Showing the Instruments: Vesalius and the Tools of Surgery and Anatomy

By Allen Shotwell

In the dedication to his famous De humani corporis fabrica of 1543, Andreas Vesalius made a deliberate connection between surgery and anatomy. Both surgery and the dissection of bodies to study anatomy relied on manual skills, according to Vesalius, and both topics had fallen out of favor. “Although [surgery] alone was developed by physicians and they strained every nerve in acquiring it, in the end it began to collapse pitifully when those same physicians discarded work of the hands for others to perform and ruined anatomy”.[1]

The skills of the dissector and the skills of the surgeon were connected to each other, and both activities required a variety of instruments to perform. While the stunning images of the body found in the Fabrica sometimes distract with both their artistic and scientific appeal, it’s important to remember that Vesalius’s great work contained pictures of instruments as well as bodies.

Instruments from Vesalius’s Fabrica (courtesy of the National Library of Medicine)

Andreas Vesalius, De humani corporis fabrica, Instruments (© National Library of Medicine).

Pictures of instruments were also a common feature of early sixteenth-century surgical texts. The table of instruments found in the Fabrica has similarities with a table of instruments originally printed at the turn of the sixteenth century in a surgical text by Hieronymus Brunschwig, the Buch der Cirurgia. The same image can be found in a number of other books, including certain editions of the famous surgical text written by the surgeon Hans von Gersdorff, the Feldbuch der Wundarznei. The fluid world of early printing meant that images like these were often re-used by printers for different books either by copying directly or by having an artist recreate the originals.

Instruments from Gersdorff and Brunschwig (©Wellcome Images, Wellcome Library)

Hans von Gersdorff, Feldbuch der Wundarzney, engraving of surgical instruments opposite folio 1. (©Wellcome Images, Wellcome Trust Library)

One of the most famous aspects of the Fabrica is Vesalius’s anger with printers and their practice of pirating images. He condemned the way his images had been reproduced by others in a letter to his own printer, Johannes Oporinus, who saw fit to include it in the prefatory materials of the Fabrica. But the images in surgical texts had a variety of connections to those found in anatomical works like the Fabrica. Since Gersdorff’s book also contained anatomical illustrations and was printed nearly three decades before the Fabrica it is often understood as an important precursor in this respect. But the images of instruments in Gersdorff are rarely compared to those in the Fabrica.[2]

Gersdorff’s anatomical images were actually fairly limited in scope and quality compared to those in the Fabrica, but the many pictures of surgical instruments were a different story. The book included a variety of striking images designed to show the reader the purpose and use of certain surgical instruments. Often, the illustrator employed inventive techniques, composing his pictures in such a way that the patient, the instrument and the surgeon were all included, but the procedure remained clear. One image, for example, showing an instrument used to operate on a patient’s head, depicts the head, the instrument and the disembodied hands of the surgeon. The patient’s face is contorted in a striking way, but the utility of the arrangement is clear, and nobody who saw it could be confused about how the instrument should be employed.

Hans von Gersdorff, Feldbuch der Wundarzney, Behandlung einer Schädelwunde (Treatment of a skull injury)

Hans von Hans von Gersdorff, Feldbuch der Wundarzney, Behandlung einer Schädelwunde (Treatment of a skull injury)

Other interesting images in Gersdorff’s text involve an instrument for setting a broken leg (the glossocum). This instrument appears in a number of sixteenth-century texts, including in the Fabrica where decorative letter F shows the instrument being employed on a bearded figure. Gersdorff’s version has the odd feature that the patient’s leg and the instrument are quite large, while the surgeon operating the instrument has been reduced in size to fit into the scene.

Glossocum, ©Wellcome Images, Wellcome Library

Hans von Gersdorff, Felbuch der Wundarzney, Knochenrichtung (Bone Setting), ©Wellcome Images, Wellcome Library

This idea of “zooming in” on the important aspects of a scene while still retaining the other elements, albeit in reduced form, resonates with another iconic image from the Fabrica: the portrait of Vesalius’s himself, which appears in the first few pages of the Fabrica, shows him dissecting the hand of a cadaver. The body he operates on, like the patient in Gersdorff’s picture, is so large that Vesalius seems miniature in comparison (much like Gersdorff’s surgeon). There are various ways to interpret the effect produced, but it seems that one possibility is to show the operation that zooms in on the key points also found in Gersdorff.[3]

Portrait of Vesalius, De humani corporis fabrica.

