Vesalius and Human Diversity in De humani corporis fabrica
Author(s): Nancy G. Siraisi
Source: Journal of the Warburg and Courtauld Institutes, Vol. 57 (1994), pp. 60-88
Published by: The Warburg Institute
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VESALIUS AND HUMAN DIVERSITY
IN DE HUMANI CORPORIS FABRICA
Nancy G. Siraisi
ccording to Cicero, the artist Zeuxis told the citizens of Croton that in
order to depict Helen of Troy, he needed five of their most beautiful young
women as nude models; from each he would select her best features to
be combined into an ideal representation of female beauty. As Panofsky long ago
noted, the anecdote became a standard Renaissance exemplum for artists. Yet the
ambiguity of the lesson was recognised by Alberti, who used the story twice: once to
accompany an admonition to paint from nature, but to choose 'the most beautiful
things', presumably as determined by some pre-existing standard; and a second
time to endorse procedures for deriving a standard of beauty from empirical
research.' Renaissance anatomists, too, sought to understand the proper relation
between ideal types and empirical investigations that were increasingly attentive to
variety and particularity, and the relation of either or both to the concept of Nature
or the natural.2 Their context was a discipline that rested on a combination of
manual techniques and intensive textual study. It had two characteristic end products: the public anatomy before an audience that might include members of civic,
courtly, and ecclesiastical elites as well as medical students; and the learned anatomy book, which described the human body in a Latin narrative, informed both by
the author's experience of dissection and by complex and constantly evolving
traditions of medical and natural philosophical learning and pedagogy, combined
with, in some cases, visual representation.3
Between the 1490s and about 1560, a number of anatomists commented in one
way or another on the proper relation between the task of presenting an account of
a generalised human body and that of seeking out information about the variety
1 Cicero, De inventione, ii.1.1-3; Cicero used the anecdote as an illustration of the rhetorician's freedom
to select and combine different literary models. L. B.
Alberti, De pictura, 55-6, De statua, 12, both in idem, On
Painting and On Sculpture:The Latin 7exts of De pictura
and De statua, ed. and tr. C. Grayson, London 1972, pp.
96-8, 132-8. E. Panofsky, Idea: A Conceptin Art Theory,
Columbia, SC 1968 (1st edn 1924), pp. 47-60 (including discussion of Raphael's awareness of the same ambiguity, expressed in his letter to Castiglione). I am grateful to Anthony Grafton for drawing my attention to
Alberti's two uses of the Zeuxis story. I am also grateful
to him and to Michael R. McVaugh and to Katharine
Park for helpful comments on an earlier draft of this
essay. My research on Vesalius has been supported by
grants from the National Endowment for the Humanities and the National Science Foundation, Washington,
DC.
2 I do not here make
any systematic attempt to trace
the awareness of anatomists of theoretical discussions in
the arts.
3 It deserves to be
emphasised the study and composition of books in learned languages was an integral part
of the work of leading Renaissance anatomists, and that,
in general, they attached as much or more importance
to verbal description as to visual representation. Hence,
some recent work on the role of language, rhetoric, and
writing in science has relevance for the study of Renaissance anatomy; see e.g. The LiteraryStructureof Scientific
Argument,ed. P. Dear, Philadelphia 1991; F. L. Holmes,
'Scientific Writing and Scientific Discovery', Isis, lxxviii,
1987, pp. 220-35; and D. M. Locke, Scienceas Writing,
New Haven, Conn. 1992. A useful overview of recent
contributions is provided in an essay review by T. Melia,
Isis, lxxxiii, 1992, pp. 100-6.
60
Journalof the Warburgand CourtauldInstitutes,Volume 57, 1994
VESALIUS
61
and diversity of humankind. They wrote in a cultural context characterised not only
by the rapid development of anatomy as a discipline, but also by much fascination
with all forms of rarity, 'monstrosity' and strangeness (including such familiar
strangeness as sexual difference). A salient feature of these remarks is their lack of
consensus. Thus, for example, Alessandro Benedetti's Anatomice (1497) advocates
that cadavers dissected for the instruction of students be as standard as possible:
male, middle-aged, neither fat nor thin, and tall.4 Berengario da Carpi, in 1521,
stressed the importance of understanding diversity owing to age, sex and popusuch underfor practical reasons-that
lation, although he suggested-presumably
use
of
to
achieved
be
animal,
supplement human,
through widespread
standing
dissection. He urged that a good anatomist should dissect numerous animals 'of
various species and both sexes and different ages, and pregnant and not pregnant
and living and dead', as well as 'foetuses of different kinds of animals'.5 Realdo
Colombo, in 1559, emphasised the uniformity of human bodies and the rarity of
anatomical anomalies. He was trying to counter the idea that variations were of
idea that he took to be widespread. In his opinion, this
frequent occurrence-an
notion was a legacy of the frivolous and ignorant scholastic physicians of the bad old
days, who, on the rare occasions when they did briefly inspect the entrails of a
cadaver, took for granted that everything they could not immediately identify in the
Canon of Avicenna or the early fourteenth-century manual of anatomy by Mondino
de' Liuzzi was some kind of monstrosity. As a corrective, Colombo devoted a separate chapter at the end of his book to accounts of the few anatomical anomalies he
had actually found himself in the 'innumerable' corpses which he had dissected.6
By contrast, Colombo's associate Juan Valverde claimed that the diversity among
human bodies was one reason for the disputes among the numerous anatomists
who spent 'their whole life in this study with many human bodies'.7
4 A. Benedetti, Anatomice, i.1, in L. R. Lind, PreVesalian Anatomy: Biography, Translations, Documents,
Philadelphia 1985, p. 83. The year 1497 is the date of
the dedication, but Roger French has pointed out that it
is uncertain whether an edition was printed before that
of 1502; see R. K. French, 'Berengario da Carpi and the
Use of Commentary in Anatomical Teaching', The
MedicalRenaissanceof the SixteenthCentury,ed. A. Wear et
al., Cambridge 1985, p. 297 n. 16.
5 'Conditiones boni anatome... incumbat
pro viribus
dissectioni animalium diversarum specierum / & diversorum sexuum / ac diversarum aetatum praegnantium
/ & non praegnantium vivorum / & mortuorum. Et ad
scientiam istam acquirendam incumbat anatomiae
foetuum diversarum specierum animalium': Carpi commentaria cum amplissimus additionibus super anatomia
Mundini, Bologna 1521, fol. VIV.On Berengario's commentary on the Anatomia, written by Mondino de'
Liuzzi (d. 1326), a professor of medicine at Bologna, to
accompany dissection of the human cadaver, and on the
role played by Mondino's work in the early stages of the
16th-century revival of anatomy, see French (as in n. 4),
pp. 42-74.
6 '...Anatomicae rei vel
prorsus ignari erant, vel quod
tonsoribus quoque notissimum erat, id tantum sciebant.
Itaque cum Anatomicam dissectionem publice profite-
bantur, situm quaerebant intestinorum, ventriculi,
iecoris, lienis, vesicae, renum, cordis, pulmonisque, deinde calvaria disrupta, cerebrum ibi contineri videbant,
reliqua oscitanter sane, et suis cum arabibus caecutientes. quod si quicquam illis occurrebat praeter haec,
aut quod cum Mundini, aut Avicennae scriptis non conveniret, id omne tanquam monstrum naturae in illius
individui fabrica ostentabant, adeo ut complura monstrosa in singulis cadaveribus esse existamerent. Ego vero
licet ab ineunte aetate innumera corpora dissecuerim,
et ab hinc quindecim annos, et amplius complura cadavera Patavii, Pisis, Romaeque in corona sequentis Academiae, tamen haec duntaxat rara visu, et a caeteris discrepantia observare potui.' Realdi Columbi...De re anatomica,
Venice 1559, xv, 'De iis quae raro in anatome reperiuntur', p. 256 (misprint for 262).
7 'Poi che ne anche hora in Italia, dove lecitamente si
fa [viz. dissections on the cadaver], et moolti [sic] con
grandissima diligenza tutta la sua vita spendono in
questo, non manca di essere assai differenza tra i piu
sani anatomisti in alcune cose; parte per la varieta de
corpi; parte per la difficulta [sic] della materia istessa.'
J. Valverde de Amusco, La anatomia del corpo umano,
Venice 1586, dedicatory epistle, sig. a3V. The first
edition of this work was published in Spanish in Rome
in 1556; the Italian translation appeared in 1560.
62
NANCY SIRAISI
But no anatomist of the period seems to have given as much consideration to
issues of diversity and uniformity as Andreas Vesalius in the Fabrica.8 It is the contention of the present paper that passages on these topics, which at first sight may
seem scattered and unrelated, have the effect of introducing a carefully limited discussion of variations not only among individuals but also among larger categories of
human beings into a book in which a major concern was the presentation of human
anatomy as a discipline with a unified subject. In what follows I shall explore some
of the remarks and assumptions in the Fabrica about anatomical diversity among
groups within the human population. The statements in question concern the differentiating effect on human bones, cartilage and muscles, of age, sex and what
would nowadays be called 'ethnic group'. Such comments need to be distinguished
from, but considered in relation to, Vesalius's interest in anatomical variability
among individual bodies.9 I shall further argue that Vesalius's treatment of aspects
of human diversity leads his readers towards an increasingly open and diversified
idea of what constitutes Nature and the natural. Although one cannot demonstrate
conclusively that the passages relating to this issue scattered through parts of the
Fabrica represent a deliberate program on the part of the author, the care with
which Vesalius planned his work as a whole makes it highly unlikely that any recurrent feature is accidental. In this view, Vesalian anatomy, too, displays the characteristic that Paolo Rossi has attributed to sixteenth-century life sciences in general:
'a conception of nature that no longer exhibited the feature of uniformity'. 0
In the first two books of his magnum opus Vesalius alludes to the subject of
human diversity in a bewildering variety of ways. The physical characteristics of
ancient peoples as reported by classical authors, anatomical anomalies in subjects
he has dissected, cases of disease he has attended, occupational characteristics he
has noted, the deciduous teeth of children, the remarkable ability of a friend to
wiggle his ears-all these and more crop up apparently at random. These passages
testify to Vesalius's lively personal interest in all kinds of evidence of human diversity, whether this reached him through his reading of ancient poets and historians,
reports from colleagues, dissection, or casual observation. But they occupy a decidappear to contrast sharply with
edly insignificant place in the work as a whole-and
its main thrust. They occur only as incidental and relatively infrequent allusions
scattered through text and pictures that, taken in their entirety, present the subject
of anatomical science as a generalised human body, essentially uniform in its fundamental framework of bone, cartilage and muscle," the subject of books i and ii.
Most of these remarks on various kinds of human diversity have already been
noted, if only because they provide a welcome change of pace amid the steady and
relentless tramp of weighty Latin periods about the characteristics of bones, cartilage and muscles. Over the last fifty years they have indeed been the object of very
8 AndreaeVesalii... de Humani
corporisfabricalibriseptem,
Basle 1543, hereafter Fabrica, 1543.
9 For a
cogent analysis of Vesalius's approach to individual variations see W. L. Straus Jr and 0. Temkin,
'Vesalius and the Problem of Variability', Bulletin of the
History of Medicine, xiv, 1943, pp. 609-33.
10 P. Rossi, Philosophy,?echnology,and theArts in theEarly
Modern Era, New York 1970, p. 67.
I For Vesalius, as for Galen, the concept
involved only muscles of voluntary motion.
of muscle
VESALIUS
63
diverse kinds of scholarly attention. Detailed technical analysis has been devoted to
Vesalius's descriptions of anatomical anomalies encountered in the course of his
own dissections or osteological studies.'2 In the context of his biography, note has
been taken of Vesalius's comments about the anatomical peculiarities of living
friends and colleagues as well as of various street characters whom he encountered.13 His interest in investigating traditional teachings about variant shapes of the
human skull has been variously praised as early physical anthropology and condemned as classicising pedantry.14 Omissions have also been noted, and the absence
from the Fabrica and the Epitome of any illustration of a female skeleton has recently
been adduced as evidence for the inability of early anatomists fully to recognise a
fundamental aspect of human diversity.15
Vesalius's scattered comments on diversity take on a somewhat different aspect
when considered collectively and in their two most immediate contexts: the Fabrica
itself, and the world of Renaissance medical and natural philosophical learning. Let
us first consider the Fabrica's presentation of anatomy as a discipline with a unified
subject in the context of the problems of uniformity and diversity of various kinds
that characterise the organisation and content of the work as a whole.
The Fabrica is deservedly famous for a striking clarity of purpose and sharp focus
highly unusual in its day. These characteristics are exemplified by Vesalius's intention (even if not fully sustained) to delineate a strictly human, as distinct from
animal, anatomy, and his avoidance of the endless chains of citations of multiple
previous authors so dear to other sixteenth-century learned writers. Yet in other respects, even in the context of the mixture of learned tradition (both scholastic and
humanistic), popular beliefs, new information, new techniques, and hybrid literary
and pedagogical genres that constituted Renaissance natural philosophy and medicine, the precise nature of Vesalius's enterprise in the Fabrica stands out as exceptionally protean, elusive, and hard to grasp. From the time of its first publication,
an anatomical atlas, a
indeed, the complex structure of the book-simultaneously
of
anatomical
a
dissection
and
a
detailed
terms,
manual,
dictionary
descriptive narrative about the human body-has
made
it
difficult
to
evaluate
always
relationships
and priorities among its various components. A case in point is the well-known objection of some of Vesalius's contemporaries that the provision of anatomical illustrations was incompatible with an emphasis on teaching and learning directly from
dissection;16 another is the publication in both the sixteenth and the twentieth centuries of partial editions that disjoin illustrations and text. Significantly, a sixteenthcentury printer, responding to traditions of medicine and natural philosophy that
remained predominantly verbal despite the new role of illustration in the descriptive sciences, chose to abbreviate his pirated edition of the Fabrica by issuing it
12 Straus and Temkin (as in n. 9).
13 C. D. O'Malley, Andreas Vesalius Brussels 1514of
1564, Berkeley and Los Angeles 1964, pp. 101, 115-17,
278.
