Lucy E. Hyde – The Conversation

Dissecting the Grinch: what anatomy reveals about Christmas’s most famous villain

2025-12-15T12:20:51Z

The Grinch is one of the holiday season’s most familiar icons. The grumpy, green, fur-covered misanthrope who plotted to sabotage Christmas in Dr Seuss’s classic 1957 work has now become a quintessential part of the yearly festive ritual he so despised.

But beneath that snarl and green fur, what kind of creature is he, really? Not even Dr Seuss really had an answer.

As an anatomist, I can’t help but wonder what the Grinch would look like on the dissection table – and what his skeleton, muscles and brain can tell us about his unique origins.

The skull

The Grinch’s most recognisable feature is, of course, his face. And underlying these characteristic features would be a unique skull – unlike anything you’d find in Whoville or on Earth.

Structurally, the Grinch’s facial skeleton would blend primate and canine traits: short, broad snout, high cranium and powerful jaws. It’s a face evolved for expression, adeptly capable of sneering, gloating and ultimately smiling with genuine warmth.

His zygomatic arches (cheekbones) are broad and flared to accommodate for the large zygomaticus major muscles needed to lift the corners of his mouth into his exaggerated, mischievous smirk.

Beneath his eyes would be a large bony canal, carrying nerves to his whisker-like facial hairs – granting exquisite tactile sensitivity to changes in air currents. Like a cat’s whiskers, they’d help him sense approaching Whos or dangling baubles – crucial for a creature who thrives on stealth.

His teeth would be similar to a chimp’s, with sharp canines for tearing through Who “roast beast,” sturdy molars for grinding tougher festive fare and incisors adapted for nibbling fruitcake or the occasional candy cane.

The upper jaw, or maxilla, would be robust and slightly vaulted, lending resonance to that infamous laugh echoing through Mount Crumpit.

The face

The Grinch’s yellow eyes, with large, forward-facing eye sockets, suggest a crepuscular lifestyle: most active at dawn and dusk.

Many animals with yellow eyes, such as owls and cats, are adapted to low light. The yellow pigment filters blue light and sharpens contrast, allowing movement to be detected in the half-light. Perfect for a nocturnal gift thief.

His nasal aperture would be tall and narrow, with a complex set of internal conchae (nasal bones) to warm the cold alpine air of Mount Crumpit. The constant twitching of his nose might indicate a highly attuned sense of smell to detect roast beast from a distance.

The Grinch’s expressiveness would involve a complex set of muscles – many of which would be unusually large so he can convey every scheme, doubt, pang of guilt and emotion he experiences. For example, he would probably have very distinct levator labii superioris alaeque nasi – “Elvis muscles” – so he can lift his upper lip sneeringly.

The spine

If you watch the Grinch walk, he’s upright but fluid, almost serpentine. His spine would probably resemble a cross between a gibbon and a cat – long, flexible and sinuous.

The lower back would be extended and highly mobile, allowing that characteristic slouch and coiled posture. The thoracic vertebrae (found in the middle and upper back) would produce a gentle outward curve – creating a hunched silhouette suited to skulking. His cervical vertebrae (neck bones) would be elongated, letting him tilt and crane his head with exaggerated expressiveness.

Like a cat, he’d be digitigrade – meaning he walks on the balls of his feet and toes rather than on the soles (as humans do). This stance softens each step – allowing for the quiet, agile motion needed to lurk through Whoville stealing presents on Christmas eve.

Though his pelvis supports an upright posture, his centre of gravity sits slightly forward and low — a design that sits somewhere between human and primate.

The brain

Anatomy often mirrors personality. Judging by behaviour, the Grinch’s frontal lobes, particularly his prefrontal cortex, would be on the small side – explaining his flat and small forehead.

Given this region governs planning, impulse control and moral reasoning, it would explain why he lacks these faculties at the story’s start. Having a smaller frontal lobe also explains his rash decisions and inability to foresee consequences beyond the next stolen bauble.

His temporal lobes, would be large and active. They process sound and memory – ideal for recognising (and despising) Whoville’s Christmas carols. They also house functional areas that process smells – important for sniffing out hidden cans of Who-Hash.

His occipital and parietal lobes would also be well developed, supporting the sharp vision, coordination and spatial awareness he needed to climb, leap and slide down chimneys.

The Grinch’s amygdala (also involved in experiencing emotions) would probably be hypertrophied – explaining his emotional volatility, paranoia and exaggerated reactions. Combined with his limbic system, part of the brain’s memory and emotion centre, creates a creature ruled by passion and reactivity.

