Across multiple plates in Fabrica, "muscle men" figures are shown in consistent poses and settings (often standing in landscapes) and with successive layers of musculature removed.
Vesalius’s first innovative approach to teaching was to descend from the lector’s chair and perform the dissections himself, allowing him to observe and compare actual anatomy, not just recite classical sources. To clarify his presentations for the audience, Vesalius introduced large charts with illustrations of the anatomy. These visual representations also were unique, as few anatomic works to date featured illustrations. In fact, most academics at the time were strictly opposed to including images in their work, as illustrations were thought to degrade scholarship.
In 1538, Vesalius published a series of six anatomic woodcut plate illustrations known as the Tabulae Sex, which set a new standard in biological illustration because they were reference-based rather than created via verbal descriptions of anatomy. These plates also are considered pioneering work because they were created specifically for well-educated doctoral students and physicians, unlike previous large broadside prints, which were designed as quick visual references for nonacademic barber-surgeons rather than detailed study tools.
In 1539, Vesalius published the Venesection Letter, which some medical historians consider to be the first evidence-based report. This important pamphlet described a European-wide debate on the best technique for humoral rebalancing via bloodletting for treatment of pleurisy. Most of the assertions in this report were based on classical sources, debating the Hippocratic method versus the Arabic method.
Vesalius contributed his insights to the debate based on his anatomic studies in the letter, which included a diagram of the thoracic venous drainage that Vesalius developed informed by his personal dissections. Thereafter, scientific arguments debating the two treatments were compelled to use direct evidence in their defense of their preferred approach, reflecting a growing emphasis on empirical observation.
The flayed muscle figure reveals layered musculature of the torso and limbs with meticulous detail, exemplifying Vesalius’s fusion of anatomical science and classical artistic tradition.
Merging Illustration with Knowledge
The word “fabrica” in the title De Humani Corporis Fabrica Libri Septem is intriguing, as this word could be simultaneously understood as “structure/construct” or “art/craft/production,” perhaps as a reference that human anatomy is an expression of purpose and artisanship. This combination of purpose and artisanship is a defining attribute of the Fabrica, because Vesalius’s anatomic observations gleaned from years of human dissection are paired with exquisitely detailed and artistic illustrations from Titian’s workshop—which included artists associated with Titian, a well-regarded Venetian painter—integrating the text and illustrations into a single, unified entity.
What separates Fabrica from similar 16th-century publications, and why it is still studied today among art scholars, is the extraordinarily high level of detail in the images, coupled with explicit references to classical antiquity and iconography.
Among the illustrations, Italian Renaissance artistic imagery is omnipresent. In the frontispiece, Vesalius is shown with one hand pointing upward and the other resting on the cadaver, which recalls Raphael’s The School of Athens (1510-1511) as a simultaneous synthesis of both the Platonic and Aristotelian philosophies.
The osteological plates with lamenting skeletons resemble Renaissance vanitas themes of death and memento mori (“remember you must die”). The second plate of the muscle men illustrations is modeled on a well-known Titian portrait, the Allocution of Alfonso d’Avalos to His Troops (1541), and the ninth plate is similar to classical poses as demonstrated in the Capitoline Antinous—a marble statue of a young male found at Hadrian’s Villa in Tivoli, Italy (though unlikely to be a direct reference).
In contrast, the abdominal visceral plates appear to be fragmentary classical sculpture, including one plate that resembles the Belvedere Torso. Interestingly, the artist who created these captivating illustrations has not been firmly established. Most modern scholarship supports the fact that the images came from Titian’s workshop in Venice, Italy, where Titian oversaw the artistic invention of the figures and scenes, and Flemish artist Jan Stephan van Calcar served as a medical designer.
The typography and print work of the Fabrica deserve specific mention. Vesalius’s use of a legend in his figures is notable. In the anatomic illustrations, one can see italic letter markings on the structures. Overall, this system of legends that cross-references the illustration with the textual descriptions was unique as a method of communicating descriptive science, and set a precedent for future scientific instruction that continues to be used today.
The intricacy of the illustrations is due to the engravers’ novel method of soaking the woodblocks in linseed oil prior to their engraving, which hardened the wood, making it more receptive to finer lines of engraving.
The pages of Fabrica exemplify the book’s groundbreaking format, in which illustrations and descriptions work together to advance the Renaissance study of human anatomy.
Also, the choice of Johannes Oporinus as the printer was crucial to the collection’s enduring success. Oporinus’s progressive publication ideas (he was the first to publish a printed version of a Latin translation of the Quran, for which he was briefly jailed), his previous medical studies under Celsus, and the location of his print shop in Basel, Switzerland, allowed for rapid distribution of the Fabrica to the French, German, Italian, and Flemish academies where Vesalius’s teachings would take hold. These factors converged to make Vesalius’s work one of the earliest widely distributed collection of scientific textbooks in European scholarship.
The Fabrica’s frontispiece, a striking and hectic scene, is a singular work of art that is among the highest achievements of wood engraving, incorporating clean and precise lines, crosshatching and shadowing, and remarkable use of perspective projection (a defining characteristic of Renaissance art).
The image depicts an open-air public anatomy conducted by young Vesalius in a renaissance-style Palladian courtyard. Vesalius is surrounded by students and fellow physicians, the rectors of the city and university, and councilors and representatives of the nobility and church.
