Introduction to Anatomy, 1532 / With English translation and an introductory essay on anatomical studies in Tudor England by C.D. O'Malley and K.F. Russell.

INTRODUCTION

On 22 August 1485 the battle of Bosworth provided its victor with the throne of England. Richard III died sword in hand and was unceremoniously buried in the Grey Friars at Leicester, and on that same day the victor, Henry Tudor, was as simply crowned and acclaimed by his troops as Henry VII. So began the Tudor dynasty in England which was to last until the death of Elizabeth in 1603, to be one of the most colourful periods of English history and to witness the arrival of the Renaissance in England. Later than its manifestation on the Continent, but thereby reaping the benefits of continental developments, English humanism as a result was soon to become no mean rival. The development of English literature is too well known for comment, while classical studies, and especially those in Greek, were to rival their continental counterpart by the end of the first quarter of the sixteenth century. Science, however, and more particularly medicine, were laggards.

In those closing years of the fifteenth century which ushered in the new Tudor monarchy the art of healing derived from two sources, the universities of Oxford and Cambridge and the organizations of barbers and surgeons. At Oxford medical teaching was organized by the fifteenth century, and medicine constituted one of the four faculties of the university together with theology, law, and arts. Yet at Oxford, as at Cambridge, the medical curriculum was long to remain medieval.[1] Both schools had taken their model from Paris, but whereas Parisian medicine had begun to stir and advance in the fifteenth century, the English universities remained somnolent. At Cambridge the degree of Doctor of Medicine required altogether twelve years of study based upon lectures and discussions drawn from medieval sources. While it is true that two years of this time were to be spent in the practice of medicine—seemingly a borrowing from the methods of Montpellier—there was no provision for human anatomical study,[2] although this was recognized and demonstrated with some slight annual regularity to the Parisian students from the latter fifteenth century onward.

If we turn to the other source of healing, the organizations of the barbers and the surgeons, in so far as anatomy was concerned the situation was no better and, indeed, it may be said to have been worse in view of the obvious relationship which ought to have obtained between surgery and anatomy. In London the fraternity of barbers existed as early as 1308,[3] and the craft of surgery as a body distinct from that of the barbers is recorded in 1368.[4] Both barbers and surgeons sought to establish rules of professional conduct for the members of their respective organizations as well as a period of time and a curriculum to be satisfied by aspirants to barbery or to surgery. Despite the efforts of the surgeons to control the practice of surgery, relegating to the barbers only the most simple and menial tasks, certain of the more ambitious barbers sought to go beyond such activities as beard-trimming, cutting, and phlebotomy, and this determination gave rise in the first quarter of the fifteenth century to the barber-surgeon[, no longer acting in the normal occupation of the barber and clearly divorced from his old trade.[5]

Throughout the fifteenth century the barber-surgeons and surgeons appear to have remained on fairly amicable terms, presumably carrying on much the same sort of practice. The surgeons, who took precedence on occasions of solemnities and festivities, were perhaps somewhat better trained, but nowhere is there any record that such training required the study of human anatomy.[6] One learned the trade by apprenticeship to a surgeon and by consulting textbooks of surgery. From surviving manuscripts it is possible to determine what these textual guides were: primarily such as those of the celebrated fourteenth-century surgeons, Gui de Chauliac and Henri de Mondeville. It is true that late medieval surgeons were accustomed to introduce the surgical subject by a short anatomical preface, medieval in character, the result of cursory and incomplete post-mortem examinations, but hardly sufficient to permit a proper grasp of anatomy even were that possible of attainment from literary sources.

Hence the opening of the Tudor dynasty in England witnessed a medicine and a surgery lacking the essential and fundamental knowledge of the human structure. The traditions of English medicine were medieval, and medieval medicine had not concerned itself especially with anatomy. If we compare continental medicine of the same period the situation is found to be considerably different. In the course of the fifteenth century anatomy was being practised—diffidently to be sure, but nevertheless recognized and employed in Paris where the first human dissection, in the form of a brief autopsy, had been performed in 1407.[7] The first human anatomy mentioned in the Commentaries of the Medical Faculty of Paris was performed in 1477-8 on the body of an executed criminal,[8] but the incident is recorded without any suggestion of its being a novelty and so raises the possibility that there may have been other dissections in previous years. The practice of human anatomy was even earlier in Italy where there is record of an autopsy in 1286,[9] and in 1316 Mundinus, called the ‘Restorer of Anatomy’, completed his Anothomia in which he describes his systematic dissection of the human body. Official decree permitted the practice of human dissection in many cities, especially those with medical schools, and such official recognition was granted at Bologna in 1405[10] and at Padua in 1429.[11] Elsewhere similar recognition of human dissection was obtained at Montpellier in 1340,[12] at Lerida in 1391,[13] at Vienna in 1435,[14] and at TÜbingen in 1485.[15] As a consequence, by the opening of the sixteenth century a series of anatomical texts, based in varying degrees upon human dissection, began to appear, such as those of Benedetti, Achillini, and Berengario da Carpi.