The heart

No anatomical analysis of the Grinch is complete without addressing the moment when “his heart grew three sizes.”

Biologically, such a sudden expansion would be catastrophic. In humans and other mammals, cardiomegaly (an enlarged heart) is a dangerous condition linked to heart failure, arrhythmias and poor pumping efficiency.

A real heart simply cannot enlarge in an instant of emotional revelation. But the brain can change rapidly.

The Grinch’s transformation is probably better understood as a neurological shift – with increased activity and connectivity occurring between the prefrontal cortex (empathy and regulation) and the limbic system (emotion and reward). His “growing heart,” is probably not an anatomical miracle but a metaphor for his brain becoming more socially attuned.

Anatomy of a redemption arc

To anatomists, the Grinch is more than a Christmas curiosity. He’s a case study in form and function. And in his final form, anatomy and morality align.

The muscles that once powered a sneer now lift into a genuine smile. The hands that stole presents now carve roast beast. His limbic system now fires with satisfaction.

So perhaps the real message of the Grinch’s anatomy is this: change is always possible.

Lucy E. Hyde does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Du tendon d’Achille aux trompes de Fallope : quand la nomenclature anatomique cache des histoires de pouvoir et d’exclusion

2025-11-10T15:10:08Z

_Gabriele Falloppio expliquant l’une de ses découvertes au cardinal-duc de Ferrare_, par Francis James Barraud (1856-1924). WellcomeTrust, CC BY-SA

La description anatomique du corps humain comprend de nombreux termes qui doivent leur nom au savant qui a découvert ou étudié pour la première fois cette partie du corps, ou encore à un personnage de la mythologie. Ces appellations dites éponymes sont à elles seules des « petits monuments » d’histoire de la médecine, mais elles véhiculent aussi des biais et ne facilitent pas toujours la compréhension. Certaines sont pittoresques quand d’autres font référence à des heures sombres du passé.

Nous nous promenons avec les noms d’inconnus gravés dans nos os, notre cerveau et nos organes.

Certains de ces noms semblent mythiques. Le tendon d’Achille, le ligament situé à l’arrière de la cheville, rend hommage à un héros de la mythologie grecque tué par une flèche dans son point faible. La pomme d’Adam fait référence à une certaine pomme biblique.

Mais la plupart de ces noms ne sont pas des mythes. Ils appartiennent à des personnes réelles, pour la plupart des anatomistes Européens d’il y a plusieurs siècles, dont l’héritage perdure chaque fois que quelqu’un ouvre un manuel de médecine. Il s’agit de ce qu’on appelle l’éponymie, c’est-à-dire que ces structures anatomiques ont reçu le nom des personnes, par exemple, qui les ont découvertes plutôt qu’un nom inspiré ou issu de leur description physique ou fonctionnelle.

Prenons l’exemple des trompes de Fallope. Ces petits conduits (qui correspondent à un véritable organe, ndlr) situés entre les ovaires et l’utérus ont été décrits en 1561 par Gabriele Falloppio, un anatomiste italien fasciné par les tubes, qui a également donné son nom au canal de Fallope dans l’oreille.

Gabriele Falloppio (1523-1562) était un anatomiste et chirurgien italien qui a décrit les trompes de Fallope dans son ouvrage de 1561, Observationes Anatomicae. commons.wikimedia.org/w/index.php ?curid=1724751

Ou encore l’aire de Broca, du nom de Paul Broca, médecin français du XIXᵉ siècle qui a établi un lien entre une région du lobe frontal gauche et la production de la parole. Si vous avez déjà étudié la psychologie ou connu quelqu’un qui a été victime d’un accident vasculaire cérébral, vous avez probablement entendu parler de cette région du cerveau.

Il y a aussi la trompe d’Eustache, ce petit conduit relié aux voies respiratoires (mais qui fait néanmoins partie du système auditif, ndlr) et qui s’ouvre lorsque vous bâillez dans un avion. Elle doit son nom à Bartolomeo Eustachi, médecin du pape au XVI^e siècle. Ces hommes ont tous laissé leur empreinte sur le langage anatomique.

Si nous avons conservé ces noms pendant des siècles, c’est parce que cela ne renvoient pas qu’à des anecdotes médicales. Ils font partie intégrante de la culture anatomique. Des générations d’étudiants ont répétés ces noms dans les amphithéâtres et les ont griffonnés dans leurs carnets. Les chirurgiens les mentionnent au milieu d’une opération comme s’ils parlaient de vieux amis.

