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Duverney's skeletons.

In 1730, shortly before his death, the Paris anatomist Joseph-Guichard Duverney wrote his will, leaving his anatomical specimens to the Académie des Sciences, of which he was a member. But the will was disputed by Pierre Chirac, supervisor of the Jardin du Roi where Duverney, as professor of anatomy, had performed most of the dissections that produced the specimens. The ensuing debate between Chirac and René-Antoine Ferchault de Réaumur, arguing for the Académie, reveals the tensions surrounding both the concept of intellectual property in this period and the collective enterprise in natural philosophy. The differing roles and audiences of the Académie and the Jardin were central to this debate. In addition, this essay explores the origins and significance of the anatomical specimens themselves and their changing role in instruction and display, as well as the transition from the cabinet of curiosities to the natural history museum.

Academies and Institutes↗

History from the ground up: bugs, political economy, and God in Kirby and Spence's Introduction to Entomology (1815-1856).

William Kirby and William Spence's Introduction to Entomology is generally recognized as one of the founding texts of entomological science in English. This essay examines the ideological allegiances of the coauthors of the Introduction. In particular, it analyzes the ideological implications of their divergent opinions on animal instinct. Different vocational pursuits shaped each man's natural history. Spence, a political economist, pursued fact-based science that was shorn of references to religion. Kirby, a Tory High Churchman, placed revelation at the very heart of his natural history. His strong commitment to partisan sectarianism cautions against reference to a homogeneous "natural theology" that was an agent of mediation. Fissures in the "common intellectual context" reached beyond the clash between natural theologians and radical anatomists to render the intellectual edifice of natural theology structurally less sound for the future.

Agriculture↗

The tale of Phineas Gage, digitally remastered.

The injury of Phineas Gage has fueled research on and fascination with the localization of cerebral functions in the past century and a half. Most physicians and anatomists believed that Gage sustained a largely bilateral injury to the frontal lobes. However, previous studies seem to have overlooked a few less obvious, but essential details. This has led us to reanalyze the injury using three-dimensional reconstruction and quantitative computer-aided techniques and to propose a new biomechanical model, in order to determine the location and extent of the injury and explain Gage's improbable survival. Unlike previous studies on this subject, our findings are based on computer-generated three-dimensional reconstructions of a thin-slice computed tomography scan (CAT) of Phineas Gage's skull. The results of our image analysis were corroborated with the clinical findings, thoroughly recorded by Dr. Harlow in 1848, as well as with a systematic examination of the original skull specimen. Our results show that the cerebral injury was limited to the left frontal lobe, did not extend to the contralateral side, did not affect the ventricular system, and did not involve vital intracranial vascular structures. Although modern neuroscience has perhaps outgrown the speculations prompted by this famous case, it is still a living part of the medical folklore and education. Setting the record straight based on clinical reasoning, observation of the physical evidence, and sound quantitative computational methods is more than mere minutia and of interest for the broad medical community.

Adult↗

Formalizing concepts of species, sex and developmental stage in anatomical ontologies.

MOTIVATION: Anatomy ontologies have a growing role in bioinformatics-for example, in indexing gene expression data in model organisms. To relate or draw conclusions from data so indexed, anatomy ontologies must be equipped with the formal vocabulary that would allow statements about meronomy to be qualified by constraints such as part of the male or part at the embryonic stage. Lacking such a vocabulary, anatomists have built this information into the structure of the ontology or into anatomical terms. For example, in the FlyBase anatomy for drosophila, the term larval abdominal segment encodes the stage in the term, while the terms male genital disc and female genital disc encode the sex. It remains implicit that a fly has one and only one of these parts during its larval stage. Such indicators of context can and should be represented explicitly in the ontology. RESULTS: The framework we have defined for anatomical ontologies allows the canonical anatomy structures of a given species to be those common to all sexes, and to have either male, female or hermaphrodite parts--but not combinations of the latter. Temporal aspects of development are addressed by associating a stage with organism parts and requiring a connected anatomy to have parts that exist at a common stage. Both sex and anatomical stage are represented by attributes. This formalization clarifies ontological structure and meaning and increases the capacity for formal reasoning about anatomy. The framework also supports generalizations such as vertebrate and invertebrate, thereby allowing the representation of anatomical structures that are common across a sub-phylum.

Anatomy↗

The anatomical basis of the caecocentral scotoma. New observations and a review.

