Andreas Vesalius The Beauty of Anatomy


Andreas Vesalius

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We are our bodies.

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We see the outside all the time, but that's less than half the story.

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The surface. The exterior. We know far less about what's inside.

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Heaven forbid that we should actually see our insides.

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Most people go through their life without

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getting a look at their organs,

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and for good reason.

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My lungs and kidneys and heart and bones and muscles,

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arteries and veins, they do their jobs unseen.

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But for the anatomists, the doctors

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and artists who have struggled for centuries to understand how

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our bodies actually work, getting inside, dissection, was vital.

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In this five-part series,

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I'll be investigating the beautiful synthesis between discoveries

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in anatomy and the works of art that illustrate them.

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As a scientist myself,

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I'm someone who is fascinated by anatomical images.

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I want to find out exactly how anatomy has inspired art,

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and art, anatomy.

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And it's going to be my privilege to see some of the greatest

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works of art in the world.

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In 1537, a young man arrived here in Padua, in Italy,

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to continue his studies in surgery.

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Very soon, he was teaching the subject himself.

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And the public dissections conducted by Professor Vesalius

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were a runaway success.

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So, how did Andreas Vesalius, in just seven years, go from being

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a student who stole bodies from the gibbets to being the most

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famous anatomist in the whole of Europe?

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His drawings, the benchmark for anatomical

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illustrations for hundreds of years to come.

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OK, so this is the right-hand side of the heart, and this is venous

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blood, how it gets into the heart and then back out of it again.

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And this is the aorta with oxygenated blood that's

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come from the lungs into the left...

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An anatomy class for first-year medical

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students at King's College, London.

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..around the aortic arch.

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So, I just now want to have a quick little look at an actual

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heart in relation to this.

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Demonstrator Sally Brook is using an unusual

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method of illustrating the body's internal organs to her students.

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Superior and inferior vena cava.

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So, here's the superior vena cava leading in...

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But some things never change.

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Here we have the instructor teaching,

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and also entertaining her audience.

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..right and left ventricle.

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In the 21st century, medical schools use a variety of illustrative

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resources to help students understand anatomy.

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But the basis of their teaching remains hands-on dissection,

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and the study of real body parts.

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500 years ago in Padua,

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another anatomy teacher tried to provide his students with

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images of the human body that were both dynamic and memorable.

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Andreas Vesalius was only 23

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when he started lecturing at the university here.

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He was just a kid.

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He was impetuous, he was ambitious and he was outspoken.

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But what was different about Vesalius was that he was innovative.

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He transformed dissection.

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He illustrated his anatomy lessons with large charts like a modern day

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slide show, something that no-one else had done before.

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Vesalius was also the first in his field to grasp

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the power of printing.

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His atlas of the human body, published in 1543,

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was the first complete account in words

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and pictures of the human anatomy and how to dissect it.

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Artistically, it was beautiful.

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The names of all the artists are not known,

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but one theory is that the title page was the work of

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none other than Titian, the most celebrated artist in nearby Venice.

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At the Wellcome Library in London, one of the archivists is

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showing me the very first edition of Vesalius's magnificent book.

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De Humani Corporis Fabrica,

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the Fabrica for short,

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is famous not just as a work of anatomy.

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It's a multi-layered philosophy of life itself.

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And it's a true privilege to be able to see it.

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Now, one of the first recipients of the Fabrica

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was the Emperor, Charles V,

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and you can see why he would've been really impressed.

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This is a hefty tome and the sheer scale of it is just knockout.

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Ah, thanks, Ross. Have a look at this poor fellow here.

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He's been stripped of all of his internal organs

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and is hanging from a rope that goes through his skull.

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What strikes you immediately about these is not just the extreme

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high quality of the drawings, but also, they're just so big.

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Have a look at this skeleton.

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He's posed. He's leaning in this slightly camp way.

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Actually leaning on a spade as if he's just dug his own grave,

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and he's laughing in this rather ghoulish way.

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This is a classic memento mori.

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"Remember, you must die."

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These are part of the so-called muscle men sequence,

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and they're all in these very active poses.

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As the flesh is progressively stripped from their body,

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they actually need something to lean on to stay upright.

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They're so vivid, they're ironically lifelike.

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These images are 500 years old,

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but they're vitality just smacks you right in the face.