Ils sont courts, percutants et familiers. « Aire de Broca » se prononce en deux secondes. Son équivalent descriptif, « partie antérieure et postérieure du gyrus frontal inférieur », ressemble davantage à une incantation. Dans les environnements cliniques très actifs, la concision l’emporte souvent.

Ces appellations sont également associées à des histoires, ce qui les rend plus faciles à mémoriser. Les étudiants se souviennent de Falloppio parce que son nom ressemble à celui d’un luthiste de la Renaissance. Ils se souviennent d’Achille parce qu’ils savent où diriger leur flèche. Dans un domaine où les termes latins sont si nombreux et si difficiles à retenir, une histoire devient un repère utile.

Le tendon d’Achille a été nommé en 1693 d’après le héros de la mythologie grecque, connu notamment par l’Iliade d’Homère, Achille. Panos Karas/Shutterstock

Il y a aussi le poids de la tradition. Le langage médical s’appuie sur des siècles de recherche. Pour beaucoup, supprimer ces noms reviendrait à effacer l’histoire elle-même.

La face sombre de la nomenclature anatomique

Mais ces aspects mnémotechniques cachent un côté plus sombre. Malgré leur charme historique, les noms éponymes manquent souvent leur objectif principal. Ils indiquent rarement la nature ou la fonction de l’élément anatomique qu’ils désignent. Le terme « trompe de Fallope », par exemple, ne donne aucune indication sur son rôle ou son emplacement. Alors que quand on dit « trompe utérine » ou « tube utérin », c’est bien plus clair.

Les noms ou expressions éponymes reflètent également une vision étroite de l’histoire. La plupart ont vu le jour pendant la Renaissance européenne, une époque où les « découvertes » anatomiques consistaient souvent à s’approprier des connaissances qui existaient déjà ailleurs. Les personnes célébrées à travers ces expressions sont donc majoritairement des hommes blancs européens. Les contributions des femmes, des savants non européens et des systèmes de connaissances autochtones sont presque invisibles dans ce langage.

Cette pratique cache parfois une vérité vraiment dérangeante : le « syndrome de Reiter », par exemple, a été nommé d’après Hans Reiter, médecin nazi qui a mené des expériences particulièrement brutales sur des prisonniers du camp de concentration de Buchenwald (Allemagne). Aujourd’hui, la communauté médicale utilise le terme neutre « arthrite réactionnelle » afin de ne plus valoriser Reiter.

Chaque nom éponyme est comparable à un petit monument. Certains sont pittoresques et inoffensifs, d’autres ne méritent pas que nous les entretenions.

Les noms descriptifs, eux, sont simplement logiques. Ils sont clairs, universels et utiles. Avec ces noms, nul besoin de mémoriser qui a découvert quoi, seulement où cela se trouve dans le corps et quelle en est la fonction.

Si vous entendez parler de « muqueuse nasale », vous savez immédiatement qu’elle se trouve dans le nez. Mais demandez à quelqu’un de localiser la « membrane de Schneider », et vous obtiendrez probablement un regard perplexe.

Les termes descriptifs sont plus faciles à traduire, à normaliser et à rechercher. Ils rendent l’anatomie plus accessible aux apprenants, aux cliniciens et au grand public. Plus important encore, ils ne glorifient personne.

Que faire alors des anciens noms ?

Un mouvement croissant vise à supprimer progressivement les éponymes, ou du moins à les utiliser parallèlement à des termes descriptifs. La Fédération internationale des associations d’anatomistes (IFAA) encourage l’utilisation de termes descriptifs dans l’enseignement et la rédaction d’articles scientifiques, les éponymes étant placés entre parenthèses.

Cela ne signifie pas que nous devrions brûler les livres d’histoire. Il s’agit simplement d’ajouter du contexte. Rien n’empêche d’enseigner l’histoire de Paul Broca tout en reconnaissant les préjugés inhérents aux traditions de dénomination. On peut aussi apprendre qui était Hans Reiter sans associer son nom à une maladie.

Cette double approche nous permet de préserver l’histoire sans la laisser dicter l’avenir. Elle rend l’anatomie plus claire, plus juste et plus honnête.

Le langage de l’anatomie n’est pas seulement un jargon académique. C’est une carte du pouvoir, de la mémoire et de l’héritage inscrits dans notre chair. Chaque fois qu’un médecin prononce le mot « trompe d’Eustache », il fait écho au XVI^e siècle. Chaque fois qu’un étudiant apprend le mot « trompe utérine », il aspire à la clarté et à l’inclusion.

