Chapter XIII.   FROM MIRACLES TO MEDICINE.

Section IX.   THE SCIENTIFIC STRUGGLE FOR ANATOMY.


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We may now take up the evolution of medical science out of the medieval view and its modern survivals.   All through the Middle Ages, as we have seen, some few laymen and ecclesiastics here and there, braving the edicts of the Church and popular superstition, persisted in medical study and practice: this was especially seen at the greater universities, which had become somewhat emancipated from ecclesiastical control.   In the thirteenth century the University of Paris gave a strong impulse to the teaching of medicine, and in that and the following century we begin to find the first intelligible reports of medical cases since the coming in of Christianity.

In the thirteenth century also the arch-enemy of the papacy, the Emperor Frederick II, showed his free-thinking tendencies by granting, from time to time, permissions to dissect the human subject.   In the centuries following, sundry other monarchs timidly followed his example: thus John of Aragon, in 1391, gave to the University of Lerida the privilege of dissecting one dead criminal every three years.[319] W

During the fifteenth century and the earlier years of the sixteenth the revival of learning, the invention of printing, and the great voyages of discovery gave a new impulse to thought, and in this medical science shared: the old theological way of thinking was greatly questioned, and gave place in many quarters to a different way of looking at the universe.

In the sixteenth century Paracelsus appears - a great genius, doing much to develop medicine beyond the reach of sacred and scholastic tradition, though still fettered by many superstitions.   More and more, in spite of theological dogmas, came a renewal of anatomical studies by dissection of the human subject.   The practice of the old Alexandrian School was thus resumed.   Mundinus, Professor of Medicine at Bologna early in the fourteenth century, dared use the human subject occasionally in his lectures; but finally came a far greater champion of scientific truth, Andreas Vesalius, founder of the modern science of anatomy.   The battle waged by this man is one of the glories of our race.

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 practising 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.   First of all men he began to place the science of human anatomy on its solid modern foundations - on careful examination and observation of the human body: this was his first great sin, and it was soon aggravated by one considered even greater.

Perhaps the most unfortunate thing that has ever been done for Christianity is the tying it to forms of science which are doomed and gradually sinking.   Just as, in the time of Roger Bacon, excellent men devoted all their energies to binding Christianity to Aristotle; just as, in the time of Reuchlin and Erasmus, they insisted on binding Christianity to Thomas Aquinas; so, in the time of Vesalius, such men made every effort to link Christianity to Galen.   The cry has been the same in all ages; it is the same which we hear in this age for curbing scientific studies: the cry for what is called "sound learning." Whether standing for Aristotle against Bacon, or for Aquinas against Erasmus, or for Galen against Vesalius, the cry is always for "sound learning": the idea always has been that the older studies are "SAFE."

At twenty-eight years of age Vesalius gave to the world his great work on human anatomy.   With it ended the old and began the new; its researches, by their thoroughness, were a triumph of science; its illustrations, by their fidelity, were a triumph of art.

To shield himself, as far as possible, in the battle which he foresaw must come, Vesalius dedicated the work to the Emperor Charles V, and in his preface he argues for his method, and against the parrot repetitions of the mediaeval text-books; he also condemns the wretched anatomical preparations and specimens made by physicians who utterly refused to advance beyond the ancient master.   The parrot-like repeaters of Galen gave battle at once.   After the manner of their time their first missiles were epithets; and, the vast arsenal of these having been exhausted, they began to use sharper weapons - weapons theologic.

In this case there were especial reasons why the theological authorities felt called upon to intervene.   First, there was the old idea prevailing in the Church that the dissection of the human body is forbidden to Christians: this was used with great force against Vesalius, but he at first gained a temporary victory; for, a conference of divines having been asked to decide whether dissection of the human body is sacrilege, gave a decision in the negative.

The reason was simple: the great Emperor Charles V had made Vesalius his physician and could not spare him; but, on the accession of Philip II to the throne of Spain and the Netherlands, the whole scene changed.   Vesalius now complained that in Spain he could not obtain even a human skull for his anatomical investigations: the medical and theological reactionists had their way, and to all appearance they have, as a rule, had it in Spain ever since.   As late as the last years of the eighteenth century an observant English traveller found that there were no dissections before medical classes in the Spanish universities, and that the doctrine of the circulation of the blood was still denied, more than a century and a half after Sarpi and Harvey had proved it.

Another theological idea barred the path of Vesalius.   Throughout the Middle Ages it was believed that there exists in man a bone imponderable, incorruptible, incombustible - the necessary nucleus of the resurrection body.   Belief in a resurrection of the physical body, despite St. Paul's Epistle to the Corinthians, had been incorporated into the formula evolved during the early Christian centuries and known as the Apostles' Creed, and was held throughout Christendom, "always, everywhere, and by all." This hypothetical bone was therefore held in great veneration, and many anatomists sought to discover it; but Vesalius, revealing so much else, did not find it.   He contented himself with saying that he left the question regarding the existence of such a bone to the theologians.   He could not lie; he did not wish to fight the Inquisition; and thus he fell under suspicion.