In this piece, Vesalius serves as the lector, ostensory, and dissector, demonstrating his absolute control over all aspects of anatomical knowledge. Three figures in ancient antiquarian dress demonstrate the classical foundations of anatomic knowledge. Galen’s reliance on animal anatomy is indicated by the dog (with a human foot) and a chained monkey in the foreground. The fully articulated skeleton in the center of the scene reinforces the Vesalian importance of bones as the underpinning of anatomic dissection, while the nude figure clinging to the column to the left reflects the importance of surface anatomy and function.
The entablature above the columns is a nod to Vesalius’s sponsors with the lion of the Venetian state and ox of the University of Padua. Above the title block, Vesalius’s family crest featuring three weasels en courant is held by two putti. The inscribed letters I and O, the monogram of Oporonius, is to the left of the crest.
An anatomical engraving of the human brain exemplifies the precision and visual clarity that transformed the study of anatomy in the sixteenth century. (Credit: Wellcome Collection)
The frontispiece of the Fabrica includes a self-fashioned portrait of Vesalius dissecting a hand and forearm. This is an overt reference to Aristotle’s De partibus animalium in which Aristotle views the hand as the organum organorum (organ of organs)—the organ that best demonstrates human intellect and capability to create civilization. The hand as a symbol of vital human essence also is seen in the Creation of Adam by Michelangelo (1511) on the Sistine Chapel ceiling.
Vesalius’s depiction of a tendon dissection finds a visual echo in Rembrandt’s The Anatomy Lesson of Dr. Nicolaes Tulp (1632), where the dissected forearm similarly serves to assert the physician’s mastery of science and the order of nature.
Summary of Each Fabrica Book
The first of the seven books in the Fabrica collection focuses on bones, which Vesalius believed to be the most critical as a framework for understanding anatomy. Three full-body skeletons appear to be in various stages of lamentation, perhaps of their own mortality.
The second book focuses on the muscles in which Vesalius’s series of muscle men are shown in an order of progressive flaying. The initial plates depict superficial muscles, and each subsequent plate reveals one deeper layer of muscles. The muscle men represent the body as a living organism with accompanying functional movements, the movements of which degrade as muscles are stripped away. These first two books account for more than half of the pages of the collection perhaps showing the sixteenth-century anatomists’ command of structural anatomy even as the physiologies of the circulatory, metabolic, and neurologic systems remained poorly understood in Vesalius’s time.
Book three features illustrations of the vascular system with venous and arterial anatomy, while book four contains representations of the central and peripheral nerves. The placement of vasculature so early in the books is a notable promotion of Vesalius’s skills as a dissector, since venous anatomy was the weakest topic area in Galen’s classical writings.
The fifth book includes illustrations of the abdominal visceral organs and both male and female reproductive systems. Book six contains images of the thoracic visceral organs, and book seven features illustrations of the brain, presented as serial axial sections.
Left: Skeleton figure leans pensively on a pedestal beside a skull—an iconic Renaissance image combining anatomical precision with a contemplative pose.
Right: Positioned in a classical pose against a detailed landscape, the muscle man figure reflects the synthesis of empirical anatomy and artistic tradition that defined Vesalius’s work.
Fabrica's Lasting Impact
Following the publication of the Fabrica, Vesalius was appointed imperial physician to Emperor Charles V of the Holy Roman Empire in 1544, a role in which he served until his death. (Vesalius is believed to have died in 1564 during a pilgrimage to Jerusalem and was buried on the Greek island of Zakynthos.)
In August 1555, Vesalius published a second edition of Fabrica with expanded and revised content, including new physiological observations based on dissection and intervention: laryngeal paralysis following transection of the recurrent laryngeal nerve, collapse of the lung after opening the pleural cavity, artificial respiration via intratracheal intubation, and survival following surgical splenectomy.
Vesalius exemplifies an early modern commitment to grounding medical knowledge in direct observation and hands-on anatomical investigation. His emphasis on dissection and surgical practice challenged divisions between learned medicine and manual surgery, arguing for anatomy as a unifying foundation of medical knowledge, even as institutional separations between physicians, surgeons, and barber-surgeons largely persisted in his lifetime. The enduring resonance of his work across medical and artistic communities is aptly symbolized by an inscription on one of his skeletal images: Vivitur ingenio, caetera mortis erunt (genius lives on, all else is mortal).
More than 700 copies of the Fabrica still exist, largely in medical libraries or museums. The author has been fortunate to be associated with two university libraries with copies of the Fabrica and would encourage readers who are interested in learning more about the Fabrica to contact their librarians and archivists to arrange a viewing. Several high-quality scanned copies also can be found online such as via the Royal Library of Belgium website at https://uurl.kbr.be/1044146.
Dr. Brendan Lovasik is a transplant surgeon at Washington University in St. Louis, Missouri.
Bibliography
Harcourt G. Andreas Vesalius and the anatomy of antique sculpture. Representations. 1987;(17):28-61.
Lacey S. Artistic influences on Andreas Vesalius’s De humani corporis fabrica libri septem and its influence on the arts in the sixteenth and seventeenth centuries. Doctus Artifex. 2012.
Saunders JB de M, O’Malley CD. The Illustrations from the Works of Andreas Vesalius of Brussels. Dover Publications; 1973.