Peut-être que l’avenir de l’anatomie ne consiste pas à effacer les anciens noms. Il s’agit plutôt de comprendre les histoires qu’ils véhiculent et de décider quels sont ceux qui méritent d’être conservés.

Lucy E. Hyde ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.

How anatomical names can carry hidden histories of power and exclusion

2025-10-27T10:18:40Z

Gabriel Falloppius explaining one of his discoveries to the Cardinal Duke of Ferrara WellcomeTrust, CC BY-SA

Buried in your body is a tribute to a long-dead Italian anatomist, and he is not the only one. You are walking around with the names of strangers stitched into your bones, brains, and organs. We all are.

Some of these names sound mythical. The Achilles tendon, the band at the back of your ankle, pays homage to a Greek hero felled by an arrow in his weak spot. The Adam’s apple nods to a certain biblical bite of fruit. But most of these names are not myths. They belong to real people, mostly European anatomists from centuries ago, whose legacies live on every time someone opens a medical textbook.

They are called eponyms: anatomical structures named after people rather than described for what they actually are.

Take the fallopian tubes. These small passageways between the ovaries and the uterus were described in 1561 by Gabriele Falloppio, an Italian anatomist with a fascination for tubes who also gave his name to the Fallopian canal in the ear.

Gabriele Falloppio (1523–1562) was an Italian anatomist and surgeon who described the fallopian tubes in his 1561 work, Observationes Anatomicae. https://commons.wikimedia.org/w/index.php?curid=1724751

Or “Broca’s area”, named for Paul Broca, the 19th-century French physician who linked a region of the left frontal lobe to speech production. If you have ever studied psychology or known someone who has had a stroke, you have probably heard his name.

Then there is the eustachian tube, that small airway you pop open when you yawn on a plane. It is named after Bartolomeo Eustachi, a 16th-century physician to the Pope. These men have all left fingerprints on our anatomy, not in the flesh, but in the language.

Why have we stuck with these names for centuries? Because eponyms are more than medical trivia. They are woven into the culture of anatomy. Generations of students have chanted them in lecture halls and scribbled them into notes. Surgeons drop them mid-operation as if chatting about old friends.

They are short, snappy and familiar. “Broca’s area” takes two seconds to say. Its descriptive alternative, “posterior inferior frontal gyrus,” feels like reciting an incantation. In busy clinical settings, brevity often wins.

Eponyms also come with stories, which make them memorable. Students remember Falloppio because he sounds like a Renaissance lute player. They remember Achilles because they know where to aim the arrow. In a field that can feel like a wall of Latin, a human story becomes a useful hook.

The Achilles tendon was named in 1693 after the Greek hero Achilles. Panos Karas/Shutterstock

And, of course, there is tradition. Medical language is built on centuries of scholarship. For many, erasing eponyms would feel like tearing down history itself.

But there is a darker side to this linguistic love affair. For all their charm, eponyms often fail at their main purpose. They rarely tell you what a structure is or what it does. “Fallopian tube” gives no clue about its role or location. “Uterine tube” does.

Eponyms also reflect a narrow version of history. Most originated during the European Renaissance, a time when anatomical “discovery” often meant claiming knowledge that already existed elsewhere. The people being celebrated are overwhelmingly white European men. The contributions of women, non-European scholars and Indigenous knowledge systems are almost invisible in this language.

Then there is the truly uncomfortable truth: some eponyms honour people with horrific pasts. “Reiter’s syndrome,” for example, was named after Hans Reiter, a Nazi physician who conducted brutal experiments on prisoners at Buchenwald. Today, the medical community uses the neutral term “reactive arthritis,” a small but meaningful refusal to celebrate someone who caused harm.

Every eponym is a small monument. Some are quaint and historical. Others are monuments we would rather not keep polishing.

Descriptive names, by contrast, simply make sense. They are clear, universal and useful. You do not need to memorise who discovered something, only where it is and what it does.

If you hear “nasal mucosa,” you immediately know it is inside the nose. Ask someone to locate the “Schneiderian membrane,” and you will probably get a blank stare.

Descriptive terms are easier to translate, standardise and search. They make anatomy more accessible for learners, clinicians and the public. Most importantly, they do not glorify anyone.

So what should we do with all these old names?

There is a growing movement to phase out eponyms, or at least to use them alongside descriptive ones. The International Federation of Associations of Anatomists (IFAA) encourages descriptive terms in teaching and writing, with eponyms in parentheses.