It is shown that the 'papillomacular bundle' of optic nerve fibres, although a concept discussed frequently in the clinical literature, lacks a clear anatomical definition. It is suggested that the explanation for this is that the 'bundle' was originally described in autopsy studies of toxic amblyopia, not normal anatomy. The optic nerve fibre projection and vascular architecture of the caecocentral region of the retina is described. These anatomical features are discussed in relation to a number of possible anatomical explanations for the fact that a caecocentral scotoma is the characteristic field defect found in toxic amblyopia. We have been unable to identify a distinct anatomical feature which might explain this vulnerability but suggest that the problem has not as yet been clearly addressed by anatomists.

Amblyopia↗

Localization of the motor hand area to a knob on the precentral gyrus. A new landmark.

Using functional magnetic resonance imaging (fMRI) we have evaluated the anatomical location of the motor hand area. The segment of the precentral gyrus that most often contained motor hand function was a knob-like structure, that is shaped like an omega or epsilon in the axial plane and like a hook in the sagittal plane. On the cortical surface of cadaver specimens this precentral knob corresponded precisely to the characteristic 'middle knee' of the central sulcus that has been described by various anatomists in the last century. We were then able to show that this knob is a reliable landmark for identifying the precentral gyrus directly. We therefore conclude that neural elements involved in motor hand function are located in a characteristic 'precentral knob' which is a reliable landmark for identifying the precentral gyrus under normal and pathological conditions. It faces and forms the 'middle knee' of the central sulcus, is located just at the cross point between the precentral sulcus and the central sulcus, and is therefore also visible on the cortical surface.

Aged↗

50 years of the Institute for Laboratory Animal Research (ILAR): 1953-2003.

The history of the Institute for Laboratory Animal Research (ILAR) begins, as does all of laboratory animal science, with the ancient philosophers, anatomists, and physiologists whose work presaged the use of animals in biomedical research and the institutions that arose due to this use. Modern laboratory animal science and medicine began in the late 1940s and early 1950s as five Chicago-area institutions hired veterinarians to manage their animal facilities. Each of these men became instrumental in the founding of the organizations that collectively make up the laboratory animal science and medicine organizations. Nathan Brewer, one of the "Chicago five," was particularly influential in the founding of ILAR. His boss at the University of Chicago, Dr. Paul Weiss, a member of the National Academy of Sciences (NAS), asked him to help establish a committee with the stated purpose of preparing recommendations to the NAS to develop an office to obtain information on sources of supply for research animals. This office became ILAR, and Brewer was chairman of its first report on the diseases of laboratory animals. He was also a founding diplomat and first president of the American College of Laboratory Animal Medicine. This history recognizes the thoughtful and energetic contributions of scientists and veterinarians to ILAR. It provides a 50-year overview of the programs and reports of ILAR and highlights examples where these reports have been adopted by scientists and federal agencies and incorporated into national laws and policies governing the use of animals in research both in the United States and in other countries.

Academies and Institutes↗

One face of beauty, one picture of health: the hidden aesthetic of medical practice.

Unrecognized presuppositions about patient appearance have become increasingly important in medicine, medical ethics and medical law. Symptoms of these historically conditioned assumptions include common ageism, aesthetic surgery, and litigation about 'wrongful life'. These phenomena suggest a societal intolerance for what is considered an 'abnormal' appearance. Among others, eighteenth-century artists and anatomists helped to set these twentieth-century precedents, actually measuring deviations of external traits to analogous deformations of the soul, and drawing moral conclusions from physiognomic measurements. Other eighteenth-century artists countered with pathognomy, recognizing that uneven physical features may indicate humanity, instead of character flaws. We suggest that there is an important and as yet unrecognized role played by visual and perceptual preferences in our judgments concerning normalcy and anomaly. We further suggest a shift away from our current fashion-magazine, youth-oriented aesthetic, and towards an aesthetic of imperfection. Physicians and medical students can be made aware of their historically conditioned reactions to 'abnormal' appearing patients by studying the understandings and methods with which artists have portrayed those who are considered deformed in appearance.

Congenital Abnormalities↗

The Unified Medical Language System (UMLS): integrating biomedical terminology.

