Charles Estienne
SKELETON BY ESTIENNE, 1545
(Reduced one-half)
Charles Estienne, better known by the name of Carolus Stephanus, was a French anatomist whose work is worthy of remembrance. Born in the early part of the sixteenth century, he was given an excellent education. He belonged to a noted Huguenot family of scholars and printers who have made the Estienne name famous. Robert Estienne, the brother of Charles, became the victim of religious persecution; he was obliged to flee to save his life, and for a time the publishing business was conducted by Charles Estienne. The latter also suffered for his faith; he was thrown into a dungeon, where he died in the year 1564. Charles Estienne wrote numerous books on literature, history, forestry and botany. His anatomical treatise, De Dissectione Partium Corporis Humani, appeared at Paris in 1545 with sixty-two full page plates which combine anatomical clearness, beauty of form, and artistic representation. A French translation of Estienne’s Anatomy was published in 1546. This work was printed as far as the middle of the third book as early as the year 1539: some of the plates are dated as early as 1530. The illustrations have been excellently cut in wood; many of them show the entire body, with much ornamentation, so that the proper anatomical part seems small and irrelevant. Some of the plates show the subject in picturesque and even loathsome attitudes. The text of this work is especially valuable for the history of anatomical discovery. Although he was an ardent Galenist, Estienne made numerous original observations in anatomy. He described the synovial glands, a discovery which has been credited to Clopton Havers. Estienne was the first anatomist to discover the canal in the spinal cord; he described the capsule of the liver, a tissue which bears Glisson’s name; and differentiated the eight pair from the sympathetic nerves. He was the first anatomist to see and describe the valves in the veins, which he called apophyses venarum— discovery which has been claimed for Jacobus Sylvius, Cannanus, Amatus and Fabricius.
The question of priority in the discovery of the valves of the veins gave rise to much controversy. It is reasonable to assume that these structures were noticed independently by all of the anatomists whose names are mentioned above.
SKULL BY DRYANDER, 1541
CHAPTER FOURTH
Vesalius’s Early Life
Andreas Vesalius, or Wesalius as the family name was inscribed prior to the year 1537, was born in Brussels on the last day of the year 1514. From astrological observations made by Jerome Cardan we learn that this event occurred about six o’clock in the morning, and under favorable stellar auspices. The placenta and caul, to which popular belief ascribed remarkable powers, were carefully preserved by the mother.
The Vesalius family originally was named Witing, (Witting, Wytinck, Wytings, according to various authorities) and adopted the name Wesalius from the town of Wesel, (Wesele, Vesel), in the Duchy of Cleves, which the family claimed as their native place. The three weasels (Flemish—“Wesel”), found in the Vesalian coat of arms, testify to this origin.
It may be said with truth that medical learning ran in the blood of the Vesalius family. Andreas’s great-great-grandfather, Peter Wesalius, wrote a treatise on some of the works of Avicenna and at great cost restored the manuscripts of several medical authors. Peter’s son, John Wesalius, held the responsible position of physician to Mary of Burgundy, the first wife of Maximilian the First; in his old age John taught medicine in the University of Louvain. From that time the Vesalius family was closely associated with the Austro-Burgundian dynasty. Eberhard, son of John Wesalius, served as physician to Mary of Burgundy; he died before attaining his thirty-sixth year, and was long survived by his father. Eberhard, who was the grandfather of Andreas, wrote commentaries upon the books of Rhazes and on the Aphorisms of Hippocrates. He was also noted as a mathematician. Eberhard’s son Andreas, the father of the anatomist, was apothecary to Charles the Fifth and to Margaret of Austria. He accompanied the great Emperor upon his numerous journeys and military expeditions. In 1538 he presented Andreas’s first anatomical plates to the Emperor, and thus opened the way to the court to his son. The father remained in the imperial service until the day of his death, which occurred in 1546. Andreas’s mother, Isabella Crabbe, exercised a great influence upon the youth whom she believed to be destined to accomplish great things. She it was who preserved the manuscripts and books of the Vesalian ancestors. Isabella happily lived long enough to see the Fabrica, to witness the intellectual triumph of her son, and to know of his activity at the Spanish court.
