History Of Anatomy - Second Part PDF

**HISTORY OF ANATOMY.** Second part **Prof. Dr. Cristian Bârsu** Important announcement This course must not be transmitted by any means outside the academic community of the Cluj-Napoca University of Medicine and Pharmacy. **Anatomy in Antic Greece** Greek antic medicine was divided into thr...

**HISTORY OF ANATOMY.** Second part **Prof. Dr. Cristian Bârsu** Important announcement This course must not be transmitted by any means outside the academic community of the Cluj-Napoca University of Medicine and Pharmacy. **Anatomy in Antic Greece** Greek antic medicine was divided into three part, having as central master Hippocrates. [A) The pre-Hippocratic period ] \- HOMER \- ALCMEON FROM CROTONA \- ARISTOTLE [B) The Hippocratic period] HIPPOCRATE [C) The post-Hippocratic period] = the Alexandrian period 1\. The Alexandrian School: \- HEROPHILOSof Chalcedon \- ERASISTRATES from Cos 2\. The Methodical school \- SORAN from EFES **HOMER (8^th^ century B. C.)** - he was [not] a physician; he was an epic poet - his anatomical knowledge is mentioned in his famous poems ILLIAD and ODYSSEY -- he used anatomical terms in a correct form: collarbone, talus, intestine, peritoneum, epiploon, bladder, perirenal fat, umbilical cord - he considered in a correct way that large vessels leave from heart to head and neck **ALCMEON FROM CROTONA (5^th^ century B. C.)** - wrote the first treatise of anatomy in the world - described: the optic nerve, the pharyngeal tube, the brain - performed the first animal dissections - differentiated in the heart the ventriculum from the atrium (world premiere) **ARISTOTLE** - He was philosopher and polymath during the Classical period of Ancient Greece - He had contributions in different sciences: biology, physics, psychology, economy and politics; he also had contributions in poetry, theatre and music. - he is considered the founder of comparative anatomy - described dentition in various animals and humans - erroneously, he considered the number of teeth in a man is greater that the number of woman s teeth **HIPPOCRATES** Elements of anatomy in the Hippocratic Corpus - osteology was partially developed, being based on traumatology - Hippocrates wrote a treatise on joints - He made some anatomical descriptions: trachea, lungs, umbilical cord, ureters - In a very correct way, he considered that anatomy and physiology were the foundations of medicine - The limits of anatomical conception were due to the following motivations: ► no dissections were performed ► the interrelationship between veins and arteries was not known ► no distinction was made between nerves and tendons But Hippocratic contribution in medicine was not limited to anatomy. He was the founder of the examination at the patient\'s bedside. He was also the creator of the observation of the evolution of the disease Hippocrates showed that: \- the disease is the imbalance of the body \- fever is a necessary phenomenon He realized the humoral theory: blood, phlegm, yellow bile and black bile The founder of the first medical doctrine based on: \- facts of observation \- rigorous reasoning \- humor theory (naive, but integrates the body into the external environment): \- altered or excessive humor should be eliminated: suddenly, through crisis or slowly, by lysis \- if the humor has not been eliminated, the disease becomes chronic -all diseases have real causes,which should be known: \- internalfactors of illnesses: disturbing the balance of the four humors of the body \- external causes: poor nutrition, sudden change in ambient temperature, polluted air and water, unhealthy housing, soil impurity, parasites, professional activity -not all organisms react the same way. **Two clinical signs** described by Hippocrates remained valid to the present day: \- [Hippocratic fingers] = clubbing of the fingers (the ends of the fingers are enlarged and the nails are sloping down) \- [Hippocratic facies] (the nose is pinched, the eyes are sunken, the ears are cold and, the skin of the forehead tense and dry, the lips pendent and cold) Hippocrates described the following illnesses: \- pneumonia \- pleurisy \- stroke. C\) The Alexandrian period At that time, there were done: - the first dissections on corpses - the first dissections on convicts - the difference between tendons, nerves and blood vessels. However, anatomy had **not** yet a scientific character. **HEROPHILOS of Chalcedon** (335 B. C. -- 280 B. C.) He is regarded one of the first anatomists of the antic world. Herophilos was the first scientist to perform systematically dissections of human cadavers. He made numerous anatomical descriptions: - many nerves - the differentiation between cranial and spinal nerves - the vascularization of the meningeal, named in his honor "the Herophilus\'s press\" - the cerebral ventricles, especially the IVth ventricle - the eye - the pancreas -- he was the first physician to give this name - the duodenum - the first physician to give this name - some glands. Herophilos was the first to differentiate between the cerebrum and the cerebellum. **ERASISTRATES from Cos** (304 B. C. -- 250 B. C.) - made the distinction between the main segments of the brain - described the valves of the heart - described the connections between arteries and veins - observed the chyle\'s vessels on sacrificial goats shortly after eating **Anatomy in Roman Empire** Beginning in the 1st century AD, civilization -- including medicine -- passed from Egypt and Greece to Italy. The leading representatives were Celsus and Galen. **GALEN** of Pergamon (129 - 201 A. D.) - famous Greek physician of different emperors (e. g. Marcus Aurelius) - at the beginning of his career, Galen was physician of gladiator in his native town - he reawakened interest in Hippocratic medicine - Galen was author of 43 books on medicine, of which two of anatomy - described: long and short bones (with all their reliefs) - introduced new terms: apophysis, epiphysis and condyle - sectioned the spinal cord at different levels to observe the distribution of the spinal nerves \- described - the spinal origin and nerve distribution cranial \- thesympathetic nervous system \- thesense organs \- the structure of the heart related to the function. \- described and named the muscles: buccinator, small pectoral and popliteal \- described: - the anatomical structures of some arteries and veins \- the arterial-venous anastomoses \- descriptions of anomalies (by dissection in animals) - bicorn uterus \- double bladder **- nearly 1400 years all his descriptions were considered dogmas (including incorrect descriptions).