Clinical Anatomy 00:00–00 (2014)
A GLIMPSE OF OUR PAST
Adriaan van den Spiegel (1578–1625): Anatomist, Physician, and Botanist SANJIB KUMAR GHOSH,* SURANJALI SHARMA, SUDIPA BISWAS, SOUMYA CHAKRABORTY
AND
Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
Adriaan van den Spiegel (1578–1625) was a Flemish anatomist and physician. He was one of the most prominent anatomists at the University of Padua during the 17th century and became professor of anatomy and surgery there in 1619. He was privileged to have two of the most accomplished anatomists of that period, Fabricius ab Aquapendente and Iulius Casserius, as his teachers. His anatomical works were published after his death by his pupil Bucretius and his sonin-law Liberalis Crema, with illustrations procured from Casserius’s unpublished anatomical atlas. He contributed significantly to establishing basic morphological facts about the developing embryo in his text De formato foetu liber singularis. In his book De humani corporis fabrica libri decem, Spiegel’s lobe (caudate lobe) of the liver and the linea semilunaris (Spiegel’s line) on the lateral side of the rectus abdominis muscle were described for the first time. Subsequently, Spigelian aponeurosis (between the lateral margin of the rectus abdominis and the linea semilunaris) and Spigelian hernia (lateral ventral hernia) were named after him. He was a renowned physician in his time and was the first to give a detailed description of malaria. He made significant contributions as a botanist: the genus Spigelia, which has six species, is named after him. Clin. Anat. 00:000–000, 2014. VC 2014 Wiley Periodicals, Inc. Key words: Spiegel’s lobe; linea semilunaris; Spigelian aponeurosis; Spigelian hernia; Padua
EARLY LIFE AND MEDICAL TRAINING Adriaan van den Spiegel or Spigelius was born in 1578 in Flanders (the Dutch-speaking northern part of Belgium) to a Protestant family (Fig. 1). His grandfather and father were noted surgeons (Morren, 1838); his father was the court surgeon to William, Prince of Orange (The Netherlands) (van Gijn and Gijselhart, 2012). Spigelius studied medicine at the University of Louvain, Belgium and later moved to the University of Leiden in the Netherlands (Favaro, 1925–1926). His father died in 1600, and in 1601 Spigelius registered himself at the University of Padua in Italy, the most prominent university in Europe during the Renaissance, particularly in the field of medicine (Taylor, 2009). He obtained his doctoral degree in medicine from Padua, probably in 1604, having been taught by two legends in the field of anatomy: Hieronymus Fabricius ab Aquapendente (1533–1619), the professor of surgery and anatomy, and his student Iulius Casserius
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(1552–1616), who went on to become professor of surgery in 1609 (Morren, 1838; Marinus, 1846; Riva et al., 2001; Smith et al., 2004).
ESTABLISHING HIMSELF AS A PHYSICIAN In 1606, Spigelius was appointed physician to the German-Dutch student community in Padua (van Gijn and Gijselhart, 2012). He assisted Fabricius in medical *Correspondence to: Dr. Sanjib Kumar Ghosh, Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata 700104, West Bengal, India. E-mail: [email protected] Received 3 February 2014; Revised 21 April 2014; Accepted 23 April 2014 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/ca.22414
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Ghosh et al. owing to the fierce rivalry between Fabricius and Casserius, the latter being officially awarded to Casserius while Fabricius continued to hold the chair of anatomy as Professore Supraordinario (Riva et al., 2001). On Fabricius’s death in 1619, the chairs of anatomy and surgery were reunited (Tosoni, 1844) and were awarded to Spigelius (Riva et al., 2001). However it can be assumed that Spigelius was not as privileged as his predecessors in terms of authority; in 1618 (while Fabricius was still alive), Francesco Piazzono (who died in 1624) was appointed to the second chair of anatomy and surgery in Padua (Porzionato et al., 2012). Nevertheless, Spigelius continued to practice medicine in Padua and is considered one of the great physicians associated with the city (Favaro, 1925– 1926). In 1623, he was appointed a Knight of St. Mark. He died two years later, on April 7, 1625, in Padua (Porzionato et al., 2012).
