Gone Medieval - Medieval Anatomy

Episode Date: January 11, 2024

How did medieval surgeons, doctors and monks understand the inner workings of the human body? Who performed the first scientific human dissections? How did artists depict human anatomy?In this episode of Gone Medieval, Matt Lewis finds out more from Dr. Taylor McCall, author of The Art of Anatomy in Medieval Europe, which explores the deep connections between visual and medical culture during the European Middle Ages.This episode was produced by Rob Weinberg.Enjoy unlimited access to award-winning original documentaries that are released weekly and AD-FREE podcasts. Get a subscription for £1 per month for 3 months with code MEDIEVAL - sign up here.You can take part in our listener survey here. Hosted on Acast. See acast.com/privacy for more information.

From long-loss Viking ships and kings buried in unexpected places to tales of murder, power, faith, and the lives of ordinary people across medieval Europe and beyond. Join me, Matt Lewis, Dr. Eleanor Jarniger, and some of the world's leading historians as we bring history's most fascinating stories to life only on history hit. With your subscription, you'll unlock hundreds of hours of exclusive documentaries with a brand new release every week exploring everything from the ancient world,

to World War II. Just visit historyhit.com forward slash subscribe. Welcome to this episode of Gone Medieval. I'm Matt Lewis. We tend to think of medieval medicine as pretty crude and uninformed and in some cases that was definitely true. There was a growing fascination though with the human body and how it works. Taylor McCall is the managing editor at Speculum, the Journal of Medieval Studies and Taylor holds a PhD in medieval art history from Cambridge and Taylor's brand new book, The Art of Anatomy, takes a look at the flourishing medical field of anatomy through the media of the images left behind to us by medieval artists. Welcome to God Medieval Taylor. It's great to have you on here. Thank you so much for having me. I'm thrilled

to be here. I'm looking forward to talking about this. Very interesting subject and from the book, some of the diagrams are pretty odd, interesting, unique. Yes, absolutely. Yep. So how early does the study of anatomy, as we might recognize it today, How early does that begin? The earliest study of anatomy that we have, which is from ancient Greece, it was the experiments of two men called Horophilus and Erosestratus. They actually performed human dissection, but we only know about that through the intermediary of a later Roman historian

who tells us about it. There was actually no tradition of anatomical study, as we might think of it, really until the Middle Ages, and the later middle ages at that. I think we think of the study of anatomy as being really tied to human dissection. And of course, the field of medicine, and it's an integral part of medical training for future doctors. But for the actual history of medicine and history of anatomy,

the reestablishment of human dissection is the crux of my work. And that didn't happen until approximately 1,300. So over 1,000 years of an interval between the earliest human dissections and the reestablishment of human dissection. And so it's interesting to understand that the earliest form of anatomical study before the reestablishment of dissection is really just based on animal dissections and also just writings of generations of medical historians and doctors who were not actually looking at the inside of the body. that's where it all begins. It's incredible that a field of study that feels like it's so central to understanding medicine and the human body can kind of just vanish for more than a millennium. People just decide not to do it and then suddenly come back to it.

Yes. And when it starts to emerge again in the later medieval period, where is it emerging in the world? Who is leading the interest in this field? The earliest record that we have of a kind of scientific human dissection, and I say that deliberately scientific because we do know that people were opening bodies before approximately 1,300 in the form of autopsies. It was also a newer thing,

but we do have records prior to 1,300 of trying to discover the cause of death for inquiries and things from about 100 years before. But the actual deliberate opening of a corpse in order to look at the interior for purposes of study, that first emerges in Bologna, actually at the University of Bologna in approximately 1,300 by a group of surgeons. And these surgeons were the first generation of educated surgeons who were literate people.

They were trying to have the discipline of surgery included in the curriculum at the University of Bologna. Because up until then, surgery had been considered a manual craft, something that was passed down from a master to a student, didn't require any kind of book learning or any kind of knowledge of any theories or anything that you would traditionally associate with a university course. These learned surgeons, they're called rational surgeons by a historian called Michael McVoe. They are trying to have their study, their discipline elevated to the rank of a university discipline. So they're the ones who are pushing for the inclusion of anatomical study.

and by saying that there are all these theories associated with anatomy that are integral to medical study, we have to be able to see and understand the way the body is put together in order to be able to accurately practice our own discipline of surgery. So that's where it really begins. And I guess that kind of answers the why, after a millennium of not doing this, people are suddenly coming back to it because surgeons seem to be realizing that there is value in understanding what goes on on the inside if you actually want to treat the human body. Yes, exactly. And so much of medical practice in the Middle Ages is based on the idea of the balance of the humors, the four humors, which is blood, phlegm, black bile, and yellow bile. And it was believed that you could only treat a person by understanding how the humors in their body were interacting with each other and being balanced. And that was quite a theoretical aspect of medical study that kind of elevated medicine to a higher level and worthy of.