The difference can be explained, at least in part, by the fact that on the Continent the classical revival of the Renaissance had caused or was causing medieval tradition to be replaced by that of classical antiquity. The Renaissance represented an effort to revive the spirit and interests of the classical world, and classical antiquity had been much interested in the structure of man. Especially important was the recovery of the Greek language and literature since it made possible the recovery of the writings of the great classical physicians, notably Hippocrates and Galen, for generally speaking classical Greece had shown more interest in human anatomy than had classical Rome. This recovery had occurred first in Italy, then moved northward across the Alps and only in the early sixteenth century did it reach England.

While even earlier some Englishmen had travelled to Italy to study the classical revival at its source, and even to study the more advanced Italian medicine of Padua, it may be said that Thomas Grocyn was the first significant leader of the new classical movement in England, in particular the recovery of Greek. He had managed to learn some Greek even in England, but it was not until after a trip to Italy in 1488, where he spent two years, that he returned to instil Oxford with an enthusiasm for classical Greek humanism.[16] But if Grocyn is of importance as an English pioneer in the recovery of Greek and Hellenic studies, of far greater importance for the present subject was Grocyn’s lifelong friend and ultimately the executor of his estate, Thomas Linacre.

Linacre looms very large in the revival of classical medicine which gave a general impetus toward a better and more modern medicine. Born at Canterbury about 1460 he was led ultimately by his studies to Oxford where he became a fellow of All Souls College in 1484.[17] Although by this time he could make some beginnings of the study of the revived classical literature, and even Greek, at Oxford, nevertheless it was still desirable if possible to pursue such studies in Italy, and with the opportunity offered him, Linacre travelled to that land about 1487, remaining at least until 1496,[18] in which latter year he received the degree of Doctor of Medicine from the University of Padua.[19]

Returned to England, Linacre taught Greek at Oxford. Grocyn was his friend, Sir Thomas More his pupil, and upon the arrival at Oxford of Erasmus, that great classical scholar likewise became an intimate, all of them enthusiasts and promoters of Greek studies.

However, as a physician Linacre had a special bent toward the Greek medical classics. This was manifested by the appearance in 1517 of his translation of Galen’s book On Hygiene. In 1519 this was followed by the Method of Treatment, in 1521 by the book On Temperaments, and two years later by the Natural Faculties and On the Use of Pulses. In 1524 just after Linacre’s death a sixth translation, that of Galen’s Differences of Symptoms and Causes of Symptoms, appeared. As yet very few physicians in England knew Greek, but they all knew Latin, and these accurate translations into clear, straightforward Latin made a considerable portion of Galen’s medical writings available for the first time. The contrast between medieval medical writings and those of Galen which had now been made available seemed to emphasize that general Renaissance belief that civilization had reached its peak in classical times and that much could be gained by a return to classical teachings, in this instance the teaching of classical physicians. It is true that only the Galenic books on medicine had been translated, but they were sufficient to whet the appetite for more, and as the new generation of physicians arose, now trained in Greek, if the pattern were followed, they would turn to the Galenic writings on anatomy in the original language as well as to those of Hippocrates.[20] The first of this younger generation who is recorded to have come under this Greek medical influence and made this possibility a reality produced two remarkable pioneer efforts: the first recorded dissection of a human body in England about 1531 and the first book on anatomy written in England, published in 1532, or, reckoned according to the Gregorian calendar, 1533.

The person responsible for these two milestones was named David Edwardes, or, in the Latin form he employed, Edguardus. However, very little is known of his life and activities. He was admitted as a scholar to Corpus Christi College, Oxford, on 9 August 1517, and the register of admissions indicates that he was then fifteen years old and a native of Northamptonshire.[21] He became Bachelor of Arts in 1522[22] although for a time previous to this, in 1521, he appears briefly to have held the readership in Greek, substituting for the regular reader, Edward Wotton, then abroad.[23] In 1525 Edwardes became Master of Arts,[24] and thereafter received a fellowship in the college. He is further mentioned in the account book of the college for 1527-8 as receiving 38s. 9d.,[25] presumably for further teaching of Greek.

