Anatomical models and wax Venuses: art masterpieces or scientific craft works?

Using represented bodies in Renaissance artworks to teach musculoskeletal and surface anatomy

Surface anatomy is an important skill for students in preparation for patient care, and peer examination is often used to teach musculoskeletal and surface anatomy. An alternative pedagogical approach is to use bodies represented in artworks. Represented bodies display fictive anatomy, providing students with the opportunity to apply their musculoskeletal knowledge and to think critically when evaluating the anatomical fidelity of a represented body. An elective course at the University of Michigan enabled undergraduate students to analyze the musculoskeletal and surface anatomy depicted in Renaissance artworks. Students traveled to Italy in 2018 (n = 14) and 2022 (n = 15) to analyze the fictive anatomy portrayed in artistic sculptures and musculoskeletal structures depicted in wax anatomy models and sculpted skeletons. In assignments, students were asked to identify musculoskeletal structures as portrayed in the context of represented anatomy created by Italian Renaissance artists and to assess the fidelity of the depicted anatomy. The students also applied their knowledge of musculoskeletal anatomy to describe body position and evaluate muscle function in their assessments of the accuracy or inaccuracy of the fictive anatomy. The students reported that evaluating the anatomical fidelity of represented bodies in artworks supported their learning of musculoskeletal and surface anatomy, and that their critical thinking skills improved in the course. Evaluation of the anatomical fidelity of represented bodies in artworks is an effective pedagogical approach that can be implemented in art museums as an adjunctive learning experience to deepen students' musculoskeletal and surface anatomy knowledge and further develop their critical thinking skills.

Anatomical description of the brain wax models of Museu da Pharmacia de Ouro Preto

BACKGROUND

In 1839, the Escola de Farmácia de Ouro Preto pioneered the teaching of pharmaceutical sciences in Brazil. At the end of the 19th century, the Escola de Farmácia possessed a French collection of anatomical models, some made of wax and paper-mâché. The models were a critical part of teaching anatomy, particularly in an era of paradigm changes about how the human brain works.

OBJECTIVE

The present study aimed to anatomically describe the brain models through a comparative analysis with the current anatomical description.

METHODS

Comparative analysis of the brain models with modern anatomical descriptions.

RESULTS

In the individual analysis of the wax models, we verified excellent anatomical accuracy of the cortical and subcortical regions. Our results identified internal structures, like the basal ganglia and white matter. Compared with modern anatomical books and websites, the wax brain models have high scientific quality.

CONCLUSION

The models of the present study gave students hands-on experience of human anatomy in the 19^th century. Nowadays, the models are part of the memory of Universidade Federal de Ouro Preto and Museu da Pharmacia de Ouro Preto . The collection of wax models shows the appreciation of neuroanatomy teaching at the turn of the century concomitant with advances in neurology and anatomy around the world.

3D Digital Technologies for the Elaboration of a Replica of a Dermatological Didactic Model Belonging to the Olavide Museum from the Original Mould

The Olavide Museum in Madrid, which was founded in the 19th century, preserves one of the most important collections in the world of three-dimensional dermatological models made of polychrome beeswax. These models have been used for the training of numerous generations of dermatologists in Spain. Unfortunately, many of the figures were preserved in precarious conditions during the time that the museum was closed in the middle of the 20th century, and some could not be found after its reopening. In this paper, we show a method for the recovery of a missing model of which only the original plaster cast remains. For this purpose, we use the combination of a structured light scanner and 3D printing, together with traditional techniques, to reproduce a copy of the original cast, in order to prevent its deterioration during the wax casting. As a result of this study, a highly realistic figure was obtained, which represented, in great detail, the small superficial reliefs of the skin lesions, as well as their colour. The conclusion of this research is that it is possible to recreate, with precision, a didactic model in beeswax from its mould, without the need to use the mould in the process, which avoids any risk of deterioration in the process.

Bygone theatres of events: A history of human anatomy and dissection

Over the last four millennia, the discipline of anatomy and its relationships with medicine and society have evolved dramatically. Human dissection, the perennial tool for anatomical discovery and education, has both guided this evolution and matured alongside it. Soon after the first cadaveric dissections recorded in ancient Greece, China, India, and Persia, clear endorsements of its practice fell largely silent in the anatomical record for 1,500 years before reappearing in Europe at the dawn of the Renaissance. Between the 13th and 18th centuries CE, the performance of anatomical dissection became a popular form of education and public entertainment, and the demand for human cadavers steadily increased among European anatomical schools while supply remained limited by legal statute. This gave rise to an informal group of amateur and professional body snatchers called the Resurrectionists and, later, inspired the Anatomy Act of 1832 CE. In the 20th and 21st centuries CE, voluntary body bequeathal programs have enabled the practice of human dissection to continue in academic centers as a cornerstone of anatomical education, now with a newfound focus on the development of affective skills. This article provides an abridged account of anatomy's development, highlighting key moments in its growth, the valuable contributions of many different societies to the discipline, and the important roles of several luminary anatomists of antiquity. Within the broader context of this history, it offers an overview of anatomical dissection's evocative past, spanning from its inception to its present-day practice.

