The Beauty of Anatomy s01e02 Episode Script

Andreas Vesalius

We are our bodies.
We see the outside all the time, but that's less than half the story.
The surface.
The exterior.
We know far less about what's inside.
Heaven forbid that we should actually see our insides.
Most people go through their life without getting a look at their organs, and for good reason.
My lungs and kidneys and heart and bones and muscles, arteries and veins, they do their jobs unseen.
But for the anatomists, the doctors and artists who have struggled for centuries to understand how our bodies actually work, getting inside, dissection, was vital.
In this five-part series, I'll be investigating the beautiful synthesis between discoveries in anatomy and the works of art that illustrate them.
As a scientist myself, I'm someone who is fascinated by anatomical images.
I want to find out exactly how anatomy has inspired art, and art, anatomy.
And it's going to be my privilege to see some of the greatest works of art in the world.
In 1537, a young man arrived here in Padua, in Italy, to continue his studies in surgery.
Very soon, he was teaching the subject himself.
And the public dissections conducted by Professor Vesalius were a runaway success.
So, how did Andreas Vesalius, in just seven years, go from being a student who stole bodies from the gibbets to being the most famous anatomist in the whole of Europe? His drawings, the benchmark for anatomical illustrations for hundreds of years to come.
OK, so this is the right-hand side of the heart, and this is venous blood, how it gets into the heart and then back out of it again.
And this is the aorta with oxygenated blood that's come from the lungs into the left An anatomy class for first-year medical students at King's College, London.
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around the aortic arch.
So, I just now want to have a quick little look at an actual heart in relation to this.
Demonstrator Sally Brook is using an unusual method of illustrating the body's internal organs to her students.
Superior and inferior vena cava.
So, here's the superior vena cava leading in But some things never change.
Here we have the instructor teaching, and also entertaining her audience.
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right and left ventricle.
In the 21st century, medical schools use a variety of illustrative resources to help students understand anatomy.
But the basis of their teaching remains hands-on dissection, and the study of real body parts.
500 years ago in Padua, another anatomy teacher tried to provide his students with images of the human body that were both dynamic and memorable.
Andreas Vesalius was only 23 when he started lecturing at the university here.
He was just a kid.
He was impetuous, he was ambitious and he was outspoken.
But what was different about Vesalius was that he was innovative.
He transformed dissection.
He illustrated his anatomy lessons with large charts like a modern day slide show, something that no-one else had done before.
Vesalius was also the first in his field to grasp the power of printing.
His atlas of the human body, published in 1543, was the first complete account in words and pictures of the human anatomy and how to dissect it.
Artistically, it was beautiful.
The names of all the artists are not known, but one theory is that the title page was the work of none other than Titian, the most celebrated artist in nearby Venice.
At the Wellcome Library in London, one of the archivists is showing me the very first edition of Vesalius's magnificent book.
De Humani Corporis Fabrica, the Fabrica for short, is famous not just as a work of anatomy.
It's a multi-layered philosophy of life itself.
And it's a true privilege to be able to see it.
Now, one of the first recipients of the Fabrica was the Emperor, Charles V, and you can see why he would've been really impressed.
This is a hefty tome and the sheer scale of it is just knockout.
Ah, thanks, Ross.
Have a look at this poor fellow here.
He's been stripped of all of his internal organs and is hanging from a rope that goes through his skull.
What strikes you immediately about these is not just the extreme high quality of the drawings, but also, they're just so big.
Have a look at this skeleton.
He's posed.
He's leaning in this slightly camp way.
Actually leaning on a spade as if he's just dug his own grave, and he's laughing in this rather ghoulish way.
This is a classic memento mori.
"Remember, you must die.
" These are part of the so-called muscle men sequence, and they're all in these very active poses.
As the flesh is progressively stripped from their body, they actually need something to lean on to stay upright.
They're so vivid, they're ironically lifelike.
These images are 500 years old, but they're vitality just smacks you right in the face.
But what's the message of these life-in-death figures? I get the posturing and how that shows off the muscles, but I'm sure there's more to it.
What are these muscle men really about? Vivian, why does Vesalius put these men in such dramatic poses? Anatomy is not just about cutting up a dead body, it's about understanding the living body, as well.
So, these are living skeletons, you might say.
And this is part of the importance of these plates, as they show the body in movement.
So these figures are not so much posing as captured in action, using their muscles and their bones.
