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The discipline of anatomy is divided into macroscopic and microscopic parts. Macroscopic anatomy, or gross anatomy, is the examination of an animal's body parts using unaided eyesight. Gross anatomy also includes the branch of superficial anatomy. Microscopic anatomy involves the use of optical instruments in the study of the tissues of various structures, known as histology, and also in the study of cells.
The history of anatomy is characterized by a progressive understanding of the functions of the organs and structures of the human body. Methods have also improved dramatically, advancing from the examination of animals by dissection of carcasses and cadavers (corpses)[5] to 20th-century medical imaging techniques, including X-ray, ultrasound, and magnetic resonance imaging.[6]
The term "anatomy" is commonly taken to refer to human anatomy. However, substantially similar structures and tissues are found throughout the rest of the animal kingdom, and the term also includes the anatomy of other animals. The term zootomy is also sometimes used to specifically refer to non-human animals. The structure and tissues of plants are of a dissimilar nature and they are studied in plant anatomy.[8]
Generally, students of certain biological sciences, paramedics, prosthetists and orthotists, physiotherapists, occupational therapists, nurses, podiatrists, and medical students learn gross anatomy and microscopic anatomy from anatomical models, skeletons, textbooks, diagrams, photographs, lectures and tutorials and in addition, medical students generally also learn gross anatomy through practical experience of dissection and inspection of cadavers. The study of microscopic anatomy (or histology) can be aided by practical experience examining histological preparations (or slides) under a microscope.[43]
Human anatomy, physiology and biochemistry are complementary basic medical sciences, which are generally taught to medical students in their first year at medical school. Human anatomy can be taught regionally or systemically; that is, respectively, studying anatomy by bodily regions such as the head and chest, or studying by specific systems, such as the nervous or respiratory systems.[3] The major anatomy textbook, Gray's Anatomy, has been reorganized from a systems format to a regional format, in line with modern teaching methods.[44][45] A thorough working knowledge of anatomy is required by physicians, especially surgeons and doctors working in some diagnostic specialties, such as histopathology and radiology.[46]
Academic anatomists are usually employed by universities, medical schools or teaching hospitals. They are often involved in teaching anatomy, and research into certain systems, organs, tissues or cells.[46]
Marcello Malpighi, the father of microscopical anatomy, discovered that plants had tubules similar to those he saw in insects like the silk worm. He observed that when a ring-like portion of bark was removed on a trunk a swelling occurred in the tissues above the ring, and he unmistakably interpreted this as growth stimulated by food coming down from the leaves, and being captured above the ring.[50]
Ancient Greek anatomy and physiology underwent great changes and advances throughout the early medieval world. Over time, this medical practice expanded by a continually developing understanding of the functions of organs and structures in the body. Phenomenal anatomical observations of the human body were made, which have contributed towards the understanding of the brain, eye, liver, reproductive organs and the nervous system.
The Hellenistic Egyptian city of Alexandria was the stepping-stone for Greek anatomy and physiology. Alexandria not only housed the biggest library for medical records and books of the liberal arts in the world during the time of the Greeks, but was also home to many medical practitioners and philosophers. Great patronage of the arts and sciences from the Ptolemaic dynasty of Egypt helped raise Alexandria up, further rivalling the cultural and scientific achievements of other Greek states.[60]
The anatomy of the muscles and skeleton is described in the Hippocratic Corpus, an Ancient Greek medical work written by unknown authors.[68] Aristotle described vertebrate anatomy based on animal dissection. Praxagoras identified the difference between arteries and veins. Also in the 4th century BCE, Herophilos and Erasistratus produced more accurate anatomical descriptions based on vivisection of criminals in Alexandria during the Ptolemaic period.[69][70]
In the 2nd century, Galen of Pergamum, an anatomist, clinician, writer and philosopher,[71] wrote the final and highly influential anatomy treatise of ancient times.[72] He compiled existing knowledge and studied anatomy through dissection of animals.[71] He was one of the first experimental physiologists through his vivisection experiments on animals.[73] Galen's drawings, based mostly on dog anatomy, became effectively the only anatomical textbook for the next thousand years.[74] His work was known to Renaissance doctors only through Islamic Golden Age medicine until it was translated from the Greek some time in the 15th century.[74]
