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The start of any medical career begins at the dissecting table so it is fitting that medicine itself began with the study of anatomy. Galen practiced medicine in the 3rd century and was one of the most influential physicians of all time. Many of his anatomic principles were based on animal dissection with the liver felt to be the seat of the soul. His teachings remained the foundation of medical care for almost 1500 years. In the centuries that followed, there were few prohibitions to human dissection though specimens were hard to come by and preservation was inadequate. Mondino de Cuzzi (1275-1326) was the first to illustrate Galen's teachings by using a human cadaver in 1315; his famous dissection in Bolognia remains a landmark.

Leonardo da Vinci (1452-1519) studied anatomy as an art form. His drawings were designed to guide other artists and they marked the beginning of the systemic study of the human body. Da Vinci's sketches were on loose leaf and were the result of 30 careful human dissections; many of these works are now found at the Royal Library of Windsor (1-3). His were the first correct drawings of the fetus and he first demonstrated the link between the brain and peripheral nerves. Early anatomic investigation was opposed by many religious groups and indeed da Vinci left the Vatican to avoid prosecution.

Medical Illustration

The first illustration of a dissection was found in Fasiciculus Medicinae by Johannes de Ketham in 1491 (4) and was inspired by the work of Mondino. Note the gentleman sitting in the chair overseeing the dissection; this is believed to be the origin of the term "chairman of the department". By 1540, British physicians were allowed to demonstrate anatomy with the dissected cadavers of four executed prisoners each year.

It was Andreas Vesalius (1514-1564) who brought medicine into the modern era with his monumental work De Humani Corporis Fabrica Libri Septum (1543), now considered one of the greatest books in the history of medicine (5-8). The magnificent illustrations are classics in medicine and were the work of Jan van Calcar, a student of Titian. Vesalius contested the accepted teachings of Galen and his independent studies started medicine, and indeed scientific investigation, on the road that has led to today's incredible achievements.

The next great landmark in medical literature came in 1628 by William Harvey when he wrote Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus. This study of circulatory physiology revolutionized medical investigation by the use of the scientific method and was a major departure from Galen, who had taught that blood ebbed and flowed throughout the body, beginning in the liver (9).

In 1632, Rembrandt van Rijn turned his attention to the study of anatomy in his famous Doctor Tulp's Anatomy Lesson (10). This work was commissioned by the Amsterdam Company of Surgeons and shows Dr. Tulp, a pathologist, pulling a tendon with one hand and reproducing that motion with the other. Note the similarity to Vaselius' portrait in that he points to the same tendon.

1-3) Sketches by Leonardo da Vinci, ca 1517

These drawings were some of the finest ever made and were primarily intended for use by other artists. Included are etchings of the muscles, skeleton, and embryo.

4) Fasciculus Medicinae (1491), by Ketham

This represents the first illustration of a dissection.

5-8) De Humani Corporis Fabrica (1543), by Vesalius

This was the first break with Galen and one of the most important works in the history of medicine, the art setting a precedent. Enclosed is the portrait of Vesalius, front page, the famous "muscleman", and the skeleton

9) De Motu Cordis (1628), by William Harvey

Medical landmark; the first use of scientific method in demonstrating circulatory physiology.

10) The Anatomy Lesson of Dr. Tulp (1632), by Rembrandt

An anatomy lesson by one of the earliest forensic pathologists as painted by Rembrandt.

 

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3) daVinci, Embryo

4) Ketham Dissection

5) Vesalius, Portrait

9) De Motu Cordis

10) Anatomy by Dr. Tulp