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But what's the message of these life-in-death figures?

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I get the posturing and how that shows off the muscles,

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but I'm sure there's more to it.

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What are these muscle men really about?

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Vivian, why does Vesalius put these men in such dramatic poses?

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Anatomy is not just about cutting up a dead body,

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it's about understanding the living body, as well.

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So, these are living skeletons, you might say.

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And this is part of the importance of these plates,

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as they show the body in movement.

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So these figures are not so much posing as captured in action,

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using their muscles and their bones.

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When it came to very detailed analysis,

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Vesalius clearly grasped that anyone studying parts of the body

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needed to see beyond the limitations of flat, two-dimensional drawing.

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Obviously, this is a hand.

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What's special about this particular illustration?

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It's taken from different angles, so you get

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an impression of somebody who's done the dissection on several occasions.

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So, these plates at the bottom here,

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all of which are the same set of wrist bones, but...

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But taken from different angles, so you can see how it fits together.

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It gives the impression of the body in three dimensions.

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The shading is really striking, you can

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see such 3-D relief in the bones of the hand.

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In the same way, Vesalius provides varying perspectives on the brain.

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And these drawings are so precise,

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you even get a sense of how good a dissector he was.

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So, in this one we've removed the skull

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and we're having a look underneath the meninges at the brain itself.

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Here you have the beginnings of the dissection

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and he gradually reveals the brain as he cuts it up in sections.

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And it is, let us say 97-98% accurate.

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It does make me wonder how this was done, in fact,

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because that is a very clean line.

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He's an incredibly tidy dissector.

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One can feel that he has the hand of a surgeon,

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that he's both delicate and strong.

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And he has this visual sense which is extremely unusual.

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He thinks like an artist.

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Even in his own lifetime, people were saying Vesalius marks a new age.

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And suddenly, this is the new anatomy.

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Andreas Vesalius was born in Brussels on the last day of 1514.

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But it was in Paris where he studied for a few years before Padua

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that he gained a reputation for being

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an extraordinarily skilled anatomist.

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It was a dark art, dissection.

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At night in Paris, Vesalius would pass out of the city gates

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and sneak up to the sites of the public gallows in Montfaucon.

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There, the bodies of executed criminals would hang

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until their rotted carcasses were taken down from the gibbet.

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Vesalius used to steal body parts from these corpses.

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He and his fellow students would play a morbid betting game where,

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blindfolded, they would have to identify the bones

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using just their hands.

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He had already a reputation for being

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an excellent dissector in Paris.

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So, when Vesalius turned up in Padua in 1537,

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he was actually still a student

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and the professors then realised

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that he was actually very

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good at what he did and rushed him

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through a medical degree

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and, very quickly, got in a position to start dissecting human bodies.

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Padua is one of the centres of the Italian renaissance,

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and it's home to one of the most respected

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and intellectually interesting

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universities in Italy.

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And that university has a medical

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school, but it's not a very strong

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medical school. It is seen to be somewhat conservative,

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somewhat lacking in the fields of surgery and anatomy.

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So, the appointment of Vesalius is a way for the university

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authorities to recognise and acknowledge this.

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To build up their own skills

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in classical humanist anatomy if you will.

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Vesalius's principal task was to teach anatomy

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and every winter he would perform a number of dissections in public.

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Now, this is a place I've wanted to visit for years.

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Inside here is one of the very few surviving original

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anatomy theatres in the world.

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It was built a few years after Vesalius worked in Padua in 1594.

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But it was modelled on exactly the same principles of a central

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stage in a public auditorium that Vesalius knew.

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And it is truly stunning.

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Every point in this room focuses down on what would've been

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the dissection table here, where the body was.

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Even today when you go for surgery,

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you go into what is referred to as a theatre,

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but this is a true theatre in the proper sense of the word

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to the extent that, before the dissections began,

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there were a group of musicians up at the top there

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who would play music to calm down the excitable students

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waiting for the professor to arrive.

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All society was here, ranked by tier.

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At the bottom in the expensive seats, eminent surgeons

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and physicians would mingle with nobility.

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Behind them, the merchant class, and at the top, in the cheap seats,

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were commoners and students.

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Everyone came to hear the words of wisdom that

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the great Vesalius would impart.

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Everyone, of course, except for the lowest rank in society,

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the condemned executed criminal.

