so far as to wax almost sentimental over the [{108}] fact that the acceptance of the post of physician to Charles V. ended Vesalius's scientific career; "for though in the years which followed the Father of Anatomy from time to time produced something original, and in 1555 brought out a new edition of his Fabrica, differing chiefly from the first one, so far as the circulation of the blood is concerned, in its bolder enunciation of its doubts about the Galenic doctrines touching the heart, he made no further solid addition to the advancement of knowledge. Henceforward his life was that of a court physician much sought after and much esteemed--a life lucrative and honorable and in many ways useful, but not a life conducive to original inquiry and thought. The change was a great and a strange one. At Padua he had lived amid dissections; not content with the public dissections in the theatre, he took parts, at least, of corpses to his own lodgings and continued his labors there. No wonder that he makes in his Fabrica some biting remarks to the effect that he who espouses science must not marry a wife; he cannot be true to both. A year after his arrival at the Court he sealed his divorce from science by marrying a wife; no more dissections at home, no more dissections indeed at all; at most, some few post-mortem examinations of patients whose lives his skill had failed to save. Henceforth his days were to be spent in courtly duties, in soothing the temporary ailments, the repeated gouty attacks of his imperial master, in healing the maladies of the nobles and others round his throne, and doubtless in giving advice to more humble folk, who were from time to time allowed to seek his aid. Whither his master went, he went too, and we may well imagine that in leisure moments he entertained the Emperor and [{109}] the Court with his intellectual talk, telling them some of the fairy tales of that realm of science which he had left, and of the later achievements of which news came to him, scantily, fitfully and from afar."
Professor White has gone much farther than Sir Michael Foster. The English physiologist knew too much about the history of medicine in Italy even to hint at any ecclesiastical opposition with regard to Vesalius. President White, however, has no scruples in the matter. This makes an excellent opportunity to write the kind of history that is to be found in his book. Apparently forgetful of the thought that the Emperor Charles V. was not at all likely to take as his body physician a man who had been in trouble with the ecclesiastical authorities in Italy, he insists that the reason why Vesalius dedicated his great work on anatomy to the Emperor Charles V. was "to shield himself as far as possible in the battle which he foresaw must come." Later he suggests that it was only the favor of the Emperor saved him from the ecclesiastical authorities.
All that has been said by historians with regard to the reasons for Vesalius's acceptance of the post of physician to the Emperor Charles V. can only have come from men who either did not know or had for the moment forgotten the story of Vesalius's ancestry. The family tradition of having one of its members as physician to the Court of the German Emperor was four generations old when Vesalius accepted the position.
Vesalius's great-grandfather occupied the position of physician-in-ordinary to Marie of Burgundy, the wife of the German Emperor Maximilian I., the distinguished patron of letters in the Renaissance period. He lived to an advanced age as a professor of medicine at Louvain. [{110}] From this time on Vesalius's family always continued in official medical relation to the Austrian-Burgundy ruling family. His grandfather took his father's place as physician to Mary of Burgundy, and wrote a series of commentaries on the aphorisms of Hippocrates. Vesalius's father was the physician and apothecary to Charles V. for a while, and accompanied the Emperor on journeys and campaigns. What more natural than that his son, having reached the distinction of being the greatest medical scientist alive, should be offered, and as a matter of course accept the post of imperial physician!
The simple facts of the matter are that Vesalius came down into Italy in order to study anatomy, because in that priest-ridden and ecclesiastically-ruled country he could get better opportunities for anatomical study and investigation than anywhere else in Europe. He spent ten years there and then wrote his classical work on anatomy. After that he spent some years applying anatomy to medicine. Then when he had come to be the acknowledged leader of the medical profession of the world, the Emperor Charles V., at that time the greatest ruler in Europe, asked him to become his court physician. Vesalius accepted, as would any other medical investigator that I have ever known, under the same circumstances. His position with Charles V. gave him opportunities to act as consultant for many of the most important personages of Europe, and it must not be forgotten that when the King of France was injured in a tournament Vesalius was summoned all the way from Madrid, and gave a bad prognosis in the case.