When it came to very detailed analysis, Vesalius clearly grasped that anyone studying parts of the body needed to see beyond the limitations of flat, two-dimensional drawing.
Obviously, this is a hand.
What's special about this particular illustration? It's taken from different angles, so you get an impression of somebody who's done the dissection on several occasions.
So, these plates at the bottom here, all of which are the same set of wrist bones, but But taken from different angles, so you can see how it fits together.
It gives the impression of the body in three dimensions.
The shading is really striking, you can see such 3-D relief in the bones of the hand.
In the same way, Vesalius provides varying perspectives on the brain.
And these drawings are so precise, you even get a sense of how good a dissector he was.
So, in this one we've removed the skull and we're having a look underneath the meninges at the brain itself.
Here you have the beginnings of the dissection and he gradually reveals the brain as he cuts it up in sections.
And it is, let us say 97-98% accurate.
It does make me wonder how this was done, in fact, because that is a very clean line.
He's an incredibly tidy dissector.
One can feel that he has the hand of a surgeon, that he's both delicate and strong.
And he has this visual sense which is extremely unusual.
He thinks like an artist.
Even in his own lifetime, people were saying Vesalius marks a new age.
And suddenly, this is the new anatomy.
Andreas Vesalius was born in Brussels on the last day of 1514.
But it was in Paris where he studied for a few years before Padua that he gained a reputation for being an extraordinarily skilled anatomist.
It was a dark art, dissection.
At night in Paris, Vesalius would pass out of the city gates and sneak up to the sites of the public gallows in Montfaucon.
There, the bodies of executed criminals would hang until their rotted carcasses were taken down from the gibbet.
Vesalius used to steal body parts from these corpses.
He and his fellow students would play a morbid betting game where, blindfolded, they would have to identify the bones using just their hands.
He had already a reputation for being an excellent dissector in Paris.
So, when Vesalius turned up in Padua in 1537, he was actually still a student and the professors then realised that he was actually very good at what he did and rushed him through a medical degree and, very quickly, got in a position to start dissecting human bodies.
Padua is one of the centres of the Italian renaissance, and it's home to one of the most respected and intellectually interesting universities in Italy.
And that university has a medical school, but it's not a very strong medical school.
It is seen to be somewhat conservative, somewhat lacking in the fields of surgery and anatomy.
So, the appointment of Vesalius is a way for the university authorities to recognise and acknowledge this.
To build up their own skills in classical humanist anatomy if you will.
Vesalius's principal task was to teach anatomy and every winter he would perform a number of dissections in public.
Now, this is a place I've wanted to visit for years.
Inside here is one of the very few surviving original anatomy theatres in the world.
It was built a few years after Vesalius worked in Padua in 1594.
But it was modelled on exactly the same principles of a central stage in a public auditorium that Vesalius knew.
And it is truly stunning.
Every point in this room focuses down on what would've been the dissection table here, where the body was.
Even today when you go for surgery, you go into what is referred to as a theatre, but this is a true theatre in the proper sense of the word to the extent that, before the dissections began, there were a group of musicians up at the top there who would play music to calm down the excitable students waiting for the professor to arrive.
All society was here, ranked by tier.
At the bottom in the expensive seats, eminent surgeons and physicians would mingle with nobility.
Behind them, the merchant class, and at the top, in the cheap seats, were commoners and students.
Everyone came to hear the words of wisdom that the great Vesalius would impart.
Everyone, of course, except for the lowest rank in society, the condemned executed criminal.
He didn't give a damn what Vesalius had to say.
Public dissection, at the time that Vesalius is practising it, is absolutely public.
Just as Roman citizens flocked to the Colosseum to see extremely barbaric blood sports, so you get the great unwashed of Padua, as it were, coming along to the anatomical theatre to see perhaps a famous criminal being torn to pieces on the slab.
It's an expression in many ways of state power.
The people being dissected here are, generally speaking, criminals.
So, it's a way for especially the Italian city states to show their power over the bodies of their citizens and especially the citizens who misbehave.
It's also, perhaps rather strangely to our modern eyes, a kind of theological demonstration as well.
If you think about Christian theology, God makes man in his own image.
So, dissection is a way, just as theologians read the book of Scripture, dissection is a way of reading the book of nature, of knowing ourselves, of understanding God's purpose more clearly by studying the way that he has made us.
The dissected body was evidence of divine design.
But there was another side to the theology of the anatomy theatre.
