History of anatomy

The history of anatomy as a science extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern scientists. It has been characterized, over time, by a continually developing understanding of the functions of organs and structures in the body. Methods have also advanced dramatically, advancing from examination of animals through dissection of cadavers to technologically complex techniques developed in the 20th century.

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Ancient anatomy

Egypt

The study of anatomy begins at least as early as 1600 BCE, the date of the ancient Egyptian Edwin Smith papyrus. This treatise shows that the heart, its vessels, liver, spleen, kidneys, uterus and bladder were recognized, and that the blood vessels were known to come from the heart. Other vessels are described, some carrying air, some mucus, and two to the right ear are said to carry the "breath of life", while two to the left ear the "breath of death". The Ebers papyrus (c. 1550 BCE) features a treatise on the heart. It notes that the heart is the center of the blood supply, with vessels attached for every member of the body. The Egyptians seem to have known little about the function of the kidneys and made the heart the meeting point of a number of vessels which carried all the fluids of the body – blood, tears, urine and sperm.^[1].

Greece

The earliest medical scientist of whose works any great part survives today is Hippocrates, a Greek physician active in the late 5th and early 4th centuries BCE (460 - 377 BCE). His work demonstrates a basic understanding of musculoskeletal structure, and the beginnings of understanding of the function of certain organs, such as the kidneys. Much of his work, however, and much of that of his students and followers later, relies on speculation rather than empirical observation of the body.

In the 4th century BCE, Aristotle and several contemporaries produced a more empirically founded system, based on dissection of animals. Works produced around this time are the first to identify the difference between arteries and veins, and the relations between organs are described more accurately than in previous works.

The first use of human cadavers for anatomical research occurred later in the 4th century BCE when Herophilos and Erasistratus performed dissections of cadavers in Alexandria under the auspices of the Ptolemaic dynasty. Herophilos in particular developed a body of anatomical knowledge much more informed by the actual structure of the human body than previous works had been.

Galen

The final major anatomist of ancient times was Galen, active in the 2nd century. He compiled much of the knowledge obtained by previous writers, and furthered the inquiry into the function of organs by performing vivisection on animals. His collection of drawings, based mostly on dog anatomy, became the anatomy textbook for 1500 years. The original text is long gone, and his work was only known to the Renaissance doctors through the careful custody of Arabic medicine. Hampered by similar religious restrictions as anatomists for centuries after him, Galen assumed that anatomical structures in dogs were the same as for humans.

Medieval anatomy

Main article: Islamic medicine - Anatomy and Physiology

After the fall of the Roman Empire, the study of anatomy became stagnant in Christian Europe but flourished in the medieval Islamic world, where Muslim physicians and Muslim scientists contributed heavily to medieval learning and culture. The Persian physician Avicenna (980-1037) absorbed the Galenic teachings on anatomy and expanded on it in The Canon of Medicine (1020s), which was very influential throughout the Islamic world and Christian Europe. The Canon remained the most authoritative book on anatomy in the Islamic world until Ibn al-Nafis in the 13th century, though the book continued to dominate European medical education for even longer until the 16th century.

The Arabian physician Ibn Zuhr (Avenzoar) (1091-1161) was the first physician known to have carried out human dissections and postmortem autopsy. He proved that the skin disease scabies was caused by a parasite, a discovery which upset the theory of humorism supported by Hippocrates and Galen. The removal of the parasite from the patient's body did not involve purging, bleeding, or any other traditional treatments associated with the four humours.^[2] In the 12th century, Saladin's physician Ibn Jumay was also one the first to undertake human dissections, and he made an explicit appeal for other physicians to do so as well. During a famine in Egypt in 1200, Abd-el-latif observed and examined a large number of skeletons, and he discovered that Galen was incorrect regarding the formation of the bones of the lower jaw and sacrum.^[3]

Ibn al-Nafis

The Arabian physician Ibn al-Nafis (1213-1288) was one of the earliest proponents of human dissection and postmortem autopsy, and in 1242, he was the first to describe the pulmonary circulation^[4] and coronary circulation^[5] of the blood, which form the basis of the circulatory system, for which he is considered the father of the theory of circulation.^[6] Ibn al-Nafis also described the earliest concept of metabolism,^[7] and developed new systems of anatomy and physiology to replace the Avicennian and Galenic doctrines, while discrediting many of their erroneous theories on the four humours, pulsation,^[8] bones, muscles, intestines, sensory organs, bilious canals, esophagus, stomach, and the anatomy of almost every other part of the human body.^[9]

Early modern anatomy

The works of Galen and Avicenna, especially The Canon of Medicine which incorporated the teachings of both, were translated into Latin, and the Canon remained the most authoritive text on anatomy in European medical education until the 16th century. The first major development in anatomy in Christian Europe, since the fall of Rome, occurred at Bologna in the 14th to 16th centuries, where a series of authors dissected cadavers and contributed to the accurate description of organs and the identification of their functions. Prominent among these anatomists were Mondino de Liuzzi and Alessandro Achillini.