14 For the former view, J. B. de C. M. Saunders and
C. D. O'Malley, The Illustrationsfrom the Worksof Andreas
Vesalius of Brussels, Cleveland 1950 (repr. New York
1973), p. 52, and F. Spencer, Ecce Homo: An Annotated
BibliographicHistory of Physical Anthropology,New York
1986, p. 41; for the latter, L. C. MacKinney and T.
Herndon, 'Tradition Against Independent Investigation
in Pre-modern Craniology', in Laudatorestemporisacti:
Studies in Memoryof WallaceEverettCaldwellProfessorof
Historyat the Universityof North CarolinabyHis Friendsand
Students(James Sprunt Studies in History and Political
Science, xlvi), Chapel Hill, North Carolina 1964, pp.
121-30.
15 L. Schiebinger, The Mind Has No Sex? Womenin the
Origins of Modern Science, Cambridge, Mass. 1989, pp.
180-4.
16 An opinion Vesalius vigorously refuted in the preface to the Fabrica.
64
NANCY SIRAISI
'complete except for the illustrations';17 and twentieth-century editors reflected
the enduring historical importance of Vesalius's contribution to the development
of anatomical illustration by publishing The Illustrations from the Works of Andreas
Vesalius.'8 In the Fabrica itself, text and illustration are not only bridged by detailed
captions, but continuously linked by the fine network of superscript and gutter
references in the text to the lettering of illustrations. In some instances a conscientious reader must turn from text to picture and back again over a hundred times in
a single short chapter.19 Text and illustration thus function together, but they are
not reduplicative. Only the text allowed for simultaneous participation in and critical evaluation of learned tradition, the verbal expression of descriptive detail, and
the presence of nuance and qualification.
Also ambiguous is the relationship of the Fabrica to its most authoritative predecessor, namely the anatomical works of Galen, and to contemporary genres of
interpretative and pedagogical writing. One possible way of reading the Fabrica is
as an endeavour to produce a single, unified manual that would replace a set of
older works, in this case Galen's. Such a reading makes it tempting to associate the
Fabrica, along with Fernel's Universa medicina, with the beginning stages of the process-to
be further developed in the late sixteenth and seventeenth centuries-of
replacing teaching by commentary on ancient authors with teaching from modern
comprehensive surveys.20
Yet the Fabrica does not really fit the description just given at all closely. For one
thing, it was designed not as an introduction for students but for eruditi vir.21 For
another, Vesalius took it for granted-as
any learned author in the philologicallyoriented world of humanistic medicine would have done-that
Galen would be
read alongside the Fabrica:
If you have carefully worked your way through the things I have gone over in this chapter
and have, at last, thoroughly considered Galen's description of the superior maxilla, many
things in which I depart from his opinion will already have occurred to you, of which, even
though in the present discussion (being confident of your industry) I will not have noted all
of them, I shall include a few.22
17 'Novae autem huius editionis haec tibi statim utilitas est proposita, quod ingens immensumque volumen
facile tecum deferre possis, ut pote in enchiridii formam contactum et conclusum, atque in duasve tres
tomos divisum: eodem accedit maxima pretio detractio.
Autorem integrum exhibemus, iis solum, quae ad eiconum intelligentiam faciebant praetermissis...' Typographus lectori, Andreae VesaliiBruxellensis,de Humani
corporisfabrica,libri VII,Lyons 1552, i, verso of title page.
The printer was Jean de Tournes. The edition is pocket
size and in two volumes. Four illustrations of the skull
are included, i, pp. 130-2. I have no knowledge of the
size of the edition or its diffusion, or whether Harvey
Cushing's pessimistic estimate of its profitability was justified (H. Cushing, A Bio-Bibliography
of Andreas Vesalius,
New York 1943, p. 89). However, the copy in Cambridge
University Library was carefully studied by a 16thcentury reader who added manuscript annotations
(mostly in the form of underlining and cross-references
to Galen) in both volumes. Karen Reeds's reminder is
salutary: 'in both the medieval academic tradition and
in the humanist revival of classical tradition, words-not
pictures-held the first place' (K. M. Reeds, Botany in
Medieval and Renaissance Universities, New York and
London 1991, p. 145).
18 Saunders and
O'Malley (as in n. 14).
19 For
example, by my count more than 150 times in
Fabrica,1543, ii.3, occupying pp. 223-9. This chapter is
by no means unusual in this respect.
20 Jean Fernel, Universa medicina, Paris 1554. In the
section entitled 'Physiologia' this work incorporates the
author's De naturali parte medicinae libri septem, first
published in 1542. See also C. B. Schmitt, 'The Rise of
the Philosophical Textbook', The CambridgeHistory of
Renaissance Philosophy,ed. C. B. Schmitt et al., Cambridge 1988, pp. 792-804; N. G. Siraisi, Avicenna in
RenaissanceItaly,Princeton 1987, pp. 101-3, 295.
21 Fabrica,1543, preface, sig. *3v
22 'Caeterum si ad amussim singula quae hoc Capite
persecutus sum excusseris, ac demum non perfunctorie
Galeni superioris maxillae descriptionem evolveris,
permulta iam occurrerunt, in quibus ab illis placitis
declinem. quae etsi omnia in praesentia (tuae fidens
industriae) non commemoravero, nonnulla tamen
VESALIUS
65
Thus, rather than precluding continued direct study of Galen, the book demands it.
Furthermore, the objective of many, perhaps most, early modern textbooks was to
summarise the ancient works they replaced, not to discard the ancient author's
views, as the tradition of Aristotelian philosophical textbooks bears witness.23 In the
case of the Fabrica, however, an account of anatomy and especially physiology that
is in general Galenic is combined with numerous and forceful criticisms of Galen's
teachings on specific points. It is thus possible to relate aspects of the Fabrica to the
tradition of teaching by commentary and, in particular, to a flourishing genre of
Renaissance commentary that focused on sharp criticism of the commented author.
Perhaps in part because of Galen's example, both as a writer of commentaries and
a harsh critic of predecessors, the production of hostile commentaries seems to
have been especially characteristic of medical milieux.24 Indeed, at one time Vesalius planned to follow up the Fabrica with an even more thoroughgoing critique of
Galen's anatomy in conventional commentary format.25
The sometimes awkward fit between different aspects of the Fabrica can be
attributed to Vesalius's free adaptation and reorganisation of a variety of existing
genres of scientific pedagogy of his day (written, visual and practical) to create a
unique and highly original whole. The goal of this assemblage of approaches to the
that will
comprehensiveness
discipline of anatomy is evidently a methodological
allow the author to present as fully and clearly as possible 'knowledge of the parts
of the whole of the human body'.26
But just as the structure of his book required of its author a series of selections
among, and combinations of, existing possibilities, so too did his definition of
human anatomy. The way in which Vesalius chose to define anatomy as a discipline
constituted a motivation to present its subject, the human body, as idealised and
unchanging. In his preface, Vesalius defined anatomy as 'the scientia of the parts of
the human body' and as 'a branch of natural philosophy'.27 To make such assertions
was to link the status of anatomy to claims, long-established in Latin academic
medical tradition, that at least some parts of medicine were subalternated to natural
philosophy and qualified as scientia. In the Aristotelian sense of the term, scientia
subjiciam.' Ibid., i.9, p. 42. For Vesalius, as this chapter
makes clear, the term 'superior maxilla' embraced most
of the bones of the face.
23 C. B. Schmitt, 'Galilei and the Seventeenth-Century
Textbook Tradition', in his Reappraisalsin Renaissance
Thought, London 1989, no. XI (article originally published 1983), gives examples of textbooks that to some
extent reflected scientific innovation, but notes that
many others, especially those written before the later
17th century, did not.
24 Siraisi (as in n. 20), pp. 188-92, 200f (Matteo Corti
and Gianbattista da Monte); idem, 'Giovanni Argenterio and Sixteenth-Century Medical Innovation: Between Princely Patronage and Academic Controversy',
Osiris,vi, 1990, pp. 161-80 (167-75). Whereas Corti and
Da Monte criticised medieval authors (Mondino de'
Liuzzi and Avicenna) on whom they wrote commentaries, Argenterio attacked Galen himself.
25
'Quae omnia ostensurus sum meis in Galeni Anatomica annotationibus, iam pridem non infoeliciter
coeptis, ac seorsum aut cum Galeni libris multo quam
antea emendatioribus aliquando cudendis.' Fabrica,
1543, ii.46, p. 219 [319] (misprint for 319; the same
style will be used hereafter for other misprinted page
numbers in the 1543 edition). According to his own account, Vesalius destroyed this work, which had grown
into a vast volume, when he left for the imperial court
in 1543 (along with an expanded and improved version
of his commentary on Rhazes and his copies of Galen
bearing his manuscript marginalia), because he expected the reaction to it to be excessively hostile (A.
Vesalius, Radicis chynae usus, Basle 1546, pp. 279f).
Nevertheless, the promise that the work was forthcoming was repeated in the 1555 edition of the Fabrica
(p. 385).
26 '...de integro humani corporis partium cognitionem eo ordine in septem libros redegi...' Fabrica,
1543, preface, sig. *3V.
27 '...ac prorsus emortuam humani corporis partium
scientiam, ipse tot praestantium virorum exemplo
provocatus, huic pro mea virili, ac iis quibus possem
rationibus opem ferendam duxi...hoc naturalis philosophiae membrum ita ab inferis revocandum putavi'.
Ibid., sig. *3r.
66
NANCY SIRAISI
(episteme) was understood to refer to certain knowledge about a distinctly defined
subject, achieved by rational demonstrations based on generally accepted premises
and leading to universally valid conclusions. The part of medicine for which the
status of scientia was usually claimed was theoria, essentially an amalgam of philosophy of medicine and basic physiology.28 Although similar claims to scientia were
sometimes made on behalf of practica and even surgery,29 these branches of medicine were more likely to be classified as artes because of their immediately practical
goals, the lack of rational demonstrations in the Aristotelian sense in their procedures, and the fact that they yielded only information about a multitude of temporal particulars and not universally valid and permanent truths.
From time to time Vesalius further stressed the status of anatomy as scientia by
pointing out that it led to a kind of knowledge about the human body that did not
necessarily have any directly practical, therapeutic objective. Thus, he remarked of
the study of the bony structure of the orbit of the eye, 'if now you are led to contemplating the fabrica of man in this way you will grasp things which although they
do not greatly conduce to the usefulness of the art [of medicine], yet demonstrate
the admirable industry of the great Creator and which without doubt were sedulously and studiously examined by the ancient professors of anatomy.'30 This is
clearly the language of scientia and, indeed, natural philosophy. However, it also
deserves to be noted that actual surgical applications were never far from Vesalius's
mind; on the page following the remark just quoted, he denounced the practice of
applying cauteries to the site of the junction of the sutures of the skull, taking the
trouble to amplify the criticism in his revisions for the edition of 1555.31 Elsewhere
he noted that an accurate understanding of the way in which the bones and muscles
of the arm functioned together was 'pleasing to sight and knowledge'-but
also
ensured that 'we knew with the greatest certainty that we had replaced a broken
and dislocated bone correctly'.32
Moreover, anatomical knowledge necessarily involved the assembling of information about large numbers of particulars. The sixteenth-century expansion of
28 Aristotle's own
explanations of episteme,techneand
related concepts are to be found principally in Posterior
Analytics, i, Metaphysics,i.1-2, 980b21-83a23, and NicomacheanEthics,vi.3-11, 1139b14-43b17 (I do not here
address the question of internal consistency among
these and other Aristotelian passages). For discussion of
the use of the concept of scientia in Latin scholastic
medicine see Siraisi (as in n. 20), pp. 226-38; also idem,
'Medicine, Physiology and Anatomy in Early SixteenthCentury Critiques of the Arts and Sciences', New Perspectives on RenaissanceThought,ed. J. Henry and S. Hutton,
London 1990, pp. 214-29 (217-21); P.-G. Ottosson,
ScholasticMedicineand Philosophy:A Studyof Commentaries
on Galen'sTegni,Naples 1984, pp. 65-126.
29 C. Crisciani, 'History, Novelty, and Progress in
Scholastic Medicine', Osiris,vi, 1990, pp. 118-39; N. G.
Siraisi, 'How to Write a Latin Book on Surgery: Organizing Principles and Authorial Devices in Guglielmo da
Saliceto and Dino del Garbo', Practical Medicinefrom
Salerno to the Black Death, ed. L. Garcia Ballester et al.,
Cambridge 1993, pp. 88-109.
30 'si modo in hominis fabrica huiusmodi etiam
duxeris intuenda, atque illis caperis, quae etsi ad artis
usum non magnopere conducunt, immensi tamen
Creatoris admirabilem arguunt industriam, et proculdubio a veteribus Anatomes professoribus sedulo ac
studiose examinata fuerunt.' Fabrica,1543, i.6, p. 29.
31 ... medici huic cauteria vulgo dicta, vel candescente
auro, vel ferro, vel urente quopiam medicamine, pro
affectus ratione (sed parum tuto interim [added 1555,
p. 37: exiguo atque commodo]) adhibent.' Ibid., p. 30.
32 'Hanc [referring to a part of the ulna] Natura trium
musculorum gratia produxit, qui ab ipsa triplici principio originem ducunt. Ac primum quidem eius musculi
est, qui inter radium in supinum ducentium brevior
habebitur. secundum autem et tertium pollicis ac indicis
famulari motibus, in secundo libro docebimus: quem
eo leviori negocio intelliges, quo consideratius ea quae
modo narramus, in ossibus spectaveris. Sunt enim haec
non minus visu ac cognitu iucunda, quam cerebri et
aliarum, quas hodie solum miramur, partium sectio. ut
interim de summo in artis nostrae operibus usu nihil
dicam, dum ad has lineas scopum figentes, fractum ac
luxatum os rite nos reposuisse certissimo cognoscimus.'
