Fabrici, Girolamo (or Fabricius Ab Aquapendente, Geronimo Fabrizio)

(b. Aquapendente, near Orvieto, Italy, ca. 1533; Padua, Italy, 21 May 1619)

anatomy, physiology, embryology, surgery.

Fabrici was born of a noble and once-wealthy family; that he was the eldest son is indicated by his having been named for his paternal grandfather. Around 1550 his family sent him to Padua where, under the patronage of a patrician Venetian family named Lippomano or Lipamano, he studied Greek and Latin, then logic and philosophy. He went on to medicine and took his degree in medicine and philosophy at Padua in about 1559.

Fabrici studied with Gabriele Falloppio, whom he succeeded as teacher of anatomy upon the latter’s death in 1562; from 1563 to 1565 he devoted himself to giving private anatomy lessons. In April 1565 he was nominated by the university to lecture on both anatomy and surgery; the position brought him an annual salary of 100 florins and entailed additional responsibilities in anatomical work. He presented his first lecture on 18 December 1566; he was repeatedly reconfirmed in his academic position (with appropriate raises in pay) and in 1600 was given life tenure, with the title sopraordinario. From 1609 on anatomy and surgery were given separately, and Fabrici became sopraordinario lecturer in anatomy only, retaining his full salary, however, which by that time amounted to 100 scudi a year. He retired from teaching in 1613, having served the University of Padua for nearly fifty years.

Fabrici’s long academic career was not without strife. in 1588 he was publicly accused by his students of neglecting his teaching—a charge that would seem to have some ground in truth, but which may be explained in part by Fabrici’s repeated illnesses. Certainly he was of difficult character, as may be seen by his clash with his German students, whom he ridiculed in the course of a public lecture in February 1589 because of their slow and harsh speech—the quarrel was reconciled only in October of that year. He further became embroiled in a protest in 1597 about having been placed after the professors of philosophy on the Rotula of the university; had an argument in 1608 with Eustachio Rudio; became involved in a dispute about the schedule of courses with his colleague Annibale Bimbiolo in 1611; and in 1613 attempted to prevent the nomination of a German councillor of the university because he was annoyed with the German students for attending the private anatomy classes given by Giulio Casseri.

It is likely, too, that Fabrici slighted his teaching duties in the interest of scientific research. He did, however, make substantial contributions to the university; among other things, the construction of a permanent anatomical theater, built in 1594 and inaugurated by him in 1595 (still preserved, and now bearing Fabrici’s name), was in large part due to his efforts. His merit as a teacher was publicly acknowledged; if some of these acknowledgments are of a formal nature (as for example, those given on the occasions of his academic reconfirmations), others are undoubtedly sincere (the gratitude expressed by the fractious German students for the course in surgery that he conducted in 1606).

Fabrici further took active part in other matters concerning the university: in 1574 he was instrumental in securing the acquittal of a German student from a charge of homicide; in 1591 he intervened on behalf of some German students who had been arrested for carrying arms; in 1592–1593 he concerned himself with the reconstruction of the temporary anatomical theater and in 1595 with free admission to the permanent theater; in 1606 he again acted on behalf of an arrested German student; and in the winter of 1608–1609 he gave a cadaver to the German students (among whom were Olaus Worm and Caspar Bartholin) so that they could prepare the skeleton. It is thus clear that his relations with his students improved with the passage of time.

As a surgeon and physician Fabrici enjoyed high professional acclaim and the patronage of many eminent people. In 1581 he attended a brother of the duke of Mantua; in 1591 he was consulted by the duke of Urbino about the cure for certain fevers that were rampant in Pesaro; and in 1594 he corresponded with Mercuriale and Tagliacozzi about a case of rectogenital fistula. He went to Florence in 1604 to treat Carlo de’ Medici, the son of Ferdinand I and Christina di Lorena, while in 1606 he visited Galileo, who subsequently became his patient. He visited Venice with Spigelio on 9 October 1607, and while he was there took care of Paolo Sarpi, who had been wounded a few days before; for these services he was made a knight of St. Mark by the Republic of Venice.