THE OLD UNIVERSITY OF LOUVAIN
(Erected early in the Fourteenth Century. The New Building dates from 1680)
Little is known of the youth of Vesalius. The traditions of his ancestors, their accomplishments in the field of letters and in medicine, and their loyalty to their sovereigns, were themes which his mother must have recounted with pleasure. At an early age Andreas was sent to the neighboring city of Louvain, whose University, founded in the year 1424, in the early part of the sixteenth century eclipsed many institutions of greater age, and in the number of its students ranked second only to the University of Paris. The theologians of Louvain were noted for their orthodox Catholicism; from the very first days of religious controversy they had battled strongly against the rising tide of the Reformation. Her professors of jurisprudence and of philosophy were men of eminent talents. Within the University were four literary schools which were named Paedagogium Castri, Porci, Lilii, and Falconis, from their insignia:—a fort, a pig, a lily, and a falcon. Here also was the Collegium trilingue Buslidianum, which was founded by Hieronymus Busleiden (+1517) for teaching the Greek, Hebrew and Latin languages. Vesalius selected the Paedagogium Castri which he fondly mentions in laudatory terms in his Fabrica. Here, and in the Busleidinian College, he obtained that thorough knowledge of ancient languages which, in later years, astonished his hearers and served him well in numerous literary controversies. The names of Vesalius’s teachers are unknown, although Adam[9] states that John Winter of Andernach was his professor of Greek. Vesalius speaks scornfully of one of his teachers, a theologian, who, in trying to explain Aristotle’s De Anima, used a picture of the Margarita Philosophica to show the structure of the brain. Among Vesalius’s school companions were Gisbertus Carbo, to whom the anatomist presented the first skeleton which he articulated (Fabrica, 1543, page 162); and the younger Granvella, who later was Chancellor to Charles the Fifth.
At an early age Vesalius possessed a desire to study the structure of the human body. His powers of observation were precociously developed. When a boy, learning to swim by the aid of bladders filled with air, he noted the elasticity of these organs, and he referred to the incident in his Fabrica (1543, page 518). When little more than a child, he tired of dialectics and tried to learn anatomy from the scholastic writings of Albertus Magnus and of Michael Scotus. He soon discovered that the true road to anatomical science led, not through books but through the actual handling of the dead tissues. He began the practical study of anatomy by dissecting the bodies of mice, moles, rats, dogs and cats.[10]
CHAPTER FIFTH
Sojourn in Paris
One thought was uppermost in the mind of Vesalius, and that was to follow the profession of his ancestors, just as in ancient Greece the sons of the Asclepiadae naturally adopted the vocation of their fathers. Andreas possessed an excellent preliminary education and was especially proficient in the Greek and Latin languages; he also knew something of Hebrew and much of Arabic. It was in the year 1533 that the young Belgian travelled to Paris for the purpose of obtaining a medical education. At that time the French capital was the Mecca of the medical world—Paris, that city where classical medicine first secured support (ubi primum medicinam prospere renasci vidimus)[11]. In Paris, under the leadership of Budaeus, Humanism had enjoyed a rapid growth; and here Petrus Brissotus, after gaining the doctor’s cap in the year 1514, produced a revolution by delivering his lectures from the books of Galen in place of the treatises of Averröes and of Avicenna. At his own expense Brissotus published Leonicenus’s translation of Galen’s Ars Curativa, in order that his pupils might not be misled by the incorrect text of the Arab authors. It will be recalled that, long before this time, classical Greek and Latin medical literature had passed through the distorting crucible of Saracenic translations. At this period medical science, purified from Arabic dross, was taught in a splendid manner in Paris by such eminent professors as Jacobus Sylvius, Jean Fernel, and Winter of Andernach. At their feet sat young men from the remotest parts of Europe.
The most popular of the Paris teachers was Jacobus Sylvius, or Jacques Dubois, whose Latinized name is perpetuated in anatomical nomenclature. He was born at Louville, near Amiens, in 1478. In his early years he was noted for his scholarly attainments in the Greek, Latin and Hebrew languages and was the author of a French grammar. His anatomical knowledge was gained under Jean Tagault, a famous Parisian practitioner and surgical author.
SYLVIUS
Sylvius was noted for his industry, for his eloquence, and above all for his avarice. It was the inordinate desire for money which led him to abandon philology for medicine. While studying under Tagault he began a course of medical lectures, explanatory of the works of Hippocrates and Galen, with such success that the Faculty of the University of Paris protested on the score that Sylvius was not a graduate. He then went to Montpellier, whose medical professors had long held a high position, where, according to Astruc, he received the doctor’s cap at the end of November, 1529. He was then above fifty years of age. Armed with this degree, he returned to Paris and immediately entered the lists as an independent medical teacher, but was again halted by the Faculty who ruled that he must first receive the Bachelor’s degree. This he gained on June 28, 1531. Sylvius then resumed his lectures with such success that his classes in the Collége de Tréguier numbered from four to five hundred, while Fernel, who was a professor in the Collége de Cornouailles, lectured to almost empty benches. In 1550, Henry the Second named Sylvius Professor of Medicine, as the successor of Vidus Vidius, in the recently established Collége de France. Sylvius died January 13, 1555, and was interred in the paupers’ cemetery as he had wished.
