The Popes and Science

At the Italian universities after the middle of the fourteenth century there is abundant evidence for perfect freedom with regard to dissection. We have already shown by our quotation from Roth that Bertrucci was very active in dissection work and did many public dissections. He was followed by Pietro di Argelata, who died toward the end of the fourteenth century. These men followed Mondino in the chair of anatomy at Bologna, and Julius Pagel, in his chapter on Anatomy and Physiology in Puschmann's Handbuch der Geschichte der Medizin (Vol. I., p. 707), says that "the successors of Mondino were in a position, owing to the gradual enlightenment of the spirit of the time and the general realization of the importance of anatomy as well as the fostering liberality of the authorities, to make regular, systematic dissections of the human body." This would bring us down, then, to the end of the fourteenth century.

To return now to Roth, who takes up the next century. He says:

"For the fifteenth century, the university statutes of Bologna for the year 1405 furnish many sources of information. There is a special division which is concerned with the annual anatomy or dissection that had to be made and the selection of the persons to be present, the payment of the expenses and other details. An addition to the statutes, made in the year 1442, determines the arrangement of the delivery of the body from the city to the university authorities. Every year two bodies, one male and one female, must be provided for the medical school dissections. In default of a female body, a second male body was to be provided. In the presence of such detailed regulations, the absence almost entirely of details as to the actual performance of dissections can mean very little. Bologna reached its highest development as a medical school at the beginning of the sixteenth century when Alexander Achillinus and Jacob Berengarius had charge of the public dissections there. Of these I shall speak later." (All this is at the University of Bologna, where ecclesiastical influence was supreme and where the Popes exercised their jurisdiction as the ultimate authority to be appealed to in all disputed educational questions.)

Roth continues: "Padua had, like Bologna, dissection in the fourteenth century. There is the record of a dissection made in the year 1341, in which Gentilis made the discovery of a gall-stone." (It is evidently not because the dissection was unusual, but because the discovery was unusual, that this incident is mentioned. The dissections were such ordinary occurrences as not to deserve special mention except for some particular reason.)

"Much more is known about dissection at Padua in the fifteenth century, when the city had become Venetian." [Footnote 11] (It is significant to note that the previous occurrence was in pre-Venetian days, for Professor White insists that it was the Venetian authorities, in opposition to the Pope, who allowed dissection at Padua. Here is the rebuttal of any such theory.) "Bertapaglia, in his Surgery, has the record of the dissection of a criminal made under the direction of Master Hugo De Senis, on the 8th of February, 1429. On the 4th of April, 1430, the dissection of a woman was made. In 1444 Professor Montagnana speaks of fourteen dissections at which he had been present." (This would seem to indicate that dissections were quite common and that the occasional records of them give no proper idea of their actual number.)

[Footnote 11: Note that this is a full century before Vesalius's time, who, Professor White insists, reintroduced dissection.]

I would not wish to produce the impression, however, that Italy was the only place in Europe in which dissections were freely done during the fourteenth and fifteenth centuries. There is no doubt that anatomy and surgery and every branch of medicine was cultivated much more assiduously and with much better opportunities provided for students down in Italy, than anywhere else in the world. This of itself alone shows the utter absurdity of the declarations that the Church was opposed to medical progress in any way, since the nearer the center of Christendom, the more ardor there was for investigation and the more liberty to pursue original researches. Other countries also began to wake up to the spirit of progress in medical education that was abroad. In France there were two centers of interest in anatomy. One of these was at Montpelier, the other at Paris. It is interesting to note, however, that the men to whom anatomical progress is due at these universities obtained their training, or at least had taken advantage of the special opportunities provided for anatomical investigation to be had, in the Italian cities. Guy de Chauliac I have already mentioned. He is spoken of as the Father of Modern Surgery, and there is no doubt that he did much to set surgery on a very practical basis and to make anatomy a fundamental feature of the training for it. He declared that it was absurd to think that surgeons could do good work unless they knew their anatomy.

Under his fostering care the study of anatomy flourished to a remarkable degree at the University of Montpelier. The difficulty hitherto had been that it was very hard to procure bodies for dissecting purposes. It is easy to understand that friends of the dead would always prevent dissections as far as they could. They do so even at the present moment, and there are not many of us who find it in our hearts to blame them over much for it. Few of us are ready to make the sacrifice of our own dead. Even the poor in those days had friends who prevented the cutting up of their remains; for large alms-houses were not presided over by paid officials, but by religious, to whom their poor in their friendlessness appealed as kindred. There were not many prisons, and they were not needed because all felonies were punished by death. Guy de Chauliac realized that here was the best opportunity to procure bodies. Accordingly it was mainly through his instrumentality that a regulation was made handing over the dead bodies of malefactors to the medical school for dissecting purposes. It must be recalled that when he did this the Papal court was at Avignon, in the South of France, and exerted great influence over the University of Montpelier, situate not far away.

