the evolution of modern medicine-第29节

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ile　and　fill　up。　For　long　years　Copernicus　had　brooded　over　the　great　thoughts　which　his　careful　observation　had　compelled。　　We　can　imagine　the　touching　scene　in　the　little　town　when　his　friend　Osiander　brought　the　first　copy　of　the　precious　volume　hot　from　the　press；　a　well　enough　printed　book。　　Already　on　his　deathbed；　stricken　with　a　long　illness；　the　old　man　must　have　had　doubts　how　his　work　would　be　received；　though　years　before　Pope　Clement　VII　had　sent　him　encouraging　words。　　Fortunately　death　saved　him　from　the　〃rending〃　which　is　the　portion　of　so　many　innovators　and　discoverers。　His　great　contemporary　reformer；　Luther；　expressed　the　view　of　the　day　when　he　said　the　fool　will　turn　topsy…turvy　the　whole　art　of　astronomy；　but　the　Bible　says　that　Joshua　commanded　the　Sun　to　stand　still；　not　the　Earth。　　The　scholarly　Melanchthon；　himself　an　astronomer；　thought　the　book　so　godless　that　he　recommended　its　suppression　（Dannemann；　Grundriss）。　The　church　was　too　much　involved　in　the　Ptolemaic　system　to　accept　any　change　and　it　was　not　until　1822　that　the　works　of　Copernicus　were　removed　from　the　Index。


VESALIUS

THE　same　year；　1542；　saw　a　very　different　picture　in　the　far…famed　city　of　Padua；　〃nursery　of　the　arts。〃　The　central　figure　was　a　man　not　yet　in　the　prime　of　life；　and　justly　full　of　its　pride；　as　you　may　see　from　his　portrait。　Like　Aristotle　and　Hippocrates　cradled　and　nurtured　in　an　AEsculapian　family；　Vesalius　was　from　his　childhood　a　student　of　nature；　and　was　now　a　wandering　scholar；　far　from　his　Belgian　home。　But　in　Italy　he　had　found　what　neither　Louvain　nor　Paris　could　give；　freedom　in　his　studies　and　golden　opportunities　for　research　in　anatomy。　What　an　impression　he　must　have　made　on　the　student　body　at　Padua　may　be　judged　from　the　fact　that　shortly　after　his　graduation　in　December；　1537；　at　the　age　of　twenty…four；　he　was　elected　to　the　chair　of　anatomy　and　surgery。　Two　things　favored　himan　insatiate　desire　to　see　and　handle　for　himself　the　parts　of　the　human　frame；　and　an　opportunity；　such　as　had　never　before　been　offered　to　the　teacher；　to　obtain　material　for　the　study　of　human　anatomy。　Learned　with　all　the　learning　of　the　Grecians　and　of　the　Arabians；　Vesalius　grasped；　as　no　modern　before　him　had　done；　the　cardinal　fact　that　to　know　the　human　machine　and　its　working；　it　is　necessary　first　to　know　its　partsits　fabric。

To　appreciate　the　work　of　this　great　man　we　must　go　back　in　a　brief　review　of　the　growth　of　the　study　of　anatomy。

Among　the　Greeks　only　the　Alexandrians　knew　human　anatomy。　What　their　knowledge　was　we　know　at　second　hand；　but　the　evidence　is　plain　that　they　knew　a　great　deal。　　Galen's　anatomy　was　first…class　and　was　based　on　the　Alexandrians　and　on　his　studies　of　the　ape　and　the　pig。　We　have　already　noted　how　much　superior　was　his　osteology　to　that　of　Mundinus。　　Between　the　Alexandrians　and　the　early　days　of　the　School　of　Salernum　we　have　no　record　of　systematic　dissections　of　the　human　body。　It　is　even　doubtful　if　these　were　permitted　at　Salernum。　　Neuburger　states　that　the　instructions　of　Frederick　II　as　to　dissections　were　merely　nominal。

How　atrocious　was　the　anatomy　of　the　early　Middle　Ages　may　be　gathered　from　the　cuts　in　the　works　of　Henri　de　Mondeville。　　In　the　Bodleian　Library　is　a　remarkable　Latin　anatomical　treatise　of　the　late　thirteenth　century；　of　English　provenance；　one　illustration　from　which　will　suffice　to　show　the　ignorance　of　the　author。　Mundinus　of　Bologna；　one　of　the　first　men　in　the　Middle　Ages　to　study　anatomy　from　the　subject；　was　under　the　strong　domination　of　the　Arabians；　from　whom　he　appears　to　have　received　a　very　imperfect　Galenic　anatomy。　　From　this　date　we　meet　with　occasional　dissections　at　various　schools；　but　we　have　seen　that　in　the　elaborate　curriculum　of　the　University　of　Padua　in　the　middle　of　the　fifteenth　century　there　was　no　provision　for　the　study　of　the　subject。　Even　well　into　the　sixteenth　century　dissections　were　not　common；　and　the　old　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　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　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　work