Kitabı oku: «The Popes and Science», sayfa 7

Students came, moreover, from even the distant North of Europe to the Italian schools of medicine during these centuries. Neil Stensen, or as he is perhaps better known by his Latin name, Nicholas Steno, the discoverer of the duct of the parotid gland, which has been named after him, and of many other anatomical details, especially of the fact that the heart is a muscle, which stamp him as an original investigator of the highest order, after having made extensive studies in the Netherlands and in France to complete the medical education which he had begun in his native city of Copenhagen, went down into Italy to secure freer opportunities for original research than he could obtain anywhere else in Europe. [Footnote 13]

[Footnote 13: It may perhaps be of interest to say that while doing investigation in anatomy and certain other sciences allied to medicine, Steno became a convert to the Catholic Church and after some years became a priest. Before his ordination, however, though after his conversion, he received the call to the chair of anatomy at Copenhagen. He accepted this and worked for several years at the Danish University, but was dissatisfied with the state of affairs around him as regards religion and went back to Italy. Eventually he was made a bishop–hence the curious picture of him in a Roman Catholic Bishop's robes in the collection of pictures of professors of anatomy at the University of Copenhagen. Not long after, at his own request, he was sent up to the Northern part of Germany in order to try to bring back to the Church as many of the Germans as might be won by his gentleness of disposition, his saintly character, his wonderful scientific knowledge, and his winning ways. He is the Father of Modern Geology as well as a great anatomist, and his little book on geology was published after he became a priest, yet did not hamper in any way his ecclesiastical preferment nor alienate him from his friends in the hierarchy. He was honored especially by the Popes. In a word, his career is the best possible disproof of any Papal or ecclesiastical opposition to science in his time.]

We have mentioned that it was while he was pursuing his special investigations in various Italian universities that Stensen was honored with the invitation to become professor of anatomy at the University of Copenhagen. This was not a chance event, but a type of the point of view in university education at the time. Just as at the present time the prestige of research in a German university counts for much as a recommendation for professorships in our American universities, so in the sixteenth and seventeenth centuries was it with regard to study in Italy. It was felt that men who had spent several years there could be reasonably expected to know all that there was to be known in the rising sciences of anatomy and physiology; at the same time there was a very general impression, quite justified by the results observed, that those who did their post-graduate work in Italy were nearly always sure to make discoveries that would add to the prestige of their universities later, and that would be a stimulus to students and to the other teachers around them such as could be provided in no other way. If read in the proper spirit, the history of the universities of those times is quite like our own, only for influence, the name of Italy must always be substituted for that of Germany. Yet Italy, if we were to believe some of the writers on the history of education and science, was at this time laboring under the incubus of ecclesiastical intolerance with regard to anatomy and an almost complete suppression of opportunities for dissection. Those who write thus know nothing at all of the actual facts of the history of science, or else they are blinding themselves for some reason to the real situation.

Fortunately students of the facts of history, especially those who have devoted any serious attention to the history of medicine, make no such mistake. For them it is perfectly clear that there was a wonderful development in anatomy which took place down in Italy, beginning about the middle of the fifteenth century or even earlier, and which led to the provision of such opportunities for dissection and original research in medicine, that students from all over the world were attracted there. For instance, Professor Clifford Allbutt, in the address on the Historical Relations of Medicine and Surgery to the end of the Sixteenth Century, already quoted, has a passage in which, as an introduction to what he has to say about Galen, he sums up the history of anatomy from the return of the Popes from Avignon to Rome, which took place just about the beginning of the last quarter of the fourteenth century, down to the time of Vesalius. This expresses so well what I have been trying to say with regard to the gradual development that led up to the Golden Age of Anatomy and to Vesalius's work, that I quote it.