Corpus Christi College had been founded in 1515-16 chiefly through the magnanimity of Richard Foxe, Bishop of Winchester, and was provided with its statutes in 1517. The founder, strongly interested in the newly revived classical learning had provided for a chair of Greek, which, as has been mentioned, was briefly held by Edwardes in an interim capacity, while the first president of the college, John Claymond, was likewise a strong advocate of the new learning.

Perhaps not sufficient stress has been placed upon the contribution made by physicians, at least in England, to the revival of Greek studies, although it is sometimes difficult to determine which of the two disciplines, medicine or Greek, was the impulsion to the study of the other. Both Linacre and Wotton were serious students of Greek before they undertook medical studies, but once embarked upon medicine, both of them having studied at Padua, not only did they become especially conscious of the failings of medieval medicine in contrast to the classical, but the philosophical and literary aspects of Galen’s writings must have caused them to retain a concern with Greek literature as a whole even though their primary consideration had come to be a single facet of the body of that literature. Furthermore, the scientific nature of their interest permitted no equivocation in their knowledge of the language. Translations of Galen or Hippocrates required an exactitude beyond that of purely literary treatises. But whatever the relevancy of such remarks, it is certainly of significance that among the first teachers of Greek in England were Linacre, Clement, and Wotton, all physicians, and for our present purpose as it relates to David Edwardes, it should be noted that two of these men, Clement and Wotton, were associated with Corpus Christi College.

In addition to the stress upon Greek studies which must inevitably have led Edwardes to the classical Greek writers upon medicine and conducted him along the pathway already marked out by Thomas Linacre, there were in the college certain possibly more direct influences towards an interest in medicine which have already been alluded to. In short, John Clement, the early lecturer of Greek[26] was a physician and friend of Linacre as well as a fellow in the College of Physicians of London which Linacre had inaugurated in 1518, while still another student of medicine was Edward Wotton, Reader in Greek and later physician to Henry VIII, for whom Edwardes had briefly substituted.

Still another incentive toward medical study may have been a requirement in chapter 25 of the original statutes. In accordance with this all fellows of the college who held the degree of Master of Arts were required to assume holy orders, unless deputed to the study of medicine. It has been suggested that recipients of this exception were originally expected to attend to the medical needs of the other inmates of the college,[27] and it seems likely that Edwardes was one of these medicinae deputati.

Our next record indicates that he had removed to the University of Cambridge where in 1528-9, and upon payment of 3s. 4d.[28] and after lecturing publicly upon Galen’s De Differentiis Febrium, he was incepted in medicine with recognition of ‘seven years study of medicine’, presumably at Oxford.[29]

In his only known book, to be considered later, Edwardes informs us that his first practice of medicine had been ‘at Bristol, having left my teachers only shortly before and begun to swim without any support’,[30] although it is not clear whether this represented a brief interlude between Oxford and Cambridge or after he had received his degree of Doctor of Medicine. Whatever the case may have been, the few remaining autobiographical references are to his practice in and around Cambridge. As a member of the Faculty of Medicine, it is possible that Edwardes was criticized for devoting an excessive amount of time to his private practice, since in 1530-1 permission was granted him to be excused from a statutory requirement of attendance at ‘all congregations, masses and exequies’.[31] Nevertheless he participated in the examinations of at least two students, one in 1537-8[32] and the other in 1540-1.[33]

Edwardes’s little book, to which reference was made above, was published in London in 1532 [O.S.] by Robert Redman. It is composed of two treatises of which the first, entitled On Symptoms and Prognostications (De Indiciis et Praecognitionibus), deals with uroscopy and medical prognostication, and since it represents merely the continuation of a medieval tradition it is of little importance except, as has been said, for its few autobiographical details. In his practice of medicine Edwardes appears to have represented, as we might expect, a combination of the old and the new. While giving support to uroscopy and displaying some sympathy toward folk medicine, he also gave allegiance to Hippocrates and Galen, and like his continental colleagues of this period he was not averse to the introduction of a word or even several lines of Greek into his text, so indicating his enthusiasm for and his ties with the classical revival. Furthermore, he was certainly one of the first English physicians to appreciate Linacre and terms him ‘the most learned physician of his age’.[34]

