Anatomy ( Ana - apart; tomy - to cut) and Physiology ( Physio – nature; ology - the study of)

1. Anatomy (Ana- apart; tomy- to cut) and Physiology (Physio – nature; ology- the study of) Man’s measure of man; advances in medicine through the Renaissance Academic decathlon, 2005

2. Schools of thought in medicine • Homeric and mythical (pre-460 BC) • Apollo (Greek god of medicine); Ascelpius’ cult • First medical schools: Cyrene, Crotona, Cnidus, & Cos • Hippocratic (BC 460 – 50) • Corpus Hippocraticum, significant speculation concerning causes, Humoral pathology (blood, mucus, black and yellow gall) • Dogmatic (BC 460 – 50) • Connection of symptom and disease; teleological arguments (objects have properties by design) • Alexandrian (BC ~300) • Clinical experience by exact methods, opposed four fundamental humors, as disease in solid parts • Methodizers (~BC 120 – 700 AD) • Disease is caused by a blockage of pores in the body, that permeate all regions and produce sensation and function Academic decathlon, 2005

3. The Early Anatomists • Hippocrates (actually 7 people, the 2nd is famous) • “Father” of western medicine (Born at Cos) • Illness had a natural cause • First to use observation of symptoms for clinical diagnosis; “observe patients” • No dissection • Used diet to counteract disease • Aristotle (dogmatic) • “Father” of comparative anatomy • “Father” of embryology • Distinguished nerves from tendons • Pre-formation theory • Herophilus (BC ~ 300, Alexandrian) • Structure and function of organs • “Father” of neuroscience • Erasistratus (BC 330 – 240, Alexandrian) • First to map cardiovascular system • Extensive mapping of the brain • Differentiated cerebrum from cerebellum Academic decathlon, 2005

4. Methodizers: Ancient Roman medicine • Disease is a contraction or relaxation of pores which allowed fine atoms to pass sensation to parts of the body • Galen (c. AD 129 - 201) • De usu partium (On the usefulness of the body parts) • Doctor to gladiators • Dissected animals, not humans • Laid groundwork for physiological connections to anatomical design • Diaphragm in respiration • Clinical observation was key to diagnosis • His texts were the basis of western medicine for 1500 years • Not challenged until Vesalius, Paracelsus, and Harvey (1550-1630’s) Academic decathlon, 2005

5. Medicine in the Middle Ages • Ibn Sina (a.k.a. Avicenna, 980-1037 AD) • The cannon of medicine • Medical standard text until the mid-1600’s Significant advances in pharmacology • Compilation of Greek, Roman, & Persian medical knowledge; information critical to survival of knowledge through the Dark ages in Europe Academic decathlon, 2005

6. Development of Medical knowledge • Byzantine • No advances, but saved ancient Greek texts of historical value • Arabian (AD 431 - ~750 - 1200) • Significant increases in pharmacology, saved Greek and Alexandrian anatomy • Establishment of western medical schools by Charlemagne (768-814) • Scholastic (1200 – present) • Establishment of School of Salerno (600 – 1100), Fall of Moors in Spain (1085) allowed rise of Univ. Bologna (~1200), Univ. Padua (1222), Univ. Montpellier (~1200). Rise of surgery and dissection of cadavers. First since Greece (Cos) and Alexandrian school. • Pneumonic Plague (1346 – 1353) • Epidemic: 25 million killed in Europe (100,000 Franciscan monks) • Humanism (1500) • Fall of Methodizer doctrine; challenge of Galen and Arabic methodology and conclusions • Use of empirical evidence and critical evaluation for inductive reasoning for underlying causes of symptoms Academic decathlon, 2005

7. Medical texts and information (700 – 1500) • The information contained within medical texts often lacked a significant amount of detail For example, diagrams within 15th century medical texts, based on the works of Galen and Ibn Sina, indicated a paucity of anatomical understanding… Academic decathlon, 2005