"Meanwhile, however, the return of the Popes to Rome (1374) and the displacement of the Albucasis and Avicenna by the Greek texts renewed the shriveling body of medicine, and with the help of anatomy, Italian medicine awoke again; though until the days of Vesalius and Harvey the renascence came rather from men of letters than of medicine. The Arabs and Paris said: "Why dissect if you trust Galen? But the Italian physicians insisted on verification; and therefore back to Italy again the earnest and clear-sighted students flocked from all regions. Vesalius was a young man when he professed in Padua, yet, young or venerable, where but in Italy would he have won, I would not say renown, but even sufferance! If normal anatomy was not directly a reformer of medicine, by way of anatomy came morbid anatomy, as conceived by the genius of Benivieni, of Morgagni, and of Valsalva; the galenical or humoral doctrine of pathology was sapped, and soaring in excelsis for the essence of disease gave place to grubbing for its roots."

A sketch of Vesalius's career will give the best possible idea of the influences at work in science during this Golden Age of anatomical discovery, and will at the same time serve to show better than anything else, how utterly unfounded is the opinion that there was opposition between religion, or theology and science, and above all medical science, at this time. On the other hand, it will demonstrate that the educational factors at work in Vesalius's time were not different from those of the preceding century, nor indeed from those that had existed for two or three centuries before his time; and though his magnificent original research introduced the new initiative which always comes after a genius has left his mark upon a scientific department, the spirit in which science was pursued after his time did not differ essentially from that which had prevailed before. He represents not a revolution in medical science, as has so often been said, though always with the purpose of demonstrating how much the so-called reformation accomplished in bringing about this great progress in anatomy, but only a striking epoch in that gradual evolution which had already advanced so far that his work was rendered easy and some such climax of progress as came in his time was inevitable.

Vesalius's earlier education was received entirely in his native town of Louvain. There were certain preparatory schools in connection with the university at Louvain, and to one of these, called Paedagogium Castri because of the sign over the door, which was that of a fort, Vesalius was sent. Here he learned Latin and Greek and some Hebrew. How well he learned his Latin can be realized from the fact that at twenty-two he was ready to lecture in that language on anatomy in Italy. His knowledge of Greek can be estimated from the tradition that he could translate Galen at sight, and he was known to have corrected a number of errors in translations from that author made by preceding translators. To those who know the traditions of that time in the teaching of the classic languages along the Rhine and in the Low Countries, these accomplishments of Vesalius will not be surprising. They knew how to teach in those pre-reformation days, and probably Latin and Greek have never been better taught than by the Brethren of the Common Life, whose schools for nearly a hundred years had been open in the Low Countries and Rhenish Germany for the children of all classes, but especially of the poor. Other schools in the same region could scarcely fail to be uplifted by such educational traditions. Altogether, Vesalius spent some nine years in the Paedagogium.

As illustrating how men will find what interests them in spite of supposed lack of opportunities, it may be said that from his earliest years Vesalius was noted for his tendency to be inquisitive with regard to natural objects, and while still a mere boy his anatomical curiosity manifested itself in a very practical way. He recalls himself in later years, that the bladders with which he learned to swim, and which were also used by the children of the time as play-toys for making all sorts of noises, became in his hands objects of anatomical investigation. Anatomy means the cutting up of things, and this Vesalius literally did with the bladders. He noted particularly that they were composed of layers and fibres of various kinds, and later on when he was studying the veins in human and animal bodies he was reminded of these early observations, and pointed out that the vein walls were made up of structures not unlike those, though more delicate, of which the bladders of his childhood days had proven to be composed.

His preparatory studies over, Vesalius entered the University of Louvain, at that time one of the most important universities of Europe. At the end of the fifteenth and the beginning of the sixteenth century, Louvain probably had more students than any other university in Europe except that of Paris, and possibly Bologna. There are good grounds for saying that the number in attendance here during the first half of the sixteenth century was always in excess of 5,000. The university was especially famous for its teaching of jurisprudence and philology. The faculty of theology, however, was considered to be one of the strongest in Europe, and Louvain, as might be expected from its position in the heart of Catholic Belgium, was generally acknowledged to be one of the great intellectual bulwarks of Catholicity against the progress of Lutheranism in the Teutonic countries at this time. Vesalius's parents were, and his family always had been, ardent Catholics, so that, quite apart from his dwelling not far away, it was very natural that he should have been sent here. He seems to have spent five years in the university mainly engaged in the study of philosophy and philology, but also of the classics and languages so far as they were taught at that time.

