Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda


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An incredible find in surgical stapling history

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Dr. Mark M. Ravitch
Dr. Mark M. Ravitch


Young surgeons today use surgical staplers without a thought as to the history of the development of these surgical devices. The same is true for many who work in the medical devices (surgical staplers) industry. I have worked as a consultant and a trainer for the stapler industry both with Ethicon Endosurgery (today Ethicon, stapling division) and the United States Surgical Corporation (today Medtronic, stapling division) and developed a special interest in the medical history related to the origin, research, and development of surgical staplers.

The history of surgical stapling is quite interesting and has many characters, starting with the early works of Humer Hutl. There are whole books dedicated to this topic.

It cannot be denied that one of the main drivers of surgical stapling in the United States was Dr. Mark M. Ravitch (1910-1989). History tells us that he saw these staplers in action being used by Dr. Nikolai Mikhailovich Amosov (1913–2002) during a visit to the Thoracic Surgical Institute in Kiev in September 1958. Kiev was then part of Russia (then called the USSR).

What I did not know is that Dr. Ravitch had his notes typewritten, and those loose leaf notes are now part of my library in a binder.

The notes in this binder are the carbon copies in onionskin paper of notes typewritten personally by Dr. Mark. M. Ravitch during his trip to the USSR in September 1958. According to his family, Dr, Ravitch had notoriously bad handwriting and he liked to maintain records of his work, so he was a very fast typewriter. He used his personal typewriter and he traveled everywhere with it even during his military service in WWII.

 

 

Dr. N. M. Amosov

Dr. Nikolai Mikhailovich Amosov

Cover of Dr. Ravitch's personal notes

Cover of Dr. Ravitch's personal notes

The original notes were bound in a book (also in my collection) and gifted by Dr. Ravitch to his parents. Unfortunately, the paper he used for the originals was not acid-free and the pages in this unique book are slowly crumbling and some of them are today unreadable. Thankfully, the carbon copies are acid-free, and the pages have been carefully scanned in TIF and PDF format by David M. Klein and then placed in separate plastic sleeves for preservation in a binder that is now in my library.

After Dr. Ravitch’s parents passing, both these notes were in the library of his son, Michael M. Ravitch, Ph.D. Michael lent these notes to Dr. Felicien Steichen (1926 – 2011) , who after a time returned the notes with a letter, also included in this binder. In this letter Dr. Steichen says that these notes should be preserved for future research, even mentioning Leon Hirsch (CEO of the United States Surgical Corporation) to support this endeavor.

Michael Ravitch’s widow, Myrnice Ravitch contacted me in 2017 because of my interest in medical history and the life and work of Dr. Ravitch. She donated some books that were in Dr. Ravitch’s library. In early 2024, and with the blessing of Dr. Ravitch’s daughter Binnie and the rest of the Ravitch family, they donated these notes that are now part of the history of surgical stapling and are today part of my library.

In a separate article I will present some of the actual notes regarding surgical stapling, although these notes also include invaluable observations on medicine and surgery in the USSR and Dr. Ravitch’s comments on the Russian culture and people at the time. Keep in mind that Dr. Ravitch’s parents where Russian immigrants and he was fluent in Russian.

In the future, and following Dr. Steichen’s suggestion, I will try to publish a book with these notes along with additional notes on Dr. Ravitch’s trip to China in 1983

Note: The photograph of Dr. Asomov was taken by Dr. Ravitch, but it has since degraded, so it was enhanced using Winxvideo AI.

Note: Dr. N.M. Amosov had an incredible surgical career and recognized with medals and honors. The Institute where Dr. Ravitch saw him operate with surgical staplers is today known as the Amosov National Institute of Cardiovascular Surgery in Kiev, Ukraine.

Sources:
1. "Current practice of surgical Stapling" Ravitch, MM; Steichen, FM; Welter,W.  1991 Lea & Ferbiger USA
2. "Stapling in Surgery" Ravitch, MM; Steichen, FM.1984 Year Book Medical Publishers USA.
3. "Surgical Rounds" Edition dedicated to Dr. M.M. Ravitch  May 1990
4. "Notes by Dr. Mark Ravitch on Trip to Russia - September 1958" Personal notes, unpublished.