PUBLICATION OF ANATOMICAL WORKS
Fig. 1. A portrait of Adriaan van den Spiegel. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
practice; Fabricius was perhaps the most highly paid and respected physician in Europe at that time. Spigelius accompanied him on a trip to Florence and another to Venice, where Fabricius gave consultations (Marinus, 1846). During this period, Spigelius studied botany and wrote an introduction to the science, Isagoges in rem herbariam libri duo (Spigelius, 1606). In 1607, he competed unsuccessfully for the chair of practical medicine in Padua, which had been left vacant by the death of Ercole Sassonia (1551–1607), a noted Italian physician (Marinus, 1846). In 1612 he left Italy for Belgium, where he stayed briefly. This was followed by a period during which he traveled widely through the countries of central Europe, namely Germany and Moravia, and eventually settled in Bohemia. During these years, Spigelius made a name for himself as a medical practitioner. In Bohemia, he was appointed court physician (medicus primarius) (Favaro, 1925–1926; van Gijn and Gijselhart, 2012).
PROFESSIONAL CAREER IN PADUA In 1616, Spigelius returned to Italy where he was appointed by the Venetian Senate as the ordinary lecturer in anatomy and surgery in Padua; the chair of anatomy remained with Fabricius (Porzionato et al., 2012). It should be noted that for the first time in the history of University of Padua, the chairs of anatomy and surgery in Padua had been separated in 1609
Spigelius’s anatomical works were published posthumously by his pupil, Daniel Bucretius, and his sonin-law, Liberalis Crema (Gycel, 1979). His text on embryology, De formato foetu liber singularis (van de Spiegel, 1626), was edited and published by Liberalis Crema (Fig. 2), who procured nine copperplate engravings that had been prepared for Casserius’s Tabulae anatomicae but could not be published during Casserius’s lifetime, probably because of opposition from Fabricius (Sterzi, 1910; De Ferrari, 1978). Spigelius’s anatomical masterpiece De humani corporis fabrica libri decem (van de Spiegel, 1627) was edited and published by Bucretius (Fig. 3). The text was illustrated with beautiful copperplate engravings, 78 of which were purchased from the inheritors of Casserius’s unpublished work (Fig. 4) while 20 were newly made (van Gijn and Gijselhart, 2012). The illustrations from both sources were prepared by the Italian painter Odoardo Fialetti (1573–1638) and engraver Francesco Valesio (1560–?) (Choulant, 1852).
CONTRIBUTIONS TO HUMAN EMBRYOLOGY Spigelius was a prominent seventeenth century embryologist and made significant contributions to establishing basic morphological facts about the developing embryo—a giant step in the history of embryology (Needham, 1959). He was greatly influenced by his teacher Fabricius, himself a devotee of Aristotle’s principles regarding comparative anatomy, who detailed the formation and generation of the human fetus with remarkable accuracy (Needham, 1959; Cunningham, 1985). Spigelius’s embryological text De formato foetu liber singularis contained plates demonstrating the gradual uncovering of the gravid uterus, in which the female abdomen is displayed open, like the petals of a flower, revealing the inner organs arranged as seeds and stamens; the illustrations are set against a watery landscape (van de Spiegel, 1626) (Fig. 5). These
A. Spiegel as an Anatomist
Fig. 2. Images from Spigelius’s De formato foetu liber singularis, which was published by his son-in-law Liberalis Crema. A: Cover page of the book. B: First page of the text. The first edition was published in 1626 and the images above are from the edition published in 1631. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Fig. 3. Images from Spigelius’s De humani corporis fabrica libri decem, which was published by his pupil Daniel Bucretius. A: Cover page of the book. B: First page of the text. The first edition was published in 1627 and the images above are from the edition of 1632. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
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Ghosh et al. presence of a nerve in the umbilical cord and the first to observe milk in the fetal breasts at birth. He refuted the notion that the presence of meconium in the fetal intestines was evidence that the fetus eats in utero (van de Spiegel, 1626; Needham, 1959).