The strength of this theological point may be judged from the fact that no less eminent a surgeon than Riolan consulted the executioner to find out whether, when he burned a criminal, all the parts were consumed; and only then was the answer received which fatally undermined this superstition.   Yet, in 1689 we find it still lingering in France, stimulating opposition in the Church to dissection.   Even as late as the eighteenth century, Bernouilli having shown that the living human body constantly undergoes a series of changes, so that all its particles are renewed in a given number of years, so much ill feeling was drawn upon him, from theologians, who saw in this statement danger to the doctrine of the resurrection of the body, that for the sake of peace he struck out his argument on this subject from his collected works.[320] W

Still other encroachments upon the theological view were made by the new school of anatomists, and especially by Vesalius.   During the Middle Ages there had been developed various theological doctrines regarding the human body; these were based upon arguments showing what the body OUGHT TO BE, and naturally, when anatomical science showed what it IS, these doctrines fell. An example of such popular theological reasoning is seen in a widespread belief of the twelfth century, that, during the year in which the cross of Christ was captured by Saladin, children, instead of having thirty or thirty-two teeth as before, had twenty or twenty-two.   So, too, in Vesalius's time another doctrine of this sort was dominant: it had long been held that Eve, having been made by the Almighty from a rib taken out of Adam's side, there must be one rib fewer on one side of every man than on the other.   This creation of Eve was a favourite subject with sculptors and painters, from Giotto, who carved it upon his beautiful Campanile at Florence, to the illuminators of missals, and even to those who illustrated Bibles and religious books in the first years after the invention of printing; but Vesalius and the anatomists who followed him put an end among thoughtful men to this belief in the missing rib, and in doing this dealt a blow at much else in the sacred theory.   Naturally, all these considerations brought the forces of ecclesiasticism against the innovators in anatomy.[321] W

A new weapon was now forged: Vesalius was charged with dissecting a living man, and, either from direct persecution, as the great majority of authors assert, or from indirect influences, as the recent apologists for Philip II admit, he became a wanderer: on a pilgrimage to the Holy Land, apparently undertaken to atone for his sin, he was shipwrecked, and in the prime of his life and strength he was lost to the world.

And yet not lost.   In this century a great painter has again given him to us.   By the magic of Hamann's pencil Vesalius again stands on earth, and we look once more into his cell.   Its windows and doors, bolted and barred within, betoken the storm of bigotry which rages without; the crucifix, toward which he turns his eyes, symbolizes the spirit in which he labours; the corpse of the plague-stricken beneath his hand ceases to be repulsive; his very soul seems to send forth rays from the canvas, which strengthen us for the good fight in this age.[322] W

His death was hastened, if not caused, by men who conscientiously supposed that he was injuring religion: his poor, blind foes aided in destroying one of religion's greatest apostles.   What was his influence on religion? He substituted, for the repetition of worn-out theories, a conscientious and reverent search into the works of the great Power giving life to the universe; he substituted, for representations of the human structure pitiful and unreal, representations revealing truths most helpful to the whole human race.

The death of this champion seems to have virtually ended the contest.   Licenses to dissect soon began to be given by sundry popes to universities, and were renewed at intervals of from three to four years, until the Reformation set in motion trains of thought which did much to release science from this yoke.[323] W

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[319] For the promotion of medical science and practice, especially in the thirteenth century, by the universities, see Baas, pp. 222-224.

[320] For permissions to dissect the human subject, given here and there during the Middle Ages, see Roth's Andreas Vesalius, Berlin, 1892, pp. 3, 13 et seq.   For religious antipathies as a factor in the persecution of Vesalius, see the biographies by Boerhaave and Albinos, 1725; Burggraeve's Etudes, 1841; also Haeser, Kingsley, and the latest and most thorough of all, Roth, as above.   Even Goethals, despite the timidity natural to a city librarian in a town like Brussels, in which clerical power is strong and relentless, feels obliged to confess that there was a certain admixture of religious hatred in the treatment of Vesalius.   See his Notice Biographique sur Andre Vesale.   For the resurrection bones, see Roth, as above, pp. 154, 155, and notes. For Vesalius, see especially Portal, Hist. de l'Anatomie et de la Chirurgie, Paris, 1770, tome i, p. 407.   For neglect of dissection and opposition to Harvey's discovery in Spain, see Townsend's Travels, edition of 1792, cited in Buckle, History of Civilization in England, vol. ii, pp. 74, 75.   Also Henry Morley, in his Clement Marot, and Other Essays.   For Bernouilli and his trouble with the theologians, see Wolf, Biographien zur Culturgeschichte der Schweiz, vol. ii, p. 95.   How different Mundinus's practice of dissection was from that of Vesalius may be seen by Cuvier's careful statement that the entire number of dissections by the former was three; the usual statement is that there were but two.   See Cuvier, Hist. des Sci.   Nat., tome ii, p. 7; also Sprengel, Fredault, Hallam, and Littre.   Also Whewell, Hist.   of the Inductive Sciences, vol. iii, p. 328; also, for a very full statement regarding the agency of Mundinus in the progress of Anatomy, see Portal, vol. i, pp. 209-216.

[321] As to the supposed change in the number of teeth, see the Gesta Philippi Augusti Francorum Regis, . . . descripta a magistro Rigardo, 1219, edited by Father Francois Duchesne, in Histories Francorum Scriptores, tom.   v, Paris, 1649, p. 24.   For representations of Adam created by the Almighty out of a pile of dust, and of Eve created from a rib of Adam, see the earlier illustrations in the Nuremberg Chronicle.   As to the relation of anatomy to theology as regards to Adam's rib, see Roth, pp. 154, 155.

[322] The original painting of Vesalius at work in his cell, by Hamann, is now at Cornell University.

[323] For a curious example of weapons drawn from Galen and used against Vesalius, see Lewes, Life of Goethe, p. 343, note.   For proofs that I have not overestimated Vesalius, see Portal, ubi supra.   Portal speaks of him as "le genie le plus droit qu'eut l'Europe"; and again, "Vesale me parait un des plus grands hommes qui ait existe." For the charge that anatomists dissected living men - against men of science before Vesalius's time - see Littre's chapter on Anatomy.   For the increased liberty given anatomy by the Reformation, see Roth's Vesalius, p. 33.