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Clin. Cardiol. 25, 135–137 (2002)
This section edited by J. Willis Hurst, M.D., and W. Bruce Fye, M.D., M.A.
Realdo Colombo
W. BRUCE FYE, M.D., M.A.
Cardiovascular Division, Mayo Clinic, Rochester, Minnesota, USA
Realdo Colombo (Fig. 1), born in Cremona, Italy, between
1510 and 1515, published the first definitive description of the
pulmonary circulation.1, 2 The son of an apothecary, he received his preliminary education in Milan. Colombo next began to study medicine as an apprentice to Giovanni Antonio
Lonigo, a prominent Venetian surgeon. After 7 years in Venice
with Lonigo, he moved to Padua to continue his medical studies at the university, a leading center for medical education. He
arrived at Padua at an exciting time. Andreas Vesalius was
writing and preparing the illustrations for his monumental
anatomical work, De humani corporis fabrica libri septum.
A superior student and talented anatomist, Colombo became Vesalius’s assistant in 1541. He substituted for him during the 1542 term, when the senior anatomist was in Switzerland overseeing the printing of his book that would appear the
following year. Their friendship ended soon, however, when
Colombo criticized Vesalius publicly. After teaching anatomy in Pisa between 1545 and 1548, Colombo moved to
Rome where he hoped to collaborate with Michelangelo on
an illustrated anatomical textbook that would compete with
Vesalius’s atlas. He began teaching at the Sapienza and spent
the rest of his life in Rome.
During the middle of the sixteenth century, anatomical dissection grew in popularity in Paris and northern Italy, and
Colombo flourished in this context. He lived at a time when a
few anatomists were beginning to challenge Galen’s anatomical teachings. Galen had dominated medical thought for almost 1400 years. But Colombo, like Vesalius, was not bound
Address for reprints:
W. Bruce Fye, M.D., M.A.
Mayo Clinic, West 16A
200 First Street, SW
Rochester, MN 55905
e-mail: [email protected]
Received: May 7, 2001
Accepted: May 11, 2001
by tradition. They were interested in extending knowledge by
direct observation. Colombo’s knowledge of anatomy was
gained firsthand—he performed countless autopsies, dissections, and vivisections during the 1540s and 1550s.
Colombo’s book, De re anatomica, incorporated his original observations and synthesized contemporary anatomical
thought. Consisting of 15 chapters, the book was completed
just before his death in 1559. Michelangelo had died 5 years
earlier, so their planned collaboration did not come to fruition.
The only illustration in Colombo’s book is an elaborate engraving that depicts him performing a dissection. According to
twentieth century scholars Robert Moes and C. D. O’Malley,
the book was very popular and influential. Because “the language was uncomplicated and the descriptions succinct,” they
thought it was very likely that most contemporary anatomists
and physicians “paid lip-service to the massive Fabrica [of
Vesalius] and read De re anatomica.”3
This rare book includes Colombo’s original description of
the pulmonary circulation, based on hundreds of dissections
and vivisections he performed. This fact sets Colombo apart
from two individuals who had already described the pulmonary circulation: the thirteenth century Arabic physician
Ibn al-Nafis of Damascus and the Spanish biologist and
philosopher Michael Servetus, who had described the pulmonary circulation in a theological book he published in 1553.
Historian Leonard Wilson concluded that Colombo arrived at
his conclusions about the pulmonary circulation independently.4 There was no printed version of Ibn al-Nafis’s observations; they were passed on in Arabic manuscripts. Almost all
copies of Servetus’s book were destroyed the year it was published—when he was burned at the stake in Geneva for heresy.
A comparison of their writings demonstrates that Colombo’s
understanding of the pulmonary circulation was more sophisticated than that of the other two writers. It was also based on
extensive anatomical investigations.
Galen completed his influential treatise on the usefulness of
the parts of the body around 175 A.D. It included detailed discussions of the anatomy and physiology of the cardiovascular
system. The ancient Greek physician believed that blood circulated from the right ventricle to the left ventricle through invisible pores in the interventricular septum.5 His notion of the
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Clin. Cardiol. Vol. 25, March 2002
cardiac anatomy and physiology. Recently, historian Jerome
Bylebyl summarized the status of the ancient Greek physician’s views about the cardiovascular system during the time
of Vesalius and Colombo:
In the Galenic physiology of the sixteenth century, the
right cardiac ventricle was thought to receive blood from
the vena cava and to send it into the pulmonary artery to
nourish the lungs. The left ventricle was supposed to ventilate the innate heat of the heart by breathing in and out
through the pulmonary vein. In addition, the left ventricle
was thought to receive blood from the right ventricle
through minute pores in the intervening septum. From
this blood and from some of the air received from the
lungs, the left ventricle generated vital spirits and arterial
blood, which it distributed to the entire body through the
arteries to preserve life.1(a)
Colombo disproved the Galenic teaching that the pulmonary artery and pulmonary vein[s] contained different amounts
of blood and air (or spirit). Based on many dissections of humans and vivisections of living animals, the Italian anatomist
argued that the pulmonary vein[s], like all other veins in the
body, contained blood rather than just air. He proposed that
blood mixed with air in the lungs rather than in the heart itself.
