INTRODUCTION

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The intelligent student of medical history has at his command an unfailing source of pleasure. To learn the successive steps by which Medicine has advanced from a priest-ridden and secret art practiced with mysterious rites in the Greek temples, passing through the schools of Greek philosophy into the light of publicity, is his privilege. To hunt through musty and worm-eaten volumes for facts regarding the great physicians of antiquity is his delight; and to communicate the knowledge thus obtained to others, who have not the time or the facilities for such research, is his duty. In every period are events and incidents of interest, but to the Middle Ages a peculiar fascination attaches; for it was during this period that Europe, emerging from an intellectual darkness of ten centuries’ duration, awoke to the Renaissance, and Medicine, as ever has been the case, kept pace with the general advance of knowledge.

The present book deals with the life of a master whose work was an essential factor in the evolution of the Anatomical Renaissance. In order to understand the New Birth of Anatomy it is necessary to know something of the scope and influence of the General Renaissance.

The General Renaissance

This, the Revival of Learning, includes an indefinite time in European history. The seeds of the new movement were planted in the Middle Ages, but they bore no fruit until the time had arrived for an apparently “spontaneous outburst of intelligence”. Definitions of the Renaissance will vary with the point of view. Artists and sculptors will say it was a revolution which was created by the recovery of ancient statues; littÉrateurs and philosophers look upon it as a radical change due to the discovery of the writings of the classical authors; astronomers and physicists will cite the names of Copernicus, Galileo, and Torricelli; geographers will point to the discovery of a New Continent; historians will name the extinction of feudalism and the capture of Constantinople by the Turks; inventors will recall the changed conditions of warfare brought about by gunpowder, the multiplication of books by the invention of printing, and the advent of new methods of engraving; and anatomists will sound the praises of Leonardo da Vinci and of Andreas Vesalius. All will agree that the Renaissance meant Revolution—revolution in thought, in conduct, in creed, and in conditions of existence. To no one fact can the Renaissance be attributed; nor can its scope be limited to any one field of human endeavor. The Renaissance was, and is, and will continue to be, as long as the race progresses.

The new movement began in Italy and grew rapidly. When, toward the end of the sixteenth century, the lamp of learning began to get dim in Italy, it was relighted by the nations of northern Europe—the Germans, the Hollanders, and the English—and by them was transferred to us. The Revival consisted largely in the recovery of the buried writings of the ancient Greek and Roman authors, together with comments on what they had written, and the production of books which were modeled after their works. But it was broader than this. It included all branches of learning, although more progress was made in some lines than in others.

Italy, a country divided into numerous small States, and so-called Republics, offered great opportunities for individual development and became famous in those paths in which individualism has gained its greatest triumphs. Thus in literature, in law, in medicine, in painting and in sculpture, the Italians were preËminent. In architecture and in the drama they reached no such heights as were attained by the French, the Germans and the English. It was in the northwest part of Italy, in the province of Tuscany, that the Renaissance gained its greatest victories. Among the earliest of the leaders of the New Learning was the Florentine poet, Dante Alighieri (1265-1321). “To Dante”, says Symonds, “in a truer sense than to any other poet, belongs the double glory of immortalising in verse the centuries behind him, while he inaugurated the new age”. His Vita Nuova (New Life) and Divina Commedia (Divine Comedy) are essentially modern in thought, but ancient in the manner in which the thought is expressed.

Petrarch may be said to fairly open the new era. Like Dante, he was a Florentine. He was the apostle of Humanism, that system of philosophy which regarded man “as a rational being apart from theological determinations” and perceived that “classic literature alone displayed human nature in the plenitude of intellectual and moral freedom”. To a revolt against the despotism of the Church, it added the attempt to unify all that had been taught and done by man. Petrarch was a poet, a lawyer, an orator, a priest, and a philosopher. He lived between the years 1304-1374. He was a great traveler, and visited the leading continental cities in order to converse with learned men. Petrarch delighted in the study of Cicero, in collecting manuscripts, and in accumulating coins and inscriptions for historic purposes. He advocated public libraries and preached the duty of preserving ancient monuments. He opposed the physicians and astrologers of his day, and ridiculed the followers of AverrÖes.

