A GLIMPSE OF OUR PAST

Giulio Cesare Casseri (c. 1552–1616): TheServant Who Became an Anatomist

BRIAN HOUSMAN,1 SHARATH BELLARY,1 SIMRAT HANSRA,1 MARTIN MORTAZAVI,2

R. SHANE TUBBS,1,2 AND MARIOS LOUKAS1,3*

1Department of Anatomical Sciences, School of Medicine, St George’s University, Grenada, West Indies2Children’s Hospital, Pediatric Neurosurgery, Birmingham, Alabama

3Department of Anatomy, Medical School, University of Varmia and Masuria, Olsztyn, Poland

Julius Casserius was born in a poor family in Piacenza in 1552. As a youngman, he moved to Padua and soon after, he became a servant to Fabricius, anoted anatomist and professor at the Universit�a Artista, who quickly becamehis mentor. Casserius eventually attended the University of Padua and receiveda degree in medicine and philosophy. In the following years, a rivalry ensuedbetween Casserius and his former mentor as they competed for teaching privi-leges, conflicted on dissection philosophies, and disregarded each other’s con-tributions in publications. Tragically, the conflict between these two influentialanatomists may have overshadowed their contributions to the study of anat-omy. Casserius was one of the first physicians to develop a comprehensivetreatise on anatomy. Unfortunately, while Casserius prepared several tractsidentifying novel structures, he did not live to see his master collection pub-lished as he died suddenly at the peak of his career in 1616. Interestingly, theEnglish anatomist and surgeon John Browne used copies of Casserius’ work forhis own anatomy text and was labeled a plagiarist. It is the contributions fromsuch pioneers as Casserius on which we base our current understanding ofhuman anatomy. Clin. Anat. 27:675–680, 2014. VC 2013 Wiley Periodicals, Inc.

Key words: history of medicine; history of anatomy; anatomical illustration

Giulio Cesare Casseri was born in Piacenza, Italyin 1552 (Riva et al., 2001). Like many early authors,Casseri is known by several names including JuliusCasserius, Piacentino, and Julius Casserius Plancen-tinus, which means “Giulio Casserio of Piacenza”(Riva et al., 2001; Casserius, 1600–1601) (Fig. 1).As a young man, he moved to Padua while in theservice of an Italian student (Sterzi, 1910; Rivaet al., 2001). Shortly thereafter, he was hired as aservant in the household of Gerolamo Fabricid’Acquapendente, also known as Fabricius, whoserved as Public Lecturer of Anatomy and Surgeryfor the Universit�a Artista, a branch of the greaterPadua University, which included among other disci-plines Medicine and Theology (Riva et al., 2001).Casserius was so inspired by Fabricius that he beganto study anatomy in his free time, including teachinghimself Greek and Latin in order to review classictexts (Casserius, 1600–1601). As described by Tom-asini, “. . .from a servant he became . . . Fabricius’

auditor, then instructor, and brilliant disciple” (Toma-sini, 1630; Riva et al., 2001).

Though the exact dates are unknown, it is clearthat Casserius enrolled in Padua’s School of Medicineand obtained a degree in medicine and philosophyaround 1580 (Sterzi, 1910; Premuda, 1993; Rivaet al., 2001). Following his graduation, Casseriusremained in Padua and began giving private lecturesto medical students. At the same time, he continuedworking as Fabricius’ anatomical dissector, and started

*Correspondence to: Marios Loukas, M.D., Ph.D., Professor andChair, Department of Anatomical Sciences, St George’s Univer-sity, School of Medicine, Grenada, West Indies. E-mail:mloukas@sgu.edu

Received 29 October 2010; Revised 19 March 2013; Accepted28 March 2013

Published online 20 August 2013 in Wiley Online Library(wileyonlinelibrary.com). DOI: 10.1002/ca.22261

VVC 2013 Wiley Periodicals, Inc.