That does not mean we should burn the history books. It means adding context. We can teach the story of Paul Broca while acknowledging the bias built into naming traditions. We can remember Hans Reiter not by attaching his name to a disease, but as a cautionary tale.

This dual approach allows us to preserve the history without letting it dictate the future. It makes anatomy clearer, fairer, and more honest.

The language of anatomy is not just academic jargon. It is a map of power, memory, and legacy written into our flesh. Every time a doctor says “Eustachian tube,” they echo the 16th century. Every time a student learns “uterine tube,” they reach for clarity and inclusion.

Perhaps the future of anatomy is not about erasing old names. It is about understanding the stories they carry and deciding which ones are worth keeping.

A sinistra história das ilustrações médicas e a questão do consentimento

2025-10-15T14:41:13Z

Nas páginas dos livros didáticos de anatomia estão figuras desnudadas, não apenas da pele, mas também da identidade, com desenhos requintados muitas vezes criados a partir dos corpos de prisioneiros, pobres e excluídos Vector Hut/Shutterstock.com

Elas estavam grávidas. Algumas eram prisioneiras. Outras eram as mais pobres entre os pobres, esquecidas na morte como na vida. Mas a dissecação e a representação de seus corpos tornaram-se a base do ensino da anatomia.

Nas páginas dos livros didáticos de anatomia encontram-se figuras desnudadas, não apenas da pele, mas também da identidade. O infame atlas da era nazista de Eduard Pernkopf contém desenhos requintados e hiper-realistas criados a partir dos corpos de prisioneiros políticos executados sob o regime de Hitler.

O célebre livro de William Hunter, The Gravid Uterus (1774), mostra mulheres grávidas dissecadas com distanciamento clínico, seus úteros inchados expostos. Mas quem eram essas mulheres? Como elas foram parar na mesa de dissecação? E, fundamentalmente, elas deram consentimento? Isso é algo raramente considerado por educadores, estudantes e pelo público em geral.

Hoje, a doação de corpos é regida por leis e ética claras. No Reino Unido, a Lei de Tecidos Humanos de 2004 (2006 na Escócia) exige consentimento informado e pessoal para investigação anatômica, além de consentimento adicional para a produção de imagens.

Serviços anuais de memorial e ação de graças também homenageiam os doadores, e aqueles que estudam anatomia são ensinados a tratar os cadáveres com a mesma dignidade que ofereceriam aos vivos — o primeiro paciente do futuro médico, embora silencioso.

Mas as ilustrações anatômicas históricas, ainda em uso na educação e na medicina, foram produzidas muito antes de tais salvaguardas existirem. A maioria dos textos e imagens apresenta pessoas que nunca deram permissão para serem dissecadas, muito menos retratadas para a eternidade. Devemos continuar usando essas imagens? Isso nos torna cúmplices de uma longa história de exploração médica?

A ilustração anatômica e, portanto, a história dos povos retratados, refletem as atitudes legais e culturais em relação à dissecação na época. As primeiras dissecações humanas registradas ocorreram por volta de 300 a.C. em Alexandria, no Egito. No século II, Galeno, um médico grego, dissecou animais e tratou gladiadores, estabelecendo as bases para o entendimento anatômico na Europa por mais de mil anos.

Na Europa medieval, a dissecação era rara e altamente ritualizada, servindo frequentemente a fins teológicos, e não científicos. No Renascimento, a anatomia começou a assumir sua forma moderna. Leonardo da Vinci realizou dissecações detalhadas, produzindo centenas de desenhos que combinavam precisão anatômica com brilhantismo artístico. No entanto, ele também não estava acima de métodos questionáveis, supostamente obtendo corpos por meio de acordos informais com hospitais e carrascos. A identidade de seus sujeitos permanece desconhecida.

Em 1543, Andreas Vesalius publicou De Humani Corporis Fabrica, desafiando séculos de erros galênicos com evidências visuais de dissecações. Seus cadáveres, no entanto, eram idealizados, musculosos, geralmente brancos e provavelmente masculinos.

Em uma imagem, um corpo segura sua própria pele para revelar sua musculatura, assim como o apóstolo São Bartolomeu em seu martírio. Nunca antes um texto anatômico havia sido tão ricamente ilustrado. As imagens eram inovadoras, mas romantizavam a morte e desumanizavam os mortos.

