... suddenly, I got the feeling that others might be afraid to post the 13th comment to our interesting quest, at the time at which I count 213 views of the extremely interesting comments, to the question Iproposed.

In fact , as I have noticed, supersticion and human Anatomy are also entangled, since the beginning of times (probably because both relate closely to the human mind. ) I have often wondered why we only count 12 pairs of cranial nerves, whereas the VIIth and VIIth bis are in fact different nerves.  and the count should raise to XIII... (that's how strange the human mind could get!

The history of medicine as universally charted by my late teacher Pedro Laín Entralgo would lend credence to Maria Bettencourt Pires´ thinking. In El cuerpo humano.Teoría actual (The Human Body. Present-Day Theory, 1988) Laín holds that throughout Western history there have arisen six basic paradigms of the human body, which have influenced all cultural spheres and particularly medicine.  These paradigms emerge out of progress in human anatomy. Antiquity used the paradigm of the body as a piece of nature (phýsis), the Renaissance employed the paradigm of the body as a piece of architecture (cf. Vesalius), the Baroque predicated the paradigm of the body as a rational machine, the mid 19th century the model of the body as a republic of cells revolting against the established order, positivistic Europe the paradigm of the body as a product of evolution, and the 20th century the model of the body as a recapitulation of all other paradigms.

Dear Colleague,

Thank you for this interesting question. Being active in anatomy for some 40 years now, I think that recent papers by Dr. Esther Bergman and co-workers will give you relevant and up-to-date information on this topic. Dr. Bergman is currently on Researchgate too.

Wishing you success,

and with kind regards,

Koos Jaap van Zwieten

thank you for two interesting contributions.

Great reading. Thanks again!

This is a very interesting question, or rather I should say thesis. No, I haven't noticed it specifically myself, but I think it's a very interesting (and to some provocatve) claim and also ties in nicely with the whole technology-dirves-science-drives-technology conversation which may or may not be happening out there among historians of science and technology. Personally I thnk you sohuld develop this idea into a paper, which I'd then most certainly assign in a history of medicine or tech class (should I ever teach the latter). So.. please do write this one, and I can guarantee a captive audience of at least one seminar class somewhere in the world!

All best

NS

Thank you, Neeraja!

Yes, this would ultimately be a good idea.

I did publish on this subject, of the interrelation of Anatomy and arts, included on a Book on Sciences and the Humanities, after a Conference I prepared on the subject of the "Hands in Medicine and in Arts", in which I included artistic representations of hands in healing activity, since the first representations of hands in primitive  caves, to modern art.(including of course, several artistic representations of hands in surgery and in dissections, as the Anatomy lesson by Rembrandt).  The book is written in my own native language, Portuguese, but could easily be translated to the English language more visible to  an international public...

https://www.researchgate.net/publication/266145215_As_Mos_na_Arte_e_na_Medicina

The concluding remarks of my paper included this question that I proposed here for discussion.

Unfortunately, I do need some negative comments to this issue, or some disagreement to the theory, to be able to proceed with more coherent work on this subject.

In our modern era of technological perfection, in times of virtual reality demands, should we reformulate our approach to modern Medical Teaching? 

Nowadays, my students, carry tablets in their pockets, instead of books and handwritten files. 

should I adapt, and substitute dissection tools by computer programs?

Chapter As Mãos na Arte e na Medicina

Dear colleagues,

The enigmas of anatomy - if we may call them by this term - will never be solved by seeing, reading, thinking / rethinking, and discussions alone. In other words, you can only get a clear idea of the structures within our bodies, if you have touched and felt them with your own hands and instruments, e.g. before, or while dissecting them.

Prehension and thus critically estimating and / or correcting your initial ideas about structures that are presented before you on the dissection table, are preconditions for apprehension, so to say.

The best "negative" comments to the issue that you wish, are those given by various members of groups of motivated and interested beginners, attending an anatomical demonstration, whenever they state : "I never thought that (name a structure : heart, hand, intestine, etcetera) was like this...(sigh)" . In other words : before attending the anatomical demonstration they had no, or just some vague, idea of these structures !

This, at least, is part of my experience in anatomy. I hope that you recognize this too.

With kind regards,

Koos Jaap van Zwieten

First of all, I have to say I am a zoologist, so I need to be careful with my comments here.

