the evolution of modern medicine(现代医药的演变)-第30章
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practice was followed of holding a professorial discourse； while the
butcher； or barber surgeon； opened the cavities of the body。 A member of a
famous Basel family of physicians； Felix Plater； has left us in his
autobiography＇19＇ details of the dissections he witnessed at Montpellier
between November 14； 1552； and January 10； 1557； only eleven in
number。 How difficult it was at that time to get subjects is shown by the
risks they ran in 〃body…snatching〃 expeditions； of which he records three。
＇19＇ There is no work from which we can get a better idea of the life of
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the sixteenth…century medical student and of the style of education and of
the degree ceremonies； etc。 Cumston has given an excellent summary of it
（Johns Hopkins Hospital Bulletin； 1912； XXIII； 105…113）。
And now came the real maker of modern anatomy。 Andreas Vesalius
had a good start in life。 Of a family long associated with the profession；
his father occupied the position of apothecary to Charles V； whom he
accompanied on his journeys and campaigns。 Trained at Louvain； he had；
from his earliest youth； an ardent desire to dissect； and cut up mice and
rats； and even cats and dogs。 To Paris； the strong school of the period； he
went in 1533； and studied under two men of great renown； Jacob Sylvius
and Guinterius。 Both were strong Galenists and regarded the Master as an
infallible authority。 He had as a fellow prosector； under the latter； the
unfortunate Servetus。 The story of his troubles and trials in getting bones
and subjects you may read in Roth's 〃Life。〃＇20＇ Many interesting
biographical details are also to be found in his own writings。 He returned
for a time to Louvain； and here he published his first book； a commentary
on the 〃Almansor〃 of Rhazes； in 1537。
＇20＇ M。 Roth： Andreas Vesalius Bruxellensis； Berlin； 1892。 An
excellent account of Vesalius and his contemporaries is given by James
Moores Ball in his superbly printed Andreas Vesalius； the Reformer of
Anatomy； St。 Louis； 1910。
Finding it difficult； either in Paris or Louvain； to pursue his anatomical
studies； he decided to go to Italy where； at Venice and Padua； the
opportunities were greater。 At Venice； he attended the practice of a
hospital （now a barracks） which was in charge of the Theatiner Order。 I
show you a photograph of the building taken last year。 And here a strange
destiny brought two men together。 In 1537； another pilgrim was working
in Venice waiting to be joined by his six disciples。 After long years of
probation； Ignatius Loyola was ready to start on the conquest of a very
different world。 Devoted to the sick and to the poor； he attached himself to
the Theatiner Order； and in the wards of the hospital and the quadrangle；
the fiery； dark…eyed； little Basque must frequently have come into contact
with the sturdy young Belgian； busy with his clinical studies and his
anatomy。 Both were to achieve phenomenal successthe one in a few
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years to revolutionize anatomy； the other within twenty years to be the
controller of universities； the counsellor of kings； and the founder of the
most famous order in the Roman Catholic Church。 It was in this hospital
that Vesalius made observations on the China…root； on which he published
a monograph in 1546。 The Paduan School was close to Venice and
associated with it； so that the young student had probably many
opportunities of going to and fro。 On the sixth of December； 1537； before
he had reached his twenty…fourth year and shortly after taking his degree；
he was elected to the chair of surgery and anatomy at Padua。
The task Vesalius set himself to accomplish was to give an accurate
description of all the parts of the human body； with proper illustrations。 He
must have had abundant material； more； probably； than any teacher before
him had ever had at his disposal。 We do not know where he conducted his
dissections； as the old amphitheatre has disappeared； but it must have been
very different from the tiny one put up by his successor； Fabricius； in 1594。
Possibly it was only a temporary building； for he says in the second
edition of the 〃Fabrica〃 that he had a splendid lecture theatre which
accommodated more than five hundred spectators （p。 681）。
With Vesalius disappeared the old didactic method of teaching
anatomy。 He did his own dissections； made his own preparations； and；
when human subjects were scarce； employed dogs； pigs or cats； and
occasionally a monkey。 For five years he taught and worked at Padua。 He
is known to have given public demonstrations in Bologna and elsewhere。
