Anatomy

ANATOMY (from the Greek anatemno - I dissect), originally designated the knowledge that could be obtained by dissecting corpses; later, the immediate and primary task of anatomy came to be considered the study of the individual systems or mechanisms from the combination of which the human body is formed. All cultured nations of antiquity possessed some information not only about external forms, but also about the internal structure of the human body. The first anatomical work is attributed to Alcmaeon of Croton, a famous physician and philosopher of the 5th century. Hippocrates (460-377 BC), who set medicine on the path of experience, still had rather vague notions of anatomy and physiology, believing, for example, that the arteries contain air, that the brain represents a collection site for mucus, but already knew, however, diploe and sutures. A significant expansion of anatomical knowledge was facilitated by the works of Aristotle. Although Aristotle himself did not engage in human anatomy, his vast knowledge of the nature of animal organization and deep philosophical ideas had a tremendous influence on anatomical science and dominated it for nearly 2,000 years. After the fall of the monarchy of Alexander the Great, Alexandria (in Egypt) became the cultural center. In its medical schools, not only were corpses dissected, but also, as the eclectic Celsus, a contemporary of the first Roman emperor Augustus, testifies, vivisections were allegedly performed on criminals condemned to death. Among the prominent physicians of this period, Herophilus and Erasistratus can be noted. The duodenum, the meninges, their venous sinuses, heart valves, and lacteal vessels became known. - Over the long period of Roman rule, only one name of an outstanding researcher and philosopher must be noted, the Greek Claudius Galen, who lived in the 2nd century AD. Although he undoubtedly had occasions to dissect human

human corpses, but mainly worked on monkeys and dogs and transferred the data he obtained to man. Not content with describing the rich material he had collected, he created theories which, owing to the fascination and talent of their exposition and the almost complete impossibility of verifying them by experiment, shackled the development of anatomy for more than 1,000 years. "Our task," writes Galen in his main work [De usu partium, i.e., on the function of organs (he wrote several hundred works in Greek)], "is to explain the usefulness to man of each part of his body (organ-tool), the reason for its position, size, shape, etc." Political upheavals, the Christian teaching which attached no importance to earthly wisdom and even considered it sinful, and subsequently the teaching of the Quran which did not permit the dissection of corpses, completely barred the way to independent research, and among the Arabs, the bearers of the new culture, the matter was reduced to translating and reworking the writings of Greek physicians, as well as the teachings of Aristotle and Galen, supplied with mystical additions. Widely disseminated and even more distorted owing to the ignorance of translators and copyists, the writings of Arabian physicians (mainly Rhazes and Averroes) served in the Middle Ages as the sole basis of all medical science and anatomical knowledge. Medicine at that time, however, did not need a deeper knowledge of anatomy. With the emergence of universities first in Italy, and then in Spain, France, and Germany, in the thirteenth and fourteenth centuries, independent works began to appear, but very timid and modest ones. Brief information on how teaching was conducted and what means were available for this purpose is given below (anatomical theaters and anatomical atlases). Numerous physiological, or rather crudely teleological, discussions found in the course of lectures delivered at the beginning of the fourteenth century by Mondino (H. de Mondeville), physician-in-ordinary to the French king Philip the Fair, usually begin with the stereotyped phrase—"utilitas huius creationis est" (the meaning of such a structure). Thus, the skull is constructed of many bones so that the vapors rising from the brain can escape through the connections between them; the brain is cold and moist to moderate the heat and dryness of the heart, etc. L. Mundinus had similar views. The cult of Galen went so far that the famous Sylvius, who brilliantly lectured on anatomy in Paris (in the sixteenth century), corrected the anatomical nomenclature and enriched anatomy with many discoveries, upon encountering facts that did not correspond to Galen's description, believed that the human body had changed drastically over thirteen centuries. In 1543, the work of the great reformer in anatomy, Vesalius, De humani corporis fabrica (on the structure of the human body), was published in Basel, in which, alongside harsh and sometimes even not entirely fair criticism of Galenic anatomy, with a logicality and precision unusual for that time, the organs of the human body are described in systematic order. Among the opponents of Vesalius should be noted his teacher Sylvius and the last publisher of Mondino's anatomy, Dryander, driven by envy of the great man, as well as B. Eustachius, who pointed out the errors of Vesalius himself, whom he surpassed by more accurate and correct concepts and the numerous discoveries he made. Much was also done for anatomy by Vesalius's pupil Fallopius. The heated polemic provoked by Vesalius prompted a turn to independent research, and discoveries rapidly followed one another. It is difficult in a brief account to mention all the outstanding researchers