Clinical Anatomy 27:675–680 (2014)

what later became a successful surgical practice (Rivaet al., 2001).

Casserius’ prestige rose quickly and in 1584, hetook Fabricius’ place as an examiner on the board forsurgical licensing; which at the time was considered alesser branch of medicine (Riva et al., 2001). How-ever, Fabricius grew to disapprove of Casserius’ teach-ing methods and soon, tensions began to growbetween Julius and his former mentor. In 1595, Cas-serius acted as a substitute lecturer while Fabriciustook a leave of absence for illness (Riva et al., 2001).Sterzi (1910) described that upon his return, Fabriciusrecognized and resented the enthusiasm with whichhis students thanked Casserius and in response,resumed his position on the board of examiners.

From 1597 to 1598, Fabricius was forced to shortenhis public course on anatomy due to a lack of cadav-ers (Riva et al., 2001). At the same time, Casseriushosted a 5-week private course in his home duringwhich he dissected a monkey, several dogs, and ninehuman cadavers (Riva et al., 2001). Once again, hisstudents were so grateful that in thanks, they

presented Casserius with an expensive silver chande-lier (Riva et al., 2001). Fabricius, no doubt inflamedby his former pupil’s success, responded by appealingto the academic authorities to enforce a statute pro-hibiting private anatomy lectures (Riva et al. 2001).As a result, there is no record of Casserius hostingfurther private lectures until 1604 (Riva et al., 2001).

The feud between Casserius and Fabricius festeredas they both aired grievances in their works. Almostat the same time, Casserius and Fabricius bothpublished anatomic works on the sense organs; Cas-serius’ De Vocis Auditus que Organis Historia Anatom-ica (1600–1601) and Fabricius’ De Visione VocisAuditus (Riva et al., 2001). For these works, Casseriushad the German painter Josias Mauer stay in his homefor the purpose of “drawing anatomic illustrations(Choulant, 1852).” Neither Fabricus nor Casseriusacknowledged the works or contributions of the other(Riva et al., 2001). Riva et al. (2001) described thateven despite the absence of names, their “. . .conflictwas echoed in the relevant dedications to the Duke ofParma (Ranuccio Farnese) and to three Venetiannoblemen. . .” Wright believed that the absence of trib-ute between Casserius and Fabricius was due to the

Fig. 1. A portrait of Giulio Cesare Casseri (picture inpublic domain, original in frontispiece of de Vocis Auditusque organis).

Fig. 2. An illustration from Tabulae Anatomicae(1627) depicting the brain and the meninges. (1971, Edi-tions Medicina Rara, New York, Facsimile of the 1627 Ven-ice edition).

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timing of experimentation and publication (Wright,1902). However, it seems clear that this evaluationwas more concerned with the history of the medicine

of the nose and throat, and had less to do with thedeteriorating relations between Casserius and his for-mer mentor (Wright, 1902). Additionally, both authors

Fig. 3. An illustration from Tabulae Anatomicae (1627) depicting the larynx, theheart, and the lungs. (1971, Editions Medicina Rara, New York, Facsimile of the 1627Venice edition).

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claimed to be preparing anatomical texts completewith plates, a resource that was, as of yet, not avail-able to medical students (Riva et al., 2001). Casser-ius, in particular, felt that a comprehensive treatise onanatomy would be his life’s work (Casserius, 1600–1601). Sterzi (1910) described that in a letter of1613, Casserius boasted 150 figures engraved in cop-per that were ready for publication.

Fabricius experienced recurrent bouts of illness andin 1604, the Rector of Padua asked Casserius to takeover the anatomy course, most likely in response tothe requests of his medical students (Riva et al.,2001). Casserius accepted the position, but refused toteach in Fabricius’ public theater and instead contin-ued to teach out of his home (Riva et al., 2001).