It may be noted as another instance in his life of how a student will find that which appeals to him even in the most unexpected sources, that Vesalius took special interest in certain treatises of Albertus Magnus and Michael Scotus, which treated of the human body in the vague, curious way of the medieval scholars, and yet with a precious amount of information, that this inquisitive youth eagerly drank in. More interesting for Vesalius himself were certain studies undertaken entirely independently of his university course. One of his biographers tells that he dissected small animals, rats and mice, and occasionally even dogs and cats, in his eagerness to learn the details of anatomy for himself and at first hand.

After graduating at Louvain in philosophy and philology, Vesalius went to Paris to study medicine. At this time at Paris, Sylvius, after whom one of the most important fissures of the brain, the sylvian, is named, was not only teaching anatomy in a very interesting way, but was also providing opportunities for original research in anatomy in connection with his own investigations. The interest that his teaching excited may be gathered from the fact that over 400 students were in attendance at his lectures. Besides Sylvius, Günther of Andernach in Switzerland was also teaching in Paris, and with both of these distinguished professors Vesalius became intimately associated. His deep interest in the subject of anatomy would of itself be quite sufficient to attract the attention of professors, but he had besides the added advantage of being known as the descendant of a family which had occupied prominent posts as medical attendants to the greatest ruling family of Europe.

It was at Paris, then, that Vesalius first was able to devote himself with the intense ardor of his character to the study of anatomy. Nothing less than original research at first hand would satisfy his ardent desire for information and his thirst for accurate knowledge. His practical temper of mind was demonstrated by a revolution that he worked in the method of doing dissections at the time. The dissections in Paris used to be performed by the barber-surgeons, as a rule rather ignorant men, who knew little of their work beyond the barest outline of the technics of dissection. Teachers in anatomy used to stand by and direct the operation and demonstrate the various parts. These teachers, however, considered it quite beneath them to use the knife themselves. The faultiness of this method can be readily understood. Vesalius began a new era in the history of anatomy by insisting on doing the dissections himself. It was not long, however, before he realized that Paris could not afford him such opportunities as he desired. Altogether he did not remain there more than a year, and then returned to the Low Countries.

At Louvain he continued his anatomical work, finding it difficult enough to procure human material, but using such as might come to hand. The story is told of his first attempt to get a complete skeleton. A felon had been executed just outside the walls of Louvain, and his remains were, as was the custom at that time, allowed to swing on the gibbet until the birds of the air had eaten his flesh and the wind and rain had bleached his bones. As might be thought, these bones were a great temptation to Vesalius. Finally, one night he and a fellow student stole out of the town and robbed the gibbet of its treasure. In order to accomplish their task–no easy one, because the skeleton was fastened to the beams of the scaffold by iron shackles–they had to remain out all night. They buried it and later removed it piecemeal, and when they had finally assembled the parts again it was exhibited as a skeleton brought from Paris.

Even this story has been made to do duty as showing the ecclesiastical opposition to dissection and the advancement of anatomical knowledge. It is hard to understand, however, why men will not look at such an incident from the standpoint of our own experience in the modern time. There are men still alive in certain states of the Union who recall how much trouble they had to go to as medical students in order to procure a skeleton. If we go back fifty years, nearly every skeleton that physicians had in their offices was obtained in some way almost as surreptitious as that just described, or was purchased through some underhand channel. They were dug up from potter's field, or sometimes procured from complacent prison officials, or occasionally stolen from respectable cemeteries. In this respect Vesalius was not much worse off than were his medical colleagues for nearly three centuries and a half after his time in the northern countries. It was easier to procure such material in Italy.