For the condemned criminal, this was a final punishment, a humiliation that engaged all of his religious fears.
If you were dismembered, what prospect was there of rising whole at the Resurrection? By the time Vesalius started to wow his audiences in Padua, public dissections had been performed in Italy for two centuries.
And for all that time there had been strict rules about how they should be done.
At the earliest dissections there were three professionals involved.
The man in charge was the professor.
With the big book of anatomy, he'd read out the instructions.
And then there was the ostensor who would stand at the side with a stick or a rod and point at the relevant bits of the corpse as the professor read them out.
And then at the coalface there was the surgeon and he would make the cuts or the incisions and peel back the skin and the flesh to reveal the relevant organs, bones or tissues.
But Vesalius's approach was different.
On the title page of his great work, Vesalius depicts a scene just after a dissection has begun, albeit with rather more of a wild rumpus.
The theatre, looking a lot like a temple, is absolutely crammed full of people and in the centre, there is a woman whose abdomen has been sliced open.
Now, what's really interesting about this scene is that there is no sign of the ostensor and there is no sign of the surgeon.
And that's because Vesalius had done away with those two positions.
He did all three jobs himself.
He prided himself on being a dissector.
In the title piece of the great book, his Fabrica, he is doing the dissection.
He's hands-on and this is a declaration saying, "I do it myself.
"It is my observation, it's my cutting, "it's my knowledge that I'm specifically demonstrating.
" And he became a kind of hero in that sense, of dissection.
In doing so, Vesalius believed he was going back the principles outlined by Galen, the 2nd-century Roman physician.
Galen's anatomist is the sole investigator.
It is what his eyes see that matters.
And that was not the only change that Vesalius made to the traditions of public dissection.
So, medieval anatomists dissect the abdomen first, then they do the chest.
Finally they do the head, and then after that they might dissect the arms and the legs and the muscles and that sort of thing.
Vesalius, however, as he always does, takes great inspiration from Galen.
Galen says any study of anatomy must begin with the bones.
He says, "The bones are the walls of the house.
" Then you study the muscles, the ligaments, the nerves, the blood vessels, then you move into the great organs and then you move up the body and finish with the brain.
So, Vesalius transforms medieval anatomy by taking an even older idea.
By taking a classical idea of how you study the body in a rational way and making it the centre of his practice.
Vesalius wasn't content with carrying out his public dissections and then merely handing over the results to other doctors or medical students or even the nobility of Padua.
No, no.
He wanted the world to share in his discoveries and, naturally, to celebrate them and him.
The answer was to create the anatomy book of the century, perhaps of all time.
The Fabrica would be the largest volume on the subject yet published.
And more accurately illustrated than any predecessor.
And its unique selling point, every description, every illustration would be based on the evidence of dissection.
The muscle men are probably the most memorable images in the book.
And Vesalius set them in a landscape.
As it turns out, a real one.
These are Euganean Hills, a few miles south of Padua.
You can just make it out in the distance over there and this is the exact landscape that Vesalius wanted to draw his muscle men in as they were progressively stripped to the bone.
The real background emphasises the notion that these figures are alive in this landscape with their very precisely drawn flexed muscles and their classical poses.
So, what is Vesalius trying to say with these figures? Are they about anatomical accuracy or has the artist idealised them? Every image in the history of anatomy is idealised in some way.
But equally, there's always the question in anatomy of how do you depict an ideal human body? Individual human bodies are full of funny little imperfections.
They don't represent the single Platonic ideal, if you like, of what a human being is supposed to be.
So, I think Vesalius is using, in some ways, a more realistic mode of depiction, but I think the images are still idealised.
Vesalius's classical poses make me realise how much a man of his time he was.
He owed a lot to Galen, but artistically, Vesalius's anatomy was Renaissance anatomy.
It was based on a new spirit of enquiry, but also informed by classical art.
To describe these images of the muscle men, he used the classical term "canonical", meaning they represented the gold standard for art.
In effect, he was saying to his colleagues, "These are the perfect anatomical figures.
" To his medical colleagues well versed in classical literature, the word "canon" would have immediately reminded them of the ancient sculptor Polykleitos from the 5th century before Christ.
Now, Polykleitos is known to have written a book called the Canon which spelt out the principles of harmony and proportions of an ideal human body.
Polykleitos is also known to have made a sculpture also called the Canon, which embodied these principles of harmony and proportion.