At some unknown time Fabrici married Violante Vidal; they had no children and she died in 1618. He did have an illegitimate son, Francesco, probably born before his marriage. Francesco also took his degree in medicine but was a source of little pleasure or pride to his father—in fact, a quarrel over money brought father and son into legal confrontation; Fabrici had serious disagreements with other close relatives as well. The person to whom he was closest was his great-grandniece, Semidea, whom he adopted on the death of her father and raised as his daughter in Padua. He married her to Daniele Dolfin on 9 May 1619; on 13 May he fell ill and died a few days later, almost certainly at his house in Padua. His funeral took place on 23 May, in the Franciscan church; the oration was given by Giovanni Tuilio, and he was buried, sine titulo, in the west cloister.

As a scientist, Fabrici was an indefatigable and scrupulous observer, describing his results with exactitude. His interpretation of observed phenomena was often shaped by tradition, however, and he may not be considered a comparative anatomist in the modern sense because he made no studies of homologous structures and did not attempt to analyze relationships and affinities of the organs that he studied. His primary purpose in his studies of fetal anatomy, for example, was to prepare a tool for the interpretation of the purpose and end of the organs under consideration; he was more concerned with finding philosophically based principles than with morphological detail and tended to modify observations that did not verify such principles. Thus he often failed to pursue his own discoveries to their logical conclusions. His interpretation of nature was, then, a teleological one, and his methods of observation derived largely from Galen.

Fabrici published his results in several volumes, including De visione, voce, auditu (Venice, 1600); De locutione et ejus instrumentis liber (Venice, 1601); De brutorum loquela (1603); De venarum ostiolis (1603); De musculi artificio, ossium de articulalionibus (1614); De respiratione et eius Instrumentis, libri duo ... (1615); De gula, ventriculo, intestinis tractatus (1618); De motu locali animalium secundum totum (1618); and Hieronymi Senis De totius animalis integumentis opusculum (1618)—all of which may be considered as parts of the uncompleted but monumental Totius animalis fabricae theatrum which he meant to publish and to which he devoted many years. In addition, there are in the St. Mark’s library in Venice 167 Tabulae anatomicae, collected in eight volumes, part of the 300 color plates that Fabrici finished in 1600 as his major purely anatomical work.

One of the most famous (and most thoroughly studied) of Fabrici’s works is De venarum ostiolis. The treatise, published in Padua, consists of twenty-three folio pages, supplemented by eight beautiful plates In it Fabrici reports that he had first observed the valves of the veins in 1574 (the first demonstration to his students was in 1578 or 1579), as was recognized by his student Salomon Alberti, who published, with Fabrici’s permission, a preliminary illustration of the venous valves (Nuremberg, 1585). Although the valves of the veins had been studied previously by G. B. Canano and by Amato Lusitano (indeed, a dispute arising therefrom had involved Vesalius, Eustachi, and Falloppio), Fabrici made no use of their contributions, perhaps intentionally; he describes the venous valves ex novo, systematically and accurately.

His interest in reconciling his observations with the traditional Galenic concepts of function misled Fabrici into missing the real significance of the venous valves, however. He accepts the notion of the blood flowing centrifugally, drawn by the viscera, and interprets the function of the venous valves to be the slowing down of the influx of the blood to provide for its even distribution to various parts of the body. He thus gives a teleological account of the number, alternate positioning, and conformation of the valves, pointing out that they are not present in the large veins of the trunk, such as the vena cava, in which the blood flows directly to the viscera and vital organs; they are found instead in the veins of the limbs, where they prevent an excessive inflow of blood, which would both cause swelling and deprive the vital organs of nourishment. He describes the valves as corresponding to the openings of collateral branches of the veins and calls them ostiola. In addition to thus regulating the flow of the blood mechanically, the valves also serve to prevent excessive stretching of the blood vessels and to reinforce the walls of the veins.

