BMCR 2023.10.29

Dissection in classical antiquity: a social and medical history

, Dissection in classical antiquity: a social and medical history. Cambridge; New York: Cambridge University Press, 2022. Pp. 412. ISBN 9781009159470.

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This book tracks the history of dissection from its earliest attestations in the fifth century BCE to the time of Galen, looking in parallel at the development of anatomical literature. Through careful scrutiny of a vast number of testimonies, Bubb shows convincingly that dissection was a widespread and well-established practice throughout Greek and Roman antiquity. She moreover argues for the centrality of animal dissection as the predominant and, so to  speak, default practice. Bubb, indeed, challenges the importance of the transition from animal to human dissection in the history of anatomy and redirects the attention to Imperial Rome considering it the epicentre and flourishing capital of dissection.

The book falls into two parts. “Part I: The Practice” is devoted to the reconstruction of the social history of the practice of dissection. The author explains at length the performative and public dimension of dissection, which becomes increasingly prominent from the Hellenistic period onwards, as well as its material aspects, the subjects on which dissection was performed and the tools used. The agonistic and performative character of medicine in both the Greek and the Roman setting is no news. Nevertheless, Bubb offers valuable considerations over the more practical aspects of dissection reminding us of its messy and technical facets.

In Ch. 2, “Dissection in the Classical and Hellenistic Periods”, the author reviews the sources, from the Presocratic philosophers, the Hippocratic authors, Aristotle, Praxagoras, to the Hellenistic doctors Herophilus and Erasistratus. Interest in the internal parts of the body is attested since the Presocratics, though the fragmentary and scanty evidence does not allow us to make any general methodological claim. For the Hippocratics, too, Bubb underlines that attested cases of dissection, whether animal or human, are exceptional. Anatomy is still largely based on theoretical models. Yet, Bubb highlights some passages showing a certain degree of methodological awareness in works such as On Joints, Nature of the Child and Internal Affections, among others, but finds only in Aristotle’s biological works “evidence of an explicit and defined program of dissection” (p. 26), something the previous tradition was lacking. It is not clear what further turning point Bubb thinks is taken in the Hellenistic period by Herophilus and Erasistratus. They, too, propose “a program of meticulous dissection” (p. 38), albeit based on both human and animal samples according to the sources and with a clearer medical focus. One idiosyncratic characteristic of this period is that medical activity establishes its position as a public practice. Doctors are called in front of the public to prove their skills and discuss controversial cases. However, this does not yet apply to dissection, which remains a private endeavour, restricted to the doctor and perhaps a few pupils.

Ch. 3, “Dissection in the Roman Period”, focuses on the evidence for dissection under the Roman Empire. Contrary to Ch. 2 where Bubb proceeds in chronological order, she here follows “the motivations of the dissector” (p. 55). There is a private practice for research purposes, mostly a solitary exercise of the dissector to hone his own skills—probably with the assistance of servants or a small group of students. Next, as Bubb underscores time and again, dissection is (often) a performance that takes place in front of a (real or fictitious/literary) audience of varying degrees of expertise and size. “Either one is dissecting before others or one is training to do so. Over and above its practical utility to the training surgeon, this is a performative skill” (p. 59). Also, public dissections were not necessarily medically geared. They were used as publicity stunts or occasions to refute rival doctors. The chapter largely draws on Galen’s own considerations and experience, and, despite Bubb’s attempt to bring minor voices into the picture, Galen’s predominant position seems unavoidable. This in part reflects an intrinsic limitation of our textual evidence: Galen is a dissector himself and often the main source for minor authors whose writings have not survived. At the same time, however, Bubb expressly opts for tracing such different motivations in the Roman period through the eyes of Galen. And this is not the only case: throughout Part II, Bubb follows Galen’s categorization of anatomical writings to assess the development of this genre.

Galen is also the focus of Ch. 4, “Practical Considerations of the Dissector.” The chapter deals with Galen’s Anatomical Procedures (AA), canvassing the concrete and material aspects of dissection. As Bubb acknowledges at the outset, AA is the only extant work that gives us explicit insights into this aspect of dissection. Bubb starts by reviewing AA with regard to the animal subjects that Galen selects for his dissections and the rationale by which he chooses them, next to commenting on more practical aspects, such as how to lay hands on animals, how much it costs, and finally going through the necessary tools in the dissector’s toolbox, their price, and the human assistants he might have at his disposal.