In the light of this simple story of Vesalius's life in Italy, and of the reasons for his going there and his departure, it is intensely amusing to read the accounts of [{111}] this portion of Vesalius's life, written by those who must maintain at all costs the historical tradition that the Church was opposed to anatomy, that the Popes had forbidden dissection, and that the ecclesiastical authorities were constantly on the watch to hamper, as far as possible at least, if not absolutely to prevent, all anatomical investigation, and were even ready to put to death those who violated the ecclesiastical regulations in this matter. Dr. White, for instance, has made a great hero of Vesalius for daring to do dissection. He was only doing what hundreds of others were doing and had been doing in Italy for hundreds of years; but to confess this would be to admit that the Church was not opposed to anatomy or the practice of dissection, and so perforce Vesalius must be a hero as well as the Father of Anatomy. To read Dr. White's paragraph in the History of the Warfare of Science with Theology, one cannot but feel sure that Vesalius must practically have risked death over and over again in order to pursue his favorite practice of dissection and his original researches in anatomy. I would be the last one in the world to wish to minimize in any way Vesalius's merits. He was a genius, a great discoverer--above all an inspiration to methods of study that have been most fruitful in their results, and withal a devout Christian and firm adherent of the Roman Catholic Church. He was not a hero in the matter of dissection, however, for there was no necessity for heroism. Dissection had been practiced very assiduously before his time in all the universities of Italy, especially in Bologna, which was a Papal city from the beginning of the sixteenth century, and also in Rome at the medical college of the Roman University under the very eye of the Popes.
In the light of this knowledge read President White's paragraph with regard to Vesalius:
"From the outset Vesalius proved himself a master. In the search for real knowledge he risked the most terrible dangers, and especially the charge of sacrilege, founded upon the teachings of the Church for ages. As we have seen, even such men in the early Church as Tertullian and St. Augustine held anatomy in abhorrence, and the decretal of Pope Boniface VIII. was universally construed as forbidding all dissection, and as threatening excommunication against those practicing it. Through this sacred conventionalism Vesalius broke without fear; despite ecclesiastical censure, great opposition in his own profession and popular fury, he studied his science by the only method that could give useful results. No peril daunted him. To secure material for his investigations, he haunted gibbets and charnel-houses, braving the fires of the Inquisition and the virus of the plague." (The italics are mine.)
A very interesting commentary on the expressions of Professor White with regard to Vesalius is to be found in a paragraph of Von Töply's article on the History of Anatomy in the second volume of Puschmann's History of Medicine, already quoted. "Out of the fruitful soil so well cultivated in the two preceding centuries, there developed at the beginning of the sixteenth century the Renaissance of anatomy, with all the great and also with all the unpleasant features which belong to the important works of art of that period. One has only to think of Donatello, Mantegna, Michel Angelo, and Verochio to realize these. The Renaissance of anatomy developed in a field of human endeavor which, if it did not owe all, at least owed very much to the art-loving and [{113}] culture-fostering rulers, Popes and cardinals of the time. Older historians have told the story of the rise of anatomy in such a way that it seemed that the Papal Curia had set itself ever in utter hostility to the development of anatomy. As a matter of fact, the Papal Court placed scarcely any hindrances in its path. On the contrary, the Popes encouraged anatomy in every way."
In the page and a half following this quotation Von Töply has condensed into brief form most of what the Popes did for medicine and the medical sciences, though more especially for anatomy, during the centuries from the sixteenth down to the beginning of the nineteenth. Some excerpts from this, with a running commentary, will form the best compendium of the history of the Papal relations to medical education and will show that they are strikingly different from what has usually been said. Von Töply begins with Paul III., who is known in history more especially for his issuance of the Bull founding the Jesuits. It might ordinarily be presumed by those who knew nothing of this Pope, that the Head of the Church, to whom is due an institution such as the Jesuits are supposed to be, would not be interested to the slightest degree in modern sciences, and would be one of the last ecclesiastical authorities from whom patronage of science could possibly be expected. It was he, however, who founded special departments for anatomy and botany and provided the funds for a salary for a prosector of anatomy at Rome.
