Enseñanza de la Anatomía Humana en la Universidad Austral de Chile: Pasado, Presente y Futuro / Teaching of Human Anatomy at the Universidad Austral de Chile: Past, Present and Future

La presente revisión narrativa trata de caracterizar como ha sido el proceso de enseñanza de la anatomía en la Universidad Austral de Chile (UACh), presentando una visión histórica desde los inicios de la Universidad a los tiempos actuales y una reflexión sobre el futuro de la Anatomía Humana. Se describen los orígenes del Instituto de Anatomía de la UACh, primeros académicos, logros institucionales, convenios interinstitucionales; además, se detallan los métodos y estrategias educativas utilizadas en la actualidad para la enseñanza anatómica y se presenta una visión panorámica del porvenir como instituto de docencia e investigación en el campo de la Anatomía humana.

SUMMARY: This narrative review tries to characterize how the anatomy teaching process has been carried out at the Universidad Austral de Chile (UACh), presenting a historical vision from the beginnings of the University to the present time and a reflection on the future of Human Anatomy. The origins of the Human Anatomy Institute at the UACh, first academics, institutional achievements, inter-institutional agreements are described; in addition, the educational methods and strategies currently used for anatomical teaching are detailed and a panoramic vision of the future as a teaching and research institute in the field of human anatomy is presented.

The Sun Also Rises: Tracing the evolution of humanistic values in anatomy pedagogy and research, including cadaveric acquisition practices.

Anatomy has always been at the intersection of the socio-cultural and political landscape, where new ideas constantly replace older wisdom. From ancient Egyptians through the Greeks, and then the Romans, finally culminating into the European Renaissance-all the significant eras of human civilisation have left their insignia and distinct marks on the evolution of anatomical practices. Despite its utility as a tool for anatomy pedagogy and research that has proven its worth over millennia, cadaveric dissection has particularly been subject to political and social vicissitudes. A major debate about anatomical dissection lay with the ethical considerations, or its lack thereof, while acquiring corpses for demonstration in the dissection halls. From antiquity, anatomical dissection-often synonymous with medical studies-had typically been carried out on the dead bodies of executed criminals with certain laws, such as the Murder Act of 1752, facilitating such uses. Gradually, the uses of unclaimed bodies, resourced primarily from the impoverished sections of society, were also introduced. However, these body acquisition protocols often missed the crucial element of humanism and ethical considerations, while knowledge augmentation was taken as sufficient reasoning. Unfortunately, a gross disregard towards humanistic values promulgated heinous and illegal practices in acquiring corpses, including grave robbery and even murders like in the case of Burke and Hare murders of 1828. Follow-up legislation, such as the Anatomy Act of 1832, and comparable laws in other European nations were passed to curb the vile. What distils from such a historical discourse on humane values in anatomy dissection, or medical science in general, is that the growth and integration of humanism in anatomy have never been linear, but there were intermittent and, yet, significant disruptions in its timeline. For example, there were serious human rights violations in anatomical practices during the Third Reich in Germany that perpetrated the holocaust. The medical community has kept evolving and introducing new moral values and principles while using such egregious events as lessons, ultimately resulting in the Declaration of Helsinki in 1964. This article revisits the heterogeneous journey of integrating humanistic values in anatomy practice. Such humanistic traits that, like medical science, have also developed over centuries through the inputs of physicians, researchers, and philosophers-from Greece to modernity with an important stopgap at the Renaissance-are a fascinating lore that deserves to be re-envisioned through the lens of contemporary values and ethos. In parallel to human medicine, humanistic values continue to influence veterinary medicine, a welcome development, as our society condemns animal cruelty in any form. There are lessons to be learned from this historical journey of how humanism shaped many of the concepts that anatomists use now. Finally, and most importantly, it might prevent the medical community from repeating the same mistakes by cautioning against the traps that are there, and in a convoluted world where morality as such is eroding from our social fabric, will always be there. Such historical account acts as a righteous, ethical, and contextual compass to guide the existing and upcoming anatomists in discerning between light and dark, right and wrong, and roads-to be or not to be-taken.

