History of anatomy

Dissection of a cadaver, 15th century painting

The history of anatomy extends from the earliest exam-inations of sacricial victims to the sophisticated analysesof the body performed by modern scientists. It has beencharacterized, over time, by a continually developing un-derstanding of the functions of organs and structures inthe body. Human anatomy was the most prominent of thebiological sciences of the 19th and early 20th centuries.Methods have also improved dramatically.[1]

1 Ancient anatomy

1.1 Egypt

The study of anatomy begins at least as early as 1600 BC,the date of the Edwin Smith Surgical Papyrus. This trea-tise shows that the heart, its vessels, liver, spleen, kidneys,hypothalamus, uterus and bladder were recognized, andthat the blood vessels were known to emanate from theheart. Other vessels are described, some carrying air,some mucus, and two to the right ear are said to carry thebreath of life, while two to the left ear the breath ofdeath.The Ebers Papyrus (c. 1550 BC) features a trea-tise on the heart. It notes that the heart is the center ofblood supply, and attached to it are vessels for everymem-ber of the body. The Egyptians seem to have known littleabout the function of the kidneys and made the heart themeeting point of a number of vessels which carried all theuids of the body blood, tears, urine and semen. How-ever, they did not have a theory as to where saliva andsweat came from.[2]

1.2 Greek Advances in Anatomy

Nomenclature, methods and applications for the study ofanatomy all date back to the Greeks.[3] The early scien-tist Alcmaeon began to construct a background for med-ical and anatomical science with the dissection of ani-mals. He identied the optic nerves and the tubes latertermed the Eustachius.[4] Others such as Acron (480 BC),Pausanias (480 BC), and Philistion of Locri made inves-tigations into anatomy. One important gure during thistime was Empedocles (480B.C.) who viewed the blood asthe innate heat which he acquired from previous folklore.He also argued that the heart was the chief organ of boththe vascular system and the pneuma (this could refer toeither breath or soul; it was considered to be distributedby the blood vessels).[5]

Many medical texts by various authors are collected inthe Hippocratic Corpus, none of which can denitely beascribed to Hippocrates himself. The texts show an un-derstanding of musculoskeletal structure, and the begin-nings of understanding of the function of certain organs,such as the kidneys. The tricuspid valve of the heart andits function is documented in the treatise On the Heart.In the 4th century BCE, Aristotle and several con-temporaries produced a more empirically founded sys-tem, based on animal dissection. Through his workwith animal dissections and evolutionary biology, Aris-totle founded comparative anatomy. Around this time,Praxagoras is credited as the rst to identify the dier-ence between arteries and veins, and the relations be-tween organs are described more accurately than in pre-vious works.The rst recorded school of anatomy was in Alexandriafrom about 300 to 2nd century BC.[6] Ptolemy I Soterwas the rst to allow for medical ocials to cut open andexamine dead bodies for the purposes of learning how hu-man bodies operated. On some occasions King Ptolemyeven took part in these dissections. Most of the early dis-sections were done on executed criminals. The rst useof human cadavers for anatomical research occurred laterin the 4th century BCE when Herophilos and Erasistratusgained permission to perform live dissections, or vivisec-tion, on criminals in Alexandria under the auspices of thePtolemaic dynasty. Herophilos in particular developeda body of anatomical knowledge much more informedby the actual structure of the human body than previousworks had been. Herophilos was the rst physician to dis-sect human bodies and is considered to be the founder ofAnatomy. He reversed the longstanding notion made by

1

2 3 EARLY MODERN ANATOMY

Aristotle that the heart was the seat of intelligence. Heargued instead that this seat was the brain.[7] However,Herophilos was eventually accused by his contemporariesof dissecting live criminals. The number of victims is saidto be around 600 prisoners.[8]