The Unified Medical Language System (http://umlsks.nlm.nih.gov) is a repository of biomedical vocabularies developed by the US National Library of Medicine. The UMLS integrates over 2 million names for some 900,000 concepts from more than 60 families of biomedical vocabularies, as well as 12 million relations among these concepts. Vocabularies integrated in the UMLS Metathesaurus include the NCBI taxonomy, Gene Ontology, the Medical Subject Headings (MeSH), OMIM and the Digital Anatomist Symbolic Knowledge Base. UMLS concepts are not only inter-related, but may also be linked to external resources such as GenBank. In addition to data, the UMLS includes tools for customizing the Metathesaurus (MetamorphoSys), for generating lexical variants of concept names (lvg) and for extracting UMLS concepts from text (MetaMap). The UMLS knowledge sources are updated quarterly. All vocabularies are available at no fee for research purposes within an institution, but UMLS users are required to sign a license agreement. The UMLS knowledge sources are distributed on CD-ROM and by FTP.

Animals↗

Obstetrics in the physical therapy curriculum.

We report the status of obstetric education in physical therapy curricula. A questionnaire was sent to 83 accredited physical therapy education programs. Of the respondents from 69 programs, 47 (68%) included a specific unit or information on obstetrics in their program. The reporting programs averaged 7.5 hours for obstetric education. The unit was required in 45 of the 47 programs. Topics covered included anatomy and physiology, psychology, labor and delivery sequence, relaxation techniques, breathing techniques, prenatal and postpartum exercises, body mechanics, nutrition, fetal development, and birthing alternatives. Fifty-three percent of the units were taught by a physical therapist and combination of other professionals including a nurse, physician, nutritionist, psychiatric social worker, physiologist, or anatomist. We present behavioral objectives, required readings, and audiovisual aids used in the units.

Curriculum↗

In vivo organ mass of Korean adults obtained from whole-body magnetic resonance data.

In vivo organ mass of the Korean adult, male and female were presented for the purpose of radiation protection. A total of 121 healthy volunteers (66 males and 55 females), whose body dimensions were close to that of average Korean adults, were recruited for this study. Whole-body magnetic resonance (MR) images were obtained, and contours of 15 organs (brain, eye, gall bladder, heart, kidney, liver, lung, pancreas, stomach, spleen, testes, thymus, thyroid, urinary bladder and uterus) and 9 bones (femur, tibia + fibula, humerus, radius + ulna, pelvis, cervical spine, thoracic and lumber spine, skull and clavicle) were segmented for organ volume rendering by anatomists using commercial software. Organ and bone masses were calculated by multiplying the Asian reference densities of the corresponding organs and bones by the measured volumes. The resulting organ and bone masses were compared with those of the International Commission of Radiological Protection (ICRP) and the Asian reference data. Significantly large standard deviation was shown in the moving organs of the respiratory and circulatory systems and in the alimentary and urogenital organs that are variable in volume in a single person. Gall bladder and pancreas showed unique Korean organ masses compared with those of ICRP and the Asian reference adults. Different from anatomical data based on autopsy, the in vivo volume and mass in this study can more exactly describe the organ volume of a living human subject for radiation protection. A larger sample size would be required for obtaining statistically more reliable results. It is also needed to establish the reference organ mass of younger age groups for which it is difficult to recruit volunteers and to immobilise the subjects for long-time MR scanning. At present, the data from this study will contribute to the establishment of a Korean reference database.

Adult↗

Political post-mortems and morbid anatomy in seventeenth-century England.

Michel Foucault argued that the development of morbid anatomy, which he located in late eighteenth-century France, led to a great increase in the power of doctors over patients. The use of autopsy findings to confirm the cause of death and to provide information for systematic pathology had a prior history, however. When introduced into England, in the seventeenth century, the practice was already well established in Europe, notably in connection with the enbalming of the French kings. Several highly controversial autopsies, conducted on royalty and politicians, publicized the procedure and helped to make it socially acceptable. English anatomists were then able to draw on the results of autopsies conducted on their patients to correlate normal anatomy with the post-mortem signs. Most patients did not feel threatened by this procedure because it was undertaken privately and with consent, as a final act of clinical care. English physicians abandoned autopsies to the surgeons towards the end of the century in pursuit of a more genteel style of self-presentation. The connection between power and morbid anatomy seems to arise not from the practice of autopsy itself but from the impersonal authority of late eighteenth-century hospital doctors over poor patients.

Anatomy↗

Database created from magnetic resonance images of a Sprague-Dawley rat, rhesus monkey, and pigmy goat.