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He didn't give a damn what Vesalius had to say.

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Public dissection, at the time that Vesalius is practising it,

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is absolutely public.

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Just as Roman citizens flocked to the Colosseum to see extremely barbaric

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blood sports, so you get the great unwashed of Padua, as it were,

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coming along to the anatomical theatre to see perhaps

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a famous criminal being torn to pieces on the slab.

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It's an expression in many ways of state power.

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The people being dissected here are, generally speaking, criminals.

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So, it's a way for especially the Italian city states to

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show their power over the bodies of their citizens

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and especially the citizens who misbehave.

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It's also, perhaps rather strangely to our modern eyes,

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a kind of theological demonstration as well.

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If you think about Christian theology,

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God makes man in his own image.

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So, dissection is a way, just as theologians read

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the book of Scripture, dissection is a way of reading the book of nature,

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of knowing ourselves, of understanding God's purpose more

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clearly by studying the way that he has made us.

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The dissected body was evidence of divine design.

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But there was another side to the theology of the anatomy theatre.

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For the condemned criminal, this was a final punishment,

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a humiliation that engaged all of his religious fears.

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If you were dismembered,

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what prospect was there of rising whole at the Resurrection?

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By the time Vesalius started to wow his audiences in Padua,

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public dissections had been performed in Italy

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for two centuries.

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And for all that time there had been strict rules about

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how they should be done.

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At the earliest dissections there were three professionals involved.

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The man in charge was the professor.

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With the big book of anatomy, he'd read out the instructions.

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And then there was the ostensor who would stand at the side with

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a stick or a rod and point at the relevant

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bits of the corpse as the professor read them out.

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And then at the coalface there was the surgeon

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and he would make the cuts or the incisions and peel back

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the skin and the flesh to reveal the relevant organs, bones or tissues.

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But Vesalius's approach was different.

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On the title page of his great work,

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Vesalius depicts a scene just after a dissection has begun,

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albeit with rather more of a wild rumpus.

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The theatre, looking a lot like a temple,

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is absolutely crammed full of people

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and in the centre, there is a woman whose abdomen has been sliced open.

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Now, what's really interesting about this scene is that there is no

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sign of the ostensor and there is no sign of the surgeon.

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And that's because Vesalius had done away with those two positions.

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He did all three jobs himself.

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He prided himself on being a dissector.

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In the title piece of the great book, his Fabrica,

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he is doing the dissection. He's hands-on

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and this is a declaration saying,

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"I do it myself.

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"It is my observation, it's my cutting,

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"it's my knowledge that I'm specifically demonstrating."

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And he became a kind of hero in that sense, of dissection.

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In doing so, Vesalius believed he was going back the principles

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outlined by Galen, the 2nd-century Roman physician.

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Galen's anatomist is the sole investigator.

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It is what his eyes see that matters.

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And that was not the only change that Vesalius made to the

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traditions of public dissection.

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So, medieval anatomists dissect the abdomen first,

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then they do the chest.

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Finally they do the head, and then after that they might dissect

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the arms and the legs and the muscles and that sort of thing.

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Vesalius, however, as he always does, takes great inspiration from Galen.

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Galen says any study of anatomy must begin with the bones.

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He says, "The bones are the walls of the house."

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Then you study the muscles, the ligaments,

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the nerves, the blood vessels, then you move into the great organs

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and then you move up the body and finish with the brain.

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So, Vesalius transforms medieval anatomy by taking an even older idea.

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By taking a classical idea of how you study the body in a rational way

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and making it the centre of his practice.

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Vesalius wasn't content with carrying out his public

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dissections and then merely handing over the results to other

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doctors or medical students or even the nobility of Padua. No, no.

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He wanted the world to share in his discoveries

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and, naturally, to celebrate them and him.

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The answer was to create the anatomy book of the century,

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perhaps of all time.

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The Fabrica would be the largest volume on the subject yet published.

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And more accurately illustrated than any predecessor.

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And its unique selling point, every description,

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every illustration would be based on the evidence of dissection.

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The muscle men are probably the most memorable images in the book.

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And Vesalius set them in a landscape.

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As it turns out, a real one.

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These are Euganean Hills, a few miles south of Padua.