The mediums of dissemination of knowledge and illustration in neurosurgery: unraveling the evolution

The earliest evidence of man's attempts in communicating ideas and emotions can be seen on cave walls and ceilings from the prehistoric era. Ingenuity, as well as the development of tools, allowed clay tablets to become the preferred method of documentation, then papyrus and eventually the codex. As civilizations advanced to develop structured systems of writing, knowledge became a power available to only those who were literate. As the search to understand the intricacies of the human brain moved forward, so did the demand for teaching the next generation of physicians. The different methods of distributing information were forced to advance, lest the civilization falls behind. Here, the authors present a historical perspective on the evolution of the mediums of illustration and knowledge dissemination through the lens of neurosurgery. They highlight how the medium of choice transitioned from primitive clay pots to cutting-edge virtual reality technology, aiding in the propagation of medical literature from generation to generation across the centuries.

Authenticity in Anatomy Art

The aim of this paper is to observe the evolution and evaluate the 'realness' and authenticity in Anatomy Art, an art form I define as one which incorporates accurate anatomical representations of the human body with artistic expression. I examine the art of 17th century wax anatomical models, the preservations of Frederik Ruysch, and Gunther von Hagens' Body Worlds plastinates, giving consideration to authenticity of both body and art. I give extra consideration to the works of Body Worlds since the exhibit creator believes he has created anatomical specimens with more educational value and bodily authenticity than ever before. Ultimately, I argue that von Hagens fails to offer Anatomy Art 'real human bodies,' and that the lack of bodily authenticity of his plastinates results in his creations being less pedagogic than he claims.

Optimizing the image of fluorescence cholangiography using ICG: a systematic review and ex vivo experiments

Background

Though often only briefly described in the literature, there are clearly factors that have an influence on the fluorescence intensity, and thereby the usefulness of the technique. This article aims to provide an overview of the factors influencing the fluorescence intensity of fluorescence imaging with Indocyanine green, primarily focussed on NIRF guided cholangiography.

Methods

A systematic search was conducted to gain an overview of currently used methods in NIRF imaging in laparoscopic cholecystectomies. Relevant literature was searched to gain advice on what methods to use. Ex vivo experiments were performed to assess various factors that influence fluorescence intensity and whether the found clinical advices can be confirmed.

Results

ICG is currently the most widely applied fluorescent dye. Optimal ICG concentration lies between 0.00195 and 0.025 mg/ml, and this dose should be given as early as achievable—but maximum 24 h—before surgery. When holding the laparoscope closer and perpendicular to the dye, the signal is most intense. In patients with a higher BMI and/or cholecystitis, fluorescence intensity is lower, but NIRF seems to be more helpful. There are differences between various marketed fluorescence systems. Also, no uniform method to assess fluorescence intensity is available yet.

Conclusions

This study identified and discussed several factors that influence the signal of fluorescence cholangiography. These factors should be taken into account when using NIRF cholangiography. Also, surgeons should be aware of new dyes and clinical systems, in order to benefit most from the potential of NIRF imaging.

Electronic supplementary material

The online version of this article (10.1007/s00464-018-6233-x) contains supplementary material, which is available to authorized users.

Displayed Wounds, Encrypted Messages: Hyper-Realism and Imagination in Medical Moulages

Moulages are three-dimensional colorful replicas of body parts with particular expressions of ailments. Historically, by operating a transition between illness and disease, moulages were a powerful tool in the consolidation of the medical specialty of dermatovenereology. Yet, moulages are not solely an objectification of biological processes suitable for medical teaching; they also activate non-medical cognitions and emotions about life, death, behavior, and morality that are rooted in the history of the art of wax modeling. Furthermore, they provide a window into a dense history of urban health and illness, sex, law enforcement, assistance, gender, class, and politics.

The history of an unknown dermatological wax collection from Cluj-Napoca University "Iuliu Hatieganu", Romania

Among the dermatological wax collections across Europe, one of the latest created is the collection from Cluj-Napoca University, Romania. The initiator was Professor Coriolan Tataru and the moulage artist employed was Dr. Richard Hoffmann. Between the years 1923 and 1928, around 200 wax moulages were made, all realised after patients hospitalised in the clinic. The majority of cases represent the dermatological infectious pathology of that time: syphilis, cutaneous tuberculosis and mycetomas. Other interesting moulages represent genodermatoses, pelagra, different cutaneous cancers, and atypical aspects of common diseases like psoriasis and eczemas. The models depicting different stages of syphilis won the gold medal at the Ninth International Congress of Dermato-Venereology held in Budapest in 1935. We believe that the collection has a great value from a historical, artistic, didactic and scientific point of view, and it is organised as a museum within the Dermatology Clinic.