Ibid., i.24, p. 112.
VESALIUS
67
interest in various branches of natural history, as well as in anatomy, presumably
testifies to a general enhancement in this period of the intellectual status of collecting, inspecting, and describing.3 Unlike Baconianism in the following century, this
interest still drew much of its inspiration from the classical past. Closer attention to
objects in nature was combined with closer attention to the empirical and the deto the Aristotelian works on animals, to Theoscriptive in ancient science-whether
phrastus and Dioscorides, or to Galen the anatomist. In this context it seems entirely legitimate to group these branches of knowledge together as'descriptive sciences',
even though the term is not a sixteenth-century one. Certainly the activities and
statements of sixteenth-century anatomists, botanists, zoologists and so on appear to
reflect their unanimous conviction th
that empirical knowledge (whether first hand or
reported) and descriptive procedures, both verbal and visual, had a valid place in
natural philosophy.34 Few or none among sixteenth-century works in any branch of
natural history, however, approach the level of detail in both verbal and visual description that characterises, for example, the Fabrica's chapters on the vertebrae.
But what of the epistemological status of the knowledge that ultimately resulted
from an asserted scientia of human anatomy? Could such a discipline be said to yield
universal and, while this world lasted, permanent truths about a distinct, unified
subject? To contemporaries, the multiple methods ofVesalian anatomy (illustration,
narration, dissection) and its multiple details about the multiple parts of the human
than had hitherto ever been collected in any single anatomical workbody-more
may have seemed to fragment rather than unify the subject. Something of this attitude emerges from the way in which Niccolo Massa damned the recently published
the Fabrica with faint praise. After claiming that he had not read the book because
he was too busy attending the sick to have time for vast volumes, he grudgingly
acknowledged that it must have taken a lot of work 'in collecting'. Massa, who had
written his own introductory survey of anatomy, also warned that the usefulness of
great amounts of detail was limited by practical considerations: 'the parts of the
living body may be innumerable, so that if you wanted to run through everything
about all of them... a year would not be long enough'.35
33
Helpful recent studies addressing these developments include Reeds (as in n. 17); P. Findlen, Possessing
Nature: Museums, Collecting,and ScientificCulturein Early
ModernItaly, Berkeley and Los Angeles 1994; S. Tugnoli
Pattaro, Metodoe sistema delle scienzenel pensierodi Ulisse
Aldrovandi,Bologna 1981; N. Jardine, 'Epistemology of
the Sciences', CambridgeHistoryof RenaissancePhilosophy,
pp. 685-711; and W. B. Ashworth, 'Natural History and
the Emblematic World View', Reappraisalsof the Scientific Revolution, ed. D. C. Lindberg and R. Westman,
Cambridge 1990, pp. 304-32. Rossi (as in n. 10), pp.
1-62, is a useful account of the similarly enhanced
status of technical skill in this period, a development of
obvious relevance for anatomy. There is, of course, evidence of interest in assembling descriptions of plants
and animals in the Middle Ages (notably, for example,
in the paraphrase of the Aristotelian books on animals
by Albertus Magnus), but the status of such 'empirical'
knowledge remained relatively low. I shall not here
attempt to discuss the relation of increased 16th-century
interest in collecting and describing to the critique of
scholasticism and the recovery of ancient scepticism.
34 For example: 'Cum vero maximam huius scientiae
cum naturali philosophia cognationem animadverterem, nec ullum egregium aut certe doctum medicum
haberi, qui non altius prima methodi medendi rudimenta ex libris de natura tanquam fonte hausisset,
coepi et ipse philosophorum qui de rebus naturalibus
commentati sunt scripta cognoscere: In quibus illa
semper in primis me delectabant, quae de metallis,
plantis et animalibus tractata reperiebam. Idque duplici
nomine: Primum quia certior de istis scientia haberi
potest, quam de meteoris, et aliis quibusdam, vel nimium subtilibus et argutis, ac procul a sensu remotis, vel
eiusmodi ut firmam eorum cognitionem nec ratione
nec sensu satis sperare liceat'. C. Gesner, Historiae animalium Lib. I de Quadrupedibusviviparis (Zurich 1551),
Epistola nucupator-ia, from A. Serrai, ConradGesner,ed.
M. Cochetti, Rome 1990, p. 306. The last part of the
passage is an echo of Aristotle, Parts of Animals, i.5,
644b23-45a4.
35
'Ego qui plurimis negotiis in viscendis aegris detentus, volumina ingentia minime legere possum, sed
(ut verius dicam) ne libare quidem... Dii boni maximus
68
NANCY SIRAISI
But besides disciplinary definition and status there were also other reasonsboth practical and theoretical-to
emphasise the uniformity and standard character of the human body that was subject of anatomy. On practical grounds Vesalius,
just as much as Massa, believed in limiting detail for beginning students, as his
composition of the introductory Epitome shows. The case of the Fabrica was more
complex. In his book for eruditi viri he was committed to including as much detail
the inner circle
as possible. Yet in the world of sixteenth-century medicine-outside
who came to the book equipped with
of leading enthusiasts for anatomy-readers
the requisite sophisticated grasp of medical learned textual tradition were likely to
have far less experience of actual dissection, even as witnesses. Relatively few people
in the sixteenth century, even in medical settings, had the opportunity to carry out
the series of sixteen dissections that Leonardo da Vinci considered essential to
achieve anatomical understanding.36 Vesalius thought his readers were also likely to
have a keen interest in anatomical rarities and 'monstrosities' without any means of
judging their actual frequency or significance. Echoing Galen, he pointed out that
only those with wide experience of dissection were in a position to know whethehr
something was an anatomical rarity or not. Hence he explicitly declared his intention to focus his anatomical narrative, like his public dissections, on a 'canonical'
human body. However, the immediate context rendered his statement of this principle somewhat ambiguous, for it was appended to an account of his own observations of instances of variation in the azygos vein and its offshoots, that was not in
fact excluded from the Fabrica:
... if I observe these things in the course of carrying out public dissections, I pass them over
in silence as if they did not exist, lest candidates in arts should think these things are to be
observed in all bodies. The more pertinaciously they admire those monstrous things-as I
have learned more than once from experience-the more attentively I have thought that
this should be done, not only in dissections but now in following through the history of
perfect man. Since it would be a considerable disadvantage for them to have chanced upon
such a body, which varies greatly from the canon of men, for the entire dissection, unless
perhaps they had [previously] been present frequently at dissections of perfect and not
monstrous men.37
certe fuit labor in congerendo...At ego res haec [a detailed point by point critique of the Fabrica]nec ex tempore, nec etiam ex praemeditatione a me vobis declarabitur, etenim innumerae sunt, partes corporis animantis, quod si singulatim omnia omnes discurrere velitis, et
ego vobis respondere velim, annus non sufficeret'. N.
Massa, Epistolaemedicinaleset philosophicae,Venice 1550,
Ep. 5, fols 52r-53v. The passage does not mention Vesalius by name. In reality, Massa read some parts of the
Fabrica quite carefully, as in this epistle, despite his
disclaimers, he enumerated a number of specific criticisms.
36 One for the internal organs and three each to study,
respectively, arteries and veins, membranes, muscles
and ligaments, the skeleton, and individual bones; see
C. D. O'Malley andJ. B. de C. M. Saunders, Leonardoda
Vinci on the Human Body, New York 1952 (repr. 1982),
p. 32.
37 'Adeo ut si
quando in publicis sectionibus haec
observo, ea tanquam non essent, tacite praeteream, ne
artis candidati in omnibus corporibus haec observari
arbitrentur. Idque tanto, non in sectionibus solum, sed
modo in absoluti hominis historia persequenda, faciendum duxi studiosius, quanto pertinacius ipsos monstruosa illa admirari, experientia non semel didici:
quum interim ipsis dolendum magis esset, tale ad integram sectionem corpus obtigisse, quod ab hominum
canone plurimum variat, nisi forte etiam crebro absolutorum et non monstruosorum hominum sectionibus
astitissent, Galeni praecepta ad finem libri primi de
Administrandis sectionibus nobis datum nunquam
negligentes.' Fabrica, 1543, iii.7, p. 280 [380]. Part of
this passage is quoted in Straus and Temkin (as in n. 9),
p. 611.
VESALIUS
69
Theoretical considerations encouraging a presentation of human anatomy that
stressed not only uniformity but perfection may have included the anti-Galenic goal
of drawing a sharp line between human anatomy and the anatomy of quadrupeds
(which Vesalius also tended to treat as homogeneous, displaying little interest, for
example, in any differences between the anatomies of apes and dogs). But undoubtedly of great importance was the insistence of Galenic teleology on the perfection
of Nature's design of the human.38 The theme is central to On the Usefulness of the
Parts of the Body, Galen's most comprehensive general account of human physiology
and anatomy and perhaps the single Galenic work to which the Fabrica makes most
constant reference. Galen's approach is exemplified in his praise of Nature's skill in
constructing the human hand in the best possible way for 'an intelligent animal
and, alone of all creatures on earth godlike'.39 From On the Usefulness of the Parts a
reader might readily infer that the task of the anatomist is to present and explain
Nature's perfect design of the human body in its 'best', most fully realised form.
Thus Vesalius assumed that for Galen the idea of a perfect human body excluded
immaturity and old age, as well as individual variations or deformities; he noted that
it was a distortion to try to save Galen's description of the coccyx by claiming correspondence with the bones of children, because 'this as if Galen had put together
the historia of children, rather than men of middle age or animals'.40
Many factors thus combined to suggest that the subject of anatomy should be
in some sense a standard human body, which would express the common nature
of humankind. But it was not necessarily clear whether the standard should be
thought of as a pre-established ideal, or as being somehow derived from experience
of many individuals. The diversity of approaches characteristic of sixteenth-century
anatomical, botanical and natural-historical illustration suggests the ambiguity of
the issue for life scientists of the period. Plants, animals, and body parts were shown
in ways that ranged from exact portraiture of individual specimens, through depiction simplified and generalised to convey essential information clearly, to rationalisation on abstract principles.41 Examples of all these approaches can in one form
38 This
point is made by Straus and Temkin, ibid.
39
De usu partium, i.2. The translation is that of Galen
on the Usefulnessof the Parts of the Body, tr. M. T. May,
Ithaca 1968, i, p. 68.
40 '...eaque autoribus ipsis imponunt, quae ne per
somnium quidem cogitarunt, quaeque ab illorum sententia sunt prorsus aliena... Porro quum fingunt Galenum coccyx nostrum os merito cartilaginis loco habuisse,
quod ipsius ossa in pueris mollia et cartilaginea spectentur, et, ut ipsi aiunt, quatuor tantum cartilagines esse appareant, est eiusmodi, ac si Galenus puerorum potius,
quam mediae aetatis hominum, aut brutorum historiam
texuisset. At hi nimis obiter expendunt, hunc in multorum ossium substantia, in tota appendicum ratione, et
numero in primis, in costarum cartilaginibus, et alibi
fere centies, simiis et canibus, utpote siccissimis, maximeque osseis, ut sic dicam, animalibus, elegantius congruere, quam homini, prae caeteris fere humidissimo et
molli.' Fabrica,1555, i.18, p. 106. This chapter was largely rewritten by Vesalius for the 1555 edition.
41 A famous
example of depiction of imperfect individual specimens is provided by some of Hans Weiditz's
illustrations for Otto Brunfels, Herbarumvivae eicones,
Strasbourg 1530; see A. Arber, Herbals:Their Origin and
Evolution, Cambridge 1988 (reprint of 2nd edn), pp.
206-8. For the development of plant and animal studies
among artists in this period see F. Koreny, AlbertDiirer
and the Animal and Plant Studies of the Renaissance,Boston, Mass. 1985. Regarding generalisation and simplification in Renaissance depictions of plants and animals
see J. S. Ackerman, 'Early Renaissance "Naturalism"and
Scientific Illustration', in his DistancePoints, Cambridge,
Mass. 1991, pp. 185-203; and idem, 'The Involvement
of Artists in Renaissance Science', Scienceand theArts in
the Renaissance,ed. J. W. Shirley and F. D. Hoeniger,
Washington, DC 1985, pp. 94-129. On the varieties of
anatomical illustration, with an extremely perceptive
analysis of Vesalius's use of illustration, see M. Kemp,
"'The Mark of Truth": Looking and Learning in Some
Anatomical Illustrations from the Renaissance and
Eighteenth Century', Medicineand theFive Senses,ed. W.
F. Bynum and R. Porter, Cambridge 1993, pp. 85-121.
70
NANCY SIRAISI
or another be found in the Fabrica, but on the whole the illustrations are carefully
designed to convey specific anatomical lessons about a human body that is both
generalised and to an extent idealised. To name only a few of the most obvious
that in the Tabulae anatomicae sex,
examples, the skeleton in the Fabrica-unlike
which has been shown to reproduce defects of the individual specimen from which
it was drawn-was not only drawn from a specimen evidently selected for its perfection, but also, according to one interpretation, had its proportions adjusted to
match current artistic canons for the proportions of the ideal human body.42 The
torsos combine imitation of antique sculpture with the careful enhancement and in
some cases displacement of selected anatomical features so as to facilitate understanding.43 The caption to the illustration of the superficial muscles in what is
surely an idealised representation of an exceptionally well-developed young man in
plate 1 of the muscle series claims, in effect, that it shows what lies underneath the
superficial depictions of muscular and well proportioned men by painters and
sculptors.44
The emphasis in the narrative of the Fabrica is somewhat different. Vesalius
seems to have explicitly defined what he meant by a 'canon' of the human body on
only one occasion, in the course of setting out recommendations for the conduct of
dissection. Although his definition was initially couched in highly idealised terms,
he immediately introduced qualifications that radically modified the concept as
a basis for anatomy. He first stated that a cadaver for public dissection should
exemplify a standard of human perfection against which other bodies could be
measured: 'very temperate, according to the proper temperament for its sex, and of
middle age, so that other bodies can be compared to this as to the statue of Polycletus. '45 This criterion of physical perfection, which combined the internal,
42 Saunders and
43 Ackerman (as in n. 41), pp. 195-200; on Vesalius
O'Malley (as in n. 14), p. 84. C.