of university study because there were all kinds of theories about how the humors interacted with the different organs and how everything worked together. So surgeons came in and said, we also need to know this kind of thing in order to be able to do what we do, which is, of course, cutting into the body and performing operations. And we also need to be teaching our students about these theories and understanding how everything works together in order to perform these treatments. And if the study is beginning again in Bologna, so in Italy, how does European study of this area compare with other parts of the world? I guess most notably the Islamic world. We generally have a view that they were quite far ahead of Europe in terms of their medical

understanding and scientific understanding at this point. Yes. Medicine, like a lot of other learned disciplines, did go through kind of a process of synthesizing and augmentation during the kind of height of the Islamic period of expansion. So prior to being translated into Latin, much of the ancient Greek and Roman texts, they were first translated into Arabic, and then when there began to be contact between the Middle East and the Latin West in approximately the 11th, 12th centuries, that's when these texts began to filter into Western Europe and be translated into Latin and assimilated into the medical study. And the, There are certainly lots of advances and lots of theories developed by Islamic authors

during the early Middle Ages and the high Middle Ages. And for anatomy, particularly, the most important person in the study of anatomy up until that point was a late Roman physician called Galen. And his writings on anatomy were really instrumental and foundational for the study of medicine and anatomy in particular in Western Europe. And these writings were condensed and organized by Islamic compilers and added to and then filtered into the West that way. But in terms of my particular interest, which is how images are reflecting these ideas and the progression of the study of the field of anatomy, we have records of Islamic images that are very similar to European images that indicate there was probably a common late antique ancestor. for this particular type of images, which are these full body depictions of each system of the body,

according to Galen's writings. And there was clearly a dialogue between the two traditions, and it is interesting to compare them. As far as outside of the Middle East and Western Europe, that's a much broader topic. And of course, we know in Chinese medicine there are anatomical images and Egyptian and other traditions. So I would love to be looking at a global history of anatomy, and that's probably something that might come up next for me. But here in this book, I focus on Western Europe, and of course, the Middle East is a huge part of that story. Yeah, fascinating that those things are kind of going

on almost in parallel, and as you say, from a common ancestry probably. Yes. Yeah. One of the things you talk about in the book a bit is, what does anatomy mean in a medieval context? When people are talking about anatomy, what do they actually mean? Does that definition change over time as well? I think so. Initially, anatomy is just a part of medical understanding, and it's not given its own specific kind of section within a book or something like that. It was just kind of part of Galen's writings, and he wrote about the importance of understanding anatomy. He actually wrote about the importance of dissection, and medieval authors believed that he had performed human dissections, but in fact, he had only performed dissection on animals that were believed to have similar interiors to humans like apes and pigs. But it initially was just something that they copied the later monks in their monasteries who received these texts. They copied them and included these exhortations by Galen to understand anatomy, but there was no effort to further that understanding until, of course, we get to the surgeons in Italy in approximately 1300. They began to compose their own original texts

that were, of course, surgical manuals, but they were the ones who first included specific sections of their new texts that were devoted to anatomy on its own. And while most of the information is nothing new, it was very heavily reliant on earlier writings, especially Galen's. It was certainly the first time that we see anatomy set apart and given its own place within a larger discipline. Of course, as the Middle Ages progressed, and as we get to the later Middle Ages, anatomical dissection becomes such a huge part of medical curricula, especially as you get towards 1500 and into the 16th century, that we see the establishment of chairs of anatomy and professors of anatomy

as a completely separate, important part of medical education. And that certainly didn't exist a few hundred years before. I think we should probably all be grateful that we owe the medieval world a debt in that our surgeons are actually trained. They go to university and they learn things. It feels like quite an important thing now. but, you know, they didn't use to have to. Yes, yeah, absolutely. And what were those who were studying anatomy trying to learn? Were they just trying to understand how the human body was arranged or the

functions of the organs, how they interacted with each other, or kind of all of those things? Exactly, all those things. And in particular, the ways in which the systems of the body, because in the study of medicine, a lot of times different parts were compartmentalized. And that was how the information was broken down. The systems of the body, according to Galen, were considered as separate, but then also, of course, they all fit together within the body. So we see the diagrams are separating everything out

into particular kind of systems that are easily digestible or meant to help students remember particular systems. So when I say systems like the veins or the arteries or the nerves or the reproductive system, the male and the female, and of course the stomach and the brain and the eyes. So they were pictured separately, but also had to be understood together. And a big part of what the medieval surgeon

and medical professor or teacher or student were trying to make sure that they understood how the parts functioned separately, but also how they interacted together and formed the whole. And again, it seems like a no-brainer today to think that you'd want to understand that as a doctor, but clearly people had survived for thousands of years without concerning themselves too much with that.