2 From ancient to medieval

2.1 Galen

The nal major anatomist of ancient times was Galen,active in the 2nd century.[6] He compiled much of theknowledge obtained by previous writers, and furtheredthe inquiry into the function of organs by performingvivisection on animals. Due to a lack of readily availablehuman specimens, discoveries through animal dissectionwere broadly applied to human anatomy as well. Galenserved as chief physician to the gladiators in Pergamum(AD 158). Through his position with the gladiators,Galen was able to study all kinds of wounds without per-forming any actual human dissection. By default, Galenwas able to view much of the abdominal cavity. His studyon pigs and apes, however, gave him more detailed infor-mation about the organs and provided the basis for hismedical tracts. Around 100 of these tracts survive andll 22 volumes of modern text. His two great anatomicalworks are On anatomical procedure and On the uses ofthe parts of the body of man.[9] The information in thesetracts became the foundation of authority for all medi-cal writers and physicians for the next 1300 years untilthey were challenged by Vesalius and Harvey in the 16thcentury.[10][11]

It was through his experiments that Galen was able tooverturn many long-held beliefs, such as the theory thatthe arteries contained air which carried it to all parts ofthe body from the heart and the lungs. This belief wasbased originally on the arteries of dead animals, whichappeared to be empty. Galen was able to demonstratethat living arteries contain blood, but in his error, whichbecame the established medical orthodoxy for centuries,was to assume that the blood goes back and forth fromthe heart in an ebb-and-ow motion.

3 Early modern anatomyIn 1275-1326 Mondino de Luzzi Mundinus car-ried out the rst systematic human dissections sinceHerophilus of Chalcedon and Erasistratus of Ceos 1500years earlier.[12][13] The rst major development inanatomy in Christian Europe since the fall of Rome oc-curred at Bologna, where anatomists dissected cadav-ers and contributed to the accurate description of or-gans and the identication of their functions. Follow-ing de Liuzzis early studies, fteenth century anatomists

Anathomia, 1541

included Alessandro Achillini and Antonio Benivieni[12][14] Pathological anatomy[15]

3.1 Leonardo da VinciLeonardo da Vinci (14521519) was trained in anatomyby Andrea del Verrocchio. In 1489 Leonardo began aseries of anatomical drawings depicting the ideal humanform. This work was carried out intermittently for over2 decades. During this time he made use of his anatom-ical knowledge in his artwork, making many sketches ofskeletal structures, muscles and organs of humans andother vertebrates that he dissected.[16][17] Initially adopt-ing an Aristotlean understanding of anatomy, he laterstudied Galen and adopted a more empirical approach,eventually abandoning Galen altogether and relying en-tirely on his own direct observation.[18] His surviving 750drawings represent groundbreaking studies in anatomy.Leonardo dissected around thirty human specimens untilhe was forced to stop under order of Pope Leo X.[19]

As an artist-anatomist, Leonardo made many importantdiscoveries, and had intended to publish a comprehen-sive treatise on human anatomy.[18] For instance, he pro-duced the rst accurate depiction of the human spine,while his notes documenting his dissection of the Floren-tine centenarian contain the earliest known description ofcirrhosis of the liver and arteriosclerosis.[18][20] He wasthe rst to develop drawing techniques in anatomy to con-vey information using cross-sections and multiple angles,although centuries would pass before anatomical draw-ings became accepted as crucial for learning anatomy.[21]None of Leonardos Notebooks were published during hislifetime, many being lost after his death, with the result

3.2 Vesalius 3

Anatomical study of the arm, by Leonardo da Vinci, (about1510)

that his anatomical discoveries remained unknown untilthey were later found and published centuries after hisdeath.[22]