This is demonstrated by the formation of varicose veins in those who do heavy work; the blood of such persons is more dense and held longer by the valves, which become dilated, then subside as the veins dilate. The valves are further demonstrable by the application of a tourniquet to the upper arm; they then appear as a series of regularly spaced knots on its surface. Fabrici observed that if, after ligating the vein, one pressed upon it with a finger, one could observe the valves in action—acting, he thought, to retard the progress of the blood; his misinterpretation may have been due in part to his confusion of laboratory observation with the clinical symptoms of valvular insufficiency that he had noted, particularly in cases of varicosity.

Perhaps the most notable contribution of De venarum ostiolis is that William Harvey drew upon it in beginning his studies of the circulation of blood. Harvey was the pupil of Fabrici—indeed, he even lived for a while in his house—and from Fabrici’s work he obtained the illustrations that would, with substantial modifications, serve him for his De motu cordis.

Fabrici’s embryological studies were written concurrently with his later anatomical works. They include De formato foetu (1604) and De formatione ovi et pulli (published posthumously in 1621); and these two treatises in themselves would assure Fabrici’s place among the most important biologists of his time.

In his introduction to De formato foetu (his last embryological treatise, despite its earlier publication), Fabrici divides his studies on generation into three parts. The first of these, dealing with the propagation of the seed and the organs that produce it, is presumably De instrumentis seminis, which was never published and is probably lost; the second, his work concerning the nature and properties of the seed and the generation and formation of the fetus, is De formatione ovi et pulli while the third, his treatment of the fetus itself, is the De formato foetu. Both of the extant works are of a rather narrative character and are written in a somewhat inelegant Latin; many reputable scholars suggest that these works grew out of Fabrici’s classroom lectures.

De formatione ovi et pulli is divided into two parts. The first, in three chapters, deals with the formation of the egg. The first chapter discusses the three bases of animal generation given by Aristotle (the egg, the seed, and spontaneously from decomposing materials); Fabrici differs from Aristotle, however, in asserting that most insects are born from eggs in which there is no differentiation between the formative and the nutritive elements; and in specific opposition to Aristotle he classifies Testacea as oviparous. In some respects, Fabrici’s classification approaches the ex ovo omnia of Harvey; he excludes from his list of oviparous creatures only mammals and those insects that he believes to have been the products of spontaneous generation. His discussion of the generation of birds involves two aspects, that of the egg (whose uterus is the ovaries and oviducts) and that of the chicken (whose uterus is the egg itself).

Although Fabrici’s embryological studies often surpassed those Aidrovandi and Coiter, he here makes two mistakes. He interprets the germinal disc of the hen’s egg as the scar left on the yolk by the detachment of the peduncle that had attached it to the ovary during its development, and he states that the function of the cloacal bursa in the hen (the bursa of Fabricius, which he discovered) is to store the semen of the rooster.

In the second chapter of De formatione ovi et pulli Fabrici states two functions of the “uterus”: the formation of the egg and, immediately thereafter, its nutrition. The yolk of the egg is formed in the “upper uterus” (the ovarium of the yolk), while the remaining part is formed in the “lower uterus” (the uterus, or ovarium of the whole egg). The egg thus leaves the ovary as a naked yolk; and the chalazae, the albumen, the two membranes of the shell, and the shell itself develop subsequently in the oviduct. The yolk grows as it is nourished by material brought to it through the blood vessels that run through the ovisac while the egg is still attached to the ovary; after detachment the egg ceases to grow and the albumen, adhering to the yolk, grows by apposition. All parts of the egg are therefore derived from the blood, although from different portions of it. The chapter closes with a discussion of the formation of the shell; the third chapter concerns the usefulness of the uterus.

