A Brief Essay on Anatomical Drawing
by Hal Sharp

"Anatomy is the foundation of medicine," the classical Greek physician Hippocrates declared, "and should be based on the form of the human body."(Persaud, p. 33) Certainly no faculty member of a modern medical school would contradict the ancient master on this point, yet for many centuries – indeed for millennia – anatomical study had a distinctly uneasy relationship with medical education and practice.  Aristotle, the famous natural philosopher two generations younger than Hippocrates, also considered anatomical study critical to medical knowledge and practice, but he developed theories of human anatomy based only on exterior physical examination and the dissection of animals.  In this important work lay the foundations for comparative anatomy, still it proved inadequate to explain the particularities of the human body.  Among Aristotle's many students was the young Alexander, son of Philip of Macedon, and when Alexander earned the epithet "the Great" by conquering a vast territory in the third century B.C. he made Greek intellectual achievements a dominant force in the civilized world.  The Greek project found perhaps its greatest expression in the library of the city Alexander established on the Nile delta.  Scholars and students of many disciplines congregated in Alexandria, where they examined both Aristotle's comparative anatomical studies and the works of Hippocrates. 

The Hippocratic corpus catalogued in Alexandria's renowned library was a collection of works by Hippocrates himself and successor physicians practicing at his school on the eastern Aegean island of Kos.

  The availability of the corpus in the stimulating intellectual environment of Hellenistic Alexandria likely inspired medical scholars finally to take up the knife and undertake systematic human anatomical studies for the first time in classical history. One of these physician-scholars was Herophilus, who produced the treatise On Anatomy, synthesizing the results of many hundred human dissections.  It seems probable that such thorough examinations must have been accompanied by drawings, though none have survived, and none of the classical works existing in transcription mention Hellenistic anatomical drawings.  With the conquest of Alexandria by Rome, a significant detriment to the advance of medicine occurred in the reversal of the cultural climate favorable to human dissections.  Although the great Roman physician Celsus, of the first century AD, and Galen, of the second, both refer to Alexandrian scholarship, the resurgent taboo on human dissection coupled with the loss of the text On Anatomy allowed descriptions of human anatomy presented as fact to slip back into the untested – and largely incorrect – domain of theory.

 

The West owes a great debt to the Arab civilization which conquered the Byzantine successors of Ancient Rome. While much of the western world lost touch with the classical past, Islamic scholars collected and translated the works of Hippocrates and Galen – among many others – and absorbed and synthesized the ancient theories with new discoveries of their own. Despite advances in medical scholarship, Quranic injunctions against human dissection and human representation in drawing placed severe limitations on the critical and accurate analysis of human anatomy. Later in the Medieval period, the resurgence of Europe led to the establishment of universities and the retranslation of classical works into Greek and Latin. In the fourteenth century, some rare human dissections were carried out at European medical schools, ordinarily with the anatomist seated on a dais at the head of a large room, reading from a manuscript of Galen, while a demonstrator opened the body, surrounded by students and other scholars.

It is with the Renaissance, however, that the era of modern anatomical studies begins.  A number of developments united at this time to form a genuinely new cultural system that produced revolutions in many disciplines.  The invention of the printing press in the mid-fifteenth century supplanted the laborious process of hand copying and illumination, and made possible the comparatively rapid and widespread dissemination of knowledge in the form of identical books with wood-cut prints.  The development of perspective in art led to much greater accuracy in the depiction of individuals and scenes, and prompted artists to make careful studies of human anatomy – including dissections – to educate themselves in the precise structure and musculature of the body.  Finally, intellectual attitudes began to break away both from the rigid structures imposed by religious doctrine and by uncritical acceptance of ancient authorities – not everywhere, of course – but the empirical testing of theories by observation and experimentation lay the foundations for the scientific advances and documentation of knowledge that characterized the eighteenth-century enlightenment and our own modern scientific method. 

