The role of Vesalius and his contemporaries in the transfiguration of human anatomical science.

The understanding of human anatomy has been an endeavour spanning thousands of years from the Egyptians and Greeks in antiquity to the present day. Scholars and scientists have overcome great barriers to discover the inner workings and complexities of the human body, from personal challenges and prejudices to obstacles placed by society. Our present understanding of anatomy has accumulated over centuries, and progressive generations of physicians have contributed to the ever-growing evidence-based knowledge. This article explores the contributions made by Vesalius and his contemporaries in the first half of the sixteenth century. These enlightened scholars advanced anatomical knowledge and, perhaps more importantly, the scientific method, directly impacting the mindset and methodologies of future anatomists. Individuals such as Berengario da Carpi and Gabriele Falloppio produced bodies of work during their lifetime that were not only important in disputing the teachings of Galen of Pergamon, which had been accepted as almost unquestionable truths for a thousand years, but also instrumental in developing a new generation of scientists. The anatomists of the late renaissance were unable to resolve many of the factual inaccuracies of Galenic teaching but provided the groundwork for scientific thinking which future generations of anatomists benefited greatly from. The principles of documenting what is observed and establishing a methodical approach to question discrepancies in experiments would go on to influence physicians such as Harvey and Malpighi to investigate and draw correct conclusions in their research and ultimately advance our understanding of human anatomy to what it is today.

Evolution of the myth of the human rete mirabile traced through text and illustrations in printed books: The case of Vesalius and his plagiarists.

Andreas Vesalius initially accepted Galen's ideas concerning the rete mirabile in humans. In 1538, Vesalius drew a diagram of the human rete mirabile as a plexiform termination of the carotid arteries, where the vital spirit is transformed into the animal spirit, before being distributed from the brain along the nerves to the body. In 1540, Vesalius demonstrated the rete mirabile at a public anatomy, using a sheep's head (due to his nascent realization that he could not demonstrate this adequately in a human cadaver, potentially eliciting ridicule). By 1543, Vesalius had fully reversed himself, denied the existence of the rete mirabile in humans, and castigated himself for his prior failure to recognize this error in Galen's works. Vesalius nevertheless illustrated both the Galenic conception of the rete mirabile in humans and a schematic of the rete mirabile in ungulates. He intended the 1543 diagram of the human rete mirabile as an example of a mistake that resulted from Galen's overreliance on animals as models of human anatomy. However, in spite of Vesalius's intentions, for more than a century afterward, his figure was repeatedly and perversely plagiarized by advocates for Galenic doctrine, who misused it as a purportedly realistic representation of human anatomy and generally omitted the contrary opinions of Berengario da Carpi and Vesalius. The protracted use of stereotyped representations of the rete mirabile in extant printed illustrations provides tangible documentation of the stagnation in anatomical thought in the sixteenth and seventeenth centuries.

Then there were 12: The illustrated cranial nerves from Vesalius to Soemmerring.

In the second century ce, Galen described seven pairs of cerebral nerves. He did not name the nerves, nor did he illustrate his work. Galen's descriptive texts survived until the mid-sixteenth century, when anatomists, influenced by the artistic and scientific revolution of the Renaissance, began a reformation in anatomical research. They closely observed their own dissected material and conveyed their results not only in words but commonly by lavish drawings. Many of the great anatomists reexamined the cerebral nerves, adding descriptive text or changing the classification. In 1778, Thomas Soemmerring (1755-1830) named 12 pairs of cerebral nerves upon which the modern cranial nerve nomenclature is based. Soemmerring matched his text with clear, decisive illustrations. This article describes the works of some of the great artists in the period from Vesalius to Soemmerring and how they used illustration to supplement and provide clarity for their textual descriptions of the cranial nerves.

Summarizing the medieval anatomy of the head and brain in a single image: Magnus Hundt (1501) and Johann Dryander (1537) as transitional pre-Vesalian anatomists.