3.2 Vesalius

The Galenic doctrine in Europe was rst seriously chal-lenged in the 16th century. Thanks to the printing press,all over Europe a collective eort proceeded to circulatethe works of Galen and later publish criticisms on theirworks. Andreas Vesalius, born and educated in Belgium,contributed themost to human anatomy. Vesalius was therst to publish a treatise,De humani corporis fabrica, thatchallenged Galen drawing for drawing. These drawingswere a detailed series of explanations and vivid drawingsof the anatomical parts of human bodies. Vesalius trav-eled all the way from Leuven[23] to Padua for permissionto dissect victims from the gallows without fear of per-secution. His superbly executed drawings are triumphantdescriptions of the dierences between dogs and humans,but it took a century for Galens inuence to fade. Hiswork led to anatomy marked a new era in the study ofanatomy and its relation to medicine. Under Vesalius,anatomy became an actual discipline. His skill in andattention to dissection featured prominently in his publi-cations as well as his demonstrations, in his research aswell as his teaching. [24] In 1540, Vesalius gave a pub-

Image of muscular anatomy from De humani corporis fabricaby Andreas Vesalius, 1543

lic demonstration of the inaccuracies of Galens anatom-ical theories, which are still the orthodoxy of the medicalprofession. Vesalius now has on display, for comparisonpurposes, the skeletons of a human being alongside that ofan ape of which he was able to show, that in many cases,Galens observations were indeed correct for the ape, butbear little relation to man. Clearly what was needed wasa new account of human anatomy. While the lecturer ex-plained human anatomy, as revealed by Galen more than1000 years earlier, an assistant pointed to the equivalentdetails on a dissected corpse. At times, the assistant wasunable to nd the organ as described, but invariably thecorpse rather than Galen was held to be in error. Vesal-ius then decided that he will dissect corpses himself andtrust to the evidence of what he found. His approachwas highly controversial, but his evident skill led to hisappointment as professor of surgery and anatomy at theUniversity of Padua.A succession of researchers proceeded to rene the bodyof anatomical knowledge, giving their names to a num-ber of anatomical structures along the way. The 16th and17th centuries also witnessed signicant advances in theunderstanding of the circulatory system, as the purposeof valves in veins was identied, the left-to-right ventri-cle ow of blood through the circulatory system was de-scribed, and the hepatic veins were identied as a separate

4 3 EARLY MODERN ANATOMY

Muscular gure in allegorical pose by Juan Valverde de Amusco,1559

portion of the circulatory system. The lymphatic systemwas also identied as a separate system at this time.

3.3 17th and 18th centuries

The Anatomy Lesson of Dr. Nicolaes Tulp, by Rembrandt,1632

The study of anatomy ourished in the 17th and 18th cen-turies. The advent of the printing press facilitated the ex-change of ideas. Because the study of anatomy concernedobservation and drawings, the popularity of the anatomist

was equal to the quality of his drawing talents, and oneneed not be an expert in Latin to take part. Many fa-mous artists studied anatomy, attended dissections, andpublished drawings for money, from Michelangelo toRembrandt. For the rst time, prominent universitiescould teach something about anatomy through drawings,rather than relying on knowledge of Latin. Contrary topopular belief, the Church neither objected to nor ob-structed anatomical research.[25]

Only certied anatomists were allowed to perform dis-sections, and sometimes then only yearly. These dis-sections were sponsored by the city councilors and of-ten charged an admission fee, rather like a circus act forscholars. Many European cities, such as Amsterdam,London, Copenhagen, Padua, and Paris, all had Royalanatomists (or some such oce) tied to local govern-ment. Indeed, Nicolaes Tulp was Mayor of Amsterdamfor three terms. Though it was a risky business to performdissections, and unpredictable depending on the availabil-ity of fresh bodies, attending dissections was legal.To cope with shortages of cadavers and the rise in med-ical students during the 17th and 18th centuries, body-snatching and even anatomymurder were practiced to ob-tain cadavers.[26] 'Body snatching' was the act of sneak-ing into a graveyard, digging up a corpse and using itfor study. Men known as 'resurrectionists emerged asoutside parties, who would steal corpses for a living andsell the bodies to anatomy schools. The leading Lon-don anatomist John Hunter paid for a regular supply ofcorpses for his anatomy school.[27] The British Parliamentpassed the Anatomy Act 1832, which nally provided foran adequate and legitimate supply of corpses by allow-ing legal dissection of executed murderers. The view ofanatomist at the time, however, became similar to that ofan executioner. Having ones body dissected was seen asa punishment worse than death, if you stole a pig, youwere hung. If you killed a man, you were hung and thendissected. Demand grew so great that some anatomist re-sorted to dissecting their own family members (WilliamHarvey dissected his own father and sister) as well as rob-bing bodies from their graves.[28]

