Out of the Flames Read online

  Vesalius, born in 1514, would probably have ended up an apothecary like his father, but fate took a happy turn. As reward for all those years spent following him around and dispensing potions, Charles removed the stain of illegitimacy from Andries's family by royal edict. The way was now paved for Vesalius to become a great man.

  After a brief stint at the University of Louvain in 1533, Vesalius was off to the much more prestigious University of Paris, where his keen enthusiasm for anatomy won him the coveted position of assistant to Guinter. As bodies were scarce, Vesalius, no doubt drawing on childhood experiences, developed his own unique form of studying. At night, he and some friends would sneak down to the charnel house and gather up any loose bones they might find lying around. Then they would blindfold each other and attempt to identify each bone simply by touch. Vesalius was a whiz at this game, although there was additional competition. “I was gravely imperiled by many savage dogs,” he reported later.

  Vesalius, as a Belgian and a subject of Charles, had to leave Paris in 1536 when the emperor invaded France. He finished off his course of study at the University of Padua, where, upon graduating in record time, he was immediately hired as professor of surgery and anatomy. Wherever he went, he made a practice of learning as much about the human body as possible. He stole bodies, bit by bit, from gallows and stakes by the side of the road, boiled the bones to soften them, and then reassembled the skeletons. He sometimes kept corpses in his apartment for up to three days before holding private anatomies for his students—this in an age before refrigeration and air-conditioning. And he never, ever missed the opportunity to perform an anatomy:

  When I returned from my visit to France I was invited by the physician of the Countess of Egmont to attend the autopsy of an eighteen-year-old girl of noble birth who, because of an enduring paleness of complexion and difficulty in breathing— although otherwise of agreeable appearance—was thought by her uncle to have been poisoned. Since the dissection had been undertaken by a thoroughly unskilled barber I could not keep my hand from the work, although except for two crude dissections lasting three days, which I had seen at school in Paris, I had never been present at one. From constriction of the thorax by a corset the girl had been accustomed to wear so that her waist might appear long and willowy, I judged that the complaint lay in a compression of the torso around the hypochondria and lungs. The attendant women left to shed their corsets as quickly as possible.

  And on another occasion:

  The handsome mistress of a certain monk of San Antonio here [in Padua] died suddenly as though from strangulation of the uterus or some quickly devastating ailment and was snatched from her tomb by the Paduan students and carried off for public dissection. By their remarkable industry they flayed the whole skin from the cadaver lest it be recognized by the monk who, with the relatives of his mistress, had complained to the municipal judge that the body had been stolen from the tomb.

  Vesalius could not help but notice that what he saw in his anatomies often did not correspond with accepted doctrine. In many key areas, Galen had been completely wrong. But it wasn't until 1540, at a public dissection in front of two hundred people in the Church of San Francesco in Italy, that Vesalius finally declared, as his biographer Charles O'Malley wrote, that “if his statement did not agree with Galen's, he would nonetheless demonstrate that he was right and Galen was wrong… It was sufficiently novel and sufficiently irritating to the conservative members of the audience so that they felt called upon to demonstrate their displeasure by marching out of the hall.”

  Then, in 1543, Vesalius did something that no one had had the nerve or the skill to do before-only twenty-nine years old, he published a book called De Humani Corporis Fabrica (On the Structure of the Human Body), in which he recorded his observations without regard to Church dogma. It was the very same year that Copernicus published On the Revolutions of the Celestial Spheres. The Fabrica was printed in folio and is one of the great books of science and perhaps the most important book ever published in the field of medicine. Vesalius described hundreds of parts of the body that had never been described before, including the heart. He charted the course of veins. But more than that, he ceaselessly refuted Galen. The lobed liver was gone, as was the compound lower jaw. The femur was now straight, and bile ducts and the uterus were accurately depicted for the first time.