Singer and C. Rabin, A Prelude to Modern Science:Being and antique sculpture see also G. Harcourt, 'Andreas
a Discussion of the History, Sources& Circumstancesof the Vesalius and the Anatomy of Antique Sculpture', Rep7abulae AnatomicaeSex of Vesalius,Cambridge 1946, p. resentations,xvii, 1987, pp. 28-61.
44 'Quandoquidem tertia fere prima est, quam ad
xii. Anatomical anomalies, some of which Vesalius regarded as normal, in the plates of Fabrica, are noted disciplinam paravimus, praesens namque (uti nec conby Straus and Temkin (as in n. 9). On the history of Re- sequens) aliquid oculis subjicit, quod non in musculosis
naissance enthusiasm for theories of human proportion et quadratis, ut sic dicam, hominibus, eruditos pictores,
(most ultimately derived from Vitruvius) see E. Panof- sculptoresque indies etiam praecipue exprimere obsersky, 'The History of the Theory of Human Proportions vamus.' Fabrica,1543, p. 171. '...in hac expressimus, ut
as a Reflection of the History of Styles', in his Meaning ista simul cum secunda et nona illis carneae membranae sedibus non ita obscurarentur: quin commode id
in the Visual Arts, Garden City, NY 1955, pp. 55-107,
and F. Z6llner, Vitruvs Proportionsfigur:Quellenkritische universum proponerent, quod pictores et sculptores in
Studien zur Kunstliteraturim 15. und 16. Jahrhundert, musculorum ratione solum fere expendunt.' Fabrica,
Worms 1987. Vesalius's interest in proportion theory is 1555, p. 211.
45 'Corpus itaque publicae sectioni adhiberi convenit,
also evident from the following passage with its allusion
to the figure of the homoad circulum:'Sedes enim mu- in suo sexu quam temperatissimum, et aetatis mediae,
cronatae cartilagini proxima, aut ut Galenus alibi etiam ut ad hoc tanquam ad Policleti statuam alia corpora
astruit, umbilicus, haudquaquam erecti corporis medi- possis conferre.' Fabrica, 1543, v.19, p. 548. Harcourt
um est, verum elatissima pubis ossium regio. At si crura (as in n. 43) discusses this statement (and draws attensimul cum cervice illi negligerent, solo videlicet cor- tion to Galen as the probable source of Vesalius's inporis trunco (quem thoracem Aristoteles vocat) intel- formation about Polykleitos) from a somewhat different
lecto, fortasse regio mucronatae cartilagini subiecta in standpoint. The translation of 'quam temperatissimum'
as 'normal' in both Harcourt's article (p. 28) and
corporis medio consisterit, uti umbiliucs fere in homine
medius est, cui circulus obducitur, qui et manuum et O'Malley (as in n. 13), p. 343, is misleading to the
pedum, et verticis summum aequalibus fere intervallis extent that it masks the role of the theory of temperacomplectitur.' Fabrica,1543, v.3, p. 389 [489] (much ab- ments and may suggest an anachronistic conception of
norms.
breviated in the 1555 edition, p. 595).
71
VESALIUS
physiological ideal of harmoniously balanced temperament with an artistic standard
of beauty in external proportions, came directly from Galen, as did the term
'canon' applied to the human body. On several occasions Galen had invoked the
example of the ancient sculptor famous for his statues of male athletes, one of
which, from the perfection of its proportions, was known as the Canon.46 But, the
passage in the Fabrica continues immediately, private dissections, 'which occur more
frequently', should use bodies of all kinds, so that 'you may follow the difference of
bodies and the real nature of many diseases'.47 In revising these remarks for the
1555 edition, moreover, Vesalius abandoned the distinction between cadavers suitable for public and for private dissections. Instead, he urged his readers to appreciate how much could be learned from the bodies actually provided for public dissection, even though they were by no means all well proportioned or the right age.48
It is perhaps not a coincidence that the entire passage occurs in the concluding
chapter of book v, which opens with an forceful reminder of the essentially unstable
and fragile nature of even the most perfect living human body.49
Also in the revised edition, Vesalius included early in book i an explicit statement that the subject of his exposition was 'corporis humani affabre compositi historia'. In that passage he made it clear that 'affabre compositi' did not refer to ideal
proportions but merely to the absence of diseases and 'monstrous things'. These he
proposed to consider in a separate volume on pathological anatomy (never in fact
completed).50 The remark occurs in the context of a discussion of supposedly natural and unnatural shapes of the head (i.5), to which I shall return. Hence it seems
clear that Vesalius's primary conceptual classification of bodies was into healthy/
In his account of the healthy/natural body, Vesalnatural and diseased/unnatural.
ius occasionally cited instances of outstandingly beautiful form in individuals-for
example, the exceptionally elegant and mobile fingers of his friend or student
Giovanni Centurio.5' In general, however, the 'natural' body described in his text
46 Galen, De
i.9, in his Operaomnia, ed.
temperamentis,
C. G. Kuhn, Leipzig 1821-33, i, p. 566; also De placitis
Hippocratiset Platonis, v.3, ed. and tr. Phillip De Lacy,
Berlin 1981, i, p. 309; and De usu partium, xvii.1 (tr.
May, as in n. 39, ii, pp. 726f). Galen's statements about
the Canon are fully analysed in J. Pigeaud, 'Homo quadratus: variations sur la beaute et la sante dans la medecine antique', Gesnerus,xlii, 1985, pp. 337-52. Although
Galenic theory and subsequent medical tradition ascribed the most perfect temperament of any animal
species to man, it was generally held that completely
perfect human temperament was never actually present
in any individual (except, according to some speculations, in a few divinely favoured personages).
47 'In privatis autem sectionibus, quae crebrius accidunt, utile erit quodvis aggredi, ut cuiusmodi id quoque
sit expendas, corporumque differentiam, veramque
multorum morborum naturam assequaris'. Fabrica,
1543, v.19, p. 548, immediately following the sentence
quoted in n. 46.
48 'Quam sedulo enim, atque adeo ex nostro arbitratu
in Italicis academiis praefectorum diligentia, et erga
doctrinarum studia singulari amore, ad publicam anatomen cadavera nunc suppeditentur, non mediocri usu
discimus: et si fortasse illa non ita quadrata, etatis
mediae, ac nonnunquam optaremus, existant'. Fabrica,
1555, v.19, p. 682.
49 'Quum itaque tota hominis moles, etiam post
iustum ipsius incrementum, in perpetuo sit fluore,
quumque nisi altera similis substantia in defluxae locum
accederat, universa ilico evaporata dissiparetur, summus
rerum Opifex homini insitas quasdam vires, deficiens
ac desideratum semper appetentes, ab initio statim indidit.' Fabrica,1555, v.l, p. 589. The version in the 1543
edition, pp. 384f [484f], makes the same point at considerably greater length. The subjects of Fabrica,v, are
nutrition and reproduction.
50 'Caeterum eiusmodi perquam innumera alio Opere
latius persequemur, quo dissectorum a me historias, ad
morborum cognitionem, totiusque artis medicae tractationem apprime idoneas describemus: quum interim
praesente Opere, corporis humani affabre compositi
tantum historiam enarrare instituamus, monstruosa
omnia, et quae in male sanis aegrisque solum occurrerunt, silentio
praeterituri.'
Fabrica, 1555, i.5, pp. 24f.
This remark does not occur in the 1543 edition.
51 Fabrica, 1543, i.27, p. 124. Notice omitted in the
1555 edition, for which this whole chapter was largely
rewritten.
72
NANCY SIRAISI
is presented not as a pre-established ideal but as based on experience of many
bodies.52 This does not, of course, mean that Vesalius was able to establish norms
in a modern sense. To do so was neither conceptually nor practically possible, notwithstanding his exceptionally wide experience, for his time, of the dissection and
study of cadavers and the study of skeletal material of various ages and both sexes.
Furthermore not only Galenic prescriptions and anatomical tradition, but deeply
engrained social assumptions, and the practice of using executed criminals as the
primary source of dissection subjects, all combined to ensure that the natural body
which Vesalius took as the standard or canon for his description of human bones
and muscles would be that of a young to middle-aged adult male.
Yet, as was long ago demonstrated in a valuable study, Vesalius knew far more
about variability in the human body than any of his predecessors, and was greatly
interested in it. Notwithstanding his declared intention to relate the historia of the
natural or canonical body, he repeatedly referred to variations that he had noted
in individual dissection subjects.53 Moreover, in most of these remarks he did not
characterise these variations as 'monstrosities'. His comments on the number of the
thoracic vertebrae are typical and may serve as an example:
There are twelve thoracic vertebrae, except that sometimes, although rarely, one is lacking
or there is one too many. But it is rarer to find a body lacking one than a body with one too
many. For at Padua two bodies each endowed with thirteen thoracic vertebrae came into my
possession, but I have never seen one with only eleven.54
This comment and many others reveal both his recognition of the presence of
variations within the general category of the natural/healthy body and his intense
interest in determining the boundaries of the natural-but
also the practical difficulties in the way of accomplishing the latter. Nevertheless, an attentive reader of
the Fabrica would be left in no doubt that, whatever the theoretical and practical
advantages of presenting a common nature of human bodies, in reality variations
occurred in the natural/healthy body. This information is not conveyed by means
of any general statement but rather by the citation of instances from time to time in
numerous particular anatomical contexts.
Vesalius's attention to anatomical variability and, as will become apparent, to
broader categories of diversity among human bodies, was doubtless the result of
the enlarged place of detailed observation in sixteenth-century anatomy, as in other
sciences. But it also deserves to be considered alongside other more picturesque
instances of sixteenth-century concern to delimit the bounds of the natural. Anatomy was only one of many areas of study and experience in which this concern was
expressed. Indeed, Vesalius's shifting use of the terms 'natural' and 'monstrous' and
related expressions provides some excellent examples of uncertainty about these
52 This idea too could be found in Galen: in De
temperamentis,i.9 (as in n. 46), Galen claimed that
both well-balanced temperament (krasis, complexio)and
beauty of proportion were empirically determined
means, derived from numerous examples by experts
with wide knowledge of many individuals.
53 Straus and Temkin (as in n. 9),
p. 613. These
authors consider a number of examples in detail. Book
iii of the Fabrica also contains some general, or programmatic, statements about variability in the veins,
for example the subheading 'Venarum seriem crebro
variare', Fabrica,1543, iii.8, p. 288 [388].
54 'Thoracis vertebrae numerantur duodecim, praeterquam quod aliquando, tametsi raro, aliquibus vel deest
una, vel superest. Sed deesse rarius, quam superesse,
invenitur. Patavii nanque duo corpora, tredecim singula
thoracis donata vertebris mihi occurrerunt, quum interim hactenus undecim tantum vertebras nunquam viderim.' Fabrica,1543, i.16, p. 72. 'Patavii' is omitted in the
1555 edition.
VESALIUS
73
concepts in Renaissance culture. Ancient accounts of distant or monstrous races,
current reports of individual monstrosities or deformities, and more or less contemporary travellers' tales from the East and the New World, all provided material for
learned discussion, which still usually tended to treat information from all these
and equally reliable.55 Moreover, for Renaistypes of source as contemporaneous
sance commentators on human variety, Vesalius among them, the boundaries between individual and group characteristics were by no means securely established.
In some respects, Vesalius's remarks about characteristics of skeletal and muscular anatomy which he ascribed to such fundamental categories of human physical
diversity as age and sex, and those he attributed to members of particular peoples
and cultures, display considerable similarities to his handling of variability among
individuals. I do not, of course, mean to claim that he actually viewed all these
categories of difference in the same light. Evidently it would have been impossible
to do so in a society in which age and gender were powerful and ever-present social,
legal, and political categories, in a way that anatomical rarities or even the ascribed
characteristics of various peoples obviously were not. What is similar is his equal
interest and his method of presenting anatomical information about diversity from
the 'canonical' body. The general presentation of a uniform human anatomy of
bones, cartilage and muscles is qualified by scatterd remarks on points of detail
which cumulatively reveal Vesalius's considerable attention to broad as well as narrower categories of diversity. Moreover, on these as on many other topics the information provided and views expressed represent a mixture of his own findings and
material taken over chiefly from Galen but also from other ancient sources. Although the subject matter of books i and ii is so closely integrated that they must be
treated as a unit, they differ signficantly in the amount of attention they devote to
the topics under review. Both books have as a central theme the mechanical interaction of bone, cartilage and skeletal muscle to stabilise and aabove all to provide
for the voluntary motions of the body. However, comments on age, sex, and group
differences mainly cluster in book i, although sex difference also receives some
attention in book ii. The bones Vesalius was able to study were of course likely to be
more diversified, at any rate as to age and sex, than most of his dissection subjects.
AGE
Despite Vesalius's general presentation of a young to middle-aged adult human
body, book i of the Fabrica displays a persistent interest in the different characteristics of bones and cartilage at different stages of life. No doubt, as far as the underlying physiology of changes from infancy to old age was concerned, Vesalius took
for granted the aspect of the Galenic theory of temperament (crasis, complexio)
which explained that the balance of elementary qualities in the human body moved
from moistness and warmth in infancy toward dryness and coldness in old age.56
55 The
scope of 16th-century writing on these topics 1964, 1971; K. Park and L. J. Daston, 'Unnatural
is far too vast and diverse to be indicated here; some Conceptions: The Study of Monsters in Sixteenth- and
useful studies include J. Ceard, La nature et les prodiges: Seventeenth-Century France and England', Past and
L'insolite au XVI siecle en France, Paris 1977; J. B. Friedman, The Monstrous Races in Medieval Art and Thought,
Present, xcii, 1981, pp. 20-54; A. T. Grafton, New Worlds
Ancient Texts, Cambridge, Mass. 1992, pp. 97-157.