The second treatise, A Brief but Excellent Introduction to Anatomy (In Anatomicen Introductio Luculenta et Brevis), is, as has been mentioned, the first work published in England which was devoted solely to anatomy, and therefore despite its brevity it deserves some consideration in the general history of medicine and even greater consideration in that of English medicine. Turning our attention now to this treatise on anatomy it should be first noted that although printed in the same volume with the work on medical symptoms and sharing a common title-page with that work, the treatise on anatomy has a separate dedication to Henry Howard (1517?-1547), Earl of Surrey. It had been at the request of Henry VIII that this young nobleman took up residence at Windsor and lived there from 1530 to 1532 as the companion of Henry’s son, the Duke of Richmond. Since Edwardes had dedicated the first treatise to the Duke of Richmond on 21 December 1532, it is not difficult to comprehend his choice of the duke’s companion for the second dedication which bears the date 1 January 1532, or, according to the Gregorian calendar, 1533. There is nothing remarkable about this latter dedication, which contains the usual flattery, except for the final passage. There the author remarked upon the ignorance of anatomy among physicians, sometimes with lethal results. He recognized that the subject of anatomy was a difficult one, hence his treatise has been written with brevity and clarity. Later, as he promised, if opportunity were to be granted to him he would write a more elaborate work.

Hereafter, if God permit, I shall compose a complete book of anatomy in which I shall further the opinions of all the learned, to which my own opinion will be added. I could have done this at present but not, however, with the same effort or with the form of an introduction preserved. It remains that this little book, which we have enlisted in the service of the commonwealth, may be pleasing to you, for it recognizes the existence of those very few unlearned physicians by whose mistakes many perish, from which this fact will be gathered, that no parts of the body should be unknown to physicians.

This promise of a more extensive work in which the author was to include his independent anatomical observations, presumably based on further human dissection, appears not to have been fulfilled or, at any rate, there is no record of any such later and more extended anatomical treatise by Edwardes.

The text of this Introduction to Anatomy fills no more than fifteen small pages, and its very brevity must have made it virtually useless; even the author says that it ‘is indeed a slight work’. The plan of presentation is that which had been popularized by Mundinus and was required by the relative speeds with which the different parts of the body succumbed to putrefaction during the course of dissection. Thus Edwardes first describes the lower venter, that is, the abdomen, abdominal cavity, and pelvis, next the thorax, and finally the brain and nervous system. Within his very brief presentation no mention is made of the extremities while, relative to the limits of the discussion, a preponderance of attention has been devoted to what were considered the organs of nutrition and blood manufacture.

The anatomical nomenclature is mildly astonishing, especially when one considers the time and place of composition. But if one considers that Edwardes was sufficiently learned in Greek to act as Reader in Greek at his college for a short period, it will not be too amazing to find him somewhat scornful of the terms employed by those he calls ‘Barbarians’, that is, the European school influenced by Moslem medical writers, chiefly through the Canon of Avicenna, which employed an anatomical terminology drawn from Latin and from curious hybrid forms partly Latin, partly Greek, partly Arabic and in some parts from Hebrew. Edwardes, on the contrary, employs classical Greek terminology as, for example, omentum rather than the medieval zirbus and mesenteric in preference to meseraic. In so far as his description extends, his nomenclature is as ‘modern’, if not more so, than that of some of the more learned anatomists on the Continent. Yet, while his vocabulary may be more modern his anatomy is not. Indeed, in the introduction he remarked, as has been mentioned, that in the future he hoped to write a more extensive work ‘to which my own opinion will be added’. By implication, then, in this first brief treatise he had drawn upon earlier authorities, and while we might expect that this student of Greek would turn to Galen and Hippocrates this is true only in part. The liver as he describes it is medieval, the three-chambered heart is Aristotelian, derived from those ‘Barbarians’ he scorned.

While the treatise is noteworthy as the first work written in England solely devoted to anatomy, the text intrinsically is of little further value except for one statement referring to the emulgent, or renal veins. ‘In the body of that one whom we dissected very recently the left branch had a higher place of origin. Very often, however, the opposite occurs, so that the right emulgent vein is carried higher in the body.’ Here we have the first reference to human dissection in England, in which, moreover, the anatomist observing through his own eyes rather than those of past authorities, noted a variation from the commonly given description of the emulgent veins, a description derived from Galen’s anatomical studies on animals.