Although it becomes restricted more and more for a variety of reasons (funds, ethics), i feel, in zoological education, too, manual dissection is indispensable. Even from textbook examples, you always learn something new, and I see no other, or at least no better, way to understand a structure´s functional and evolutionary significance, and get a clear idea of how things really are, than to perform manual dissection on the actual sample. Every alternative proposed so far (drawings, tomographies, 3D-models) already underwent the interpretation by its creator and is influenced by his/her assumptions. Additionally, from learning psychology, there is no other way utilising so many sensory channels at once. (The same reason why I believe creating sketch drawings is more effective than taking photographs to remember details).

As to the history of medicine: Would you include battlefield surgery into "human dissection"? I am not an expert here, but I feel that in times when warfare was synonymous with hand-to-hand combat featuring bladed weapons, a lot of knowledge and experience was gained from battlefield traumata. Obviously, human dissection in medical training ist the vastly preferable alternative. Is there information available on the progress of anatomical knowledge during times of military conflict?  I am thinking ancient greece here, I think there was an example about the eye-brain connection, but can´t remember. Also, from archeological findings, surgeons seem to have been skilled and experienced in the late years of the english "War of the Roses" ("Blood Red Roses - The Archaeology of a Mass Grave from the Battle of Towton AD 1461 ;ISBN-13: 978-1842172896) The other question is, whether this kind of personal experience ever made it to canonical textbook knowledge. Maybe in ancient Greece, but I am not sure about medieval Europe, thanks to religious restrictions.

Dear Colleagues,

Once again, I agree with previous comments, especially now that colleague Bergmann calls attention to military surgery in pre-Vesalian centuries. Our former Leiden Professor of Anatomy, the late Johan Dankmeijer, used to say this in his lectures too.  Now, after the writings of Prof. John Scarborough (e.g. his "Galen and the Gladiators", 2013), we get the impression that there existed a certain continuum of evidence-based anatomical knowledge and hands-on experience among (military) surgeons, from the Roman empire throughout the Middle Ages. However, in medieval Europe, the surgeons (and barbers) stayed enclosed in guilds - not necessarily parts of the universities. This situation remained until the French Revolution, after which guilds did not exist anymore.

With kind greetings,

Koos Jaap van Zwieten

Dear, dear Colleagues!

I'm thrilled at all your wealthy enriching contributions! I compliment you, and I must thank you all. 

This gets better by the day, and well worth recollecting in the form a written compilation of your valuable contributions.

Daer Colleague,

Thank you again, for your friendly words. It is always a privilege to "spread the good news of anatomy". With regard to the last contributions, I would like to refer to our paper:

van Zwieten KJ, Schmidt KP, Zubova IA, Varzin SA, Zinkovsky AV, Piskùn OE (2014) Some Byzantine / Greek influences on the early work of the Anatomist Andreas Vesalius (1514-1564). In: SA Varzin et al. (Eds.) Proceedings of the 9th annual scientific and practical conference with international participation "Health - the basis of human development: problems and solutions", 20-22 November 2014, Medical Faculty, St.-Petersburg State University, St.-Petersburg (in press).

This publication will be available via ResearchGate too, in due time.

With kind greetings,

Koos Jaap van Zwieten

In more recent times, Shauna Devine in Learning from the Wounded makes the arguement that the encouragement of autopsy's performed on soldiers KIA during the American Civil War provided valuable insights to the physicians at the time.  The whole medical museum phenomena (John Hunter's Museum, the Army Medical Museum, the Musée Dupuytren) was premised on antomical and eventually pathological dissection. 

You should look at the development of virtual dissection - the anatomical models of Jerome Auzoux of the 19th century - developed as an aid for dissection and the visible human project and the virtual autopsy of the 21st century.  

You should also look at Rebecca Skloot The Immortal Life of Hernrietta Lacks to look at the public perception of the issue.  Despite the benefits of autopsy to society, the general public was never fond of the practice.

Thank you for a few more, lovely contributions to the issue.

I was waiting for some free time during the weekend, to answer correctly to colleague  van Zwieten, in strict accordance to his knowledgeable writtings.