Boccaccio, who has been called the Father of Italian Prose, and is most widely known as the author of the Decameron, did not spend all of his time in describing the escapades of the knights and ladies of old. Influenced potently by Petrarch, Boccaccio regretted the years he had wasted in law and trade, when he should have been reading the classics. Late in life he began the study of Greek that he might read the Iliad and the Odyssey. What he lacked in genuine scholarship he made up in industry. He continued the work begun by Petrarch of hunting for lost manuscripts of the ancient Greek and Roman authors. Many of these precious documents were stored in the conventual libraries, where, too often, they were either wantonly destroyed or were mutilated, the words of the author being erased from the parchment to make way for new prayers. Boccaccio tells of a visit which he made to the Benedictine Monastery of Monte Cassino near the city of Salernum. He wished to see the books and found them in a room without door or key. Many of them were mutilated. On making inquiry as to the cause, the monks answered that they had sold some of the sheets, having first erased the original words, replacing them with psalters. The margins of the old pages were made into charms and were sold to women.

It was owing to the unselfish labors of such men as Petrarch and Boccaccio that the works of Livy, Cicero, Quintilian, Terence, and others of the ancient authors, were preserved. In this enterprise they were encouraged by the rulers. Thus Cosimo de’ Medici in Florence, Alfonso the Magnanimous in Naples, and Nicholas V. in Rome, to say nothing of the despots of the smaller cities, rivaled one another in their zeal in unearthing and multiplying the manuscripts of the ancient writers. They spared neither time nor money to increase their store of manuscript books. They surrounded themselves with learned men who lived in high esteem, and who were supported by salaries paid by the State or by private pensions.

The fifteenth century, which was one of the most remarkable epochs in history, was rich in accomplishment. Almost all of the great events which have influenced European commercial and intellectual development can be traced to that period. The invention of printing, the discovery of America, the fall of the Roman Empire in the East, the birth of the Reformation, and the rise of art in Italy, all belong to this wonderful century. In this period, when almost every city in Italy was a new Athens, the Italian poets, historians, and artists vied with the eminent men of the ancient world in carrying the lamp of learning. The Italian cities—Florence, Bologna, Milan, Venice, Rome and Ferrara—fought with one another, not for the spoils of the battlefield but for the victories of science and of art; not so much for the profits of commerce as for the wealth of genius and of learning. The intellectual development which occurred in northern Italy under the rule of the house of Medici, and particularly under the auspices of Lorenzo the Magnificent, forms one of the most interesting periods in European history.

It is impossible in the present work to trace the steps by which the exquisite taste of the ancients in works of art was revived in modern times. Nevertheless, a few words may be devoted to this subject. While much must be credited to those Greek artists who had left their country and had settled in the Italian peninsula, it must be conceded that many of the works of art of the native Italians were not the less meritorious. The same circumstances which favored the revival of letters, operated to further the cause of art; and the same individuals, who were interested in the preservation of the manuscripts of the older authors, also busied themselves with the collection of ancient statues, paintings, gems and tapestry. The freedom of the Italian Republics permitted the minds of men to expand to full fruition; and the encouragement which was given by its rulers to artists, sculptors and artisans, made the city of Florence, in the fifteenth century, a not less renowned centre of culture than Athens had been in ancient times.

The revival of art dates from the time of Cimabue (1240-1300) and Giotto (1276-1336). The former is known as the Father of Modern Painters; the latter constructed the Campanile at Florence. To Giovanni Cimabue, scion of a noble Florentine family, is usually given the credit of being the restorer of art in Italy. He is thought to have been the first painter to throw expression into the human countenance. His work, if judged by present standards, would be called crude, rude and incomplete. Much of the fame of this painter is to be attributed to his being the first person whom Vasari chronicled in his Lives of the Painters. For more than a century after the time of Cimabue and Giotto, painters displayed only a smattering of anatomical knowledge.