Little more can be said about Edwardes. He seems to have died about 1542,[35] and perhaps this explains why the larger work was never to be published. Perhaps, had he remained at Oxford, he might have established an anatomical tradition, and so provided the influence which his book was not to have. Today only one copy of this little treatise is known, that in the library of the British Museum, and no consideration appears to have been paid to it from Edwardes’s day to the present. However, its virtual extinction was not the result of hard usage by students such as that which determined the almost complete annihilation of Vesalius’ Tabulae Anatomicae. As has been said, no contemporary mentioned Edwardes, despite the fact that his book was published in London. The edition must have been a small one, and copies were not likely to have been preserved as other and better works on anatomy began to be imported from the Continent.

Meanwhile the universities continued their drowsy course so far unaffected in any way by the efforts of an alumnus of one of them. The barber-surgeons and surgeons appear to have been equally unproductive of anything new, still leaning upon earlier continental writers. Yet a few individuals recognized the need for improvement. Well before the surgeons of England received official encouragement for anatomical study the surgeons of Edinburgh had asked for and obtained bodies for dissection. On 1 July 1505 the magistrates of Edinburgh granted a Seal of Cause to the Guild of Surgeons and Barbers, and this was confirmed by James IV on 13 October 1506. Among the clauses regulating the practice of the barbers and the surgeons is one giving them the body of one felon each year for an anatomy:

... and that we may have anis [once] in the yeir ane condampnit man efter he be deid to mak antomell of, quhairthraw we may haif experience, ilk ane to instrict vtheris ... and that na barbour, maister nor seruand, within this burgh hantt [practise] vse nor exerce the craft of Surregenrie without he be expert and knaw perfytelie the thingis abouewritten.[36]

Edinburgh, therefore, was the cradle of anatomical study in the British Isles. In England Thomas Linacre had founded the College of Physicians of London in 1518 with the idea of its being a select body of physicians to raise medical standards and maintain them through its power of licensing to practice. The need of more modern surgical texts was indicated by the publication in 1525 of a translation of the work of the late fifteenth-century German surgeon, Hieronymus Brunschwig, which contained a brief section on anatomy, but there appears to have been no attempt to produce a new and up-to-date surgery in England. The fact was that the more advanced books from continental Europe proceeded to smother any continuance of independent native efforts, and in the field of anatomy this makes the early appearance of David Edwardes’s little treatise an astonishing chronological anomaly in the history of English anatomical writing. The importance of anatomy was now to be recognized, but it would be a long time before another native English treatise on the subject was published.

The introduction of the officially recognized, and even encouraged, study of human anatomy into England was the result of influences brought to bear from several sources: the desire of King Henry VIII to improve the practice of medicine and surgery in England and possibly, too, with thoughts for a higher quality of military surgery; and the desire, as well, of some of the more thoughtful surgeons, of whom Thomas Vicary was probably one. So it was that in 1540 the Company of Barbers was united with the Fraternity of Surgeons to form what was called the United Company of Barber-Surgeons of which Thomas Vicary was named Master in 1541, an event handsomely commemorated in a painting commissioned from Hans Holbein the younger.[37]

In the Charter by which the union was officially sanctioned, a statement is to be found which was to be of particular importance to the advancement of anatomical knowledge:

the sayd maysters or governours of the mistery and comminaltie of barbours and surgeons of London, and their successours yerely for ever after their sad discrecions at their free liberte and pleasure shal and maie have and take without contradiction foure persons condempned adiudged and put to deathe for feloni by the due order of the kynges lawe of thys realme for anatomies without any further sute or labour to be made to the kynges highnes his heyres or successours for the same. And to make incision of the same deade bodies or otherwyse to order the same after their said discrecions at their pleasures for their further and better knowlage instruction insight learnyng and experience in the sayd scyence or facultie of surgery.[38]

It is of interest to note that very soon after the Charter had been granted, Thomas Vicary approached the Lord Mayor and Aldermen of London to make sure that the Barber-Surgeons should receive the bodies of the felons for anatomical study. It would seem that the Court of Aldermen were not sure how they should direct their Sheriffs, for the Minutes of the Court for 14 December 1540 state:

... Item, Master Laxton & Master Bowes, Shreves of this Citye, prayed the Advyse of this howse for & concernying the Delyuerye ouer of one of the dedde bodyes of the Felons of late condempned to dethe within this Citye, And requyred of the seyd Master Shreves by Master Vycary & other the surgeons of this Citye for Annotamye, Accordyng to the fourme of an Acte of parlyament thereof lately made. And Agreyd that the same Acte be first seen & then Master Shreves to work ther after.[39]

