Anatomy is considered one of the oldest medical sciences and has long been associated with the arts.
Anatomy is concerned with identifying and describing the structure of the body and its component parts. It's important to all fields of medicine, but particularly for the diagnosis and classification of different diseases and other health issues.
Most early anatomical knowledge was discovered because of religious or philosophical questions. The Babylonians dissected animals in order to make predictions based on what they found in the organs, and the Ancient Greeks used anatomy to contemplate the location of the soul. A fundamental stumbling block to the study of human anatomy was widespread discomfort with the idea of dissecting corpses. In most cultures, cutting open a dead body was seen as a desecration—a taboo.
The influential anatomical studies of the Greek-born physician Galen (129–216 CE) were to dominate European medicine for hundreds of years, despite human dissection being forbidden in the Roman Empire, where he spent the majority of his working life.
As an alternative, he recommended that anatomy students dissect the local barbary apes, a species which was considered 'most like man'.
For Galen, anatomy demonstrated that the functions and structure of the body were not determined by chance. Understanding more about the body therefore meant learning more about nature and the purpose of life.
During the medieval period, in both Western Europe and the Islamic Empire to the east, anatomy continued to be seen as a means of exploring religious beliefs as well as humanity’s place in the world. The practice remained relatively static, however, and was largely based around classical texts and the dissection of animals.
The work of individuals such as Ibn al-Nafis (1210–88) indicates that some human dissection was being carried out during the Middle Ages, albeit not widely known in Europe.
The public dissection
Because the supply of bodies available for study was at best highly restricted, most physicians had to rely on existing texts for their knowledge of human anatomy. But as early as the 1300s, universities in Europe were beginning to offer public human dissections to their medical students.
The actual dissecting was done by an assistant, while the lecturer observed proceedings from above, reading from a text by Galen or some other authority. The subject was usually the corpse of an executed criminal.
Without a means of preservation, the order of dissection was determined by the rate of decay of body parts. The abdomen was first, followed by the contents of the chest, the brain and finally the limbs.
The natural decomposition of the body meant that a cadaver only remained suitable for dissection for three or four days following death. After this, the stench became too much to bear. In warm or wet weather the cadaver decomposed even faster, so most dissections were performed in the winter months.
By the 1400s, the number of dissections and the quantity of books on anatomy had increased and there was greater demand for anatomical training from prospective surgeons and physicians.
Vesalius and Renaissance anatomy
During the European Renaissance of the 1500s, there was a renewed interest in the knowledge contained in the early classical Greek and Roman texts. The study of anatomy itself was fuelled by the rediscovery of several major works, including a new translation of Galen's On Anatomical Procedures in 1531, which included procedures for dissection.
Through practical dissection, anatomists aimed to achieve a better understanding of such classical texts. This was Flemish physician Andreas Vesalius' (1514–64) intention when he compared his results with the work of established authorities like Galen.
In practice, Vesalius discovered a number of inaccuracies. These were mainly the result of Galen’s reliance on animal dissections for his descriptions of human anatomy.
Vesalius’s book De humani corporis fabrica (On the Fabric of the Human Body), published in 1543, subsequently broke with convention by relying on the direct observation of human dissection for its illustrations and descriptions of human anatomy.
Although he corrected inaccuracies found in the classical texts, Vesalius saw himself as continuing in the tradition of Galen rather than replacing him.
He also worked with an artist and an engraver to transform his dissections into beautifully detailed and annotated images. The figures followed the conventions of Ancient Greek sculpture, with an emphasis on muscular bodies depicted as if they were standing within classical landscapes. This style spawned many imitators and became a standard way to portray the human body.
Vesalius’ lavishly illustrated seven-volume book was aimed at wealthy patrons and ‘gentlemen’ interested in the anatomy of the body and its representation. In contrast, most medical students at the time had to content themselves with smaller, far cheaper publications with illustrations that were crude in comparison.
Anatomy in art
To be an artist during the Renaissance was, for many, to be an anatomist. As European artists such as Michelangelo turned towards more lifelike portrayals of the human body, they needed a deeper understanding of how the structures of the body worked together - and not only the surface of the body; the muscles and bones as seen through the skin were also of interest.
For similar reasons, Leonardo da Vinci carried out his own dissections on animals and human corpses. He produced numerous drawings and sketches based on these investigations, possibly intended for an anatomical text of his own. However, he warned fellow artists interested in dissection of 'the fear of living through the night hours in the company of quartered and flayed corpses fearful to behold'.
