History's Youngest Heroes: The Grisly World of Andreas Vesalius

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A heads up.

This story is about the early days of anatomy and contains details of human dissection.

If you're squeamish, you might want to listen to another episode.

A violent crime was the talk of Basel, Switzerland, in the spring of 1543.

Jakob Karr was a career criminal.

He was visiting his second wife and family on the outskirts of Basel when he heard shouting.

He turned and saw his first wife, who he had abandoned.

His first wife was an honest woman.

She had refused to follow him into a life of crime.

She was in the area searching for cheap meat to buy for her neighbours.

Shocked to see Kara, she said, Good husband, is that woman whom you have with you your wife?

Tell me, have you married her?

Why are you silent?

Why have you turned pale?

Why have you dared to add another to your crimes?

Kara denied everything, saying the second woman wasn't his wife.

He claimed she was just following him.

Outraged, his second wife then spoke up.

Certainly you are my husband.

You married me in the regular way in church two years ago.

The first wife left and continued her shopping.

As she was returning home, Kara followed her.

When she rested in a field, he attacked her with a sword and a lance and left her for dead.

Thirty men set out to search for Kara.

He was soon apprehended and sent to jail.

Miraculously, his wife was saved by surgeons.

Kara was sentenced to death by beheading.

A young man was waiting for his corpse.

A young man with an insatiable interest in dead bodies.

When he received Kara's remains, the young man removed the flesh and reassembled the bones into a complete skeleton.

Today, the bones of bigamist and attempted murderer Jakob Karr are still on display at the University of Basel.

They form the oldest surviving articulated skeleton in the world.

The young man who reassembled Kara's remains, the young man who sought out dead bodies, was Andreas Vesalius.

I'm Nicola Cochlin, and for BBC Radio 4, this is History's Youngest Heroes:

Rebellion, Risk, and the Radical Power of Youth.

The Grisly World of Andreas Vesalius.

I'm a little bit of a fangirl when it comes to Vesalius.

When people ask you, who are the people that you would want to have for dinner?

He's it.

He's absolutely it.

Professor Dame See Black is a forensic anthropologist.

In 2009, she used an analysis of vein patterns to confirm the identity of a criminal suspect.

It was the first time that this technique was used to convict a suspect.

It's amazing the amount of information we have about people before they die.

So we might have medical records and dental records, we have photographs, we have pieces that will tell us what tattoos they had, whether they walked with a limp, all these sorts of narratives that we can pull together and help to identify that individual.

Black can trace her interest in anatomy back to her childhood in Inverness, Scotland.

She lived a life that was not for the squeamish.

So my father would go out with with the shotgun.

I would go with him and he'd show me how to skin a rabbit or how to pluck a pheasant or a great Scottish word, how to grill a chadir, take the insides out.

So from a very early age, five, I thought nothing of being up to my elbows in blood and guts and, you know, bits of dead animal.

At 13, it seemed logical to go into a butcher shop.

And so I worked every weekend in a butcher shop, whereas all my friends were selling makeup.

By her third year at university in Aberdeen, Black planned to pursue a career in biology.

When I walked into that dissecting room in Aberdeen University, I knew I'd come home.

You will be given a human cadaver, and you will spend a year dissecting that cadaver from the top of the head to the bottom of the toes.

And I thought, that's like a butcher shop.

It's another animal, a different animal.

And for me, that was the greatest gift.

I knew I was an anatomist that moment going forward.

The Vatican.

In the year 1514.

The 62-year-old Leonardo da Vinci had been appointed by Pope Leo X's brother and had been working here for a year.

Among Leonardo's projects was an anatomy book.

To research this, he dissected both animal and human corpses.

At the time, The human bodies available for dissection were those of executed criminals or of destitute people who died with no one to claim them.

Leonardo drew a stunningly accurate sketch of a five-month-old fetus in a dissected womb and speculated on its cognitive capacity and its soul.

This was delicate theological ground.

Papal authorities withdrew support for Leonardo's work, and he was branded a heretic by Pope Leo.

Leonardo was told to stop doing the dissections and he came back to other occupations, for example, drawing and civil engineer.

Dr.