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You can just make it out in the distance over there

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and this is the exact landscape that Vesalius wanted to

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draw his muscle men in as they were progressively stripped to the bone.

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The real background emphasises the notion that these

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figures are alive in this landscape with their very precisely drawn

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flexed muscles and their classical poses.

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So, what is Vesalius trying to say with these figures?

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Are they about anatomical accuracy or has the artist idealised them?

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Every image in the history of anatomy is idealised in some way.

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But equally, there's always the question in anatomy of

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how do you depict an ideal human body?

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Individual human bodies are full of funny little imperfections.

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They don't represent the single Platonic ideal, if you like,

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of what a human being is supposed to be.

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So, I think Vesalius is using, in some ways, a more realistic

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mode of depiction, but I think the images are still idealised.

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Vesalius's classical poses make me

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realise how much a man of his time he was.

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He owed a lot to Galen, but artistically,

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Vesalius's anatomy was Renaissance anatomy.

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It was based on a new spirit of enquiry,

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but also informed by classical art.

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To describe these images of the muscle men,

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he used the classical term "canonical",

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meaning they represented the gold standard for art.

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In effect, he was saying to his colleagues,

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"These are the perfect anatomical figures."

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To his medical colleagues well versed in classical literature,

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the word "canon" would have immediately reminded them

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of the ancient sculptor Polykleitos

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from the 5th century before Christ.

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Now, Polykleitos is known to have written a book called

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the Canon which spelt out the principles of harmony

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and proportions of an ideal human body.

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Polykleitos is also known to have made a sculpture also called

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the Canon, which embodied these principles of harmony and proportion.

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Later artists used Polykleitos's

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Canon as a yardstick by which they measured their own craft.

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Vesalius wanted his work to be seen as a descendant

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of the best of classical art.

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But was that how it came across at the time it was published?

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If I was asked what are the great functions of the Fabrica,

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I'd probably come up with a slightly cynical answer,

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or perhaps two cynical answers.

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One is to make Vesalius's reputation.

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He is doing something which is very expensive, very grand

0:22:270:22:31

and very innovatory and he knew absolutely what he was doing.

0:22:310:22:35

And the other shorter, snappier one is to get a good job.

0:22:350:22:38

It was successful because he became physician

0:22:410:22:45

to the Holy Roman Emperor Charles V

0:22:450:22:47

and although medics didn't need all that on anatomical knowledge

0:22:470:22:52

it of course put him down as the

0:22:520:22:55

international star of the human body.

0:22:550:22:58

I'm curious to know how far that international stardom spread.

0:23:010:23:05

Did anatomists in Britain know his work?

0:23:050:23:07

In fact, what was happening in anatomy in Tudor Britain?

0:23:070:23:11

Well, here at the university library in Cambridge,

0:23:120:23:14

there's intriguing evidence that Vesalius's

0:23:140:23:17

influence had hopped across the Channel by the 1560s

0:23:170:23:20

and found its way into the dissecting rooms in Cambridge.

0:23:200:23:23

Let me show you a book which certainly demonstrates

0:23:270:23:31

the extent of the influence of Vesalius.

0:23:310:23:36

It's certainly true that by Italian standards,

0:23:360:23:38

English anatomists were catching up, but there's

0:23:380:23:41

plenty of evidence in this book

0:23:410:23:43

and in other sources to show that Vesalius and Vesalian anatomy

0:23:430:23:48

was having an influence by the middle of the 16th century.

0:23:480:23:51

This book was owned by Thomas Lorkin who was

0:23:520:23:56

the Regius Professor of Physic, that is to say, medicine,

0:23:560:23:59

at Cambridge from 1564.

0:23:590:24:02

This is Lorkin's monogram

0:24:020:24:04

and the price he paid for it is up at the top there.

0:24:040:24:06

-How much?

-Two shillings.

0:24:060:24:08

And although this text dates from before Vesalius's Fabrica,

0:24:090:24:14

we can see that Lorkin was bringing this text up-to-date.

0:24:140:24:19

Here, it says in the margin, for example, "Vesalius dicit",

0:24:190:24:22

in Latin, "Vesalius says."

0:24:220:24:25

And he's correcting the older text with what he's

0:24:250:24:27

learnt from his study of Vesalius.