Early in the fifteenth century two Flemish artists, Hubert van Eyck (1365-1426) and his brother John (1385-1441), in their polyptych of the Adoration of the Lamb, boldly struck out along new lines and committed the unheard-of deed of painting nude figures. Italy, however, was the real birthplace of Art-Anatomy. While the Flemings and others of the North painted everything that they saw, including the nude, the Italians were the first men of the Renaissance who thought of painting the nude figure before draping it. Leo Battista Alberti (1404-1472), in his works on painting, insists that the bony skeleton must first be drawn and then clothed with its muscles and flesh. This was an important step in advance, since it shows that the Florentine artists were progressing towards realism and were breaking away from the symbolism of the early Christian painters and mosaic-workers. The new movement in art found a worthy champion in Antonio Pollaiuolo (1432-1498). In his knowledge of the anatomy of the human figure he surpassed all of the artists of his day; and as a result of his labors he may justly be named the founder of the scientific study of the nude. His knowledge of anatomy was so accurate, and so extensive, that it could have been gained only in the dissecting room.

Under the patronage of Lorenzo de’ Medici and the guiding mind of Pollaiuolo, there occurred a revival of pseudo-paganism in Art. The old Church subjects were largely neglected; mythological subjects again became the fashion; draperies were either modified or were laid aside; and the scientific study of anatomy, both as regards the nude figure and the dissection of the individual parts, became the necessary training of the student. Of all the masters of this period, the palm for excellence in drawing the naked figure must be awarded to Luca Signorelli (1442-1524), from whose work Michael Angelo is known to have profited.

The alliance between skilled anatomists and master artists was of reciprocal benefit. The anatomical studies which were made conjointly by Leonardo da Vinci and the celebrated teacher of anatomy, Marc Antonio della Torre, were lost to the world by the untimely death of the latter, before he had finished a magnificent treatise on human anatomy. Leonardo’s anatomical sketches, if they had been published during his lifetime, would have revolutionized anatomy both as regards discoveries in the body and the teaching of the structure of man. These masterpieces of anatomical illustration long remained hidden from the world; they were published only in the year 1902. Even now their cost is so great that only a few wealthy libraries can possess them. Leonardo’s long unpublished drawings show him to have been a most accurate anatomist. At the same time, he constantly kept in view the aim of fine art, which, in so far as practical anatomy is concerned, needs a knowledge of only the bones and the muscles.

Nor was Leonardo the only artist who made dissections. Raffaello Santi, Michael Angelo, Bartholomaus Torre, Luigi Cardi or Civoli, Jan Stephan van Calcar, Giuseppe Ribera, Arnold Myntens, and Pietro da Cortona studied practical anatomy. Rubens’s long-lost sketch-book[1], which was published one hundred and thirty-three years after his death, shows with what care he had studied human anatomy. Albrecht DÜrer’s Treatise on the Proportions of the Human Body is also worthy of mention.

In the number and fame of her Universities, Italy showed supremacy. At the end of the fifteenth century she could boast of sixteen seats of learning, a number equal to that of the combined institutions of Britain, France, Germany, Hungary, Bohemia and Bavaria.

This digression has led us away from the Humanists. Their list is a long one. Among them were Poggio Bracciolini, who discovered the manuscript of the Institutions of Quintilian and the writings of Vitruvius; Poliziano, the first poet of the fifteenth century, and the translator of the works of Hippocrates and Galen; Pontanus, whose De Stellis and Urania were much admired by Italian scholars; Sannazzaro, whose epic on the birth of Christ cost him twenty years of labor; Vida, whose Christiad and other poems were much admired; and Fracastoro, whose Syphilis was hailed as a divine poem.