ANATOMICAL INNOVATIONS Spiegel’s lobe, which is considered the caudate lobe of the liver, together with the papillary process by the anatomists and most of the caudate lobe by the surgeons, was first described by Spigelius (van de Spiegel, 1627; Murukami and Hata, 2002). More recently, this structure has become an important target for aggressive management of carcinoma of the liver, as
Fig. 4. Illustration of the dissection of the back from Spigelius’s De humani corporis fabrica libri decem. This is one of the 78 copperplate engravings procured by Bucretius from the heirs of Iulius Casserius’s unpublished anatomical atlas and published along with Spigelius’s text. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
illustrations reflect the analogies between botany and human anatomy, particularly in relation to the female body, which prevailed during the Renaissance period (Kemp and Wallace, 2000). Although Spigelius was himself a noted botanist, he is unlikely to have influenced the plates used in his work because they were either prepared for Casserius’s anatomical atlas or commissioned after his death (Gycel, 1979). In his text, Spigelius gave a detailed description of the human placenta; he believed that the purpose of the placenta was to prevent severe blood loss at the time of birth, as would have occurred were the fetus attached to the mother by one big vessel rather than the numerous small ones present in the placenta. He affirmed that the fetal heart did beat in utero and argued that umbilical vessels carry vital fluids away from the fetal heart and not exclusively to it. He was the first to deny the
Fig. 5. An illustration from Spigelius’s De formato foetu liber singularis revealing the gravid uterus, in which the female abdomen is displayed open like the petals of a flower and the internal organs are arranged as seeds and stamens. This is one of the nine copperplate engravings procured by Liberalis Crema from the heirs of Iulius Casserius’s unpublished anatomical atlas and published along with Spigelius’s text. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
A. Spiegel as an Anatomist it is embryologically and anatomically independent of the right and left lobes (Abdalla et al., 2002; Hwang et al., 2010). In his text, Spigelius emphasizes the aponeurotic fascia of the transverse and oblique abdominal muscles, present as a curved line on the lateral side of the rectus abdominis. He proposed the name linea semilunaris for this anatomical structure, and this eventually became the official term (van de Spiegel, 1627). Spiegel’s line or linea semilunaris extends between the 9th costal cartilage and the pubic tubercle (Hilger and Baglaj, 2006). Subsequently, the aponeurosis of the transverse abdominal muscle, limited by the linea semilunaris laterally and the lateral margin of the rectus abdominis muscle medially, was named the Spigelian aponeurosis (Skandalakis et al., 2006). Spigelian hernia, also known as lateral ventral hernia, constitutes 1–2% of all hernias and is a protrusion of preperitoneal fat, a peritoneal sac or organs through a congenital or acquired defect in the Spigelian aponeurosis (Skandalakis et al., 2006). Spigelian hernia was described by Le Dran in 1742, Le Clause in 1746, and De Blegny in 1860. However, it was Josef Klinkosh who established the definitive nosological and topographical arrangement of this hernia in 1764 and named it Spigelian hernia (Angelici et al., 2006). Spigelius described four diameters of the human skull in order to characterize the normal form of the head (van de Spiegel, 1627) and laid the foundation of modern day craniometry, an essential tool in physical anthropology. Indeed, he was described as the “father of craniometry” by the famous French anthropologist Paul Topinard (1830– 1911) (Gycel, 1979).
OTHER ACHIEVEMENTS Beyond the field of anatomy, Spigelius made a major contribution to public health as he gave the first detailed description of malaria in De semitertiana libri quatuor (van de Spiegel, 1624; Porzionato et al., 2012). As a physician, his observations regarding changes in the proportions of the human body during growth and the effects of illness on growth are noteworthy (Gycel, 1979). He was a well-known botanist of his time and the genus Spigelia, which has six species, is named after him (Spigelius, 1606). Traditionally, the rhizome and roots of Spigelia merilandica were used to cure intestinal parasites (Bittner et al., 2008). In his text Isagoge in rem herbarium libri duo (Spigelius, 1606), a treatise on botanical science, Spigelius was the first to give instructions for making dried herbarium specimens—a technique that became popular only during the last century.
CONCLUSION Adriaan van den Spiegel was arguably one of the most influential anatomists and physicians of the 17th century. He was fortunate to have Fabricius and Casserius as his teachers in Padua; they were the outstanding anatomists of that period. However, because he worked alongside such greats, most of his achieve-
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ments passed unnoticed, particularly under the towering influence of Fabricius. Moreover, his career in Padua may have been affected by the fierce rivalry between Fabricius and Casserius. His untimely death also contributed to the failure of Spigelius to achieve the recognition he deserved for his achievements in anatomy. Nevertheless, his remarkable contributions to the discipline deserve to be recognized and remembered in modern times for their clinical relevance, which is evident from the fact that his anatomical discoveries still bear his name.
