The document discusses the importance of human cadaver dissection-based anatomy instruction in medical training, emphasizing that a thorough understanding of anatomy is crucial for diagnosis and treatment. It traces the historical development of anatomical knowledge through significant figures like Giovanni Battista Morgagni and Andreas Vesalius, highlighting the evolution of scientific methodology in understanding the human body. The presentation argues that despite advances in imaging techniques, actual dissection remains essential for training healthcare professionals, as it establishes a connection to the real human experience.

1. The Obligatory Utility of Actual Human Cadaver
Dissection-Based Anatomy Instruction in Medical Training
By Mohammed Ashraf Aziz, Ph.D.
Professor Emeritus, Howard University College of Medicine

2. DISCLOSURE & BIAS
Presenter: Dr. Mohammed A. Aziz
I disclose that I have no commercial interests
whatsoever with this presentation.
There is no perceived or potential conflict of
interest for delivery of this program material
There is no need to mitigate any potential bias
for this presentation.

3. A symptomatic patient
is examined by a
physician. The patient
presents:
• a vague pain in the
middle of the
abdomen
• a painful bellybutton
area (umbilicus)
• pain moves to the
right lower abdomen
• nausea and vomiting

4. Giovanni Battista Morgagni
Physician, Pathologist, Anatomist
De sedibus, 1765
“Where is Disease?”
(What is the disease? What causes it?
What would be its progression? What
other neighboring organs might be
implicated? Etc.)
These are all anatomical
questions. They demand a
thorough and detailed knowledge
of the structural organization of
the patient’s body.

5. What Is Anatomy?

6. Anatomy (“dissection”) is the
branch of biology concerned
with the study of the structure
of organisms and their parts.

7. The specific aims of contemporary anatomy are:
 Factual inventory of the body’s constituents using internationally-sanctioned
nomenclature;
 Classification of organs, their segregation and assortment into the nearly dozen
systems;
 Development of an accurate map of the body’s deep-seated constituent parts and
its projection on to the body’s surface to be used during the physical examination;
 Correlation of actual anatomy with diagnostic radiological and nonradiological
imaging;
 Establishment of the approximate base-line of “normal” anatomy against which
diagnostic trauma or disease-induced pathological changes may be assessed.
 Professionalism grounded in the empathy inducing view that humans are vulnerable
beings deserving of compassionate care.

8. HUMAN ANATOMY IS A BASIC SCIENCE WHICH
EMPLOYS THE SCIENTIFIC METHOD TO ANSWER
DIAGNOSTIC QUESTIONS RELATING TO CHANGES IN
THE BODY’S STRUCTURE CAUSED BY TRAUMA.
Steps of the scientific method:
1) Observations
2) Hypothesis (provisional diagnosis)
3) Testing of hypothesis:
observational or experimental
4) Confirmation or refutation of the
hypothesis (final diagnosis)

9. Anatomical Vocabulary
It took 3,000 years of effort to
develop the international
sanctioned vocabulary describing
the parts and their positional
relationships in the body.
Currently, there are over 6,000
named parts of the human body.
Any of them can be the source of
disease. The vocabulary has to be
memorized. Language is the tool of
thought.

10. Scientific Anatomy & the Scientific Method
were born and co-evolved during the Great
Age of Exploration in the 15th Century
• Exploration of new worlds
• Exploration of the cosmos
• Exploration of the deep human body
All these explorations occurred about 500 years ago in tandem.

11. Columbus In America
(1492)

12. Vasco da Gama
lands at
Calicut, India
May 1498

13. Amerigo Vespucci sailed around the world in the 16th Century

14. Nicolaus Copernicus the Father of Modern Astronomy
in his printed book (1543):
“De revolutionibus”

15. Martin Luther’s rebellion against the Catholic Church began the
Age of Reformation which re-imagined the relationship between
the individual and God. It liberated the individual from church
hierarchy to directly relate to our Maker. The beginnings of the
age of individualism.

16. In 1543, Andreas
Vesalius published
his detailed,
actually observed,
annotated
anatomical atlas
[De humani
corporis fabrica]
of the human
body based on
cadaver
dissections.
A portrait of Vesalius

17. In practice and in instruction, Vesalius emphasized:
• “The human body itself is the most truthful book of anatomy. We must open
it and read its pages by direct inspection of the revealed contents.”
• No printed book equals the dissected body in revealing the truths of the
human body.
• The printed book is derived from the body; the body is not derived from the
printed book.

18. The Anatomy Lesson of Dr Nicolaes Tulp by Rembrandt (1632)
This iconic painting encapsulates the Vesalian method of the practice of scientific anatomy.

19. Thomas Eakins, The Agnew Clinic 1889

20. Da Vinci was amongst the earliest explorers of the
deep human anatomy; but his illustrations were not
found until the late 19th century.

21. The backdrop of these events were:
Invention of:
• moveable type printing press by
Johannes Guttenberg (1450s)
• linear perspective in art by Filippo
Brunelleschi in early 15th Century.
• reproducible woodcut printing
• shading techniques creating a 3-D
impression on the page allowing
accurate depiction of observed nature;
chiaroscuro
• sophisticated shipbuilding and
navigational instruments

22. The most complete application of the use of the
scientific method to conceptualize the human
body was by William Harvey. This methodology is
used in contemporary medical training.
William Harvey (1 April 1578 – 3 June
1657) was an English physician who
made seminal contributions in
anatomy and physiology. He was the
first known physician to describe
completely and in detail the systemic
circulation and properties of blood
being pumped to the brain and body
by the heart.

23. William Harvey’s contributions to the
advancement of scientific anatomy:
• He expanded (accurate measurements; animal
models; experiments) the 16th century scientific
method to use detailed factual anatomy to
compute functions
• He saw the body as interconnected system of
functioning machines where structure subsumed
function.
• He used accurate descriptive anatomy to abstract
the circular organization of the vascular circuit of
the body in which the heart pumped blood in one
direction
• His method states: memorize to conceptualize (1628)

24. Starting in late 19th century several radiological
and nonradiological imaging techniques to
diagnose illness have been developed
Radiological
• Conventional x-ray
• Contrast media x-rays
• Cinematographic x-rays
• CT scans
Nonradiological
• MR scans
• Functional MR scans
• PET scans
• Ultrasound

25. 1. X-ray
2. Contrast
medium
3. CT scan
4. 3-D CT scan
5. MRI
6. 3-D MRI heart
1
4
5
6
3
2

26. Virtual Anatomy
including dissection
Question?
Given that we now have radiological,
nonradiological and virtual means of
visualizing the deep anatomy of the patient,
do we still need actual dissection of the
cadaver to train healthcare professionals?
Answer:
Yes, Why?

27. If it is the patient who has experienced morbidity and mortality
then the raison d'etre of the healthcare professions, must begin
with the “analog” deceased patient.
But because virtual media had not yet been invented, Dr.
Peabody did not emphasize the actuality of the patient. In life
and in death, the real human being must remain at the center of
the healthcare professions.

28. The role of virtual anatomy programs
when used in conjunction with the living patient or
the dissected cadaver visualized information
systems amplify learning and diagnostics. In the age
of information technology, we cannot function
without it.

29. The Doctor by Sir Luke Fildes (1891)

30. Thank You
I would to acknowledge my colleague Mr. Stafford Battle’s (Howard University)
contribution to the development of this program.