From the viewpoint of the medical historian an important event occurred in the year 1443, when Thomas of Sarzana, later known as Pope Nicholas V., discovered a manuscript copy of the De Medicina of Aulus Cornelius Celsus. This classic, which had been lost for many centuries, was one of the first medical books to pass through the press. It gave physicians an insight into Hippocratic medicine without the disadvantage of an imperfect translation. Physicians took an active part in the Renaissance. Thus Nicholas Leonicenus, of Ferrara, translated the Aphorisms of Hippocrates and the Natural History of Pliny; and Winter of Andernach did similar labor for the writings of Galen, Alexander, and Paulus Aegineta. Their efforts seem insignificant in comparison with those of Anutius Foesius, a humble practitioner of Metz, who spent forty years of his life in preparing a complete Greek edition of the works of Hippocrates. The New Learning was brought to England by two physicians, Thomas Linacre and John Kaye (Caius).

Some of the Humanists were printers. The history of printing in Italy naturally forms a part of the history of the Renaissance. In 1462, Maintz was pillaged by Adolph of Nassau and its printers were scattered over Europe. Two of them wandered into Italy, living in a village in the Sabine mountains, where, in October, 1465, the first book was printed from an Italian press. It was a Latin edition of Lactantius. Six years later a press was established in Florence. In 1478, Mondino’s Anathomia was printed in Pavia. It has been estimated that before the first year of the sixteenth century, five thousand books had been printed in Italy. In those days the editions were small, 265 copies being considered one edition. An immense amount of labor was required to get out a new edition. First, the manuscripts of the ancient author had to be collected, compared and corrected, this work being done by learned men who resided in the home of the publisher. The corrections were made without the aid of dictionaries, grammars, or book-helps of any kind. The proof was read aloud to the assembled scholars and the final corrections were added. In time, Venice came to be the most noted of the Italian cities in the publishing business, owing chiefly to the family of Aldo. This family of printers became famous for finely printed Greek and Latin books, which are still called Aldine editions. Nine years after the printing of the first book in Italy, the art was practiced in England by Caxton.

Humanism in Italy began to decline toward the close of the fifteenth century. Long before this time it had degenerated into Paganism. The scholars influenced all life, customs and thought. Although the nation remained Catholic, it was such only in name. Everyone bowed before the shrine of classical literature. Even in the christening of children the Christian name was sacrificed to paganism. The saints were forgotten, and the names most frequently chosen were those from heathen mythology. The polite authors described scenes, events and actions in their writings in terms which long since have been banished from good society. A spade was called by its true name. Bembo, the secretary of Leo X., could write a hymn to Saint Stephen or a monologue for Priapus with equal ease and elegance. The amours of the high and the low were flaunted in print. The nation degenerated into an intellectual and sensual state which involved even the Popes. Scholars and rich men alike vied with one another in returning to those pursuits, habits, and methods of thought which had ruled ancient Rome in her most corrupt days.

Such a condition could not exist forever. The turning-point came in 1527, when Charles the Fifth, engaging in war with Pope Clement VII., captured and sacked the city of Rome. After that event everything was changed. Not only had the scholars lost their influence, but many of them had lost their lives. Valeriano, who returned to Rome after the siege, pathetically exclaims: “Good God! when first I began to enquire for the philosophers, orators, poets and professors of Greek and Latin literature, whose names were written on my tablets, how great, how horrible a tragedy was offered to me! Of all those lettered men whom I had hoped to see, how many had perished miserably, carried off by the most cruel of all fates, overwhelmed by undeserved calamities; some dead of plague, some brought to a slow end by penury in exile, others slaughtered by a foeman’s sword, others worn out by daily tortures; some, again, and these of all the most unhappy, driven by anguish to self-murder”. Such was the end of the men who made the Italian Renaissance. The Spaniards, the Inquisition, and the changed policy of the Church prevented a second revival of Humanism.

While the sack of Rome marks the end of the Humanists, the Revival in Medicine continued to grow in vigor and extent. Many of the greatest discoveries in anatomy were made, and most of the important books on this subject were written, in the middle and latter part of the sixteenth century. Italian history is rich in contradictions. While peace, ease and comfort are generally considered to be necessary to the development of science and culture, Italy offers the strange spectacle of the steady increase in medical knowledge in spite of wars and alarms. The Inquisition, which had been introduced from Spain in 1224, was given a new and horrible impetus when, in 1540, Paul III. appointed six cardinals to add to its tortures. One of them, Caraffa, became Pope Paul IV. in 1555, and four years later originated the Index Expurgatorius. Torn by civil and foreign wars, and terrorized by the Inquisition, which was not abolished until late in the eighteenth century, Italy gradually lost her commercial and intellectual supremacy. That she should have accomplished so much under such unfavorable circumstances, is now a matter of wonderment.