The reputation of the University of Paris is such that we should not expect her to be backward in this important department of education. As a matter of fact, there is abundant evidence of dissection having been carried on here at the end of the thirteenth century, and the practice was not interrupted at the beginning of the fourteenth century. Lanfranc, the famous surgeon who had studied with William of Salicet in Italy (we have already mentioned both of them and we shall have much to say of them hereafter), taught surgery from a very practical standpoint in Paris, and illustrated his teachings by means of dissections. Lanfranc was succeeded in Paris by Mondeville, whose name is also associated with the practice of dissection by most historians of medicine, and whose teaching was of such a practical character that there can be no doubt that he must have employed this valuable adjunct in his surgical training of students. In general, however, the records of dissecting work and of anatomical development are not near so satisfactory at Paris as in the Italian universities. As is the case in our own day and has always been true, universities were inclined to specialties in the Middle Ages, and the specialty of Paris was Philosophy and Theology. This was choice, however, not compulsion, any more than similar conditions in our own time. The medical school continued to be in spite of this one of the best in the world, though it was not famous for its original work, except in surgery, which is, however, the subject most nearly related to anatomy and the one whose development would seem necessarily to demand attention to anatomy.

With the Renaissance, which is usually said to begin after the fall of Constantinople in 1453, and the consequent dispersion of Greek scholars throughout Italy, a new spirit entered into anatomy as into every other department of intellectual life at this time. The reason for it is not easy to explain. Perhaps the spread of Greek texts with regard to medicine inspired students and teachers to try out their problems for themselves, and so a new impetus was given to anatomical investigation. Whatever it was that caused it, the new movement came unhampered by the Church, and Italy continued to be even to a greater degree than before the Mecca for medical students who wished to do original work in anatomy. During the last fifty years of the fifteenth century anatomy began its modern phase, and original work of a very high order was accomplished. There are five names that deserve to be mentioned in this period. They are Gabriele Zerbi, Achillini, Berengar of Carpi, Matthew of Gradi and Benivieni. Each of these men did work that was epoch-making in anatomy, and each has a place in the history of the science that will never be lost.

Zerbi, who did his work at Verona, traced the olfactory nerves and describes the nerve supply of the special senses more completely than it had ever been done before. After his time it was only a question of filling in the details of this subject. Achillini added much to our knowledge of the anatomy of the head, being the first to describe the small bones of the ear and also to recognize the orifices of Wharton's ducts. Besides this, which would have been quite enough to have given him a place in the history of anatomy, he added important details to what had been previously known with regard to the intestines, and described very clearly the ileocecal valve and suggested its function. Matthew of Gradi, or De Gradibus, was the first, according to Professor Turner in his article on Anatomy in the Encyclopaedia Britannica, who represented the ovaries in the correct light as regards their anatomical relations and their function.

The most important of these fifteenth century investigators in pure anatomy, however, is Berengarius or Berengar of Carpi, who did his work at Bologna at the end of the fifteenth and the beginning of the sixteenth century. His commentaries on Mondino's work show how much he added to that great teacher's instruction. If he had no other distinction than that of having been the first to undertake a systematic view of the several textures of which the body is composed, it would have been sufficient to stamp him as a great original worker in anatomy. He treats successively of the anatomical characters and properties of fat, of membrane in general, of flesh, of nerve, of villus or fibre, of ligament, of sinew or tendon, and of muscle in general. Almost needless to say, he must have made many dissections to obtain such clear details of information, and, as we shall see, he probably did make many hundreds. If he had done nothing else but be the first to mention the vermiform appendix, it would have been quite sufficient to give him a distinction in our day. Everything that he touched, however, he illuminated. His anatomy of the fetus was excellent. He was the first to note that the chest of the male was larger than in the female, while the capacity of the female pelvis was in the opposite ratio. In the larynx he discovered the two arytenoid cartilages. He recognized the opening of the common biliary duct, and was the first to give a good description of the thymus gland. All this, it must be remembered, before the end of the second decade of the sixteenth century, that is, almost before Vesalius was born.

Berengar's work was done at Bologna. Some five years before his death Bologna became a Papal city. There is no sign, however, that this change in the political fortunes of the city made any difference in Berengar's application to his favorite studies in anatomy. As we shall see in the chapter on The Papal Medical School, already the Popes were laying the foundations of their own great medical school in Rome, in which anatomy was to be cultivated above all the other sciences, so that there would be no reason to expect from other sources of historical knowledge any interruption of Berengar's work, and it did not come.