The influence of censorship laws on Viennese anatomy textbooks from the outgoing 18th century until after the student revolution of 1848 in Austrian absolutism.

INTRODUCTION: Anatomy textbooks´ connection to the rigid censoring laws enacted by Habsburg rulers, was never sufficiently investigated. Using anatomy textbooks written at the University of Vienna, our article aims at investigating the influence of censorship laws on the anatomy textbooks in Vienna between 1786 and 1865. METHODS: In our case study we compared legal text and archival sources (source material A) with seven prefaces of textbooks written by Viennese anatomists (source material B). The prefaces were comparatively investigated by applying the following questions based on source material A: (1) What motives for writing the textbooks were indicated by the anatomists in the prefaces? (2) What legal or other influences were mentioned as motives that point to a connection to the censorship regulations installed? (3) Referring to changing censorship guidelines is there a change in the mentioned audience? RESULTS: Our results are that we found evidence for censorship regulations (source material A) in the prefaces (source material B). Also, the motives for writing those textbooks changed over time because of changing censorship regulations. CONCLUSION: Our findings show that Viennese anatomy textbooks were part of the Austrian censorship laws in the investigated period with a timely correlation between the appointment as professor and the publication of the textbooks and prefaces (indirectly) referring to censorship laws. The academic tradition of writing textbooks arose from this system, when freedom of speech stood in opposition to the absolute Habsburg reign. Thus, when working with historical anatomy textbooks it is important to reflect on their censorship heritage.

Asociación Argentina de Anatomía: sus Inicios / Argentine Association of Anatomy: its Beginnings

Realizamos una reseña de los primeros años de la Asociación Argentina de Anatomía, que se creó en el año 2000 y que actualmente continúa vigente. Se describen sus orígenes, objetivos, primeros presidentes y congresos, así como publicaciones, además de sus relaciones inter-societarias, entre ellas se destaca la Sociedad Chilena de Anatomía.

SUMMARY: We make a review of the first years of the Argentine Association of Anatomy, which was created in the year 2000 and which is currently still in force. Its origins, objectives, first presidents and congresses are described, as well as publications, in addition to its inter-societal relations, among them the Chilean Society of Anatomy stands out.

The Emergence and Effects of the First Anatomy Theatres in Western Europe / El Surgimiento y los Efectos de las Primeras Salas de Anatomía en Europa Occidental

SUMMARY: The spread of the idea that the human body should be learned from cadavers, especially under the leadership of Vesalius, and the strong support of this idea among surgeons and medical students of that period, led to the emergence of anatomy theatres, particularly in the rich centres of Western Europe. Anatomy theatres have become prestigious places that make contributions to financial income for the cities they are located in. They have contributed to the importance of universities with the students they attract. Anatomy has become a more visual and international science because of the spread of anatomical drawings in scientific medical books, the newly invented printing press making it easier to print more books and the increasing interest of the people of the period. Learning medicine has become easier with the spread of visual anatomy books and cadaver studies. Cadaver studies and anatomy theatres, which started to become widespread under the leadership of brave science warriors such as Vesalius, who lived in the Renaissance period, became the subject of the paintings of painters of the period such as Rembrandt under the name anatomy activities. It is beneficial and necessary for society to keep in memory what this period brought to the world of anatomy and the present with its historical processes.