Stefano Sandrone is a neuroscientist and co-author of Brain Renaissance, From Vesalius to Modern Neuroscience.

While Leonardo was obliged to turn away from anatomy, 900 miles away, Andreas Vesalius had just been born in the Duchy of Brabant, now part of modern Belgium.

His family, especially on the father's side, was

very well connected.

It was a family of physicians and pharmacists, and many of them personally attended royalty.

Andreas' father, Anders van Wiesel, was the apothecary to Charles V of Spain, the Holy Roman Emperor, and then to Charles' son, Philip II of Spain.

The van Wiesel house in Brussels overlooked a place called Gallows Hill, where criminals were executed.

Their bodies were left for scavenging birds.

As a child, when Andreas played in the fields near the house, something impelled him to approach the corpses.

He was intoxicated by the spectacle of rotting guts and decaying flesh.

Andreas was a gifted scholar and enrolled in the Catholic University of Leuven when he was just 14 or 15.

He would later become known by a Latinized version of his Dutch surname, von Wesel, as Andreas Vesalius.

Vesalius studied grammar, algebra, rhetoric, astrology, and music.

With his wide interests and intense hunger for knowledge, the young man embodied the spirit of the Renaissance.

The Renaissance was an era of new discoveries.

There was a lot of enthusiasm towards discovering new things, toward mapping new things, to visualizing new things.

In the Renaissance, youth and strength were considered virtues.

Times were changing fast, and young men, as well as a few women, were experimenting with radical new ideas.

Vesalius moved to Paris to study medicine.

There, he began to dissect animal corpses.

Thesalius obsessed over human bones, which were readily available in Paris's cemeteries.

He placed bets with friends that he could identify any bone blindfolded, just by touch.

Though this was an era of scientific and technical advancement, medical treatment lagged behind.

Ancient Greek and Roman theory still held sway, proposing that the body was held in balance by by four humors, black bile, yellow bile, phlegm, and blood.

If you fell ill, it might be thought you had an excess of blood.

Leeches would be set to your skin to drain some away.

The true intricacies of our bodies were a mystery.

When Vesadius was studying at the University of Paris, lecturers read from the works of Galen of Pergamon, a Greek physician who had worked over 1,300 years earlier.

Galen served as physician to the Roman emperors Marcus Aurelius, Commodus, and Septimius Severus.

He wrote 600 books covering anatomy, physiology, pathology.

Even by the time Vesalius was studying in the 16th century, these ancient texts were still considered definitive on anatomy and medicine.

So there was not the need to know more because it was there already.

Medical lectures at the time were carried out by three men who would dissect a corpse in front of students.

The students, including Vesalius, would sit around around in a theater looking down at a table with the corpse laid out.

Next to the corpse, there was the reader.

It was the professor who actually read from Galen's texts and he was sitting in an elevated chair.

Then there was the dissector, usually a barber surgeon who performed the dissection at the anatomical table.

The job of cutting into the body was far less prestigious than reading out Galen's words.

Surgery at this time was often left to barbers who were thought to be nimble with their fingers.

Usually, they already possessed a set of razors and knives.

Dissection was left to them too.

Some barber surgeons took exams to qualify in surgery.

Many did not.

They simply learned their trade and got on with it.

Meanwhile, physicians mostly learned anatomy as theory, not practice.

They rarely got their hands dirty.

The third man was called the ostensor.

The demonstrator, who actually indicated the different anatomical structures that were named by the reader and dissected by the dissector.

Vesalius, who was unusually strong-stomached, impressed his lecturer so much that he was invited to participate.

The teachers gave him a great opportunity because they asked him to replace the Barber surgeon during the anatomical demonstration.

This was unprecedented.

It was like an incredible privilege for an 18-year-old medical student.

Vesalius listened to the professor reading from Galen, hearing body parts described.

Bones, muscles, organs.

As the professor named each part, he carefully dissected them, allowing the demonstrator to point out the features to students.

Before long, though, he realized something was wrong.

Vesalius started to notice differences, mismatches between the Galeni's descriptions and what Vesalius actually saw at the dissecting table.

Galen had never actually dissected a human body.