REFERENCES Abdalla EK, Vauthey JN, Couinaud C. 2002. The caudate lobe of liver: Implications of embryology and anatomy for surgery. Surg Oncol Clin N Am 11:835–848. Angelici AM, Nasti AG, Petrucciani N, Leonetti G, Palumbo P. 2006. Spigelian hernia: A case report and review of the literature. G Chir 27:433–435. Bittner JG, Edwards MA, Shah MB, MacFayden BV, Mellinger JD. 2008. Mesh-free laparoscopic Spigelian hernia repair. Am Surg 74:713–720. Choulant L. 1852. History and Bibliography of Antomic Illustration. Chicago: The University of Chicago Press. Cunningham A. 1985. Fabricius and the ‘Aristotle Project’. Anatomical teaching and research at Padova. In: Wear A, French RK, Lonie IM, editors. The Medical Renaissance of the Sixteenth Century. Cambridge, MA: Cambridge University Press. p 195–222. De Ferrari A. 1978. Casseri (Casserio) Giulio Cesare. Dizionario Biografico degli Italiani. Roma: Instituto dell Enciclopedia Italiana. Vol. XV, p 833. Favaro G. 1925–1926. Contributo alla biografia di A. Spigeli nel terzo centenario della sua morte (1625–1925). Atti del Instituto Veneto di Scienze, Lettere ed Arti 85:213–252. Gycel C. 1979. The dentistry of Adriaan van den Spiegel from Brussels (1578–1625–1978). Rev Belge Med Dent 34:99–120. Hilger T, Baglaj M. 2006. Rare abdominal hernias in children. Adv Clin Exp Med 15:733–740. Hwang SE, Cho BH, Hirai I, Kim HT, Kim JH, Fujiyama M, Murakami G, Kimura W. 2010. Topographical anatomy of Spiegel’s lobe and its adjacent organs in mid-term foetuses: Its implication on the development of the lesser sac and the adult morphology of the upper abdomen. Clin Anat 23:712–719. Kemp M, Wallace M. 2000. Spectacular bodies: The art and science of the human body from Leonardo to Now. Berkeley: University of California Press. Marinus JB. 1846. Eloge de van den Spiegel. Bull Acad Roy Med 5: 842–860. Morren M. 1838. Adrien Spiegel. Revue de Bruxelles 1:51–79. Murukami G, Hata F. 2002. Human liver caudate lobe and liver segment. Anat Sci Int 77:211–224. Needham J. 1959. A History of Embryology. New York: AbelardSchuman. Issue 374, p 98–100. Porzionato A, Macchi V, Stecco C, Parenti A, De Caro R. 2012. The anatomical school of Padua. Anat Rec (Hoboken) 295:902–916. Riva A, Orru B, Pirino A, Riva FT. 2001. Iulius Casserius (1552– 1616): The self-made anatomist of Padua’s golden age. Anat Rec 265:168–175. Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P. 2006. Spigelian hernia: Surgical anatomy, embryology, and technique of repair. Am Surg 72:42–48. Smith SB, Macchi V, Parenti A, De Caro R. 2004. Hieronymus Fabricius ab Acquapendente (1533–1619). Clin Anat 17:540–543. Spigelius A. 1606. Isagoges in rem herbarium libri duo. Padua: Paul Megeitto. Sterzi G. 1910. Giulio Casseri, anatomico e chirurgo (1552–1616), Nuova Arch Veneto, N.S. XVIII, P.II: 1–64.
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Taylor J. 2009. Padua University: The role it has played in the history of medicine and cardiology and its position today. Eur Heart J 30:629–635. Tosoni P. 1844. Della anatomia degli antichi e della scuola anatomica padovana. Padova: Tipografia del Seminario. 107 p. van de Spiegel A. 1624. De Semitertiana libri quatuor. Francofurti: Apud haeredes Jo & Theodori de Bry.
van de Spiegel A. 1626. De formato foetu liber singularis. Expensis ejusdem Liberalis Cremae. Patavij: Apud lo Bap de Martinis & Liuiu Pasquato. van de Spiegel A. 1627. De humani corporis fabrica libri decem. Opus posthumum/Daniel Bucretius. Venetiis: Apud Euangelistam Deuchinum. van Gijn J, Gijselhart JP. 2012. Van den Spiegel and his line. Ned Tijdschr Geneeskd 156:A4123.