After this practically every Pope in this century has some special benefaction for anatomy to his credit. Pope Paul IV. (1555-59) called Columbus to Rome and gave him every opportunity for the development of his original genius in anatomical research. Columbus had [{114}] succeeded Vesalius at Padua and had been tempted from there to Pisa by the duke who wished to create in that city a university with the most prominent teachers in every department that there was in Italy, yet it was from this lucrative post that Pope Paul IV. succeeded in winning Columbus. Quite apart from what we know of Columbus's career at Rome and his successful investigation on the cadaver of many anatomical problems, perhaps the best evidence of the friendly relations of the Popes to him and to his work is to be found in the fact that, first Columbus himself, and then after his death his sons, in issuing their father's magnificent work De Re Anatomica, dedicated it to the successor of Pope Paul IV., the reigning Pope Pius IV. In the meantime Cardinal Della Rovere had brought Eustachius to Rome to succeed Columbus.
Under Sixtus V., who was Pope from 1585 to 1590, the distinguished writer on medicine, and especially on anatomy, Piccolomini, published his lectures on anatomy with a dedication to that Pope. It is well known that the relations between the professor of anatomy at the Papal Medical School and the Pope were very friendly. As was the case with regard to Colombo or Columbus, so also with Caesalpinus. Columbus was the first to describe the pulmonary circulation. Caesalpinus is generally claimed by the Italians to have made the discovery of the circulation of the blood throughout the body before Harvey. Columbus had been at Pisa and was tempted to come to Rome. Caesalpinus had also been at Pisa until Clement VIII. held out inducements that brought him to Rome. Clement is the last Pope of the century, but Von Töply mentions five Popes in the next century who were in intimate relations with [{115}] distinguished investigators into medical subjects and whose names are in some way connected with some of the most noteworthy teaching and writing in medical matters during the seventeenth century.
It will be readily seen what a caricature of the life of Vesalius is Prof. White's paragraph, if one compares it with the following paragraph taken from so readily available an historical source as the article on the History of Anatomy, by Prof. Turner, of Edinburgh, in the first volume of the Encyclopaedia Britannica. The distinguished Scotch anatomist who so worthily filled the chair of anatomy at the University of Edinburgh says with regard to Berengar of Carpi, who was the professor of anatomy at Bologna thirty-five years before Vesalius's time, that, "In the annals of medicine Berengar's name will be remembered as one of the most zealous and eminent in cultivating the anatomy of the human body. It was long before the anatomists of the following age could boast of equalling him. His assiduity was indefatigable, and he declares that he dissected above one hundred human bodies." This should be enough, it seems to me, to settle the question that anatomy was permitted very freely before Vesalius's time. Professor Turner's authority in such a matter is above all suspicion. He knew the history of anatomy.
If more evidence be needed, compare with President White's fantastic sketch of Vesalius the following sketch of his great contemporary, Columbus or Colombo, to whose anatomical investigations we owe the discovery of the pulmonary circulation:
"The fame of Columbus as an anatomical teacher was exceedingly great and widespread. Students were attracted to the universities where he professed, from all [{116}] quarters and in large numbers. He was an ardent student of his favorite science and was imbued with the genius and enthusiasm of an original investigator. He was not satisfied with the critical examination of mere structure, but extended his researches into the more subtle, difficult and important investigation of the physiological function. He has been most aptly styled the Claude Bernard of the sixteenth century. The work of Columbus is a masterpiece of method and purity of style, as well as on account of its richness in facts and observations. He spent over forty years in these studies and researches. He dissected an extraordinary number of human bodies. It must have been an age of remarkable tolerance for scientific investigation, for in a single year he dissected no less than fourteen bodies. He also entered the crypts and catacombs of ancient churches, where the bones of the dead had been preserved and had accumulated century after century, and there, with unwearied care, he handled and compared over a half million of human skulls."
This account was written by Dr. George Jackson Fisher in his "Historical and Bibliographical Notes" for the Annals of Anatomy and Surgery (Brooklyn, 1878-1880). All the material that Dr. Fisher used in his sketch is to be found in Roth's "Life of Vesalius," p. 256. Now, Columbus was a contemporary of Vesalius, and worked with him at Bologna. The years of their lives correspond almost exactly. When Vesalius left Padua to become the royal physician to Charles V., it was Columbus who succeeded him. Later he taught also at Pisa. Then, strange as it may seem for those who have put any faith in Dr. White's excursion into medical science, he was invited to become Professor of [{117}] Anatomy at the Papal University at Rome, and it was while there that he had as many as three hundred students present at his demonstrations in anatomy and there that he did fourteen dissections in one year. The pretense that there was any ecclesiastical objection to dissection becomes absolutely farcical when one compares the life of Vesalius sketched by President White with a motive, and the life of his contemporary and successor, Columbus, by an unbiased physician, whose only idea was to bring out the facts.