Cambridge, Mass. 1981; M. Hodgen, Early Anthropology 56 Vesalius certainly took for granted the related ideas
in the Sixteenth and SeventeenthCenturies,Philadelphia that each bodily part and each animal species had its
74
NANCY SIRAISI
Quite different from anything in Galen's anatomical works, however, is the way in
which the attention of the reader of book i of the Fabrica is repeatedly drawn to differences between juvenile and adult specimens. The most emphatic and memorable
passage on the topic is worth quoting in full.
For if I never knew the bones of old men to be different from those of youths, and those of
boys again from youths, I would certainly have learned it in the recent anatomy at Bologna.
On that occasion, because I was teaching Galen's On the Bones there before the dissection of
muscles, besides a number of [other] bones, the bones of a newborn male infant, of an old
man in his nineties, and of middle-aged men were sedulously brought into the schools by
the candidates in medicine. For since many of them prepared for themselves bones for inspection from broken tombs and bodies collected from hospitals, it easily happened that
one of them chanced upon the bones of an old man, another on those of a boy and again
another on those of this or that age of men, and they carried them into the school. Then
therefore (that the discourse may return to its subject) we find that in the bones of newborn
infants all are smooth, disjoined, soft, full of cartilage, with the processes very little prominent and many of the bones that are considered to be one in adults are in them made up
from several. For the sake of fractures, dislocations, distortions, and twistings in individual
bones, I am not at all reluctant to add this to the lesson. Both scholars of true medicine who
have pored over the books of Hippocrates57 and those who have learned from daily experience that in children the dislocation of the appendices [epiphyses] from the bones occurs
more frequently than dislocation of the joints58... understand very clearly how important it
is to know this.59
Moreover, the foregoing passage was not, as was once supposed, completely
eliminated from the 1555 edition. Instead, abbreviated and stripped of its dramatic
and anecdotal quality, it was appropriately relocated to a chapter giving instructions
same chapter in which the recommenon how to conduct an anatomy lesson-the
dations for the type of cadaver that should be used for dissection were so carefully
revised.60 Perhaps more importantly, in both the original edition of 1543 and the
own characteristic temperament: the first chapter of the
Fabrica opens with the words 'Os caeterarum hominis
partium est durissimum, et aridissimum, maximequae
terrestre et frigidum...'; see also nn. 40, 76. For Galen's
own ideas on temperament and the life cycle, repeated
ii.2,
by innumerable later authors, see De temperamentis,
(Kuhn, as in n. 46, i, pp. 577-82). On medieval and
Renaissance ideas about aging in general see E. Sears,
'The
Agesof Man, Princeton 1986.
57 OnJoints,46, Hippocrates,iii, with translation by E. T.
Withington (Loeb Classical Library), repr. Cambridge,
Mass. 1984, pp. 290-2.
58 As is the case. See K. L. Moore, Clinically Oriented
Anatomy,2nd edn, Baltimore 1985, p. 675.
59 'Nam etsi nunquam senum ossa a iuvenum ossibus,
et puerorum rursus a iuvenum variare cognovissem, in
postrema Bononiensi Anatome id sane didicissem, ubi
praeter quamplurima ossa, iam nati pueruli ossa, et
nonagenarii senis, et mediae aetatis hominum ossa in
scholis sedulo a medicinae candidatis adferebantur,
quum Galeni librum de Ossibus ante musculorum sectionem istic enarrarem. Quando enim permulti effractis
monumentis, atque ex xenodochiis conquisitis corporibus ossa ad inspectionem sibi parabant, facile accidit ut
alius in senis, alius in pueri, ac rursus alius in huius
illiusque aetatis hominum ossa inciderent, atque in
scholas deportarent. Tunc itaque (ut ad se revertatur
oratio) in puerulorum ossibus omnia est laevia, disiuncta, mollia, pleraque cartilaginea, et processus minimum prominere, et quamplurima quae in adultis unius
ossis loco habentur, in illis ex pluribus construi expendimus: quae in singulis ossibus fracturarum, luxationum,
distorsionum, et plicationum gratia, sermoni addere
haud gravabor. Quanti enim momenti sit haec novisse,
abunde intelligunt, tum qui verae medicinae studiosi
Hippocratis libros evolverunt: tum qui appendices in
pueris ab ossibus saepius quam articulos luxari, quotidiana experientia didicere, ac ab ineunte aetate luxatos,
aut aliter in ossibus affectos, aliquando sectioni accomodarunt.' Fabrica,1543, i.6, p. 27.
60 '...sedulo effeci, ut variorum hominum ossa mihi
ad manum essent, quaedam invicem attexta, quaedam
seiuncta ac in arculis posita: puerorum dico, iuvenum,
senum mulierun et virorum ossa, quae tum mea, turn
aliorum medicinae candidatorum diligentia in Italiae
scholis mihi magno numero et copia adfuere'. Fabrica,
1555, v.19, p. 681. O'Malley (as in n. 13), pp. 277f,
noted the removal of the entire passage from book i and
suggested that this was because of the overt reference
to tomb robbing, which was indeed eliminated in the
VESALIUS
75
1555 revision, the same information about age-related changes is conveyed by repeated comments in chapter after chapter on individual bones and their associated
cartilages. Repetition and detail are much more characteristic of Vesalius the
teacher than broad generalisations. From the description of varieties of cartilage in
chapter 2 to the concluding instructions on how to prepare and mount a skeleton
for oneself in chapter 39 (chapter 40 in the 1555 edition), the reader encounters
one reminder after another that bones, cartilage, and joints change with age. To
mention only a few of many possible examples, in chapter 3, on the parts of bones,
the reader is instructed to observe the nature of the epiphyses in young animals
when served a joint of veal or lamb (Vesalius urged anatomical observation at the
table with a frequency that would make any compliant reader a trying dinner companion). Chapter 6 includes discussion of the obliteration of the sutures in the
skulls of old people and the unclosed sutures of infants.61' Gabriele Falloppia's criticism of the erroneous description of the deciduous teeth of children in chapter
11 is well-known, as is Vesalius's self-satisfied comment on the eruption of his own
wisdom teeth while he was writing the Fabrica.62 Changes from childhood to old
age are also noted for the cervical vertebrae, sacrum, ribs, scapula, and sesamoid
bones. 63 And at least two of the innumerable minor verbal revisions by the author
that characterise the 1555 edition consist of the addition of phrases about characteristics of individual bones in juvenile specimens.64
In striking contrast to the repeated references to the special characteristics of
immaturity and old age in book i, the subject disappears completely from book ii on
the muscles. As noted, the absence of age from book ii may be simply a reflection of
the relatively restricted age range of most of Vesalius's dissection subjects. But it is
evidently also a consequence of an approach to teaching about muscle that, as will
become apparent, did not address the topic of increase or decrease in muscle mass
and strength, or the reasons for it.
SEX
As is well known, the exposition of female anatomy in the Fabrica chiefly concerns
the reproductive organs and is mostly to be found in the chapters on generation in
book v.65 Nevertheless, discussion of real and supposed sex differences also occurs
shorter version in the 1555 edition.
61 Fabrica,1543,
pp. 4f, 7, 27, 31, and, finally, 'Coctioni
[of bones when preparing a skeleton] nullum tempus
praefinitur, quum id ex aetatum ratione plurimum
variet. Duabus enim aut tribus horis plusquam satis sit,
puerulorum ossa coquuntur praecipue, quum in illis
studendum sit, ne inter mundandum ossa, appendices
decidant: quarum coalitus in provectioris aetatis hominibus vix unquam, quantumvis coxeris dissolvitur'
(ibid., p. 157).
62 Fabrica, 1543,
pp. 46f. G. Falloppia, Observationes
anatomicaein his Omnia... opera,Venice 1584, fols 230r31'. The remark 'Id quod ipse etiam modo experior, cui
haec scribenti trigesimus secundus dens aetatis vigesimo
sexto anno succrescit' (Fabrica, 1543, i.ll, p. 46), still
called attention to the youth of the author in the revised
edition published 12 years after the first (Fabrica,1555,
p. 58).
63 Fabrica, 1543, i.15,
p. 71 (in a different location
within the chapter in the 1555 edition, p. 83); i.18, pp.
83, 85; i.19, p. 90; i.21, p. 98; i.28, p. 126 (amplified
1555, p. 152).
64 'Deinde praesentis sinus supercilia [added 1555,
p. 158: quae nonnullis puerulis appendice efformata
vidimus] in anteriori ipsius sede levius, quam in posteriori protuberant', Fabrica,1543, i.29, p. 130. Also, 'huic
etenim depressae et utcunque asperae calcis [calcis
omitted 1555] parti [added 1555, p. 178: (quae in
pueris appendice constat)] tendo implantatur', Fabrica,
1543, i.33, p. 146.
65 The implications for the history of
gender of Renaissance views of female anatomy and physiology are
discussed by I. Maclean, The Renaissance Notion of
Woman,Cambridge 1980, pp. 28-46; Schiebinger (as in
n. 15), chap. 6 (as far as Vesalius is concerned, chiefly
with reference to the Epitomeand the diffusion of his
76
NANCY SIRAISI
in other contexts, including that of skeletal and muscular anatomy. As one might by
this time expect, the subject of sex difference in bones and muscles is not addressed
at the level of generalisation: neither the 1543 nor the revised 1555 edition includes
in its text any general statement about relative size, mass, or proportion in bones
and muscles of the two sexes. Characteristically, even the underlying assumption
that the framework of the skeleton was designed by Nature to accommodate equally
the functions of both sexes is allowed to emerge from a passing remark in the
chapter on the thorax, which explains that one reason why the abdomen, unlike the
thorax, is not surrounded by a bony structure is to allow for the swelling of pregnancy. (This assertion, like most of Vesalius's more imaginative flights of teleology,
is a more or less direct quotation from Galen's On the Usefulness of the Parts; a parallel reflection comments that if the abdomen were rigidly confined by bone, so that
food and drink had to be consumed continuously like air, mankind would have no
time for philosophy and the muses.)66
But just as in the case of age differences, comments in books i and ii on individual bones and muscles repeatedly draw the reader's attention to sexual differentiation. The information conveyed, unlike that about aging, has a double thrust:
it is concerned both to repudiate alleged differences between male and female that
Vesalius judged to be imaginary, as well as to describe those he identified as real.
Supposed differences between men and women denied by Vesalius relate to the
number of cranial sutures, teeth, and ribs. The first two of these beliefs had the
authority of Aristotle. Correction of Aristotle's assertions about the number of the
teeth was, as Vesalius remarked, merely a matter of counting. The sutures presented
a more complex issue. Aristotle's claim about the distribution of the cranial sutures
was a consequence of his conception of their function, which he believed to be
to allow ventilation of the brain; the brain of man, allegedly larger than that of
woman, demanded a more elaborate set of sutures than hers.67 In the Fabrica, the
function of the cranial sutures is explained in terms of a modified Galenism. Following Galen, Vesalius allowed some role to the sutures as outlets for vaporous excrements rising to the top of the body like smoke to the roof of a house; however, he
made it plain that he regarded any excretory function as secondary in importance
to the attachment of fibres of the dura mater.68 Vesalius, like Galen, ignored the
topic of brain size. Thus, Vesalius's superior observational knowledge of the anatomy of the skull, his generally anti-Aristotelian stance, and perhaps his underlying
Galenism combined to render invisible the generalisation from body size, or gender
stereotypes, or both, that presumably was the ultimate basis of Aristotle's account of
the sutures.
illustrations); T. Laqueur, Making Sex: Body and Gender
from the Greeksto Freud,Cambridge, Mass. 1990, pp. 63148, a work presenting a somewhat controversial interpretation of premodern sexual physiology and anatomy. Although he criticised Galen's description of the
anatomy of the uterus, Vesalius's understanding of
female physiology was largely Galenic; his social views
concerning women were, as far as can be determined,
entirely conventional for his time. Both aspects appear
in Fabrica,1543, v.15, pp. 529-39.
66 Fabrica, 1543, i.19, p. 89. Compare Galen, De usu
partium,vii.21 (Kuhn, as in n. 46, iii, p. 601). The entire
passage was omitted from the 1555 edition of the
Fabrica.
67 Parts of Animals, ii.7, 653a26-b4; History of Animals,
ii.3, 501b20-4. The 19th-century history of essentially
similar ideas about the brain is summarised in S. J.
Gould, The Mismeasureof Man, New York 1981, pp.
103-8.
68 De usu partium, ix.l (Kuhn, as in n. 46, iii, p. 688);
Fabrica,1543, i.6, p. 26; the passage is extensively revised
to emphasise the connections with the dura mater still
further, Fabrica,1555, pp. 31f.
VESALIUS
77
According to Vesalius, not learned but popular tradition was responsible for the
belief that men and women differed in the number of their ribs. Men were supposed to have one more, the survivor of an extra pair that had yielded the rib for
the creation of Eve. The treatment of this topic in the Fabrica foreshadows the medical interest in categorising and exploding 'popular errors' that emerged in the later
sixteenth and seventeenth centuries. To identify an idea as an opinion of the vulgar
was to open it to learned criticism, in this case notwithstanding a tangential association with Scripture. In terms blunter than he usually applied to learned authors,
Vesalius characterised the belief in question as 'plainly ridiculous', allowing however
that Adam himself (alone) might have had one fewer rib than the rest of humankind.69
Remarks differentiating between male and female bones and cartilage range
from a succinct description of the difference between the male and female thyroid
cartilage (termed by Vesalius the scutiform or shield-shaped cartilage) of the larynx,
to considerably less substantial or significant observations: for example, an allusion
to the thinning of the mandible (for Vesalius the lower maxilla) in toothless old
women or a passing remark that bone structure was responsible for 'very beautiful'
tapering female fingers. He also mistakenly believed that he had found minute
ossicles in the male larynx that were lacking in women-an
error that certainly
a
constant
alertness
to
the
of
sexual
difference.70
suggests
possibility
However, Vesalius properly gave his fullest attention to the one structure by
which a female skeleton could most securely be identified, namely the pelvis. In a
pioneering passage of exposition he described and compared, substantially and in
detail, the size, shape, and relation of the bones of the female and male pelvic
girdles:
But the anterior bone which is called the pubis is seen to be thin everywhere, and the right
bone is joined to the left by the intervention of cartilage as if in the manner of union
[symphysis pubis]. For by the extent to which a person is more advanced in age that connection is less filled with cartilage, or shows less cartilage. And that is common to men and
women.