A GLIMPSE OF OUR PAST
Adriaan van den Spiegel (1578–1625): Anatomist, Physician, and Botanist SANJIB KUMAR GHOSH,* SURANJALI SHARMA, SUDIPA BISWAS, SOUMYA CHAKRABORTY
AND
Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
Adriaan van den Spiegel (1578–1625) was a Flemish anatomist and physician. He was one of the most prominent anatomists at the University of Padua during the 17th century and became professor of anatomy and surgery there in 1619. He was privileged to have two of the most accomplished anatomists of that period, Fabricius ab Aquapendente and Iulius Casserius, as his teachers. His anatomical works were published after his death by his pupil Bucretius and his sonin-law Liberalis Crema, with illustrations procured from Casserius’s unpublished anatomical atlas. He contributed significantly to establishing basic morphological facts about the developing embryo in his text De formato foetu liber singularis. In his book De humani corporis fabrica libri decem, Spiegel’s lobe (caudate lobe) of the liver and the linea semilunaris (Spiegel’s line) on the lateral side of the rectus abdominis muscle were described for the first time. Subsequently, Spigelian aponeurosis (between the lateral margin of the rectus abdominis and the linea semilunaris) and Spigelian hernia (lateral ventral hernia) were named after him. He was a renowned physician in his time and was the first to give a detailed description of malaria. He made significant contributions as a botanist: the genus Spigelia, which has six species, is named after him. Clin. Anat. 00:000–000, 2014. VC 2014 Wiley Periodicals, Inc. Key words: Spiegel’s lobe; linea semilunaris; Spigelian aponeurosis; Spigelian hernia; Padua
EARLY LIFE AND MEDICAL TRAINING Adriaan van den Spiegel or Spigelius was born in 1578 in Flanders (the Dutch-speaking northern part of Belgium) to a Protestant family (Fig. 1). His grandfather and father were noted surgeons (Morren, 1838); his father was the court surgeon to William, Prince of Orange (The Netherlands) (van Gijn and Gijselhart, 2012). Spigelius studied medicine at the University of Louvain, Belgium and later moved to the University of Leiden in the Netherlands (Favaro, 1925–1926). His father died in 1600, and in 1601 Spigelius registered himself at the University of Padua in Italy, the most prominent university in Europe during the Renaissance, particularly in the field of medicine (Taylor, 2009). He obtained his doctoral degree in medicine from Padua, probably in 1604, having been taught by two legends in the field of anatomy: Hieronymus Fabricius ab Aquapendente (1533–1619), the professor of surgery and anatomy, and his student Iulius Casserius
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(1552–1616), who went on to become professor of surgery in 1609 (Morren, 1838; Marinus, 1846; Riva et al., 2001; Smith et al., 2004).
ESTABLISHING HIMSELF AS A PHYSICIAN In 1606, Spigelius was appointed physician to the German-Dutch student community in Padua (van Gijn and Gijselhart, 2012). He assisted Fabricius in medical *Correspondence to: Dr. Sanjib Kumar Ghosh, Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata 700104, West Bengal, India. E-mail: [email protected] Received 3 February 2014; Revised 21 April 2014; Accepted 23 April 2014 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/ca.22414
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Ghosh et al. owing to the fierce rivalry between Fabricius and Casserius, the latter being officially awarded to Casserius while Fabricius continued to hold the chair of anatomy as Professore Supraordinario (Riva et al., 2001). On Fabricius’s death in 1619, the chairs of anatomy and surgery were reunited (Tosoni, 1844) and were awarded to Spigelius (Riva et al., 2001). However it can be assumed that Spigelius was not as privileged as his predecessors in terms of authority; in 1618 (while Fabricius was still alive), Francesco Piazzono (who died in 1624) was appointed to the second chair of anatomy and surgery in Padua (Porzionato et al., 2012). Nevertheless, Spigelius continued to practice medicine in Padua and is considered one of the great physicians associated with the city (Favaro, 1925– 1926). In 1623, he was appointed a Knight of St. Mark. He died two years later, on April 7, 1625, in Padua (Porzionato et al., 2012).