who laid a firm foundation for anatomy on firmly established facts; the names of many of them are known from anatomical terms. Although the needs of medicine, so to speak, set the tone for anatomical research, the narrowly utilitarian trend in anatomy gradually ceased to be sufficient. The dissection of animals ceased to be an addition to the insufficient number of human corpse dissections and was already carried out under the influence of the ever-growing need to clarify the essence of the organization of the animal body, the way it arises, and to solve physiological problems. The discovery of blood circulation by W. Harvey in 1628 and his embryological works, where he opposed Aristotle's doctrine of spontaneous generation ("omne vivum ex ovo"), also led to new research and called to life much that had been forgotten since the time of Galen. The lacteal and lymphatic vessels were described. M. Malpighi (1628–1694) is justly considered the creator of microscopic anatomy; he succeeded in demonstrating the movement of blood in the capillary system and made numerous discoveries in almost all fields of microscopic anatomy. The most brilliant representative of the physiological trend in anatomy is A. Haller (1708–1777). In 1760, the work of the St. Petersburg academician C. F. Wolff, Theoria generationis (theory of generation), appeared, in which the author proved that during the development of the chicken, a series of successive transformations and new formations (epigenesis) takes place. Subsequent scientists were no longer content with the study of individual natural-historical facts and sought to determine the general laws of the development of the organic world—biology arose, with which the scientific anatomy of man became inextricably linked. Great discoveries in the field of comparative anatomy and, later, paleontology, together with Darwin's theory, led to the dominance in anatomy of the morphological, genetic method, a brilliant representative of which was C. Gegenbaur (1826–1903), professor at the University of Heidelberg. Until approximately the end of the eighteenth century, anatomists studied not only the normal structure of the human body, but also its functions (physiology) and changes in its organs caused by disease (pathological anatomy). From the beginning of the nineteenth century, both physiology and pathological anatomy gradually began to move away from normal or systematic anatomy and little by little turned into independent branches of knowledge. The most famous anatomists of the first half of the nineteenth century still continued to be physiologists, for example, Charles Bell (1774–1842), Johannes Müller (1801–1858), Henle (1809–1885), Ernst Heinrich Weber (1795–1878) and Eduard Friedrich Weber (1806–1871), etc. The anatomy textbook by Joseph Hyrtl (1810–1894), which the older generation of contemporary Russian doctors studied from, was titled: Manual of the Anatomy of the Human Body with Indications of its Physiological Foundations and Practical Applications. Pure cadaveric anatomy was created approximately in the middle of the nineteenth century. Torn away from the living subject, anatomy lost much of its former vital interest and plunged, in the person of some of its representatives, into the detailed study of dead material; it became, literally, descriptive anatomy. This boring era of meticulous descriptions filled, predominantly, the second half of the nineteenth century and in some places continues to the present day. But alongside such a purely descriptive bias in anatomy, from the same middle of the nineteenth century, the evolutionary theory began to develop intensively, and along with it those branches of knowledge from which it drew its material—zoology, comparative anatomy, embryology, comparative physiology, paleontology, anthropology, teratology, etc. New ideas began to penetrate the field of descriptive anatomy of man and, ultimately, dramatically changed its character, returning anatomy once again to the direct resolution of the questions of life. Thus, the end of the nineteenth century can be considered the beginning of a new anatomical era. Modern human anatomy not only seeks to acquaint one with the position, structure, and shape of the various systems and organs of the human body, but also attempts to explain why they have such a structure, position, and shape. In other words, modern anatomy must answer not only the question how, but also the question why. At the present time, it is essentially only one of the chapters of animal morphology. Human anatomy must directly serve the disclosure of general biological laws. As one of the brilliant representatives of this trend, one can point to the English anatomist Prof. Keith. Thanks to his two popular works translated into Russian (The Human Body and The Engines of the Human Body), his name should be well known. Among his special works, his Human Embryology and Morphology and The Antiquity of Man are particularly famous. A representative of the same trend in England is Prof. Wood Jones. His most famous works are The Principles of Anatomy as Seen in the Hand and Arboreal Man. However, even in the very heyday of "descriptive anatomy," i.e., in the period of the dominance of dry description of forms, there were always authors who, from the study of particular anatomical facts, attempted to ascend to the general laws of human organization. This kind of trend at the end of the nineteenth and beginning of the twentieth centuries was called philosophical anatomy, general anatomy, theoretical anatomy. A prominent representative of this trend in Russia was P. Lesgaft (1837–1909).

