Body painting: five centuries of Frenchanatomical illustrations



A touch of France
Body painting: five centuries of French anatomical illustrations


by C. Régnier, France






More than any other branch of medicine, anatomy should be pictorial, illustrative, visual. Anatomy takes a critical, esthetic, as well as a practical look at the human body, through the eyes of a scientist, physician, student, surgeon, scholar, and artist. Without visual representation anatomy would scarce exist, and artwork has been used to illustrate descriptive text in anatomy books since the 16th century. Anatomist and artist had to work together, to give and take, the anatomist wedded to graphic faithfulness to what the scalpel reveals, the artist wielding crayon, burin, or brush to represent the body, the cadaver, death itself. Great was the temptation for anatomists to illustrate their dissections themselves, to make do without, or to seek to emulate, an artist’s ways of seeing. French anatomists stood at the crossroads of the great Northern European schools of anatomy, close to the German master engravers, influenced by the artists of the Italian Renaissance. They were therefore well placed to make an original contribution to the history of anatomy and its artistic representation, and it was in France that the first attempts weremade to print anatomical plates and drawings in color. Throughout the 19th century, the French school of anatomy reinvented the relation between the body and its ailments: accurately illustrated organs and sick bodies, surgical procedures rooted in a new descriptive and topographic anatomy stripped of all stylistic flourishes. Anatomists in France made great strides through mastery of chromolithography (the making of multicolor prints) and the invention of techniques for preserving bodies. And then came the modern era with its photography, x-rays, electron microscopy, and computing.

Medicographia. 2012;34:106-115 (see French abstract on page 115)

Drawing by J. B. Léveillé, illustrating Ludovic Hirschfeld’s Névrologie ou Description et Iconographie du Système Nerveux et des Organes des Sens de l’Homme Avec Leur Mode de Préparation. Paris, France: Éditions Baillière; 1853.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

In the Renaissance, liberation of the mind and the emergence of the humanist movement benefited medicine and more particularly anatomy, which assumed the status of a “science.” The Flemish anatomist Andries van Wesel (1514- 1564), better known as Andreas Vesalius, was one of the first to ally the acuity of the anatomical view and the beauty of artistic representation. Vesalius studied in Paris around 1533-1536 under the French anatomist Jacques Dubois (1478-1555), known also as Sylvius, but they fell out, as Sylvius opposed the use of illustrations in anatomy books and refused to countenance that Galen’s anatomy could be challenged. Heedless of censure, Vesalius dissected cadavers from the gibbet of Montfaucon (near the current Buttes Chaumont Park in the 19th arrondissement of Paris) and from the Cemetery of the Innocents (the place Joachim-du-Bellay in the “Les Halles” district in the center of Paris now covers the site of the cemetery). This work enabled Vesalius to correct numerous anatomical errors in the canons of osteology and myology. In 1543 he published in Basel his masterwork De Humani Corporis Fabrica Libri Septem (“On the Fabric of the Human Body in Seven Books”; 661 pages), which was illustrated by 300 plates by Jan Stefan Van Kalkar and others working in the studio of Titian. These were the first plates in which scientific representation of the body was allied with a strange pictorial amalgam of plants, architectural elements, and allegories. Anatomy illustrations aspired to the status of works of art through the drawing and engraving techniques used and the way the image was portrayed. Anatomist and artist became at one and the same time associates and rivals.1-4

Charles Estienne, father of French anatomy

In their printworks on the rue Saint-Jean-de-Beauvais in Paris, the Estienne family published the works of Galen and Sylvius. Charles Estienne (ca 1504-1564) studied medicine in Padua and in 1534 graduated in Paris, where he met Vesalius. Together they surreptitiously dissected the cadavers of torture victims and the hanged. By 1536, Estienne had almost completed his projected three-volume work on human anatomy De Dissectione Partium Corporis Humani Libri Tres. However, legal proceedings brought against the Estienne family in 1539 by the surgeon and draftsman Étienne de la Rivière delayed publication, and the book only appeared in 1545 in its Latin version and the following year in French. De la Rivière was the initiator of the book and wanted his name to appear on the engravings that Estienne had re-used, together with simple anatomical illustrations engraved separately. Court artists at Fontainebleau did the 62 wood engravings in a somewhat Italianate style.2-4