Yeah, exactly. Yeah. Your book is focused mainly on the art that is left behind to us of some of these early diagrams of anatomical studies and things. What difference does the various type of authors of those things make? So you've got monks, you've got surgeons, you've got professional illustrators. Presumably they all bring something different to the table when they're drawing this. Yes, and I start with monks because the earliest images that we have were

copied by monks. And the earliest anatomical images that exist in Western Europe are from a small Bavarian monastery created in approximately 1165. And again, it's that visualization of the different systems taken one by one in easily digestible format. The veins, arteries, nerves, and bones and muscles, each pattern on a different human figure. And the monks of this particular monastery in Bavaria actually included these images along with a longer, what we call an image cycle, so a series of images that were more spiritual in nature. And this whole image cycle preceded a compilation of religious texts. We see throughout this kind of copying of these images and inclusion along with spiritual materials where we as modern viewers would think of science and the church as completely separate

and not having anything really to do with each other. But what that reveals, at least what I believe it reveals is the desire of the part of these monks to both preserve this information because they viewed it as important copies of the writings of a very revered historical figure Galen, but also an effort to understand how his writings might apply to their own spiritual journeys and their own understandings of their bodies within this larger divine creation, particularly the idea of the body as a microcosm of the universe, And so we see the association of different body parts with the planets and the stars and astrological figures. And each zodiac sign was associated with a part of the body.

And again, we might think zodiac and Christianity, that doesn't really seem to go together. But actually in the Middle Ages, they were one and the same. They were completely understood as all parts of the universe that was created by God for a particular reason. and each body reflected these larger divine designs. So that's where the book begins with how monks understood these images and why they would have included them in these otherwise religious manuscripts. And then I progress on to understanding why surgeons would have included these images and why then they decided to go ahead and make their own images.

The monks were copying earlier traditions, and then the first time that we see original artwork on anatomy is by these surgeons who were trying to update earlier imagery that we think mostly for the purposes of teaching, their students. We have records of anatomical diagrams being displayed for students in the University of Paris, and then we have manuscript records of these images. And then as you get into the later medieval period,

we then see the use of professional artists to either illustrate these texts and then professional manuscript artists bringing their own flair to these images. And also, even later on, we see the development of anatomy as a really important part of artistic training itself. And that, of course, goes into the Renaissance. And I think most notably, we see that with Da Vinci and his famous anatomical drawings, where clearly he was looking into dissected bodies, and he was very carefully recording how everything fit together within the interior in order to be able to realistically as possible paint these bodies on,

canvas or wherever he was painting them because the object of art became how can we portray or actually communicate to the viewer like the heaviness of the flesh and the realistic way that the body fits together and proportions and of course it was all idealized but it was very important for them to build the body from the bones upwards so that's the range of images that we have and that I try to get into across the book yeah and I thought that was a really interesting way to look at it because it's interesting what each of those individual people bring to the party, if you like, not that dissecting human bodies is a party, but you've got the monks who are heavily into the spiritual understanding of why the body is the way it is. But, you know, we have to

allow that even the surgeons, they might be looking at it at a more practical level, but religion is still such an important part of their life that that still affects their thinking too. And the illustrator might be bringing his devotion to art to it, but he's still affected. by the surgeon's desire for accuracy and the spiritual element of it too. So all of those things feeding in together, I thought was a really interesting mixture of how these images came about and how and why they can be slightly different. Yeah, and the understanding of the kind of astrological part of things was also very important for practical purposes for the surgeons, because an integral part of medical practice was called phobotomy or bloodletting, and surgeons were the ones who

would mostly undertake those procedures and they had to know exactly the right vein to pick, but that particular part of the body was tied to a planet or a zodiac symbol and they had to be able to calculate when it was okay in the zodiac calendar and the movement of the planets to let blood from that particular vein for that particular person because it was believed that if you did it at the wrong time, your patient could bleed out and die. Everything was all connected. And again, there was no perceived, as we see it now, this strict division between the divine and the religious part of things versus the scientific. There wasn't that divide. Everything was considered holistically and as all again fitting into a divine plan. You mentioned a little bit before about

universities and how the study of anatomy became more of a university subject. So how did the desire to improve surgery and to study anatomy feed into the emergence of universities? You know, they're growing throughout this period at the same time as anatomy and surgery are coming on. Did they work together quite well? It's interesting because you would think that there would be a big movement once established in Italy where they started to have annual human dissections that was built into the university statutes for the medical faculty, they said there's a provision for one a year and it needed to be, of course, in the winter, otherwise the body would decompose and it would be really smelly

