When we think about anatomy today, various images come to mind. Perhaps you’re taken back to high school, when dissecting pig organs or a frog was your earliest window into the body’s interior. Or perhaps you envision a cold, sterile hospital environment where greying cadavers lay on chrome tables, waiting to be examined by eager (or not so eager) medical students.

Regardless of what comes to mind, it is likely to be some sort of representation that is the outcome of centuries of acquired medical tradition and knowledge. But have you ever wondered how it all started?

Well, a new paper offers some perspectives on various activities and experiences ancient people may have had which would have offered insights into the hidden parts of the body. The paper was originally part of first author Grzegorz Wysiadecki's PhD dissertation. Over the centuries, these initially simple, casual observations of humans and animals may have helped accumulate into formal bodies of knowledge, if you’ll forgive the pun.   

In essence, the authors argue that five types of opportunities would have allowed ancient people to start observing anatomy. These included the preparation of animal bodies for food, the use of animal entrails for magical and divination rituals, the use of animals for sacrifices in religious ceremonies, the process of embalming human bodies in preparation for the afterlife, and the observation of severe wounds on injured people.

The first of these is kind of self-explanatory, but the others are worth exploring in more detail.

Divining through bits and pieces

Regarding the use of animal organs for divination, the Babylonians believed that hints about the cosmic order of things could be gleaned from examining hidden signs. One such source was the entrails of animals which priests, called baru, would effectively “research”, as part of what the authors argue was the first example of “comparative anatomy.”

However, this should not be confused with the type of “scientific research” we understand today. Although the authors do stress that the purpose of accumulated anatomical knowledge in this context was to look for signs that served as a source of prophecy, it is easy to assume a closer link between these different practices than was necessarily the case.

This is a challenge of looking back at historical activities with an eye to match them to present-day versions. It can be easy to flatten the past and simplify differences in order to make a coherent chronology. Still, the team presents some interesting examples of how ancient people first started poking around inside bodies.

For example, the baru believed the liver was a particularly important organ for divination as it was thought to be the seat of the soul and the point where emotional and mental activity took place. They would seek out sheep livers to make prophecies, which not only required the priests to know where the organ was, but also meant they became extremely familiar with its shape, size, and details.

To help initiates learn what to look for in these animal signs, the baru made clay models of the liver that reproduced their overall shape and, as the authors write, “selected anatomical details related to the organ’s structure.”

At the same time, the Babylonians produced the first forms of anatomical terminology grounded on their empirical approach (first-hand experience) of treating disease. This also let them draw conclusions and general regularities based on these observations; though it should be stressed that this does not mean there was agreement on how specific diseases were caused and how to treat them at the time.

The authors also mention the work of another class of priest – the ašipu – who practiced diagnosis, treatment, and exorcism (which was a spiritual treatment not necessarily seen as separate from a physical one). At a time when witchcraft, science, and magic were largely combined, these practitioners would help combat sorcery while also healing disease.

At present, it is not clear to what extent (or even if) the ašipu and baru shared their observations, though the authors speculate that they may have. According to them, it is possible that the baru offered explanations and insights gleaned from their “dissections” of animal bodies. Again, this is far from clear.

Corpse preparation 

When we think about ancient corpse preservation, many of us instantly think about Egyptian mummies. The origins of this practice are far from clear, but we do know the motivations. According to the Ancient Egyptians, parts of the soul – Ba – resided in the land of the dead after death as long as their bodies had been preserved. Mummification was therefore a religious and spiritual rite designed to protect the body from decay.

For a long time, scholars have understood that mummification, although not driven by scientific exploration, may have provided insights into the body’s interior that contributed to early anatomical knowledge. Moreover, the practice evolved over time, with it reaching its height during the New Kingdom period (between 1550-1070 BCE).  

During this time, new approaches to body preservation were developed, including the ways that incisions were made to access organs, how they were dealt with, which substances were used for embalming, the use of artificial organs (for example, artificial eyes, which helped the body appear “lifelike” in death), and the methods for wrapping the corpse.

Injuries and wounds

Among the oldest known sources of medical knowledge is the Edwin Smith papyrus, the authors state, which is dated to around the 17^th century BCE. The text may be a copy of a much older version, and describes 48 medical cases including injuries to the neck, head, clavicle, sternum, spine, arm, and shoulder, as well as the prognosis and treatment of various wounds. The papyrus demonstrates that ancient physicians learned from their encounters with wounds and used this as a chance to gain some rudimentary insight into the body’s structure.

One special feature of the Edwin Smith papyrus is its mention of the “brain”. It is the first medical text to do so, and also describes cerebrospinal fluid. The cases in the ancient text show that physicians were able to identify signs that some injuries were far more fatal than others, such as skull fragments breaching the meninges (the three layers of membrane that protect the brain and spinal cord), any exposure of the brain, infection of skull wounds, deep penetrating wounds, and aphasia accompanying the injury.

The paper's authors also include references to the various wounds described in Homer’s Iliad, which were sustained in the battles outside the city of Troy. Although this narrative mostly deals with supernatural phenomena, scholars have identified 151 references to injuries sustained through combat, as well as how they were caused and by which weapons.

However, it is not clear how we can infer broader associations between these wounds and Greek knowledge about anatomy more generally. As with the above statement about the Babylonian priests, it is difficult to say exactly how ancient practices that delved into the internal world of the body helped to necessarily contribute to later developments in anatomical knowledge. There is also the question as to how other sources of knowledge from non-Western societies, such as ancient China, may have introduced later traditions as well. 

But this work does show that humans have always found reasons to poke around inside the body and have been curious to know what is inside.

The paper is published in the journal Translational Research in Anatomy.