La difusión de la idea de que el cuerpo humano se debe aprender a partir de cadáveres, especialmente bajo el liderazgo de Vesalius, y el fuerte apoyo de esta idea entre los cirujanos y estudiantes de medicina de ese período, condujo al surgimiento de las salas de anatomía, particularmente en los ricos centros de Europa Occidental. Las salas de anatomía se han convertido en lugares de prestigio que contribuyen a los ingresos económicos de las ciudades en las que están ubicados y han contribuido a la importancia de las universidades con los estudiantes que atraen. La anatomía se ha convertido en una ciencia más visual e internacional debido a la difusión de los dibujos anatómicos en los libros médicos científicos, la imprenta recién inventada que facilita la impresión de libros y el creciente interés de la gente de la época. Aprender medicina se ha vuelto más fácil con la difusión de libros de anatomía visual y estudios de cadáveres. Los estudios de cadáveres y las salas de anatomía, que comenzaron a generalizarse bajo el liderazgo de valientes guerreros de la ciencia como Vesalius, que vivió en el Renacimiento, se convirtieron en el tema de las pinturas de artistas de la época como Rembrandt bajo el nombre de actividades de anatomía. Es beneficioso y necesario que la sociedad guarde en la memoria lo que este período trajo al mundo de la anatomía y el presente con sus procesos históricos.

Bartolomeo Panizza (1785-1867) and his contribution to the discovery of the visual cortex.

Bartolomeo Panizza (1785-1867) was an eminent anatomist and a pupil of Antonio Scarpa (1752-1832) at the University of Pavia. In 1855, before the revolutionary studies of Paul Broca (1824-1880) on aphasia that supported the theory of cortical localizations, Panizza delivered a lecture in Milan on the anatomy of the visual system, Osservazioni sul Nervo Ottico ("Observations on the optic nerve"). This lecture contains the first description of the cortical projection of the visual pathways in the occipital lobe, anticipating the revolutionary studies performed by Hermann Munk (1839-1912) in the late 19th century. The findings of Panizza questioned the assumption of the French physiologist, Marie-Jean-Pierre Flourens (1794-1867) who was defending the holistic concept of cerebral equipotentiality, which was widely accepted among the scientific community in the early 19th century. The present essay highlights the life and the scientific studies of Bartolomeo Panizza, with emphasis on the issue of cerebral localization that was simmering in the scientific community at that time.

Medical specimens and the erasure of racial violence: the case of Harriet Cole.

This article analyses the complex narrative of Harriet Cole, a 36-year-old African-American woman whose body was delivered to the anatomy department of Hahnemann Medical School in 1888. The anatomist Rufus B Weaver used her preserved remains to create a singular anatomical specimen, an intact extraction of the 'cerebro-spinal nervous system'. Initially anonymised, deracialised and unsexed, the central nervous system specimen endured for decades before her identity as a working-class woman of colour was reunited with her remains. In the 1930s, media accounts began to circulate that Harriet Cole had bequeathed her remains to the anatomist, a claim that continues to circulate uncritically in the biomedical literature today. Although we conclude that this is likely a confabulation that erased the history of violence to her autonomy and her dead body, the rhetorical possibility that Harriet Cole might have chosen to donate her body to the medical school reflects the racial, political and legal dimensions that influenced how and why the story of Harriet Cole's 'gift' served multiple purposes in the century and a half since her death.

Anatomy From Nazi Germany to Today.

This viewpoint reviews the anatomical body procurement used in Nazi Germany, notes the continued use of those images, and calls for disclosure of the biographical history of the people whose bodies and tissues are now studied.

Historia de la Sociedad-Asociación Rioplatense de Anatomía (1964-2000) / History of the Rioplatense Society-Association of Anatomy (1964-2000)

Realizamos una reseña histórica de la Sociedad-Asociación Rioplatense de Anatomía, que fue una agrupación de anatomistas argentino-uruguaya. Se consideran sus orígenes y objetivos, estructura organizativa, congresos y publicaciones. Posteriormente con el crecimiento de la anatomía en ambos países se desdobló en la Asociación Argentina de Anatomía y la Sociedad Uruguaya de Anatomía.

SUMMARY: We carry out a historical review of the Rioplatense Society-Association of Anatomy, which was a group of Argentine-Uruguayan anatomists. Its origins and objectives, organizational structure, congresses and publications are considered. Later, with the growth of anatomy in both countries, it was divided into the Argentine Association of Anatomy and the Uruguayan Society of Anatomy.

