Throughout history, there have been three forms of autopsy: the anatomic autopsy, the clinical autopsy, and the forensic autopsy. The anatomic autopsy focuses on the function and structure of the body, whereas the clinical autopsy involves investigating the underlying causes and development of disease. Lastly, the forensic autopsy helps to determine the cause and manner of death, as well as assessing whether external violence contributed to it. Evidence of forensic autopsies dates back to at least the 13th century in Bologna, while the anatomic autopsy rose to significance in Padua before influencing other cities across Europe. In the 19th and early 20th centuries, clinical autopsy rose to popularity, becoming the main method of anatomical research.[1]
Around 3000 BCE, ancient Egyptians were one of the first civilizations to practice the removal and examination of the internal organs of humans in the religious practice of mummification.
Autopsies that opened the body to determine the cause of death were attested to occur at least in the early third millennium BCE. However, opposition to autopsy existed in many ancient societies, due to the belief that the outward disfigurement of dead persons prevented them from entering the afterlife. This was the case in Egypt, where the organs were removed through tiny slits in the body. Notable Greek autopsists were Erasistratus and Herophilus of Chalcedon, who lived in 3rd century BCE Alexandria. In general, however, autopsies were rare in ancient Greece. In 44 BCE, Julius Caesar was the subject of an official autopsy after his murder by rival senators. The physician's report noted that the second stab wound Caesar received was the fatal one. By around 150 BCE, ancient Roman legal practice had established clear parameters for autopsies. One significant ancient anatomist was Galen (129 – c. 216 CE), who gained most of his anatomical knowledge from dissecting animals. His findings went largely unchallenged for over a thousand years, until the Renaissance.
The dissection of human remains for medical or scientific reasons continued to be practiced irregularly after the Romans, for instance by the Arab physicians Avenzoar and Ibn al-Nafis. In Europe they were done with enough regularity to become skilled, as early as 1200, and successful efforts to preserve the body, by filling the veins with wax and metals. Until the 20th century, it was thought that the modern autopsy process derived from the anatomists of the Renaissance.
Ibn Tufail (c. 1109/10-1185/86), a Moorish philosopher and physician amongst other things, elaborated on autopsy in his treatise called Hayy ibn Yaqzan and Nadia Maftouni, discussing the subject in an extensive article, believes him to be among the early supporters of autopsy and vivisection.
In addition to these early supporters, there were also key figures that directly opposed autopsy. Pope Boniface VIII (c. 1230-1303) was one of these individuals. He forbade the cooking of bodies to separate the flesh from bone, which had been a common practice to bring home people who had died fighting in the Crusades.[2][3] Many interpreted this as meaning that any interference with human bodies, even for the purpose of study, was forbidden. This led to a hesitation among physicians to perform autopsies and a decline in anatomical research. In the late 15th century, Pope Sixtus IV issued a bull that permitted students at Bologna and Padua universities to dissect human bodies,[3] representing the beginning of acceptance towards autopsy by the Catholic Church and paving the way for future anatomists such as Andreas Vesalius and Giovanni Battista Morgaani.
Andreas Vesalius (c. 1514-1564), a pioneering, Netherlands-born anatomist, helped advance the study of human anatomy mainly through anatomical autopsy, where he focused on the structure and function of the human body. In 1543, Vesalius conducted a public dissection of the body of a former criminal. He articulated the bones, creating what is considered the world's oldest surviving anatomical preparation. His famous text on human anatomy, De Humani Corporis Fabrica Libri Septum (1543), gained traction across Europe, becoming the foundational work of early modern anatomy and reshaping medical understanding of the structure of the human body, particularly the skeletal and muscular systems. In his work, Vesalius emphasized musculoskeletal system more thoroughly than his predecessors by including detailed, more accurate drawings of these structures. Through anatomical illustrations of skeletons contemplating their own deaths, Vesalius validated the human experience and cemented human anatomy as the centerpiece of 16th century investigations.[4]
Giovanni Battista Morgagni (1682-1771), an Italian anatomist, performed clinical autopsies to study the mechanisms of disease, linking symptoms of living patients to physical changes in organs after death. His research marked a new understanding of pathology through clinical observation.[3] Morgagni, who is celebrated as the father of anatomical pathology, wrote the first exhaustive work on pathology, De Sedibus et Causis Morborum per Anatomen Indagatis (The Seats and Causes of Diseases Investigated by Anatomy, 1769).
During Morgagni's lifetime, Theophile Bonet (1620-1689), a Swiss anatomist, published a work, the Sepulchretum in 1679. Nearly 450 authors, including Galen and Vesalius, were mentioned. The medical compilation included various examples of autopsies that had been performed, providing knowledge about anatomy and demonstrating the extent to which medical knowledge had been gathered up until this point.[3]
In the mid-1800s, Carl von Rokitansky and colleagues at the Second Vienna Medical School began to undertake dissections as a means to improve diagnostic medicine.
In the 19th century, there was a general lack of standardization. Rudolf Virchow, in response to this inconsistency in autopsy procedures, established and published specific autopsy protocols (one such protocol still bears his name).
During the turn of the 20th century, people began to further develop forensic science. The Scotland Yard created the Office of the Forensic Pathologist, a medical examiner trained in medicine, charged with investigating the cause of all unnatural deaths, including accidents, homicides, suicides, etc.
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edit- ↑ Madea, Burkhard (2017-01-01). History of Forensic Medicine. Lehmanns Media. ISBN 978-3-86541-205-8.
- ↑ Park, Katharine (1995). "The Life of the Corpse: Division and Dissection in Late Medieval Europe". Journal of the History of Medicine and Allied Sciences. 50 (1): 111–132. doi:10.1093/jhmas/50.1.111. ISSN 0022-5045.
- 1 2 3 4 King, L. S.; Meehan, M. C. (1973-11). "A history of the autopsy. A review". The American Journal of Pathology. 73 (2): 514–544. ISSN 0002-9440. PMC 1904067. PMID 4586127.
{{cite journal}}: Check date values in:|date=(help) - ↑ Vesalius, Andreas (1973). The illustrations from the works of Andreas Vesalius of Brussels; with annotations and translations, a discussion of the plates and their background, authorship and influence, and a biographical sketch of Vesalius. Internet Archive. New York, Dover Publications. ISBN 978-0-486-20968-5.