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The Changing Face of Human Anatomy Practice: Learning from History and Benefiting from Technology

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The Changing Face of Human Anatomy Practice: Learning from History and Benefiting from Technology EDITORIAL Anatomy Journal of Africa, 2014; 3 (2): 308 - 312 THE CHANGING FACE OF HUMAN ANATOMY PRACTICE: LEARNING FROM HISTORY AND BENEFITING FROM TECHNOLOGY Julius Ogeng’o, PhD Editor in Chief, Anatomy Journal of Africa Contemporary practice of Human Anatomy The account of History of Anatomy by should combine historical practices and current Siddiquey et al (2009) chronicles the most advances in technology. The history of Anatomy luminary of legends including Hippocrates (460 has changed dramatically over the years. It was - 377 BCE) who taught anatomy in Greece and not until the Grecian Period that people began is regarded as father of medicine. He stated, to accept anatomy as a science. Originally “The nature of the body is the beginning of nobody knew anything about anatomy and its medical science”. Aristotle (384-322 BCE) was relationship with disease. It was believed, for the first person to use the term “anatome” a example, that if you had a disease it was Greek word meaning “cutting up or taking because god was punishing you. The Grecian apart”. The Latin word dissecare has similar period produced, among others, the famous meaning. The most influential anatomist in Greek physician, Hippocrates (Swain, 2012). ancient world was Galen (about 130 - 200AD), The face of Human Anatomy has been a physician and prolific writer who studied transformed by changes in cultural and religious anatomy at Alexandria and later worked at beliefs, and legislative frame-works. There have Rome. Andreas Vesalius’s (1514-1564 AD) also been increasing additional objective masterpiece De Human Corporis Fabrica, findings and advancements in technology. published in 1543, marked a new era in the These factors have contributed to evolution of history of Medicine. Vesalius recognized knowledge, methods of study, sources of anatomy as the firm foundation of medicine. bodies and approaches to Human Anatomy The Arabian physician Ibn Zuhr (Avenzoar) teaching and research. This editorial covers (1091-1161) was the first physician known to historical highlights of some legends, methods have carried out human dissection and post of study, sources of bodies, current practices mortem autopsy. In the 12th century, Saladin’s and future prospects in Human Anatomy. physician Ibn Jumay was also one of the first to undertake human dissection and he made an explicit appeal for other physician to do so as 308 Anatomy Journal of Africa, 2014; 3 (2): 308 - 312 well. Leonardo da Vinci (1489) dissected about is one of the earliest surgeons of recorded thirty human corpses, many of them at a history (Saraf and Parihar, 2006; Bhattacharya, mortuary in Rome and produced a series of 2009). This man was one of the earliest to anatomical drawings amounting to some 750, advocate for, and practice the study of the including studies of bone structures, muscles, human body, by dissection from the surface to internal organs, the brain and even the position superficial and internal structures (Loukas et of the foetus in the uterus. al., 2010). Sushruta’s accounts are contained in his compendium, the “Sushruta Samhita”. In this issue, of Anatomy Journal of Africa Deepa Most accounts of History of Anatomy often fail and Pushpalatha (2014) highlight the vast to recognize the heroes of ancient India. One contribution of Sushruta to Anatomy and such was Rishi Sushruta [about 600BC], a man emphasize how thorough knowledge of whose work preceded that of the European Anatomy must have helped him in becoming stallwarts – Hippocrates, Galen and Celsius He the father of Indian surgery. Rishi Sushruta at work about 600BC To encourage scholars to document the role University of the Free State, in South Africa individuals play in promoting Human Anatomy, (Correia and Wessels, 2014). we have also carried the article, which pays tribute to Johannes Toerien for the role he Several methods of studying the human body played in entrenching Human Anatomy at the are recorded in history and contemporary 309 Anatomy Journal of Africa, 2014; 3 (2): 308 - 312 practice. (McLachlan and Pattern 2006). The most recent, but often neglected approach Herophilus and Erasistratus, (3rd century BC) is the so-called living anatomy, that is teaching made the first scientific studies designed to anatomy through the study of the living body. discover the workings of human anatomy by Two publications – “Anatomy in the living vivisection, that is, “dissection” of live bodies. model” (Waterson, 1931) and “Living Anatomy” They vivisected convicted criminals. Proponents (Lockhart, 1947) emphasize the value of this of vivisection - justified the suffering of the method of Anatomy instruction. Indeed criminals as providing 'remedies for innocent Lockhart advised: “Keeping your eye on the people of all future ages' (Atalic, 2012). body, especially the living body is the first Another method of study, practiced by Sushruta principle of anatomy”. Barrows et al (1968) of Ancient India, was “dissection without