Com o tempo, o realismo anatômico tornou-se o objetivo. Nos séculos XVII e XVIII, anatomistas holandeses e britânicos como Govard Bidloo e William Hunter adotaram detalhes implacáveis — retratando a morbidez do cadáver, mostrando a decomposição, incisões muitas vezes violentas e as ferramentas de dissecação.

A obra de Hunter, The Gravid Uterus, tinha como objetivo transformar a obstetrícia por meio do realismo. Mas ela se baseava em 14 corpos de mulheres grávidas cujas origens permanecem eticamente questionáveis.

O útero grávido. Gravura em cobre de G. Scotin baseada em I.V. Rymsdyk, para W. Hunter The Gravid Uterus. 1774, reimpresso em 1851.

Como ele os obteve? Embora a Lei do Assassinato de 1752 permitisse a anatomização de assassinos executados, apenas alguns corpos estavam legalmente disponíveis dessa forma, insuficientes para a demanda. Entre 1752 e 1776, apenas quatro cadáveres foram obtidos sob a lei em Londres.

Na época, a proporção de mulheres que morriam no parto também era baixa, cerca de 1,4%. A probabilidade de os espécimes de Hunter terem sido obtidos legalmente é pequena. É mais provável que tenham sido adquiridos através do roubo de cadáveres, uma prática comum, mas ilegal. Suas identidades nunca foram registradas. Suas imagens perduram.

Ladrões de túmulos ou “homens da ressurreição” ajudaram a atender à crescente demanda por cadáveres — impulsionada pela expansão da educação médica e pelas restrições legais ao fornecimento — visando os pobres: aqueles enterrados em sepulturas rasas, recentes ou sem identificação nas margens dos cemitérios. As pessoas mais ricas podiam proteger seus mortos em cemitérios fechados, patrulhados por guardas pagos, com caixões protegidos por gaiolas de ferro ou em criptas de pedra.

Os ricos podiam comprar segurança mesmo na morte. Os pobres ficavam expostos, não porque não tivessem valor, mas porque não tinham poder.

A Lei de Anatomia de 1832 coibiu a profanação de túmulos, mas consolidou a injustiça. Os corpos institucionalizados não reclamados tornaram-se o novo fornecimento legal, aqueles provenientes de casas de trabalho, asilos, prisões e hospitais.

Até a Lei de Anatomia de 1984 e, mais definitivamente, a Lei de Tecidos Humanos de 2004, o consentimento informado não era necessário. Sejamos claros: os corpos na maioria das imagens anatômicas não eram voluntários. Eram pobres, criminalizados e marginalizados — aqueles que já sofriam mais em vida.

Eduard Pernkopf em trajes acadêmicos completos. Medizinische Universität WienImmediate

O exemplo mais extremo e moderno é o Atlas de Anatomia Humana Topográfica e Aplicada, de Pernkopf. Amplamente considerado um dos textos anatômicos mais detalhados e visualmente impressionantes, particularmente em sua representação dos nervos periféricos, é o mais problemático do ponto de vista ético.

O atlas foi criado durante o regime nazista, com pelo menos 1.300 corpos de prisioneiros judeus, ciganos, indivíduos queer e dissidentes políticos, muitos dos quais foram executados na prisão da Gestapo em Viena.

Apesar de suas origens em atrocidades médicas, o atlas permaneceu em circulação até a década de 1990. Mesmo décadas depois, sua influência persiste. Um estudo de 2019 descobriu que 13% dos neurocirurgiões ainda usam o atlas.

Alguns defendem seu uso contínuo, citando sua precisão anatômica, especialmente em cirurgias neurológicas complexas, desde que sua história sombria seja reconhecida. Outros argumentam que qualquer benefício clínico é superado pelo custo ético, e que o uso contínuo implica o endosso de suas origens.

Esforços em andamento

Mas Pernkopf é apenas o exemplo mais perigoso. Em muitas imagens históricas, surge a mesma questão fundamental: o conhecimento médico baseado na exploração pode ser totalmente separado dela?

Não existe uma solução única, mas há esforços em andamento. Alguns educadores estão adicionando contexto em palestras, notas de rodapé e materiais didáticos, dedicando tempo para ensinar a história, reconhecendo quem provavelmente foi retratado e em que circunstâncias.

Ilustradores médicos estão criando novas imagens com base no consentimento informado e nas diretrizes modernas, em parte também para criar uma representação diversificada em termos de história da população, gênero, tipo físico e capacidade. Instituições estão digitalizando e catalogando coleções antigas com notas históricas adequadas, para que não sejam usadas de forma acrítica.

