Find below a fantastic essay, a runner-up, of the Anatomy Blog Competition, detailing the importance of human cadaveric dissection, written by Sheveen Wijesuriya.
“I strive that in public dissection the students do as much as possible so that if even the least trained of them must dissect a cadaver before a group of spectators, he will be able to perform it accurately with his own hands; and by comparing their studies one with another they will properly understand, this part of medicine.” - Andreas Vesalius from “De Humani Corporis Fabrica”
Introduction
Anatomy is the oldest of the medical sciences [1]. There has been a plethora of anatomical discoveries which have been noted over many years. To define one as the most “significant” could look at factors such as its longevity and use in the future, impact on the patient population and its versatility in terms of its uses. While any of the structures within the human body could be argued for, it is worth highlighting an integral process that allows them to be studied in the first place – human cadaveric dissection.
Origins – Human Cadaveric Dissection
Human cadaveric dissection provided the gateway to studying and understanding the importance of anatomy from its key implementation in 3rd century BC in ancient Greece [2]. Anatomy itself derived from the Greek verb “anatomein” which means to “to cut up, to dissect” - this demonstrating the fundamental link dissection has [3]. It was thought to be first used by Herophilus and Erasistratus, famous anatomical teachers in Egypt [4].
Significant contributions
There have been many occasions in which human cadaveric dissections have been crucial over the course of history.
Andreas Vesalius
One important instance was the correction of Galen’s work by Andreas Vesalius. Galen’s works had mentioned concepts such as the liver producing blood that were not conclusively backed up with evidence at the time [5]. In addition, Galen had been restricted to using Barbery apes as it was forbidden to perform human dissection by the Church [6]. Vesalius was able to correct these errors through human cadaveric dissection, ultimately leading to him publishing his work “De Humani Corporis Fabrica” in 1543 [7]. This is important as Galen’s teachings had been an unanimous staple of the medical curriculum and to dispute it would have been seen in an unfavourable light. As a consequence, a change like this not only facilitated redirection to greater accuracy but also enhanced curiosity, which led to further development in the field of anatomy. Furthermore, Vesalius introduced a more hands-on approach to dissection in contrast to just observation alone. This in turn fostered the students’ inquisitiveness and independence through them actively being involved, therefore solidifying their understanding of the subject.
Leonardo da Vinci
Outside of academics, human cadaveric dissection has had a key role to play in the general population, such as through art. This can be seen by the works of Leonardo da Vinci. He is renowned as one of the most notable artists in history, with a proclivity for anatomy. Many of his pieces were created with the aid of human cadaveric dissection, that he himself carried out. An example of this can be seen in Figure 1, where da Vinci was able to capture the intrauterine position of the foetus [8]. This sparked further curiosity in anatomy in the population as they could see that a notable artist was directly using human cadaveric dissection and its effects in his works, thus contributing to dissection being used as a tool in the future.
Figure 1 Foetus in utero (Perloff, J.K., 2013)
It is worth noting that a vital issue arising from dissections was the lack of preservatives to maintain the body for long periods of time after death. In current times, the method of preservation commonly used is embalming through formaldehyde [9]. As a result of a lack of preservatives, bodies would degrade very quickly and thus wouldn’t be able to be used in order to discern anatomical structures. Da Vinci was able to counter this by using his natural ability of visual recall and precise observation such as when he portrayed the complex and swift movements of a bird, thus transferring these skills to accurately portray various anatomical structures observed [10].
Qualities outside of academic knowledge
Alongside the wealth of academic knowledge that is provided, human cadaveric dissection has benefits that extend to society and our general behaviours in everyday life.
A key quality developed through the use of human cadaveric dissection is respect. This is essential especially for healthcare professionals interacting with patients, given that maintaining patient comfort and safety is paramount . It also applies to how you treat others in society and generally being a good person, as this is how harmony, effective communication and efficient teamworking is maintained.
Respect of the human body is something that was emphasised by da Vinci when he performed dissections for his artwork. It is always worth remembering to be grateful to those who selflessly donated their bodies for educational purposes. This gratitude naturally carries into medical practice when interacting with patients, as patients trust doctors, and share sensitive information about themselves that they would not otherwise do.
Another characteristic that is brought to the forefront of dissections is independence. Students are able to carefully think through each of their mental steps for the dissection, and have a reasoning behind each of them, with minimal prompts. As a result, this can lead to more initiative being taken, as well as students gaining more confidence in their abilities, without hesitation hanging over their heads.
Criticisms
In spite of the many positive factors arising from human cadaveric dissection, there are a few questions that arise as to whether it is the most significant anatomical discovery.