In the 〃China…root〃 he remarks that he once taught in three universities in
one year。 The first fruit of his work is of great importance in connection
with the evolution of his knowledge。 In 1538； he published six anatomical
tables issued apparently in single leaves。 Of the famous 〃Tabulae
Anatomicae〃 only two copies are known； one in the San Marco Library；
Venice； and the other in the possession of Sir John Stirling…Maxwell；
whose father had it reproduced in facsimile （thirty copies only） in 1874。
Some of the figures were drawn by Vesalius himself； and some are from
the pencil of his friend and countryman； Stephan van Calcar。 Those plates
were extensively pirated。 About this time he also edited for the Giunti
some of the anatomical works of Galen。＇21＇
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＇21 De anatomicis administrationibus； De venarum arterinrumque
dissectione； included in the various Juntine editions of Galen。
We know very little of his private life at Padua。 His most important
colleague in the faculty was the famous Montanus； professor of medicine。
Among his students and associates was the Englishman Caius； who lived
in the same house with him。 When the output is considered； he cannot
have had much spare time at Padua。
He did not create human anatomythat had been done by the
Alexandriansbut he studied it in so orderly and thorough a manner that
for the first time in history it could be presented in a way that explained
the entire structure of the human body。 Early in 1542 the MS。 was ready；
the drawings had been made with infinite care； the blocks for the figures
had been cut； and in September； he wrote to Oporinus urging that the
greatest pains should be taken with the book； that the paper should be
strong and of equal thickness； the workmen chosen for their skill； and that
every detail of the pictures must be distinctly visible。 He writes with the
confidence of a man who realized the significance of the work he had
done。 It is difficult to speak in terms of moderation of the 〃Fabrica。〃 To
appreciate its relative value one must compare it with the other anatomical
works of the period； and for this purpose I put before you two figures from
a text…book on the subject that was available for students during the first
half of the sixteenth century。 In the figures and text of the 〃Fabrica〃 we
have anatomy as we know it； and let us be honest and say； too； largely as
Galen knew it。 Time will not allow me to go into the question of the
relations of these two great anatomists； but we must remember that at this
period Galen ruled supreme； and was regarded in the schools as infallible。
And now； after five years of incessant labor； Vesalius was prepared to
leave his much loved Padua and his devoted students。 He had
accomplished an extraordinary work。 He knew； I feel sure； what he had
done。 He knew that the MSS。 contained something that the world had not
seen since the great Pergamenian sent the rolls of his 〃Manual of
Anatomy〃 among his friends。 Too precious to entrust to any printer but the
bestand the best in the middle of the sixteenth century was Transalpine
he was preparing to go north with the precious burden。 We can picture the
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youthful teacherhe was but twenty…eightamong students in a university
which they themselves controlledsome of them perhaps the very men
who five years before had elected himat the last meeting with his class；
perhaps giving a final demonstration of the woodcuts； which were of an
accuracy and beauty never seen before by students' eyes； and reading his
introduction。 There would be sad hearts at the parting； for never had
anyone taught anatomy as he had taught itno one had ever known
anatomy as he knew it。 But the strong； confident look was on his face and
with the courage of youth and sure of the future； he would picture a happy
return to attack new and untried problems。 Little did he dream that his
happy days as student and teacher were finished； that his work as an
anatomist was over； that the most brilliant and epoch…making part of his
career as a professor was a thing of the past。 A year or more was spent at
Basel with his friend Oporinus supervising the printing of the great work；
which appeared in 1543 with the title 〃De Humani Corporis Fabrica。〃 The
worth of a book； as of a man； must be judged by results； and； so judged；
the 〃Fabrica〃 is one of the great books of the world； and would come in
any century of volumes which embraced the richest harvest of the human
mind。 In medicine； it represents the full flower of the Renaissance。 As a
book it is a sumptuous tome a worthy setting of his jewelpaper； type and
illustration to match； as you may see for yourselves i
