AUTOPSIES, ART, AND ANATOMY

12 May

While  the  artists  and  anatomists of the  Renaissance  are  inextricably associated with the reform of anatomy, the study of human anat- omy—from   bodies,  as  well  as  from  books—had  not  been  entirely neglected since the death of Galen. During the Middle Ages, human dis- section  was  not  pursued   with  the  freedom  and  intensity  so  briefly enjoyed by Herophilus and Erasistratus, but it had not been absolutely forbidden  or abandoned. Interest in dissection and vivisection increased slowly between the twelfth and the seventeenth  centuries, but medieval autopsies  were normally  conducted  to investigate  suspicious deaths  or outbreaks of plague, or even to search for special signs inside the bodies of purported saints. Such postmortems were probably  about  as informative  as the rituals  conducted  in some primitive  tribes  to deter- mine whether death  was due to witchcraft.

Human   dissection  was  practiced  to  a  limited  extent  during  the thirteenth and  fourteenth centuries  in  those  universities  in  southern Europe  having medical faculties. Statutes  of the University  of Bologna dating  back to 1405 recognized the practice  of dissection.  In 1442, the city of Bologna  authorized  the provision  of two cadavers  each year to the university  for dissection.  During  the fifteenth  century,  similar pro- visions were made for most of the major  European universities.  Thus, medical students were able to observe a limited number of human dissections.  However,  they  knew  that  examinations and  dissertations required  knowledge of accepted  texts, not  the ability to perform  prac- tical  demonstrations. Students  pragmatically   attended   dissections  to confirm their readings of the ancient authorities  and to prepare for examinations. Medieval  and  Renaissance  students  were probably  not too  different  from  students  running  a typical ‘‘cookbook’’ experiment today.  Such experiments  are performed  to teach a standard technique or confirm some accepted  fact, not to make novel observations.

Anatomical demonstrations throughout Europe  varied  consider- ably, but  the typical public anatomy  featured  the corpse of a criminal guilty of a crime heinous enough to merit the sentence of ‘‘execution and dissection.’’ After acknowledgment of the Papal Indulgence for the cere- mony, a learned  professor  would read a great oration  on the structure of the human  body while a barber-surgeon attacked  the cadaver.  Gen- erally,  the  debates  between  the  Galenists  of  the  medical  faculty  and the Aristotelians of the faculty of philosophy  drew more attention than the mutilated  corpse.  Anatomical demonstrations continue  to provide public education  and entertainment, as indicated  by public displays of transparent anatomical models. Transparent organs  were on display at the First International Hygiene Exhibition  (1911). Museums  in Europe and  the  United  States  were exhibiting  various  Transparent Men  and Transparent Women in the 1930s.

By about  1400, human  dissection  was part  of the curriculum  of most  medical schools.  Anatomies  were also performed  in some hospi- tals.  However,  well into  the  sixteenth  century,  medical  students  were in little danger  of being forced  to confront  radically  new ideas about the nature  of the human  body.  The medical curriculum  of the Renais- sance university  reflected a heavy commitment to the ancient  authori- ties. Students  were expected  to master  texts by Avicenna,  Galen,  and Hippocrates.  The   number   of   medical   students   was  rather   small, especially in northern Europe.  Throughout the  sixteenth  century,  the annual  number  of candidates  for  the degree of Bachelor  of Medicine in Paris was less than  20.

For  teachers  as well as students,  the purpose  of dissection  was to supplement  the study  of Galenic  texts,  but  because  of the complexity of  Galen’s  writings,  simplified  guides  were needed.  One  of  the  best- known  early dissection  manuals  was the Anatomy (1316) of Mondino de Luzzi (ca. 1275–1326), who served as public lecturer at the University of Bologna  from 1314 to 1324. Mondino’s  Anatomy was practical  and succinct.  The  first  printed   edition  of  the  popular   text  appeared   in

1478 and  was followed by at least 40 editions.  But medical humanists rejected the work, and turned  to newly restored  editions of anatomical works by Galen,  especially On the Use of the Parts  and On Anatomical Procedures. Some of the early texts included simple diagrams,  but these images  did  little  to  illuminate  anatomical principles.  Mastery  of  the principles of artistic  perspective  in the fifteenth  century  made the new art of anatomical illustration possible.

