Medical Knowledge: It's evolution and how observation plays a part
by Provisional Polygon on October 26, 2016 - 5:12pm
Published in 1792, the 12th edition of William Cheselden’s The Anatomy of the Human Body is unlike any book of anatomy you’ve ever seen. Its size is comparable to a novel you may find on your bookshelf; the 300+ page textbook is approximately 15cm wide by 25cm long and weighs about half a kilogram. It includes detailed drawings (carved from copper plates) of human body parts from the skeletal system to the muscles and even inner organs. Each drawing is carefully labeled and gives the name and a description of the body part. Along with the general overview of the human body and its anatomy, case studies can be found at the very end of the book. Cheselden describes instances where his expertise were necessary and gives a general overview of how he dealt with a patient in a specific situation. The case studies also include an illustration to aid in the visualization of the procedure. These carvings, like the others in this book are artfully composed with each figure taking on a pose that both maximizes the reader’s understanding of anatomy but also often includes artistic liberties taken by the engraver. What makes this book so unique to what we know anatomy books to be today is just that. The page shown on the far right is the visual representation of one of the aforementioned case studies where, “a miller[‘s] arm with the scapula was torn off from his body, by a rope winding around it the other end being fastened to the cogs of a mill” (Cheselden 321). The detail put into this image is a product of the artist’s first hand observation of the subject but also shows the artistic liberties taken to enhance the reader’s understanding of the material. In fact, the entirety of this book is a product of first hand observation of the human body by Cheselden.
The Anatomy of the Human Body is distinctly different from the early modern period’s paradigm and is a perfect example of the changes in medical knowledge caused by that paradigm shift. During the early modern period “the practice of physic… concerned the ability to move intellectually from knowledge rooted in certainty to opinion based upon that certainty” (Cook 409). That is to say the practice of medicine came from theory that fit within what was agreed upon as truth. This book does the opposite of that. The avenue taken to justify knowledge is synonymous with what we see at the end of the 17th century and matches the values upheld by Hermann Boerhaave who, “held that the truths of physic could be discovered only by observation supplemented with reason”(432). The knowledge presented in this book is heavily backed up by the observations of Cheselden and are not backed up by any “knowledge rooted in certainty”(409).
It is because of this that medical knowledge moved away from the four humors. In that paradigm the majority of a physician’s training was actually based on theory and a “physician could ‘practice’ his science even if he had never treated patients” (409). The fact that this book ends with case studies shows how practicing and observing the human body first hand in order to properly be able to treat a patient has become important to a physician in training.
Another observation worth noting is the fact that none of the case studies in this case discuss the “nature” of the patient. Whereas the focus when treating a patient during the early modern period would have been to figure out what the “inner nature to the outward world” of the patient is, Cheselden does not mention anything about his patients “hair colour, body type, dominant behavior [or] mood” (410). He greatly relies on his observations of the patients’ anatomy and backs it up with reasoning of what he has learned previously when working with the human body firsthand.
If any observation of this book should be mentioned, it is that the medical knowledge presented in this book that was published over two hundred years ago more closely resembles what we know today than medical knowledge in the early 17th century. William Cheselden’s The Anatomy of the Human Body is essentially the parent of the modern anatomy textbook.
Cheselden, William. The Anatomy of the Human Body. 12th ed. London: Printed for J. Dodsley, T. Cadell, R. Baldwin, T, Lowndes, S.Hayes, J. Anderson, J. Deighton, 1792. Print.
Cook, Harold J. “Medicine,” in Katherine Park and Lorraine Daston (eds.) The Cambridge History of Science (Cambridge: Cambridge University Press, 2003): 407-434.