Andreas Vesalius 1514-1564 By Stephen N. Joffe, M.D. Vesalius was the foremost pioneer of modern anatomy. Born in Brussels, he came from a family of physicians. Educated in Louvain, he studied medicine in Montpelier and Paris, returning to Louvain to teach anatomy. In 1535 he went to France to be an army surgeon to King Charles V and two years later became a professor of anatomy in Padua, Italy. Subsequently he became a physician to the court of Philip II of Spain. On a pilgrimage to Jerusalem, he received a call to return to Padua to occupy chair of Fallopius. In a storm leading to a shipwreck and subsequent death on the Isle of Zante, Vesalius was buried there in an unmarked grave in 1564. This marked the end of the 'prince of anatomy.' Vesalius' book De Humani Corporus Fabrica published in Basel in 1543, contributes one of the greatest treasures of western civilization and culture. With its companion volume the Epitome, began the modern observational science and research.

The Nd: YAG laser has finally become the multidisciplinary and muitispeciaity tool of the 1980s. Primarily developed for gastrointestinal applications for controlling bleeding, at present it is also used for endoscopic treatment of gastrointestinal tumors, endobronchial cancer, and bladder and gynecological lesions and finding applications in otorhinolaryngology and neurosurgery. De velopment of laser scalpels and focusing head-pieces has now allowed the Nd: YAG laser to be used for open surgical procedures in general and plastic surgery, head and neck surgery, urology, gynecology, dermatology, and neu rosurgery. The rapid development in ceramic technology has led to contact surgery allowing physicians a choice of excision, vaporization, coagulation, incision, or combinations thereof by easily changing probes rather than having to select new laser wavelengths. This technology is rapidly replacing the carbon dioxide laser which currently has no adequate flexible waveguide for fiberoptic en doscopy, cannot be used in a water medium (e.g., bladder), and has poor coagulation properties when compared to the Nd: YAG laser. Future developments may see the Nd: YAG laser even replacing electro cautery in the operating room due to its greater safety and efficacy. Local hyperthermia (laserthermia) with computer control, photodynamic therapy, and ophthalmic applications make the Nd: YAG laser the most exciting tech nological advancement in medicine and surgery for the 1980s."

In every area of human endeavor, technology has opened the door for new advancements to occur. Much of the progress in medicine over the last few years is due, in large part, to new technological tools made available to clinicians and researchers. Laser is an expanding technological discipline in medicine that will ultimately contribute to a broad and rapid expansion of both diagnostic and treatment procedures. Laser is to light what music is to noise. Those physicians who wish to be most successful in the application of this technology, to the benefit of their patient, will learn of the subtle interactions of light with tissue. No technology is good or bad in itself. It is only in the choices we make, in when and how to apply that technology, that it gains its moral value. The use of lasers in medicine has some very definite advantages in the surgical and medical treatment of a variety of disorders. At the same time we must all be careful to not perpetrate the myth of lasers in medicine. Vastly overstated claims of the value of 'laser surgery' have been held out to the general public, resulting in health care being sought on the basis of laser availability.