The Greatest Benefit to Mankind: A Medical History of Humanity. Roy Porter

used by William Harvey as evidence of the circulation of the blood. Another crucial correction of Galen came in Book VII, on the brain, where Vesalius denied the existence of the rete mirabile in humans.

      In the end, Vesalius’s importance lay in daring to think the unthinkable: that Galen might actually be wrong, and Galen worship with it:

      How much has been attributed to Galen, easily leader of the professors of dissection, by those physicians and anatomists who have followed him, and often against reason! … Indeed, I myself cannot wonder enough at my own stupidity and too great trust in the writings of Galen and other anatomists.

      The Fabrica thus laid the groundwork for observation-based anatomy, announcing a new principle of fact-finding and truth-testing: all anatomical statements were to be subjected to the test of human cadavers.

Later anatomists corrected Vesalius as he had corrected Galen, and independent observation thus became sovereign. Anatomists also grew impatient to establish personal priority in discovering new structures. Amerigo Vespucci had his name immortalized in a continent; for an anatomist, naming a bodily part could be crucial for making his name.^*

      The frontispiece of the Fabrica presents the dreams, the programme, the agenda, of the new medicine. The cadaver is the central figure. Its abdomen has been opened so that everyone can peer in; it is as if death itself had been put on display. A faceless skeleton points towards the open abdomen. Then there is Vesalius, who looks out as if extending an invitation to anatomy. Medicine would thenceforth be about looking inside bodies for the truth of disease. The violation of the body would be the revelation of its truth.

      By transference, the idea of anatomizing became a potent medical metaphor during the next couple of centuries, as in Robert Burton’s Anatomy of Melancholy (1621) or John Donne’s poem ‘An Anatomy of the World’ (1611), and modern medicine adopted the anatomy lesson as its signature: medicine was represented as a probe into nature’s secrets, peeling away layer upon layer in the hunt for truth; nothing would resist its gaze. The knife also suggested other modes of mastery, not least sexual conquest, as when Donne likens the lover’s caress to a surgeon’s knife:

      And such in searching wounds the surgeon is

      As wee, when wee embrace, or touch, or kiss.

      A new genre came into fashion: self-anatomy, introspection into one’s own soul, a kind of spiritual or psychological dissection. ‘I have cut up mine owne Anatomy,’ declared Donne, ‘dissected myselfe, and they are got to read upon me.’

      Practical anatomy advanced on a broad front after the Fabrica. Accounts of the whole body continued to be published, for instance Charles Estienne’s (1504–64) De dissectione partium corporis humani (1545) [On the Dissection of the Human Body]. Realdo Colombo, an apothecary’s son who studied surgery at Padua, succeeding Vesalius there in 1544, corrected some of his errors in his De re anatomica [On Anatomy], published posthumously in 1559. He accused Vesalius of passing off descriptions of animal anatomy as human – precisely Vesalius’s charge against Galen. Colombo’s discovery of the pulmonary transit and elucidation of the heartbeat were momentous. Vivisection experiments showed that blood went from the right side of the heart through the lungs to the left side; that the pulmonary vein did not, as Galen had thought, contain air but blood; and that blood was mixed with air not in the left ventricle of the heart but in the lungs, where it took on the bright red hue of arterial blood. Describing the heartbeat, Colombo held, opposing former views, that the heart acted with greater force in systole (contraction) than in diastole (dilation); this too was crucial for Harvey.

      Gabriele Falloppia (1523–63) was appointed in 1551 to perform the annual anatomies at Padua, and he produced more criticism of the Fabrica in his Observationes anatomicae (1561) [Anatomical Observations]. The tremendous kudos of the new anatomical teaching is illustrated by an incident in 1555, when the university authorities sought to revive the old style of anatomizing as ordained by the statutes. A junior lecturer was to read out Mondino’s Anatomia, and the senior professor, Vettor Trincavella (1490–1563), was to deliver theoretical lectures. Falloppia’s role as anatomist would thereby have been demeaned. In the event, Trincavella’s orations were broken up by rowdy students chanting vogliamo il Falloppio (‘we want Falloppia’), after which anatomy was entirely in his hands.

      Falloppia’s Observationes may be regarded as a coda to the Fabrica, adding new observations and correcting errors in both Galenic and Visalia anatomy. Though not a systematic textbook, it covered a wide range of subjects, with emphasis on the skeleton, especially the skull, and the muscles. Particularly important were his descriptions of the structure of the inner ear, the carotid arteries, the head and neck muscles, and the orbital muscles of the eye. It also contains the famous description of the uterine tubes bearing his name. Falloppia meanwhile kept up a huge practice, claiming to have examined the genitals of 10,000 syphilitics.

      Unlike Vesalius, later anatomists produced specialized studies of body parts, such as the treatises on the kidney, the ear and the venous system published by Bartolomeo Eustachio (c. 1500–74) in his Opusula anatomica (1564) [Anatomical Studies]. He scolded Vesalius for depicting a dog’s kidney instead of a human one, and produced figures of the ear ossicles and the tensor tympani in man and in dogs. The Eustachian tube from the throat to the middle ear was described, though priority really belonged to Giovanni Ingrassia (1510–80), who had discovered it in 1546.

      Study of specific structures encouraged comparative anatomy, in which different animals were correlated in a self-consciously Aristotelian manner; Aristotle had been keen to compare animal anatomy for classification purposes and to discover essential structural/functional correlations. The greatest comparative anatomist was one of Falloppia’s pupils, Hieronymus Fabricius ab Aquapendente (Fabrizio or Fabrici: c. 1533–1619), who succeeded to his Padua chair in 1565. Fabricius’s aim was to produce a work to be called Totius animalis fabricae theatrum [The Theatre of the Entire Animal Structure], but only small sections emerged. As an anatomist he was less interested in Visalia structural architecture than a comparative approach which stressed three aspects of anatomy: the description, action, and use of body parts. Although Vesalius had surpassed the ancients in descriptive accuracy, he had written little on the action and use of the parts; this was what Fabricius aimed to remedy.

      Fabricius’s most significant work was De venarum ostiolis (1603) [On the Valves of the Veins], for the venous valves were to be crucial for William Harvey’s demonstration of the blood circulation. It was not Fabricius who discovered them, but he was the first to discuss them at any length. The valves, he maintained, were designed to prevent the extremities from being flooded with blood and to ensure that the other body parts would get their fair share. This theory tallied with the Galenic view that blood was attracted from the liver, the blood-making organ, by each part of the body when it needed nourishment. The valves thus helped the central and upper parts to get blood by preventing its tendency to gather at the extremities.

      Fabricius’s embryological treatises also influenced Harvey. De formatione ovi et pulli (1621) deals with the development of the egg and the generation of the chick, while De formatu foetu (1604) [On the Formation of the Foetus] describes how nature provides the means for foetal growth, nourishment and birth. His descriptions of foetal development lay within the Aristotelian theoretical framework of the female contributing the matter and the male the form.

      A more idiosyncratic challenge to Galenic physiology had meanwhile come from the polymath Michael Servetus (1511–53). Sickened by the corruption of the Roman Church, Servetus went further than Luther along the road of heresy and developed anti-Trinitarian views, leading to condemnation by Catholics and Protestants alike. In Lyons he had met the medical humanist Symphorien Champier (c. 1471–1539), who advised him to study in Paris, where he worked with the cream of the faculty: Sylvius, Fernel and Guinther von Andernacht. But he soon fell under suspicion, and was condemned in 1538 by the Parlement of Paris for lecturing on astrology. In 1553 he anonymously published his major work, the 700-page Christianismi restitutio [The Restoration