According to Prof. White's opinion, Vesalius dedicated his work to Charles V. to shield himself as far as possible, and after this gave up his anatomical studies in Italy to put himself under the protection of Charles V.
Vesalius's successor, Columbus, did not have to do any such thing. Instead, he went down to Rome, and under the protection of the Popes continued to carry on his anatomical work there.
When Charles V. died, however, according to President White, a new weapon was forged against Vesalius. Vesalius was charged with dissecting a living man. President White hints that "the forces of ecclesiasticism united against the innovators of anatomy, and either from direct persecution or from indirect influences Vesalius became a wanderer." Just what that means I do not know. President White does not say that he was exiled, though that idea is implied. There is a great deal of doubt about this charge of Vesalius having made an autopsy on a living person. Roth discusses various versions. The whole thing seems to be a trumped-up story; but supposing it true, would it not be only proper that a man who made an autopsy on a living person should be brought before the court? He certainly would [{118}] in our day in any civilized country. Professor Foster, of the University of Cambridge in England, following the lead of President White in this matter, blames the Inquisition for instituting the prosecution. If this were true, no more proof would be needed that the Inquisition was a civil and not a religious institution, since after all the killing of a man by a premature autopsy is a plain case of homicide.
The fact of the matter seems to be that Vesalius, who had not been very well in the unsuitable climate of Madrid, made the trip to the Holy Land, partly for reasons of health, but partly also for reasons of piety. While returning he was shipwrecked on the island of Zante and died from exposure. Vesalius had been born in Brabant, at that time one of the most faithful Catholic countries in Europe. Like most of the other great men of his time, the reformation utterly failed to tempt him from his adhesion to the Catholic Church. His greatest colleagues in anatomy and in medicine were Italians, most of whom were in intimate relations with the Catholic ecclesiastics of the time and continued this intimacy in spite of the disturbing influences that were abroad. Many of these men will be mentioned in our account of the Papal Medical School and of the Papal Physicians during the next two or three centuries. The distinguished anatomists and physicians of France in Vesalius's time were quite as faithful Catholics as he was. Even Paracelsus, the Swiss, whose thorough-going independence of mind would, it might naturally seem, have tempted him to take up with the reformed doctrines, had no sympathy with them at all. He recognized the abuses in the Church, but said that Luther and the so-called reformers were doing much more harm [{119}] than good, and that until they were gotten rid of no improvement in ecclesiastical matters could be looked for. When Paracelsus came to die he left his money mainly to the Shrine of the Blessed Virgin in his native town of Einsiedeln and for masses for his soul. Since their time most of the distinguished medical scientists have been quite as faithful in their Catholicity as these two great medical colleagues of the Renaissance period. While medicine is supposed to be unorthodox in its tendencies, the really great thinkers in medicine, the men to whose names important discoveries in the science were attached, were not only faithful believers in the doctrines of Christianity, but were much more often than has been thought even devout Catholics.
At the death of Vesalius the Golden Age of the development of anatomy was not at its close, but was just beginning. Eustachius, Caesalpinus, Harvey and Malpighi were during the course of the next century to make anatomy a science in the strict sense of that word. After Vesalius's time the history of anatomy in Italy centers around the Papal Medical School to a great extent. During Vesalius's lifetime his greatest rival became the professor of anatomy there. The anatomical school of Bologna, in connection with that city, became an important focus of anatomical investigation. At this time Bologna was a Papal city. It was in the dominions of the Popes, then, as we shall see, that anatomy was carried on with the most success and with the most ardor. Far from there being any opposition to the development of the science, every encouragement was given to it, and it was the patronage of the Popes and of the higher ecclesiastics that to a great degree made possible the glorious evolution of the science during the next century.