Fabrica

In the early 16th century anatomy became an increasingly important component of a doctor’s learning. The Renaissance brought with it an influx of newly translated Galenic texts (including large anatomical guides), and these helped to enhance this fashionable area of study. In addition there emerged an emphasis on physicians doing dissection themselves—seeing with their own eyes what parts of the body look like. The foremost exponent of this practical, hands-on approach was Andreas Vesalius.

Born in Brussels in 1514, Vesalius was the son of an apothecary. He studied medicine at Paris, where he was educated in the teachings of Galen, before being appointed to a lectureship in surgery and anatomy at Padua. He was 23 years old. In 1540 Vesalius utilised Renaissance ideas surrounding anatomy to begin work on his definitive treatise. The result, in 1543, was De humani corporis fabrica (On the Workings of the Human Body, or “the Fabrica”), which the Oxford Medical Companion describes as “probably the most influential of all medical works.”

Before the Fabrica there had for some time been a dearth of accurate anatomical illustration. The standard procedure was for anatomists to employ artists to do illustrations under their instruction. Invariably the anatomists would guide their depiction in the vein of traditional images rather than direct observation, thereby retaining longstanding inaccuracies.

Three factors can be seen as accounting for the Fabrica’s outstanding anatomical content: Vesalius’s brilliant technical skill with the scalpel, his insistence on using as evidence only that which he had observed, and his copious knowledge of the Galenic corpus. Hence it can be appreciated that the Fabrica, when published, set the standard in anatomical illustration. The quality of the book’s artwork is such that it has, arguably, received more attention than the textual content. Not only are the drawings highly accurate, they also evince an outstanding level of artistic skill—the artist is thought to have been a pupil of Titian.

Of central importance is Vesalius’s treatment of Galenic anatomy. Although much of the content of the Fabrica remains true to Galen, Vesalius was also keen to highlight the inaccuracies and shortcomings of the Greek physician. Galen had used animals, often apes, as his anatomical subjects, and as a result there were several errors, for example in the depiction of the heart’s chambers, that Vesalius looked to rectify.

Reaction to the publication of the Fabrica could have been easily predicted. Vesalius would have known the controversy that his book’s attack on Galen would cause and, most likely, would have welcomed it in the knowledge that it would add to his publicity. The text was groundbreaking in its anatomical content, and its innovative illustrations and modes of presentation were also novel. Ultimately the Fabrica helped to advance the career of Vesalius—he became household physician to Emperor Charles V.