Book Review

On the Fabric of the Human Body: Book I: The bones and cartilages

N Engl J Med 1998; 339:1720-1721December 3, 1998

Article

On the Fabric of the Human Body: Book I: The bones and cartilages
(Norman Anatomy Series. No. 1.) By Andreas Vesalius. Translated by William Frank Richardson, in collaboration with John Burd Carman. 416 pp., illustrated. San Francisco, Norman, 1998. $225. ISBN: 0-930405-73-0

This book, by Andreas Vesalius, was first published in 1543. It is well known to gross anatomists and medical historians as the first scientifically based textbook on human anatomy. Along with Copernicus's book that describes the heliocentric universe, it is recognized as one of the two major scientific treatises of the early Renaissance. Vesalius's book was published in Latin in 1543 but has never before been translated into English. The translator and his collaborator have produced a superb translation that is readable and that captures the sense of change that was occurring in science in this era.

To describe Nature accurately was the fundamental goal of science in the 16th century. Vesalius was an observer and a dissector, and his observations and descriptions of human anatomy challenged the work of Galen, which had dominated the accepted medical and religious views for over 1300 years. Galen, a Greek physician practicing in the royal courts of Rome, followed the philosophy of the Greeks that dissection of the human body was forbidden. He therefore described human anatomy on the basis of his observation from comparative anatomical studies of dissection of apes and other animals. Since few physicians dissected human cadavers before the late 15th century, Galen's books were memorized and accepted as gospel, without challenge.

Vesalius studied first in Louvain and then began studying medicine in Paris, where he had access to human cadavers. He frequently found Galen's descriptions to be inaccurate and began to challenge the medical dogma in his teaching to students and members of the medical profession. After passing his examinations on Galenic concepts, he was appointed Professor of Anatomy and Surgery at Padua, in 1537. He was 23 years old.

This book deals with the bones and cartilages. It is the first of seven volumes that will complete the entire translation of De Humani Corporis Fabrica Libri Septum. This translation accurately describes the bones and cartilages of the human skeleton and illustrates in detail the osteologic elements of the adult human. The illustrations are artistically superb and are accompanied by detailed legends. When initially published, these illustrations served as the basis for the first accurate anatomical atlases.

The main text is cross-referenced to the illustrations as well as to the translated volumes planned for the future to deal with the muscles, nerves, vessels, and viscera. This format can be challenging and would be confusing to a reader who does not have a knowledge of gross anatomy. Because the original book was a single volume, its cross-references would have been easily understood by even a novice Renaissance anatomist. This translation also refers to muscles, nerves, and bones by number rather than by their Latin names, and the authors provide a table that assigns the modern anatomical names to these numerical designations. Interestingly, the use of numbers still remains in the current designation for certain anatomical structures such as the first, second, third, fourth, and fifth metacarpal and metatarsal bones.

The highlights of this book are the accurate and artistic illustrations and the dialogue. The translation captures the tensions inherent in describing science in the 16th century. Vesalius takes care to respect the roles of the Creator and Nature in designing an efficient and marvelous anatomical framework that would then allow the human body to exist and function. The same respect is not given to Galen or other writers regarding their erroneous descriptions of human anatomy. Although Vesalius recognizes Galen as “the prince of anatomists and easily the top man among the professors of anatomy,” he also states that “Nature . . . is much more precious to me than Galen.” Readers will also enjoy Vesalius's rationale for selecting standardized terminology for his book. He compares the multiple names for various structures and selects from the Latin and Greek terms the name that he will use throughout the book.

This translation is a scholarly achievement. It is a reference book that should be available to gross anatomists and medical historians. Its high price, however, will mean that most copies will be purchased by libraries and institutions. I believe that it will be important to have these books in the medical library of my institution.

Charles E. Slonecker, D.D.S., Ph.D.
University of British Columbia, Vancouver, BC V6T 1Z2, Canada