With human dissection material assured, the United Company proceeded to appoint a Reader of Anatomy, the first perhaps being Thomas Vicary, and although the intervening records of the company are not complete, it is known that in 1546 Dr. John Caius, lately returned from Padua, where he had been acquainted with and even lived for a time with the celebrated anatomist Andreas Vesalius, was appointed and held the position of Reader of Anatomy for the next seventeen years. In his brief autobiography Caius refers to these dissections which he performed ‘for almost twenty years’, and adds, ‘By the wish of the most illustrious prince Henry VIII, King of England, I performed them in London before the surgeons; among the physicians at that time there was no dissection.’[40] It may be assumed, however, that by ‘physicians’ Caius was referring to those of London rather than to those of the universities. Nevertheless, his remark helps to explain the lack of anatomical works which might have competed with those of the Continent. The physicians, although better trained in languages than the surgeons and, we may assume, literary exposition, were as yet not interested in the subject of anatomy.

Nevertheless it does seem somewhat incredible that the physicians were so late in taking up the practice of human dissection. While it is always dangerous to exceed the limits of evidence, this peculiar situation in regard to the College of Physicians of London requires that attention be called to a statute of the college reproduced by Munk who gives it the date 1569-70.[41] According to this authority, the terms employed in the statute, reproduced below in translation, suggest that human anatomical dissection was already being employed by the physicians of the college at the time, although it seems impossible to determine whether or not the reference is to a period earlier than 1565 when Elizabeth granted them four bodies annually for anatomical purposes.[42] However, it seems unlikely that the college, which was so concerned with the enforcement of laws concerning medicine would itself perform an illegal action and therefore that Elizabeth’s grant to the college most likely introduced it to human dissection. Furthermore, one wonders just how frequently the college employed its new right, and in this respect it is interesting to note that there is no reference either to Elizabeth’s grant or to any dissection at all in the Annals of the college as written by John Caius.[43]

Although the study of human anatomy was now officially recognized and regularly pursued, at least in London, it would be incorrect to believe that native English anatomical writings would be forthcoming to continue the course modestly established by David Edwardes. The apathy or even hostility of physicians toward anatomical studies was an obstacle experienced earlier on the Continent and referred to by Vesalius who contributed no small share to the growth of anatomy’s respectability in the eyes of physicians. However, the time lag between the Continent and England had resulted in a disregard of anatomical studies by English physicians at the very times when continental physicians had begun to interest themselves in the subject and publish anatomical studies. As a result it was inevitable that for such Englishmen as were interested in anatomy it was easier to import the more advanced and elaborate continental texts, and dependence on such alien works was for long to be the regular pattern. But even with these advanced, contemporary works available, the practice continued among the surgeons of republishing old and obsolete anatomico-surgical treatises of late medieval times. If such a practice was dictated by an elementary knowledge, certainly the continuance of it would not lead to any development.

In 1544 a Flemish engraver named Thomas Lambrit, better known under his pseudonym of Geminus, engraved on copper a series of anatomical figures plagiarized from the Fabrica and Epitome of Vesalius. Geminus displayed the plates, which are of considerable artistic merit, indeed, the first of high quality to be produced in England, to King Henry VIII. That monarch, aware of the need of anatomical books to bolster the anatomical teaching now in progress, urged Geminus to publish his engravings. Never one to scorn the chance of gain, Geminus proceeded to follow this royal advice in the succeeding year (1545) and added to his plates a dedication to the king and the text of Vesalius’ Epitome.[44] For some peculiar reason the completely innocent John Caius has occasionally been blamed as the impetus to this plagiarized publication despite the fact that Geminus states plainly in his preface that Henry VIII was responsible for his decision to publish.

While the illustrations plagiarized from Vesalius may have been of some pedagogical value, the text of the Epitome certainly was no anatomical manual, and the fact that it was in Latin, which many if not most of the surgeons could not read, gave it even less value.