He compiled an excellent two-volume guide entitled Fundamentals of Theoretical Anatomy, Part 1 (1905) and Part 2 (1909–1922). In the preface to this guide, Lesgaft wrote: "The assimilation of the basic idea of the structure of the human body and the elucidation of its forms on the basis of this idea constitutes the subject of theoretical anatomy," and further: "Without a philosophy of the subject there is no science, no elucidation of the connection between form and function. It is necessary to learn to read the functions associated with them from the forms. In the study of anatomy, the main object should always be the living organism, from observations of which every study must proceed; the dead preparation should serve only as a verification and supplement to the living organism being studied." It goes without saying that applied anatomy, like systematic anatomy, must first of all be the anatomy of the living human body. Applied anatomy consists of: 1) plastic anatomy, or the anatomy of forms, 2) topographical anatomy, or the anatomy of the mutual relations of various parts and organs of the human body, and 3) clinical anatomy, which connects the data of systematic anatomy with the clinic. Plastic anatomy is also called artistic anatomy. It is equally necessary for physicians and artists. Through the study of the skeleton and the dissection of corpses, plastic anatomy obtains the basis for understanding the external forms of the human body, not only in its resting state, but also at various moments of its activity. The doctrine of body types, laws of growth, correlation of parts, etc., also belongs here, to the anatomy of forms. Topographical anatomy has hitherto been predominantly associated with operative surgery, but for the therapist it is no less important than for the surgeon. Clinical anatomy must note the important role that anatomical data play in the origin and development of diseases and injuries of the body. The diagnosis of surgical, nervous, eye, ear, and other diseases is based to a large extent on clinical anatomy, and the modern doctrine of pathways has emerged almost entirely from the depths of clinical anatomy. Recently, even psychiatry has been trying to place various forms of the human body in a more or less close connection with mental deviations and diseases. Anatomical methodology. Initially, only simple dissection of cavities was performed, then the art of dissection began to develop. For better visualization of blood vessels and the establishment of their anastomotic connections, vessels began to be filled with solidifying fluids, mostly brightly colored. Swammerdam (1637–1680) was the first to use injection with solidifying masses; this technique was perfected to a high degree by Ruysch (1638–1731). To obtain exact casts of very small vessels of any organ, these vessels were injected with one or another solidifying mass, extremely resistant to the dissolving action of alkalis or acids; when the injection mass solidified, the organ was immersed in a corresponding alkali or acid to destroy the tissues of both the organ itself and the vascular walls, while the injection mass remained unchanged. To facilitate the dissection of nervous tissue, various methods of its hardening and staining and various methods of destroying the tissue surrounding the nerves were used, for example, the use of acetic acid. To preserve as much as possible the shape and interrelation of organs, the corpse also began to be treated with corresponding hardening substances. Methods of colored injections for the lymphatic system were developed (Gerota, 1896). Finally, methods of tissue preservation, even with the preservation of their normal coloration, were developed (Melnikov-Razvedenkov, 1896). To study anatomy in the living human, X-rays as well as experiments on animals began to be widely used. Many anatomical questions were resolved through observations of patients and persons living in various conditions of geographical and social environment. The data of comparative anatomy, embryology, and paleontology were also widely used by anatomists. Until the very last time, anatomy in Russia was developed almost exclusively in universities and only in very rare cases by hospital prosectors. In 1867, the 1st Congress of Russian Naturalists was convened, later taking the name "Congress of Russian Naturalists and Physicians"; the congress had a section of anatomy. Anatomical questions were also discussed at the Pirogov congresses, where there was a special section of "histology, embryology, anatomy, and anthropology." Anatomical questions were also raised at congresses of physicians dedicated to one or another specialty. In 1922, the First All-Russian Congress of Zoologists, Anatomists, and Histologists took place in Petrograd. 30 reports were made at the section of anatomy. The second congress took place in Moscow in 1925, and the section of anatomy was subdivided into 2 subsections: 1) anatomy and 2) anthropology. 69 reports were made at the anatomy subsection, and 21 reports at the anthropology subsection. There is no special journal dedicated to questions of anatomy in the USSR. Anatomical works are published in the Russian Archive of Anatomy, Histology, and Embryology, in the Russian Anthropological Journal, in the Bulletin of the Society of Naturalists, and in the general medical press. Many Russian works dedicated to questions of anatomy were and are published in foreign journals.