PUBLICATION OF ANATOMICAL WORKS
Fig. 1. A portrait of Adriaan van den Spiegel. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
practice; Fabricius was perhaps the most highly paid and respected physician in Europe at that time. Spigelius accompanied him on a trip to Florence and another to Venice, where Fabricius gave consultations (Marinus, 1846). During this period, Spigelius studied botany and wrote an introduction to the science, Isagoges in rem herbariam libri duo (Spigelius, 1606). In 1607, he competed unsuccessfully for the chair of practical medicine in Padua, which had been left vacant by the death of Ercole Sassonia (1551–1607), a noted Italian physician (Marinus, 1846). In 1612 he left Italy for Belgium, where he stayed briefly. This was followed by a period during which he traveled widely through the countries of central Europe, namely Germany and Moravia, and eventually settled in Bohemia. During these years, Spigelius made a name for himself as a medical practitioner. In Bohemia, he was appointed court physician (medicus primarius) (Favaro, 1925–1926; van Gijn and Gijselhart, 2012).
PROFESSIONAL CAREER IN PADUA In 1616, Spigelius returned to Italy where he was appointed by the Venetian Senate as the ordinary lecturer in anatomy and surgery in Padua; the chair of anatomy remained with Fabricius (Porzionato et al., 2012). It should be noted that for the first time in the history of University of Padua, the chairs of anatomy and surgery in Padua had been separated in 1609
Spigelius’s anatomical works were published posthumously by his pupil, Daniel Bucretius, and his sonin-law, Liberalis Crema (Gycel, 1979). His text on embryology, De formato foetu liber singularis (van de Spiegel, 1626), was edited and published by Liberalis Crema (Fig. 2), who procured nine copperplate engravings that had been prepared for Casserius’s Tabulae anatomicae but could not be published during Casserius’s lifetime, probably because of opposition from Fabricius (Sterzi, 1910; De Ferrari, 1978). Spigelius’s anatomical masterpiece De humani corporis fabrica libri decem (van de Spiegel, 1627) was edited and published by Bucretius (Fig. 3). The text was illustrated with beautiful copperplate engravings, 78 of which were purchased from the inheritors of Casserius’s unpublished work (Fig. 4) while 20 were newly made (van Gijn and Gijselhart, 2012). The illustrations from both sources were prepared by the Italian painter Odoardo Fialetti (1573–1638) and engraver Francesco Valesio (1560–?) (Choulant, 1852).
CONTRIBUTIONS TO HUMAN EMBRYOLOGY Spigelius was a prominent seventeenth century embryologist and made significant contributions to establishing basic morphological facts about the developing embryo—a giant step in the history of embryology (Needham, 1959). He was greatly influenced by his teacher Fabricius, himself a devotee of Aristotle’s principles regarding comparative anatomy, who detailed the formation and generation of the human fetus with remarkable accuracy (Needham, 1959; Cunningham, 1985). Spigelius’s embryological text De formato foetu liber singularis contained plates demonstrating the gradual uncovering of the gravid uterus, in which the female abdomen is displayed open, like the petals of a flower, revealing the inner organs arranged as seeds and stamens; the illustrations are set against a watery landscape (van de Spiegel, 1626) (Fig. 5). These
A. Spiegel as an Anatomist
Fig. 2. Images from Spigelius’s De formato foetu liber singularis, which was published by his son-in-law Liberalis Crema. A: Cover page of the book. B: First page of the text. The first edition was published in 1626 and the images above are from the edition published in 1631. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Fig. 3. Images from Spigelius’s De humani corporis fabrica libri decem, which was published by his pupil Daniel Bucretius. A: Cover page of the book. B: First page of the text. The first edition was published in 1627 and the images above are from the edition of 1632. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
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Ghosh et al. presence of a nerve in the umbilical cord and the first to observe milk in the fetal breasts at birth. He refuted the notion that the presence of meconium in the fetal intestines was evidence that the fetus eats in utero (van de Spiegel, 1626; Needham, 1959).
