Andries van Wesel was born in Brussels in the winter of 1514. He was born during the Renaissance, a period of time when the people of Europe were experiencing a great deal of change in their world. Many of the ways they had previously understood and done things were being upended. Major transformations were happening in their art, architecture, politics, science and literature, for instance, as well as in their music, mathematics, medicine, banking and religion.

More than 60 universities were founded in Europe, Ireland, Scotland, and Russia during this, the 16^th, century. Scholars were, in general, moving on from testing the doctrinal accuracy of old (classical Greco-Roman) concepts – as they had done in the past couple of hundred years – and were now asserting some radically new ideas that were based on their empirical and mathematical research. The Polish astronomer Nicolaus Copernicus, for example, discovered that Earth revolves around the sun but sensibly didn’t publish his findings until he was dying – as this view ‘sacrilegiously’ opposed the Roman Catholic Church’s  ‘geocentric’ stance on this matter. And William Harvey, an English physician, showed how blood continuously circulates through the body.

By this time, anatomical dissections (typically performed by the three-member lector, ostensor and sector team described in my last article) were an established part of medical education, even if they may not, by today’s standards, have been very effective as an educative tool …

“Despite the growing number of universities in which human anatomies were performed, the true worth of this discipline to students is subject to serious doubts. The dissections were annual or sometimes biennial and the number of students privileged to attend such demonstrations, which lasted for only a few days, was limited strictly. Furthermore, to finish the dissection in such a brief time, it had to be carried on almost nonstop with little opportunity for the student to digest and comprehend even such inadequate fare as was offered to him.” (O’Malley, 1964, p. 16)

Eighteen-year-old Andries began his university studies in Paris, and soon developed a passion for anatomy. Anatomy was then viewed as part of a well-rounded academic education, so it was studied by many different types of students – not just those preparing for a medical career. Andries took an especially keen interest in the classes taught by Jacques Dubois (known as Jacobus Sylvius in Latin). Sylvius (1478-1555) was an orthodox anatomist, so his teaching was in keeping with the ways the body had been classically described by Galen of Pergamon. Roman law had prohibited human dissection during Galen’s (130-c. 216 CE) lifetime, so he dissected the bodies of animals – including dogs, monkeys, and pigs. Like many of his colleagues, he also studied what he could see through the gaps of his patients’ wounds and the surgical incisions he made in their flesh. Galen passed on his many new ideas and discoveries through his teaching, and a large amount of scholarly writing. His texts were so highly regarded that they were widely circulated and copied many times over. Those that survived Western Europe’s cultural descent into the Dark Ages (many didn’t) were translated into Arabic, and from Arabic into medieval Latin, powerfully influencing the ways people (including Sylvius) thought about anatomy for most of the next 1,500 years.

As his studies progressed, Andries became increasingly frustrated with Sylvius’s style of teaching. Simply put, Sylvius – along with most of his predecessors, peers, and the Roman Catholic Church – firmly believed that Galen had been inspired by God. This basically meant that Galen’s knowledge of anatomy was holy, could not be faulted, and would never require any improvement. Sylvius consequently taught anatomy in the traditional manner – i.e., by restating and interpreting Galen’s age-old ideas. Following Galen’s lead, he only used the bodies of animals – never human cadavers – in his anatomy demonstrations. Any troublesome discrepancies between the book and the corpse in front of him were blamed on the corpse. Galen was, at least as far as Sylvius was concerned, an infallible authority!

Andries’ and his friends’ extracurricular trips to look at the piles of human bones stored in a nearby cemetery’s ossuary showed that the structure of some bones – such as the mandible (or jawbone) and sacrum – regularly differed from the way Galen had described them many centuries earlier. Andries worried that Sylvius’s loyalty to Galen’s ideas prevented him from acknowledging these seeming ‘discrepancies’ in bone structure. Was it possible that Galen’s descriptions of human anatomy might not have been as perfect as most people, especially Sylvius, seemed to think they were?