A fifth great student of anatomy during the fifteenth century was Benivieni, who has been neglected in the ordinary histories of anatomy because his work concerned itself almost exclusively with pathological, not with normal anatomy. In our increasing interest in pathology during the nineteenth century, he has very properly come in for his due share of attention. Professor Allbutt, in his address on the Historical Relations of Medicine and Surgery down to the Sixteenth Century, declares that Benivieni should be revered as the forerunner of Morgagni and as one of the greatest physicians of the late Middle Ages. Benivieni's life occupies almost exactly the second half of the fifteenth century, as he was born probably in 1448, and died in 1502. Allbutt says:–

"He was not a professor, but an eminent practitioner in Florence, at a period when, in spite of its Platonism, Florence on the whole was doing most for science; for as Bologna turned to law, Padua turned to humanism and philosophy. He was one of those fresh and independent observers who, like Mondeville, was oppressed by the authority neither of Arab nor Greek."

We are not interested, however, at the present time in what he accomplished for surgery, though there are a number of features of his work, including the crushing of stone in the bladder and his puncture of the hymen for retained menses, as well as his methods of division and slow extension of the cicatricial contractions resulting from burns near the elbow, which place him among the most ingenious and original of surgical thinkers. It is his interest in dissection that commends him to us here. He must have done a very great number of autopsies.

His interest in the causes of disease was so great that he seems to have taken every possible opportunity to search out changes in organs which would account for symptoms that he had observed. His place in anatomy and the history of pathology has not been properly appreciated in this matter, and Professor Allbutt claims for him the title of Father of Pathology, rather than for those to whom it has been given, and demands for his work done in Florence during the second half of the fifteenth century the credit of laying the real foundation-stones of the great science of pathological anatomy. Unfortunately, he died comparatively young and without having had time properly to publish his own contributions to medical science. Professor Allbutt says:–

"The little book De abditis causis morborum (brief title), was not published in any form by Antony Benivieni himself, but posthumously by his brother Jerome, who found these precious notes in Antony's desk after his death, and with the hearty cooperation of a friend competent in the subject, published them in 1506 in a form which no doubt justly merits our admiration. Benivieni's chief fame for us is far more than all this; it is that he was the founder of pathological anatomy. So far as I know, he was the first to make the custom and to declare the need of necropsy to reveal what he called not exactly "the secret causes," but the hidden causes of diseases. Before Vesalius, before Eustachius, he opened the bodies of the dead as deliberately and clear-sightedly as any pathologist in the spacious time of Baillie, Bright and Addison. Virchow, in his address at Rome, said Morgagni was the first pathological anatomist who, instead of asking What is disease? asked Where is it?"

But Benivieni asked this question plainly before Morgagni: "Not only," says he, "must we observe the disease, but also with more diligence search out the seat of it." The precept is so important, I will quote the original words: "Oportet igitur medicum non solum morbum cognoscere, sed et locum in quo fit, diligentius perscrutari."

Among the pathological reports are morbus coxae (two cases); biliary calculus (two cases); abscess of the mesentery, thrombosis of the mesenteric vessels; stenosis of the intestine; some remarkable cardiac cases, several of "polypus" (clot, which was a will-of-the-wisp to the elder pathologists); scirrhus of the pylorus, and probably another case in the colon; ruptured bowel (two cases); caries of ribs with exposure of the heart. He gives a good description of senile gangrene which even Paré did not discriminate. He seems to have had remarkable success in obtaining necropsies; concerning one fatal case he says plaintively, "Sed nescio qua superstitione versi negantibus cognatis," etc. Of another he says, "cadavere publicae utilitatis gratia inciso" (the case of cancer of the stomach). With this admirable and original leader, Italian medicine of the fifteenth century closes gloriously, to slumber for some fifty years, till the dayspring of the new learning. Of his work Malpighi says, and apparently with truth, "up to now it is the only work in pathology which owes nothing to anyone."

This should be enough, it seems to me, to settle the question that anatomy was permitted very freely before Versalius's time. I have said it in other places, but it may be well to recall here, that Berengar did his dissection at Bologna just before and after the time it became a Papal city and when Papal influence was very strong. In spite of the fact that in 1512 Bologna passed under the dominion of the Popes, there is no question of any interruption or hampering of Berengar's work in anatomy, and as a matter of fact, this great anatomist did not succeed to the professorship of anatomy, which had been held up to this time by Achillini, until in the very year when Bologna came under Papal sway, and had his opportunity to do his independent work only after this. Professor Turner can scarcely find words strong enough to set down his admiration for Berengar and his work. Besides what we have already quoted he says that, "the science of anatomy boasts in Berengar of one of its most distinguished founders."

