On the Fabric of the Human Body. Book III, The Veins and Arteries. Book IV, The Nerves (review)

In the future when I am feeling a bit down, one of my pick-me-ups will be to reread Vesalius's essay on the hollow vein, or his brilliant discussion of the cross-sectional shapes of the intracranial venous sinuses, or indeed much else in this memorable account of some of the most difficult-to-describe anatomy in the human body.

John Carman, Anatomist's Preface (p. xxvi)

Talk about your recherché pleasures! Nevertheless, in the context of Richardson and Carman's learned, humane, gracious, and ambitious undertaking—rendering the whole of Vesalius's Fabrica into modern English and current nomenclature—it is not so surprising.

Considering the practical and theoretical difficulties he faced in his material, the Vesalian accomplishment in the present volumes is amazing. Today's official schedule of anatomical terms, the Nomina Anatomica, lists about 1,300 blood vessels and nerves, and Vesalius identifies more than six hundred. Since Vesalius did not attempt to count the smaller blood vessels or terminals of cutaneous nerves, as Carman observes, "this is an extraordinarily high proportion of the vessels and nerves now routinely recognized" (p. xiv).

Books III and IV, presented here in one volume, introduce material more challenging both to Vesalius and to us as readers than did the bones and muscles, the subjects of books I and II, respectively. The blood vessels and the nerves are more complex in themselves, are more numerous, and were much less understood by the Galenic tradition in which the Belgian anatomist had been formed. We know now that many of the Galenic physiological doctrines presumably based on faulty anatomical findings were largely incorrect and inspired fundamentally different metaphors to guide the formation of terminology. With the circulatory schema of Harvey in mind, we envision the veins as rivers and see "tributaries coming together to form main streams" (p. xii). In contrast, the ancient view of fluids and spirits ebbing and flowing within the veins, arteries, and nerves virtually independently, led to the image of the "tree whose trunks divide into branches and twigs" (p. xii).

We sympathize with Richardson as he recalls how his "heart sank" when at the beginning of chapter iii book iii Vesalius stated: "in fully developed human beings after birth there are, in total and at most, four veins." Thus Richardson and Carman were forced to struggle with language in which (for instance) what is now known as the anterior tibial vein is designated as the outer offshoot of the outer branch of the division of the large vein of the leg (p. 94).

Incidentally, to find Vesalius's designation of the anterior tibial vein, one looks it up in the index to veins on page 282: the reference is "94 g," which takes us sufficiently well to the point in the descriptive text, but, as has often been remarked, these minute alphabetical designations are extremely difficult to find in illustrations, even in the larger folio-sized images such as the original of the full-length vein man reproduced on p. 32. One longs for a digital image that could highlight the alphabetical references for us. The next step in this project, therefore, is to convert this excellent rendering of the Fabrica into an electronic book (an "e-book").

One of the most helpful notes of the translator illuminates a prime Vesalian refutation of Galenic dicta. Galen had held that the vena cava originated in the liver, as the vein was greatest at that point, a contention to which Vesalius took strong exception. On page...