Mas esses esforços são fragmentados. Não há padrões ou regulamentos universais sobre as imagens anatômicas históricas, ficando fora da alçada até mesmo do órgão regulador mais rigoroso. Enquanto isso, essas ilustrações circulam livremente online, em livros didáticos e até mesmo nas redes sociais, desprovidas de contexto e separadas de suas origens.

E assim, as mesmas injustiças correm o risco de se perpetuar silenciosamente. Devemos começar por fazer perguntas melhores: quem está representado nas imagens anatômicas hoje? Quais corpos estão faltando? E quais histórias nunca foram contadas?

A curto prazo, precisamos de uma pesquisa clara sobre a proveniência, rotulagem e transparência em torno das ilustrações históricas. Professores, editores e editoras devem reconhecer as fontes dessas imagens, mesmo que desconhecidas.

A longo prazo, devemos investir na criação de novas bibliotecas anatômicas inclusivas que reflitam toda a diversidade dos corpos humanos, em todas as identidades de gênero, origens raciais, deficiências e fases da vida. Com fontes éticas e consentimento claro, podemos criar materiais que respeitem tanto os vivos quanto os mortos.

As pessoas nessas ilustrações, silenciosas, anônimas e dissecadas, nunca foram convidadas a nos ensinar. Mas elas o fizeram e agora é nossa responsabilidade perguntar: que tipo de legado estamos criando em troca?

Se queremos que a medicina seja ética, inclusiva e justa, isso começa com as próprias imagens com as quais aprendemos. É hora de olhar novamente para os corpos por trás dos desenhos. E, desta vez, vê-los de verdade.

Lucy E. Hyde não presta consultoria, trabalha, possui ações ou recebe financiamento de qualquer empresa ou organização que poderia se beneficiar com a publicação deste artigo e não revelou nenhum vínculo relevante além de seu cargo acadêmico.

The dark history of medical illustrations and the question of consent

2025-10-13T16:12:54Z

Vector Hut/Shutterstock.com

They were pregnant. Some were prisoners. Others were the poorest of the poor, forgotten in death as in life. Yet dissection and depiction of their bodies have become the foundation of anatomical teaching.

Cradled in the pages of anatomy textbooks are figures stripped bare, not only of skin but of identity. Eduard Pernkopf’s infamous Nazi-era atlas contains exquisite, hyper-realistic drawings created from the bodies of political prisoners executed under Hitler’s regime.

William Hunter’s celebrated The Gravid Uterus (1774) shows dissected pregnant women with clinical detachment, their swollen wombs exposed. But who were these women? How did they end up on the dissection table? And, crucially, did they ever consent? It’s something rarely considered by educators, students and the public alike.

Today, body donation is governed by clear laws and ethics. In the UK, the 2004 Human Tissue Act (2006 in Scotland) requires informed, personal consent for anatomical investigation, and further consent to be given for production of images.

Annual memorial and thanksgiving services also honour donors, and those studying anatomy are taught to treat cadavers with the same dignity they would offer the living – the medic’s first patient, albeit silent.

But historical anatomical illustrations, still in use across education and medicine, were produced at times long before such safeguards existed. Most texts and imagery feature people who never gave permission to be dissected, let alone depicted for eternity. Should we keep using these images? Or does that make us complicit in a long history of medical exploitation?

Anatomical illustration and, therefore, the history of the peoples depicted, mirrors the legal and cultural attitudes toward dissection at the time. The first recorded human dissections occurred around 300BC in Alexandria, Egypt. In the second century, Galen, a Greek physician, dissected animals and treated gladiators, and laid the foundations for anatomical understanding in Europe for over a thousand years.

In medieval Europe, dissection was rare and heavily ritualised, often serving theological rather than scientific purposes. By the Renaissance, anatomy began to take its modern form. Leonardo da Vinci conducted detailed dissections, producing hundreds of drawings that combined anatomical accuracy with artistic brilliance. Yet he, too, was not above questionable methods, reportedly obtaining bodies through informal deals with hospitals and executioners. The identities of his subjects remain unknown.

In 1543, Andreas Vesalius published De Humani Corporis Fabrica, challenging centuries of Galenic error with visual evidence from dissection. His cadavers, however, were idealised, muscular, often white and probably male.

In one image, a body holds back its own skin to reveal its musculature, just like Saint Bartholomew the Apostle in his martyrdom. Never before had an anatomical text been so highly illustrated. The images were groundbreaking, but they romanticised death and dehumanised the dead.