A brief history of topographical anatomy

This brief history of topographical anatomy begins with Egyptian medical papyri and the works known collectively as the Greco-Arabian canon, the time line then moves on to the excitement of discovery that characterised the Renaissance, the increasing regulatory and legislative frameworks introduced in the 18th and 19th centuries, and ends with a consideration of the impact of technology that epitomises the period from the late 19th century to the present day. This paper is based on a lecture I gave at the Winter Meeting of the Anatomical Society in Cambridge in December 2015, when I was awarded the Anatomical Society Medal.

Uncovered secret of a Vasseur-Tramond wax model

The technique of anatomical wax modelling reached its heyday in Italy during the 18th century, through a fruitful collaboration between sculptors and anatomists. It soon spread to other countries, and prestigious schools were created in England, France, Spain and Austria. Paris subsequently replaced Italy as the major centre of manufacture, and anatomical waxes were created there from the mid-19th century in workshops such as that of Vasseur-Tramond. This workshop began to sell waxes to European Faculties of Medicine and Schools of Surgery around 1880. Little is known of the technique employed in the creation of such artefacts as this was deemed a professional secret. To gain some insight into the methods of construction, we have studied a Vasseur-Tramond wax model in the Valladolid University Anatomy Museum, Spain, by means of multi-slice computerised tomography and X-ray analysis by means of environmental scanning electron microscopy. Scanning electron microscopy was used to examine the hair. These results have revealed some of the methods used to make these anatomical models and the materials employed.

Modern day relevance of William Hunter's approach to teaching "The organ of hearing"

William Hunter, a pioneering teacher of Anatomy in the the eighteenth century, championed the use of dissected specimens as aids in the teaching of anatomy. Although Hunter promoted the Paris method of learning Anatomy, by student dissection, he also used prosected material as an adjunct to his lectures. We are fortunate that Hunter bequeathed his extensive collection of over 3,000 museum specimens to the University of Glasgow, many of which are housed in the Laboratory of Human Anatomy in the Thomson Building. Regions such as the temporal bone are frequently difficult for students, and indeed postgraduate trainees in ear nose and throat surgery, to visualize and understand. Hunter overcame this difficulty by producing elegant specimens highlighting the three-dimensional complexity of the area. The current vignette stresses the importance of Hunter in his contemporary setting, but also demonstrates the potential of his approach for current and future teaching programmes in this age of the Internet.

Gerota and Brâncuşi: Romanian anatomy and art face to face

Gerota's name is associated with two eponyms and two histochemical methods, but he was also Brâncuşi's teacher and supervisor. When Brâncuşi was a student in Bucharest, he produced an 'écorché' (flayed man), of which six plaster replicas still exist, two in apparently the original shape and four which have been modified/'cosmetized'. The two are in the University of Arts in Bucharest, one in the main hall, the other in the classroom used for teaching students. Of the other four, one is in the Museum of Arts and one in the Museum of Natural Sciences of Carol I National College in Craiova (where Gerota graduated in 1885), and one each in the Faculties of Medicine in Cluj Napoca and Iassy. One more probably existed in the Faculty of Medicine in Bucharest, and one in the Faculty of Fine Arts in Iassy but no trace of them could be found. The original clay model was lost (or destroyed during transportation) in the 1930s or 1956. Two variants of the écorché exist: one 'artistic' (slender and smoother) in the University of Arts in Bucharest; the other more 'anatomical' (muscular, robust, athletic) in Craiova, Cluj and Iassy. Both variants are a very realistic representation of the human muscular system, but with that extra which only a master artist can add. Interestingly, the head of the écorché bears a striking resemblance in attitude and curves to that of Brâncuşi's famous head of Mademoiselle Pogany. The replicas appear to have been distributed to embellish the capitals of four of the six historical Romanian provinces: Muntenia (Bucharest), Oltenia (Craiova), Moldavia (Iassy), and Transylvania (Cluj).

Facial reconstruction--anatomical art or artistic anatomy?

Facial reconstruction is employed in the context of forensic investigation and for creating three-dimensional portraits of people from the past, from ancient Egyptian mummies and bog bodies to digital animations of J. S. Bach. This paper considers a facial reconstruction method (commonly known as the Manchester method) associated with the depiction and identification of the deceased from skeletal remains. Issues of artistic licence and scientific rigour, in relation to soft tissue reconstruction, anatomical variation and skeletal assessment, are discussed. The need for artistic interpretation is greatest where only skeletal material is available, particularly for the morphology of the ears and mouth, and with the skin for an ageing adult. The greatest accuracy is possible when information is available from preserved soft tissue, from a portrait, or from a pathological condition or healed injury.