Of the early-sixteenth century pre-Vesalian anatomists, Magnus Hundt in 1501 and Johannes Eichmann (known as Johann Dryander) in 1537 both attempted to summarize the anatomy of the head and brain in a single complex figure. Dryander clearly based his illustration on the earlier one from Hundt, but he made several improvements, based in part on Dryander's own dissections. Whereas Hundt's entire monograph was medieval in character, Dryander's monograph was a mixture of medieval and early-modern frameworks; nevertheless, the corresponding illustrations of the anatomy of the head and brain in Hundt (1501) and Dryander (Dryandrum 1537) were both essentially medieval. This article examines in detail the symbology of both illustrations within the context of the medieval framework for neuroanatomy and neurophysiology. These two woodcuts of the head and brain provide the most detailed pictorial representation of medieval cranial anatomy in a printed book prior to the work of Andreas Vesalius in 1543.

The three fetal shunts: A story of wrong eponyms.

The fetal circulatory system bypasses the lungs and liver with three shunts. The foramen ovale allows the transfer of the blood from the right to the left atrium, and the ductus arteriosus permits the transfer of the blood from the pulmonary artery to the aorta. The ductus venosus is the continuation of the umbilical vein, allowing a large part of the oxygenated blood from the placenta to join the supradiaphragmatic inferior vena cava, bypassing the fetal liver and directly connecting the right atrium. These structures are named after the physicians who are thought to have discovered them. The foramen ovale and the ductus arteriosus are called the "foramen Botalli" and the "ductus Botalli," after Leonardo Botallo (1530-c. 1587). The ductus venosus is styled "ductus Arantii" after Giulio Cesare Arantius (1530-1589). However, these eponyms have been incorrectly applied as these structures were, in fact, discovered by others earlier. Indeed, the foramen ovale and the ductus arteriosus were described by Galen of Pergamon centuries earlier (c. 129-210 AD). He understood that these structures were peculiar to the fetal heart and that they undergo closure after birth. The ductus venosus was first described by Andreas Vesalius (1514-1564) 3 years before Arantius. Therefore, the current anatomical nomenclature of the fetal cardiac shunts is historically inappropriate.

Andreas Vesalius of Brussels (1514-1564): his contribution to the field of functional neuroanatomy and the criticism to his predecessors.

Until the fifteenth century, the knowledge about anatomy and function of the nervous system had been significantly influenced by theological notions. Andreas Vesalius of Brussels (1514-1564), based on human cadavers' dissections, criticized his predecessors and contributed to the construction of the current knowledge about functional neuroanatomy. Although he did not avoid mistakes, he successfully demonstrated the high value of human cadavers' dissection in anatomical teaching.

Andreas Vesalius (1515-1564) on animal cognition.

Until well in the 19th century, the Aristotelian concept of the scala naturae (ladder of nature) was the most common biological theory among Western scientists. It dictated that only humans possessed a rational soul that provided the ability to reason and reflect. Michel Eyquem de Montaigne (1533-1592) was the first philosopher influential enough to lastingly posit that animals are cognitive creatures. His view stirred a fierce controversy, with René Descartes (1596-1650) leading among his many adversaries. Only after it became accepted that animals and humans alike have cognitive abilities, did the research on the influence of conscious awareness and intention on the behavior of an animal become possible in the 20th century. We found the anatomist Andreas Vesalius (1515-1564) to have already rejected the Aristotelian view on the lack of the rational soul in animals in his 1543 opus magnum De Humani Corporis Fabrica Libri Septem. His observation "that there is a difference in size according to the amount of reason that they seem to possess: man's brain is the largest, followed by the ape's, the dog's, and so on, corresponding to the amount of rational force that we deduce each animal to have" resonated some 330 years later when Darwin concluded that "the difference in mind between man and the higher animals, great as it is, certainly is one of degree and not of kind." We conclude that Vesalius was instrumental in breaking with two millenniums of dominance of the concept of lack of animal cognition.

Andreas Vesalius, the Predecessor of Neurosurgery: How his Progressive Scientific Achievements Affected his Professional Life and Destiny.

