the evolution of modern medicine(现代医药的演变)-第31章
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book it is a sumptuous tome a worthy setting of his jewelpaper； type and
illustration to match； as you may see for yourselves in this foliothe chef
d'oeuvre of any medical library。
In every section； Vesalius enlarged and corrected the work of Galen。
Into the details we need not enter： they are all given in Roth's monograph；
and it is a chapter of ancient history not specially illuminating。
Never did a great piece of literary work have a better setting。 Vesalius
must have had a keen appreciation of the artistic side of the art of printing；
and he must also have realized the fact that the masters of the art had by
this time moved north of the Alps。
While superintending the printing of the precious work in the winter of
1542…1543 in Basel； Vesalius prepared for the medical school a skeleton
from the body of an executed man； which is probably the earliest
preparation of the kind in Europe。 How little anatomy had been studied at
the period may be judged from that fact that there had been no dissection
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at Basel since 1531。＇22＇ The specimen is now in the Vesalianum； Basel； of
which I show you a picture taken by Dr。 Harvey Cushing。 From the
typographical standpoint no more superb volume on anatomy has been
issued from any press； except indeed the second edition； issued in 1555。
The paper is； as Vesalius directed； strong and good； but it is not； as he
asked； always of equal thickness； as a rule it is thick and heavy； but there
are copies on a good paper of a much lighter quality。 The illustrations
drawn by his friend and fellow countryman； van Calcar； are very much in
advance of anything previously seen； except those of Leonardo。 The title…
page； one of the most celebrated pictures in the history of medicine； shows
Vesalius in a large amphitheatre （an imaginary one of the artist； I am afraid）
dissecting a female subject。 He is demonstrating the abdomen to a group
of students about the table； but standing in the auditorium are elderly
citizens and even women。 One student is reading from an open book。
There is a monkey on one side of the picture and a dog on the other。
Above the picture on a shield are the three weasels； the arms of Vesal。 The
reproduction which I show you here is from the 〃Epitome〃a smaller
work issued before ＇？＇ the 〃Fabrica；〃 with rather larger plates； two of
which represent nude human bodies and are not reproduced in the great
work。 The freshest and most beautiful copy is the one on vellum which
formerly belonged to Dr。 Mead； now in the British Museum； and from it
this picture was taken。 One of the most interesting features of the book are
the full…page illustrations of the anatomy of the arteries； veins and nerves。
They had not in those days the art of making corrosion preparations； but
they could in some way dissect to their finest ramifications the arteries；
veins and nerves； which were then spread on boards and dried。 Several
such preparations are now at the College of Physicians in London； brought
from Padua by Harvey。 The plates of the muscles are remarkably good；
more correct； though not better perhaps； on the whole； than some of
Leonardo's。
＇22＇ The next； in 1559； is recorded by Plater in his autobiography； who
gave a public dissection during three days in the Church of St。 Elizabeth。
Vesalius had no idea of a general circulation。 Though he had escaped
from the domination of the great Pergamenian in anatomy； he was still his
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follower in physiology。 The two figures annexed； taken from one of the
two existing copies of the 〃Tabulae Anatomica；〃 are unique in anatomical
illustration； and are of special value as illustrating the notion of the
vascular system that prevailed until Harvey's day。 I have already called
your attention to Galen's view of the two separate systems； one containing
the coarse； venous blood for the general nutrition of the body； the other the
arterial； full of a thinner； warmer blood with which were distributed the
vital spirits and the vital heat。 The veins had their origin in the liver； the
superior vena cava communicated with the right heart； and； as Galen
taught； some blood was distributed to the lungs； but the two systems were
closed； though Galen believed there was a communication at the periphery
between the arteries and veins。 Vesalius accepted Galen's view that there is
some communication between the venous and arterial systems through
pores in the septum of the ventricles； though he had his doubts； and in the
second edition of his book （1555） says that inspite of the authority of the