The illustrations and terminology of Hamse-i Sânizâde written by Sânizâde Ataullah Efendi: the stomach / Las ilustraciones y terminología de Hamse-i Sânizâde escrito por Sânizâde Ataullah Efendi: el estómago

SUMMARY: The book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" written by Sânîzâde Mehmet Ataullah Efendi was the first illustrated anatomy book published in the Ottoman Empire. The aim of this study was to determine the similarities and differences between the terms and definitions of stomach anatomy used by Sânîzâde at that time and those used today. The stomach section of the "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" was examined and related plates were translated into the Turkish language. Anatomical terms and definitions of stomach anatomy in this book were compared to the stomach terminology used in "Terminologia Anatomica" which is the reference book for terminology today. The stomach section was explained under the title "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Illustrated Stomach Anatomy) in this book. Parts, margins, arteries, veins, nerves and layers of the stomach were explained with the terms and definitions of that period. Terminologia Anatomica has 33 anatomical terms related to the stomach, while 15 terms were identified in the book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Although more terms related to the stomach anatomy are used today, the fundamental information on stomach anatomy in Sânîzâde's book was compatible with much of the information used in modern anatomy books today.

El libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l- Insân" escrito por Sânîzâde Mehmet Ataullah Efendi fue el primer libro de anatomía ilustrado y publicado en el Imperio Otomano. El objetivo de este estudio fue determinar las similitudes y diferen- cias entre los términos y definiciones de la anatomía del estómago utilizados por Sânîzâde en ese momento y los que se utilizan en la actualidad. Se examinó la sección del estómago del "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" y las placas relacionadas se tradujeron al idioma turco. Los términos anatómicos y las definiciones de la anatomía del estómago en este libro se compararon con la terminología del estómago utilizada en Terminologia Anatomica, el libro de referencia para la terminología utilizado actualmente. La sección del estómago se explicó bajo el título "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Anatomía del estómago ilustrada) en este libro. Fueron definidas las partes, márgenes, arterias, venas, nervios y capas del estómago con los términos y definiciones de esa época. Terminologia Anatomica tiene 33 términos anatómicos relacionados con el estómago, mientras que 15 términos fueron identificados en el libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Aunque hoy en día se utilizan más términos relacionados con la anatomía del estómago, la información fundamental sobre la anatomía del estómago en el libro de Sânîzâde era compatible con gran parte de la información utilizada en los libros de anatomía modernos en la actualidad.

Rest in Pieces: Body Donation in Mid-Twentieth Century America.

By the mid-1950s, formal body donation programs began to supplant the decades-long reliance on the anatomy acts that made the bodies of the indigent and unclaimed available for medical education and research. By the mid-1980s, nearly all American medical schools relied on voluntary anatomical gifts of dead bodies. Throughout the nineteenth century, a handful of Americans requested through wills, letters, and suicide notes that their corpses be given to doctors and medical schools. The dramatic expansion of American newspapers after the Civil War helped establish bequeathing one's body as an available, albeit eccentric, afterlife. A significant shift in American deathways in the twentieth century, the rise of blood donation and organ transplantation, and a serious decline in the number of unclaimed bodies spurred anatomists finally to accept, and then to promote, this new corporeal philanthropy.

The place of ethics in practice of anatomical sciences: have we left our dark past behind and looking towards a bright future?