and all these kinds of things, you would think that would spread and catch on pretty easily for the other emerging universities across Europe. But actually, it took quite a long time for human dissection to become part of medical curricula across Europe, especially in northern universities. It just wasn't seen as an integral part of medical study for a long time because of the way that the medical curricula were set up. It was more of a focus on dissecting texts, if you will. rather than bodies. So the way dissection would work is they would read aloud from a text

while the body was laying on the plinth being dissected by surgeons or the dissectors. But the point was to use the dissection as a tool to better understand the text. But the primary focus was still the text. It wasn't, oh, we're just going to go in and look at the interior and write down what we see and come up with some ideas about how things might work. It was still really heavily reliant on the writings of these recognized authorities like Galen or Avicenna or whoever else were, you know, considered to be the kind of the big names in anatomical studies. Even though it did spread, it spread very slowly. And it really wasn't until the post-medieval period, the 16th century, that we actually see these dissectors and anatomists looking into the body and saying, oh, hang on, I think this

1,000-year-old text got some things wrong. And especially because Galen, he, he, was writing his observations based on animal anatomy, there wasn't a kind of effort to discredit his theories because he was so revered and it wasn't this kind of empirical study or exploration that we think of as so integral to scientific exploration today. That was not the purpose of early dissections. It was more to reinforce the text rather than question the text. And it did take quite a while to, again, to spread to all the universities. And it, I think, mirrors the progression of university study, which was originally very didactic and very based on discussion of texts. And then it did, as we know, shift more towards exploration and more of a study of

nature. Yeah, I mean, I'm always saying how much I love the medieval world and how great it is and everything else. But one of the most bonkers things is their utter reliance on often, even by that point one, two, three thousand year old texts that you couldn't question. You know, we don't need to cut open a human body because Galen saw the inside of a pig and told us what the human body must look like based on that. We don't need to question it. It's kind of a mad position to be in for so many hundreds of years, I think. Yeah, it is interesting though, because so much of what they wanted to know was more of the theories about how the body worked rather than the actual placement of the parts within the body, if that makes sense. Instead of being more concerned with the

kind of cosmetics of it, they were more interested in theoretically, how do the nerves work? Where is the seat of emotion? Or what does the brain control? Those kinds of things that are impossible to see, but were very important in both medical but also philosophical teachings. So it was definitely just the priorities of understanding the anatomy really shifted over the course of the period. And what do you think we can learn about the medieval world perhaps and about people in it from their desire to understand the inner workings of the bodies and the way that they went about furthering it

and the development of what would become anatomy as an academic field of study? It's a complicated question because from my own study, All I can say really is that there's no single answer for something like that. And the point of this whole book was to see what these bodies meant to different people and why they created them and what was the context for the creation of all these images. But I would say it really just varied. And there's no kind of overarching thing that we can say other than there was an interest and there was a concerted effort to understand the mysteries of the interior because it is

incredible that we are able to get through every day and that our bodies propel us through life and trying to understand what that meant within a larger worldview. Whether that is the divine, is there a plan for us as how is God working through our bodies or whether that was particularly a little bit more detailed. How can I become a better practitioner of medicine to be able to save more people and help more people? Or how can I elevate my art in order to affect more people and really connect with the viewer through the art that I'm making. So there's a huge range of possibilities and I think it's pretty exciting to consider and that it's an important and something that we all should consider as well.

I think I was quite struck by. We tend to think that we have to wait several centuries after the end of the medieval period to get the Enlightenment, when all of a sudden people suddenly understand science and all of that kind of thing and unshackle themselves from that old belief that the book is king and you don't need to question anything. But throughout this book, what you see is from, say, 1,300 onwards is the emergence of empirical investigation and an understanding of a need to go back and question those texts? And that's happening three, four hundred years before where we normally plant the Enlightenment, that people are questioning and they are

developing empirical investigation that results in diagrams and things that help them do their job. I thought that was a really interesting element of it that we don't normally think about, just how early people were starting to investigate these things. Wonderful. It's been great to investigate a bit of medicine and surgery and the drawing of the human body with these. Thank you very, very much for joining us, Taylor. Thank you so much for having me. It's been great. Taylor's brand new book, The Art of Anatomy, is available now. If you want to have a look at more diagrams of the inside of human beings,

and why wouldn't you? And to understand better the development of of the academic discipline of anatomy. There are new episodes of Gone Medieval every Tuesday and Friday, so please do join us next time for more from the greatest millennium in human history. Don't forget to also subscribe or follow us wherever you get your podcasts from and to tell all of your friends and family that you've gone medieval. If you get a moment, please do drop us a review or rate us anywhere that you listen to podcasts. It really does help new listeners to find us out.

Anyway, I'd better let you go. I've been Matt Lewis, and we've just gone medieval. with history hits.