The differenceof connectionsof the bonesto the sacrumin men and women
For in no way should it be thought, on account of the opinion of the vulgar [substituted1555:
plebian medical practitioners], that the bones of the pubis are continuous in men, but held
together by intervening cartilage in women so that at when they give birth the bones can be
released and unjoined from one another. For in parturient women (and in quadrupeds)
these bones are by no means disjoined from one another; but women have a special characteristic in the joining of these bones, in that in them they are not connected by as long a line
as in men. Then the lowest parts of the bones of the coxendix [ischium], at the right I say,
and the left, are much further apart in women than in men. Besides, the lowest parts of the
bones of the pubis, where they are separated beneath their connection, are much further
apart and distant from one another [added 1555: and rendered sinuous and thin] in women
than in men. Moreover, in the bones of women the empty space between the coccyx and the
69 Fabrica, 1543, i.19,
p. 89. A specific reference to
Genesis 2 is omitted from the 1555 edition, p. 111.
70 Fabrica, 1543, i.38,
p. 153; i.10, p. 44; i.27, p. 122.
For Vesalius on the larynx see now D. H. Garrison and
M. H. Hast, 'Andreas Vesalius on the Larynx and Hyoid
Bone: An Annotated Translation from the 1543 and
1555 Editions of De humani corporisfabrica', Medical
History,xxxvii, 1993, pp. 3-36, which is accompanied by
useful anatomical annotation. For the probable basis of
the erroneous claim see ibid., p. 9 and nn. 10, 20.
78
NANCY SIRAISI
internal regions of the lowest parts of the coxendix is much ampler than in men. This difference is so notable that it alone should make abundantly clear that the pubis bone is not
opened during parturition, even as by touch within in the process of giving birth the same
thing, with difficulty, may be attested... But in order that they carry the uterus with less
trouble and more lightly, the ilia of women are much broader and their crests drawn out to
the sides much further than in men, and also those bones are more notably curved outward,
and, that I may say it once, these form a convenient place for the gestation of the foetus. But
I think it will be hidden from no-one who is studious of dissection that among no peoples is
the bone of the pubis either compressed or disjointed for the sake of allowing young women
to give birth to infants more easily, however much the vulgar pertinaciously affirm it, now
about this nation, now about that.71
As is evident from this passage, in the case of the female pelvis, as in that of the
ribs, Vesalius was primarily concerned to challenge an 'opinion of the vulgar', or as
he revised the expression subsequently, of 'plebeian medical practitioners'. These
individuals believed that in women-or
at any rate the women of certain peoples
-the
bones
were
pelvic
separated by compressed cartilage which expanded to
allow for giving birth. The same belief was among the 'popular errors' excoriated by
Laurent Joubert in his eponymously titled work first published in 1578. Although
Joubert, who attributed the belief to 'ignorance of anatomy', provided a very general description of the bones of the pelvis, he did not mention any difference between
male and female bones, referring instead to the narrow passage through the pelvis
as the cause of pain in childbirth. Like Vesalius, Joubert noted the propensity for
such stories to be told of particular peoples: he found it necessary to refute the
belief that Genoese mothers and midwives broke apart the bones of their infant
71 Fabrica,1543, i.29,
pp. 131f. Words between // were
omitted in the revised edition of 1555; words between []
were added.
'Anterior vero, quae pubis os dicitur, tenuis utcunque
cernitur, et dextrum os sinistro cartilaginis interventu
quasi unionis modo committitur. quo enim homo aetate
sit provectior, eo semper connexus iste minus cartilagine oppletur, minusve cartilaginis ostendit. Atque id
viris pariter ac mulieribus commune est.
Ossiumsacroossi nexorumin viris et mulieribusdifferentia.
Neutiquam enim /ob vulgi sententiam/ [1555, p. 159:
cum plebeis medicis] arbitrandum est, pubis ossa viris
esse continua, mulieribus autem in hoc cartilaginis interventu compacta, ut partus tempore remitti atque invicem disiungi queant. Parturientibus nanque mulieribus
(uti neque quadrupedibus) haec ossa invicem haud disiunguntur: verum id mulieres in hoc ossium coalitu
peculiare sibi vendicant, quod ipsis non tam longa linea,
atque in viris, committuntur. Deinde coxendicis ossium
infimae partes, dextram dico et sinistram, in mulieribus
mutuo longe magis distant, quam viris. Praeterea infimae pubis ossium partes /invicem/ [1555: mutuo] sub
ipsorum connexu diremptae, multo etiam magis mulieribus quam viris seiunguntur ac [1555: veluti sinuatae,
tenuesque redditae, invicem] distant. Adeo ut in mulierum ossibus vacua sedes inter coccyx os et internas
regiones infimarum partium coxendicis ossium, multo
amplior quam in viris occurrat. haecque differentia tam
est insignis, ut vel ipsa abunde /doceat/ [1555: doceret], pubis ossa in partu non recludi, etiam si tactus
inter pariendum, idem non levi opera attestaretur.
/Quantum vero ad hanc amplam sedem magis adhuc
partus tempore dilatandam coccyx os iuvet, licet animalia, quae caudam habent, id liquido parientia ostendant: tamen id quoque in mulieribus observare integrum est, quibus id os extrorsum caudae modo adeo
porrigitur, et etiam huius ossis gratia ipsis sedes in circulum incisae apud omnes quas unquam vidi nationes adaptentur. Atque ideo etiam pleraeque mulieres genibus
innixae, quas unquam vidi nationes adaptentur. Atque
ideo etiam pleraeque mulieres genibus innixae, et aliquantisper antrorsum inflexae foelicius pariunt: quemadmodum contra erectae, aut retrorsum inclinatae,
difficilius. Atque ita excludendo foetui Natura foeminis/ [1555: Hac itaque ratione (ne id quod de coccyge
osse suo loco proditum est, adijciam) Natura foetui excludendo] prospexit. Quo autem minori negocio leviusque uterum gererent, ilium ossa mulieribus multo
ampliora sunt, ipsorumque spina in latera longe magis
quam in viris, educitur, et etiam illa ossa extrorsum
insignius cavantur: et ut semel dicam, haec commodam
gestando foetui sedem efformant. Quod autem nuper
natis puellis partus facilioris gratia, apud nullas gentes
pubis ossa aut comprimantur, aut disiungantur, neminem dissectionis studiosum latere arbitror: quantumvis
id pertinaciter vulgus nunc de his, nunc illis nationibus
affirmet.'
(The divisions of the bone of the hip used by Vesalius
ilium and pubis-had slightly different
-coxendix,
boundaries from the modern ischium, ilium and pubis.)
79
VESALIUS
daughters in order to facilitate childbirth later.72 Indeed, Vesalius's scorn for this
anatomical myth did not prevent him from including curious remarks about childbirth practices 'among all the nations I have ever seen' in the same passage (they
were eliminated from the second edition).
Unlike the subject of aging, that of sex difference remains present in book ii,
although treated in Vesalius's usual terse, economical, and allusive fashion. Thus,
the rubric at the head of an introductory chapter on the skin and subcutaneous
layer directs the reader to separate illustrations of male and female in book v-with
the impatient remark,
But these parts are in every way such that even without any illustration there is no-one who
does not recognise them, if only he has sometimes undertaken or witnessed a dissection.73
The descriptive scheme of book ii includes chapters on muscles associated by
Vesalius with the testicles, penis, and uterus, and these too share sex-differentiated
illustrations in book v by means of cross-references. The device is typical of Vesalius's efficient use of his lavish illustration scheme. 74 A primary goal of book ii was
to teach how to demonstrate the muscles by dissection, that is, how to acquire the
technical skill to which Vesalius himself principally owed his reputation as a practicing anatomist and which was, it would seem, the main source of his pride and
self-confidence. Accordingly, in book ii alone descriptive chapters alternate with
chapters of instructions for dissection. In these chapters, occasional reminders of
differences in body mass and muscular development between men and women are
included strictly as a matter of practical utility. These remarks primarily call attention to the greater amount and different distribution of fat in females, but also characterise muscles of the female buttock and thigh as poorly developed. 75
Since, following traditional Galenic physiological theory, Vesalius associated
the tendency to accumulate fat with the cold and humid complexio or temperament,
such as was ascribed to woman, he presumably regarded that tendency as an inherent characteristic.76 He offered readers of book ii no clue whether or to what extent he regarded female muscular development as capable of being altered by use
or occupation. However, occasional remarks obliquely draw the reader's attention
to a relation between habitual use and muscular development: such, for example, is
72 L. Joubert, Erreurs
populairesau fait de la medecineet
regimede sante, Bordeaux 1578, iv.l, pp. 331-9, tr. G. D.
de Rocher in L.Joubert, PopularErrors,Tuscaloosa 1989,
pp. 167f. Joubert believed that Genoese women did in
fact give birth with less pain than other women, but that
this was due to their sexual promiscuity. D. Jacquart, 'La
morphologie du corps feminin', Micrologus,i, 1993, pp.
81-98, shows that the belief that the bones separated
in childbirth grew out of efforts by scholastic commentators to interpret a cryptic phrase of Avicenna. She also
notes that the belief was still shared by Berengario da
Carpi, writing in 1522, although he endeavoured to
make it more anatomically precise and briefly remarked
on a difference of shape between the male and the
female pelvis (pp. 97f).
73 'Verum istae partes tales omnino sunt, quae citra
omnem figuram nemo non novit, si modo aut ipse sectionem aliquando aggressus fuerit, aut secanti astiterit.'
Fabrica, 1543, ii.5, p. 231, following
a cross-reference
forward to v, pls 20 and 25. The comment is omitted in
the 1555 edition, p. 277.
74
Fabrica,
1543, i.33, p. 285. Elsewhere,
in somewhat
comparable fashion, he economised on illustration by
reproducing the same figure in two different chapters,
but with a different index in each case: see ibid., i.6, fig.
5 and index, p. 22, and i.9, fig. 2 and index, p. 38. The
actual lettering on the figure is the same in each case,
but the two indices each refer to different items of
lettering.
75 Ibid., ii.2,
p. 222; ii.6, p. 234; ii.53, p. 231 [331];
ii.56, p. 239 [339].
76 'Atque adeps humidis frigidisque animalibus (ex
quo numerorum homo et porcus sunt) plurimus colligitur, siccis vero et calidis, nullus aut perquam exiguus, ut
leonibus, et canibus venaticis, ipsique etiam simiae.'
Ibid., ii.5, p. 233.
NANCY SIRAISI
80
the account of the entertainer at Padua whose jaw muscles were so strong that he
made his living by lifting weights with his teeth.77
TIME,
PEOPLES,
CULTURE
Although their cumulative effect is considerable, most of the repeated reminders
about age and sex differences in books i and ii are individually inconspicuous.
Moreover, these comments are not reinforced by illustrations placed within books i
and ii. In contrast, diversity in the shape of the human head is the subject of a substantial portion of a chapter and a striking set of illustrations prominently placed
near the beginning of book i.78 In this chapter, exposition of natural/healthy and
unnatural/unhealthy
shapes of the head merges into discussion of anatomical diversity among peoples, the possibility that anatomical features might change over
historic time, and the relation between custom and inheritance. To these topics Vesalius brought the full range of his reading in ancient texts, both medical and nonmedical, and of his own experience both as a medical practitioner and as an anatomist dissecting the brain and investigating skulls in cemeteries. The importance
that he attached to this material is suggested by his exceptionally thorough revision
and considerable augmentation of the chapter
e Fabrica.
eetinfor the 1555 edition of the
The fundamental methodology and objectives of the chapter are, of course, still
those of sixteenth-century natural history and medicine, even at their most innovative and critical: re-examination of individual strands of ancient theory or asserted
fact in the light of contemporary experience and contemporary reading of a wider
range of ancient texts than was customary or available in the medieval schools. In
this case as in so many others, the result was modification rather than rejection.
Nevertheless, the discussion allowed Vesalius to explore more fully than elsewhere
idea of diversity within a natural or
-but
still tentatively and ambiguously-the
normal range. Moreover, the topic also touched on broader concerns in contemporary learned culture: time, history, and the characteristics of peoples. The Middle
Ages and Renaissance inherited from antiquity the fundamental assumption that
different peoples, however defined, who inhabited different places, would have different temperaments and, consequently, physical characteristics and customs.79 In
the 1560s this idea would receive a famous reworking at the hands of Jean Bodin,
who used the concept to distinguish the political character of contemporary peoples
of Europe with minute particularity. By Bodin's account, geographical features explained why the Florentines were more subtle than the Venetians.80 Vesalius's remarks about differences between peoples could similarly blend the physical and the
social, as in the comment that most Thracians and Cretans do not (as a matter of
custom or of anatomy? the answer is unclear) turn their heads from side to side.81
His interest in such differences-which
will already have become apparent from
77 Ibid., ii.15,
p. 248.
78
Ibid., i.5, pp. 18f; 1555 edn, pp. 21-5.
79 See C. J. Glacken, Traces on the Rhodian
Shore,
Berkeley 1967, pp. 80-115.
80
ed. K. D.