Charles Estienne.
De Dissectione Partium Corporis Humani Libri Tres. Wood engraving attributed to Jean Jollat. Paris, France; 1545.
Cross-sectional view of a dissected brain showing the cerebellum, third ventricle, and pineal body. The man’s body seems to be in forward motion. On the table are dissecting
instruments, and French Renaissance architecture forms the backdrop.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Govert Bidloo.
Anatomia Humani Corporis, Centum et Quinque Tabulis. Amsterdam, Netherlands. Johann Someren, 1685.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Gerard de Lairesse, artist to Govert Bidloo

In the 17th and 18th centuries, the emergence of microscopy revolutionized anatomical studies, linking organs to their function and thrusting physiology into the field of anatomy. It was also the era of comparative and of functional anatomy. Artists and anatomists pursued their collaboration, but were beginning to go their separate ways. Artists no longer sought to depict the absolute truth of forms, but rather to establish aesthetic canons. Anatomists, on the other hand, wanted to use their observations to explicate physiology and to understand pathology. In 1690, Govert Bidloo (1649-1713), a professor of anatomy in Leiden, published Ontleding des Menschelyken Lichaams (Anatomy of the Human Body), which was illustrated by 107 intaglio engravings by Abraham van Blooteling, based on drawings and paintings by Gerard de Lairesse, a student of Rembrandt.

Lairesse observed and painted during Bidloo’s dissections, which were often swiftly done, thus accounting for numerous anatomical approximations in the resulting artwork. Keen to show the cadaver pinned to the dissecting table, and as a master of the technique of shading, Lairesse produced work bearing the aesthetic hallmarks of French 17th-century classicism. Bidloo’s book was not a success, either in Dutch or in the later Latin edition (1685), but its engravings took on a life of their own when the English anatomist William Cowper (1666-1709) purchased and published them in 1697 under his own name and with his own legends.2-5

Jacques Fabien Gautier d’Agoty. “L’Ange Anatomique” (The Flayed Angel), in: Myologie Complète en Couleur et Grandeur Nature. Paris, France; 1746.
The surrealists dubbed plate XIV (60.5 × 46 cm) “The Flayed Angel.” In this detailed dissection of a woman’s back from neck to sacrum, the “red wings” are muscles pulled back that contrast with the green background. Jacques Prévert wrote of this plate: “A pretty woman with naked or rather flayed shoulders, the skin pinned back on each side… Horror and visceral splendor.”
© BIU Santé Paris/R. Caussimon.

Gautier d’Agoty and the advent of color

From the 18th century onwards, black and white line drawings gave way to color illustrations, which created a sense of tissue volume and texture. Jacques Fabien Gautier d’Agoty (1717-1785), an artist from Marseille, published the first mechanically printed, color intaglio anatomy books. D’Agoty learned three-color printing (blue, yellow, red) from the printer Le Blon, adding black in the process, to increase sharpness and draw shadows. He published Myologie Complète en Couleur et Grandeur Naturelle, a treatise on muscle anatomy, in 1746, Anatomie Générale des Viscères (General Anatomy of the Viscera) four years later, and Exposition Anatomique du Corps Humain (Anatomical Exhibition of the Human Body) in 1759, all with full-size, color illustrations, some two meters high. This return of color, which had been used in the Middle Ages, enhanced lifelikeness, but three-color printing was costly and d’Agoty’s illustrations were mediocre and wanting in anatomical accuracy, and the books were commercial failures.1,2,6,7