INTRODUCTION: Anatomical sciences involve handling of human tissues and, therefore, application of principles of bioethics is central to anatomical practice. For a considerable period of time, anatomy was practiced without ethical norms as concept of ethics developed during second half of twentieth century. Hence, possible glimpse into contrast in ethical standards between anatomy in the past and present was deemed as an intriguing research theme. METHODS: A literature search was undertaken from indexed databases (Medline and Pubmed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar). Relevant data were extracted from 37 articles that were selected from an initial pool of 752 articles based on search criteria set for the study. RESULTS: Prevalent anatomical practices in the past such as dissection of executed criminals, acts of vivisection, illegal procurement of human remains, use of human tissues obtained as part of war crimes and dissection of human fetuses as well as their archival were analyzed through prism of established ethical norms in present day. The observations from past were presented vis-à-vis ethical practices undertaken in present times such as use of donated bodies and/or body parts procured through legal means for dissection, adherence to ethical norms during dissection, archival of human tissues mandating stringent regulation and dignified disposal of human remains. Existing loop holes were identified and future prospects regarding ethical standards in anatomy were highlighted based on rational judgment of existing trends. CONCLUSION: The article concludes with defense on future prospects of ethics in anatomy based on documented arguments.

Eugène-Louis Doyen and his Atlas d'Anatomie Topographique (1911): Sensationalism and gruesome theater.

French surgeon and anatomist Eugène-Louis Doyen (1859-1916) was a focus of controversy and scandal throughout his career, an innovative surgeon of great technical skill whose unsurpassed abilities were offset by narcissistic and frequently unethical behavior. Doyen produced the most controversial atlas of human anatomy of the early-twentieth century, his Atlas d'Anatomie Topographique. He used a chemical process to fix whole cadavers, then used a motorized band saw with a sliding table to precisely cut sequential slices in all three anatomic planes. His intentionally arresting images of the nervous system in situ (using heliotypes in his atlas and projected images of prepared specimens in his lectures) made for gruesome theater, directed more at the public than the medical profession, which Doyen disdained and delighted in antagonizing. Although photography and photomechanical reproduction facilitated the rapid production of Doyen's atlas, many of the fine details were lost. In addition, although he developed tissue fixation techniques that preserved the natural colors of tissues, this was not evident in the monochrome images of the printed atlas. Doyen's atlas is compared with other anatomic atlases of the late-nineteenth century that included serial sections of the central nervous system, either from sections of entire cadavers, the isolated head, or the excised brain. In retrospect, Doyen's fevered activity, including his efforts to depict the topographic anatomy of the nervous system, produced only modest benefits, and often produced significant costs for his patients, his colleagues, the medical profession, and his own reputation.

Evolution of the myth of the human rete mirabile traced through text and illustrations in printed books: The case of Vesalius and his plagiarists.

Andreas Vesalius initially accepted Galen's ideas concerning the rete mirabile in humans. In 1538, Vesalius drew a diagram of the human rete mirabile as a plexiform termination of the carotid arteries, where the vital spirit is transformed into the animal spirit, before being distributed from the brain along the nerves to the body. In 1540, Vesalius demonstrated the rete mirabile at a public anatomy, using a sheep's head (due to his nascent realization that he could not demonstrate this adequately in a human cadaver, potentially eliciting ridicule). By 1543, Vesalius had fully reversed himself, denied the existence of the rete mirabile in humans, and castigated himself for his prior failure to recognize this error in Galen's works. Vesalius nevertheless illustrated both the Galenic conception of the rete mirabile in humans and a schematic of the rete mirabile in ungulates. He intended the 1543 diagram of the human rete mirabile as an example of a mistake that resulted from Galen's overreliance on animals as models of human anatomy. However, in spite of Vesalius's intentions, for more than a century afterward, his figure was repeatedly and perversely plagiarized by advocates for Galenic doctrine, who misused it as a purportedly realistic representation of human anatomy and generally omitted the contrary opinions of Berengario da Carpi and Vesalius. The protracted use of stereotyped representations of the rete mirabile in extant printed illustrations provides tangible documentation of the stagnation in anatomical thought in the sixteenth and seventeenth centuries.

Then there were 12: The illustrated cranial nerves from Vesalius to Soemmerring.