The first challenges to the Galenic doctrine in Europe occurred in the 16th century. Thanks to the printing press, all over Europe a collective effort proceeded to circulate the works of Galen and Avicenna, and later publish criticisms on their works. Vesalius was the first to publish a treatise, De humani corporis fabrica, that challenged Galen "drawing for drawing" travelling all the way from Leuven^[10] to Padua for permission to dissect victims from the gallows without fear of persecution. His drawings are triumphant descriptions of the, sometimes major, discrepancies between dogs and humans, showing superb drawing ability. Many later anatomists challenged Galen in their texts, though Galen reigned supreme for another century.

A succession of researchers proceeded to refine the body of anatomical knowledge, giving their names to a number of anatomical structures along the way. The 16th and 17th centuries also witnessed significant advances in the understanding of the circulatory system, as the purpose of valves in veins was identified, the left-to-right ventricle flow of blood through the circulatory system was described, and the hepatic veins were identified as a separate portion of the circulatory system. The lymphatic system was also identified as a separate system at this time.

17th and 18th centuries

The study of anatomy flourished in the 17th and 18th centuries. The advent of the printing press facillitated the exchange of ideas. Because the study of anatomy concerned observation and drawings, the popularity of the anatomist was equal to the quality of his drawing talents, and one need not be an expert in Latin to take part. [3] Many famous artists studied anatomy, attended dissections, and published drawings for money, from Michelangelo to Rembrandt. For the first time, prominent universities could teach something about anatomy through drawings, rather than relying on knowledge of Latin. The only impediment was a possible reprimand from the Church, which frightened several anatomists of that time from performing dissections on their own kind. Though a very fruitful period for the sciences, the Renaissance could be dangerous, as seen in the case of Galileo. Some scientists were scared enough to keep moving from city to city. Descartes is a prime example. Only certified anatomists were allowed to perform dissections, and sometimes then only yearly. These dissections were sponsored by the city councilors and often charged an admission fee, rather like a circus act for scholars. Many European cities, such as Amsterdam, London, Copenhagen, Padua, and Paris, all had Royal anatomists (or some such office) tied to local government. Indeed, Nicolaes Tulp was Mayor of Amsterdam for three terms. Though it was a risky business to perform dissections, and unpredictable depending on the availability of fresh bodies, attending dissections was perfectly legal. Many anatomy students traveled around Europe from dissection to dissection during the course of their study - they had to go where a fresh body was available (eg after a hanging) because before refrigeration, a body would decay rapidly and become unsuitable for examination.

Many Europeans interested in the study of anatomy traveled to Italy, then the center of anatomy. Only in Italy could certain important research methods be used, such as dissections on women. M. R. Columbus and Gabriele Falloppio were pupils of Vesalius, the 16th century anatomist. Columbus, as his immediate successor in Padua, and afterwards professor at Rome, distinguished himself by rectifying and improving the anatomy of the bones, by giving correct accounts of the shape and cavities of the heart, of the pulmonary artery and aorta and their valves, and tracing the course of the blood from the right to the left side of the heart, by a good description of the brain and its vessels, and by correct understanding of the internal ear, and the first good account of the ventricles of the larynx. Osteology at nearly the same time found an assiduous cultivator in Giovanni Filippo Ingrassias.

19th century anatomy

  During the 19th century, anatomists largely finalised and systematised the descriptive human anatomy of the previous century. The discipline also progressed to establish growing sources of knowledge in histology and developmental biology, not only of humans but also of animals. Extensive research was conducted in more areas of anatomy. England was particularly important in this research.^{[citation needed]} Demand for cadavers grew so great there that body-snatching and even murder came into use as a means of obtaining them.^{[citation needed]} In response, parliament passed the Anatomy Act 1832, which finally provided for an adequate and legitimate supply of corpses. The relaxed restrictions on dissection provided a suitable environment for Gray's Anatomy, a text that was a collective effort and became widely popular. Now seen as unwieldy, Gray's Anatomy was born out of a need to create a single volume on anatomy for the traveling doctor.

Modern anatomy

Anatomical research in the past hundred years has taken advantage of technological developments and growing understanding of sciences such as evolutionary and molecular biology to create a thorough understanding of the body's organs and structures. Disciplines such as endocrinology have explained the purpose of glands that anatomists previously could not explain; medical devices such as MRI machines and CAT scanners have enabled researchers to study the organs of living people or of dead ones. Progress today in anatomy is centered in the development, evolution, and function of anatomical features, as the macroscopic aspects of human anatomy have been largely catalogued. The subfield of non-human anatomy is particularly active as modern anatomists seek to understand basic organizing principles of anatomy through the use of advanced techniques ranging from finite element analysis to molecular biology.

Notes

Bibliography

• Mazzio, C. (1997). The Body in Parts: Discourses and Anatomies in Early Modern Europe. Routledge. ISBN 0-415-91694-1. 
• Porter, R. (1997). The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. Harper Collins. ISBN 0-00-215173-1. 
• Sawday, J. (1996). The Body Emblazoned: Dissection and the Human Body in Renaissance Culture. Routledge. ISBN 0-415-15719-6.