War intervened and Andries returned home to Belgium, where he completed his bachelor’s degree. He then obtained his doctorate in medicine at Italy’s University of Padua. His moving there had a lot to do with Italy’s more progressive attitude to anatomical dissection. Living in Italy gave him access to a plentiful supply of human cadavers that he could lawfully dissect, after their original owners had been killed at the gallows.

Andreas Vesalius (or Vesalius), as he was now internationally known in Latin, chose to perform his public anatomy dissections all by himself. He spoke off-the-cuff rather than reading from a book, he got his hands dirty, and personally pointed to the body parts he was describing. Vesalius’s research discoveries reinforced many of Galen’s earlier findings and, also, enabled him to correct some of Galen’s unintentional descriptive errors. His unconventional approach to anatomy – based on observations made during his dissections – attracted its critics, vociferously including Sylvius, as well as a rapidly growing number of supporters.

Vesalius’s first two books were published in 1543, shortly before his 30^th birthday: De Humani Corporis Fabrica Libri Septum (‘On the Fabric of the Human Body in Seven Books’); and De Humani Corporis Fabrica Librorum Epitome, an illustrated compendium volume that became commonly known as the Epitome.  As far as is known, these were the world’s first technically accurate anatomy textbooks. They famously included a specially commissioned, and soon to be much plagiarised, set of highly detailed and accurate anatomical drawings. Both books, and in particular their artwork, were instantly and enormously successful, and played an influential role in the promotion of a new, scientific dissection-based understanding of human anatomy that was better attuned to the needs of 16^th century European society than its age-old predecessor had been.

Vesalius’s use of scientific principles and human dissection rather than old-fashioned rhetoric heralded a revitalization of anatomy – so much so, Vesalius is often identified as ‘the founder’ of modern human anatomy.  Despite this, he doesn’t appear to have been specifically interested in, or developed any new information about, the fascial membranes that covered the body’s more robust bones, muscles, and organs. In Richardson and Carman’s 7-volume English language translation of Fabrica (1998-2009), for instance, he scarcely mentions membranes (or membrana as they were generally termed in Latin), does not use the word fascia, and these delicate elements are almost entirely absent in his famous dissection pictures. This ought not be surprising as, scientific dissection or not, he could still only see the body before him with his naked eyesight – as his predecessors had done for several millennia. That situation could only change after compound microscopes were eventually invented and applied to anatomy research.

If you’re interested, you can read some more about anatomy and fascia in my recently published (2021) book, The Living Wetsuit

The evolving history of fascia-focused anatomy is also outlined in the first chapter of the just released 2^nd edition of Fascia: The tensional network of the Human Body (Adstrum, 2022).

And, if you haven’t already done so, please connect with me at linkedin.com/in/sueadstrum

References:

• Adstrum, S. (2022). Evolution of fascia-focused anatomy. In R. Schleip, C. Stecco, M. Driscoll, & P. Huijing (Eds). Fascia: The tensional network of the human body (2^nd edition, pp. 4-19) . Edinburgh: Elsevier.

• Adstrum, S. (2021). The Living Wetsuit. Auckland, NZ: Integrative Anatomy Solutions.

• Adstrum, S., & Nicholson, H. (2019). A history of fascia. Clinical Anatomy 23(7): 862-870.

• O’Malley, C. D. (1964). Andreas Vesalius of Brussels, 1514-1564. Berkeley, CA: University of California Press.

• Vesalius, A., Richardson, W. F., & Carman, J. B. (1998-2009) On the fabric of the human body. Books I – VII. Novato, CA : Norman Pub. [I – The bones and cartilages (1998); II – The ligaments and muscles (1998); III – The veins and arteries (2002); IV – The nerves (2002); V – The organs of nutrition and generation (2007); VI – The heart and associated organs (2009); VII – The brain (2009)]