Vesalius had that precious quality that makes the investigator desire to see and know things for himself. He could not get opportunities for definite anatomical knowledge in the western part of Europe, so he gave up his practice, though Louvain, his native town, was a most promising place, having nearly 200,000 inhabitants and business relations with all the world at the moment, and went down into Italy where he knew that he could pursue his anatomical studies to his heart's content. The tradition of the work that Zerbi and Achillini had done, and especially what Benivieni and Berengar had accomplished within a few decades before this time, was commonly known in all the medical schools of Europe, and many an ardent young anatomist in the West yearned for the opportunities and the incentive that he could obtain down there. Church influence was predominant; the ecclesiastics were the actual rulers of the universities, but medical science, and above all anatomy, was being studied very ardently. Vesalius thus prompted, came and found what he looked for. At the end of ten short years of work down there, he had completed his text-book of anatomy which was to earn for him deservedly the title of Father of Anatomy.

At first Vesalius seems to have spent some time in Venice, where he attracted considerable attention by his thorough, practical anatomical knowledge and independent mode of thinking. After only a short period in Venice, however, he proceeded to Padua, where he spent some months in preparation for his doctor's examination. It is known that, having completed his examination in the early part of December, 1537, he was allowed within a few days to begin the teaching of anatomy, and, indeed, was given the title of professor by the university authorities.

The next six years were spent in teaching at Padua, Bologna and Pisa, and in fruitful investigation. Every opportunity to make dissections was gladly seized, and Vesalius's influence enabled him to obtain a large amount of excellent anatomical material. He began at once the preparations for the publication of an important work on the anatomy of the human body. This was published in 1543 at Basel, at a time when its author was not yet thirty years of age. It is one of the classics of anatomical literature. Even at the present day it is often consulted by those who wish to see the illustrative details of Vesalius's wonderful dissections as given in the magnificent plates that the work contains. It has become one of the most precious of medical books, and is eagerly sought for by collectors.

For ten years more Vesalius devoted himself to his favorite studies in anatomy and physiology, for it must not be forgotten that he was constantly applying his knowledge of form and tissue to function, and came to be looked upon as the leading medical investigator of the world. It is apparently sometimes not realized, however, that Vesalius was no mere laboratory or dissecting room investigator. After the publication of his great work on anatomy he set himself seriously to the application of what he had discovered to practical medicine and surgery. He was an intensely practical man. As a consequence, it was not long before consultations began to pour in on him, and he came to be considered as one of the greatest medical practitioners of his time. Ruling princes in Italy, visitors of distinction, high ecclesiastics–all wished to have Vesalius's opinion when their cases became puzzling. This is a side of his character that many of his modern biographers have missed. Even Sir Michael Foster, whose knowledge of the history of medicine, and especially of physiology, makes one hesitate to disagree with him, seems not to have appreciated Vesalius's interest in practical medicine. A laboratory man himself, he was apparently not able to appreciate why Vesalius should have given up his scientific research in Italy to accept the post of Royal Physician to the Emperor Charles V.