The  development   of  a  special  relationship   with  the  sciences, especially anatomy,  mathematics, and optics, as well as the inspiration of classical Greek  ideals, gave Renaissance  art  much  of its distinctive character. Both artists and physicians sought accurate anatomical knowledge.  Artists  placed  a new emphasis  on accurately  representing animals and plants,  scientific use of perspective, and above all the idea that the human  body was beautiful and worthy of study. To make their art  true  to  life and  to  death,  artists  attended   public  anatomies   and executions  and  studied  intact  and  flayed  bodies  in order  to  see how the muscles and bones worked.

While  many  Renaissance   painters  and  sculptors  turned  to  dis- section, none exceeded Leonardo da Vinci (1452–1519)—painter, archi- tect, anatomist, engineer, and inventor—in terms of artistic and scientific imagination. Leonardo’s  notebooks present a man of formidable  genius and  insatiable  intellectual  curiosity;  they  also  reveal  the  problem  of situating   Leonardo within  the  history  of  science  and  medicine.  His notebooks are  full of brilliant  projects,  observations, and  hypotheses about  human  beings, animals, light, mechanics,  and more. Freud,  who ‘‘psychoanalyzed’’  Leonardo,  called  the  artist   ‘‘the  forerunner .. . of Bacon and Copernicus.’’ But the grand  projects were never completed, and  thousands of pages of notes  and  sketches went unpublished. The secretive, left-handed  artist kept his notebooks in code, a kind of mirror writing. It is tempting  to speculate that  if Leonardo had systematically completed his ambitious projects and conscientiously published and publicized his work, he might have revolutionized  several scientific dis- ciplines. Instead, Leonardo’s  legacy has been assessed as ‘‘the epitome of greatness  in failure,’’ because that  which is unknown,  incomplete,  and disorganized  cannot  be considered a contribution to science. To regard Leonardo as typical of his era is of course unrealistic,  although  he had many brilliant contemporaries. Nevertheless, Leonardo’s  work indicates the scope of the ideas and work that  a person  of genius might achieve with the materials  available in the fifteenth century.

Leonardo, who was the illegitimate son of a peasant  woman and a Florentine lawyer,  grew up in his father’s  house.  At  14 years of age, Leonardo  was  apprenticed  to   Andrea   del  Verrochio   (1435–1488), painter, sculptor, and the foremost teacher of art in Florence. Verrochio insisted that  all his pupils  learn  anatomy.  Within  10 years, Leonardo was recognized as a distinguished  artist  and had acquired  wealthy and powerful  patrons. Despite  these  advantages,   Leonardo led  a  restless and  adventurous life, serving various  patrons, prosecuted  on  charges of homosexuality, beginning and discarding numerous  projects for machines, statues,  and books.  It was art that  first led Leonardo to dis- section, but he pursued anatomical studies of animals and humans with almost  morbid  fascination  for  nearly  50 years,  dissecting  pigs, oxen, horses,  monkeys,  insects,  and  so forth.  Granted permission  to  study cadavers at a hospital in Florence, the artist spent many sleepless nights surrounded by corpses. While planning a revolutionary anatomical treatise,  Leonardo dissected  about   thirty  bodies,  including  a  seven- month  fetus and a very elderly man.

Studies of the superficial anatomy  of the human  body had inexo-rably led Leonardo to an exploration of general anatomy,  comparative

anatomy, and physiological experiments. Through dissection and experimentation, Leonardo believed he would uncover the mechanisms that  governed  movement  and  even  life itself.  Leonardo  constructed models  to  study  the  mechanism  of  action  of  muscles  and  the  heart valves and  carried  out  vivisections  to  gain  insight  into  the heartbeat. For example, he drilled through  the thoracic  wall of a pig and, keeping the incision open with pins, observed the motion of the heart. Although he realized that  the heart  was actually a very powerful muscle, he gen- erally accepted Galen’s views on the movement  and distribution of the blood, including the imaginary pores in the septum. Like so many of his projects, Leonardo’s  great book on the anatomy  of ‘‘natural man’’ was left unfinished.  When  he died,  his manuscripts  were scattered  among various  libraries,  and some were probably  lost.

Convinced  that  all problems  could  be reduced  to mechanics  and mathematics, Leonardo was contemptuous of astrology  and  alchemy and  distrustful  of medicine.  Indeed,  he believed that  preserving  one’s health was most easily accomplished by avoiding doctors and their drugs. Like Cato and Pliny, he denounced physicians as ‘‘the destroyers of life,’’ who lusted after wealth despite their inability to make an informed diagnosis.  Leonardo’s   notebooks,  however,  contain   prescriptions  as bizarre  as any Galenical  remedy,  such as a mixture  of nutshells,  fruit pits, and chickpeas to break up stones in the bladder.

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