Books that unlocked the secrets of the human body

Books are time capsules. They preserve the knowledge and the attitudes of their age. This is true of all books, even of science fiction, which may conjure extraordinarily inventive futures or pasts, but only from the perspective of the present in which it was written. Writers cannot imagine the unimaginable. This is especially true of non-fiction, which records the truth as it was understood at the time of writing. Knowledge expands, cultures evolve, and successive books on any subject demonstrate these changes. Put them all in a single library and they combine to present a social and scientific history of the wisdom in question.

Anatomy can make a strong case for being the oldest science, with a written history stretching back thousands of years. [The Anatomist's Library] contains a fraction of the published works of anatomy, but nevertheless covers well over 150 books spanning more than 5,000 years—from the Edwin Smith Papyrus, which describes the surgical treatment of combat injuries in ancient Egypt, to the current edition of Musculoskeletal MRI, reflecting technological advances in the 21st century, and The Human Anatomy and Physiology Coloring Book, a book for children that shows just how far society has come in overcoming the myth and mistrust which surrounded anatomy for so long.

It’s only natural that anatomy should have preoccupied humanity for so long. Our bodies are our selves. Whether or not we believe that they contain our souls, they certainly hold our blood and our beating hearts, our lives and (one way or another) our mortality. The American comedian Allan Sherman, in his brilliant anatomical parody of the song "You Gotta Have Heart", sang:

Skin is what you feel at home in
And without it, furthermore,
Both your liver and abdomen
Would keep falling on the floor.

"Looking in detail at human anatomy," Alice Roberts, the popular British medical writer and broadcaster, has said, "I’m always left with two practically irreconcilable thoughts: our bodies are wonderful, intricate masterpieces; and then they are cobbled-together, rag-bag, sometimes clunking machines." They are extraordinary self-regulating, self-repairing machines; but when they break down or leak, often through the brutality or carelessness of our fellow human beings or ourselves, we want to be able to fix them.

If the earliest application of anatomy was on the battlefield, it soon took on a more spiritual aspect. With the development of philosophical ideas (as explored in this book’s sister publication The Philosopher’s Library) by ancient thinkers in Egypt and Greece, the concept of a soul was born. Soul and thought, detached from the practical functions of the body, were nevertheless held to be contained within it. Early anatomists engaged in furious academic debate about the relative roles of the head and the heart. Where did the soul reside? Which was the seat of reason? In an anatomical hierarchy, did the heart rule the head, or vice versa? We are, in a more metaphorical way, having the same arguments today, when we ask ourselves, "Do I follow my head, or my heart?"

A sky-lit anatomy theatre with anatomical specimens in jars and a suspended skeleton. Joseph Constantine Stadler, CC BY 4.0, via Wikimedia Commons.

Anatomy is not immune to global events. Wars between civilisations drove early curiosity about the body. Later, when the Roman Empire collapsed in the 5th century, ushering in a period of barbarism in western Europe, new centres of learning sprung up to the east, launching an Islamic Golden Age which made significant contributions to the study of anatomy. And at the end of that age, western scholars visited the former centres of Islamic learning in Spain to translate Islamic texts back into Latin. In the 20th century, the horrors of the Second World War contributed to the publication of what many consider the finest anatomical illustrations ever. The four-volume Topographic Anatomy of Man by Austrian anatomist Eduard Pernkopf cannot, however, be seen in isolation; it is forever tainted by its association with the atrocities committed by the Nazis in the conflict.

Through experimental dissection, early anatomists such as Herophilos, Galen, Rhazes and Avicenna began to explore the truth about what goes on beneath the skin, and to record their findings in books. Myths were dispelled or perpetuated—for example, that the veins carried blood produced in the liver and the arteries were ducts for a mystical energy called pneuma, which was inhaled along with the air we breathe, stoking the imagined fires of life.

If the world was made of air, earth, fire and water, natural philosophers argued, then the body must be composed of comparable materials—black bile, yellow bile, blood and phlegm. An imbalance of these so-called "humors" must then be responsible for illnesses of the body. The theory of humorism, of which Galen was a leading proponent, persisted in anatomy literature for centuries, even after the reality of the circulation of blood was discovered by William Harvey in the 17th century. Doctors would, it was said, "rather err with Galen than proclaim the truth with Harvey."

It was a brave and difficult step for any anatomist to dissociate himself from the prevailing influence of religion on anatomical theory. The Catholic Church had a powerful grip on society in the Middle Ages and one unfortunate Spanish anatomist, Miguel Servet, was burnt alive on a pyre of his books for daring to challenge its orthodoxy. Gradually however, science began to separate from church and state.