Later artists used Polykleitos's Canon as a yardstick by which they measured their own craft.
Vesalius wanted his work to be seen as a descendant of the best of classical art.
But was that how it came across at the time it was published? If I was asked what are the great functions of the Fabrica, I'd probably come up with a slightly cynical answer, or perhaps two cynical answers.
One is to make Vesalius's reputation.
He is doing something which is very expensive, very grand and very innovatory and he knew absolutely what he was doing.
And the other shorter, snappier one is to get a good job.
It was successful because he became physician to the Holy Roman Emperor Charles V and although medics didn't need all that on anatomical knowledge it of course put him down as the international star of the human body.
I'm curious to know how far that international stardom spread.
Did anatomists in Britain know his work? In fact, what was happening in anatomy in Tudor Britain? Well, here at the university library in Cambridge, there's intriguing evidence that Vesalius's influence had hopped across the Channel by the 1560s and found its way into the dissecting rooms in Cambridge.
Let me show you a book which certainly demonstrates the extent of the influence of Vesalius.
It's certainly true that by Italian standards, English anatomists were catching up, but there's plenty of evidence in this book and in other sources to show that Vesalius and Vesalian anatomy was having an influence by the middle of the 16th century.
This book was owned by Thomas Lorkin who was the Regius Professor of Physic, that is to say, medicine, at Cambridge from 1564.
This is Lorkin's monogram and the price he paid for it is up at the top there.
How much? Two shillings.
And although this text dates from before Vesalius's Fabrica, we can see that Lorkin was bringing this text up-to-date.
Here, it says in the margin, for example, "Vesalius dicit", in Latin, "Vesalius says.
" And he's correcting the older text with what he's learnt from his study of Vesalius.
The thing I'd like to show you particularly is this opening here which in fact shows the record of the first two dissections ever held in Elizabethan Cambridge.
"Anno domini 1565, the 28th of March, I did make anatomy of Richard," and then he crossed out Richard and put Ralph over the top, "Tipple at Magdalen College, continuing Wednesday, Thursday, "and Friday, and on Saturday morning buried him at 8 o'clock "being the fifth day after his hanging.
" And as you can probably also see, it's quite stained.
So, when you say it's stained, I can see some watermarks, but are you suggesting that this might have been right next to the body itself at the first ever dissection in Cambridge? I think that's very likely, judging by the annotations and the state of the book, it looks very much as if this book was actually present at a messy dissection scene in Cambridge in 1565.
Crikey, that's astonishing.
This shows that Vesalius's influence spread far and wide.
Tudor physicians like Lorkin not only knew about him, but applied his ideas here in Cambridge.
Vesalius's work circulated in different versions and some of them could be quite elaborate.
This is called the Epitome, an abbreviated edition of the Fabrica for students with handy practical features.
Vesalius said what you should do is take the two plates at the back and cut them up because they have figures of the organs, and then stick them on to parchment to strengthen them and then you can actually mount them.
Oh, wow.
At the base of this is a picture of the nerve system, but on top of it are those cut out layers of organs and systems that Vesalius instructs you to attach to the nerve figure here.
You can actually lift up each layer and go down the body .
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and you can see they're all stuck on individually.
And look, underneath it on the backing of the organs, it actually has some writing.
That's right, this is, in effect, a medieval manuscript under here.
It is astonishing to think that, at some point, a student was cutting out a piece of parchment, something which is probably invaluable now, but was the equivalent of a magazine in order to stick these pieces on.
Well, by the time this was being done, of course, medieval manuscripts were kind of going out of fashion because there were these grand new printed books and to have a 15th century manuscript was to have essentially a piece of scrap which you could use to make a mount.
As a medical student in the 16th century, you could've used these to visualise what was going on Anatomy advanced in a series of leaps and bounds throughout the 1500s.
By the end of the century, it was a well respected scientific discipline.
It might not have helped physicians overcome disease, but never before had the mechanics of the body, how the body works, been so well understood.
The changes that took place in the 16th century were largely due to Vesalius, rightly called the founder of modern anatomy.
After him, theories about the structure and functions of the body would only be considered reliable if they were based on evidence.
Andreas Vesalius forced doctors to recognise the absolute importance of recording and personal observations, but done with flair and vitality and nowhere is that more present than in the beautiful illustrations in the pages of the Fabrica.
That book set the gold standard for anatomy for the next 300 years.

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