J. Bodin, The Six Bookesof a Commonweale,
MacRae, Cambridge, Mass. 1962 (facsimile of 1606 English translation), v.1, pp. 545-68; the remark about the
Florentines and Venetians at p. 563.
81 '...ac deinde quo caput retrorsum reflectimus et
reclinamus, ea prorsus functione, qua Thraces et Cretensium plerique hac etiam aetate videntur abnuere. Illi
enim abnuentes, in posteriora caput recta removent,
sublevantve: non autem ut nos renuentes, id circumagunt, seu circumducunt.' Fabrica,1543, i.l5, p. 63.
VESALIUS
81
Bodin's version of the theory of climate perhaps revarious remarks cited-like
flects an increasingly intense consciousness of group identities in sixteenth-century
Europe.
Fabrica i.5 brings together two separate traditional topics, one the idea of a
standard set of natural and unnatural shapes of the head, the other a teleological
explanation of the 'natural' shape. The chapter opens with illustrations and closes
with discussion of the natural/unnatural scheme; sandwiched between is an evaluation of the Galenic explanation for the shape of the assumedly natural/healthy
human skull. The theory that there was a certain standard set of head shapes, one
natural and the others unnatural, was summarised in the Galenic Ars medica (Microtechne, Ars parva) and the Canon of Avicenna, texts fundamental to university teaching of medicine since thethe irteenth century. In the former it occurred in the context of the localisation of brain function and involved the idea that 'deviant' head
shapes were associated with categories of mental defect; in the latter it was part of a
discussion of the sutures.82 By Vesalius's day the original Greek formulations of the
idea were readily availabl e in the opening passages of two treatises that lay close to
the heart of Renaissance enthusiasm for anatomy and surgery, and the study of
hitherto little-known Greek medical texts:83 the author of the Hippocratic treatise
On Wounds of the Head described four shapes and corresponding suture patterns
without characterising any of them as either natural or unnatural; in On the Bones
Galen explained that there was one natural shape (defined as a sphere slightly compressed in front on both sides), and three deviant shapes, distinguished by the absence, respectively, of the posterior prominence and lambdoid suture, the anterior
prominence and coronal suture, and both posterior and anterior prominences. But
in On the Usefulness of the Parts, Galen added that a fourth unnatural shape with
prominences at the sides could theoretically be imagined, but could not exist in
reality as it would be 'a monster incapable of life'.84 The illustrations to Fabrica i.5
depict the full scheme of one natural and four unnatural shapes (P1. 15); the text
makes it clear that Vesalius assimilated Galen's four unnatural shapes to the four
shapes described by the author of On Wounds of the Head (and hence assumed that
in that treatise the Hippocratic author had not described the 'natural' shape at
all).85
No doubt, by illustrating and discussing traditional schemes of head shapes
Vesalius extended their life; his attention stimulated polemic pro and contra,
82 Galen, Ars medica,vi
(Kufhn,as in n. 46, i, pp. 320f).
Avicennae Arabum medicorumprincipis (Canon), i.1.5.2,
Venice 1595, i, p. 37. For other medieval versions of the
theory see MacKinney and Herndon (as in n. 14).
83 De vulneribuscapitis, like other Hippocratic surgical
treatises, was scarcely if at all known in the Middle Ages;
see P. Kibre, Hippocrateslatinus, New York 1985, p. 234.
Knowledge of it began to spread after its inclusion in
editions in the Hippocratic Opera in Greek (Venice
[Aldus] 1526; Basle 1538) and in the translations of the
Opera into Latin by Fabius Calvus (Rome 1525), and
Janus Cornarius (Venice 1545). The first published
commentary was by Falloppia, dated 1566 and based on
lectures given in 1559; see V. Nutton, 'Humanist Surgery', The Medical Renaissance of the Sixteenth Century (as
in n. 4), pp. 77, 299 n. 7. De ossibuswas first published
in Latin translation by Ferdinando Balamio (who was
subsequently sharply criticised by Vesalius for his unwillingness to lend the Greek manuscript) in 1535; in
that year editions of Balamio's translation appeared at
Rome, Paris, and Lyons. Vesalius lectured on the book
at least three times at Padua, beginning in 1537; see
O'Malley (as in n. 13), pp. 111, 439; and R. J. Durling,
'A Chronological Census of Renaissance Editions and
Translations of Galen', this Journal, xxiv, 1961, p. 288,
no. 79. De ossibus is constantly referred to throughout
book i of the Fabrica.
84 De usu partium, ix.17 (Kuhn, as in n. 46, iii, pp.
750-5); tr. May (as in n. 39), i, p. 460.
85 'Quarta species non naturalis figurae ab Hippocrate
quoque enumeratur',
Fabrica, 1543, i.5, p. 19.
82
NANCY SIRAISI
modifications, and elaborations over more than a century.86 But in his version, tradition was radically modified. He disassociated suture patterns and the shape of the
skull both from one other and from any automatic connection with mental defect.
On the basis of personal experience, he asserted that skulls matching the supposed
standard set of defects in sutures/shapes were very rare indeed-a
remark more
but
not
much
less
than
diatribe
about
temperate
sceptical
Falloppia's subsequent
the absolute impossibility of finding them. However, experience, both his own and
that of a friend who had visited cemeteries in the Alps, also showed that the shape
of the human skull did in fact vary. Such variations encountered in cemeteries, in
dissection subjects, and in living people did not, however, in reality necessarily affect
the shape of the brain and consequently entail mental defect, since so-called unnatural shapes 'are in fact found in outstandingly sagacious people'.87 Finally, he
insisted that Galen's fourth unnatural shape, far from being purely imaginary as
Galen had alleged, in fact corresponded to symptoms of hydrocephalus or other
deformities that he had himself observed. Thus, he ended up with a scheme that
retained the fundamental idea of a distinction between natural/healthy and unin the shape of the head, but reduced it in essentials to a twonatural/unhealthy
fold division: the natural, which encompassed the traditional 'natural' shape and a
range of variation; and the diseased.
Modified in this way the theory served two functions. In the first place, it provided Vesalius with the basis for an attempt to distinguish pathology from rarity.
Such an endeavour was, evidently, a crucial first step in resolving some of the ambiguities around the issues and terminology of the natural and the unnatural, the
monstrous, and the unhealthy. The issue was also of obvious relevance for the
practice of medicine, as other contemporary physicians were aware; for example,
Gianbattista da Monte discussed at length why morbus was an inappropriate word
of
for conditions such as a sixth finger on the hand..8equation
Thus, although the
fourth
with-Galen's
certain pathological conditions of the head with-and
only
'unnatural' shape made no distinction between disease in individuals and group
characteristics, it was nevertheless of conceptual significance. The importance Vesalius himself attached to this part of his argument becomes clear from the way he
expanded it in revision; the few brief examples of casually observed skull deformities offered in 1543 were supplemented with long supporting case histories from
his own practice in 1555.89
86
MacKinney and Herndon (as in n. 14), pp. 126-30,
list a number of participants in the debate (awarding
gold stars to the critics of tradition among them). But
all such discussions are evidence for the interest of 16th-
and 17th-century anatomists and erudite physicians in
the details of Vesalius's exposition.
87 'Capitis autem figurarum non naturalium hic meminimus, quod illae a dissectionum professoribus sunt
quoque passim pertractatae: quodque non naturales
capitis vocatae effigies, etiam in egregie prudentibus
(quandoquidem scilicet cerebrum nulla, uti iam innuimus, propria admodum indigeat figura) interdum spectentur, etiam si tales calvariae, ac potissimum suturarum
specie, ut proximo dicetur Capite, a naturali forma
differentes, nobis in coemiteriis nimis perquam raro
se offerant. ut profecto subinde forsan occurrerent, si
Alpium quae Stiriam spectant, accolarum coemiteria
non dictis modo
scrutaremur: quum illos homines,
capitis figuris, sed longe etiam magis discrepantibus
deformes esse audiam.' Fabrica, 1555, i.5, p. 25 (expanded and revised from a briefer comment in the 1543
edition, p. 19). Compare Falloppia, Observationesanatomicae(as in n. 62), fols 226v-27r.
88 G. da Monte, Lectiones...in secundamfen primi Canonis Avicennae..., Venice 1557, pp. 54-6; for a brief discussion see Siraisi (as in n. 20), pp. 346f.
89 Fabrica,1543, i.5, p. 19; 1555, pp. 23-5.
VESALIUS
83
Secondly, the revised theory became part of a revised teleology of the 'natural'
shape of the head, necessary because Vesalius had been obliged to abandon Galen's
teleological explanation on anatomical grounds. In On the Usefulness of the Parts
Galen had asserted that Nature designed the skull as a (close-fitting) helmet for the
brain, the overall shape of which was in turn determined by the location of the cerebellum and the supposed origin of the nerves of sense from the front of the brain.90
Vesalius invoked his own dissections of skull and brain to show that the overall
shape of the skull did not in fact follow the shape of the brain so very closely. The
effect was of course to refute the claim that the reason why the skull was a particular
shape was that it followed the shape of the brain, and to detach the idea that the
skull protected the brain from the idea that the skull's shape was necessarily determined by that of the brain. But if the shape of the brain did not determine the
shape of the skull, what did? In attempting to answer this question Vesalius directed
attention toward the skeletal structure as a system functioning in its own right. The
shape of the skull was dictated by the requirements of balancing the head on the
is, by the mechanics of skeletal function-and
by the presence
spinal column-that
of the orbits of the eye, the nose, and the bones of the upper maxilla.91
But he evidently did not find an explanation couched in terms of the functioning of the skeleton as a mechanical system sufficient to provide complete replacement for the Galenic accounts. It still seemed necessary to have an underlying
causal explanation for the general shape of the human head and for real or supposed divergences among different individuals or peoples. In search of such an
explanation, he turned to a famous passage in the Hippocratic treatise Airs Waters
Places, one of the key texts for the entire tradition of climate and geography as
causes of human variation. Its author told of a remote people who had once practiced the custom of headbinding on their infants. He alleged that 'Custom originally so acted that through force such a nature [that is, the desired long head]
came into being; but as time went on the process became natural'-the
long heads
ceased to be an artificially induced deformity and became not only hereditary but
natural for the people in question.92 In the treatise the function of the anecdote was
90 De usu partium,viii.6 and ix.1 (Kfihn, as in n. 46, iii,
pp. 636-47, 688).
91 'Formae huius rationem Galenus ad cerebrum refert, calvariam, quum cerebri sit receptaculum, ac veluti
galea et propugnaculum, illius debere forma exprimere
astruens: et addens pariter, qui posteriori cerebri parti
cerebellum allocetur, dorsalisque medulla illinc prodeat: anteriori vero parte ad olfactus organa, et ad
oculos a cerebro processus educantur. quum interim
nos facile in septimo libro ostendemus, cerebrum nulla
peculiari eguisse figura, et posteriorem eius partem retrorsum magis quam ipsum cerebellum prominere, ac
praeterea processus illos olfactui servientes, et visorios
nervos ex cerebri basis quasi medio, non autem ex
anteriori ipsius sede initium ducere: adeo ut cerebri
ratione nihil obstiterit, quo minus calvariam instar exacti globi, sphaeraeve, utpote figurae iniuriis repellendis
promptissimae, efformatam cernamus. Verum maxillae
superioris, et nasi, oculorumque sedium, et temporalium musculorum habenda fuit ratio, et insuper connexus calvariae cum dorsi vertebris gratia, posteriorem
capitis partem latiorem capaciorem fieri decuit, si modo
iusti ponderis haud negligenda erat occasio.' Fabrica,
1555, i.5, pp. 22f (addition, not in the 1543 edition). On
Vesalius's understanding of the term 'superior maxilla'
see above, n. 22.
92 Airs WatersPlaces, 14,
Hippocrates,i, with translation
by W. H. S. Jones (Loeb Classical Library), repr. Cambridge, Mass. 1972, p. 110. The treatise was translated
into Latin in the early Middle Ages and again in the
12th century (Kibre, Hippocrateslatinus, pp. 25-8); a
medieval version was printed in Articella nuperrimeimpressa..., Lyons 1515. The Greek text was printed in the
Renaissance editions of the Hippocratic Opera mentioned in n. 83 above; it was retranslated into Latin by
both Fabius Calvus andJanus Cornarius and included in
their respective collections of the Hippocratic Operain
Latin. The only known Latin commentaries belong to
the 16th century (one of them is by Girolamo Cardano,
who discussed desirable head shapes and their possible
hereditability at some length in his exposition of this
passage; see his Operaomnia,Lyons 1663, viii, pp. 139f).
84
NANCY SIRAISI
to support claims that a trait acquired during the parent's life could be passed on to
future generations and that the inheritance of idiosyncratic traits endorsed the
theory that semen came from all parts of the body (and therefore transmitted the
characteristics of every part). Vesalius's interpretation of this Hippocratic passage
reads as follows.
Hippocrates seems rather to have thrown the cause of the shape called natural by us back on
to midwives and nurses, because he asserts that certain people thought oblong heads were
beautiful and therefore compressed them in small children and so at length they were procreated in that oblong form by nature, in almost that same way in which it is esttablished
that many peoples acquired for themselves whatever is characteristic of them in the shape of
the head. For the heads of the Genoese and even more those of the Greeks and the Turks
are almost completely round; and, with great solicitude on the part of the mothers, some
nurses help to achieve this [shape] too (which not a few of them consider elegant and suited
for the respective headcoverings that they wear). Indeed, many Germans are seen with a
compressed occiput and side of the head because the infants in the cradles always lie on
their backs...93
Unlike the Hippocratic author, who insisted on the uniqueness, the difference
from other peoples, of the people he was describing, Vesalius evidently saw in the
story a possible explanation of the origin of the contours of the human skull in
general, including, though not limited to, 'the shape called natural by us'. Thus, he
was able to draw from the passage both the needed alternative causal explanation
and support for the idea that naturalness and variation were not per se incompatible concepts as far as head shape was concerned. Yet his response to this passage
remained highly ambivalent. Despite his acceptance of the Hippocratic anecdote
to medical traand his own osteological experience as suggesting that-contrary
was no single 'natural' shape, he evidently also continued to believe
dition-there
that among the healthy some shapes were preferable to others; by his account, his
own compatriots achieved superiorly shaped heads through superior swaddling
methods.