The hands have indeed a lot to do with the intertwining relations between Arts, Humanities and Sciences., because the hands and the evolution and the motion of hands in general are so closely related to the human brain. (Aristote called the hands, the "instrument of the instruments"...) . In account of this, an infinity of ideas coulld arise on this issue . (I will endlessly reffer to Frank Wilson's «The Hand»)

Thank you Paavo Bergmann for bringing up the idea of the  war injuries. It is, of course, strictly interrelated  with the necessity of more profound anatomical studies, to perfect and enhance the future of medical practice. I would avoid the issue of commenting on how much Neurology and Neurosurgery evolved in the 20th C, with Mengele's studies during WWII...

In my Country, traumatology and physiatric wards are mostly devoted to a diversity of injuries from a different war, as we face one of the highest rates of traffic car accidents in Europe. And our "hero" warriors of the trafic have a lot to offer in terms of extravagant injuries, that may well help to improve the general performance of surgeons.

Thank you Alan Hawk, for your interesting comments.

I read "The Immortal Life of Hernrietta Lacks", nonstop, during the Summer of 2010, shortly after the first publication, and have been waiting for some free times to review the subject and the immensity of ethical and legal issues, brought by the subject of how a nearly anonymous donnor contributed to some of the greatest scientific  advances in the 20th century, and how the HeLa cells will still be useful in the future.

Even if this case-study relates to the "perduration" (can't find a less-latin word) of living human material, the question of ethics and of legal demands, in terms of human donations, are of course, one of the main issues in the discussion related to dissection and anonymous contributions to the advances in medical studies and clinical practice.

... suddenly, I got the feeling that others might be afraid to post the 13th comment to our interesting quest, at the time at which I count 213 views of the extremely interesting comments, to the question Iproposed.

In fact , as I have noticed, supersticion and human Anatomy are also entangled, since the beginning of times (probably because both relate closely to the human mind. ) I have often wondered why we only count 12 pairs of cranial nerves, whereas the VIIth and VIIth bis are in fact different nerves.  and the count should raise to XIII... (that's how strange the human mind could get!

The cranial nerves and their numbers is another story. There is a I bis and the two VIIIs which nobody cares about. A lot of Anglo-Saxon handbooks do not mention VII bis Wrisberg's etc.

About dissection, check Sophie Bolt's book When I shall die I shall go to the University.

I saw you asked about Peking's IFAA Congress - as you see in my paper I sent you, there were plenty of sessions on teaching anatomy separated by geographic areas, so no consensus was even touched.

As a private opinion, I consider dissection an essential part of   medical education.  

Thank you Andy Chirculescu.

We share, indeed, on that opinion. Please let me thank you also  for your interesting paper. I was very interested. I think I remember receiving your visit to Lisbon in 1994 for the International Congress of IFAA Anatomists, in which I worked as a secretary, in the beginning of my anatomist career. 

In 2012, I attended in Brasil, the XXII International Symposium of Morphological Sciences (ISSM), which included an extremely interesting debate on Medical Education, and the necessity of update of teaching Anatomy in the "molecular era".

In this interesting debate, I heard a phrase that I 'll never forget:

"Anatomy is to Medicine, as essencial as Geography is to History"

Amazing...

I can't help feeling astonished on how modern and always interesting, these questions that we receive from ancient times, such as the importance of dissection in Medical Education  ,still could get to us so unresolved as to nourrish endless modern debate.

The attached file on my previous comment is from the Final Program Book of the 2012 XXII International Syumposium on Morphological Sciences, that I attended in S. Paulo Brasil  that included a whole day of interesting debate on the importance of teaching Morphological Sciences in the Medical Curricula. 

My attention was caught by the mini-symposium on "Cutting-edge Education" , sponsored by the American Association of Anatomists.

I think that this statement is largely true. I believe that Actual human dissection is a an indicator of how involved do medical professionals are in their search for medical knowledge. I believe that the more of your physical & mental self you involve in the learning process, the more profound and long lasting your professional knowledge is going to be. The willingness to experience the human dissection personally is an indication of a relentless, stubborn and whole heartedly involved scientific researchers.  Such environment of committed research is bound to be very fruitful.                                  

Thank you, Malek, for your interesting statements.

My sensibility to these questions tells me that there is hope. After an extremely technicistic era of Sciences in general, the Humanity is now slowly approaching a new era of Humanism,

Youngsters are demanding for new approaches on their rational, fully technological world.

The seminars on History of Medicine are always crowded. 

Our  Medical students in Portugal are eager to dissect. They want medical training that gets them closer to hospitals were they can observe and interact with real patients. In Anatomy, they get their first approach to the human body, and they demand practical observation of the inner  structures of the embalmed bodies that we offer for study. 