Andreas Vesalius, the father of modern anatomy and a predecessor of neuroscience, was a distinguished medical scholar and Renaissance figure of the 16th Century Scientific Revolution. He challenged traditional anatomy by applying empirical methods of cadaveric dissection to the study of the human body. His revolutionary book, De Humani Corporis Fabrica, established anatomy as a scientific discipline that challenged conventional medical knowledge, but often caused controversy. Charles V, the Holy Roman Emperor and King of Spain to whom De Humani was dedicated, appointed Vesalius to his court. While in Spain, Vesalius' work antagonized the academic establishment, current medical knowledge, and ecclesial authority. Consequently, his methods were unacceptable to the academic and religious status quo, therefore, we believe that his professional life-as well as his tragic death-was affected by the political state of affairs that dominated 16th Century Europe. Ultimately, he went on a pilgrimage to the Holy Land that jeopardized his life. While returning home, his ship was driven ashore on the Greek island of Zakynthos (Zante) where he became ill and suddenly died in 1564 at the age of 49. Vesalius' ideas helped free medicine from the limitations of the 16th Century and advanced scientific knowledge. His influence is still felt more than 500 years later. In this article, we acknowledge Vesalius' neuroanatomic contributions and we discuss the historical facts and political circumstances that influenced his scientific career and personal life, emphasizing the conditions of his pilgrimage to the Holy Land that led to his untimely death.

Vesalius criticism on Galen's musculoskeletal anatomy.

Galen of Pergamum (129-216/217 AD), an important Greek physician, influenced the history of medicine for more than 1400 years. However, Andreas Vesalius (1514-1564), after performing dissections of human cadavers, remarked that Galen made several mistakes due to the fact that his dissections were on animals, particularly on apes. The current study summarizes the main points in which Vesalius criticized Galen in terms of the musculoskeletal anatomy.

Juan Valverde de Amusco (1525-1588): an eminent anatomist of the renaissance or a plagiarist of Vesalius? His work and its impact in renaissance anatomy.

INTRODUCTION: The purpose of this study is to review and summarize the life and work of Juan Valverde de Amusco (1525-1588), his impact on the anatomy of the sixteenth century and focus on his controversy with Andreas Vesalius. METHODS: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in history books through the internet and in History and Medical University libraries. RESULTS: Valverde took almost directly from Andreas Vesalius 38 pictures. Occasionally, however, Valverde corrected Vesalius' images, as in his depictions of the muscles of the eyes, nose and larynx. CONCLUSION: Valverde copied the work of Vesalius in many instances. Nevertheless, he had his fair share of contribution in the history of Anatomy; he managed to popularize and spread the new anatomy of the Rennaissance through his work which was far more cheaper than that of Vesalius; furthermore, his anatomic discoveries like the first depiction of the intracranial course of the carotid arteries (several decades before Willis's description), the extrinsic ocular muscles and the middle ear bones contribute to the spirit of the Scientific Revolution.

Developing the Brain-Early Illustrations of Cerebral Cortex and Its Gyri.

BACKGROUND: Throughout the Middle Ages, most representations of the brain amounted to highly schematized ventricles housed within abstract squiggles of neural tissue. The works by the pre-eminent Flemish anatomist Andreas Vesalius in his De Humani Corporis Fabrica (1543) added considerably more accuracy and detail; still, his drawings of cerebral hemispheres do not exhibit the gyral-sulcal pattern recognized today. Identifiable cortical landmarks would not be featured in print until Cerebri Anatome (1664) by the English physician Thomas Willis. METHODS: A review of primary and secondary sources on the subject. RESULTS: Medieval doctors understood neurophysiology according to the cell doctrine, whereby the first cell (modern-day lateral ventricles) was responsible for sensation, the second cell (third ventricle) for cognition, and the third cell (fourth ventricle) for memory. Vesalius challenged this ventricle-centric model and resolved to portray physical form only, without the influence of conceptual function. A century later, Willis and his illustrator, Christopher Wren, citing limited clinical evidence, proposed that the corpus striatum, the white matter, and the gray matter replace the three cells, finally allowing the cortex a physiological rather than a structurally supportive role. This relocation of executive function demanded the more meticulous rendering of the brain provided in the Cerebri Anatome. CONCLUSIONS: Thomas Willis produced anatomic drawings of the brain depicting previously ill-defined surface features, as in Fabrica by Vesalius, because of a paradigm shift in neurophysiology, emphasizing the cortex over the ventricles, not because of advances in techniques of dissection or illustration. Perhaps, as the study of the brain continues, another future revelation in neurophysiology will drive another unexpected, enduring change in the study of the structures of the nervous system.