The distinguished Edinburgh anatomist harbors no illusions with regard to any supposed opposition of the Church to dissection or to the development of anatomy. As a life-long student of anatomy who knew the history of his favorite science, he appreciated very well just who had been the great workers in it and where their work had been done. He says that "Italy long retained the distinction of giving birth to the first eminent anatomists in Europe, and the glory she acquired in the names of Mondino, Achillini, Berengar of Carpi, and Massa was destined to become more conspicuous in the labors of Columbus, Fallopius and Eustachius." These are the greatest names in the history of anatomy down to the beginning of the seventeenth century, with the single exception of Vesalius.

All this of anatomical development in Italy at universities that were directly under the ecclesiastical authorities would seem to settle all question of interference by the Popes or the Church with any phase of anatomical development. It does not seem sufficient for Dr. White, however. When I called attention to all these details of the history of anatomy, long before the reformation and before Vesalius, Dr. White's response was the following paragraph in which he explains how dissection came to be practiced at all, and reiterates not only his belief that Pope Boniface's bull prevented dissection, but even insists on what cannot but seem utterly absurd to any one who has read even the brief account I have given here, that except at one or two places, and then only to a very limited degree, dissection was not practiced at all. Here is how the history of dissection must be viewed according to Dr. White:–

"But Dr. Walsh elsewhere falls back on the fact that shortly after the decree of Pope Boniface VIII., which struck so severe a blow at dissection, the Venetian Senate passed a decree ordaining that a dissection of the human body should be made every year in the city of Venice, and he leaves his readers to conclude that this effectually proves that dissection had not really been discouraged by the Pope. The very opposite conclusion would be deduced by anyone familiar with the relations between the Republic of Venice and the Papacy. These two powers were always struggling against each other; again and again the Venetian Republic, in maintaining its rights, braved the Papal interdicts. The fact that it allowed dissections, so far from proving that the Pope allowed them, would seem to prove that in this case, and in so many other cases, and especially that of Vesalius of Padua, the Venetian Senate sought to show the Vatican that it would yield none of its rights to clerical control. This very fact–that Venice refused to be bound with regard to anatomical investigation by an order from the Vatican–seems to be entirely in the line with all the other facts in the case, which show that the Roman court had committed itself, most unfortunately, against the main means of progress in anatomy and medicine."

Here then is the answer that a modern historian and educator makes to all the representations with regard to the development of anatomy and the practice of dissection during the Middle Ages. If the practice of dissection was permitted it was in spite of the Popes. The fact that there were a dozen of medical schools in Italy at which dissection was carried on is ignored. The great anatomists of the fourteenth and fifteenth centuries simply did not exist–Dr. White knows nothing about them. There must be no admission that the Popes permitted dissection or any other form of science. Dr. White makes his last stand by a really marvelous tour d'esprit. It was Venice defying the Vatican that permitted dissection. This, he supposes, may help him, for anatomy did develop very wonderfully at Padua when it was Venetian territory. But, as pointed out by Roth, dissection was practiced very successfully, and the anatomical tradition established at Padua, before it came under the dominion of Venice. At all the other important cities of Italy dissection was carried on. We have given some of the evidence for Verona, for Pisa, for Naples, for Bologna, for Florence, and, be it remembered, even for Rome. Padua was the rival of Bologna in anatomy only for a comparatively short time. Bologna always maintained a primacy in the field of anatomy, and never more so than after she became a Papal city at the beginning of the sixteenth century. Vesalius taught and demonstrated not at Padua alone, but also at Bologna and at Pisa. For two centuries Rome was the most successful rival of Bologna, and hundreds of dissections were done in the Papal Medical School.

Of course, the appeal to Venetian opposition to the Papacy as an explanation for dissection being carried on in Italy in spite of ecclesiastical regulations to the contrary is only a subterfuge. It can only be found in histories written by those who refuse to see facts as they were, because those facts do not accord with pet theories as to Papal Opposition to Science, and the Warfare Between Theology and Science, which must be maintained at all costs, though with an air of apology always for having to tell such unpleasant truths of these old-time religious authorities.