The second part of the treatise, also in three chapters, is concerned with the generation of the chick within the egg and begins with a description of the eggs of various species. Many of the notions and arguments set forth in the first part of the book are then summarized.

The second chapter of the second part deals with the three basic functions of the egg: the formation, growth, and nutrition of the chick. These considerations draw Fabrici into complex and difficult problems that he is unable to resolve, not because of any inadequacy as an observer but rather because of the science that he has inherited. He concludes his discussion with the trophic functions of both yolk and albumen and goes on to demonstrate that the chalaza attached to the thicker part of the egg is the only possible source of formative material. He considers semen to act as only the effective cause of generation; it never enters the egg, being prevented from doing so by the depth and plication of the uterus, which combine to keep the semen from reaching the upper oviduct—and by the time the egg has reached the lower oviduct it is encased in its protective shell. Fabrici postulates that semen is collected in the cloacal bursa of the hen and thence, through its radiant or spiritual powers, fertilizes the entire egg and uterus.

Thus, in oviparous animals the material and the agent of generation are not only distinct but separated by a notable physical distance; this view in no way contradicts Aristotle’s doctrine that all the material for generation is contained in the female. (In dealing with viviparous animals, however, Fabrici adopts the Galenic interpretation by which the male seed is both material and efficient cause of generation.)

Fabrici then speculates further on the various possible causes and conditions of generation, including a discussion of the order in which various parts of the embryo are formed during its development. This question had been debated since Aristotle’s time, and Fabrici affirmed that certain structures constituting the “carina” (or “Keel”) can be seen prior to the development of the heart and viscera; it is probable that his “carina” is in fact the whole one- or two-day-old embryo, in which the head, vertebral column, and ribs are visible to the naked eye. H. B. Adelmann (in The Embryological Treatises of Hieronymus Fabricius of Aquapendente [Ithaca, 1942]) maintains, on the basis of Fabrici’s rather complicated discussion, that he did not, like Aristotle, consider the heart to be the first organ formed, nor yet, like Galen, the liver; rather, he may be thought to have preceded Harvey in giving priority to the blood.

The last chapter of the treatise returns to teleology to consider the utility of both the egg and the semen of the rooster.

De formatione ovi et pulli is illustrated with seven plates, of which only the first three are labeled. The last five plates are the most significant since they represent the first printed figures of the development of the chick, beginning with the third or fourth day of incubation. Some of these figures—especially those illustrating embryonic appendages—are difficult to interpret, although all are admirable for their subtlety of detail (obtained without magnification). The representation of vascularization at the third and sixth days of incubation is perhaps typical of the series. The time of hatching is, however, somewhat oddly given as twenty-four days, perhaps as the result of retardation induced by the experimental incubation.

Fabrici’s other major embryological work, De formato foetu, illustrates the way in which nature provides for the necessities of the fetus during its intrauterine life. It treats specifically of the umbilical vessels, the urachus, the fetal membranes, fetal waste products, the “carnea substantia” (placenta), and the uterus. The treatise includes comparative studies of morphological details in dogs, cats, rabbits, mice, guinea pigs, sheep, cattle, goats, roebuck, horses, pigs, birds, sharks, and man. Fabrici’s description of the umbilical cord and its vessels is accurate, as is his differentiation of the action of the umbilical vessels in various animals; he also provides an adequate description of the right and left atria of the heart, the foramen ovale and the ductus arteriosus, the vena cava, and the pulmonary vein in the fetus.

The value of Fabrici’s observations is, however, lessened by his need to impose a Galenic interpretation upon them. He posits that no fetal organ exercises any “public” action—that is, any function for the benefit of the whole organism—but only “private” ones; each attracts, utilizes, and voids nutriment for itself alone. The whole fetus needs only nutriment and vital spirit (which helps to digest the nutriment) in order to grow; the nutriment and vital spirit reach the fetus through the umbilical veins and arteries, with the maternal uterus thus doing the work of the fetal heart and liver. (If the umbilical vessels are ligated just above the umbilicus the fetal heart and arteries cease to pulsate, thereby demonstrating that the flow of vital spirit has been interrupted.) Although Fabrici differs from Galen on occasion (as when, for instance, he maintains that the blood which reaches the fetal liver does not need purification), his embryological theories are most often in agreement with him.