Style and non-style in anatomical illustration: From Renaissance Humanism to Henry Gray

Style is a familiar category for the analysis of art. It is less so in the history of anatomical illustration. The great Renaissance and Baroque picture books of anatomy illustrated with stylish woodcuts and engravings, such as those by Charles Estienne, Andreas Vesalius and Govard Bidloo, showed figures in dramatic action in keeping with philosophical and theological ideas about human nature. Parallels can be found in paintings of the period, such as those by Titian, Michelangelo and Hans Baldung Grien. The anatomists also claimed to portray the body in an objective manner, and showed themselves as heroes of the discovery of human knowledge. Rembrandt's painting of Dr Nicholas Tulp is the best-known image of the anatomist as hero. The British empirical tradition in the 18th century saw William Cheselden and William Hunter working with techniques of representation that were intended to guarantee detailed realism. The ambition to portray forms life-size led to massive volumes, such as those by Antonio Mascagni. John Bell, the Scottish anatomist, criticized the size and pretensions of the earlier books and argued for a plain style adapted to the needs of teaching and surgery. Henry Gray's famous Anatomy of 1858, illustrated by Henry Vandyke Carter, aspired to a simple descriptive mode of functional representation that avoided stylishness, resulting in a style of its own. Successive editions of Gray progressively saw the replacement of Gray's method and of all his illustrations. The 150th anniversary edition, edited by Susan Standring, radically re-thinks the role of Gray's book within the teaching of medicine.

The evolution of anatomical illustration and wax modelling in Italy from the 16th to early 19th centuries

Although the contribution to anatomical illustration by Vesalius and his followers has received much attention, less credit has been given to Veslingius and particularly Fabricius. By 1600, Fabricius had amassed more than 300 paintings that together made the Tabulae Pictae, a great atlas of anatomy that was highly admired by his contemporaries. Many of his new observations were incorporated into subsequent books, including those by Casserius, Spighelius, Harvey and Veslingius. Also of importance were the Tabulae by Eustachius (1552), which, although only published in 1714, greatly influenced anatomical wax modelling. In 1742, Pope Benedict XIV established a Museum of Anatomy in Bologna, entrusting to Ercole Lelli the creation of several anatomical preparations in wax. Felice Fontana realised that the production of a large number of models by the casting method would make cadaveric specimens superfluous for anatomical teaching and in 1771 he asked the Grand Duke to fund a wax-modelling workshop in Florence as part of the Natural History Museum, later known as La Specola. Fontana engaged Giuseppe Ferrini as his first modeller and then the 19-year-old Clemente Susini who, by his death in 1814, had superintended the production of, or personally made, more than 2000 models. In 1780, the Austrian Emperor Joseph II visited La Specola and ordered a great number of models for his Josephinum museum; these were made by Fontana with the help of Clemente Susini and supervised by the anatomist Paolo Mascagni. It is, however, in Cagliari that some of Susini's greatest waxes are to be found. These were made when he was free of Fontana's influence and were based on dissections made by Francesco Antonio Boi (University of Cagliari). Their distinctive anatomical features include the emphasis given to nerves and the absence of lymphatics in the brain, a mistake made on earlier waxes. The refined technical perfection of the anatomical details demonstrates the closeness of the cooperation between Susini and Boi, whereas the expressiveness of the faces and the harmony of colours make the models of Cagliari masterpieces of figurative art.

The diagnosis of the cause of the death of Venerina

Venerina (little Venus) is the name given to a wax model representing a pregnant young woman that was created in Florence (Italy) by Clemente Susini (1754-1814) in 1782. It is currently located in the historic Science Museum of the University of Bologna. The model was constructed so as to enable removal of the thoracic and abdominal walls and various organs, exposing the heart, diaphragm and an opened uterus with a well-developed fetus. The woman is small, about 145 cm (4' 9') tall and of delicate build; she looks like a teenage girl. We know that Clemente Susini worked directly with the cadaver and copied the anatomical preparation exactly. This artist often represented the true structure using a wax mould; the existence of two other versions of this specimen suggests that this model was made in this way. Therefore, Venerina's body may be a faithful representation of a young woman who died while pregnant. Observation of the body confirms that the organs are normal, except for the heart and great vessels. The walls of both ventricles are of equal thickness and the ventricles themselves of approximately equal size. The arch of the aorta and the enlarged pulmonary trunk are connected by a short duct about 3.5 mm in diameter. If this structure represents an open arterial duct, we can deduce that the two ventricles worked under the same conditions of blood pressure, hence their equal wall thickness. If the young woman died from this congenital disease, the cause of death has been diagnosed on a wax model of her body after more than two centuries.