Portrait of Vesalius, De humani corporis fabrica (©National Library of Medicine).

There is no evidence that Vesalius or his artist knew of Gersdorff’s work, but imagery associated with instruments was a shared aspect of both anatomical and surgical works in the sixteenth century. Surgery texts sometimes borrowed images of the body from anatomical texts, and works on anatomy sometimes incorporated instruments. There is a Renaissance edition of an anatomical text from the fourteenth century, for example, that includes anatomical figures from Berengario da Carpi’s early sixteenth-century book on anatomy redrawn so that the cadavers are holding surgical/dissection instruments in their hands. [4]

In another example, Jean Tagault’s De chirurgica institutione used images from Gersdorff’s text as well as redrawn anatomical figures taken from Vesalius’s Six Anatomical Tables, one of his early books that predated the Fabrica.[5] Surgery and anatomy, especially anatomical dissection, were closely linked in the minds of reforming sixteenth-century humanists like Vesalius, and the connection spilled over into the visual representations they included in their texts. Both subjects required manual skills and the ability to use instruments, and those instruments were prime material for printed illustrations. In a world where the visual dominated showing the instruments was a natural extension of seeing for oneself.[6]

 

Allen Shotwell is a dean and professor of liberal arts at Ivy Tech Community College. After several years of teaching in the physical sciences, he recently switched gears, completing his PhD in the History and Philosophy of Science in 2013. His research focuses on anatomy, medicine and surgery in the early sixteenth century, and his most recent publication is “Animals, Pictures, and Skeletons: Andreas Vesalius’s Reinvention of the Public Anatomy Lesson”, Journal of the History of Medicine and Allied Sciences (online first, March 2015). You can follow him on Twitter @AllenShotwell

 

[1]. “Haec nanque cuum prius a medicis unicem excoleretur, ipsique in hac adipiscenda omnes neruos intenderent, tum demum miserem collabi coepit, quum ipsi manuum munus ad alios reiicientes, Anatomen perdiderunt”. Andreas Vesalius, De humani corporis fabrica libri septem (Basel, 1543), 3r

[2]. For a recent study of the anatomical images found in Gersdorff in the context of sixteenth-century see Andrea Carlino, “Paper bodies: a catalogue of anatomical fugitive sheets 1538-1687”, Medical History Supplement, 1999(19).

[3]. For a recent analysis of the illustration see Katharine Park, Secrets of Women, Gender, Generation, and the Origins of Human Dissection (New York, 2006), 250-53. Park sees the scene as indicating the intimacy between the anatomist and the cadaver that was such an important element of Vesalius’ assertions and reflective of medieval Christian devotional practice. It should be noted that Andrea Carlino, unlike Park, refers to the cadaver as a woman, not a man but also notices the disproportionate size of the cadaver. See Andrea Carlino, Books of the Body: Anatomical Ritual and Renaissance Learning (Chicago, 1999), 52.

[4]. Anatomia Mvndini collata, iustoq, suo ordini restituta, per Ioannem Dryandrum… Adiectae sunt, quarumcunq; partium corporis, ad uiuum expressae figurae (Marburg, 1541).

[5]. Jean Tagault, De chirurgica institutione (Paris, 1543).

[6]. The visual nature of early modern science and the role of autopsia is a perennial theme in the history of medicine and anatomy. For some recent work see Sachiko Kusukawa, Picturing the Book of Nature: Image, Text, and Argument in Sixteenth-century Human Anatomy and Medical Botany (Chicago: The University of Chicago Press, 2012)

3 comments

  1. Pingback: Whewell’s Gazette: Year 2, Vol. #09 | Whewell's Ghost

  2. Pingback: 16th-century Surgical Instruments: Forcipes denticulatae – Darin Hayton

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