  But however overpowering the scholarship, what made this book so unique were its illustrations. The Fabrica ran to 663 pages, of which 277 were woodcuts of muscles, blood vessels, organs, and nerves. These were illustrations of such incredible beauty, accuracy, and detail that although the artist or artists remain anonymous, prevailing thought credits them to the workshop of Titian. The title page illustration, an engraving depicting Vesalius dissecting a cadaver in the midst of a packed and enthralled crowd of students, is one of the most famous in printing history.

  (The original woodcuts were carefully preserved and protected, surviving numerous wars, plagues, and panics. They were lost for a time, only to be rediscovered in 1893, hidden in the library at the University of Munich. Then, after four hundred years, these priceless pieces of art were destroyed, along with the one-of-a-kind skeleton of the giant carnivorous dinosaur Spinosaurus, by Allied bombs in World War II.)

  The Fabrica was an instant sensation. The illustrations in particular were so convincing that Galenic theory crumbled almost from the day it was published. With one exception, Vesalius's description of human anatomy remained the standard for over four centuries. But that exception was enormous. Galen had postulated that blood moved from one side of the heart to the other through pores in the heart wall. In all of his autopsies, Vesalius had failed to observe these pores, yet in this one instance only he did not trust his own eyes. Rather he concluded that the pores in the septum did exist but were simply too small to be seen. So Vesalius missed entirely the heart's role in circulating blood through the body, and therefore also the functions and importance of the circulatory and respiratory systems, and without these there could be no real advancements of medical knowledge.

  The Fabrica was the pinnacle of Vesalius's career. The very next year, his father died and left him a sizable inheritance, and he gave up research and academia to accept the more prestigious position of personal physician to Charles V. He got married, built a big house, and relaxed into his new role. When Charles abdicated in 1556, Vesalius moved to Spain to become court physician to his successor, Philip II.

  But Vesalius's devotion to anatomy ultimately had its price. There was a rumor that while in Spain, during the dissection of a young nobleman, Vesalius touched the heart with his pointer and it suddenly beat. Another rumor claimed that while he was dissecting a young woman who had died of a strangled uterus, she suddenly but briefly sprung back to life, much to the consternation of her relatives. Whatever the reason, in 1564 he felt obliged to resign his office and make amends by undertaking a pilgrimage to Palestine. He made it there, but on the return trip he was shipwrecked on a deserted island. The man who gave the world the human body died miserably and alone, somewhere off the coast of Greece

  CHAPTER NINE

  THE MAN WHO replaced Andreas Vesalius as Guinter of An-dernach's assistant was Michael Servetus. Guinter considered them equals and called Servetus a young man “distinguished by his literary acquirements of every kind, and scarcely second to any in his knowledge of Galenical doctrine.” Nowhere was the versatility of Servetus's genius more evident than in his time at the medical school in Paris. Within three years of taking up an entirely new course of study, one with which he had no previous experience and no family background, during a time when he lectured on at least two unrelated subjects, Michael Servetus, by virtue of one great discovery, became one of the foremost anatomists in the world.

  Servetus was an unusual student in a number of respects. Actually, he was not officially a student at all—his name appears nowhere in the ledgers. In order to register, an applicant was required to produce a birth certificate, and
Michel de Villeneuve would have been unlikely to submit a document that revealed that he was really the arch-heretic Servetus. He probably bluffed his way in with the promise to produce his proofs at a later date and then either continued to finesse the issue or allowed it to be forgotten. This of course meant that when he left the university three years later, he didn't officially have a degree, either. Yet it is clear that he was there, that he did study medicine and complete the course brilliantly. Graduate students, then as now, were encouraged to teach as a supplement to their income, and Servetus, editor of Ptolemy, began to lecture on geography and astronomy, as well as mathematics. Apparently he was an engaging speaker, because his lecture series became very popular and was well attended by many important people, including an ambitious and talented young priest by the name of Pierre Palmier.