Older postgraduate students are returning to our Department to practice and develop new surgical approaches, for our specialized surgical training courses with hands-on cadaveric training. 

The tremendous success of our undergraduate and postgraduate courses with cadaveric training indicates that we are working on the right direction.

We have even received several solicitations from foreign Countries to participate in these courses.

I have great hope for the future.

In the attached file, you'll find a Prezi presentation that we prepared, on this subject,  for the EACA Euriopean Joint Congress of Clinical Anatomy, in 2013. ( http://prezi.com/qk-muuogpev7/?utm_campaign=share&utm_medium=copy&rc=ex0share )

I suppose the first attempts to dissect human body, originates from the Reductionism or atomistic)  approach to analyze any structure by reducing it to its components and studying the parts to understand the whole.Of course, historically, the hemodynamic ( blood circulation) and many surgical approaches could not be discovered without an exact knowledge of human anatomy and or dissection. Actually this approach has yet continued as physiology, molecular biology , biochemistry, embryology etc to discover the mechanism of living bodies in normal or pathological states.Interestingly in the field of human anatomy, there are still some key points that can be notified merely by human dissection, for instance the "Neurovascular bundle" preservation (nerve sparing procedure) in radical prostatectomy ( as an example in my profession) could be feasible just by meticulous dissection of Retzius space. However such as any "map navigation" there is some limit on clinical anatomy pertains to the data recovered by dissection, I mean whereas the data collected from traditional anatomy limited to the macroscopic observables , it does not include the microscopic world of human body, and on the other hand the era of knowledge in human anatomy has arrived to final point, i.e. there are very few questions that remained open in it. Nevertheless the role of cadaveric dissection in training and criminal situations remain as a mainstay in the medical investigation.  

Dear Manouchehr Amiri,

It took me sometime to think of an appropriate answer for the collection of interesting statements that you posted here.

The enriching statments that you offer, fully adapt in a positive way, to the issues here in discussion, and I thank you for that.

I fully agree to what I seem to understand as the  fundament to your idea, as to the necessity of total modernization and update of modern Medical Education, in general, including Anatomy teaching in particular.  The recent advances of our totally technological world offers a new kind of medical students and future Health care professionals, with different demands and quests, and health education should adapt. Nevertheless, the humanistic approach of those that care directly with other global human beings, including the ethical and psychological approach, will always find a good fundament in ancient times' history of Medicine.

In this sense, I strongly believe that the direct approach to the human body, as offered by dissection classes, should be kept as an integrating part of modern Medical Education. This can easily be completed and update with more modern approaches, such as 3D modelling or computer-assisted methods. This complement should not be a substitute. Many of our students use their tablets and e-Books in complement, to assist them in dissection. (our expenses in large dissection gloves has fully increased, because the students are using gloves to protect their i-phone and tablets during dissection...)

The update to the molecular era is, of course, an important necessity. This is the fundament for our efforts to modernise fully integrated teaching curricula, adapted to the modern world.

When we consider these efforts to adapt and «integrate» modern medical curricula, I should disagree with your statements, in the sense that Anatomical knowledge has fully evolved, with great advances from Microscopic updates, and in this field, there is constant research and new data collected from microscopic anatomical studies. When you consuilt the latest issues of «Anatomical Records», you'll be amazed at the fully modernized update to the molecular and biochemical, or immunological insights that modern Anatomy has to offer.

(Even as I write these lines, I am working with a group of students that collected an interesting anatomical element from their pelvic cadaveric dissection, last year. We took it for microscopic analysis and photography, and are currently working, under my supervision, to produce a modern anatomical discription report.) 

This was a difficult answer to correspond to your interesting remarks, but I hope this was useful.

I send you greetings from a sunny, cold, South of Europe!

Anatomy dissection was essential, to learn medicine, before all the investigative modalities like US,CT, MRI were available. Now I see patients walking into Out-patient departments with these results on hand!. As for surgical skills acquirement , less said the better!

Thank you Pradeep, for your interesting point of view, that wil surely modernize this debate. 

Nevertheless, in terms of medical education, and future investments in good medical practise, I hope they will soon invent 3D-MRI...

Maria, that is what I am afraid of!. The machine will give a beautiful  picture. The interpretation and carrying out the procedure require proper anatomical and pathological expertise! If the surgeon is not confident of his anatomy, how he is going to carry out the procedure?