THE GOLDEN AGE OF ANATOMY

VESALIUS

The Golden Age of discovery in anatomy culminated during the first half of the sixteenth century. This will not be surprising if it is but recalled that this period represents the culmination also of that larger golden age of achievement in art and letters, which has been called the Renaissance. Columbus and Copernicus were giving men a new world and a new universe. Raphael, Michael Angelo, Lionardo da Vinci, the Bellinis and Titian were creating a new world of art. Most of these artists were deeply interested in anatomy. Every phase of human thought was being born anew. Unfortunately, this word Renaissance has given rise to many misunderstandings. Many people have taken its significance of re-birth to mean that art and letters, and with them education and thinking, were born again into the modern world at this time with the coming in of the New Learning, just as if there had been nothing worth while talking about in these lines of human accomplishment in the preceding centuries. Taken in this sense, the word Renaissance is entirely a misnomer. Magnificent achievements in art and letters and every form of education preceded the Renaissance by at least three or four centuries. The Gothic cathedrals and the enduring artistic development that took place in their making, the magnificent organization of technical education in the training of artist artisans by the guilds of the time (we would be glad if our technical schools could accomplish anything like the same results, for evidently, though the name technical education is our invention, these medieval peoples had the reality to a high degree), and finally the universities, which have remained essentially the same down to our own day–all these serve to show how much was done for every form of education many centuries before the beginning of the Renaissance so-called.

It is not surprising that with this much of education abroad in the land men succeeded in making enduring literature in every form and in every country in Europe, and in setting examples of style in prose and verse that succeeding generations have nearly always gone back to admire lovingly. Such an amount of education and development of thinking could not have come without profound attention to science, and, as a matter of fact, there was much more anticipation of even what is most modern in our scientific thinking than most scholars seem to have any idea of. Personally, I have found, in writing the history of The Thirteenth the Greatest of Centuries, more that interested me in the science of this century than in almost any other department of its wonderful educational development.

We have already seen that while anatomy had during preceding centuries only the beginning of the development that it was destined to reach during the sixteenth century, it would be a serious mistake to think that the study of anatomy, having died in the old classical days, was not re-born until the sixteenth century. This would be to commit the error that many ardent devotees of the Renaissance make with regard to all the accomplishments of this period. In spite of the contrary almost universal impression, the Renaissance was not original to any marked degree. With the touch of the Greek spirit that had come again into the world, it only carried the preceding work of great original thinkers to a high order of perfection. This happened as well in anatomy as in art and architecture and literature. Anatomical science was a lusty infant of great promise when Vesalius, the Father of Anatomy, came on the scene. The great painters, Raphael and Lionardo and Michael Angelo, owed much to Giotto and Fra Angelico, who had preceded them, but not more than Vesalius and his contemporaries, who did such magnificent work in original anatomical investigation, owed to Mondino, Bertrucci, Zerbi, Achillini, and above all to Berengar of Carpi and Benivieni, who did their work before and just after the sixteenth century opened. There is never a sudden development in the history of any department of man's knowledge or achievement, as there is nothing absolutely new under the sun, though it is still the custom of the young man in his graduation essay to talk of such things, and older men sometimes fail to realize the truth that in history as in biology, life always comes from preceding life–omne vivum ex vivo--and there is no such thing as spontaneous generation.

If the achievements of this earlier period of scientific work, which affected anatomy even more than any of the other sciences, be kept in mind, the discussion of the Golden Age of Anatomy will find its proper place in the history of the relation of the Popes to science. Though the date of the Golden Age in Anatomy follows that of the so-called reformation, there is absolutely no connection between the two series of events, for the one took place in Germany and the other in Italy. The Golden Age of Anatomy was indeed a perfectly legitimate and quite to be expected culmination of the anatomical interest which had been gradually rising to a climax in the Italian universities during the preceding century. It has a definite place in the evolution of science, and is not a sudden or unlooked for phenomenon.

If there was any place in the world at the beginning of the sixteenth century in which the ecclesiastical authorities had much to say with regard to what should not be taught and what should not be studied in the universities, it was Italy. In spite of this fact, all medical men who wanted to do post-graduate work in medicine went down into Italy. This was especially true for those who desired to obtain ampler opportunities for anatomical study than were afforded by the rest of Europe. In his maturer years as a student of medicine, Vesalius went down to Italy in order to avail himself of the magnificent field for investigation that was provided there. This favorable state of affairs as regards research in anatomy had existed for more than a century before his time. It continued to be true for at least two centuries after his time. As a matter of fact, Italy was to the rest of the world of the fifteenth and sixteenth and seventeenth centuries the home of post-graduate opportunities in all sciences as well as in medicine.

These are not idle words, but are fully substantiated by the lives of the men who stand at the head of our modern medicine. More than a decade before Vesalius was born, Linacre, the distinguished English physician and founder of the Royal College of Physicians, went to Italy to complete his medical studies and incidentally also to round out his education in the midst of the new learning which was so thoroughly cultivated there. When Linacre was leaving Italy, with true classic spirit he set up a little altar on the top of the Alps whence he could get his last view of the Italian plains, and greeted the charming country that he was leaving so reluctantly with the beautiful name of Alma Mater Studiorum. To him, after his return to England, English-speaking medical men owe the establishment of the institution which above all others has helped to uplift the dignity of the medical profession and make the practice of the healing art something more than a mere trade–the Royal College of Physicians.