8. Galenic blood flow and the cardiovascular system • Three body centers: • Liver (nutrition and growth) • Heart (vitality) • Brain (sensation and reason) • Two types of blood • Venous • Nourishment from blood produced in the liver • Arterial • Vitality from blood produced in the heart • Contained “pnuema” (spirituous air) that fed the body, it does not return to the heart (no circulation) • Heart does not drive blood: diastole (dilation) sucked blood into the heart. Blood movement by “pulsative faculty” within arteries Academic decathlon, 2005

9. Galenic blood flow • Blood from right to left side via invisible channels (pores) in the interventricular septum • Blood then “changed” from venous to arterial • Only enough blood to nourish lungs leaves right side of heart • If air is necessary to make arterial blood, how did air get to the heart? • Pulmonary vein conveyed air from the lung to the left side of the heart. • Mix of pneuma and blood in ventricle (bright versus dark red blood) • By product “sooty vapors” that travel to the lungs via same pulmonary vein, and are expelled Academic decathlon, 2005

10. Anatomy in the Renaissance • Leonardo da Vinci (1442 – 1519) • Use of artists to display and represent the human form • Scale and perspective Academic decathlon, 2005

11. da Vinci’s sketches of the human form Academic decathlon, 2005

12. da Vinci’s sketches of the human form Academic decathlon, 2005

13. da Vinci’s sketches of the human form • Dramatic increases in accuracy Academic decathlon, 2005

14. Sculpture and perfection in display of the human form Michelangelo Buonarroti (1457 – 1564) Sculpture added three dimensionality to the study of anatomy & muscle sketches found in 1495 Academic decathlon, 2005

15. Influence of Renaissance artists .. • Albrecht Durer (1471 – 1528) There was a need for perspective and scale in the development of accurate anatomical plates Academic decathlon, 2005

16. Andreas Vesalius (1514-1564) • Founder of modern anatomy • Significant advances in surgery • Extensive diagrams & use of technology (printing press) 1543: De Humani Corporis Fabrica (On the Fabric of the Human Body) Academic decathlon, 2005

17. Andreas Vesalius (1514-1564) • De Humani Corporis Fabrica • Second edition contained specific corrections: Septum of the heart for blood flow Connections of the cardiovascular system Dispelled venesection (blood-letting) • The systemic, rational approach to solving medical problems using careful observation and critical thinking. Academic decathlon, 2005

18. Role of institutions • Students of Vesalius • Michael Servetus (1511) • Pulmonary circulation and interventricular septum; burned at the stake for heresy by John Calvin in 1553 • Realdo Columbus • Coined “circulation” and linked respiration to blood (1559), pulmonary circulation Academic decathlon, 2005

19. Anatomy in the 16th century • Study of specific structures and systems in the body & technology (microscopes) • Hieronymus Fabricius (valves and circulation) • Gabriello Fallopio (reproductive system, hearing) • Bartolomeo Eustacius (sensory systems) Academic decathlon, 2005

20. Advances in surgery • Ambroise Pare (1510 – 1590) • Field surgeon in Italy and France • Gunshot wounds and arterial hemorrhage • Ended cauterization of wounds with oil • Contused wounds were bandaged and ligature was used to end hemorrhage • Championed the use of artificial limbs • Perfected lithotomy (kidney stone removal) and hernia surgery • Introduced podalic childbirth (feet first) and manipulation of fetus in womb Academic decathlon, 2005

21. Anatomy in the 17th Century • Marcello Malpighi • Father of cytology, histology, and modern embryology Academic decathlon, 2005

22. Circulation of blood • William Harvey • Essay on the Motion of the Heart and Blood Academic decathlon, 2005

23. Vessels and capillary beds Academic decathlon, 2005

24. Anatomy in the 18th Century • Henry Gray (1827-1861) • Lecturer in Anatomy- St. George’s • Published Gray’s Anatomy (1858) • Diagrams by Dr. H. VanDyke Carter Academic decathlon, 2005