From 1605 to 1608, Casserius’ gave successful pri-vate lectures from his home while Fabricius’ courseswere reduced to a minimum (Riva et al., 2001). Thiscontinued until 1609 when the University of Paduaseparated the teaching of anatomy and surgery intotwo disciplines; anatomy was given back to Fabriciusand surgery to Casserius (Riva et al., 2001). They

taught their respective departments until 1613 when,after 50 years of lecturing, Fabricius retired from theUniversity of Padua and recommended Giulio CesareSala as his replacement (Riva et al., 2001).

In January 1616, Casserius finally taught dissectionin a public theater at the request of academic author-ities (Riva et al., 2001). The 3-week course was sosuccessful that his students, in another display ofgratitude, published a laudatory booklet thanking Cas-serius for his teaching (Riva et al., 2001).

Shortly after the conclusion of the course, and atthe apex of his fame, Casserius’ meteoric success wastragically cut short when on March 8, 1616 he con-tracted a fever and died suddenly (Riva et al., 2001).Fabricius held the chair of anatomy until 1619 whenhe died, and the Departments of Anatomy and Sur-gery were reunited under the leadership of Adriaanvan den Spieghel (1578–1625) (Riva et al., 2001).Interestingly, in his will, Spieghel (Spigelius) wouldask the German physician Daniel Rindfleisch to pub-lish his posthumous work De humani corporis fabrica,which had no illustrations (Choulant, 1852).

Fig. 4. An illustration from Tabulae Anatomicae(1627) of a pregnant woman in which the anterior ab-dominal wall is reflected exposing the peritoneal cavity.(1971, Editions Medicina Rara, New York, Facsimile of the1627 Venice edition).

Fig. 5. An illustration from De Formato Foetu (1627)of a pregnant woman in which the anterior abdominal wallis reflected and the placenta with the surrounding vesselsand the fetus is exposed. (1971, Editions Medicina Rara,New York, Facsimile of the 1627 Venice edition)

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Rindfleisch approached the heirs of Casserius andasked to include the anatomical plates of their relativein the work of Spieghel. Eventually, 77 plates from theTabulae plus 9 from Casserius’ plates were added tothe text of Spieghel (Choulant, 1852; Sterzi, 1910).

Sadly, Casserius’ life was marked by his feud withhis former mentor Fabricius. However, this should notovershadow the substantial contributions that hemade to anatomy. During his life, Casserius saw thepublication of two major works: De Vocis Auditus queOrganis Historia Anatomica (1600–1601) and Pen-taestheion (1609) (Riva et al., 2001). Casserius’ambition to create a comprehensive anatomy text wasnot realized during his lifetime, but Iulii Casserii Pla-centini Tabulae Anatomicae was published posthu-mously in 1627 (Riva et al., 2001). The anatomicillustrations in this text were drawn by Odoardo Fia-letti and etched on copper plates, which were pub-lished 11 years after Casserius’ death (Riva et al.,

2001) (Figs. 2–7). In this volume, Casserius madeseveral novel anatomic descriptions and oftenattempted to explain human anatomy by reference tolower animals (Choulant, 1852). He was the first, forexample, to accurately describe the muscles of theabdomen and the back (Riva et al., 2001). Casseriusalso discovered the lumbrical muscles of the hand, thetransverse head of the adductor hallucis, the inguinalfossae, and was the first to illustrate the circular foldsof the small intestine. He also identified the vascularsupply of the appendix, the musculature of the urinarybladder, the navicular fossa of the urethra, and finally,he was the first to illustrate both the thyroid and pros-tate glands as single organs (Riva et al., 2001; Ignja-tovic, 2010). Casserius also made significantcontributions to areas of contemporary anatomy. Forexample, while Galen was the first anatomist to iden-tify the recurrent laryngeal nerve and its relationshipto phonation, Casserius correctly described the larynxas a cartilaginous structure (Riva et al., 2001; Kaplan

Fig. 6. An illustration from De Formato Foetu (1627)depicting a fetus in which the contents of the abdominalcavity are exposed. (1971, Editions Medicina Rara, NewYork, Facsimile of the 1627 Venice edition).

