the evolution of modern medicine(现代医药的演变)-第42章
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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 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 d