In terms of Renaissance anatomy, the two names most closely associated with the progression toward critical analysis and accuracy are Leonardo da Vinci and Andreas Vesalius.  Da Vinci approached anatomy from the point of view of the artist, but his meticulous and inquisitive mind quickly propelled him into an anatomical project for its own sake, unfortunately never published.  His more than 750 anatomical drawings – most made from observations of dissections he performed – carried the genre of anatomical illustration to extraordinary refinement. 

Vesalius, born in 1514, five years before the death of da Vinci, studied medicine in Paris, Louvain (Belgium) and Padua (Italy), where the faculty named the 23-year-old a Professor of Surgery and anatomy at the completion of his doctorate.  Vesalius made a name for himself among his students by descending from the chair to conduct dissections without an intermediary, and earned renown among the faculty and profession by successfully challenging the authority of Galen.  He put the ancient master to the critical test and revealed errors in his anatomical theory.  A series of six anatomical drawings produced by Vesalius proved so popular with his students that he published them in 1538, and here likely germinated the idea for his masterpiece, De Humani Corporis Fabrica, first published in 1543.  This volume paired detailed descriptive text with carefully worked anatomical drawings, both of details and entire bodies, all rendered with extreme accuracy, not the least emphasized by the external supports given the sequence of standing figures who successively lose the capacity to "stand" on their own as the layers of musculature are removed.  In the perspective distance behind most of these figures is a continuous cityscape of Padua, a further subtle statement of accuracy or truthfulness in the illustrations, as well as an indication of the important scholarly environment within which Vesalius worked.  The frontispiece of the Fabrica likewise shows Vesalius himself at the dissecting table, reinforcing his position as a scholar not hidebound by conventional thinking.

From this point forward, many, many new anatomical titles appeared, some overtly plagiarized from Vesalius, others new studies, but human dissections and the goal of accurate anatomical illustration never again fell away from the medical curriculum.  By the eighteenth century, advances in printing technology enabled the production of larger, folio volumes with copper plate engravings of even greater clarity of detail over the earlier wood cut blocks.  The most exceptional author of this era is Sigfried Albinus, whose copper plate engravings derived not from freehand drawings wholly dependent on the eye of the artist but from an elaborate surveying mechanism used by architects that regulated artistic talent to make accurate, verifiable measurements and produce precisely proportioned details.

The nineteenth century brought further technological advances in printing, particularly chromolithography, a method for accurate color printing, and changes in paper production methods that lowered costs.  These permitted an even greater diffusion of images and texts, making single books and prints available not simply at the level of the school or the professor, but also that of the classroom, student, and practitioner.  One type of publication in use at the end of the century was the anatomical chart, and the eight images presented here all come from a single set produced in Great Britain and reprinted in several editions into the first decades of the twentieth century in both Britain and America.  Developed by the anatomist Sir William Turner, of the prestigious medical school at the University of Edinburgh, the prints evidence the profession's attention to microscopic anatomy which had come to the fore in the mid-nineteenth century.  With the microscope came many of the discoveries that revolutionized medical theories and treatments in the last quarter of the century, marking a final, decisive break with a medical tradition that extended back to the generation before Hippocrates. 

Turner joined the faculty at Edinburgh as a demonstrator of anatomy in 1854 and remained at the University for 62 years, the last thirteen of which he served as president.  He published numerous papers on anatomy and anthropology, and was one of the founders of the Journal of Anatomy and Physiology, continued from his death in 1916 as the Journal of Anatomy and still published – electronically – today.  Turner's charts treat eight systems:  1) bones;  2) ligaments;  3) muscles;  4) heart and arteries;  5) veins and lungs;  6) organs of digestion;  7) nervous system;  and 8) organs of sense and voice.  All are given realistic coloring and are keyed by plate numbers and letters to descriptive text – which does not survive in the Health Sciences Library collection.  The tablet of charts would have been displayed in the anatomy laboratory or a classroom of a medical school.  The ones displayed here were the property of Dr. William Gayle Crutchfield, a professor of neurological surgery at the University of Virginia School of Medicine for 33 years; they are the gift of his son, William Crutchfield.