Professor Foster thinks it necessary, then, to find some other reason than the temptation of the importance of the position to account for Vesalius's acceptance of it. He concludes that it was because of discouragement in his purely scientific studies as a consequence of the opposition of the Galenists. Opposition on the part of the old conservative school of medicine there was, and some of it was rather serious. This was not enough, however, to have discouraged Vesalius. Professor Foster goes so far as to wax almost sentimental over the fact that the acceptance of the post of physician to Charles V. ended Vesalius's scientific career; "for though in the years which followed the Father of Anatomy from time to time produced something original, and in 1555 brought out a new edition of his Fabrica, differing chiefly from the first one, so far as the circulation of the blood is concerned, in its bolder enunciation of its doubts about the Galenic doctrines touching the heart, he made no further solid addition to the advancement of knowledge. Henceforward his life was that of a court physician much sought after and much esteemed–a life lucrative and honorable and in many ways useful, but not a life conducive to original inquiry and thought. The change was a great and a strange one. At Padua he had lived amid dissections; not content with the public dissections in the theatre, he took parts, at least, of corpses to his own lodgings and continued his labors there. No wonder that he makes in his Fabrica some biting remarks to the effect that he who espouses science must not marry a wife; he cannot be true to both. A year after his arrival at the Court he sealed his divorce from science by marrying a wife; no more dissections at home, no more dissections indeed at all; at most, some few post-mortem examinations of patients whose lives his skill had failed to save. Henceforth his days were to be spent in courtly duties, in soothing the temporary ailments, the repeated gouty attacks of his imperial master, in healing the maladies of the nobles and others round his throne, and doubtless in giving advice to more humble folk, who were from time to time allowed to seek his aid. Whither his master went, he went too, and we may well imagine that in leisure moments he entertained the Emperor and the Court with his intellectual talk, telling them some of the fairy tales of that realm of science which he had left, and of the later achievements of which news came to him, scantily, fitfully and from afar."

Professor White has gone much farther than Sir Michael Foster. The English physiologist knew too much about the history of medicine in Italy even to hint at any ecclesiastical opposition with regard to Vesalius. President White, however, has no scruples in the matter. This makes an excellent opportunity to write the kind of history that is to be found in his book. Apparently forgetful of the thought that the Emperor Charles V. was not at all likely to take as his body physician a man who had been in trouble with the ecclesiastical authorities in Italy, he insists that the reason why Vesalius dedicated his great work on anatomy to the Emperor Charles V. was "to shield himself as far as possible in the battle which he foresaw must come." Later he suggests that it was only the favor of the Emperor saved him from the ecclesiastical authorities.

All that has been said by historians with regard to the reasons for Vesalius's acceptance of the post of physician to the Emperor Charles V. can only have come from men who either did not know or had for the moment forgotten the story of Vesalius's ancestry. The family tradition of having one of its members as physician to the Court of the German Emperor was four generations old when Vesalius accepted the position.

Vesalius's great-grandfather occupied the position of physician-in-ordinary to Marie of Burgundy, the wife of the German Emperor Maximilian I., the distinguished patron of letters in the Renaissance period. He lived to an advanced age as a professor of medicine at Louvain. From this time on Vesalius's family always continued in official medical relation to the Austrian-Burgundy ruling family. His grandfather took his father's place as physician to Mary of Burgundy, and wrote a series of commentaries on the aphorisms of Hippocrates. Vesalius's father was the physician and apothecary to Charles V. for a while, and accompanied the Emperor on journeys and campaigns. What more natural than that his son, having reached the distinction of being the greatest medical scientist alive, should be offered, and as a matter of course accept the post of imperial physician!

The simple facts of the matter are that Vesalius came down into Italy in order to study anatomy, because in that priest-ridden and ecclesiastically-ruled country he could get better opportunities for anatomical study and investigation than anywhere else in Europe. He spent ten years there and then wrote his classical work on anatomy. After that he spent some years applying anatomy to medicine. Then when he had come to be the acknowledged leader of the medical profession of the world, the Emperor Charles V., at that time the greatest ruler in Europe, asked him to become his court physician. Vesalius accepted, as would any other medical investigator that I have ever known, under the same circumstances. His position with Charles V. gave him opportunities to act as consultant for many of the most important personages of Europe, and it must not be forgotten that when the King of France was injured in a tournament Vesalius was summoned all the way from Madrid, and gave a bad prognosis in the case.