ANATOMICAL INNOVATIONS Spiegel’s lobe, which is considered the caudate lobe of the liver, together with the papillary process by the anatomists and most of the caudate lobe by the surgeons, was first described by Spigelius (van de Spiegel, 1627; Murukami and Hata, 2002). More recently, this structure has become an important target for aggressive management of carcinoma of the liver, as
Fig. 4. Illustration of the dissection of the back from Spigelius’s De humani corporis fabrica libri decem. This is one of the 78 copperplate engravings procured by Bucretius from the heirs of Iulius Casserius’s unpublished anatomical atlas and published along with Spigelius’s text. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
illustrations reflect the analogies between botany and human anatomy, particularly in relation to the female body, which prevailed during the Renaissance period (Kemp and Wallace, 2000). Although Spigelius was himself a noted botanist, he is unlikely to have influenced the plates used in his work because they were either prepared for Casserius’s anatomical atlas or commissioned after his death (Gycel, 1979). In his text, Spigelius gave a detailed description of the human placenta; he believed that the purpose of the placenta was to prevent severe blood loss at the time of birth, as would have occurred were the fetus attached to the mother by one big vessel rather than the numerous small ones present in the placenta. He affirmed that the fetal heart did beat in utero and argued that umbilical vessels carry vital fluids away from the fetal heart and not exclusively to it. He was the first to deny the
Fig. 5. An illustration from Spigelius’s De formato foetu liber singularis revealing the gravid uterus, in which the female abdomen is displayed open like the petals of a flower and the internal organs are arranged as seeds and stamens. This is one of the nine copperplate engravings procured by Liberalis Crema from the heirs of Iulius Casserius’s unpublished anatomical atlas and published along with Spigelius’s text. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
A. Spiegel as an Anatomist it is embryologically and anatomically independent of the right and left lobes (Abdalla et al., 2002; Hwang et al., 2010). In his text, Spigelius emphasizes the aponeurotic fascia of the transverse and oblique abdominal muscles, present as a curved line on the lateral side of the rectus abdominis. He proposed the name linea semilunaris for this anatomical structure, and this eventually became the official term (van de Spiegel, 1627). Spiegel’s line or linea semilunaris extends between the 9th costal cartilage and the pubic tubercle (Hilger and Baglaj, 2006). Subsequently, the aponeurosis of the transverse abdominal muscle, limited by the linea semilunaris laterally and the lateral margin of the rectus abdominis muscle medially, was named the Spigelian aponeurosis (Skandalakis et al., 2006). Spigelian hernia, also known as lateral ventral hernia, constitutes 1–2% of all hernias and is a protrusion of preperitoneal fat, a peritoneal sac or organs through a congenital or acquired defect in the Spigelian aponeurosis (Skandalakis et al., 2006). Spigelian hernia was described by Le Dran in 1742, Le Clause in 1746, and De Blegny in 1860. However, it was Josef Klinkosh who established the definitive nosological and topographical arrangement of this hernia in 1764 and named it Spigelian hernia (Angelici et al., 2006). Spigelius described four diameters of the human skull in order to characterize the normal form of the head (van de Spiegel, 1627) and laid the foundation of modern day craniometry, an essential tool in physical anthropology. Indeed, he was described as the “father of craniometry” by the famous French anthropologist Paul Topinard (1830– 1911) (Gycel, 1979).
OTHER ACHIEVEMENTS Beyond the field of anatomy, Spigelius made a major contribution to public health as he gave the first detailed description of malaria in De semitertiana libri quatuor (van de Spiegel, 1624; Porzionato et al., 2012). As a physician, his observations regarding changes in the proportions of the human body during growth and the effects of illness on growth are noteworthy (Gycel, 1979). He was a well-known botanist of his time and the genus Spigelia, which has six species, is named after him (Spigelius, 1606). Traditionally, the rhizome and roots of Spigelia merilandica were used to cure intestinal parasites (Bittner et al., 2008). In his text Isagoge in rem herbarium libri duo (Spigelius, 1606), a treatise on botanical science, Spigelius was the first to give instructions for making dried herbarium specimens—a technique that became popular only during the last century.
CONCLUSION Adriaan van den Spiegel was arguably one of the most influential anatomists and physicians of the 17th century. He was fortunate to have Fabricius and Casserius as his teachers in Padua; they were the outstanding anatomists of that period. However, because he worked alongside such greats, most of his achieve-
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ments passed unnoticed, particularly under the towering influence of Fabricius. Moreover, his career in Padua may have been affected by the fierce rivalry between Fabricius and Casserius. His untimely death also contributed to the failure of Spigelius to achieve the recognition he deserved for his achievements in anatomy. Nevertheless, his remarkable contributions to the discipline deserve to be recognized and remembered in modern times for their clinical relevance, which is evident from the fact that his anatomical discoveries still bear his name.
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![[Johann Gottfried Zinn--a Franconian anatomist and botanist].](/assets/img/hold.png)