For sometime, in the past we had a simple (now obsolete) ultrasound device in our Department, that the students learned to use, in complement to their cadaveric dissections for the 1st year gross Anatomy course. This fortunate complement would help students update the necessary "bridging" between basic anatomy and medical imaging. 

When  first visited Edinburgh University, I remember feeling astonished at the hight of the walls that surrounded the city grave-yard. I was told that they had to put up these high walls to prevent the Medical students from stealing corpses at night, for the purpose of their anatomical studies. (This «legend» may not be true, as it is, but it made me think that medical students are eager for human dissection, to  facilitate their anatomical knowledge... 

« I wish to work miracles;  - it may be that I shall possess less than other men of more ppeaceful lifes, or than those who want to grow rich in a day. I may live for a long time in great poverty, as always happens, and to all eternitywill happen, to alchemists, the would-be creators of gold and silver, and to engineers who would hav dead water stir itself into life and perpetual motion, and to chpose supreme fools, the necromancer and the enchanter.

And you, who say that it would be better to watch an anatomist at work than to see these drawings, you would be right, if it were possible to observe all the things which are demonstrated in such drawings in a single figure, in which you, with all your cleverness will not see nor obtain knowledge of more than a few veins, to obtain a true and perfect knowledge of which I have dissected more than ten human bodies, destroying all the other members, and removing the very minutest particles of the flesh by which these veins are surrounded, without causing them to bleed, excepting the insensible bleeding of the capillary veins; and one single body would not last long, since it was necessary to proceed with several bodies by degrees, until I came to an end and had a complete knowledge; this I repeated twice, to learn the differences. »

[...]

LEONARDO DA VINCI - Notebooks - On Anatomy

« [...] And if you should have a love for such things you might be prevented from loathing, and if that did not prevent you , you might be deterred by the fear of living in the night hours in the company of those corpses, quartered and flayed and horrible to see. »

Now arguing from the opposite pole, with virtual 3D recreation of the lesion and robotic surgery, is there a need to be trained at all in anatomy and diagnostics?

Yes and no, dear Pradeep...

Yes, because it all depends of the kind of medical practitioners you want or need to train.

I have noticed that the closest proximity or not, to real human bodies , as from the introduction of human dissection since the first year of Medical Education moulds those students minds, to have them appreciate and evolve into medical practitioners, that act in closer proximity, not fearing to approach their patients and to closer observe them. This leads to a more humanistic medical practice.

We have two Medical Faculties in both Lisbon Universities, and I can notice the different results. As soon as I enter one of the Lisbon hospitals, I imediately perceive which of the medical students were educated in my Nova Lisbon Medical School, with full integration of human dissection in their medical curriculum, acting quite differently from those that come from other Medical Schools in the Country, where Dissection is not in their curriculum.

It'a amazing ! (always works!) 

Of course, the obvious answer to your question can also be considered as a square «No», , if you prefer students highly prepared for this Molecular Era, and with a perfectioned technological approach to their patients, in which there is no need for direct observation, in which they can easily get their full diagnosis through the newest expensive Imaging technologies, , without even ever having to touch their patients. And it is even easier if they don't even raise their heads from the prescription papers or computers, to look at the patient.

But they will soon be consulting through e-mail or telephone, or the internet, because there is no longer need for physical contact with patients.

Nevertheless , please allow me the pleasure of having the acquired medical experience to be sure that certain medical acts of diagnosis that imply human to human proximity, such as taking a patients pulse, may and surely can act simultaneously as the intricate first step of a healing process,  because physical contact can and should transmit messages of security, that will sooth much of the psychological burden inherent to physical ailment and diseases.

In this sense, Human dissection is certainly the fundamental part of a Medical curriculum that will prepare medical students for a more humanistic approach to their future patients.

Anatomy is like a geography... Can be learned from atlases, or can be learned on terrain. May be combination of both is the best. 

Thank you, dear Slobodan.

Yes, you can say that Anatomy is to Medicine, as Geography is to History ...

Yes, depending on what kind of Medicine you want to practice, I certainly prefer going on terrain!

Students should be offered both, to choose from. 

And also to come back to, in Postgraduation .

