Anatomy Theaters and Anatomy Teaching
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The teaching of anatomy through dissection had its roots in the medieval university. Early manuscripts from Salerno in the twelfth century included dissection manuals written to explain the dissection of a pig for teaching anatomy (Corner 1927), and human cadavers were certainly dissected for teaching purposes in the medical school at Bologna by the early fourteenth century as evidence by the dissection manual of Mondino de’ Liuzzi, a member of the medical faculty there (Singer 1925). Anatomical demonstrations involving dissection were codified into university statutes in Italy in the fifteenth century, and by the sixteenth century, anatomy had become an important subject, and the demonstrations grew in prominence. The first permanent anatomy theaters were not built until second half of the century, however, and they served a variety of purposes in addition to being venues for anatomical demonstrations. By the seventeenth century, anatomical demonstrations also occurred outside medical schools in a variety of spaces and before a variety of audiences.
The Anatomical Demonstration
Anatomy did not take a formal place in the university curriculum until later in the sixteenth century. Earlier than that, rather than prescribe lectures on anatomy in the normal rotation of the curriculum and appoint chairs of anatomy to teach it, an annual anatomy lesson, a demonstration employing dissection of a human body, was used to teach the students. Despite this unique approach, anatomy was an important subject that permeated the concepts of medical theory and practice, not to mention surgery and even natural philosophy (Grendler 2002).
The anatomical demonstration followed a specific order first established by Mondino and in place well into the sixteenth century. This order accommodated the decay of the body by beginning with the parts that were corrupted first and then proceeding to other organs. As Mondino described it, the body was divided into three sections, often referred to as venters or bellies. The first, and lowest, venter included the organs in the lower abdomen as well as the organs of generation. After the layers of the skin and muscle covering the abdomen were described and removed, the demonstration proceeded to the intestines, mesentery, stomach, spleen, liver, gall bladder, kidneys, sex organs, and bladder. The second venter involved the heart, and lungs came next, and the third and the last focused on the skull and the brain. Overall, the demonstration focused largely on the internal organs, neglecting the bones, muscles, and other systems of the body like nerves, at least before the middle of the sixteenth century, largely because, as Mondino noted, there were practical constraints associated in viewing those parts in a whole corpse (Singer 1925). By the sixteenth century, the corpse was augmented by sketches made by the demonstrator, images from anatomical texts, skeletons, and a variety of animal bodies (that were both dissected and vivisected) in order to expand the range of topics that could be covered (Shotwell 2015).
Early anatomical demonstrations officially involved three separate actors – one member of the medical faculty who lectured, using Mondino’s text as his source, a second member who demonstrated the lecture by pointing at the parts removed from the corpse, and a third person who did the actual dissection. The person performing the dissection could be either one of the lecturers in surgery or a hired surgeon if the officials felt the lecturer was not appropriately skilled in the work. Throughout Europe, anatomical demonstrations were conducted in temporary structures, generally built for the occasion and then removed, until relatively late in the sixteenth century (Ferrari 1987; Carlino 1999). It is important to note that there was room for variation in this process from very early in its history, much of it driven by the practices at individual universities, and that by the sixteenth century, these three roles were often significantly altered or eliminated (Kibre 1953; O’Malley 1959). For example, in 1540 in Bologna, Vesalius both dissected and lectured as he did so, while Matteo Corti provided lectures in a separate space and at different times (Heseler 1959).
By the fifteenth century, anatomical demonstrations had become popular events of interest to a wide variety of people, not just medical students. Fifteenth-century statutes at Bologna focused primarily on crowd control, limiting the size and composition of the audience and specifying that the bodies dissected should be of executed criminals who were not from Bologna (Ferrari 1987). In the second half of the fifteenth century, anatomical demonstrations were also attracting the interest of important personages. For example, in Bologna, Hieronymo Manfredi indicated that he had written his work on anatomy at the behest of his dedicatee, Giovanni Bentivoglio ruler of Bologna, who had attended a demonstration (Singer 1917), and in Venice Alessandro Benedetti expressed the hope that his dedicatee, the Emperor Maximilian I, would be able to attend a public dissection along with several other dignitaries (Ferrari 1987).