  After his first year, Servetus felt himself sufficiently advanced in his studies to compose a pamphlet on digestive aids entitled The Syrups. The full title was A Complete Account of Syrups Carefully Refined According to the Judgment of Galen to which, after a full discourse on concoction has been added the true method of purgation, as well as an exposition on the aphorism: Medicate that which has been concocted. After the author's name, Michael Villanovanus, was appended modestly, “You who are going to concoct the crude humors and restore health to the human body. Observe the teachings of this book.”

  The Syrups was little more than an extremely accurate translation of Galen. In the Galenic model, food is taken into the stomach, then “concocted,” or cooked, to provide energy. Any unused portion then passes into the blood and is circulated by the veins through the body, where the food undergoes a second “concoction” by the body's heat. As the concocted food flows with the blood, each organ or body part assimilates what it needs for nourishment, then passes whatever is left to the next part, and on and on, until every part of the body has had its shot. Anything still unused is then expelled in the traditional manner.

  When everything works properly, the result is a balance in the blood of the four humors. Eat a bad lobster, however, and the balance is disrupted. Disrupted balance means incomplete assimilation, and that in turn could lead to putrefaction of the blood. As part of the treatment to restore balance, “syrups,” or sweetened herbal or fruit liquids that encouraged heat in the stomach to aid digestion (read: purgative), were employed.

  Despite pithy passages on such processes as the generation of pus and bile, Servetus's little tract has no current medical relevance whatever. At the time, however, it was considered a very helpful manual, and it went to six printings, making its author a nice bit of money while adding to his reputation as a medical scholar.

  Servetus was now the author of a popular book, an instructor in a popular lecture series, and the archdeacon of students in the medical school. He was more secure than he had ever been before. But as a biographer would later write, he was also saddled with “a genius for indiscretion,” a trait that he brought forth with gusto now. He began in his lectures to criticize some of the faculty for lack of talent or sufficient education. Specifically, his complaint was that these professors did not study astronomy, and that no physician's education could be complete without it. In those days, astronomy was a broadly defined discipline that included the effects of weather. It also included astrology, one branch of which was called “judicial astrology” and was, in fact, little more than fortune-telling.

  Servetus, as passionate and bull-headed when he was wrong as when he was right, thought it laughable that medical professors were too shortsighted to grasp that the stars affected the timing of cures. As always, he expressed his opinions colorfully and often. He called his professors “the plagues of society,” among other things.

  The medical faculty, understandably, did not appreciate his remarks, and the dean of the school had Servetus in his office several times, objecting to his language and warning him not to incorporate horoscopes or the influence of the stars into medical treatment. Servetus reacted by preparing a scathing pamphlet in which he attacked the medical faculty even more vociferously. When the faculty learned that Servetus was preparing a written diatribe, they went to the Parlement of Paris and petitioned them to prevent Servetus from publishing his tract. When Servetus learned that the faculty had sued to suppress his pamphlet, he rushed it into print by promising a larger fee to the publisher and then made sure that it was distributed for maximum impact and embarrassment to the professors.

  Then it was again the professors' turn. They bypassed the Parlement and went directly to the Inquisition, demanding that Servetus be cited for heresy, not because he was criticizing them, of course, but for practicing judicial astrology. While this degree of heresy was not nearly as heinous as, say, denying the Trinity, who but Michael Servetus could then have walked in under an assumed name, calmly faced a tribunal that would have happily sentenced him to death if they had had any idea who he actually was, and argued persuasively (and successfully) that his accusers didn't know what they were talking about?

  After the Inquisition tossed out the case, the faculty went back to the civil authorities and demanded that the pamphlet be suppressed and that Servetus be enjoined from lecturing on proscribed topics. There was a trial and Servetus hired a lawyer to defend him. Perhaps he shouldn't have, for although his counsel argued strenuously that his client was a practitioner of astronomy, not judicial astrology, the Parlement disagreed, ultimately accepting the plaintiff's case almost word for word. Servetus was required to recall all the copies of his pamphlet and told to stop predicting the future. However, to show how unimportant they considered the case, the Parlement dismissed the entire matter with what amounted to a finger-wagging lecture. Servetus was told to be polite to his professors, and his professors were told to treat him with gentleness, as parents treat their children.