The relationship between Vesalius and the Borgarucci family.

Two of the four brothers Borgarucci were medical doctors and in one way or another, be it distantly, connected with the great master Vesalius. Giulio Borgarucci was a physician, who became a Calvinist and emigrated to England where he treated many noblemen and friends of Queen Elisabeth I. He was present at a conversation between the Italian writer and traveler Pietro Bizzari and the Venetian jeweler who witnessed Vesalius' death in Zakynthos. Prospero Borgarucci became professor of anatomy and surgery in Padua, some 20 years after Vesalius. He published several treatises on anatomy, pestilential disease, and materia medica. Prospero Borgarucci became physician to Queen Catherine de Medicis in France, and to Archduke Karl II of Habsburg in Graz. His most important work is the so-called Chirurgia Magna of Vesalius. Text and illustrations of this spurious Vesalian work point to the use of passages of the Epitome, surgical college notes and copied Vesalian images in Borgarucci's Chirurgia Magna.

Andreas Vesalius' 500th Anniversary: Initial Integral Understanding of Voice Production.

BACKGROUND: Voice production relies on the integrated functioning of a three-part system: respiration, phonation and resonance, and articulation. To commemorate the 500th anniversary of the great anatomist Andreas Vesalius (1515-1564), we report on his understanding of this integral system. METHODS: The text of Vesalius' masterpiece De Humani Corporis Fabrica Libri Septum and an eyewitness report of the public dissection of three corpses by Vesalius in Bologna, Italy, in 1540, were searched for references to the voice-producing anatomical structures and their function. We clustered the traced, separate parts for the first time. RESULTS: We found that Vesalius recognized the importance for voice production of many details of the respiratory system, the voice box, and various structures of resonance and articulation. He stressed that voice production was a cerebral function and extensively recorded the innervation of the voice-producing organs by the cranial nerves. CONCLUSIONS: Vesalius was the first to publicly record the concept of voice production as an integrated and cerebrally directed function of respiration, phonation and resonance, and articulation. In doing so nearly 500 years ago, he laid a firm basis for the understanding of the physiology of voice production and speech and its management as we know it today.

Centennial ties: Harvey Cushing (1869-1939) and William Osler (1849-1919) on Andreas Vesalius (1514-1564).

Andreas Vesalius is often regarded as the founding father of modern anatomical study. The quincentennial anniversary of his birth - 31 December 2014 - has been very widely commemorated, and it is the purpose of this article to contrast these celebrations with what happened during the Vesalius quatercentenary year of 1914. More specifically, we look at how Vesalius was perceived a century ago by examining his influence on two of western medicine's most iconic gentlemen - Harvey Williams Cushing (1869-1939) and his larger than life mentor, Sir William Osler (1849-1919).

Two cases of 16th century head injuries managed in royal European families.

In Europe, during the 16th century, there were a number of prominent general surgeons adventurous enough to consider operating on the brain for head injuries. From the time of Hippocrates, operating on the skull and brain was considered both treacherous and too dangerous to be undertaken except on rare occasions. Operating on a member of a royal court was considered even more exceptional because if the outcome was poor, the surgeon could lose a hand or limb, or, even worse, be beheaded. The authors present two interesting cases of royal family members who underwent surgery for head injuries that were quite severe. The surgeons involved, Ambroise Paré, Andreas Vesalius, and Berengario da Carpi, were among the most prominent surgeons in Europe. Despite very challenging political situations, all were willing to undertake a complex surgical intervention on the member of a prominent royal family. The individuals involved, both royal and medical, plus the neurosurgical injuries are discussed.