In his discussion of the function of the lungs Colombo stated
that air
FIG. 1 Realdo Colombo (1510/1515–1559). (From the collection
of W. Bruce Fye.)
heart’s anatomy and physiology was coming under increasing
scrutiny as Renaissance anatomists began to perform vivisections and dissect human cadavers. In the second (1555) edition
of his anatomy, Vesalius rejected Galen’s teaching that blood
passed through the interventricular septum, although he did
not propose an alternate route for the fluid to get from the right
ventricle to the left ventricle. Several of Vesalius’s contemporaries, most of whom embraced Galen’s teachings, protested.
Colombo went further than his former colleague Vesalius.
He explained in his 1559 book,
Between these ventricles there is a septum through
which almost everyone believes there opens a pathway
for the blood from the right ventricle to the left, and that
the blood is rendered thin so that this may be done more
easily for the generation of vital spirits. But they are in
great error, for the blood is carried through the pulmonary artery to the lung and is there attenuated; then it
is carried, along with air, through the pulmonary vein to
the left ventricle of the heart. Hitherto no one has noticed
this or left it in writing, and it especially should be observed by all.6
So Colombo made and published his classic observations in
the context of growing controversy about Galen’s teachings of
. . . is carried by means of the trachea through the whole
lung, but the lung mixed the air together with that blood
which is carried from the right ventricle of the heart
through the pulmonary artery. For this pulmonary artery,
in addition to the fact that it carries blood for its nutrition,
is so broad that it could carry it for the sake of another
purpose as well. Blood of this kind is agitated on account
of the unceasing movement of the lungs, it is rendered
thin and it is mixed together with the air, and in this collision and breaking up it is prepared so that mixed blood
and air are taken up at the same time through the pulmonary vein and finally are carried through its trunk to
the left ventricle of the heart.4(a)
Colombo also understood the function of the cardiac valves
and used his knowledge to further undermine the traditional
Galenic view of the heart’s structure and function. Speaking of
the four valves, he explained,
. . . two of them have been constructed so that they carry
[blood] inwardly to the heart, that is, when the heart is dilated [in diastole]; but the other two carry [blood] outward when the heart is constricted [in systole]. Therefore
when it is dilated, and those membranes are loosened and
yield ingress, the heart receives blood from the vena cava
into the right ventricle, and also prepared blood from the
pulmonary vein, as we said, along with air into the left
ventricle. And when the heart is compressed [in systole],
these valves are closed lest the vessels receive anything
regressing along the same path; and at the same time the
valves of both the aorta and the pulmonary artery are
W. B. Fye: Realdo Colombo
opened; they permit the passage of the outgoing spirituous blood which is diffused through the whole body and
of the natural blood which is carried to the lungs; and it is
always thus when the heart is dilated, as we noted before:
[that the] other [valves] open and then shut. And so you
will find that the blood which has entered the right ventricle is unable to return to the vena cava.6(a)
Colombo’s book and its clear articulation of the pulmonary
circulation had a profound effect on English physician
William Harvey, who published his description of the circulation of the blood in 1628. Harvey had used Colombo’s book
when he prepared his 1616 lectures on anatomy for the College of Physicians of London. Gweneth Whitteridge, a leading
Harvey scholar, showed that he owed his understanding of cardiac systole and diastole as well as the pulmonary circulation
to Colombo.7 The pioneering Italian anatomist died in 1559 in
Rome, just as his book was about to be published.
137
References
1.
Bylebyl JJ: Realdo Colombo. In Dictionary of Scientific Biography
(Ed. Gillespie CC), p. 354–357. New York: Charles Scribner’s
Sons, 1971;(a) p. 356
2.
Ekoynan G, De Santo NG: Realdo Colombo (1516–1559): A reappraisal. Am J Nephrol 1997;17:261–268
3.
Moes RJ, O’Malley CD: Realdo Colombo: On those things rarely
found in anatomy. An annotated translation from his De Re
Anatomica (1559). Bull Hist Med 1960;34:508–528
4.
Wilson LG: The problem of the discovery of the pulmonary circulation. J Hist Med Allied Sci 1962;17:229–244;(a) p. 243
5.
Harris CRS: The Heart and Vascular System in Ancient Greek
Medicine. London: Oxford University Press, 1973
6.
Coppola ED: The discovery of the pulmonary circulation: A new
approach. Bull Hist Med 1957;21:44–77;(a) p. 65
7.
Whitteridge G: William Harvey and the Circulation of the Blood.
London: Macdonald, 1971