It was perhaps at least partly for these reasons that Thomas Vicary appears to have issued in 1548 an anatomical text in English entitled A Profitable Treatise of the Anatomie of Mans Body. No copy of it is known to exist today, and its existence is realized only through mention of it on the title-page of an edition published in 1577 by the surgeons of St. Bartholomew’s Hospital and a reference to it in 1565 by another surgeon, John Halle, who refers to Vicary as ‘the firste that euer wrote a treatyse of Anatomye in English (to the profite of his brethren chirurgiens and the helpe of younge studientes) as farre as I can learne’.[45] However, to refer to the ‘profite’ and ‘helpe’ to be obtained from Vicary’s treatise is to reveal the deplorable state of anatomical studies in England at the time and to cause one to wonder if Halle had read by way of contrast the continental writings of that period. It seems very likely that what has been termed Vicary’s anatomy was nothing other than a copy of a manuscript, presently in the Wellcome Historical Medical Library in London, dated 1392 and merely a compilation of Lanfranc, Henri de Mondeville, and Gui de Chauliac, the most recent of them dead in 1367. Thus not only was Vicary’s work not based upon dissection, except for a secondhand account of crude fourteenth-century autopsy, but it represented a definite case of retrogression.

The next anatomical publication in England was a new edition in 1553 of Geminus’s plagiarized anatomical plates, but this time with an English text by Nicholas Udall, best known as the author of the first important English comedy, Ralph Roister Doister, and utterly lacking in knowledge of anatomy. In consequence one may correctly hazard that this work, published with commercial rather than pedagogical motives, would not contribute much to knowledge of anatomy in England, even though the text was now in English. It is true that Vesalius’ descriptions of his illustrations were put into English, the first translation into English of any portion of the Fabrica, but the text which now replaced the Epitome of the earlier edition of 1545, like Vicary’s work, is predominantly indebted to that same fourteenth-century manuscript compiled from the writings of late medieval surgeons. Finally, the sheets of this work were reissued in 1559 with a new preface written by Richard Eden which aimed to delude the public into the belief that the publication had been revised.

About this time, too, a small series of anatomical fugitive sheets with superimposed flaps made their appearance in England. One, at least, had two leaves of English text to explain the woodcut and is nearly always discovered bound into the 1559 reissue of Geminus’s book. The fugitive sheets, like their continental predecessors and followers, added very little to anatomical knowledge and must have been for popular consumption.

If we turn now for a moment to give consideration to continental activity during the same period, there is no difficulty in observing the superiority of publications abroad. In 1543 the Fabrica of Vesalius was published, in 1545 the De Dissectione of RiviÈre and Estienne, in 1555 the revised and much improved second edition of the Fabrica, in 1556 Composicion del Cuerpo Humano of Valverde, and in 1559 the De Re Anatomica of Colombo. It is little wonder that these foreign texts overwhelmed the English market and prevented any initiative which might have led to the publication of any but the most rudimentary manuals, presuming that there was in England anyone who had pursued the study of anatomy sufficiently to be in a position to compete with the continental authorities. On the other hand, the superiority of the foreign publications owed part of that superiority to the fact that they were the work of much better educated physicians who had undertaken the study of anatomy, whereas in England the subject was yet very largely under the control of the less learned and less articulate surgeons who thought of anatomy more as a limited body of technical information required for surgery rather than a field of knowledge to be studied for itself and capable of indefinite expansion. David Edwardes had sought to set medicine on the right course, but to no avail. While in time the Faculties of Medicine in the two universities would pay some lip-service to anatomy, yet some considerable time was to pass before they became genuinely interested in the subject.

In 1549 a royal examination of the Oxford statutes led to a declaration that they were ‘antiquated, semi-barbarous and obscure’, and new ones were substituted. In regard to medicine it was declared that before receiving the degree of Bachelor of Medicine the student must see two anatomical dissections, and himself perform two dissections before receiving his licence to practice. Before receiving the degree of Doctor of Medicine he was required to observe two or three more dissections.[46] This, however, seems more likely to have been the ideal than the reality and echoes a similar but normally unfulfilled requirement in fifteenth-century Paris. It is more likely that the frequency with which anatomy was conducted at Oxford would have depended upon the particular interest of the Professor of Medicine, such as Walter Bayley (1529-93) who became Regius Professor of Medicine in 1561 and who at his death left his ‘skeleton of bones in Oxford’ to his successor in the chair.[47] However, no Reader in Anatomy was appointed at Oxford until 1624. Indeed, the founder of the readership, Richard Tomlins, recognized the situation in his grant by noting that the study of anatomy was

more particularly necessary for the faculties and Artes of Phisicke and Chirurgery, the perfection whereof doth much avayle to the safety health and comfort of the whole Commonwealth in the conservation of theire persons: And that there is as yet in neither of the Vniversities of this Kingdome (thoughe otherwise the most florisshing of the whole Christian world) any such Anatomy Lecture founded or established.[48]