Furthermore, his exposition of the passage begins by following the lead of this
Hippocratic author (and Aristotle)94 in seeming to accept the idea that acquired
then almost
characteristics could become natural in subsequent generations-but
Greeks and
the
about
remark
the
with
into
retreats
Genoese,
ambiguity
immediately
Turks. These peoples get their head shapes in 'almost the same way' as the Hippocratic headbinders, but it is unclear whether the reader is supposed to conclude
93 'Hippocrates porro naturalis appellatae nobis formae causam in obstetrices nutricesque videtur reiecisse,
quum asserit quosdam oblonga capita existimasse esse
pulchra, hosque ideo in puerulis ea compressisse, atque
ita tandem natura in hanc oblongam formam procreata
esse: eo prope modo, quo plerasque nationes peculiare
quid in capitis forma sibi vendicare constat. Genuensium namque, et magis adhuc Graecorum et Turcarum
capita globi fere imaginem exprimunt, ad hanc quoque
(quam illorum non pauci elegantem, et capitis quibus
varie utuntur tegumentis accommodum censent) obstetricibus nonnunquam magna matrum solicitudine
opem ferentibus. Germani vero compresso plerunque
occipitio, et lato capite spectantur, quod pueri in cunis
dorso semper incumbant, ac manibus fere citra fasci-
arum usum, cunarum lateribus utrinque alligentur.
Belgis oblongiora caeteris propemodum reservantur
permanentve capita, quod matres suos puerolos fasciis
involutos, in latere et temporibus potissimum dormire
sinant.' Fabrica, 1555, i.5, p. 23 (addition, not in the
1543 edition).
94 Aristotle alleged the hereditability of deformities
such as lameness, blindness, and scars in Historia animalium, vii.6, 585b30-5. One Hippocratic author expressed doubts; see I. M. Lonie, The HippocraticTreatises
'On Generation' 'On the Nature of the Child' Diseases IV
(Ars medica.Texteund Untersuchungenzur Quellenkundeder
alten Medizin, Abteilung Griechischlateinisch Medizin,
vii), Berlin and New York 1981, 'The seed', ? 11.
VESALIUS
85
herited characteristic, or that they are creating the desired shape afresh in every
generation. By the time the Germans come on the scene ambiguity has vanished.
There is no hint that their compressed heads are inherited; rather, they are plainly
ascribed exclusively to childrearing practices. But this was not Vesalius's last word on
the subject.
He evidently continued to ponder the relation between custom and inheritance
as exemplifed by the Hippocratic headbinders as he worked his way through the
revision of the rest of the Fabrica. One of the more substantial additions to the 1555
edition is a pioneering account of the hymen in book v. As might be expected, the
subject lent itself to allusions to customs of peoples. In addition to once again debunking the belief that some peoples broke apart the pelvic bones of their baby
girls, Vesalius took note of female circumcision among the Egyptians, male circumcision among the Jews, the practice of midwives of breaking the supposed 'chain of
the tongue', and reports he had heard that some midwives broke the hymen in
female infants. He went on to speculate that the last practice might explain why
some girls were apparently born without a hymen,
just as we do not doubt certain rare shapes of the head, beyond any compression by midwives or mothers, were made, as it were, already proper to them and [just as] it is established that many peculiar characteristics of the foals of horses come about in the course of
time.95
Indeed, the exposition of the Hippocratic passage in book i and its sequel in
book v merit consideration in the context of the place of time and history in Vesalius's anatomical enterprise. Inhis use of this Hippocratic anecdote, time figures
prominently in several senses: the opinion of a more ancient author is set against
Galen, the practices of an ancient people are described, and the possibility that variations in nature might develop over time are considered. In one sense, ideas about
history play a fairly prominent part in Vesalian anatomy. When he considered anatomy as a human activity, Vesalius gave considerable emphasis to a largely mythical
history of the subject. As physicians and surgeons had done before him since at
least the thirteenth century,96 he described his own discipline as invented and perfected by figures of the remote past, then falling into obscurity and error, only to
be subsequently recalled to light.97 In the hands of some sixteenth-century writers,
however, such traditional formulations took on new power: supported by Renaissance appreciation of the full range and diversity of ancient philosophy and science
and veneration for the most ancient sources of wisdom, they became a tool for the
critique of conventional school authors, notably Aristotle and Galen. In Vesalius's
case, as Nutton and others have noted, these ideas were expressed in the form of
95 'ab obstetricibus matronisque quibusdam interdum
audivi, nonnullis morem esse, ut puellulis membranulam quandam, seu pelliculam, perinde ac frustra mulieribus datam, ita effringant, ut Iudaeos virilem glandem
resecare adhuc hodie cernidetegere, praeputiumque
ut hac quoque occasione puellas absque
mus...adeo,
hymene non secus nasci contingeret, quam Iudaeorum
pueros interdum recutitos in lucem prodire certissimum est: utque raras quasdam capitis figuras, citra
omnem
quae ab obstetricibus matribusque adhibetur
nonnullis nationibus, veluti proprias
compressionem,
iam esse factas, non ambigimus, multaque peculiaria in
equorum pullis tempore evenire constat.' Fabrica, 1555,
v.15, pp. 654f. The references to the other practices
mentioned are on pp. 653f.
96 See Crisciani (as in n. 29).
97 Notably in the preface to the Fabrica.
86
NANCY SIRAISI
repeated claims that the anatomical knowledge, teaching, and techniques of 'the
ancients who taught dissection to boys in their homes', and who lived before Galen,
were greatly superior to Galen's own.98
By contrast, the assumption that the subject of anatomy, the human body itself,
had not changed since classical antiquity was obviously fundamental to Vesalius's
critique of Galen. It was, of course, in opposition to this assumption that Jacobus
Sylvius claimed that Vesalius had identified not errors in Galen, but ways in which
the human body had changed and deteriorated (specifically by degenerating in
size) since Galen's time.99 Vesalius is deservedly famous for having the better of the
argument, but his belief that the human body had not changed in historic time
went hand-in-hand with a wholly a-historic view of ancient writers as sources of information about anatomy: not only Hippocrates, Aristotle and Galen but also Homer
and Herodotus were for him timeless witnesses, whose statements about human
bones and muscles were to be judged strictly by the standard of his own anatomical
understanding. In the Fabrica, statements agreeing with that understanding are
treated as exactly equivalent to reports from living witnesses, or, indeed, Vesalius's
own observations. Thus, a remark from Herodotus about skulls without visible sutures found in Persia takes its place alongside the account of the skulls of old
people collected by Vesalius's pupils: both are good evidence for the obliteration
of skull sutures in the aged.'00 An ambiguous statement merits serious consideration: did Homer mean to say that the head of Thersites, ugliest of the Greeks,
was pointed or round?101 Such an approach both to phenomena in nature and to
ancient authors is of course, entirely in line with the generally static concept of
natural or of human affairs-that
historia-whether
prevailed in the sixteenth
his
Vesalius
differed
from
century.
contemporaries chiefly in his notable readiness
to reject out of hand statements that did not accord with his own view of human
anatomy.
98 '...veteres
qui pueros domi sedulo dissecandi rationem docebant', Fabrica, 1543, i.3, p. 7. Many other
similar remarks could be quoted. V. Nutton, "'Priscidissectionum professores": Greek Texts and Renaissance
Anatomists', The Usesof Greekand Latin, ed. A. C. Dionisotti, A. T. Grafton andJ. Kraye, London 1988, pp. 11126 (123f).
99 J. Sylvius, Vaesani cuiusdam calumniarum in Hippocratis Galeniquerem anatomicamdepulsio,Paris 1551, esp.
fol. 13r-'; Sylvius's views are summed up by the remark
'Nec in hoc est Galeni peccatum, sed naturae in nobis
mutatio' (ibid., fol. 13'). See Nutton, op. cit., pp. 117f.
As is well known, Sylvius (Jacques Dubois), a leading
participant in the revival of Galenic anatomy, had been
Vesalius's teacher in Paris.
100 'Quod autem Herodotus, ac praeter illum plerique
etiam alii in Persia calvarias reperiri scribunt, nullis
prorsus suturis interstinctas, ipseque Aristoteles suo
tempore viri calvariam absque suturis repertam tradit,
neutiquam miror: quum valde senum calvariae nobis
suturarum situm duntaxat, idque perquam obscure
etiam referant, nulla interim suturae imagine conspicua.' Fabrica,1543, i.6, p. 27.
101 'Deinde tertia...in
qua...caput ad amussim rotundum ac instar exactae sphaerae observatur. Ista figura
Thersites ab Homero fuisse traditur. hanc enim ab ipso
phoxos appellari, nonnulli asserunt: quanquam plerisque omnes acuminatas capitis figuras eo nomine, et
oxykephalos,nuncupare libuerit.' Fabrica,1543, i.5, p. 19;
Iliad, ii.219. This may show Vesalius as a reader of
Homer-at any rate, I have not succeeded in locating
the citation in Galen-but he could have lifted the reference from Leonhart Fuchs's commentary on book vi
of the Hippocratic Epidemics,where the same lines are
quoted in a discussion of the shapes of the head; see
Hippocratis... EpidemiorumLiberSextus,The Hague 1532,
fols 3r-4r, with the reference to Homer at 4r. Vesalius's
suggestion of an alternative meaning was doubtless
based on De usu partium,ix.17 (Kuhn, as in n. 46, iii, pp.
752f), in which Galen used phoxos as a collective adjective for all the 'unnatural' shapes, of which one was
described as a perfect sphere. The translation of De usu
partium by Niccolo da Reggio was used in the Renaissance editions of Galen's works in Latin; in the version
emended by Sylvius and Martinus Gregorius the 'unnatural' shapes are termed 'acuta' and 'acuminata
capita'; see Galen, Opera,Basle 1542, cols 630f; in the
version emended by Agostino Gadaldino, the reference
is to the sutures of 'capitum fastigiatorum seu acuminatorum (graece phoxon)' and to 'quarta autem species
acuminati capitis'; see Galen, Omnia quae extant opera,
Venice 1576 (5thJunta edn), i, fols 176v-77r.
VESALIUS
87
Yet histo'ra in both senses did occasionally include ideas of chronological development. The significant innovations introduced by some sixteenth-century writers
on human history lie outside the scope of this paper. In natural history, however,
there was certainly one form in which time was present: the idea, derived ultimately
from Lucretius, that the world itself was aging, and undergoing all the weakening
and deterioration that the process entailed.102 Sylvius's argument against Vesalius,
for all the ridicule it has inspired over the centuries, fitted easily into the concept of
an aging world. And ancient discussions of inheritance of physical characteristics
from generation to generation could, at least potentially, bring the idea of change
over time into a specifically anatomical context. Vesalius's awareness of this last
possibility may be the most fundamental reason for his ambiguous handling of the
passage from Airs WatersPlaces (elsewhere he was less cautious, casually repeating a
story told him by a pupil that attributed extraordinary physical characteristics to the
ancient Genoese).103 The Hippocratic account of the headbinders served the purpose of providing a more ancient authority to set against Galen; it provided a model
for an explanation of the assumedly normal shape of the head and for variations
within the range of the normal; but to generalise from it unreservedly would be to
acknowledge the possibility that the human body had changed since the time of the
ancient medical authors.
Whatever the ambiguities of its content, the function of the chapter on shapes
of the head in the scheme of the Fabrica seems clear. At the very beginning of the
book, this chapter forces the concept of human diversity on the reader's attention.
By its insistence that natural/healthy skulls can be of diverse shapes it encourages
(or should encourage) recognition of forms of diversity or variation that are not
'monstrous' or 'unnatural' but rather encompassed within the natural. And it insists
equally on the importance of learning to distinguish between pathological conditions and variant forms.
CONCLUSION
Taken as a whole, in text and illustrations the Fabrica establishes the subject of the
scientia of anatomy as a standardised version of the natural/healthy human body
-neither
infant nor aged, unchanged in any time, people, or culture, and male
unless specified as female. Nevertheless, Vesalius repeatedly indicated the limitations of this artificial creation as a representation of reality. He thus taught a
scientia of anatomy that in its fullest presentation required attention to diversity as
well as uniformity. His recognition of the tension and relation between these two
concepts was generated not only by his own anatomical experience but also by
broader aspects of mid-sixteenth-century culture: interest in the extent of the diversity of the natural, the boundaries of the normal among human beings, and the
supposed characteristics of ancient and modern peoples.
His means of introducing these qualifications characteristically took the form of
brief passages or small comments embedded in his narrative as and when specific
occasion arose. The Fabrica is indeed a mass of details; and, as the innumerable
minute stylistic revisions in the 1555 edition show, the details that mattered to the
102 Glacken (as in n. 79), pp. 134-6, 379-82.
103
Fabrica, 1543, i.19, p. 90; repeated
1555 edn, p. 111.
88
NANCY SIRAISI
author were verbal as well as anatomical. Characteristically, too, his central ideas
about the nature of anatomy are as likely to emerge from his adaptations of Galenic
material as from his attacks on Galen. Thus only by examining individually the
many separate specific anatomical contexts in which this most elusive of sixteenthcentury learned authors expressed his views is it possible to begin to grasp the
larger patterns of his thought. Collectively, however, the chapter on shapes of the
head and the allusions to other types of difference in books i and ii seem to invite
readers to view the natural/healthy body as encompassing elements of diversity of
many different kinds. The complex structure of the Fabrica facilitated an equally
complex interplay between generalisation, detail, and nuanced qualification.
CITY UNIVERSITY OF NEW YORK
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