The fifth and final chapter of Part I, “The Broader Social Contexts of Dissection”, considers how the phenomenon of dissection is embedded into Greek and Roman society and makes a strong case for looking outside of medical practice and sources to better understand this phenomenon. Bubb goes through different aspects of ancient life and their connection with medicine and in particular dissection and vivisection. “[B]odies—and with them conception about their structure and function—are implicated in just about every facet of life in antiquity” (p. 141). Medicine is not the only discipline discussed coram populo. Public performances were extremely common, varying in terms of contents (medicine, philosophy, law) and crowds (small/large turnouts, expert and non-expert audiences). People were also familiar with animals and their bodies, of course from butchery, but also because of veterinary issues involving farm animals or religious practices. In general, the manipulation of animals for the sake of human use was largely accepted and pursued with diverse aims in mind. For this reason, doctors had no problem justifying their own usage of animals, but they would have had to distance themselves from other kinds of ‘experts’ who derived their anatomical knowledge from magic and religious practices, such as divinatory practices involving animal viscera. Bubb also mentions human anatomical votives, which attest to a comparable and yet distinct religiously inspired interest in the inner workings of the human body. At this juncture, Bubb interestingly suggests that: “a desire to avoid this association may well have been an element in dissuading doctors of the fifth and fourth centuries BC from publicizing their practice of dissection to a wide audience in the early days before it became a routine and recognized avenue of medical and philosophical research. Doctors of the Roman period—when dissection was a long-established practice and spectacles of animal death were public and diverse—could afford to be less self-conscious on this front” (p. 152). The chapter concludes with a section on the popular imagination and the relative familiarity with corpses and their inner parts brought about by well-known literary examples, direct and indirect experiences on the battlefield and public display of punishment.

The second part of the book, “Part II: Text,” chronicles the history of dissection outlined in Part I from the perspective of the production, circulation and reception of anatomical texts. Bubb’s analysis unfolds following two common threads: the sway held by (some) authors and texts over time, and the degree to which they rely on the practice of dissection. As already noted in the Introduction and “Part I”, the writing of anatomical texts does not rely solely or exclusively on the practice of dissection, and Bubb attempts to track down this discrepancy in the sources. We find four chapters, each dedicated to the authors and periods encountered in “Part I” (Ch. 6, “Anatomical Texts of the Classical and Hellenistic Periods”, Ch. 7, “Anatomical Texts of the Roman Period”, Ch. 8 “Galen’s Minor Anatomical Works”, Ch. 9 “Galen’s Anatomical Procedures and Its Innovations”), and a final chapter, Ch. 10, “Epilogue—A Waxing and Waning Art”, which depicts with a broad brush what happens to the field of anatomy and the practice of dissection after Galen.

Ch. 6 maps the development of anatomical writings in the Classical and Hellenistic periods. Contrary to what the reader finds in the following chapters, little consideration is here paid to the ways in which each author relies on dissection. Bubb focuses more on the reception of these texts in the Roman period, especially, if not exclusively, in Galen. For many authors of this period, anatomical insights are for the most part not dealt with in anatomy-specific texts but rather treated in works touching upon anatomy in philosophical or medical contexts. Also, works relying on dissection do not necessarily exert greater influence in time. Erasistratus is considered an interesting case in point: though a great dissector himself, he did not write a work dedicated to anatomy and, except for Galen, later authors do not consider him an authority in anatomical matters.

Anatomical writings take a turn in the Roman period. Perhaps fostered by the public dimension dissection displays, there is an increase in the production and circulation of anatomical texts. In Ch. 7, Bubb surveys a variety of texts with different scopes and purposes. To give a couple of the examples she provides, Rufus of Ephesus focused on anatomical nomenclature in On the Names of the Parts of the Body and most likely reported on dissection happening before him, attesting to a revival of interest in dissection at his times. According to Galen’s testimony, Marinus wrote an anatomical work in twenty books and also authored the first anatomical compendium with detailed instructions on dissection, thus ushering in a new strand of anatomical literature. Finally, Bubb looks into the corpus of medical papyri which offers yet another glimpse into the multifariousness of anatomical texts.

In Ch. 8 and 9, Galen certainly emerges as a pivotal character in the history of dissection. Bubb first reviews the minor works on anatomy, which bear witness to the increasingly important role held by dissection in Galen’s mind. Finally, she turns to AA, where “for the first time, the practice of dissection merges seamlessly with an anatomical text” (316). As already acknowledged in Ch. 4, AA is invaluable for the technical information it delivers. On top of this, Bubb highlights the educational purpose of the treatise and zeroes in on the different audiences Galen addresses throughout, analyzing their literacy and the degree of technical training Galen expects or assumes his readers have, underlining once again the interplay between medicine and its social context.

All in all, Bubb provides a thorough analysis of the evidence of dissection encompassing about seven centuries and a variety of settings and especially argues for the importance of Imperial Rome in this history. This book is a welcome addition to the literature on the social history of ancient medicine and its performative facet.[1] The author presents dissection in all its complexity, expounding on often overlooked aspects of the practice, such as the availability of and familiarity with animal bodies and the costs of performing dissections. It is unfortunate not to find a detailed Index Locorum at the end, given the large number of texts and testimonies examined.

 

Notes

[1] Wear, A. (ed.), 1992. Medicine in Society: Historical Essays, CUP; van der Eijk, P.J., Horstmanshoff, H.F.J., and Schrijvers, P.H. (eds.), 1995. Ancient Medicine in Its Socio-Cultural Context, Rodopi. Gleason, M., 2009. “Shock and Awe: The Performance Dimension of Galen’s Anatomy Demonstrations”. In Gill, Whitmarsh, and Wilkins (eds.), Galen and the World of Knowledge, CUP: 85–114. Lang, P., 2013. Medicine and Society in Ptolemaic Egypt, Brill. Salas, L.A., 2020. Cutting Words: Polemical Dimensions of Galen’s Anatomical Experiments, Brill.