Prince of Physicians he cannot see how the smallest quantity of blood
could be transmitted through so dense a muscular septum。 Two years
before this （1553）；＇*＇ his old fellow student； Michael Servetus； had in his
〃Christianismi Restitutio〃 annatomical touch with one another！
＇*＇ See the Servetus Notes in the Osler Anniversary Volumes； New
York； 1919； Vol。 II。Ed。
The publication of the 〃Fabrica〃 shook the medical world to its
foundations。 Galen ruled supreme in the schools： to doubt him in the least
particular roused the same kind of feeling as did doubts on the verbal
inspiration of the Scriptures fifty years ago！ His old teachers in Paris were
up in arms： Sylvius； nostrae aetatis medicorum decus； as Vesalius calls
him； wrote furious letters； and later spoke of him as a madman （vaesanus）。
The younger men were with him and he had many friends； but he had
aroused a roaring tide of detraction against which he protested a few years
later in his work on the 〃China…root；〃 which is full of details about the
〃Fabrica。〃 In a fit of temper he threw his notes on Galen and other MSS。
in the fire。 No sadder page exists in medical writings than the one in which
Vesalius tells of the burning of his books and MSS。 It is here reproduced
and translated。＇23＇ His life for a couple of years is not easy to follow； but
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we know that in 1546 he took service with Charles V as his body
physician； and the greatest anatomist of his age was lost in the wanderings
of court and campaigns。 He became an active practitioner； a distinguished
surgeon； much consulted by his colleagues； and there are references to
many of his cases； the most important of which are to internal aneurysms；
which he was one of the first to recognize。 In 1555 he brought out the
second edition of the 〃Fabrica；〃 an even more sumptuous volume than the
first。
＇23＇ Epistle on China…root； 1546； p。 196。 Vesalius may be quoted in
explanationin palliation：
〃All these impediments I made light of； for I was too young to seek
gain by my art； and I was sustained by my eager desire to learn and to
promote the studies in which I shared。 I say nothing of my diligence in
anatomizingthose who attended my lectures in Italy know how I spent
three whole weeks over a single public dissection。 But consider that in one
year I once taught in three different universities。 If I had put off the task of
writing till this time； if I were now just beginning to digest my materials；
students would not have had the use of my anatomical labours； which
posterity may or may not judge superior to the rechauffes formerly in use；
whether of Mesua； of Gatinaria； of some Stephanus or other on the
differences； causes and symptoms of diseases； or； lastly； of a part of
Servitor's pharmacopoeia。 As to my notes； which had grown into a huge
volume； they were all destroyed by me； and on the same day there
similarly perished the whole of my paraphrase on the ten books of Rhazes
to King Almansor； which had been composed by me with far more care
than the one which is prefaced to the ninth book。 With these also went the
books of some author or other on the formulae and preparation of
medicines； to which I had added much matter of my own which I judged
to be not without utility； and the same fate overtook all the books of Galen
which I had used in learning anatomy； and which I had liberally disfigured
in the usual fashion。 I was on the point of leaving Italy and going to Court；
those physicians you know of had made to the Emperor and to the nobles a
most unfavourable report of my books and of all that is published
nowadays for the promotion of study； I therefore burnt all these works that
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I have mentioned； thinking at the same time that it would be an easy
matter to abstain from writing for the future。 I must show that I have since
repented more than once of my impatience； and regretted that I did not
take the advice of the friends who were then with me。〃
There is no such pathetic tragedy in the history of our profession。
Before the age of thirty Vesalius had effected a revolution in anatomy； he
became the valued physician of the greatest court of Europe； but call no
man happy till he is dead！ A mystery surrounds his last days。 The story is
that he had obtained permission to perform a post…mortem examination on
the body of a young Spanish nobleman； whom he had attended。 When the
body was opened； the spectators to their horror saw the heart beating； and
there were signs of life！ Accused； so it is said； by the Inquisition of murder
and also of general impiety he only escaped through the intervention of the
King； with the condition that he make a pilgrimage to the