To obtain a database of accurate anatomical images onto which dosimetry data of electromagnetic fields could be mapped, a healthy Sprague-Dawley rat, rhesus monkey, and pigmy goat were scanned using magnetic resonance imaging (MRI). Axial sections throughout the length of the animals were collected. Sections were 3 mm thick for the rat and 5 mm thick for the monkey and goat. Sagittal sections (2 mm thick) of the rat head were also scanned. Images were recorded on magnetic tape and transferred to computer disk for image enhancement and network distribution. Images are available in 16 bit Big Endian signed or 8 bit TIFF formats. This is the first database of contiguous MRI axial scans of rat, monkey, and goat available for distribution via magnetic tape (4 mm DDS) or Internet file transfer protocol. Digital transfer of the data was selected to preserve the integrity of each image, circumventing the need for the user to scan the images back into a digital format for use with their software. These images should be useful to physiologists, neuroscientists, veterinarians, anatomists, and teachers. Reconstructing these 2-dimensional images into 3-dimensional structures is an effective media for conveying spatial anatomical information in a quick and comprehensive manner.

Animals↗

Everard Home, John Hunter, and cutaneous horns: a historical review.

A cutaneous horn is a protrusion from the skin made up of cornified material. These horns can be derived from a variety of epidermal lesions, both benign and malignant. This historical article reviews a number of early instances of cutaneous horns, some reported in the 16th and 17th centuries. The Danish anatomist Thomas Bartholin was the first to have a correct theory of the ethiology of these horny growths, and the English surgeons John Hunter and Everard Home confirmed his findings in the late 18th century.

Dermatology↗

Seeing patients and life contexts: the visual arts in medical education.

In many ways, the practice of medicine has been a visual science from the time of the early Renaissance anatomists to the high-speed scanners of today. But images of patients and their anatomical parts do not necessarily lead to an understanding of their problems. Meaning must follow the sensory experience and be coupled with reflection. The visual arts, therefore, can be used to help physicians in training increase their observational and interpretive skills. Works by classic and contemporary artists can be used to increase awareness of the complex nature of human beings and their conditions, which lie beneath the appearances. In addition to painting, television, motion pictures, and printed media may also be used in classroom settings to educate. Medical schools that do not have accessible fine arts or humanities programs may form allegiances with local artists to increase communication and understanding between these disciplines.

Art↗

Early intravenous anesthesia: an eyewitness account.

Descriptions of the earliest iv injections of various substances by individuals who actually witnessed the experiments in 1656 are presented. Of particular interest is an apparently overlooked account of an experiment in which opium was administered intravenously to a dog many years before 1674 as related by the physician and anatomist Thomas Willis. He does not identify the precise date nor the experimenters. However, at the time of this event Willis would have been at Oxford. There he was a very close professional associate of Christopher Wren who originated the practice of iv injection. These eyewitness accounts are worthy of note because the articles usually cited to establish Wren as the first individual to administer a drug intravenously were not written by anyone who actually observed the experiments.

Anesthesia, Intravenous↗

Müller's superior tarsal muscle: anatomy, physiology, and clinical significance.

Müller's superior tarsal muscle has been extensively studied by anatomists and physiologists but has been largely ignored by surgeons. This muscle is considered from the standpoint of both gross and finer anatomy. Concepts regarding the uncertain course of its sympathetic nerve supply fibers are reviewed, and "semi-conclusions" are given. The physiology of the muscle, both normal and pathological, is considered in view of both accepted and controversial concepts. Methods of weakening an overactive Müller's muscle medically and surgically are discussed. Some methods that have attempted to utilize the lid-elevating power of Müller's muscle are described, and the muscle's potential in this regard is considered. This small muscle is deserving of more appreciation and of a higher surgical status than it has received in the past.

Adult↗

The potential of computerized representations of anatomy in the training of health care providers.

The purpose of anatomy education is to develop the skills for anatomical reasoning, which is a requirement for performing a number of clinical tasks. Anatomical reasoning integrates an understanding of the three-dimensional (3-D) geometry of the body and its parts (the spatial domain of anatomical information) with an understanding of functional, developmental, pathological, and other relationships among anatomic entities (the symbolic domain of anatomical information). Traditional methods in anatomy have substantial shortcomings for representing and integrating these two information domains. Computer-based methods of knowledge representation have a great potential for overcoming the shortcomings and for promoting anatomical reasoning. To realize this potential, there is a need for (1) establishing 3-D electronic atlases of the human body; (2) generating models of symbolic anatomical information, and (3) developing computer programs (user interfaces) that integrate these knowledge sources and serve the needs of trainees and practitioners in different fields of the health sciences. The Digital Anatomist Program at the University of Washington has begun to build such a client-server framework for anatomical information, and its application for biomedical education is being evaluated.

Anatomy↗