['A sad and painful heart'--Andreas Vesalius as cardiologist]

One needs courage to dissociate oneself from ideas maintained for ages and put forward by authorities. How laborious this process has been for Vesalius concerning the heart, is obvious when we compare the information of an eye-witness with both editions of the De Humani Corporis Fabrica (1543 and 1555). He must have come hesitantly to the conclusion that the views on the permeability of the septum cordis, as they were supported by Galen, Mondino and Johann Winther, a professor at Louvain, could not be defended. However, they had been essential in the considerations about the blood-flow. Although Vesalius demonstrated by vivisection-experiments that a relation exists between the pulse and the heart contractions, he was not an experimenting cardiophysiologist. In this respect, he stood far behind his contemporary Leonardo da Vinci, who made experiments on heart ntractions and the bloodstream along the heart valves. Vesalius was an anatomist! And a morphologist! But he was also a physician. In this respect, he also was interested in the pathological aspects of anatomy. So he recalled in, his last book, Anatomicarum Gabrielis Fallopii Observationum Examen (1564) some cardiologically interesting patients, a.o. the courtier van Immerseel, with a very unequal pulse and "a sad and painful heart" (tristi in corde, sensu doloreve), by whom a heart abnormality was found post mortem, that in modern terms we could call "an old heart infarction with thrombus formation." According to Schenk von Grafenberg, Vesalius was dreaming of a big book about anatomo-pathology, but alas, he never wrote it. Undoubtedly he would have trusted more his eyes and less Galen: "non solum ex Galenis testimonio, sed etiam oculis ipsis perspexeris".