Pathological dissections in early modern Europe: practice and knowledge

In the chapter devoted to the head in the second edition of De humani corporis fabrica (On the fabric of the human body, 1555), Andreas Vesalius reported the dissection of a girl, in whose brain he had found a great quantity of water. He explained this as the result of the girl’s hydrocephalus. Next, he described the illness and autopsy of a nobleman whose heart appeared to be enlarged, just like the girl’s brain or a uterus. The heart also included a substantial piece of flesh, globulous and blackish.1 The juxtaposition of a brain, a heart and the womb may seem odd today, but was based on the ability of these organs to expand either naturally, as in the case of the womb, or as the effect of a disease. Vesalius could compare them because he was used to dissecting both normal and diseased bodies, and did so in the chapter to engage more broadly with a vexed issue in early modern medicine: how to distinguish between variations within the natural and healthy, the rare and wondrous, and pathology.2 Some might at that time have interpreted the flesh inside the nobleman’s heart as an admirable sign, but Vesalius understood it as pathological. Explicitly highlighting the productive interaction between post-mortems and reflection on diseases, he concluded the chapter by announcing a forthcoming work in which he would collect his ‘histories of dissections’; these, he claimed, would be ‘eminently suitable for a knowledge of diseases and a discussion of the medical art as a whole’.