One of Vesalius's most distinguished fellow students at Padua was Dr. John Caius, who was later to become the worthy president of the Royal College of Physicians of England and the author of certain important medical works. Dr. Caius was the first to introduce the practice of public dissections into England. Caius and Vesalius were roommates, though at the time Vesalius was an instructor at the University, and the inspiration of his originality seems to have had a great effect upon young Caius. They were nearly of the same age, though Vesalius was a precocious genius, and Caius's greatness only showed itself in maturity. Caius was studying in Italy partly because the religious disturbances in England had made it uncomfortable for him to remain in his native country, for he was a firm adherent of the old Church and he hoped they would pass over, but mainly because he coveted the opportunities afforded by that country. Later in life, out of the revenues of his position as Royal Physician to Queen Mary and subsequently for some time to Queen Elizabeth, he founded the famous Caius College at Cambridge, usually called Key's College by Cantabrigians.

Before either of these men there had been a third distinguished English physician who had gone down to Italy for his education. This was the celebrated and learned John Phreas, who was born about the commencement of the fifteenth century. Very little is known of his career, but what we do know is of great interest. He was educated at Oxford and obtained a fellowship on the foundation of Balliol College. Afterward he seems to have studied medicine with a physician in England, but was not satisfied with the medical education thus obtained. He set the fashion for going down into Italy sometime during the first half of the fifteenth century, and after some years spent at Padua received the degree of doctor in medicine, which in those days carried with it, as the name implies, the right to teach. As not infrequently happens to the brilliant medical student, he settled down for practice in the university town in which he graduated, to take up both occupations, that of teacher and practitioner. He is said to have made a large fortune in the practice of physic. [Footnote 12] The best proof of his scholarship is to be found in some letters still preserved in the Bodleian and in the Library of Balliol College. Personally, I have considered that his career was interesting from another standpoint. I have often looked in history for the cases of appendicitis which occur so frequently in our day and with regard to which people ask how is it they did not occur in the past. The fact is, they did occur, but were unrecognized. People were taken suddenly ill, not infrequently a short time after a meal, and after considerable pain and fever, swelling and great tenderness in the abdomen developed, and they died with all the signs of poisoning. They were actually poisoned, not by some extraneous material, but by the putrid contents of their own intestines which found a way out through the ruptured appendix. These cases were set down as poisoning cases, and usually some interested person was the subject of suspicion. Dr. Phreas's learning had obtained for him an appointment to a bishopric in England, a curious bit of evidence of the absence of opposition between medical science and religion in his time. He died shortly after this, under circumstances that raised a suspicion of poisoning in the minds of some of his contemporaries–but raises the thought of appendicitis in mine,–and one of his rivals was blamed for it.

[Footnote 12: Like the other distinguished physicians of this time, John Phreas did not devote himself to medicine alone. He had a taste for literature, and besides being an accomplished scholar he was a poet.]

Nor did the custom for English medical students to go down to Italy to complete their education cease with the so-called reformation. Some two generations after Vesalius's time another distinguished Englishman, Harvey, went down to Italy to complete the studies he had already made and eventually to lay the foundation of that knowledge on which he was twenty years later to construct his doctrine of the circulation of the blood. This doctrine, however, remained merely a theory until the distinguished Italian anatomist, Malpighi, after another half century, demonstrated the existence of the capillaries, the little blood vessels which connect the veins and arteries, and by thus showing the continuity of both the blood systems, proved beyond all doubt the certainty of the teaching that the blood does circulate.

Students came, moreover, from even the distant North of Europe to the Italian schools of medicine during these centuries. Neil Stensen, or as he is perhaps better known by his Latin name, Nicholas Steno, the discoverer of the duct of the parotid gland, which has been named after him, and of many other anatomical details, especially of the fact that the heart is a muscle, which stamp him as an original investigator of the highest order, after having made extensive studies in the Netherlands and in France to complete the medical education which he had begun in his native city of Copenhagen, went down into Italy to secure freer opportunities for original research than he could obtain anywhere else in Europe. [Footnote 13]

[Footnote 13: It may perhaps be of interest to say that while doing investigation in anatomy and certain other sciences allied to medicine, Steno became a convert to the Catholic Church and after some years became a priest. Before his ordination, however, though after his conversion, he received the call to the chair of anatomy at Copenhagen. He accepted this and worked for several years at the Danish University, but was dissatisfied with the state of affairs around him as regards religion and went back to Italy. Eventually he was made a bishop–hence the curious picture of him in a Roman Catholic Bishop's robes in the collection of pictures of professors of anatomy at the University of Copenhagen. Not long after, at his own request, he was sent up to the Northern part of Germany in order to try to bring back to the Church as many of the Germans as might be won by his gentleness of disposition, his saintly character, his wonderful scientific knowledge, and his winning ways. He is the Father of Modern Geology as well as a great anatomist, and his little book on geology was published after he became a priest, yet did not hamper in any way his ecclesiastical preferment nor alienate him from his friends in the hierarchy. He was honored especially by the Popes. In a word, his career is the best possible disproof of any Papal or ecclesiastical opposition to science in his time.]