Despite the efforts at controlling the anatomical demonstration, the audiences, at least in Bologna, continued to be unruly well into the sixteenth century. When Andreas Vesalius performed a dissection at Bologna in 1540, the students were frequently disruptive, disconcerting Vesalius so that he had trouble focusing on his remarks, jostling each other, shouting, and sometimes behaving so badly that they were asked to leave and come back in a few at a time. The faculty also argued and stormed out over disputed points (Heseler 1959). An important motivation for building permanent anatomical theaters at the end of the sixteenth century was the desire to impose decorum on these audiences and instill respect for the demonstrator by establishing the proper atmosphere (Klestinec 2004; Klestinec 2011).
In Italy, permanent anatomy theaters were constructed in Ferrara in 1551, Pavia in 1552, Pisa in 1569, Padua in 1594, and Bologna in 1595 (Ferrari 1987). In Spain theaters were built in Salamanca in 1554, in Barcelona (a location in a hospital set aside for demonstrations) in 1573, and in Zaragoza in 1586 (Skaarup 2015). In France theaters appeared in Montpelier in the 1550s but not in Paris until 1617, and permanent theaters continued to be built throughout Europe in the seventeenth century including in Leiden and in Copenhagen in the earliest decades of the century (Guerrini 2015; Bartholin 2015).
Some early anatomical theaters are still standing, and others have been reconstructed or rebuilt. We also have detailed information about some of the theaters, including inventories and building plans. Theater design varied but typically involved a central dissection table surrounded by tiered seating, often in an oval or circular pattern, with a general effect similar to what we would think of as a theater today. In addition to the viewing area, space was also often available for preparing the bodies prior to their appearance before an audience. Anatomical theaters often acted as museums as well as theaters, housing collections of body parts, skeletons, rare and exotic plants, animal skins and bones, wax models, minerals and other curiosities, and artifacts (Skaarup 2015; Bartholin 2015; Klestinec 2011).
The teaching of anatomy by dissection was not limited to the anatomical demonstration, whether in permanent theaters or temporary structures. References to students learning by dissecting pigs themselves under the guidance of teachers date from very early in the sixteenth century (Schullian 1952; Berengario 1959). Students and medical faculty also had a chance to dissect the bodies of the deceased in hospital settings (Klestinec 2011), and a certain amount of grave robbing was always a part of medical student life (Jennett 1962).
Public demonstrations of anatomy also took place outside the context of university medical schools and for reasons other than teaching medical students. In Paris, for example, the medical faculty taught the local surgeons, who were not students at the university, through anatomical demonstration in the sixteenth century, and demonstrations were held in Venice for similar purposes. By the seventeenth century, anatomical demonstrations were also given in the Jardin du Roi in Paris which was geographically and administratively outside of the purview of the medical faculty (Guerrini 2015). In Leiden in the seventeenth century, student disputations, dissections, and experiments combined in a rich mixture of investigations into anatomy and physiology that went beyond simple didactic purposes (Ragland 2017).
The history of early modern teaching of anatomy and of anatomical theaters has been interpreted from various perspectives including the history of science and medicine, art history, literary theory, and philosophy. Some historians have focused on the development of modern investigative principles evidenced by the changing nature of the anatomical demonstration, especially in the work of Vesalius who they see as breaking free from a long-standing, didactic role of dissection found in anatomical demonstration and investigating the body to question ancient, textual authority instead (O’Malley 1964). Others have focused on the theatrical nature of the demonstrations which coincided with carnival and attracted dignitaries as well as medical students and their teachers (Ferrari 1987). Illustrations of anatomical dissections, found mainly in printed works on anatomy, have also proven fruitful subjects of analysis especially in tracing the changing perception of dissection (Carlino 1999; Bylebyl 1990). The public display of a body violently severed into pieces has led to a narrative of the development of modern science overcoming a natural distaste for human dissection and the taboos associated with it (Sawday 1995). The existence of such distaste and taboos has been disputed (Park 1994). Gender has also played an important role in the history of anatomical dissections since women’s bodies were an important aspect of anatomical demonstrations (Park 2006). It has also been argued that the anatomical theaters, like the one at Padua, were intended to bolster the authority the medical faculty and quell student distaste for new approaches to studying the body (Klestinec 2011). Finally, the role of teaching anatomy in the development of Vesalius’s understanding of the body has been analyzed using different sources (Shotwell 2015; Nutton 2017). The range of topics and perspectives related to anatomical teaching and anatomy theaters is an indication of their importance for both modern scholars and in the early modern context.
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