Félix Vicq d’Azyr: the return to anatomical realism

Félix Vicq d’Azyr (1748-1794) was Queen Marie-Antoinette’s physician and a member of the French Academy of Sciences and of the Academy of Medicine. He wrote the section on pathological anatomy in L’Encyclopédie by Denis Diderot and Jean le Rond d’Alembert, and in 1786 published Traité d’Anatomie du Cerveau, which was lauded as one of the most realistic works of neuroanatomy. To illustrate his treatise, Vicq d’Azyr called upon the engraver Alexandre Briceau and his daughter Angélique, who used aquatint, an intaglio printmaking technique. A layer or successive layers of acid-resistant resin are baked onto a copper plate, which is then immersed in nitric acid to create different tones in the unprotected areas between resin particles, depending on acid concentration and exposure time. The plate is inked and prints are made. This complex technique achieves the delicacy of wash-paints, crayons, watercolors, and pastels. The etcher makes three plates, using aquatint (ocher), point engraving (red), and cutting wheel (black).2,7,8

Jacques Fabien Gautier d’Agoty. Exposition
Anatomique du Corps Humain. Marseille, France; 1759.
Man dissected to reveal the circulatory system and the urogenital
system. At his feet is a glass containing seminal fluid. These engravings
sacrifice anatomic verisimilitude to an esthetic and macabre vision of
the human body. © BIUM, Bibliothèque Interuniversitaire de Médecine.

Félix Vicq d’Azyr. Traité d’Anatomie et de Physiologie, avec des Planches Coloriées Représentant au Naturel les Divers Organes de l’Homme et des Animaux. Paris, France: François Ambroise Didot l’Aîné; 1786.
Dissection of the right brain lobe. In this engraving, use of the cutting wheel
and scraper gives a feeling of volume to the cerebral gyri and convolutions.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Anatomists and artists: diverging paths

By the early 19th century, artists and anatomists had parted ways forever: artists gravitated toward the fine arts while anatomists focused on medical matters. Microscopy and the work of Xavier Bichat (1771-1802) on tissues and organs gave birth to applied anatomy. Bichat’s studies initiated a period marked by the preeminence of the French school: Béclard, Portal, Rouvière, Ranvier, Mathias Duval, Breschet, Sappey, Testut, and Latarget. In the early 1830s, the Parisian phar- macist Jean-Nicolas Gannal proposed a new technique for preserving cadavers by injecting sulfate of alumina into the carotid artery. Anatomists were therefore no longer pressed for time in their dissections and other anatomical preparations.

With the invention of lithography, a new process of reproduction, artists offered their services to surgeons and anatomists whose requirements in terms of accuracy were no longer negotiable. The ceremonial depiction of human cadavers accompanied by allegories was now unthinkable. There was one anatomy for physicians and another for artists, as seen in this hybrid work illustrated by aquatints produced with two copper plates and published in 1812 by Jean- Galbert Salvage, who was both an anatomist and artist.2-5,9

Jean-Galbert Salvage. Anatomie du Gladiateur
Combattant, Applicable aux Beaux-Arts, ou Traité des Os, des Muscles, des Mécanismes des Mouvements, des Proportions et des Caractères du Corps Humain. Paris, France; 1812.
Among 22 self-published printed plates, is this study of a gladiator after an ancient Greek statue.
Salvage, who was a military doctor under Napoleon, arranged the cadavers of soldiers in gladiatorial poses before making his sketches.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Lithography at the service of anatomy

Jules Germain Cloquet (1790-1883), the son of a famous engraver and illustrator, studied under, and became the friend of, the surgeon Achille Cléophas Flaubert, the father of Gustave Flaubert, in Rouen. He worked for a while making wax anatomical models at the Paris Faculty of Medicine, and later became a surgeon and professor of external pathology, and a member of the Academy of Medicine and of the Academy of Sciences. This was a time when Paris was the center of anatomy and its hospitals supplied physicians of the state health services with a large number of cadavers for dissection. 2,3,5,8,9 Cloquet and his sister Lise, whose father had taught them to draw, took up lithography, which greatly reduced the cost of printing. In the first lithography studio in Paris, founded by Charles Philibert de Lasteyrie, the artists Feillet, Langlumé, and Frey made black and white lithographs of 300 anatomical plates drawn by Haincelin. Cloquet used these in his five-volume Anatomie de l’Homme, published from 1821 to 1831 in Paris, the first anatomy atlas to be illustrated with lithographs. In 1825 Cloquet published his Manuel d’Anatomie Descriptive du Corps Humain, an easy-to-use and affordable quarto book illustrated by 340 plates, some handcolored, and by pictures of tissue samples and microscopic anatomy drawings not included in the 1821 treatise. Still beyond the means of students, these great anatomy treatises were to be found in the libraries of the fast-growing bourgeoisie.