Galen made his anatomical observations upon dissecting oxen, pigs and monkeys.

The Roman law, at the time it was called Lex de Sepulchris, had prohibited dissections of the human body.

When you look at the times of Galen, for example, there was the awareness that man was created in God's image, and therefore to desecrate the body of man was to desecrate the concept of God, and therefore to in any way violate the human body was considered to be an offense to God.

The works were translated into different languages, into Arabic and Latin, and they became the only source of knowledge for Catholics and Muslims.

In the lecture hall, Vesalius was frustrated.

He could see there were differences between human and animal anatomy.

He approached his lecturers asking, could Galen have been wrong?

They were not receptive.

It was a very dogmatic knowledge.

Galen was the authority, and nobody for almost 1,300 years dared to challenge that knowledge.

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Sucks.

The new musical has made Tony award-winning history on Broadway.

We demand to be heard.

Winner, best score.

We demand to be seen.

Winner best book.

We demand to be quality.

It's a theatrical masterpiece that's thrilling, inspiring, dazzlingly entertaining, and unquestionably the most emotionally stirring musical this season.

Suffs!

Playing the Orpheum Theater October 22nd through November 9th.

Tickets at BroadwaySF.com

But Vesalius' studies were interrupted when he had to flee from Paris.

In July 1536, French troops crossed the Italian border, starting a war between King Francis I of France and Charles V, Holy Roman Emperor.

The French hoped to capture large areas of northern Italy.

In response, Spanish troops invaded the south of France, taking the town of Ais-en-Provence.

As the son of the apothecary to Charles V, If Vesalius stayed in France, his life would be in danger.

He returned to Brabant and set about building connections with the rich and powerful.

For what he was planning next, Vesalius would need money and bodies.

He wanted to see with his own eyes

how was the body.

He wanted to see it, not just relying on somebody else's writing.

To advance Galen's study of anatomy, Vesalius needed the dead, and those would come directly from the gallows in and around Leuven.

Was he breaking the law?

Possibly.

Was he in fear of prosecution?

Possibly.

You know, but he was still prepared to do it.

Vesalius persuaded the mayor of Leuven to permit official dissections and began work.

He soon collected enough body parts to build a whole skeleton.

When he could open the rib cage, the jaws and the brain for the first time, he could clearly identify Galen's mistakes.

In the summer of 1537, Vesalius traveled by horse-drawn coach to Padua in Italy.

He would continue his work at the University of Padua's renowned anatomy department.

Padua had long allowed anatomical dissection as part of medical training.

What was more, Padua was powerful enough to resist the power of the Vatican.

The church had shut down Leonardo's anatomical studies.

Vesalius wanted to avoid that.

It has always had a strong tradition of intellectual freedom and independence from papal control.

Vesalius built alliances at the university.

In December that year, he graduated with top marks as a doctor of medicine.

Within a day, he was appointed professor of surgery.

Vesalius got to work, revolutionizing the discipline of anatomy.

He started doing medications, not only for the students, but also for the public.

Word spread, and Vesalius often dissected in front of a large crowd.

There was no three-man anatomy team.

It was just him.

He would display a skeleton or manipulate parts to reveal bone structure.

He demonstrated the structure of arteries, veins, and nerves, and offered his own commentary.

It was a sensation.

People coming from different places, Idiot of seeing glimpses of Vesalius the Anatomist doing the dissection.

Cosimo de' Medici invited Vesalius to do a dissection in Tuscany.

and it was overcrowded.

There were people shouting against Vesalius Vesalius and people saying bad things against Galen.

So it was like at the football match nowadays.

Vesalius was thrilled by the impact of his work.

He wanted to share his knowledge even more widely.

He searched for an artist he could provide him with anatomical drawings.

There's some debate over which artist he employed.

Traditionally, it is thought to have been Jans Devon van Kalker, a young German artist working in Venice in the studio of the great painter Titian.

Vesalius planned obsessively, writing and sketching late into the night.

He knew he would need more bodies than ever before, and as fresh as possible.

Probably the body used were the ones of criminals.

Venice was awash with crime.

Vesalius courted senators and magistrates to get more corpses.

He's got to have the teams around him that if he can't get there first, others will secure that body for him.