Sylvius was not only an eloquent lecturer but he was also a demonstrative teacher. He was the first professor in France who taught anatomy from the human cadaver. In his lectures on botany he used a collection of plants to elucidate the subject. His chief fault was a blind reverence for ancient authors. He regarded Galen’s writings as gospel; if the cadaver presented structures unlike Galen’s description, the fault was not in the book but in the dead body, or, perchance, human structure had changed since Galen’s time! In one of his early books[12], Sylvius declared that Galen’s anatomy was infallible; that Galen’s treatise, De Usu Partium, was divine; and that further progress was impossible!
The character of Sylvius was contemptible. He was a man of vast learning and at the same time was rough, coarse and brutal. His avarice led him to endure the cold winters of Paris without the benefit of a fire; in severe weather he would play at football, or engage in other violent exercise in his room, to save the cost of fuel. Once, and once only, did his friends find him hilarious; they wondered and asked the cause. Sylvius said he was happy because he had dismissed his “three beasts, his mule, his cat and his maid”. He was notoriously rigid in exacting his fees from students, and on one occasion he threatened to stop his lectures until two delinquents should pay their dues. Although he was supposed to have amassed great wealth, little of it was found after his death, and these sums were secreted in secluded places. In 1616, when his former residence in the rue Saint-Jacques was demolished, numerous gold pieces were found. His reputation for miserliness followed him beyond the grave, as witness his epitaph:
Sylbius hic situs est, gratis qui nil dedit unquàm,
Mortuus et gratis quod legis ista dolet.
“Sylvius lies here, who never gave anything for nothing:
Being dead, he even grieves that you read these lines for nothing.”
In controversies he was violent and vindictive—a pastmaster in the use of bitter language. Jealous of the fame of other anatomists, he was particularly enraged when, in later years, he was opposed by Vesalius. Sylvius spoke of him not as Vesalius, but as Vesanus, a madman, who poisoned Europe by his impiety and clouded knowledge by his blunders. Such was the man who, in the mid-part of the sixteenth century, filled the position of highest honor in the Medical Faculty of the Collége de France[13].
Sylvius rendered valuable service in naming the muscles which, prior to his time, were designated by numbers. These, says Northcote[14] “were differently applied by almost every author; so that it was the description, and not the name, that must lead one to know what part was meant by such authors; and this required a previous thorough knowledge of anatomy”. He is the first writer who mentions colored injections and is supposed to have discovered this useful adjunct of anatomical study. He was the first anatomist who published satisfactory descriptions of the pterygoid and clinoid processes of the sphenoid bone, and of the os unguis. He gave a good account of the sphenoidal sinus in the adult but denied its existence in the child, as had been affirmed by Fallopius[15]. Sylvius also wrote intelligently concerning the vertebrae but incorrectly described the sternum. His observation concerning the valves in the veins gave rise to much discussion; the honor of priority in the discovery, however, belongs to other anatomists—Estienne and Cannanus. His discoveries in cerebral anatomy have caused his name to be attached to the aqueduct, the fissure and the artery of Sylvius.
The manner in which Sylvius conducted his anatomical course is known to us by his own writings, by the testimony of Moreau[16], and by that of Vesalius[17]. Thus the course for the year 1535 began with the reading, by Sylvius, of Galen’s treatise De Usu Partium. When the middle of the first book was reached, Sylvius remarked that the subject was too difficult for his students to understand and that he would not plague his class with it. He then jumped to the fourth book, read all to the tenth book, discussed a part of the tenth and omitting the eleventh, twelfth and thirteenth, he took up the fourteenth and the remaining three books. Thus he omitted all that Galen had said concerning the extremities. A second Galenic work which Sylvius used was the anatomico-physiologic treatise, De Musculorum Motu. Not infrequently the professor was unable to demonstrate in dissection the parts on which he had lectured. Thus, on one occasion, the students succeeded in finding the pulmonary and aortic valves which Sylvius had failed to find on the preceding day.