** Galen also had contributions in internal medicine,in surgery, in pharmacy etc. [The consequences of abandoning dissection]s: - anatomy in Europe has been stopped evolving for approx.1300 years, until Renaissance. - physiology could not be constituted as a science - pathology has stagnated - the development of anatomy knowledge was done only by some Arab important physicians in the Middle Ages **ANTOMY IN MIDDLE AGES** **^IN\ MEDIEVAL\ WESTERN\ EUROPE^** **GARIOPONTUS (11th century)** \- he was a professor at the Medical School of Salerno \- Latinized many Greek and Arabic anatomical names (orientation that is maintained today) **MONDINO DEI LUZZI (14^th^ century)** - he was an anatomist and surgeon - performed public dissections at Faculty of Medicine from Bologna in 1315 - wrote an anatomy book, which was a compilation of specialized books since then **^THE\ ANATOMY\ OF\ THE\ RENAISSANCE^** **LEONARDO DA VINCI (1452 - 1519)** ~-\ he\ was\ not\ a\ physician;\ he\ was\ famous\ painter,\ sculptor,\ architect,\ scientist,\ engineer\ =\ a\ polymath~ \- he did 30 autopsies and many anatomical molds -- e. g. injected wax in the cerebral ventricles - Da Vinci realized 750 anatomical sketches and 1500 drawings, which he was preparing for an anatomy treatise, which he had begun to write in collaboration with the anatomist Marc Antonio della Torre (1481-1511). - Della Torre\'s death stopped the completion of the book. The results of Da Vinci\'s studies were recorded in the form of notebooks. Theywere published much later, only at the beginning of the twentieth century. **Albrect DÜRER** (1471 - 1528) - he was a prestigious German, who wrote the first \"Treaty of plastic anatomy for painters ", in which he presented the proportions human body (the book has become the basic landmark for painters and sculptors). **MICHELANGELO Buonarroti (1475 -- 1564)** briliant Italian sculptor and painter; he was also architect, engineer and poet \- he performed dissections in his house from Florence; he also made dissections in association with Marc-Antonio Della Torre and Realdo Colombo \- he made some anatomical drawings **Andreas VESAL (VESALIUS) (1514 - 1564)** **-- the founder of modern anatomy** \- as a child, he made some „dissections" of rabbits and ducks \- Professor of Anatomy in Padua (1537) \- his method = comparative anatomy \- wrote: \"Tabulaeanatomicae\" (1538) „ De humaniCorporisFabrica\" (1542) - 7 volumes - illustrations of St.Calcar (Titian\'s pupil) - listed 200 mistakes of Galen made in anatomy - descriptions of Vesal: heart, veins, internal and external ear, mesentery, mediastinum, arytenoid cartilage arytenoid (larynx), sternum, sacrum bone etc. - gave a new explanation for the curvature of the femur and humerus - studied the internal organs (e.g. spleen) - he made some anatomical mistakes: - - - The anatomical conceptions of Vesal: - a\) the anatomy is rational - b\) the structure correlates with the function - c\) the \"wisdom of the divine force\" that created the morphology - Vesal made **the first anatomical preparation in the world** in 1543 = a skeleton which was donated to the University of Basel - Vesal was sentenced to burn at the request of the Catholic Church, accused of autopsying an agonist \- the sentence was commuted by the king to a pilgrimage to Jerusalem \- on his return to Europe, Vesal was shipwrecked on the island of Zakynthos, where he died of typhus. Vesal had very important pupils: **Mateo Realdo Colombo, Bartholomeo Eustachio,** **Gabriel Faloppio etc.** **Mateo Realdo COLOMBO (1516-1559)** - he was a professor of anatomy in Rome - described: peritoneal folds, mediastinum, etc. - his most important description was the pulmonary circulation (1559) - he wrote the book "De re anatomica" **Bartholomeo EUSTACHIO (1510-1574)** - he was a professor of anatomy at Rome - at the beginning of his career, he was disciple of Vesal, then he became his adversary - described: the inner ear tube, adrenal glands, optic nerve, thoracic duct etc. **Gabriel FALOPPIO (1524-1562)** - when he was very young, he was canon - then he left his career church and became anatomist - he followed Colombo as professor of anatomy at Padua - Fallopio described: the inner ear, the trigeminal nerve branches, the sphenoid etc. \- his most important discovering was the tubes that stretch from the ovaries to the uterus; it his honour this structure is name „the Fallopian tube\". **Miguel SERVET** (c. 1509-1553) \- he was physician, philosopher and theologian; hewasburned at thestake for heresy - \- discovered the pulmonary circulation of the blood **Girolamo Fabricius d'ACQUAPENDENTE (1537 - 1619)** - he was the founder of the first permanent anatomy amphitheater at the University from Padua (1583). There was a dissection table in the middle of the amphitheater - lifting its lid allowed the corpse to be brought, which was transported on a water channel to that place.