Over time, anatomical realism became the goal. In the 17th and 18th centuries, Dutch and British anatomists like Govard Bidloo and William Hunter embraced unflinching detail – depicting the morbidity of the cadaver, showing decomposition, often violent incisions, and the tools of dissection.

Hunter’s The Gravid Uterus aimed to transform obstetrics through realism. But it relied on 14 pregnant bodies whose origins remain ethically troubling.

The gravid uterus. Copperplate engraving by G. Scotin after I.V. Rymsdyk, for W. Hunter The Gravid Uterus. 1774, reprinted 1851.

How did he obtain them? Even though the 1752 Murder Act allowed the anatomisation of executed murderers, only a few bodies were legally available in this way, insufficient for demand. Between 1752 and 1776, just four cadavers were sourced under the Act in London.

At the time, the proportion of women dying in childbirth was also low, around 1.4%. The likelihood that Hunter’s subjects were legally obtained is slim. More likely, they were acquired through body snatching, a common but illegal practice. Their identities were never recorded. Their images endure.

Grave robbers or “resurrection men” helped meet the growing demand for cadavers – driven by the expansion of medical education and legal restrictions on supply – by targeting the poor: those buried in shallow, recent or unmarked graves at the edges of cemeteries. Wealthier people could protect their dead in gated cemeteries patrolled by paid guards, coffins protected by iron cages or in stone vaults.

The rich could buy safety even in death. The poor were left exposed, not because they lacked value, but because they lacked power.

The 1832 Anatomy Act curbed grave robbing but entrenched injustice. Unclaimed institutionalised bodies became the new legal supply, those from workhouses, poorhouses, asylums, prisons and hospitals.

Until the 1984 Anatomy Act, and more definitively the 2004 Human Tissue Act, informed consent was not required. Let’s be clear: the bodies in most anatomical images were not volunteers. They were poor, criminalised and marginalised – those who in life already suffered the most.

Eduard Pernkopf in full academic regalia. Medizinische Universität WienImmediate

The most extreme more modern example is Pernkopf’s Atlas of Topographical and Applied Human Anatomy. Widely regarded as one of the most detailed and visually stunning anatomical texts, particularly in its depiction of the peripheral nerves, it is the most ethically troubling.

The atlas was created during the Nazi regime, with at least 1,300 bodies of Jewish prisoners, Roma, queer individuals and political dissidents, many of whom were executed in Vienna’s Gestapo prison.

Despite its origins in medical atrocities, the atlas remained in print until the 1990s. Even decades later, its influence persists. A 2019 study found that 13% of neurosurgeons still use the atlas.

Some defend its continued use, citing its anatomical precision, especially in complex neurological surgeries, so long as its dark history is acknowledged. Others argue that any clinical benefit is outweighed by the ethical cost, and that continued use implies endorsement of its origins.

Efforts underway

But Pernkopf is only the most dangerous example. Across many historical images, the same fundamental question arises: can medical knowledge built on exploitation ever be fully separated from it?

There’s no single solution, but there are efforts underway. Some educators are adding context in lectures, footnotes and course materials, taking time to teach the history, acknowledging who was probably depicted and under what circumstances.

Medical illustrators are creating new images based on informed consent and modern day guidelines, partly also to create diverse representation across population history, gender, body type and ability. Institutions are digitising and cataloguing old collections with proper historical notes, so they aren’t used uncritically.

But these efforts are piecemeal. There are no universal standards or regulations governing historical anatomical imagery, falling out of the remit of even the most strict governing body. Meanwhile, these illustrations circulate freely online, in textbooks, even on social media, stripped of context, divorced from their origins.

And so, the same injustices risk being quietly perpetuated. We must start by asking better questions: who is represented in anatomical imagery today? Whose bodies are missing? And whose stories are never told?

Short term, we need clear provenance research, labelling and transparency around historical illustrations. Teachers, editors and publishers must acknowledge the sources of these images, even if unknown.

Long term, we must invest in creating new, inclusive anatomical libraries that reflect the full diversity of human bodies, across gender identities, racial backgrounds, disabilities and life stages. With ethical sourcing and clear consent, we can build materials that respect the living and the dead alike.

The people in these illustrations, silent, anonymous and dissected, were never asked to teach us. But they have and now, it’s our responsibility to ask: what kind of legacy are we creating in return?

If we want medicine to be ethical, inclusive and just, it starts with the very images we learn from. It’s time to look again at the bodies behind the drawings. And this time, to really see them.