Vesalius requested that executions be rescheduled to suit his timetable.

He hired premises at St.

Mark's School of Medicine, close to Culker's studio.

Then, the bodies arrived.

Vesalius dissected, while his illustrator watched and sketched.

They worked fast.

There was no embalming.

There was very little cold storage.

So speed was the utmost thing.

If it's fresh, in the heat heat of a summer, you've got a couple of days before that body's going to start to bloat and it's going to start to decompose.

The flies are going to start to lay eggs.

The maggots are going to use it as a food source.

It will decompose in front of your eyes and all you can do is just brush the maggots away.

It was a good thing the sale is had such a strong stomach.

It's gas that escapes.

The smell is difficult.

The sight is difficult.

Handling liquefying, decomposing tissue is unpleasant

and you were doing that without gloves in the clothes that you would wear normally in a day and you weren't going home and having a shower at night that stench of death would stay with you but i suspect vesalius smelt worse than most quite frankly given what he was up to

vesalius worked through the night the brains decayed so quickly that he needed six different heads to complete his work

he was going deeper into human anatomy than anyone before him.

Was it for money?

Was it for reputation?

I suspect there was a little bit of that in there as well.

You can't draw the crowds that he was drawing and not be affected by that, but I really hope it was the drive for truth that pushed him forward.

In 1541, Vesalius completed the manuscripts of two books.

He took these 500 miles north to a publisher in Switzerland.

The distance was deliberate.

He knew the works were controversial, and he needed to guard against censorship.

Over the following year, Vesalius completed five more volumes.

Together, he titled these works De Humani Corporis Fabrica, on the fabric of the human body.

The fabrica ran to almost 700 richly illustrated and detailed pages.

It took a total of five years to complete.

On its frontispiece was an illustration of Vesalius as a celebrity.

He stands in the center, dissecting a corpse.

Bearded and handsome, he is portrayed as much younger than all the grey-haired men around him.

He is the only figure looking directly at the viewer.

Despite his youth, he is shown taking complete charge of the scene.

Surrounding him is a large, admiring crowd of spectators.

So many are jammed in that there are people climbing up the room's columns.

Some are even sitting under the dissection table.

Some of the chaos of 16th century medicine is on show, too.

A couple of men have brought their pets to the anatomy theater.

One has a dog, which is being held back from investigating the corpse too closely.

Another plays with a monkey.

Each volume of the fabrica focused on a different aspect of the human body.

Starting from the bones, going to muscles, arteries and veins, the nerves, and then the internal organs of the abdomen, chest, and seventh book is about the brain.

Classical medical texts had tended to focus on the digestive system as the body's foundation.

Vesalius began instead with the skeleton, moving on to different systems until he ended with the brain.

Throughout the work, Vesalius cited Galen, painstakingly documenting his mistakes.

There is a chapter in the book of the Fabrica, which is a direct attack on the idea

that was in many ways at the art of Galen's doctrine.

For instance, Galen had described the rete mirabile, a network of blood vessels in the brain, which he believed converted the vital spirit into the animal spirit.

This structure was thought by Galen to sustain cerebral functions and control the reproductive process.

Clearly said Galen was wrong with the so-called retemirabilis.

Galen had actually found the structure in sheep.

In humans, Vesalius showed it did not exist.

Back in Padua, Vesalius, now 29 years old, awaited the reaction to his newly published fabrica.

It was absolutely explosive.

Not only because Vesalius identified, labeled, and created a system around the different individual parts of the body, but it became very quickly one of the most important works of that time.

The illustrations proved controversial.

At that time, many physicians were absolutely furious about the use of of illustrations because they thought that images would only degrade scholarship because

the great learning found in the classical works only had texts, not figures.

In particular, Vesalius' old lecturers in Paris were incensed.

Jacob Silvius described Vesalius as a very ignorant and arrogant man.

He added that through his ignorance, ingratitude, impudence, and impiety, Vesalius denies everything his deranged and feeble vision cannot locate.

Other people nickname him Vesanus, which was a common Latin name for madman.

Vesalius had seen this coming.

He had deliberately set out to challenge his teachers.