In the light of this simple story of Vesalius's life in Italy, and of the reasons for his going there and his departure, it is intensely amusing to read the accounts of this portion of Vesalius's life, written by those who must maintain at all costs the historical tradition that the Church was opposed to anatomy, that the Popes had forbidden dissection, and that the ecclesiastical authorities were constantly on the watch to hamper, as far as possible at least, if not absolutely to prevent, all anatomical investigation, and were even ready to put to death those who violated the ecclesiastical regulations in this matter. Dr. White, for instance, has made a great hero of Vesalius for daring to do dissection. He was only doing what hundreds of others were doing and had been doing in Italy for hundreds of years; but to confess this would be to admit that the Church was not opposed to anatomy or the practice of dissection, and so perforce Vesalius must be a hero as well as the Father of Anatomy. To read Dr. White's paragraph in the History of the Warfare of Science with Theology, one cannot but feel sure that Vesalius must practically have risked death over and over again in order to pursue his favorite practice of dissection and his original researches in anatomy. I would be the last one in the world to wish to minimize in any way Vesalius's merits. He was a genius, a great discoverer–above all an inspiration to methods of study that have been most fruitful in their results, and withal a devout Christian and firm adherent of the Roman Catholic Church. He was not a hero in the matter of dissection, however, for there was no necessity for heroism. Dissection had been practiced very assiduously before his time in all the universities of Italy, especially in Bologna, which was a Papal city from the beginning of the sixteenth century, and also in Rome at the medical college of the Roman University under the very eye of the Popes.

In the light of this knowledge read President White's paragraph with regard to Vesalius:

"From the outset Vesalius proved himself a master. In the search for real knowledge he risked the most terrible dangers, and especially the charge of sacrilege, founded upon the teachings of the Church for ages. As we have seen, even such men in the early Church as Tertullian and St. Augustine held anatomy in abhorrence, and the decretal of Pope Boniface VIII. was universally construed as forbidding all dissection, and as threatening excommunication against those practicing it. Through this sacred conventionalism Vesalius broke without fear; despite ecclesiastical censure, great opposition in his own profession and popular fury, he studied his science by the only method that could give useful results. No peril daunted him. To secure material for his investigations, he haunted gibbets and charnel-houses, braving the fires of the Inquisition and the virus of the plague." (The italics are mine.)

A very interesting commentary on the expressions of Professor White with regard to Vesalius is to be found in a paragraph of Von Töply's article on the History of Anatomy in the second volume of Puschmann's History of Medicine, already quoted. "Out of the fruitful soil so well cultivated in the two preceding centuries, there developed at the beginning of the sixteenth century the Renaissance of anatomy, with all the great and also with all the unpleasant features which belong to the important works of art of that period. One has only to think of Donatello, Mantegna, Michel Angelo, and Verochio to realize these. The Renaissance of anatomy developed in a field of human endeavor which, if it did not owe all, at least owed very much to the art-loving and culture-fostering rulers, Popes and cardinals of the time. Older historians have told the story of the rise of anatomy in such a way that it seemed that the Papal Curia had set itself ever in utter hostility to the development of anatomy. As a matter of fact, the Papal Court placed scarcely any hindrances in its path. On the contrary, the Popes encouraged anatomy in every way."

In the page and a half following this quotation Von Töply has condensed into brief form most of what the Popes did for medicine and the medical sciences, though more especially for anatomy, during the centuries from the sixteenth down to the beginning of the nineteenth. Some excerpts from this, with a running commentary, will form the best compendium of the history of the Papal relations to medical education and will show that they are strikingly different from what has usually been said. Von Töply begins with Paul III., who is known in history more especially for his issuance of the Bull founding the Jesuits. It might ordinarily be presumed by those who knew nothing of this Pope, that the Head of the Church, to whom is due an institution such as the Jesuits are supposed to be, would not be interested to the slightest degree in modern sciences, and would be one of the last ecclesiastical authorities from whom patronage of science could possibly be expected. It was he, however, who founded special departments for anatomy and botany and provided the funds for a salary for a prosector of anatomy at Rome.