Master of anatomic pathology

Jean Cruveilhier (1791-1874) was a medical student in the same class as Jules Cloquet, and later became professor of anatomy and head of anatomy studies at the Faculty of Medicine in Paris, where he turned anatomic pathology into a whole new medical discipline. Cruveilhier, like Flaubert’s Dr Larivière, the physician called to attend to the dying Emma Bovary after she swallowed arsenic, “belonged to that great school of surgery begotten of Bichat.” Cruveilhier followed the teachings of the surgeon Guillaume Dupuytren and was president of the Anatomical Society from 1826 to 1866. Apart from a treatise on descriptive anatomy (Traité d’Anatomie Descriptive; 1834), his main work was Anatomie Pathologique du Corps Humain, which he started in 1828 and completed in 1842. It was illustrated by 233 splendid lithographs produced by Langlumé from hand-colored drawings by Antoine Chazal, the resident artist and professor of drawing at the National Museum of Natural History in Paris. Every day he and Cruveilhier spent hours poring over and checking the plates.3,5,8,10

Jean Cloquet. Manuel d’Anatomie Descriptive du Corps Humain,
Représentée en Planches Lithographiées. Paris, France: Bechet;
1825-1836.
Volume 4. Plate 209. Left ventricle of open heart, vessels of anterior and posterior
parts of the heart, root of the aorta. Drawings: Haincelin. Lithograph: Frey G.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Jean Cruveilhier. Anatomie Pathologique du Corps Humain, ou
Descriptions, Avec Figure Lithographiées et Coloriées des Diverses
Altérations Morbides Dont le Corps Humain est Susceptible. Paris,
France: Baillière; 1829-1842.
Kidney diseases. Figure 1. “Renal phlebitis,” Figure 2 and 2’. Fatty cysts in the
renal cortex. Figure 3. Atrophy of the medullary substance. Volume 2, Part 3,
Section 36, plate 3. © BIUM, Bibliothèque Interuniversitaire de Médecine.

Jean-Baptiste Sarlandière.
Anatomie Méthodique ou Organographie Humaine en Tableaux Synoptiques avec Figures, à l’Usage des Universités.
Paris, France: 1829. Plate 13: Angiography.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

From France to America: anatomy color plates

In Paris in 1829 Jean-Baptiste Sarlandière (1787-1838) published Anatomie Méthodique ou Organographie Humaine (Methodical Anatomy or Human Organography). Republished the following year, and then in Latin in 1831, it appeared in two American editions (1835 and 1837) under the title Systematized Anatomy. This 32-page book designed to educate and enlighten the general public contained 15 plates, based on the anatomical preparations of Leboyer, Talrich, and Pichonnière, lithographed and hand-colored in 54.8 × 35 cm format by Langlumé, Delaporte, and Courtin. Sarlandière was a friend of François Magendie, professor of medicine at the Collège de France and one of Claude Bernard’s teachers, and also devoted himself to acupuncture, electrotherapy, electropuncture, and massage techniques.2-4,7,10