Artists and anatomists worked together to investigate the body through dissection. They produced images of the body that combined medical knowledge and an artistic vision of humanity's place in the world. The visual culture of anatomy was revealed through paintings and sculptures and in numerous printed forms, from lavishly illustrated books to popular mass-produced leaflets.
Following Vesalius' lead, the dissected figures—whether skeletons or écorchés, the 'muscle men' whose skin had been flayed off—were usually portrayed as upright living figures, often situated in classical landscapes.
The dead and dissected bodies were deliberately made to look alive. A clue to this convention is suggested by a Latin phrase found in many anatomical illustrations, the frontispiece of books or even carved into the fabric of the anatomy theatres of this period. Nosce te ipsum means 'know thyself'; the phrase suggested to viewers that anatomy was a way to self-knowledge—spiritual as well as physical.
Such depictions also served as reminders, both of the divine nature of the body as created by God and of human fragility. They formed part of a wider culture of vanitas and memento mori that recalled mortality and the inevitability of death.
Dissection dilemmas
Anatomy and dissection are still taught and practised in medical schools worldwide. Today’s cadavers have mostly been donated and modern preservation techniques mean there is less urgency to complete a dissection—but for a long time the demand for human bodies outstripped supply.
In England in 1540, King Henry VIII passed an order that allowed the Company of Barber-Surgeons to dissect the cadavers of four executed criminals each year. By 1752, English judges were granted additional powers to decide on the fate of the bodies of executed murderers.
Wellcome Collection, CC-BY
With increasing numbers of crimes attracting the death sentence, the humiliation of being dissected after death was the only thing that made punishment for murder more extreme than that for theft. But supplies remained insufficient to meet the needs of the new hospitals and anatomy schools that opened during the 1700s.
In 1831, only 11 bodies were legally available for dissection in London, a city in which over 900 students were studying anatomy. Desperation led some teaching centres to 'ask no questions' about the bodies they were offered and grave-robbing became a flourishing trade.
Even as surgeons sought to establish their credentials as respectable professionals, their desire for cadavers led them into relationships with so-called body snatchers. Even more horrific were instances in which people were kidnapped and murdered to order and their bodies sold to the schools in whole or parts.
Wellcome Collection (CC BY 4.0)
Image source
for Etching of body-snatchers being caught by nightwatchmen
In an attempt to control the trade, England’s 1832 Anatomy Act made the bodies of unclaimed individuals available to anatomy schools. Similar legislation was passed in the USA through state acts, beginning with Massachusetts in 1831.
These included bodies of poverty-stricken individuals who died in the many workhouses, one of the key reasons why the poor tried to avoid ending up in such places.
The autopsy
The invention of the microscope was crucial to the development of pathological anatomy from the late 1700s. Specialist doctors known as pathologists could look for changes in the body’s organs and tissues caused by disease. Specific diseases could thus be identified or a diagnosis confirmed through a combination of internal changes observed after death as well as external signs and symptoms.
The word autopsy derives from the Ancient Greek for ‘see for yourself’. The practice is recorded in the ancient world, although it was not widespread and tended only to be carried out on important people who died an unnatural or suspicious death. One of the most notable early autopsies was performed on Roman Emperor Julius Caesar, who was stabbed to death as he entered the Senate.
The practical origins of the modern autopsy lie with Renaissance anatomist Giovanni Morgagni (1682–1771). He produced the first major work on the subject in 1761, The Seats and Causes of Disease Investigated by Anatomy.
Over the course of the 1800s, dissection become more than simply a way to gain knowledge about the structure of the body. Hospitals began to routinely perform autopsies, also referred to as a post-mortem, on patients who had died within their walls to try and confirm the cause of death.
Today, autopsies are popularly associated with crime-solving, but typically perform a far more routine medical function. The body is examined both outside and in, with tissues and organs removed, examined and analysed. Pathologists establish the general state of health before death and determine whether any medical diagnosis or treatment given was correct and appropriate.
Autopsies have contributed greatly to medical knowledge as they provide information not easily attainable by other means. They are integral to much of the legislation and regulation associated with modern death. Autopsies are ordered when a death is unexpected, suspicious or if there are uncertainties about its exact cause. A significant minority of autopsies reveal death was caused by something other than what was expected.
Suggestions for further research
Books
- B A Rifkin, Human Anatomy: A Visual History from the Renaissance to the Digital Age, 2011
- A Cunningham, The Anatomical Renaissance: The Resurrection Of The Anatomical Projects Of The Ancients, 1997
- S N Joffe, Andreas Vesalius: The Making, The Madman, and the Myth, 2014
- R Richardson, Death, Dissection, and the Destitute, 1987