We have mentioned that it was while he was pursuing his special investigations in various Italian universities that Stensen was honored with the invitation to become professor of anatomy at the University of Copenhagen. This was not a chance event, but a type of the point of view in university education at the time. Just as at the present time the prestige of research in a German university counts for much as a recommendation for professorships in our American universities, so in the sixteenth and seventeenth centuries was it with regard to study in Italy. It was felt that men who had spent several years there could be reasonably expected to know all that there was to be known in the rising sciences of anatomy and physiology; at the same time there was a very general impression, quite justified by the results observed, that those who did their post-graduate work in Italy were nearly always sure to make discoveries that would add to the prestige of their universities later, and that would be a stimulus to students and to the other teachers around them such as could be provided in no other way. If read in the proper spirit, the history of the universities of those times is quite like our own, only for influence, the name of Italy must always be substituted for that of Germany. Yet Italy, if we were to believe some of the writers on the history of education and science, was at this time laboring under the incubus of ecclesiastical intolerance with regard to anatomy and an almost complete suppression of opportunities for dissection. Those who write thus know nothing at all of the actual facts of the history of science, or else they are blinding themselves for some reason to the real situation.

Fortunately students of the facts of history, especially those who have devoted any serious attention to the history of medicine, make no such mistake. For them it is perfectly clear that there was a wonderful development in anatomy which took place down in Italy, beginning about the middle of the fifteenth century or even earlier, and which led to the provision of such opportunities for dissection and original research in medicine, that students from all over the world were attracted there. For instance, Professor Clifford Allbutt, in the address on the Historical Relations of Medicine and Surgery to the end of the Sixteenth Century, already quoted, has a passage in which, as an introduction to what he has to say about Galen, he sums up the history of anatomy from the return of the Popes from Avignon to Rome, which took place just about the beginning of the last quarter of the fourteenth century, down to the time of Vesalius. This expresses so well what I have been trying to say with regard to the gradual development that led up to the Golden Age of Anatomy and to Vesalius's work, that I quote it.

"Meanwhile, however, the return of the Popes to Rome (1374) and the displacement of the Albucasis and Avicenna by the Greek texts renewed the shriveling body of medicine, and with the help of anatomy, Italian medicine awoke again; though until the days of Vesalius and Harvey the renascence came rather from men of letters than of medicine. The Arabs and Paris said: "Why dissect if you trust Galen? But the Italian physicians insisted on verification; and therefore back to Italy again the earnest and clear-sighted students flocked from all regions. Vesalius was a young man when he professed in Padua, yet, young or venerable, where but in Italy would he have won, I would not say renown, but even sufferance! If normal anatomy was not directly a reformer of medicine, by way of anatomy came morbid anatomy, as conceived by the genius of Benivieni, of Morgagni, and of Valsalva; the galenical or humoral doctrine of pathology was sapped, and soaring in excelsis for the essence of disease gave place to grubbing for its roots."

A sketch of Vesalius's career will give the best possible idea of the influences at work in science during this Golden Age of anatomical discovery, and will at the same time serve to show better than anything else, how utterly unfounded is the opinion that there was opposition between religion, or theology and science, and above all medical science, at this time. On the other hand, it will demonstrate that the educational factors at work in Vesalius's time were not different from those of the preceding century, nor indeed from those that had existed for two or three centuries before his time; and though his magnificent original research introduced the new initiative which always comes after a genius has left his mark upon a scientific department, the spirit in which science was pursued after his time did not differ essentially from that which had prevailed before. He represents not a revolution in medical science, as has so often been said, though always with the purpose of demonstrating how much the so-called reformation accomplished in bringing about this great progress in anatomy, but only a striking epoch in that gradual evolution which had already advanced so far that his work was rendered easy and some such climax of progress as came in his time was inevitable.