Chesterton on the Progress of Medical Technology:

" The Professor was, of course, bursting with hope and progressive optimism. He thinks that everything is going very well indeed, and the world improving with wonderful rapidity. As an example of this, he says that men are loosing their eyes, teeth, hair, and senses of hearing with a rapidity that raises the happiest anticipations in a humane lover of his kind. He explained that when we have got rid of all these rude and extinct organs, we should have mechanical scientific substitutes... He did not explain how soon it will be possible to manufacture that minor part of the machinery which has hitherto escaped so many inquiring mechanics; I mean the little thing that actually sees, hears, smells, speaks, and thinks. For strange and exasperating as it seems, without that one little thing (which nobody can find anywhere) it will generally be found that telescopes cannot see for themselves, telephones cannot hear for themselves, books cannot write or read themselves; and a man cannot even talk entirely without thinking. Though he sometimes comes pretty near it.  "

-----

G.K CHESTERTON. Come to think of it London, Methuen, 1930

Dear Maria Bettencourt Pires,

Thank you for your Excellent question?

I am not from field, perhaps that make me to respond: NO!... Your assumption refers only to the modern medicine evolution which may be positioned only in Europe… As we can observe in comments nobody mentioned Avicenna (the Arabic medicine from Middle Ages which was evolved from the ancient Greek Medicine and influence of Hindu and Chinese Traditional medicine… ). To make a more complete analyse of Modern medicine you have to study these fields and have to take in consideration the alchemy evolution which had important role in medicaments evolution, too…

One interesting observation can be connected to the Chinese traditional medicine example to the acupuncture treatments… In Europe, Americas are using acupuncture treatments with more needles which are used (pushed in acupuncture points) “together” at one occasion pushed… the needles are very thin barely feeling them at the using… At the same time I have met in China (Mingxi, Fujian) an acupuncture treatments style when “healer” are used one needle which was approximately four-six (?) times thicker than needle used in Europe…. With only thick needle the “healer” stabbed  the body in the important acupuncture points well defined order… Only in few treatments the treatment effect was excellent… Eliminated a back-pain  (over 30 years)… This miracle healers learning their knowledge from their ascendings,  and they do not betray their secret…   

Dear Lazló-Attila !

Thank you very very much for your important contribute. Yes, I was refering to Occidental / Western modern Medicine. But, of course, we cannot neglect the fundamental contribute of traditional Eastern healing practices.

Nevertheless, as you bring the outstanding contribute of Acupuncture, can I remind you that these needles are carefully pushed into meridian points, and these points need accurate knowledge of Anatomy and the morphology and variations of the human body...

Also Yoga, concerns the accurate inner notion of the several parts of your body...The whole concept of how to acquire anatomical knowledge can or should be reviewed in light of the modern knowledge of these ancient traditional medical practices. In my Department of Human Medical Anatomy, we undertook a very interesting and demanding innovative teaching experience, as we opened a postgraduation course of human dissection for accupuncturers.

It was  a great thrill to prepare the dissection of peripheral nerves in one half of the bodies, and leave the other half intact for the practice of acupuncture. I hope you wouldn't be amazed to notice that the practice of acupuncture evolved much quicker in those that could have the sight of the innervation points, as they searched for their conventional acupuncture meridians. 

These hands-on dissection postgraduation courses have currently been performed with good success for medical surgical training, for more than ten years, now.

The practical knowledge of human anatomical dissection is fundamental for every medical and surgical practitioner.My further proposition is that you will notice that the greatest advances in medical knowledge come in close relation to the times when Anatomical dissection was widely performed 

Yes, Avicenna was one of the greatest anatomists . He fundamented his wide anatomical knowledge in careful dissections of the human body.

Thank you very much for your contribute to this question.

Warm regards from sunny Portugal,

Maria

Dear Colleagues Horváth and Bettencourt-Pires,

I completely agree with your recent comments.

Please allow me to add that if necessary I do mention Avicenna, especially in order to better understand Leonardo's backgrounds. So I referred to them in our 2005 article (in Dutch) entitled "Science and Observation" (Wetenschap en Waarneming).

Please find this in attachment, on pp. 30 - 33 of the 2005 issue of Journal "Gamma". Avicenna can be found at the beginning of p. 32.

Wishing you much success,

with kind greetings,

Koos Jaap van Zwieten

Thank you for one more very pertinent comment, K. J. van Zwieten.