Fabrici champions Galen against Aranzio in the question of the relationship between the maternal and fetal blood vessels; he maintains that during pregnancy the uterine vessels terminate in apertures to which the fetal vessels are in some way united (although he does not specify the nature of this union). These connections are always of vein to vein and artery to artery to prevent confusion in the distribution of the vital spirit. Fabrici presents observations of the chorionic villi and the crypts of the placenta and interprets them respectively as the terminals of umbilical and uterine vessels. He considered the chorionic villi as patent, however, whereas Harvey thought them to be blind. Aranzio and Harvey, in their belief in the separateness of maternal and fetal circulation, were closer to the truth than Fabrici. Fabrici’s explanation of the atrophy of the umbilical cord following birth is Aristotelian; having served its purpose, it is destined to decay.

Fabrici describes the relationship between the chorion and the allantois in some species in a fuller and more accurate manner than Vesalius, Colombo, or even Harvey. He follows tradition in considering the amnion to be a receptacle for fetal sweat and, in agreement with Falloppio, says that fetal urine is (except in species provided with allantois) stored in the chorion. He next examines the embryonic appendages of some herbivorous animals in light of this theory and states that Aranzio is in error when he says that the human fetus lacks a urachus and discharges urine into the amniotic cavity.

Fabrici then discusses fetal waste products and the Galenic principle whereby there are only six of them: sweat (in the amnion); urine (in the chorion or allantois); bile; phlegm; feces; and the white, caseous residue adhering to the skin, cast off by the fetus in the course of assimilating nutrition.

Although Fabrici’s work on the umbilical vessels, the fetal membranes, and fetal waste products are of only limited (if any) originality, he does draw some original, if faulty, conclusions about the significance of the placenta, which he studied more fully than any of his predecessors, including Vesalius and Falloppio. Fabrici is the first to give a reasoned classification of the various forms of placentas and to attempt to correlate these forms with the various types of animals; he limits the term “placenta” (introduced by Colombo) to refer to the discoidal type of placenta found in humans and in some animals (including rabbits, mice, rats, and guinea pigs). He is also the first to study human decidua and the subplacenta of the guinea pig and to print illustrations of the chorionic villi and uterine crypts of horses, pigs, and ruminant animals. In passing he deals with the complex problem of the cotyledons, which had been controversial since the work of Praxagorus and Aristotle.

Fabrici contests Aranzio’s view of the function of the placenta—that it acts as a uterine liver to purify the blood of the fetus—although he admits that a small amount of blood is purified by the fleshy placental substance (but only to provide for its own nutrition and hence as à “private” and not a “public” action). The work ends with a chapter containing a highly traditional account of how much nature does to ensure the safe birth of the fetus.

De formato foetu is, like its predecessor, illustrated. It contains thirty-four plates of great interest which illustrate, in some instances for the first time, various aspects of the anatomy of the uterus and of the fetus in humans and in sheep, cows, horses, pigs, dogs, rats, mice, guinea pigs, and sharks. As Fabrici was the first to study he was also the first to illustrate the decidua of the human uterus, the uterine crypts in animals (interpreted as the open ends of uterine vessels), and the subplacenta in guinea pigs. In addition, the work contains interesting plates of the venous and arterialducts and of the omphalomesenteric vein and artery in the dog; the last plate in the book illustrates the development of serpents, a topic on which Fabrici does not touch in the text. The plates, the work of an unknown artist, are well executed although sometimes lacking clarity (although many fine details are shown), and they are better integrated into the text than those of De formatione ovi et pulli. Adelmann discusses the embryological color illustrations.