Many Europeans interested in the study of anatomy trav-eled to Italy, then the centre of anatomy. Only inItaly could certain important research methods be used,such as dissections on women. Realdo Colombo (alsoknown as Realdus Columbus) and Gabriele Falloppiowere pupils of Vesalius. Columbus, as Vesaliuss im-mediate successor in Padua, and afterwards professor atRome, distinguished himself by describing the shape andcavities of the heart, the structure of the pulmonary arteryand aorta and their valves, and tracing the course of theblood from the right to the left side of the heart.[29]

3.4 Anatomical Theatres

Anatomical theatres became a popular form for anatom-

5An Anatomical Theatre In Leiden, 1616

ical teaching in the early 16th century. The Universityof Padua was the rst and most widely known theatre,founded in 1594. As a result, Italy became the center forhuman dissection. People came from all over to watch asprofessors taught lectures on the human physiology andanatomy, as anyone was welcome to witness the specta-cle. Participants were fascinated by corporeal display,by the body undergoing dissection..[30] Most professorsdid not do the dissections themselves. Instead they sat inseats above the bodies while hired hands did the cutting.Students and observers would be placed around the tablein a circular, stadium like arena and listen as professorsexplained the various anatomical parts. The 19th centuryeventually saw a move from anatomical theatres to class-rooms, reducing the number of people who could benetfrom each cadaver. [6]

4 19th century anatomyFurther information: History of anatomy in the 19thcentury

During the 19th century, anatomical research was ex-tended with histology and developmental biology of bothhumans and animals. Women, who were not allowed toattend medical school, could attend the anatomy theatres.From 1822 the Royal College of Surgeons forced unregu-lated schools to close.[31] Medical museums provided ex-amples in comparative anatomy, and were often used in

teaching.[32]

5 Modern anatomy

Gunther von Hagens has popularised anatomy with his plasti-nated specimens, here a gorilla.

Anatomical research in the past hundred years has takenadvantage of technological developments and grow-ing understanding of sciences such as evolutionary andmolecular biology to create a thorough understanding ofthe bodys organs and structures. Disciplines such asendocrinology have explained the purpose of glands thatanatomists previously could not explain; medical devicessuch as MRI machines and CAT scanners have enabledresearchers to study organs, living or dead, in unprece-dented detail. Progress today in anatomy is centered inthe development, evolution, and function of anatomicalfeatures, as the macroscopic aspects of human anatomyhave largely been catalogued. Non-human anatomy isparticularly active as researchers use techniques rangingfrom nite element analysis to molecular biology.To save time, some medical schools such as Birmingham,England have adopted prosection, where a demonstratordissects and explains to an audience, in place of dissectionby students. This enables students to observe more than

6 6 REFERENCES

one body. Improvements in colour images and photogra-phy means that an anatomy text is no longer an aid to dis-section but rather a central material to learn from. Plasticmodels are regularly used in anatomy teaching, oeringa good substitute to the real thing. Use of living modelsfor anatomy demonstration is once again becoming pop-ular within teaching of anatomy. Surface landmarks thatcan be palpated on another individual provide practice forfuture clinical situations. It is possible to do this on one-self; in the Integrated Biology course at the University ofBerkeley, students are encouraged to introspect[33] onthemselves and link what they are being taught to theirown body.[31]

Donations of bodies have declined with public con-dence in themedical profession.[34] In Britain, the HumanTissue Act 2004 has tightened up the availability ofresources to anatomy departments. The outbreaks ofBovine Spongiform Encephalitis (BSE) in the late 80sand early 90s further restricted the handling of braintissue.[31][35]

