Andreas Vesalius: modern founder of anatomy

The human anatomy references used by doctors through the year AD 1500 were actually based mostly on animal studies, more myth and error than truth.

Andreas Vesalius (1514-1564) was the first to insist on dissections, on exact physiological experiment and direct observation.

Vesalius discovered many errors in Galen’s work and revealed his evidence to discredit Galen and to show that Galen’s description of curved human thighbones, heart chambers, segmented breast bones, etc, better matched the anatomy of apes than humans.

Vesalius dissected the cadavers himself. This contravened the usual procedure, on which the professor read from a Galenic text while the body was opened by a menial or prosector. Vesalius began to employ drawings to clarify the various structures of the body.

Vesalius detailed more than 200 discrepancies between actual human and Galen’s descriptions, Time after time, Vesalius showed that what every doctor and surgeon in Europe relied on fit better with apes, dogs, and sheep than human body.

Vesalius De Humani Corporis Fabrica was completed and published his magnificent anatomy book in 1542.

Ultimately the scientific study of anatomy became accepted as the avenue of increasing the knowledge of this discipline and the practice of medicine.

With the rise of modern science, the approach that Vesalius pioneered became the standard for medicine. Physicians followed him into the body dissecting it as a way of understanding how it worked.
Andreas Vesalius: modern founder of anatomy

Retinal anatomy

The retina was first described by Herophilus of Chalcedon around 300 BC. It was named by Rufos of Ephesus (c, 110 AD) and appeared to early anatomists as a surrounding net which supported the vitreous.

Herophilus of Chalcedon was one of only two scientists (the other one being Erasistratus of Ceos) to perform systematic scientific dissections of human cadavers. The sensitive layer at the back of the eye seemed to him rather like a spider’s web. Hence he named it the amphiblestroides, the Latin translation of which is ‘retina’.

Though Galen noted structural similarities to the brain, he was unable to provide further understanding regarding its function.

For Galen, the crystalline lens was the ‘receptive organ’ of the eye, while the retina was an organ of nutrition and conveyors of visual spirits to and from the lens.

Galen emphasized the similarities between the retina and the brain and maintained that the retina and optic nerves were really displaced parts of the brain.

Apparently, William Briggs in 1685 first illustrated the fibrous nature of the retina. Briggs trained as a physicist and wrote several texts on the anatomy of the eye.

It was Johannes Kepler who first suggested that the retina served as the eye’s primary photoreceptor tissue. By using alcohol fixation, Treviranus in 1835 performed the first detailed microscopic retinal studies.

A better understanding of the structure of the retina came after 1840 the year in which Adolph Hannover began to use chromic acid to harden tissue, in order to slice thinner sections.

He then described the receptors as facing away from the vitreous chamber and identified and numbered the principle layers of the retina.

Only with the subsequent development of electron microscopy, trypsin digest, clinical fluorescein angiography, and optical coherence tomography have scientists been able to understand the retinal’s cellular connections, ultra-structure and retinal vasculature, as well as correlate anatomical and clinical findings.
Retinal anatomy

Antonine plague (165 – 180 AD)

The Antonine Plague of the Roman Empire was also called the Plague of Galen. Generally thought to have been smallpox or measles and it lasted for fifteen years.  The plague was named Antonine Plague because it claimed the lives of two Roman Emperors with the family name of Antonine: Lucius Verus in 169 and Marcus Aurelius Antoninus in 180.

The Antonine plaque reached the Empire in 165. This disease had enormous long-term consequences in manpower, the leashing of agricultural land, the erection of public buildings and the production of bricks, coins and inscriptions.

The Antonine plague began with the soldiers serving on the eastern frontiers of the Empire with Verus, the co-Emperor with Marcus Aurelius.

It spread rapidly on the return of the infected soldiers after the Parthian War and reached Rome itself in 166.  Thousands died daily in Rome.

Roman doctors, annalists, and historians such as Galen, Cassius Dio, and Ammianus Marcellinus reported that the epidemic spread throughout Europe from the frontiers of the Persian to the Rhine and Gaul, contributing widespread famine.

Galen is said to have fled from it but he was recalled by the joint Emperors Marcus Aurelius and Verus to advice on the control of the pandemic.

The plague travelling via the Roman trade routes, there were even reports of the plague spreading as far as China.
Antonine plague (165 – 180 AD)

History of epilepsy

Since the earliest times epilepsy was considered a disease of a marked supernatural character, a ‘sacred disease’ that could be driven out only by magical means.