In England, anatomy was the subject of the first public lectures given in any science; these were given by the Company of Barbers and Surgeons in the 16th century, joined in 1583 by the Lumleian lectures in surgery at the Royal College of Physicians.[82]
In the United States, medical schools began to be set up towards the end of the 18th century. Classes in anatomy needed a continual stream of cadavers for dissection and these were difficult to obtain. Philadelphia, Baltimore and New York were all renowned for body snatching activity as criminals raided graveyards at night, removing newly buried corpses from their coffins.[83] A similar problem existed in Britain where demand for bodies became so great that grave-raiding and even anatomy murder were practised to obtain cadavers.[84] Some graveyards were in consequence protected with watchtowers. The practice was halted in Britain by the Anatomy Act of 1832,[85][86] while in the United States, similar legislation was enacted after the physician William S. Forbes of Jefferson Medical College was found guilty in 1882 of "complicity with resurrectionists in the despoliation of graves in Lebanon Cemetery".[87]
The teaching of anatomy in Britain was transformed by Sir John Struthers, Regius Professor of Anatomy at the University of Aberdeen from 1863 to 1889. He was responsible for setting up the system of three years of "pre-clinical" academic teaching in the sciences underlying medicine, including especially anatomy. This system lasted until the reform of medical training in 1993 and 2003. As well as teaching, he collected many vertebrate skeletons for his museum of comparative anatomy, published over 70 research papers, and became famous for his public dissection of the Tay Whale.[88][89] From 1822 the Royal College of Surgeons regulated the teaching of anatomy in medical schools.[90] Medical museums provided examples in comparative anatomy, and were often used in teaching.[91] Ignaz Semmelweis investigated puerperal fever and he discovered how it was caused. He noticed that the frequently fatal fever occurred more often in mothers examined by medical students than by midwives. The students went from the dissecting room to the hospital ward and examined women in childbirth. Semmelweis showed that when the trainees washed their hands in chlorinated lime before each clinical examination, the incidence of puerperal fever among the mothers could be reduced dramatically.[92]
Before the modern medical era, the main means for studying the internal structures of the body were dissection of the dead and inspection, palpation and auscultation of the living. It was the advent of microscopy that opened up an understanding of the building blocks that constituted living tissues. Technical advances in the development of achromatic lenses increased the resolving power of the microscope and around 1839, Matthias Jakob Schleiden and Theodor Schwann identified that cells were the fundamental unit of organization of all living things. Study of small structures involved passing light through them and the microtome was invented to provide sufficiently thin slices of tissue to examine. Staining techniques using artificial dyes were established to help distinguish between different types of tissue. Advances in the fields of histology and cytology began in the late 19th century[93] along with advances in surgical techniques allowing for the painless and safe removal of biopsy specimens. The invention of the electron microscope brought a great advance in resolution power and allowed research into the ultrastructure of cells and the organelles and other structures within them. About the same time, in the 1950s, the use of X-ray diffraction for studying the crystal structures of proteins, nucleic acids and other biological molecules gave rise to a new field of molecular anatomy.[93]
Anatomy in undergraduate education has been in decline for many years. Some suggest that it has fallen below a safe level. Balances between detail and safety, and assimilation and application of anatomy have yet to be established as the methods of teaching undergo another metamorphosis. For doctors, the human body is the focus of investigation and intervention on a daily basis; for this reason, the study of anatomy in some form will continue to be essential to safe medical practice. It is necessary for core knowledge of anatomy to be assimilated by all doctors in order to practice and communicate safely. It may be true that most doctors do not need to dissect a cadaver or study a prosection in order to practice, but if it can improve their understanding of what they do and why they do it, this surely has to be of benefit both for the safety of the patient and satisfaction of the doctor as a professional. Integration of newer teaching modalities and modern technology will encourage interest and retention of anatomical knowledge and its clinical relevance. Anatomy has a promising future in postgraduate specialist and surgical training. Detailed knowledge should be integrated into specialist training when it is clinically relevant allowing specialists of the future to practice safely and accurately and also to provide a strong base for future clinical developments.
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