Vesalius's earlier education was received entirely in his native town of Louvain. There were certain preparatory schools in connection with the university at Louvain, and to one of these, called Paedagogium Castri because of the sign over the door, which was that of a fort, Vesalius was sent. Here he learned Latin and Greek and some Hebrew. How well he learned his Latin can be realized from the fact that at twenty-two he was ready to lecture in that language on anatomy in Italy. His knowledge of Greek can be estimated from the tradition that he could translate Galen at sight, and he was known to have corrected a number of errors in translations from that author made by preceding translators. To those who know the traditions of that time in the teaching of the classic languages along the Rhine and in the Low Countries, these accomplishments of Vesalius will not be surprising. They knew how to teach in those pre-reformation days, and probably Latin and Greek have never been better taught than by the Brethren of the Common Life, whose schools for nearly a hundred years had been open in the Low Countries and Rhenish Germany for the children of all classes, but especially of the poor. Other schools in the same region could scarcely fail to be uplifted by such educational traditions. Altogether, Vesalius spent some nine years in the Paedagogium.

As illustrating how men will find what interests them in spite of supposed lack of opportunities, it may be said that from his earliest years Vesalius was noted for his tendency to be inquisitive with regard to natural objects, and while still a mere boy his anatomical curiosity manifested itself in a very practical way. He recalls himself in later years, that the bladders with which he learned to swim, and which were also used by the children of the time as play-toys for making all sorts of noises, became in his hands objects of anatomical investigation. Anatomy means the cutting up of things, and this Vesalius literally did with the bladders. He noted particularly that they were composed of layers and fibres of various kinds, and later on when he was studying the veins in human and animal bodies he was reminded of these early observations, and pointed out that the vein walls were made up of structures not unlike those, though more delicate, of which the bladders of his childhood days had proven to be composed.

His preparatory studies over, Vesalius entered the University of Louvain, at that time one of the most important universities of Europe. At the end of the fifteenth and the beginning of the sixteenth century, Louvain probably had more students than any other university in Europe except that of Paris, and possibly Bologna. There are good grounds for saying that the number in attendance here during the first half of the sixteenth century was always in excess of 5,000. The university was especially famous for its teaching of jurisprudence and philology. The faculty of theology, however, was considered to be one of the strongest in Europe, and Louvain, as might be expected from its position in the heart of Catholic Belgium, was generally acknowledged to be one of the great intellectual bulwarks of Catholicity against the progress of Lutheranism in the Teutonic countries at this time. Vesalius's parents were, and his family always had been, ardent Catholics, so that, quite apart from his dwelling not far away, it was very natural that he should have been sent here. He seems to have spent five years in the university mainly engaged in the study of philosophy and philology, but also of the classics and languages so far as they were taught at that time.

It may be noted as another instance in his life of how a student will find that which appeals to him even in the most unexpected sources, that Vesalius took special interest in certain treatises of Albertus Magnus and Michael Scotus, which treated of the human body in the vague, curious way of the medieval scholars, and yet with a precious amount of information, that this inquisitive youth eagerly drank in. More interesting for Vesalius himself were certain studies undertaken entirely independently of his university course. One of his biographers tells that he dissected small animals, rats and mice, and occasionally even dogs and cats, in his eagerness to learn the details of anatomy for himself and at first hand.

After graduating at Louvain in philosophy and philology, Vesalius went to Paris to study medicine. At this time at Paris, Sylvius, after whom one of the most important fissures of the brain, the sylvian, is named, was not only teaching anatomy in a very interesting way, but was also providing opportunities for original research in anatomy in connection with his own investigations. The interest that his teaching excited may be gathered from the fact that over 400 students were in attendance at his lectures. Besides Sylvius, Günther of Andernach in Switzerland was also teaching in Paris, and with both of these distinguished professors Vesalius became intimately associated. His deep interest in the subject of anatomy would of itself be quite sufficient to attract the attention of professors, but he had besides the added advantage of being known as the descendant of a family which had occupied prominent posts as medical attendants to the greatest ruling family of Europe.

It was at Paris, then, that Vesalius first was able to devote himself with the intense ardor of his character to the study of anatomy. Nothing less than original research at first hand would satisfy his ardent desire for information and his thirst for accurate knowledge. His practical temper of mind was demonstrated by a revolution that he worked in the method of doing dissections at the time. The dissections in Paris used to be performed by the barber-surgeons, as a rule rather ignorant men, who knew little of their work beyond the barest outline of the technics of dissection. Teachers in anatomy used to stand by and direct the operation and demonstrate the various parts. These teachers, however, considered it quite beneath them to use the knife themselves. The faultiness of this method can be readily understood. Vesalius began a new era in the history of anatomy by insisting on doing the dissections himself. It was not long, however, before he realized that Paris could not afford him such opportunities as he desired. Altogether he did not remain there more than a year, and then returned to the Low Countries.