The controversy with Gunther von Hagens and public dis-plays of dissections, preserved by plastination, may divideopinions on what is ethical or legal.[36]

6 References[1] Hakim Syed Zillur Rahman. Tarikh llm Tashrih [An ex-

tensive Book in Urdu on History of anatomy] (1967),Tibbi Academy, Delhi, Second revised edition 2009(ISBN 978-81-906070-7-0), Ibn Sina Academy of Me-dieval Medicine and Sciences, Aligarh

[2] Porter, Roy (1999-10-17). The Greatest Benet toMankind: A Medical History of Humanity (The NortonHistory of Science). W. W. Norton. pp. 4950. ISBN9780393319804. Retrieved 17 November 2013.

[3] Singer, Charles (1957). A Short History of Anatomy &Physiology from Greeks to Harvey. NEw York: DoverPublications Inc. p. 5.

[4] Singer, Charles (1957). A Short History of Anatomy &Physiology from Greeks to Harvey. NEw York: DoverPublications Inc. p. 7.

[5] Singer, Charles (1957). A Short History of Anatomy &Physiology from Greeks to Harvey. NEw York: DoverPublications Inc. p. 10.

[6] Siddiquey, Ak Shamsuddin Husain (2009). History ofAnatomy. Bangladesh Journal of Anatomy 7 (1).

[7] Singer, Charles (1957). A Short History of Anatomy &Physiology from Greeks to Harvey. NEw York: DoverPublications Inc. p. 29.

[8] Roach, Mary (2003). Sti: The curious Lives of HumanCadavers. New York: W.W. Norton. p. 41.

[9] Singer, Charles (1957). A Short History of Anatomy &Physiology from Greeks to Harvey. NEw York: DoverPublications Inc. p. 47.

[10] Boas, Marie (1970). The Scientic Renaissance 1450-1630. Fontana. pp. 120, 248. Vesalius, nding Galenfull of errors, was quite certain that he had been able toeradicate them.

[11] Boas, Marie (1970). The Scientic Renaissance 1450-1630. Fontana. p. 262. Like any sixteenth-centuryanatomist too he [Harvey] began with what Gelen hadtaught, andmanaged to interpret Galens words to win sup-port for his new doctrine.

[12] Zimmerman, Leo M.; Veith, Ilza (1993-08-01). GreatIdeas in the History of Surgery. Norman Publishing. ISBN9780930405533. Retrieved 7 December 2012.

[13] Crombie, Alistair Cameron (1959). The History of Sci-ence From Augustine to Galileo. Courier Dover Publica-tions. ISBN 9780486288505. Retrieved 19 December2012.

[14] Benivieni, Antonio; Polybus; Guinterius, Joannes (1529).De abditis nonnullis ac mirandis morborum & sanationumcausis. apud Andream Cratandrum. Retrieved 7 Decem-ber 2012.

[15] Thorndike, Lynn (1958). A History of Magic and Ex-perimental Science: Fourteenth and fteenth centuries.Columbia University Press. ISBN 9780231087971. Re-trieved 7 December 2012.

[16] Boas, Marie (1970). The Scientic Renaissance 14501630. Fontana. pp. 120143. (First published by Collins,1962.)

[17] Mason, Stephen F. (1962). AHistory of the Sciences. NewYork: Collier. p. 550.

[18] O'Malley, Charles D. (1983). Leonardo on the HumanBody. New York: Dover.

[19] Gasciogne, Bamber. History of Anatomy. HistoryWorld. Retrieved 30 Oct 2013.

[20] Leonardo the Man , His machines. Lairweb. Retrieved2 November 2014.

[21] Leonardo Da Vinci rst Anatomist. Life in The FastLane. Retrieved 2 November 2014.

[22] Leonardo Da Vincis Notebook Project. Irvine ValleyCollege. Retrieved 2 November 2014.