recommended the use of the life models in cutting”, since Hindu tradition and religious anatomy teaching, commenting that “during the beliefs prohibited cutting of bodies. This is anatomy course, the students gradually develop therefore how they prepared their “cadavers”. an objective but respectful attitude towards the Having removed all the fecal matter from the cadaver. Studies have concluded that ‘live body, the body was wrapped in grass, placed in models are superior to using cadavers, a cage and firmly secured in a hidden spot in a especially in demonstrating superficial anatomy river, with slowly flowing water. After 7 nights, landmarks’ (Barrow et al., 1968; Stillman et al., the thoroughly decomposed body was taken 1978)”. out and very slowly scrubbed with a whisk, made of grass roots (of Kusa) to peel off the The demand for bodies has always outpaced layers of the skin and study the interior. Every the legally available supply, especially in part of the body, beginning with the skin was countries with lack of regulations, among them then examined systematically [Rajgopal et al., the United States in the 19th century. The 2002]. result was the development of an illegal trade in bodies obtained by ‘‘bodysnatching,’’ the The method we are most conversant with is theft of bodies of the recently deceased from cadaver dissection, which has remained core to graveyards (Olry, 1999) and the use of bodies anatomy teaching in most parts of the world of disenfranchised members of society, such as since Renaissance. Dissection in the early days, criminals, the executed, the poor, the black, in Italy, was done in the anatomy theatre open and the immigrants. Body procurement lay for the public to view. Laboratory dissection, either in the hands of anatomy staff and restricted to designated practitioners and medical students, or professional ‘‘body- students came later. In Italy, women were not snatchers’’ (Hildebrandt, 2010). permitted to take part in anatomy classes. Subsequently, dissection became encultured The legal ways of securing bodies include into medical education such that it has become obtaining unclaimed bodies and those of body an almost universal expectation of medical donation programs. Two driving forces for courses. Recently, however, there has been establishment of body donation programs: are worldwide debate on whether or not to teach the decreased availability of unclaimed bodies anatomy by cadaver dissection (McLachlan and and the change in public opinion concerning Patten, 2006). The position taken by the so- modern medicine. The combination of called conservatists has been to retain cadaver improvement in general health of the dissection and supplement it with any other, so population as well as better burial benefits led called newer methods of instruction (Ogeng’o, to a decrease of unclaimed bodies from public 2009; Ogeng’o et al., 2012). A reassuring institutions by the middle of the 20th century aspect of teaching of Anatomy in Africa is the (Garment et al., 2007; Warner, 2009). While positive attitude displayed by students in new sporadic body donations had been known to medical schools (Karau et al., 2014). occur in Europe and the United States in the 18th and 19th century, these were usually 310 Anatomy Journal of Africa, 2014; 3 (2): 308 - 312 individual donations from anatomists, doctors analysis, nanotechnology and molecular biology and prominent individuals. (Siddiquey et al., 2009). A remarkable feature of this issue of the journal is the experimental Teaching of Human Anatomy and Anatomical nature of Anatomical studies (Akinola et al., research has recently taken advantage of 2014; Balogun et al., 2014). This character technological advancement. Ultrasound, brings life to Anatomy, and has the potential to computerized tomography, magnetic resonance enhance research in Anatomy. imaging, positrion emission tomography and angiography allow the study of organs in living This special issue of the Anatomy Journal of and dead individuals. Progress in anatomy Africa carries a combination of informative today is centered on the development, articles covering rich historical gleanings, evolution, and function of anatomical features. interesting descriptive accounts, experimental The subfield of non-human anatomy is studies in human beings and animal models, particularly active as the “modern” anatomist and attitudes towards dissection, all seeks to understand basic organizing principles contextualized to enrich the progress of of anatomy through the use of advanced Anatomy. techniques encompassing light and electron microscopy, histochemistry, finite element REFERENCES 1. Akinola OB, Omotoso OG, Akinlolu AA, Ayangbemi KD. 2014. Identification of the anthropometric index that best correlates with fasting blood glucose and BMI in Nigerians. Anat J Afri 3 (2): 324-328. 2. Atalic B 2012. Historical development and ethical considerations of vivisectionists and antivivisectionist movement JAHR 3 (6): 399 – 414. 3. Balogun WG, brahim RB, Ishola AO, Imam A, Adeyemo KA, Alabi AS, Enaibe BU. 2014. Histological hanges in the ungs of adult Wister rats following exposure to paint fumes. Anat J Afr 3 (2): 329 – 335. 4. Barrows HS, Patek PR, Abrahamson S.
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