The Netter Collection of Medical Illustrations Vol 1-8
An attempt to determine the natal hours of modern scientific anatomy is as unavailing as would be an effort to set an exact date for the beginning of the Renaissance era. The changes of mind, intellect and interest, of conceptual thinking, which we in our time admire in retrospect, began slowly and developed only over a span of two centuries. One can, however, scarcely go wrong in stating that the momentum for scientific research was at no time (except perhaps our own) as poignant as in the fifteenth and sixteenth centuries.
This was the period in which philosophers, scientists, physicians and the great artists alike became not only interested in but devoted to the study of forms and structures inside the human body. The motives of an Andrea del Verrocchio (1435–1488), of a Donatello (1386–1466), of a Leonardo da Vinci (1452–1519), of a Michelangelo Buonarroti (1475–1564), of a Raffaello Santi (1483–1520)—just to name a few of the bestknown Renaissance artists—for drawing anatomic subjects are difficult to explain. Whether it was sheer curiosity, a fashionable trend, scientific interest or other reasons that prompted them to leave to posterity these magnificent works of art concerned with the muscles, bones and internal parts of Homo sapiens, one can be sure that these drawings were not meant to accompany or to clarify the anatomist’s dissections and descriptions. Nevertheless, the painters of that period can be designated as the creators of medical illustration, because it may safely be assumed that the first useful instrument that provided a general and more popular knowledge of the inner structures of the human body was not the knife of the dissecting anatomist or his description written in Latin, but the pencil of the artist. Health, standing second only to nutrition in the minds of people of all times, must have been a “hot news” topic half a millennium ago as it is in our day, in which the so-called “science writer” has taken over the function of making accessible to contemporary intellectuals what the language or idiom of the scientist has left inaccessible.
With the exception of Leonardo, whose geniality and universal inquisitiveness in every field of science led him to be far ahead of his contemporaries, none of the many excellent artists who took a fancy to drawing or painting anatomic subject matter contributed to the factual knowledge of anatomy or medicine, but it became a landmark of extraordinary significance when Andreas Vesalius (1514–1564) wrote his De Corporis Humani Fabrica and found in John de Calcar (1499–1546), Flemish painter and pupil of Titian (1477–1576), the congenial artist who supplemented the great anatomist’s revolutionizing work with his magnificent illustrations, the first true-to-life reproductions of the structures of the human organism. The “Magna Carta” of anatomy, as posterity has called Vesalius’ opus, was engendered by an ideal union of scientist and artist as two equal partners, as far as creative power, each in his own field, goes. The mystery of the propagation of life occupied the minds and emotions of mankind from the time the deities of fertility demanded devotion and sacrifice. One naturally is inclined, therefore, to expect that in ages progressive in science, such as the Renaissance, the knowledge of the generative tract, or more generally, the search to elucidate procreative processes, would be exposed to special benefi t and encouragement. This, however, seems not to be the case, perhaps because specialization was a thing of naught to Renaissance mentality. The advances in knowledge of the anatomy of the reproductive system during the time of Vesalius and the 300 years after him were as respectable as those in the lore of all other sciences, but not more so. Remarkable contributions and disclosures were reported, as witnessed by the many anatomic designations which still carry the names of their discoverers, such as Gabriello Fallopio (1523–1562), Thomas Wharton (1614–1673), Regnier de Graaf (1641–1673), Anton Nuck (1650–1692), Edward Tyson (1650–1708), Caspar Bartholin (1655–1738), Alexis Littré (1658– 1726), William Cowper (1666–1709), James Douglas (1675–1742), Kaspar Friedrich Wolff (1733–1794), Johannes Müller (1801–1852) and others, names that will be encountered on many pages of this book. But anatomy of the genital organs and the physiology (or pathology) of reproduction were not favored by the appearance of a Harvey who revolutionized the physiology of circulation and, with it, of medicine in general. It is from this historical aspect the more surprising to observe that under our own eyes, as a matter of fact within scarcely more than a single generation, so many new phenomena have come to light, and discoveries so revolutionizing have been made that our concepts and knowledge of the physiology and pathology of reproduction have undergone fundamental changes. Endocrinologic research has presented to us the story of the mutual relationship between the pituitary gland and the gonads and of the activities and functions of the secretion products of these organs on the genitals and other parts of the body. The impact of these scientifi c accomplishments on the practice of medicine, particularly for the interpretation of genito-urinary and gynecologic diseases, has been tremendous. In addition to the progress in endocrinology, we have lived to see simultaneously the rise of chemotherapy, which inaugurated a magic alteration in the character, management and prognosis of the formerly most frequent diseases of the reproductive structures.
This progress is not, of course, as everybody knows, the result of the genius of one or of a few single individuals; it is the yield of the efforts of an endless number of scientists from all parts of the world and—in view of the foregoing paragraphs—it should also be remembered that the speed and the intensity with which this progress has been achieved have not been restricted solitarily to the science of reproductive physiology or pathology of the genital organs but belong to the scientific tide of our times, as can be noticed in all branches of science.
These chips of thoughts have been uttered here, because those about the early artist-illustrators occupied my mind in the few hours of leisure permitted me during the preparation of this book, and those about the recent changes in our specific topic suggested themselves continuously during the preparation of the new and the checking of the older plates. The situation the advancements in our knowledge have caused, as indicated sketchily in the foregoing, presented a specific task and, concurrently, a straightforward challenge. In spite of my intentions and efforts, shared, I am sure, by all responsible practicing physicians, to “keep informed”, many of the facts, facets, connections, concepts, etc., which experimental biology and medicine have brought to light, were novelties to me, as they must be or have been to a generation of still-active physicians—those who studied medicine during the time of my school days or even before. The challenge, therefore, was to absorb and assimilate the new learning and to exhibit it in a form easily understandable, attractive and so instructive that the essential points could be readily visualized and the more important details grasped without need for search in specific or original publications.
The subjects of the pictures were selected on the basis of what seemed to be of the greatest clinical import and interest. Although we aimed to secure a reasonably complete coverage, it is obvious that not everything could be included. With the newer knowledge crowding in so rapidly upon the old and from so many sources—chemistry, biology, anatomy, physiology, pathology, etc .—with the accumulation of so many pertinent data, the book could have grown to twice its size. Would we, with greater completeness, have better served the student or busy practitioner with his difficulties in following and correlating? It was the opinion of all concerned that this would not have been the case and that the adopted restriction would prove more helpful. Actually, the book grew much larger than was originally anticipated, particularly because it was felt that certain “correlation” or “summation” plates, e.g., pages 5, 105, 115, 120, 162, 175, 211, 213, 214, and 241, were necessary for the mission we flattered ourselves this book could fulfill.
In view of the steadily increasing number of plates, it was natural that at some time during the preparation of the book the question should be seriously discussed and considered whether the treatise on the male and female reproductive systems should appear as separately bound books or in one volume under the same cover. The decision fell in favour of a single volume containing
the exhibit of both genital tracts, because separation into two volumes would have seriously counteracted my earnest striving for integration of the knowledge on the two tracts. It was also felt very strongly that the small monetary advantage that would have been gained by those distinctly interested in only one part of the book—in all probability a small minority—would be more than compensated by the educational benefit conferred by the contiguity of the topics and the amalgamation of the two parts.
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