If we may believe John Caius, writing after the middle of the century, the first early enthusiasm for Greek studies had worn off among physicians. Caius, himself a very competent Grecist, wrote in advocacy of the study of Greek medicine in the Greek language, that

as each is more capable in his own tongue so he is consistent and always remains himself which contributes much to clarity, since each tongue has its own idioms and inexpressible terms which when translated do not retain the same emphasis or a like grace. In short, translators some times do not understand certain things, elsewhere they fall asleep, do not retain exactness of diction, restrain freedom, and since we are all human and so desirous of variety, from time to time they slip so that not only may there be obscurity but even ambiguity.

Nevertheless, wrote Caius, in his day ‘everyone turns to the Latin editions and no one touches the Greek’.[49]

It is certainly true that after that first generation of men like Linacre, there was little interest in England in the original language of Galen and Hippocrates. The surgeons, certainly, knew no Greek, and the physicians were not interested in anatomy. There was to be little controversy, therefore, as to the meaning of any of Galen’s anatomical terms and less likelihood of investigating and disputing Galenic assertions. Acceptance without demur of the translation was a long step toward unquestioned acceptance of the content of the original. Hence it appears that by the middle of the sixteenth century the authority of Galen in Latin dress, or of his commentators, was not very likely to be opposed. On the Continent it had been instances of questions and opposition which had brought about anatomical advancement by resort to the only arbiter of doubts and questions, that is, the cadaver.

With conditions as they have been portrayed it is no wonder, therefore, that little initiative was displayed in England. The most popular of the foreign works in England, as on the Continent, appears to have been the De Re Anatomica of Colombo which held its position until well after the opening of the seventeenth century. It was excellent for its time, not certainly the equal of the Fabrica, but on the other hand much cheaper to purchase, less bulky to hold, and not so detailed as to be confusing. It was probably this particular work in its several editions which more than any other prevented the appearance of a native English anatomical text.

In 1578 John Banister published a book entitled The Historie of Man, sucked from the Sappe of the most approued Anathomistes. The title indicates the character of the work, drawn from continental authorities, and especially from Colombo, despite the fact that Banister was Reader in Anatomy to the United Company and therefore in a position to undertake independent researches. Indeed, a contemporary painting shows Banister in his capacity as Reader standing beside an open copy of Colombo’s De Re Anatomica.[50]

It is clearly apparent that English anatomy in the Tudor period remained far behind that of the Continent, at least on the basis of such books as were published in England, and thereby renders that modest but early effort of David Edwardes all the more curious.

Edwardes, it must be recalled, had presented his brief treatise in the same form which was being employed on the Continent, and we may assume that it represented his method. What he did was to ignore medieval writers and return directly to Galen, the supreme authority of that age, the ‘Prince of Physicians’. Coupled with this, he had begun to dissect, first, it may be assumed, for better comprehension of Galen but ultimately by Edwardes or his successors, discrepancies between the text of Galen and the observed anatomy would at once have indicated the classic error and the path to knowledge. Such was the course of continental development, but English anatomy of the period was faced by an insurmountable obstacle.

Whereas the medical faculties of continental universities came to accept anatomy, such was not to be the case with English medicine until well into the seventeenth century. As a result, anatomy was not an end in itself but rather a limited field of knowledge learned in so far as it might be usefully applied in surgery.

There were, of course, some Englishmen whose training and knowledge were superior to the quality demonstrated in English texts, men who had had Paduan training such as Caius and Harvey. But even Caius remained a Galenist when continental anatomy had become Vesalian, and Harvey, despite his thoroughly scientific attitude in respect to physiology, remained very conservative in his approach to purely anatomical problems, seeking authority not only in Galen but in the even more ancient Aristotle.

Under these conditions it seems remarkable that such great contributions were made to physiology in seventeenth-century England. The contributions of Harvey, Boyle, Hooke, and Lower form an amazing contrast to the static and even retrograde position of anatomy in the preceding century. In 1565 John Halle, a distinguished surgeon, published his Anatomy or Dissection of the Body of Man which was largely a translation of the surgery of Guido Lanfranc who died in 1315, yet fifty-one years later Harvey had arrived at the circulation of the blood.[51]

Clyx.com