The origin of the Renaissance in Italy was due to many causes. The early Roman civilization was not entirely blotted out by the invasion of the barbarians of the North. And in the matter of language the Italians possessed an advantage, since the transition from Latin to Italian was easier than from Latin to Spanish, French, English or German. The fertility of the country; the mildness of the climate; the division into semi-independent states; the infusion of new northern blood into the veins of the Italians; the removal of the papal court to Avignon in 1309; and the gradual rise of a powerful middle class, whose members included the devotees of the professions of law and medicine, were factors which determined that Italy, rather than France or Spain, should be the field for the Revival of Letters.

To Italy, then, belongs the glory of having been the first to free herself from the trammels of ancient scholasticism and the fetters of mediaeval theology. She abandoned the wordy dialectics and metaphysical gymnastics of the philosophers of old. In place of mortification, penance and solitary confinement in cloistered monasteries and convents, she began to have a proper conception of the dignity of man and his relation to nature.

Italy, in the time of her freedom, received the torch of learning from Greece; Italy revived its brilliancy, and, when her time of adversity and ruin arrived, she passed it on to the nations of Northern Europe. They in turn have transferred it to America, to Australia, to India, and to the uttermost parts of the earth.

The Anatomical Renaissance

Italy in the sixteenth century was the fount from which issued a ceaseless stream of anatomical discoveries. The ancient and illustrious Universities of Bologna, Pavia, Padua, Pisa and Rome, eclipsed the schools of Paris and Montpellier, of Toulouse and Salamanca; and the Italian peninsula, which, in early mediaeval times, had gloried in the skill of the physicians of Salernum, a second time became the medical centre of Europe. Vesalius and his pupil, Fallopius, taught at Padua; the ancient fame of Bologna was supported by Arantius and Varolius; Vidius, returned from establishing the anatomical school at Paris, taught at Pisa; Eustachius was at Rome, Ingrassias lectured at Naples, and the fame of the New Anatomy spread throughout the world. The Italian cities were filled with students from foreign lands. Padua had more than one thousand new students every year, salaries were paid to her one hundred professors, and medicine was looked upon as a noble profession.

While the Italians were the leaders in progress, the Germans were still lecturing on Galen and Avicenna, the English had done almost nothing, and the CollÉge de France was not established until 1530.

Legalized by imperial authority and sanctioned by the Church, dissection was no longer regarded as a crime. A bull by Pope Boniface VIII., issued in the year 1300, forbidding the evisceration of the dead and the boiling of their bodies to secure the bones for consecrated ground, as was done by the Crusaders, was wrongly interpreted as forbidding anatomical dissection. Two centuries later the Popes, standing in the vanguard of science, permitted dissections to be made in all the Italian medical schools, and paved the way for the Anatomical Renaissance.

Great things were done in the sixteenth century. Under the scalpel and pen of Vesalius, anatomy was revolutionized. Surgery was guided into new paths by Ambroise ParÉ; and obstetrics, thanks to the labors of Eucharius Rhodion and Jacques Guillemeau, began to assume its legitimate place among the medical sciences. Servetus, visionary and argumentative, correctly described the pulmonary circulation in a theological work which was burned with its author. Eustachius, Columbus and Fallopius widened the path which had been blazed by Vesalius. Arantius, Caesalpinus and Fabricius added materially to anatomical science. The labors of all these great masters prepared the way for the greatest event occurring in the seventeenth century, namely, William Harvey’s discovery of the circulatory movement of the blood.

INITIAL LETTER BY VESALIUS
(From the “Fabrica”, 1543)

                                                                                                                                                                                                                                                                                                           

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