0:24:270:24:30

The thing I'd like to show you particularly is this opening here

0:24:300:24:34

which in fact shows the record of the first two dissections

0:24:340:24:38

ever held in Elizabethan Cambridge.

0:24:380:24:42

"Anno domini 1565, the 28th of March, I did make anatomy of Richard,"

0:24:420:24:47

and then he crossed out Richard and put Ralph over the top,

0:24:470:24:50

"Tipple at Magdalen College, continuing Wednesday, Thursday,

0:24:500:24:55

"and Friday, and on Saturday morning buried him at 8 o'clock

0:24:550:25:00

"being the fifth day after his hanging."

0:25:000:25:03

And as you can probably also see, it's quite stained.

0:25:030:25:07

So, when you say it's stained, I can see some watermarks,

0:25:070:25:10

but are you suggesting that this might have been right

0:25:100:25:13

next to the body itself at the first ever dissection in Cambridge?

0:25:130:25:17

I think that's very likely, judging by the annotations and the state of

0:25:170:25:21

the book, it looks very much as if this book was actually present at a

0:25:210:25:26

messy dissection scene in Cambridge in 1565.

0:25:260:25:30

Crikey, that's astonishing.

0:25:300:25:32

This shows that Vesalius's influence spread far and wide.

0:25:370:25:41

Tudor physicians like Lorkin not only knew about him,

0:25:410:25:44

but applied his ideas here in Cambridge.

0:25:440:25:47

Vesalius's work circulated in different versions

0:25:500:25:53

and some of them could be quite elaborate.

0:25:530:25:57

This is called the Epitome, an abbreviated edition

0:25:580:26:01

of the Fabrica for students with handy practical features.

0:26:010:26:05

Vesalius said what you should do is take the two plates at the back

0:26:050:26:10

and cut them up because they have figures of the organs,

0:26:100:26:14

and then stick them on to parchment to strengthen them

0:26:140:26:18

and then you can actually mount them.

0:26:180:26:21

Oh, wow.

0:26:210:26:22

At the base of this is a picture of the nerve system,

0:26:220:26:25

but on top of it are those cut out layers of organs and systems

0:26:250:26:31

that Vesalius instructs you to attach to the nerve figure here.

0:26:310:26:36

You can actually lift up each layer and go down the body...

0:26:370:26:42

..and you can see they're all stuck on individually.

0:26:440:26:47

And look, underneath it on the backing of the organs,

0:26:470:26:50

it actually has some writing.

0:26:500:26:51

That's right, this is, in effect, a medieval manuscript under here.

0:26:510:26:55

It is astonishing to think that,

0:26:550:26:57

at some point, a student was cutting out a piece of parchment,

0:26:570:27:01

something which is probably invaluable now,

0:27:010:27:03

but was the equivalent of a magazine in order to stick these pieces on.

0:27:030:27:07

Well, by the time this was being done, of course,

0:27:070:27:09

medieval manuscripts were kind of going out of fashion

0:27:090:27:12

because there were these grand new printed books

0:27:120:27:14

and to have a 15th century manuscript was to have

0:27:140:27:18

essentially a piece of scrap which you could use to make a mount.

0:27:180:27:21

As a medical student in the 16th century, you could've used

0:27:260:27:29

these to visualise what was going on...

0:27:290:27:33

Anatomy advanced in a series of leaps and bounds

0:27:330:27:35

throughout the 1500s.

0:27:350:27:37

By the end of the century,

0:27:390:27:40

it was a well respected scientific discipline.

0:27:400:27:43

It might not have helped physicians overcome disease,

0:27:430:27:46

but never before had the mechanics of the body,

0:27:460:27:49

how the body works, been so well understood.

0:27:490:27:52

The changes that took place in the 16th century were largely

0:27:540:27:58

due to Vesalius, rightly called the founder of modern anatomy.

0:27:580:28:03

After him, theories about the structure and functions of the body

0:28:030:28:06

would only be considered reliable if they were based on evidence.

0:28:060:28:11

Andreas Vesalius forced doctors to recognise the absolute

0:28:120:28:16

importance of recording and personal observations,

0:28:160:28:20

but done with flair and vitality and nowhere is that more present

0:28:200:28:25

than in the beautiful illustrations in the pages of the Fabrica.

0:28:250:28:29

That book set the gold standard for anatomy for the next 300 years.

0:28:290:28:35

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