Andreas Vesalius, the Reformer of Anatomy

by James Moores Ball

It was in the famous Alexandrian University that human anatomy was first studied systematically and legally.

Alexander the Great, after the fall of Tyre (332 B. C.) and the siege of Gaza, ordered his fleet to sail up the Nile as far as Memphis while he proceeded overland with the army. It was probably on this march, while viewing the pyramids and other marvelous works of the ancient Egyptians, that he conceived the grand idea of founding a city upon the banks of the Nile, which should be a model of architectural beauty, a centre of intellectual life and a lasting monument of his own greatness and magnificence. The foundation of Alexandria was laid by the warrior whose name it bears; but the credit of instituting the Library belongs to one of his lieutenants, Ptolemy Soter.

PTOLEMY SOTER

The new city which for centuries was the intellectual and commercial storehouse of Europe, Africa and India, was of oblong form. Lake Mareotis washed its walls on the south, while the Mediterranean bathed its ramparts on the north. Provided with broad streets, it was adorned with magnificent houses, temples and public buildings. At the centre of the city was the Mausoleum in which was deposited the body of Alexander, embalmed after the manner of the Egyptians. Alexandria was divided into three parts: the Regio Judaeorum or Jews’ quarter, in the northwest; the Rhacotis, or Egyptian section, on the west, containing the Serapeum with a large part of the Library; and on the north, the Bruchaeum, or Greek portion, containing the greater part of the Library, the Museum, the Temple of the Caesars and the Court of Justice. The population was cosmopolitan in character; the statues of the Greek gods stood by the side of those of Osiris and of Isis; the Jews forgot their language and spoke Greek; and under the Ptolemies, who were of Greek descent, Alexandria became a centre of intellectual life and culture.

To the medical historian the most interesting feature of Alexandria was the Museum or University. Here were assembled the intellectual giants of the earth: Archimedes and Hero, the philosophers; Apelles, the painter; Hipparchus and Ptolemy, the astronomers; Euclid, the geometer; Eratosthenes and Strabo, the geographers; Manetho, the historian; Aristophanes, the rhetorician; Theocritus and Callimichus, the poets; and Erasistratus and Herophilus, the anatomists, all of whom labored in quiet upon the peaceful banks of the Nile. The early Christian church drew from “the divine school at Alexandria” such eminent teachers as Origen and Athanasius. Here were a chemical laboratory, a botanical and zoölogical garden, an astronomical observatory, a great library, and a room for the dissection of the dead.

In the Alexandrian school of medicine Erasistratus and Herophilus taught the science of organization from actual dissections. The generosity of the Ptolemies not only furnished them with an abundance of dead material, but condemned malefactors were used for human vivisection. Celsus[5] states that the Alexandrian anatomists obtained criminals, “for dissection alive, and contemplated, even while they breathed, those parts which nature had before concealed.”

Herophilus made many anatomical discoveries. He traced the delicate arachnoid membrane into the ventricles of the brain, which he held to be the seat of the soul; and first described that junction of the six cerebral sinuses opposite the occipital protuberance, which to this day is called the torcular Herophili. He saw the lacteals, but knew not their use, and regarded the nerves as organs of sensation arising from the brain; he described the different tunics of the eye, giving them names which are still retained; and first named the duodenum and discovered the epididymis. He attributed the pulsation of arteries to the action of the heart; the paralysis of muscles to an affection of the nerves; and first named the furrow in the fourth cerebral ventricle, calling it calamus scriptorius.

Erasistratus gave names to the auricles of the heart; declared that the veins were blood-vessels; and the arteries, from being found empty after death, were air-vessels. He believed that the purpose of respiration was to fill the arteries with air; the air distended the arteries, made them beat, and in this manner the pulse was produced. When once the air gained entrance to the left ventricle, it became the vital spirits. The function of the veins was to carry blood to the extremities. He is said to have had a vague idea of the division of nerves into nerves of sensation and of motion; to the former he assigned an origin in the membranes of the brain, while the latter proceeded from the cerebral substance itself. He recognized the use of the trachea as the tube which conveys air to the lungs. A catheter, the first invented, which was figured in ancient surgical works, bore the name of the catheter of Erasistratus. He gravely tells us, as the result of his anatomical studies, that the soul is located in the membranes of the brain.

The practice of human dissection did not long exist in the city of its origin, and after the second century was unknown. Then science underwent a retrogression; observations and experiments were replaced by useless discussions and subtle theories. The decline of the Alexandrian University was due to a series of disasters which began with the Roman domination and reached their climax with the capture of the city by the Arabs.