That liberation gave anatomists the opportunity to explore the human body purely for the sake of knowledge. The modern science of anatomy was born in the 16th century, initially swept along by the thirst for truth of the Italian Renaissance. It wasn’t only surgeons who needed to understand the body; sculptors and painters also wanted to be able to depict the human form to perfection. Artists started to attend public demonstrations of anatomy, and even to learn how to dissect corpses themselves. The spaces between the bookshelves in the anatomist’s library are decorated with astonishing examples of artists’ understanding of the body.

The supply of bodies for dissection has been a challenge and a source of controversy throughout the history of anatomy. Social conventions have often made any dissection illegal, blasphemous or at least distasteful. At other times it was considered an additional punishment that criminals executed for their crimes would be dissected after death. In London the Barber-Surgeons’ Hall was deliberately built on a site near Newgate Prison, from which a steady supply of bodies could be expected. As the popularity of anatomy courses increased from the seventeenth to the 19th century, supply could not keep up with demand, and body snatchers stole freshly buried corpses and sold them to needy lecturers and students. [The Anatomist's Library] includes the sensational account of the trial of two such graverobbers in Edinburgh in 1829, and a notebook bound with the skin of one of them. Leonardo da Vinci and Michelangelo both had back-door arrangements with local hospitals to get access to fresh cadavers for the purpose of study.

Anatomy has been taught in art schools ever since the Renaissance. Animator Walt Disney attended drawing classes ten years before he launched his first character, Mickey Mouse, in 1928. Later he recalled, "Our most difficult job was to develop the cartoon’s unnatural but seemingly natural anatomy for humans and animals." Understanding anatomy was as important to Disney as it was to Albrecht Dürer, the great 16th-century illustrator, who famously produced a quite anatomically accurate image of a rhinoceros without ever having seen one. Dürer produced one of the earliest anatomy books for artists rather than surgeons.

The relationship between art and anatomy is a symbiotic one, and illustrations in anatomy books over the ages tell as good a story as the text itself. From the frog-like, whole-figure diagrams of some early Islamic texts, to focussed and accurate drawings of specific organs, anatomy has adopted the latest visual technology to present itself from age to age. It was an early adopter of printing when many books were still copied by hand. For example, The Wounded Man—the unfortunate figure designed to exhibit as many different types of injury in a single image as possible—was illustrated with crude woodblocks. Woodcarving skills became more refined through the medieval period before giving way to the fine detail made possible by lithography in the Renaissance. The invention of photography made greater realism possible, although often an idealised image by an artist was better than a photograph at showing the intended details, especially with the refinement of colour printing in the 19th century.

The wounded man, Field book of surgery, 1517. Hans von Gersdorff (1455-1529). Public domain.

The technological advances in how we look at anatomy—from the invention of the microscope in the 17th century to that of the endoscope in the early 19th, from the discovery of X-rays to the CT and MRI scans of today—have transformed the way in which anatomy can be made visual. Scan images can be artificially coloured to highlight the details they have captured.

In the 21st century an anatomical image from an MRI scan is as likely to be an online three-dimensional view as a printed two-dimensional still. Perhaps, in the internet age, the anatomy book will become a thing entirely of the past. This book concentrates on those published up to the end of the 19th century. By then, human macroscopic anatomy (the anatomy visible to the naked eye) was more or less complete. There was a name for every part, and a good understanding of how all the parts worked together to keep us alive and moving. From the 20th century onwards, the great advances in anatomy have been at the cellular or subcellular level, and anatomy is in a new, microscopic phase.

The history of anatomy is the history of how we overcome our physical shortcomings. Another great animator, Chuck Jones, who created some of the world’s most recognisable cartoon characters including Bugs Bunny and his nemesis Wile E Coyote, once commented, "The Coyote is limited, as Bugs is limited, by his anatomy." We are all limited by our anatomy. By writing about it and illustrating it, by reading about it and seeing it, we can understand our limitations and sometimes even conquer them. Each of us lives in a marvellous machine, our body: finely tuned and at the same time a delicate chaos of interdependent systems, constantly at risk of failure. To know anatomy is, in a very real sense, to know our selves.

The Anatomist's Library by Colin Salter (Ivy Press, July 2023) is available now

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Cover image: Anatomy Lesson of Dr. Frederik Ruysch (1670). Adriaen Backer, Public domain, via Wikimedia Commons

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