As far as we know, anatomy is the oldest medical science. Cave paintings of the early Stone Age, about 30,000 years ago,* show a simple knowledge of the anatomy of animals, and it is assumed that these cave dwellers applied some of their anatomical knowledge to their own bodies. The civilizations of the Babylonians, as Syrians, Egyptians, Chinese, and Hindus made no serious attempt to learn anatomy because they were interested in the supernatural world, not the natural one, and their cultures placed strong religious restrictions against debasing the body. Any anatomical dissections that were performed on animals were made to “study” organs in an effort to predict the future and to tell fortunes.
*The Stone Age, the earliest known period of human culture, is characterized by the use of small stone tools.
Anatomy in Ancient Greece
The systematic study of anatomy may have begun in the fifth century B.C ., with the work of two Greek scientists, Alcmaeon (ca. 500 B.C.) in Italy and Empedocles (ca. 490-430 B.C) in Sicily, where Greek culture and science flourished. Alcmaeon was probably the first person to dissect the human body for research purposes, and he is also given credit for proposing that the brain is the center of intelligence. Empedocles, who believed that the heart distributed life-giving heat to the body, initiated the idea that an ethereal substance called pneuma, which was both life and soul, flowed through the blood vessels. Although such early anatomists were often incorrect, their work was essential to the development of later scientists.
Anatomical inferences without dissection continued in Greece with Hippocrates (ca. 460-377 B.C ), who is known as the Father of Medicine. (Many medical students still take the Hippocratic Oath upon graduation from medical school.) He might also be called the Father of Holistic Medicine, since he advocated the importance of the relationship between patient, physician, and disease in title diagnosis and treatment of illness. This philosophy was rejected at a time when diseases were still thought to be punishments from the gods.
Hippocrates’ knowledge of internal anatomy was severely limited by the lack of dissections, and not until Aristotle (384-322 B.C) did physicians begin to dissect animals carefully enough to deduce even the barest essentials of human anatomy. Aristotle corrected many of the anatomical errors of his predecessors, but because he was primarily a philosopher rather than a physician, he depended more on logical deduction than on observation and experimentation. His scanty knowledge of the inner workings of the human body led to many gross inaccuracies; for example, He believed that the brain cooled the heart by secreting “phlegm,” and that the arteries contained only air. Nevertheless, he had an enormous influence on scientists for hundreds of years.
The Beginnings of Modern Anatomy
With the decline of Greek influence on the mainland, Alexandria became the transplanted center of Greek culture. It was there that the Greeks Herophilus (ca. 335-280 B.C) andErasistratus (ca. 310-250 B.C) conducted the first systematic dissections of the human body. Herophilus established the brain as the center of intelligence, distinguished between veins and arteries, and made many other accurate observations about the structure of the human body, especially the nervous system. He conducted the first public dissection and is supposed to have taught the first female medical student. Erasistratus, an intense rival of Herophilus, was more interested in physiology than anatomy and studied the process of circulation in the body. He believed that pneuma, or vital air, was carried by the arteries. The written works of both Greeks were lost when the library at Alexandria was destroyed in A.D,272, but their ideas were found in the writings of the Roman Celsus (30 B.C.-A. D. 30) and the physician Claudius Galenus, popularly known as Galen.
Galen (ca. A.D 129-199), considered to be the greatest ancient physician after Hippocrates, was born in Pergamon in Asia Minor (now Pergama in Turkey). His early knowledge of anatomy derived from his studies in Asia Minor, Greece, and Alexandria, and after his return to Pergamon, his job as chief physician to the gladiators. Galen’s dissections of African monkeys (human dissections were still forbidden) provided him with enough related information about humans so that he described correctly many brain structures, the structural differences between veins and arteries, and many other structures of the human body, including heart valves. He also observed that muscles contract in response to a stimulus from nerves, and demonstrated experimentally that the arteries carry blood, not air.
Despite Galen’s improvements on earlier anatomical studies and his other achievements, he is often remembered for the fact that the Catholic church did not allow his ideas to be criticized; thus many of his erroneous ideas were perpetuated and major progress in the field of anatomy was halted until the sixteenth century.
The twelfth and thirteenth centuries saw a gradual reawakening of valid scientific investigation after the barren years of the Dark Ages. The first true university was founded in Bologna in the twelfth century, and a medical faculty was established there by 1156. By the end of the thirteenth century, the demand for accurate information was so great that the medical dissection of human corpses began in earnest. Anatomists at this time were still conditioned to revere the outdated notions of Aristotle and Galen, and if an autopsy revealed a deviation from prior teachings, the anatomists concluded that the body was abnormal.
The fourteenth century brought a more scientific attitude to the study of the human body. To some extent, artists, rather than scientists, set the pace in revealing new aspects on human anatomy Leonardo da Vinci (1452-1519) was undoubtedly the most industrious artist, producing hundreds of anatomical drawings made from dissections; unfortunately he had little influence on the anatomists of his time.
Five years before the death of Leonardo, the true “Father of Anatomy” was born. This was Andreas Vesalius (15141564), who at the age of 29 published his seven-volume De humanicorporis fabrica (On the Structure of the Human Body), in which he carefully integrated text and drawings made from dissections, setting anatomy on a new course toward the scientific method. (The drawings were made by Jan Calcar, a student of Titian.) Another significant scientific event occurred in the same year, 1543, when the Polish astronomer Nicolaus Copernicus (1473-1543) published his view that the earth revolved around a stationary sun.
The publication of the Fabrica was a major scientific event because it was instrumental in overcoming the authority of the Catholic church. For the first time, anatomy was placed on an objective level, and Galen’s inaccuracies were exposed. Unfortunately, Vesalius’s ideas were originally rebuked by anatomists because they challenged Galen and others.
The Contributions of William Harvey
The English physician and anatomist William Harvey (1578-1657) studied at the University of Padua (the newly established center of medical research) several years after Vesalius taught there. In 1628, Harvey published An Anatomical Treatise on the Motion of the Heart and Blood in Animals, in which he described for the first time how blood is pumped by the contractions of the heart, circulates throughout the body, and returns to the heart. Both the accurate plan of the circulation and the idea that the heart is a pump were enormous breakthroughs that helped overcome the primitive ideas of Aristotle and Galen once and for all. Although Harvey’s discovery was attacked by Galen’s steadfast followers, it was difficult to argue against Harvey’s methods of first-hand observation and experimentation. Harvey had not only made a most important anatomical discovery, he had also demonstrated a logical and scientific approach that set the standard fofuture anatomical research. From then on, physicians and anatomists considered structure and function when investigating the human body. Such research was aided by microscopes, beginning with those produced by the Dutch microscopist, Antonie Van Leewenhoek (1632-1723), which enabled scientists to examine the cells, tissues, and fluids of the body.
To many, gross human anatomy is associated with Gray’s Anatomy, originally published by the English surgeon Sir Henry Gray in 1858. Since then the book has had several authors and has evolved into the current thirty-seventh edition in Great Britain and the thirtieth edition in the United States, each with its own character.
Radiological advances in the twentieth century have allowed scientists to make remarkable connections between anatomy and physiology, and researchers are integrating the study of anatomy with other disciplines, including biochemistry, genetics, and biophysics. Physicians now have access to advanced technology such as CAT and PET scanners, and magnetic resonance imaging (MRI), all of which go far beyond microscopy and x-rays. These techniques permit physicians to look inside the body without performing surgery, yet another major breakthrough in the history of anatomy.
Taken from “Human Anatomy” by Robert Carola et al copyright © 1992 by McGRAW-Hill Press.