ANATOMY 458 ANATOMY the changes brought on by disease, in various organs or tissues. HisTORv: Greek and Latin Period. — Anatomical knowledge had its beginnings verj' early in the history of the race. Animal sacrifices led to a knowledge of animal anatomy which was readily applied to man. The art of embalming also necessitated a knowledge of the position of blood vessels and certain organic relations. Even Homer u.sed many terms which indicate a mucli deeper knowledge of human struct- ures than might be expected thus early. The first real development of anatomy as a science, however, did not come until the time of Hippocrates of Cos, about 400 n. c. The Grecian Father of Medicine knew the bones well, probably because of the ready opportunities for their study to be found in tombs, but did not know the distinction between veins and arteries, and uses the term apr-qpla in reference to the trachea. He used the term nerve to signify a sinew or tendon. Until the time of Aristotle, about 330 B. c, no additions were made to anatomical knowledge. There seems to be no doubt that this Grecian philosopher frequently dissected animals. His description of the aorta and its branches is surprisingly correct. This is the first time in the history of anatomy that the word aorta, Greek iopTTi, a knapsack, was used. His knowledge of the nerves was almost as little as that of Hi]5pocrates, but he was thoroughly familiar with the internal viscera, and he distinguishes the jejunum or empty portion of the small intestine; the ca?cum, or blind gut, so called because it is a sort of cul-de-sac; the colon, and the sigmoid flexure. The word rectum is the literal translation of his description of the straight process of the bowel to the anus. A contemporary of Aristotle, Praxagoras of Cos, was the first who distinguished the arteries from the veins and spoke of the former as air vessels because after death they always contained only air. All of this knowledge had been gained from dis- sections of animals. It was at Alexandria in the beginning of the third century before Christ that two Greek philosophers, Herophilus and Erasis- tratus, made the first dissections of the human body. None of their writings have come down to us. We know what they discovered, however, from the refer- ences to them made by Galen, Oribasius, and other medical wTiters. Erasistratus discovered the heart valves and called them, from their forms, sigmoid and tricuspid. He studied the convolutions of the brain and recognized the nature of nerves which he described as coming from the brain. He seems even to have appreciated the difference between nerves of motion and sensation. There is a claim that he discovered the lymph vessels in the mesentery also. Herophilus applied the name of twelve incli portion of the intestine to the part which has since been called the duodenum. He described the straight venous sinus within the skull which is still sometimes called by his name. He is also said to have given the name of calamiLs scriptorius to the linear furrow at the lower part of the fourth ventricle. Nearly three himdred years passed before another great name in anatomy occurred, namely, that of Celsas, who saw the dilTerence between the trachea and the cesophagus, described the size, positions, and relatioixs of the diaphragm as well as the relations of the various organs to one another, and added much to the knowledge of the lungs and the heart. He knew most of the minute points in osteology with almost modern thoroughness. The sutures ant'l most of the foramma of the .skull and the upper and lower jaw-bones with the tcetli, he describes very perfectly. He mentions many small holes in the nasal cavities anil evidently knew the ethmoid bone. He even seemed to liave distinguished the semi-circular canals of the car. After Celsus, who lived during the half-century before Christ, the next important name is that of Galen, who was born about a. d. 130. Galen was not only an investigator but a collator of all the medical knowledge down to his time. His work was destined to rule anatomical science down to Vesalius and even beyond it, that is, for nearly fourteen hundred years. Galen's osteology is almost perfect. His knowledge of muscles was more in- complete, but it was far beyond that of any of his predecessors. He did not add much to the previous knowledge with regard to blood vessels, though he made the cardinal demonstration that in living animals arteries contained not air but blood. His description of the veins and arteries, however, is rather confused and here his knowledge is most imperfect. His additions to the knowledge of the nervous system are very important. He described the falx and exposed by successive sections the ventricles and the choroid plexus. In general, his description of the gross anatomy of the brain is quite advanced. Medieval Period. — ^^Vith the fall of the Roman Empire and the incursions of the barbarians there came an end for at least five or six ceiituries to all anatomical study. The first signs of a reawakening of interest in anatomy after this long sleep showed them- selves at the famous medical school at Salernum. There is no doubt that even during the tenth century Salernum had a reputation as the best place for invalids with ailments that could not be cured elsewhere. Many of the distinguished nobility and members of reigning families found their way down to this little town and its reputation soon attracted medical students. There is a tradition connecting the rise of the school at Salernum with the Benedic- tine monks whose great monastery of Monte Cassino was not far aw-ay. Definite details are, however, lacking. In the ele-enth century the medical courses at Salernum began to l^e regularly organized. At the beginning of the twelfth century regulations for the first State examinations in medicine were made. Anatomy was a required subject, but was studied by means of the pig which was thought to be closely related to man in anatomical structure. Curiously enough this animal is now reassuming a place in medicine as a favourite subject for research and instruction in embryology. About the middle of the thirteenth century Frederick II made it a rule that the students at Saler- num should be present at one human dissection at least each year. About this time the other rising universities of Europe took up the serious study of anatomy and proved successful ri-als to Salermun. Montpellier was one of the earliest to make a name for itself, but both Paris and Bologna were not far behind. At Paris before the end of the thirteenth century the famous Hermondaville was giving a series of demonstrations on human cadavers that attracted students from all over Europe, and William of Salicet, at Bologna, attracted quite as much attention. There appears to be no doubt that he made many human dissections, and there is a definite tradition of his having made a medico-legal autopsy on the body of a nobleman in order to determine whether death was due to poisoning. This fact of itself would seem to show that this was not an un- usual procedure, since if William were not accus- tomed to seeing bodies dissected frequently he would scarcely be trusted as an expert in determining the presence or absence of poison. It is very commonly accepted that there was an interruption in the development of anatomical knowledge about the beginning of the fourteentli century because of a papal decree forbidding dis- section. The statement that such a decree wa^ promulgated is to be found in nearly every history of medicine published in English, and has been made
