The rise and fall of human dissection

The practice of dissecting human bodies can be traced back to the Greek physicians Herophilus (335–280 BC) and Erasistratus (304–250 BC) of Alexandria, or even earlier to a rite of passage of the pharaohs to the kingdom of the dead. Roman law and early Christian teachings prohibited dissection, so that early anatomists such as Galen (AD 129 -216) were reduced to studying monkeys and pigs. As long as monks controlled medical education, the interdict was obeyed, but by the late Middle Ages, anatomy came to be regarded as essential to the medical curriculum at the universities of Paris (1150), Bologna (1158), Oxford (1167), Montpellier (1181), Padua (1222), and Salerno (1235). Mondino de Luzzi is believed to have performed the first public human dissection in 1315 at the University of Bologna. Dissection became routine during the Renaissance with the opening of the Anatomical Theatres in northern Italy and with the explorations of Vesalius, Colombo, Morgagni, Malpighi, and others. In succeeding centuries, the teaching of anatomy became commonplace in continental Europe, reaching its apogee when medical educators decided that students needed to spend long hours in the dissecting room.

In France, Germany, Italy, and Holland, the authorities eventually removed obstacles to physicians conducting dissections, so that anatomists had an ample supply of the bodies of executed criminals or persons dying in hospitals or jails. Not so in Great Britain. There, the supply of cadavers had long been restricted by law, eventually giving rise to the profitable but disreputable trade of body snatching. It was done by so-called resurrectionists, who skillfully opened coffins, used a rope to extract the buried body, and then tidied up everything to avoid detection. They sold the bodies for profit to students or professors and surgeons, so that there came a time when nobody could be sure that their loved one might not end up on a dissection table. As the demand for bodies grew, body snatchers such as the famous William Burke and William Hare changed tactics and began to murder older men and women. It caused a scandal and riots against medical doctors, and eventually the laws had to be changed to ensure that anatomy schools had enough cadavers for their students to dissect and study.

By the beginning of the twentieth century, learning anatomy was routine in most developed countries. It often took place in dismal surroundings, in dissecting halls reeking of formalin, with bits of scapulae and pelvic bones scattered around and eyeless skulls available for studying the muscles of the tongue and the structures of the sphenopalatine fossa. Learning all those names in Latin presented a challenge, for the BNA (Basle Nomina Anatomica) was still the Bible until mercifully replaced, at least in English-speaking countries, by the Birmingham and other revisions. Working in groups of as many as twelve per cadaver, students slugged away dissecting a body for as long as one year and cutting up a brain for several more months, in addition to having already been toughened by time spent in “premed” by studying zoology, cutting up stingrays and oxen hearts, and learning by rote the mouthparts of the cockroach. Mnemonics were great aide memos, but some were raunchy ones that described the relations between the lingual nerve, Wharton’s duct, and the hyoglossus.

All went well for the science of anatomy until about the middle of the twentieth century when students also had to learn statistics, pharmacology, physiology, and much more. Curricula have changed dramatically, and so have teaching and learning techniques. At first, some students stopped bothering to attend the dissection room and merely studied from well-illustrated atlases. Now, they use sophisticated digital imaging techniques, plastinated prosections, three-dimensional interactive computer programs, and various active learning techniques. The COVID-19 pandemic has further revolutionized education and new ingenious learning techniques are constantly being developed. Conservative educators still argue that anatomical dissection is an essential stage in the education of a physician, but they are fighting a losing battle. For most, the days of Vesalius and Malpighi are gone forever. The day of learning by advanced technology has arrived, and there is no turning back.

Hektoen International

The rise and fall of human dissection

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