  Servetus left Paris soon afterward. He had not spent the requisite four years at medical school to get his degree, which could not have been conferred anyway, but he had learned pretty much all he needed to know. In fact, he had learned more. After observing at most two or three anatomies, Servetus had made a stunning intellectual leap. It would be one of science's great deductions, the very thing that Vesal-ius, a brilliant observer but a far less intuitive thinker, had missed. Servetus's discovery would later be called “a bridge between the medieval world and the modern.”

  He would not publish it for another fifteen years.

  AFTER SERVETUS LEFT PARIS, he returned for a brief time to Lyon before setting up practice as a country doctor in nearby Charlieu in the spring of 1538. Charlieu didn't have too many doctors educated at the University of Paris, so he was accepted almost immediately by the town's leading citizens and his practice thrived. There is even a hint of a romantic connection with a local girl.

  But not everybody in town was pleased that the brilliant Dr. Vil-leneuve had decided to settle down there. Professional jealousy was ap-parently expressed in a much more direct fashion in those days. Servetus was attacked one night on his way to tend a patient, by marauders representing a competing doctor. There was a sword fight in the dark. Servetus succeeded in driving off his attackers, slicing one up in the process. He himself was slightly wounded. As a result of this incident, he was arrested (no doubt at the instigation of the other doctor) but was released two or three days later.

  After this experience, he began to look around for a new place to practice. His old student, Pierre Palmier, had recently been appointed archbishop of Vienne. Vienne, on the Rhône about twenty miles south of Lyon, was an important ecclesiastical city. Four previous bishops had been elevated to sainthood, and one had been elected pope. Palmier, who had the heart of an ecclesiastic but the soul of a humanist, was now the leader of the church for the entire province of Dauphiny. When he heard of Servetus's availability, he stepped in and asked him to transfer to Vienne, even offering him apartments at his own château.

  (The tradition of referring to the French heir to the throne as “dauphin” originated in Daup
hiny. Dauphiny had been a separate principality, but in 1349 Humbert, the sovereign, “having had the misfortune of dropping his only son into the Rhône,” entered a monastery and gave his country to the French king, Philippe de Valois, on the condition that the eldest son of the king from then on always be referred to as “dauphin.” In addition, royal edicts were not to be in force in Dauphiny unless they were submitted independently, with the king referred to as “Dauphin of Vienne.”)

  In Vienne, as in Calvin's birthplace of Noyon, social as well as ecclesiastical life revolved around the archbishop. Servetus could count not only on getting a lot of business, but on meeting the very best, most educated, wealthiest people in the province, which included renewing his old acquaintance with Cardinal de Tournon, by then perhaps the most powerful Church official in France. More than that, Vienne was the site of a new branch printing office of the Trechsels' publishing house. If he moved to Vienne, Servetus could continue to edit, which he obviously enjoyed, as well as practice medicine.

  He accepted Palmier's invitation and within two years had gained a reputation, through his own hard work and humanitarianism, as one of the leading doctors in the province. Among his patients were not only Palmier but also Guy de Maugiron, lieutenant governor of the province and a commander in the king's council. As had Champier before him, Servetus treated the poor as well as the rich, and when plague struck Lyon in 1542, he ignored the personal risks and dedicated himself to caring for the sick.

  MICHAEL SERVETUS SETTLED into the most idyllic period of his life. He was celebrated as a physician and mixed freely with the highest levels of local society. He had money, position, and the leisure to pursue the studies necessary to a rich intellectual life. His reputation as a scholar commended him to other men of letters and ensured that he was in demand as an editor of important works.