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Stamp vignette on medical science| Volume 94, ISSUE 5, e67-e68, May 2019

Andreas Vesalius and De Fabrica

      Andreas Vesalius was one of the most notable and influential anatomists of all time. He was born on December 31, 1514, into a wealthy and well-connected Flemish family in Brussels, which was then under the control of the Austrian House of Habsburg. His grandfather had been the Royal Physician to Holy Roman Emperor Maximilian I (1459-1519), while his father was an apothecary and served as valet to Maximilian’s imperial successor, Charles V (1500-1558). Vesalius’ birth name was Andries van Wesel, which was later Latinized, as was customary for scientists and other scholars at that time.
      After preliminary education in his family’s library and private tutoring, Vesalius entered the Castle College of the University of Leuven in Brabant when he was 13 years old. In 1532, at age 17, he went on to the University of Paris for medical education.
      In the 16th century, anatomy in European universities was still taught from the classical Roman texts of Galen. Typically, a medical school professor would read Galen’s text while a barber-surgeon assistant would point to the area that the professor was describing on a cadaver (or, more commonly, an animal). Frequently the anatomy lectures were overly crowded with students who found it difficult to see the described structures. In rare cases in which a cadaver was available to students, the poorly supervised students often mangled the cadaver and obtained little insight into anatomical structures.
      Vesalius grew dissatisfied with this method of teaching and resolved to do better. In Paris, Vesalius had the opportunity to perform human dissections himself, as he had access to bodies of a few executed criminals and also to skeletons from a cemetery (the Parisian Cemetery of the Innocents, closed in 1780). He quickly became known as a masterful anatomist.
      In 1536, because of hostilities between the Holy Roman Empire and France, Vesalius was forced to leave Paris and return to Leuven, where he graduated after completing a dissertation on the Persian physician and alchemist Rhazes. In early 1537, he went to the University of Padua, which was then part of the Republic of Venice, and was granted a doctoral degree with honors at the end of the year. On the day following his graduation, he was appointed as a professor of surgery and anatomy at the University of the City of Venice, but stayed only briefly before returning to Padua as an instructor and lecturer on anatomy. Recalling his earlier experiences, Vesalius urged his students to perform dissections themselves and developed a systematic approach to demonstrate anatomy to students.
      In 1538, with the assistance of Johan van Calcar, an illustrator who had studied with the artist Titian, Vesalius prepared 6 elaborate anatomical plates for teaching anatomy. These plates, known as Tabulae Anatomicae Sex (“Six anatomical tables”), were far superior in detail to any previous anatomic illustrations and increased his reputation.
      In 1543, Vesalius published his masterpiece, De humani corporis fabrica libri septem (Latin for “Seven books on the structure of the human body”), with more than 200 woodcut illustrations. A highly regarded Swiss printer and humanist in Basel, Johannes Oporinius (1507-1568), published the book and oversaw its distribution throughout Northern Europe. The 7 books included descriptions of: 1) bones and cartilage; 2) ligaments and muscles 3) veins and arteries; 4) nerves; 5) gastrointestinal and reproductive organs; 6) organs of the thorax; and 7) the brain.
      De Fabrica, as it became widely known, quickly became the most influential book on human anatomy. The book was updated in 1555. About 700 copies survive, mostly in medical libraries and museums. A 1543 copy that came up for private auction in 2017 sold for 367,000 Euros (approximately $415,000 USD at the time of the sale).
      Vesalius’ experience with dissection led him to challenge Galen’s anatomical findings, which included numerous errors. For example, Galen thought the human sternum included 7 bones and the mandible 2 bones. Galen also believed that the cardiac ventricular septum was porous. Vesalius corrected these and other misconceptions. Vesalius had the advantage of actual human dissection, while he discovered in 1541 that Galen’s anatomy had been largely based on animal dissections. Galen’s texts also lacked illustrations, but De Fabrica included delicate engraved woodcut prints with high-quality illustrations, especially of muscle groups. Finally, Galen did not use a systematic anatomical nomenclature; in contrast, Vesalius identified and enumerated each illustration.
      Vesalius presented a unique color copy of De Fabrica to the Holy Roman Emperor Charles V, who was so impressed that he appointed Vesalius the imperial physician in 1544, which largely put an end to Vesalius’ scholarly work.
      In 1564, Vesalius visited Jerusalem on a pilgrimage. While in Jerusalem, the senate of Venice requested that he succeed his friend and former student Gabriel Fallopius (1503-1562) as professor of anatomy in Padua, as Fallopius had died. On his way to Padua, however, the vessel Vesalius was traveling on was shipwrecked on the island of Zakynthos (Zante) in the Ionian Sea. This is where Vesalius died and was buried.
      Andreas Vesalius is commonly credited as the founder of modern anatomy. He revolutionized the teaching of anatomy and methods of dissection, transforming anatomy into a modern observational science. His work paved the way for developments in physiology, pathology, and comparative anatomy.
      Vesalius has been honored philatelically at least 12 times, including 4 times by Belgium. Belgium issued a stamp (Scott number #606) on March 2, 1964, to commemorate the 400th anniversary of his death. The image was adopted from the frontispiece of his masterpiece De Fabrica. On this stamp, a dissected upper limb is exaggerated in size to emphasize the importance of dissection.