Jean Marc Bourgery’s anatomy treatise: a monumental work of the 19th century

Jean Marc Bourgery (1797-1849) studied under Jean-Baptiste Lamarck, worked in Paris as an intern for René Théophile Laennec and Guillaume Dupuytren, and devoted his life to anatomy.2,3,5,11 His Traité Complet de l’Anatomie de l’Homme, Comprenant la Médecine Opératoire (Complete Treatise on Human Anatomy, Including Surgery) is one of the most remarkable works in the history of anatomy, and the greatest of the 19th century. Published in Paris between 1831 and 1854, this 8-volume work contained 2108 pages of folio-sized text (80 × 30 cm) illustrated by 725 plates comprising 3750 lithographed figures. It covered descriptive and physiological anatomy, surgical anatomy and surgery, philosophical anatomy and embryology, and microscopic anatomy. The last volume was edited by Claude Bernard (1813-1878) after Bourgery’s death, as was the second edition. Claude Bernard in person supervised (and sometimes performed) the dissections, and Nicolas Henri Jacob, a student of Jacques-Louis David, did the drawings, with help from Ludovic Hirschfeld.

Jean Marc Bourgery. Traité Complet de l’Anatomie
de l’Homme par les Drs Bourgery et Claude Bernard et
le Professeur-Dessinateur-Anatomiste N. H. Jacob Avec
le Concours de Ludovic Hirschfeld. Paris, France: L. Guérin;
1866-1867. Volume 4. Plate 32. Dissection of the armpit.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

igismond Laskowski.
Anatomie Normale du Corps Humain: Atlas Iconographique de XVI Planches Dessinées d’Après les Préparations de l’Auteur par S. Balicki. Geneva, Switzerland: Braun et Cie, 1894.
© BIUM, Bibliothèque Interuniversitaire de Médecine.

Ludovic Hirschfeld, the sedulous student

As a demonstrator and laboratory assistant, Ludovic Hirschfeld (1816-1876) helped Bourgery prepare his famous treatise. He worked at the surgical clinic run by Léon Rostan at the Hôtel-Dieu in Paris, and his passion for neuroanatomy led him to publish in 1853 Névrologie ou Description du Système Nerveux, a treatise on neurology illustrated by 92 chromolithographs by Léveillé, a celebrated Parisian lithographer.

A second enlarged and corrected edition appeared in 1866, when Hirschfeld was a professor of anatomy in Warsaw (see his “Dissection of the armpit,” page 113, as well as the illustration at the beginning of this article, page 107).3,10

A farewell to the anatomy of yesteryear

From the end of the 19th century onwards, the anatomical image was transformed by new techniques that captured “reality” like photography and radiology. The last treatises to be illustrated by hand drawings were rolling off the presses, and in the 1860s, some 25 years before the discovery of x-rays, Vincent Paulet and Jules Sarazin published a superb book on topographic anatomy illustrated by 244 watercolors printed as chromolithographs. Paulet did the anatomical preparations and Sarazin, a doctor in the imperial army, painted the watercolors. Paulet later held the chair of anatomy at the Faculty of Medicine in Lyon (1877 to 1884) and then in Montpellier (1888). Sigismond Laskowski (1841- 1928), an anatomist of Polish origin exiled in Paris and professor of anatomy in Geneva, published in 1894 Anatomie Normale du Corps Humain with 16 color plates, prints of which were used for teaching purposes. Laskowski became a renowned embalmer and considerably improved the preservation of bodies through his inventions of arterial injection of sodium borate and glycerin, the use of phenol, and venous drainage.2,5,9,11

Epilogue

In the contemporary era, radiologic anatomy (computed tomography and magnetic resonance imaging), a new branch of anatomy with direct practical applications, and electron microscopy, since the 1960s, have revolutionized anatomy. Contemporary anatomists focus on the teaching of anatomy, notably its relation to physiology and medicine, quantitative anatomy (development ofmeasurement techniques, introduction of statistical methods), the use of real-time in vivo imaging, and questions of international nomenclature. And in the 21st century, anatomy entered the digital era. Three-dimensional computer graphics are used to represent the human body, as in the Visible Human Project, in which the body of a man was cut into over 1800 one-millimeter slices which were photographed and digitized.12 _

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