One question is surrounding the morals and ethical dilemmas associated with how cadavers were obtained. There were instances in which grave robbing and body snatching were utilised in order to obtain enough bodies for dissection. An example of this is Native American graves being robbed by nineteenth‐century anthropologists for osteological collections [11]. This certainly raises concerns about the lack of respect to the bodies that were used. Despite this, there has been a progression in attitude to show more respect to the cadavers and to show gratitude for our use in learning, which has led to students saying that it increases their respect for human life [12].
Another criticism which may arise is how not every student may reap the benefits of dissections due to poor experiences. These poor experiences may be brought about due to the pungent odour and even fainting. Despite this, as shown in Table 1, a longitudinal study conducted looking at medical students’ thoughts about dissection during their sessions at 3 different points in time suggested that students’ thoughts on associated negative aspects of dissection diminished over the course of multiple sessions [13]. In addition, their enthusiasm and excitement appeared to increase through these sessions, thus suggesting human cadaveric dissection had a very significant role as an effective and engaging method of learning anatomy.
Conclusion
Overall, defining the most significant anatomical discovery can look at a multitude of areas it has impacts on. Consequently, there is great subjectivity as each area can have a varying level of importance to different people. However, human cadaveric dissection provides the common link between these different views given that it has allowed the initial steps into future anatomical discoveries by paving the way for a more thorough understanding of the human body. It provided the catalyst for anatomical discoveries in the past, it is currently essential as a learning tool and it will continue to be instrumental in the future for anatomists, surgeons, physicians, students and society alike.
Cover picture taken from Unsplash
References
[1] Shin, E.K. and Meals, R.A. (2005) “The historical importance of the hand in advancing the study of human anatomy,” The Journal of Hand Surgery, 30(2), pp. 209–221. Available at: https://doi.org/10.1016/j.jhsa.2004.09.004.
[2] Ghosh, S.K. (2015) “Human cadaveric dissection: A historical account from Ancient Greece to the modern era,” Anatomy & Cell Biology, 48(3), p. 153. Available at: https://doi.org/10.5115/acb.2015.48.3.153.
[3] The history of anatomy - from the beginnings to the 20th century (2018) Körperwelten. Available at: https://bodyworlds.com/about/history-of-anatomy/ (Accessed: February 26, 2023).
[4] Siddiquey, A.S., Husain, S.S. and Laila, S.Z.H., 2009. History of anatomy. Bangladesh Journal of Anatomy, 7(1), pp.1-3.
[5] AIRD, W.C. (2011) “Discovery of the cardiovascular system: From Galen to William Harvey,” Journal of Thrombosis and Haemostasis, 9, pp. 118–129. Available at: https://doi.org/10.1111/j.1538-7836.2011.04312.x.
[6] Cosans, C.E. (1998) “The Experimental Foundations of galen's teleology,” Studies in History and Philosophy of Science Part A, 29(1), pp. 63–80. Available at: https://doi.org/10.1016/s0039-3681(96)00005-2.
[7] Barr, J. (2015) “The anatomist Andreas Vesalius at 500 Years Old,” Journal of Vascular Surgery, 61(5), pp. 1370–1374. Available at: https://doi.org/10.1016/j.jvs.2014.11.080.
[8] Perloff, J.K. (2013) “Human dissection and the science and art of Leonardo da Vinci,” The American Journal of Cardiology, 111(5), pp. 775–777. Available at: https://doi.org/10.1016/j.amjcard.2012.12.031.
[9] Whitehead, M.C. and Savoia, M.C. (2007) “Evaluation of methods to reduce formaldehyde levels of cadavers in the dissection laboratory,” Clinical Anatomy, 21(1), pp. 75–81. Available at: https://doi.org/10.1002/ca.20567.
[10] Capra, F., 2008. The science of Leonardo: Inside the mind of the great genius of the Renaissance. Anchor.
[11] Highet, M.J. (2005) “Body snatching & grave robbing: Bodies for science,” History and Anthropology, 16(4), pp. 415–440. Available at: https://doi.org/10.1080/02757200500390981.
[12] Mafinejad, M.K. et al. (2021) “Teaching professionalism in cadaver dissection: Medical students' perspective,” Journal of Medical Ethics and History of Medicine [Preprint]. Available at: https://doi.org/10.18502/jmehm.v14i7.6751.
[13] Mulu, A. and Tegabu, D. (2012). Medical students’ attitudinal changes towards cadaver dissection: a longitudinal study. Ethiopian journal of health sciences, 22(1), pp.51-58.