An early text from Mesopotamia 11th BC) described the condition of anta’dubbu as a person whose neck turns left, whose hand and feet are intent and eyes wide open, froth flowing from the mouth and consciousness being loss, resulting from the hand of a god.

The term epilepsy originated from the Greek word for ‘seize’ or ‘attack’ and probably was derived from the idea of the individual being sized or attack by the gods.

Hippocrates opined that epilepsy was a natural affection with a hereditary origin, with its pathogenesis in the brain.

The Hippocratic writings referred to epilepsy as the ‘great disease’ a term subsequently adopted in its French translation as ‘grand mal’ to describe epileptic attacks.

Galen, the Greek physician and philosopher of the second century, attributed epilepsy to accumulation of two humors, phlegm and bile in cerebral ventricles.

Galen work not accessible until 11th century. During this period, epilepsy was surrounded by superstition and magic.

In the nineteenth and early twentieth centuries, epilepsy was a common diagnosis in the asylums and in some, patients with epilepsy were segregated in separate wards.

It is often said that the history of epilepsy surgery began on May 25, 1886, when Victor Horsley operated, at the National Hospital for the Paralyzed and Epileptic at Queen’s Square in London, on a patient of John Hughlings Jackson.
History of epilepsy

History of cow’s milk allergy

Allergic reactions to food affecting the gastrointestinal tract have been known since ancient times. 

Hippocrates (460-370 BC) was among the first to report the adverse effects of cow’s milk, including hives and gastrointestinal disorders.

He observed that cow’s milk caused gastrointestinal symptoms as well as urticaria and that some infants led cow’s milk developed prolonged diarrhea, vomiting and failure to thrive that resolved only after removal of cowls milk from their diet.

Galen described allergy to goat’s milk in 130 AD.

In 1745 Charles Edward Stuart, the pretender to the English throne, was reputed to have ‘bloody influx’ due to milk which could have been allergic colitis.

Since 1905 there have been reports in the modern literature recognizing allergic response to cow’s milk. It was not until 1901 in Germany and 1916 in America, that scientists began formally documenting cow’s milk allergy.

Reports on adverse reactions to cow’s milk protein were published in Germany literature. In these reports adverse reactions to cow’s milk were described as ‘idiosyncrasy’.

Wernstedt, in Sweden, was probably the first to refer such reactions as allergy.

In 1942 A.F.R. Anderson proposed food allergy and especially milk, as a cause of ulcerative colitis.

In 1950 researchers performed the first blind, placebo-controlled study of milk allergy. By 1956, using microscopes, scientists were able to view how cow’s milk proteins and those from other foods, can induce an immune system response.
History of cow’s milk allergy

Galen on Herophilus

Galen on Herophilus
Herophilus ‘attained the highest degree of accuracy in things which became known by dissection and he obtained the greater part of his knowledge, not like the majority from irrational animals, but from human beings themselves.’ – by Galen

Galen was born in 129 AD in Pergamum, on the Aegean coasts of modern Turkey, but he lived much of his live in Rome. He deplored the laws that forbade human dissection: at least three of his many treatise were devoted to human anatomy, ostensibly as understood by the Alexandrians.

He received medical training in Smyma and Alexandria.

Galen served as a physician to the gladiators, and he may have taken advantage of gaping wounds to observe internal structure.

A great experimenter, he dissected animals, both living and dead, his preferred subjects being a pig and the rhesus monkey.

He extrapolated from animals to humans and devised elaborate theories concerning anatomical strictures, the motion of blood, and the origin and sustenance of life.

Galen’s genius was evident in the physiological experiments he conducted on animals. The work On the Use of the Parts of the Human Body comprised seventeen books concerning this topic. To study the function of the kidneys in producing urine, he tied the ureters and observed the swelling of the kidneys.

Some observations were accurate for animals but missed their marked when applied or humans, for example, he ascribed five lobes to the liver and a vascular network in the brain called the rete mirable.

Galen’s writings are authoritative and bragging, and his teleological perspective allowed him to conceive of all structures as having been created for a purpose.

His immediate successors may have carried out some human dissection, but anatomies became rare and ritualized exercise for endorsing Galen’s authority, not for seeking truth.

Galen spent the rest of his life at the Court writing an enormous corpus of medical works until his death in 201 AD.
Galen on Herophilus