Fabrici’s surgical works are gathered in the Pentateuchos cheirurgicum (printed in Frankfurt am Main in 1592, and edited by a pupil of Fabrici, Johann Hartman Beyer, apparently without his consent) and in the Operationes chirurgicae, published in Venice in 1619 as an addendum to the Pentateuchos.

The five books of the Pentateuchos are primarily devoted to the description of tumors, wounds, ulcers and fistulas, fractures, and dislocations; to these the Operationes adds a description of surgical instruments (some of which are illustrated) and classic surgical techniques, including a discussion of particular technical expedients devised by Fabrici himself and emphasizing some differences between Fabrici’s technique and that of others. Of particular interest are two plates illustrating an orthopedic device, in the shape of a man, designed to combine in one apparatus the principles for all existing devices for the correction of orthopedic injuries and deformities. A passage by Antonio Vallisneri indicates that this device was actually built and used.

Although Fabrici’s surgical works have not yet been studied in any detail it is clear that they rely on both Hippocrates and Galen in diagnostics and therapy. (The medications that Fabrici prescribes are, for example, traditional ones.) Yet the books had great success and went through many editions in many languages; the versification of the first book of the Pentateuchos by Antonio Filippo Ciucci (Rome, 1653) can be taken as an exemplar of Fabrici’s fame as a surgeon.

BIBLIOGRAPHY

I. Original Works. Fabrici’s works were collected into Opera omnia anatomica et physiologica (Leipzig, 1687); a later ed. (Leiden, 1738) is more complete. Individual works are cited in the text; unless otherwise specified, all were published in Padua.

Modern eds. are Delle valvole delle vene, with trans. and intro. by Felice Grondona (Milan, 1966); and Dell’orecchio, organo dell’udito and Della laringe, organo della voce, trans. and commentary by Luigi Stroppiana (Rome, 1967).

II. Secondary Literature. On Fabrici’s life and work see H. B. Adelmann, The Embryological Treatises of Hieronymus Fabricius of Aquapendente (Ithaca, N.Y., 1942); L. Belloni, “Di una avvenuta chiamata di Gaspare Tagliacozzi allo studio di Padova (1594) e di un consulto epistolare tra G. Mercuriali, G. Tagliacozzi e G. Fabrici d’Acquapendente sovra un caso di fistola retto-genitale,” in Rivista di storia delle scienze mediche e naturali, 43 (1952); “Die deutsche Aussprache in einer kurzen Abhandlung von Conrad Hofmann an Hieronymus Fabrici ab Aquapendente,” in Sudhoffs Archiv für Geschichte der Medizin und der Naturwissenschaften, 37 (1953); and “Valvole venose e flusso centrifugo del sangue. Cenni storici,” in Simposi Clinici Ciba, 5 (1968); A. F. Ciucci, L ’Ospidale di Parnaso, Bruno Zanobio, ed. (Milan, 1962); G. Favaro, “Contributi alla biografia di Girolamo Fabrici di Acquapendente,” in Memorie e documenti per la storia della Università di Padova (Padua, 1922); “L’insegnamento anatomico di Girolamo Fabrici d’Acquapendente,” in Monografie storiche sullo studio di Padova. Contributo del R. Istituto Veneto di scienze, lettere ed arti alla celebrazzione del VII centenario della università (Venice, 1922); K. J. Franklin, De venarum ostiolis of Hieronymus Fabricius of Aquapendente (Baltimore, 1933); E. Gurlt, Geschichte der Chirurgie, II (Berlin, 1898), 445–481; G. Sterzi, “Le ’Tabulae Anatomicae’ ed i Codici marciani con note autografe di Hieronymus Fabricius ab Aquapendente,” in Anatomischer Anzeiger, 35 (1910); and L. Stroppiana, “Realtà scomparse. Divagando tra G. Fabrizi d’Acquapendente e Antonio Vallisneri,” in Humana studia, 4 (1952).

Bruno Zanobio