I'll look forward to reading you! Kind regards, Maria

Through my simple experience with the students as a teacher of plant anatomy I noticed that the direct anatomy of the parts of the plant by the student and comparing them with the painting of these parts gives more confidence in the results and reality because the human being to be convinced of what he sees and touches. I think their combination is better

Greetings

dear Azhar Sosa! Thank you. Yours is a superb contribute. I had not thought of the "Anatomy of Plants"...

But I am certain that whenever we go deeper into the analysis of subjects, and any living subjects in particular, this leeds to the improvement of Science, overall. 

I have another argument to make here, that dissection can be a hypothesis-testing tool. Right now, most people dissect to make sure that they have all the observations they need to formulate an hypothesis, or just as a way to begin to suggest how something works, using expected elements of a structure, always from the point of view of the anatomy. However, Dominique Homberger did the opposite, but with comparative anatomy, and in a way that could easily be applied to the animal of human descent.

Oh, sure she saw the articles describing feathers and the easily identified structures associated with moving the feathers, but she watched birds and saw whole lines of feathers rise up as a whole. She wondered if there were structures in the skin responsible for this behavior that we are missing. Most anatomists relied upon cross-sections of skin to look at the histology, and of course, the skin was pickled first. She realized that structures change when put into the preserving fluids. So she DISSECTED out all structures (under a microscope)  in freshly dead, unpreserved skin, but only after she had designed a model that could explain how the bird managed to raise every feather in a tract at once. See Homberger, D. G. et al. (2000). Functional microanatomy of the feather-bearing avian integument: Implications for the evolution of birds and avian flight. American Zoologist 40(4): 553-574.

Of course we cannot dissect fresh skin or any organ in a human safely, but her thought pattern, developed with comparative anatomy, can be applied toward using human anatomy as an hypothesis-testing tool. Her model found that fat pads in the skin were critical for her model to work (along with a tiny layer of elastic tissue, seen only in fresh skin and with a microscope).

This "binary" differentiation leads to realizing that the fat that is metabolized for energy (meaning lipids are broken down to supply energy for anaerobic activity) is not the same fat used to help raise all feathers at once in a feather tract. The latter fat is more permanent as structural fat.

We have the same distinction in our fat, but for different reasons. Metabolizable fat is fairly pure adipocytes, loose collagenous/elastic fibers and blood vessels, but structural fat can have a lot more collagenous connective tissue associated with it, and is probably not metabolizable. It is "structural" because it is more densely packed and its purpose is to shape the body and cushion other structures.

Dear Martha. This is simply beautiful. Thank you !!!

The simplest and straightest reasonings leeds us further than more complex arguments, with expensive technologies.

So true Maria, Dominique Homberger comes from a European tradition, a long one, concerning anatomical theory (especially in Germany and Switzerland, but especially Europe in general), something that researchers in the US do not get. For us, anatomy is only a tool, not an important part of theory. The tradition in the US became using biomechanics and EMG as methods for hypothesis-testing. However, there is still a problem of adequate controls for anatomy as a method to test hypotheses. However, it should be used by orthopedic doctors at the least to help them with developing treatment methods.

Thank you very much for your important contribute!

As a classical (old-fashioned!) European, I very much appreciate the modernity of the American approach to Anatomy.

We must struggle to find consensus and grab the positive side of both perspectives, if we want to build a better, modernised internationally acceptable Anatomy. We'll get there someday, I hope.

It is in fact a fundamental tool for the advancement of Medical Science.

The main difficulty I find with Anatomy, as I face its fundamental knowledge, is that it is indeed fundamental, not only in Medical terms (first purpose) but also for General fields of Knowledge, such as >Arts, Architecture, Egineering, or even philosophical reasoning.

This was the greatest contribute of Leonardo to Anatomy.

Good and strong point by Martha Hyde

Thank you, @Peter, for your fundamental contribute to the question. Your historical notes are important to build our more accurate analysis, and also to try and modernize the way we teach our difficult subject.

Yes, Galen dissected animals, and then he extrapolated from those observations, to build theoretical knowledge on human anatomy and physiology.

The Greek performed human dissection, to gain knowledge from direct observation.

Vesalius took to modernize human dissection, although he also performed animal dissection, to build comparative anatomy knowledge.

Galen's times were followed by the long medieval period, with scarce visibility of novelty in science.

The Greek civilization and the Renaissance times were were times of flourishment of the greatest philosophical ideas and scientific endeavours... These are facts.