In the second century ce, Galen described seven pairs of cerebral nerves. He did not name the nerves, nor did he illustrate his work. Galen's descriptive texts survived until the mid-sixteenth century, when anatomists, influenced by the artistic and scientific revolution of the Renaissance, began a reformation in anatomical research. They closely observed their own dissected material and conveyed their results not only in words but commonly by lavish drawings. Many of the great anatomists reexamined the cerebral nerves, adding descriptive text or changing the classification. In 1778, Thomas Soemmerring (1755-1830) named 12 pairs of cerebral nerves upon which the modern cranial nerve nomenclature is based. Soemmerring matched his text with clear, decisive illustrations. This article describes the works of some of the great artists in the period from Vesalius to Soemmerring and how they used illustration to supplement and provide clarity for their textual descriptions of the cranial nerves.

Summarizing the medieval anatomy of the head and brain in a single image: Magnus Hundt (1501) and Johann Dryander (1537) as transitional pre-Vesalian anatomists.

Of the early-sixteenth century pre-Vesalian anatomists, Magnus Hundt in 1501 and Johannes Eichmann (known as Johann Dryander) in 1537 both attempted to summarize the anatomy of the head and brain in a single complex figure. Dryander clearly based his illustration on the earlier one from Hundt, but he made several improvements, based in part on Dryander's own dissections. Whereas Hundt's entire monograph was medieval in character, Dryander's monograph was a mixture of medieval and early-modern frameworks; nevertheless, the corresponding illustrations of the anatomy of the head and brain in Hundt (1501) and Dryander (Dryandrum 1537) were both essentially medieval. This article examines in detail the symbology of both illustrations within the context of the medieval framework for neuroanatomy and neurophysiology. These two woodcuts of the head and brain provide the most detailed pictorial representation of medieval cranial anatomy in a printed book prior to the work of Andreas Vesalius in 1543.

The evolution of epistemological methodologies in anatomy: From antiquity to modern times.

Present day scenario regarding epistemological methods in anatomy is in sharp contrast to the situation during ancient period. This study aimed to explore the evolution of epistemological methodologies in anatomy across centuries. In ancient times Egyptian embalmers acquired anatomical knowledge from handling human bodies and likewise anatomical studies in India involved human dissection. Ancient Greeks used theological principles-based methods, animal dissection and human dissection in practice of anatomy. Human dissection was also practiced in ancient China for gaining anatomical knowledge. Prohibition of human dissection led to use of animal dissection in ancient Rome and the trend continued in Europe through Middle Ages. Epistemological methods used by Muslim scholars during Middle Ages are not clearly chronicled. Human dissection returned as primary epistemological method in Renaissance Europe and empirical methods were reinstated after ancient period in human dissection during 16th century. The situation further improved with introduction of pragmatic experiment based approach during 17th century and autopsy-based methods during 18th century. Advances in anatomical knowledge continued with advent of microscope-based methods and emergence of anatomical sections in practice of human dissection in 19th century. Introduction of human observational studies, medical imaging, and molecular methods presented more options in terms of epistemological methods for investigating the human body during 20th century. Onset of 21st century has witnessed dominance of technology-based methods in anatomy. Limited emphasis on ethics in epistemological methodologies since antiquity is a dark aspect of otherwise an eventful evolutionary journey but recent developments are in positive direction.

Intimate Connections: Marie Marguerite Biheron and Her "Little Boudoir".

This essay considers the pursuits and occupational trajectory of the Parisian anatomical modeler Marie Marguerite Biheron (1719-95), who was celebrated for her anatomical cabinet. It highlights the role of Biheron's circle of friends and supporters in nourishing her place in the anatomical world. I argue that a focus on social and affective relations, such as friendship, can enhance our understanding of the careers of female medical practitioners and medical artists like Biheron. Her case provides a useful vantage point to reconstruct how a woman, who could not rely on the support of her family nor, for most of her life, on royal patronage, could successfully engage in anatomical practice and become renowned. Casting light on early modern economies of care, Biheron's story also helps illuminate the broader significance of amicable and affective relations in the histories of medicine and natural inquiry.