[23] Katholieke Universiteit Leuven. Kuleuven.ac.be. Re-trieved 2012-06-13.

[24] Klestinec, Cynthia (2004). A History of Anatomy The-aters in Sixteenth-Century Padua. Journal of the His-tory of Medicine and Allied Sciences 59 (3): 375412.doi:10.1093/jhmas/59.3.375.

[25] Howse, Christopher (10 June 2009). The myth of theanatomy lesson. The Daily Telegraph (London). Re-trieved 4 May 2010.

[26] Rosner, Lisa. 2010. The Anatomy Murders. Being theTrue and Spectacular History of Edinburghs NotoriousBurke and Hare and of the Man of Science Who AbettedThem in the Commission of Their Most Heinous Crimes.University of Pennsylvania Press

7[27] Moore, Wendy (2006). The Knife Man: Blood, Body-Snatching and the Birth of Modern Surgery. Bantam. pp.8795 and passim. ISBN 0-553-81618-7.

[28] Roach, Mary (2003). Sti: The curious Lives of HumanCadavers. New York: W.W. Norton. pp. 3757.

[29] Boas, Marie (1970). The Scientic Renaissance 1450-1630. Fontana. pp. 254256.

[30] Klestinec, Cynthia (2004). A History of Anatomy The-aters in Sixteenth-Century Padua. Journal of the His-tory of Medicine and Allied Sciences 59 (3): 375412.doi:10.1093/jhmas/59.3.375.

[31] McLachlan J., Patten D. (2006). Anatomy teaching:ghosts of the past, present and future. Medical Education40 (3): 24353. doi:10.1111/j.1365-2929.2006.02401.x.

[32] Reinarz J (2005). The age ofmuseummedicine: The riseand fall of the medical museum at Birminghams Schoolof Medicine. Social History of Medicine 18 (3): 41937.doi:10.1093/shm/hki050.

[33] Diamond M. 2005. Integrative Biology 131 - Lecture 01:Organization of Body. Berkeley, University of California.

[34] British Broadcasting Corporation (BBC) News. 2001.Organ scandal background. http://news.bbc.co.uk/1/hi/health/1136723.stm Accessed 22 April 2008.

[35] Demiryurek D. Bayramoglu, Ustacelebi S. (2002). In-fective agents in xed human cadavers: a brief review andsuggested guidelines. Anatomical Record 269 (1): 1947.

[36] British Broadcasting Corporation (BBC) News. 2002Controversial autopsy goes ahead. http://news.bbc.co.uk/1/hi/health/2493291.stm Accessed 22 April 2008.

7 BibliographySee also: Bibliography of anatomy

Knoe, Rina (2012). Dutch Anatomy and ClinicalMedicine in 17th-Century Europe. Leibniz Instituteof European History.

Mazzio, C. (1997). The Body in Parts: Discoursesand Anatomies in Early Modern Europe. Routledge.ISBN 0-415-91694-1.

Porter, R. (1997). The Greatest Benet to Mankind:AMedical History of Humanity from Antiquity to thePresent. Harper Collins. ISBN 0-00-215173-1.

Sawday, J. (1996). The Body Emblazoned: Dissec-tion and the Human Body in Renaissance Culture.Routledge. ISBN 0-415-15719-6.

8 External links Historical Anatomies on the Web. National Libraryof Medicine. Selected images from notable anatom-ical atlases.

Anatomia 1522-1867: Anatomical Plates from theThomas Fisher Rare Book Library

Human Anatomy & Physiology Society A society topromote communication among teachers of humananatomy and physiology in colleges, universities, andrelated institutions.

8 9 TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

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Ancient anatomyEgyptGreek Advances in Anatomy

From ancient to medievalGalen

Early modern anatomyLeonardo da VinciVesalius17th and 18th centuriesAnatomical Theatres

19th century anatomyModern anatomyReferencesBibliographyExternal linksText and image sources, contributors, and licensesTextImagesContent license