Fig. 7. An illustration from De Formato Foetu (1627)depicting a fetus in which the abdominal aorta and the in-ferior vena cava are exposed. (1971, Editions MedicinaRara, New York, Facsimile of the 1627 Venice edition).

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et al., 2009). Additionally, Eustachius was the first todescribe the suprarenal (adrenal) glands, but Casser-ius confirmed this finding with his published illustra-tions (Hiatt and Hiatt, 1997).

Casserius is remembered eponymously by Casser-io’s muscle and nerve, the coracobrachialis muscle,and musculocutaneous nerve, also often referred toas the “perforans Casserii,” and for the “antrumCesserii” more commonly referred to as the maxillarysinus (Lund, 2002). These illustrations were so wellreceived that they continued to be reprinted in anat-omy textbooks through the 17th and 18th centuries,and are even appreciated as baroque-inspired art(Sawday, 1996; Riva et al., 2001). Interestingly, theEnglish anatomist and surgeon John Browne (1642–1702) would use copies of the anatomical drawingsfrom the Iulii Casseri Placentini Tabulae Anatomicaefor his own anatomy text and would go on to be la-beled a plagiarist (Loukas et al., 2010). Choulant(1852) would say of the artwork used by Casserius:

“Casserius’ plates mark a new epoch in the his-tory of anatomic representation, owing to thecorrectness of the anatomic drawing, their taste-ful arrangement, and the beauty of their techni-cal execution. And this all the more, since theycover the whole field of anatomy and havebecome the models for anatomic illustrations incopper, just as the Vesalian representations hadbeen for anatomic woodcuts.”

Julius Casserius was a gifted lecturer and anato-mist. Unfortunately, his legacy is plagued by the his-tory of his feud with Fabricius, his former professor

and mentor. However, this unfortunate relationshipshould not overwhelm his devotion as a professor, orhis tremendous contributions to anatomy.

REFERENCES

Casserius I. 1600–1601. De Vocis Auditus Que Organis Historia Ana-tomica. Venice: Ferrariae.

Casserius I. 1627. Tabulae Anatomicae LXXIIX. Venice: EDuechinum.

Choulant L. 1852. Geschichte Und Bibliographie Der AnatomischenAbbildung. Leipzig: Rudolph Weigel.

Hiatt JR, Hiatt N. 1997. The conquest of Addison’s disease. Am JSurg 174:280–283.

Ignjatovic M. 2010. The thyroid gland in works of famous old anato-mists and great artists. Langenbecks. Arch Surg 395:973–85.

Kaplan EL, Salti GI, Roncella M, Fulton N, Kadowaki M. 2009. Historyof the recurrent laryngeal nerve: From Galen to Lahey. World JSurg 33:386–393.

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Lund V. 2002. The evolution of surgery on the maxillary sinus forchronic rhinosinusitis. Laryngoscope 112:415–419.

Premuda L. 1993. Storia dell’iconografia anatomica. Oreggio: Ciba-Geigy. 387 p.

Riva A, Orru B, Pirino A, Riva FT. 2001. Iulius Casserius (1552–1616): The self-made anatomist of Padua’s golden age. Anat Rec265:168–175.

Sawday J. 1996. The Body Emblazoned: Dissection and theHuman Body in Renaissance Culture. New York: Routledge.p 183.

Sterzi G. 1910. Giulio Casseri, Anatomico E Chirurgo (1552c.–1616). Nuovo Arch Veneto, N.S. XVIII, p II:1–64.

Tomasini I. 1630. Illustriumvirorum Elogia Iconibusexornata.Paravii; D. Pasquardum et Socium; pp. 336.

Wright J. 1902. The nose and throat in the history of medicine.Laryngoscope 12:9–32.

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