Vesalius thought that the only place where his mentors use a knife was at the dinner table because they never decided a thing.

As well as criticism, the fabrica attracted huge support from many physicians, academics, and students.

The work was so popular that Vesalius created a shortened version for students.

Within months, it became a standard text.

And he also had that connection to the printing press.

That's the thing that made the huge difference.

So many of the books before that, so few copies, hand-copied.

But when you can get to a mass production of something, then that's when you can change the world.

There were more controversies.

In book six, focusing on the organs of the chest, readers noticed one illustration of a man whose chest had been cut open to reveal the organs inside.

The man is still wearing trousers, and there's a rope tied around his neck, suggesting that little time has passed since his execution.

Was this man alive?

Dissection was legal.

Vivisection of a living person was absolutely illegal.

For the second edition of his book, Vesalius removed this particular illustration.

But the word was out.

Some began to question Vesalius' character.

Was his thirst for knowledge so great?

But he would dissect the living.

Despite the controversy, much of Italy celebrated Vesalius.

He traveled to Pisa, Bologna, and Florence.

People will have wanted to learn from him.

And when you have a cadaver, you only have one chance to dissect it.

So if you're not there, you don't see it.

In Pisa, a public holiday was declared to allow people to attend.

Officially, only dead criminals can be dissected, but the Bishop of Pisa arranged for Vesalius to be provided with bodies from a hospital, including that of a nun.

In 1544, the Holy Roman Emperor Charles V prepared for another war with France.

He needed more surgeons and offered Vesalius a position as Imperial physician.

Vesalius and his new wife Anne van Ham took up this offer and joined Charles' court.

Vesalius travelled with the court for 11 years.

His research and reputation continued to grow.

In the mid-1550s, Emperor Charles V retired.

He left the Holy Roman Empire to his brother Ferdinand and the Kingdom of Spain to his son, Philip.

Vesalius moved with Philip's court to Madrid.

Philip II was a devout supporter of of the Spanish Inquisition and took steps to limit freedom of thought.

Spaniards were banned from attending foreign universities.

Vesalius soon began to find this restricted intellectual environment stifling.

Vesalius convinced the king to let him leave and he went to a pilgrimage to the Holy Land.

It was probably he wanted to study some herbal remedies in Palestine.

Vesalius traveled around Palestine for four months.

He showed very little interest in the religious pilgrimage sites he had told King Philip II he would visit, and showed much more interest in local medicine.

At the end of his trip, he hoped to return to the liberal and open environment of Padua.

So he took a ship, and instead of waiting for the one of the Venetian fleets, he decided to board on a ship full of pilgrims.

In the Mediterranean Sea, the ship was beset by storms.

Vesalius fell seriously ill.

He rapidly deteriorated and died on the Greek island of Zakyntos.

500 years later, Vesalius' work continues to shape science into the modern era.

If he hadn't had the courage and the arrogance as a young man to challenge his teachers, it might have taken much longer for modern medicine to develop.

Vesalius wasn't the most likable of characters, and his interest in dead bodies may still sound ghoulish.

But his pursuit of truth in anatomy laid the foundation for saving millions of lives.

Even in the 21st century, he continues to inspire Professor Dame Sue Black.

So much of his writing and his illustrations, they still stand today,

shows you just how meticulous he was as a scientist.

Next time, on history's youngest heroes.

Deep in the waters of the Caribbean Sea, a young Soviet naval officer must make a decision that could either save the world or trigger its destruction.

They cannot be entirely clear whether World War III has broken out, whether these explosions that they are feeling and hearing around them are for real or not.

Vasily Arkhipov and the End of Days:

BBC Sounds, music, radio, podcasts.

Humanity's journey to understanding the body has been a gory one, littered with unethical experiments, unintended consequences, and unimaginable pain.

In The Human Subject from BBC Radio 4, we investigate the stories of the discoveries that came at great human cost, but ones that also save countless lives.

I'm Dr.

Julia Shaw.

And I'm Dr.

Adam Rutherford.

And in this series, we're going to investigate the threads connecting modern-day medicine to its often brutal origins.

And reveal the untold stories of the people who endured them.

Listen on BBC Sounds.

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