Andreas Vesalius' understanding of pulmonary ventilation.

The historical evolution of understanding of the mechanical aspects of respiration is not well recorded. That the anatomist Andreas Vesalius (1515-1564) first recorded many of these mechanics in De Humani Corporis Fabrica Libri Septem has received little attention. We searched a digital copy of De Fabrica (1543) and its English translation as provided by Richardson and Carman (1998-2009) for references to aspects of pulmonary ventilation. We found that Vesalius grasped the essentials of tidal and forced respiration. He recognized that atmospheric pressure carried air into the lungs, approximately 100 years before Borelli did. He described an in vivo experiment of breathing, some 120 years before John Mayow produced his artificial model. He reported on positive pressure ventilation through a tracheotomy and on its life-saving effect, some 100 years before Robert Hook did. In publicly recording his insights over 450 years ago, Vesalius laid a firm basis for our understanding of the physiology of respiration and the management of its disorders.

Animals, Pictures, and Skeletons: Andreas Vesalius's Reinvention of the Public Anatomy Lesson.

In this paper, I examine the procedures used by Andreas Vesalius for conducting public dissections in the early sixteenth century. I point out that in order to overcome the limitations of public anatomical demonstration noted by his predecessors, Vesalius employed several innovative strategies, including the use of animals as dissection subjects, the preparation and display of articulated skeletons, and the use of printed and hand-drawn illustrations. I suggest that the examination of these three strategies for resolving the challenges of public anatomical demonstration helps us to reinterpret Vesalius's contributions to sixteenth-century anatomy.

The first description of the absence of the palmaris longus muscle.

BACKGROUND: While Realdo Colombo from Cremona, Italy has, to date, been acknowledged to be the first to describe the possible absence of the palmaris longus muscle in men in 1559, the authors found this absence to be recorded in the first edition of "De Humani Corporis Fabrica Libri Septum" by Andreas Vesalius, published in 1543. METHOD: To commemorate Vesalius' 500th birthday, this earlier record is quoted and discussed. RESULTS AND CONCLUSION: It remains unknown whether the observation on the absence of the palmaris longus was first done by Vesalius or was based on joined work by Vesalius and Colombo.

Renaissance Neurosurgery: Italy's Iconic Contributions.

Various changes in the sociopolitical milieu of Italy led to the increasing tolerance of the study of cadavers in the late Middle Ages. The efforts of Mondino de Liuzzi (1276-1326) and Guido da Vigevano (1280-1349) led to an explosion of cadaver-centric studies in centers such as Bologna, Florence, and Padua during the Renaissance period. Legendary scientists from this era, including Leonardo Da Vinci, Andreas Vesalius, Bartolomeo Eustachio, and Costanzo Varolio, furthered the study of neuroanatomy. The various texts produced during this period not only helped increase the understanding of neuroanatomy and neurophysiology but also led to the formalization of medical education. With increased understanding came new techniques to address various neurosurgical problems from skull fractures to severed peripheral nerves. The present study aims to review the major developments in Italy during the vibrant Renaissance period that led to major progress in the field of neurosurgery.

Andreas Vesalius' five hundreth anniversary: initiation of the rotator cuff concept.

PURPOSE: The rotator cuff concept refers to the four scapulohumeral muscles that stabilize and rotate the humerus relative to the scapula. To date, the first description of the rotator cuff remained unidentified. METHOD: In light of the 500th birthday of Andreas Vesalius (1515-1564) we searched his 1543 masterwork "Fabrica Corporis Humani Libri Septem" for references to the morphology and function of the rotator cuff muscles. RESULT: Even though he distinguished three rather than four scapulohumeral muscles, Vesalius recognized the need for structures that prevent dislocation of the shoulder inherent to the morphology of the humeral caput and scapular socket. He recorded "three strong ligaments" and the "three muscles that rotate the arm" of which the tendons completely "embrace the ligaments of the joint" as such structures. CONCLUSION: Vesalius defined the rotator cuff concept avant la lettre.