The Beauty of Anatomy s01e01 Episode Script

Galen and Leonardo

We are our bodies.
We see the outside all the time, but that's less than half the story.
The surface, the exterior.
We know far less about what's inside.
Heaven forbid that we should actually see our insides.
Most people go through their life without getting a look at their organs, and for good reason.
My lungs and kidneys and heart, bones and muscles, arteries and veins, they do their jobs unseen.
But for the anatomists, the doctors and artists who have struggled for centuries to understand how our bodies actually work, getting inside, dissection, was vital.
In this five-part series, I'll be investigating the beautiful synthesis between discoveries in anatomy and works of art that illustrate them.
'As a scientist myself, 'and someone who is fascinated by anatomical images, I want 'to find out exactly how anatomy has inspired art, and art anatomy.
' And it's going to be my privilege to see some of the greatest works of art in the world.
The most influential doctor ever to study our anatomical structure lived and worked in Rome, in the second century AD.
He went by the name of Galen.
Galen's ideas influenced some of the greatest artists of all time, including Leonardo da Vinci, who took anatomy to new artistic heights.
Galen's teachings held sway for more than 1,500 years after he died, and in this first episode, I have just one question - why? The Roman physician and surgeon Claudius Galen was fascinated by everything that goes on beneath our skin.
He studied muscles, veins, arteries, sight and smell, how we move, breathe and bleed.
He is best known for his theory of the humours, the essential fluids that flow through us and shape our characters and our health.
Galen's view of the body is based on an idea of health and disease as a matter of balance.
So it's a materialist view of the body, it's not about demons and spirits, but about physical processes and substances.
And it's a view of the body that very strongly connects the mind with the functioning of the body and with what we would now call lifestyle and environment.
The basis of this idea is the so-called four humours, the idea that health and disease are governed by the movement of these subtle fluids around the body.
Galen's work provides the basis of initially classical medicine and then Renaissance Western medicine for an incredibly long period of time.
It's not really until, I think, probably the early 19th century that Western medicine finally rids itself of a Galenic influence.
So, Galen's ideas are clearly enormously persuasive - there's something about them that speaks to our understanding of our body.
In the second century, Galen was famous because he was the physician to the emperor Marcus Aurelius.
The Romans had banned human dissection, so Galen learned about our anatomy from treating gladiators' wounds and from dissecting animals.
Everything he discovered he wrote down, but none of it was illustrated.
I've come to Cambridge to find out how Galen's writings survived and how his work led to a surprising flowering of artistic interpretations after the Empire ended.
How is it that his ideas survived so well? Well, this book gives us a clue.
It's written in Persian and it shows that Galen's influence was felt as far away as what is present-day Iran.
This text was written in 1386, and it's the so-called Anatomy of Mansur.
'What this book proves is that original texts of Galen's work 'made their way out of the classical world 'and into Persia, where they were translated.
'They were then put together with artists' impressions of Galen's 'writings from ancient Egypt.
' Although this text here is not by Galen, it might as well be, because almost everything written in it testifies to Galen's own ideas.
And, indeed, these diagrams that go with the text probably go back to Alexandria, where Galenic anatomy was being taught in the fifth century AD.
These pictures in this Persian manuscript seem to go right back to that source, because they contain the same series of figures.
There are five figures in all, each featuring a major system of the body.
So, we have the vein man, the nerve man, the artery man.
And then two which, for that time, are particularly interesting.
Even though he'd only dissected animals nearly 2,000 years ago, Galen's description of the human skeleton is almost completely correct, and his muscles are largely right too.
He had an idea of what we would now call physiology, how the body worked, and he associated that with three organs in particular - the brain, which controlled the mental processes and thought, and then the heart, which was supposed to be responsible for the system which allowed the body to move, and then the liver, which was supposed to control digestion and other bodily processes through the veins.
So, it was all knitted together into one big system, and anatomy, as it were, was the structure behind this.
But the function of the organs was the important part.
So, what matters to Galenic anatomy is the relationship between organs - indeed, between all the features of the body.
And where I'm going now, there's a book that shows us that these ideas of Galen's were alive and well in Europe over 1,000 years after his death.
This is Lambeth Palace, and here in the library there is a gem of medieval anatomy, a little French book that tells us loads about how our internal organs and bodies were viewed in the Middle Ages.
Galen thought anatomy was more than just a skill.
He believed it revealed the relationship between man and the universe as a whole.
And this is what I've come to see.
Thank you, Naomi.
It might not look very big or impressive, until you look inside.
This is a book of hours, a devotional book.
One from which Christians would read Psalms and prayers, and this one is just lavish.
There is incredible lettering, and the pictures are brought to life with gold leaf.
The book was owned by a French nobleman named Simon Vostre.
He commissioned it from the printer Philippe Pigouchet, and it was finished in 1498.
Early on in the book is something very different from the other richly decorated pages.
Anatomy.
Now, this particular image is called The Planet Man, and it's meant to show the influence of the planets and the heavens on our lives and our health.
The man in the middle has his abdomen exposed and you can see his organs - there's the heart, and I guess the liver and intestines right there, visible on the page.
Now, you can see that the illustration is heavily annotated, but it's written in 15th century French, and my medieval French is a bit rusty, so I've asked Caroline Petit to help me translate.
Caroline, what do the captions actually say? Well, the captions connect planets and other heavenly bodies with parts of the body.
So here, for example, you have the sun connected with the stomach.
So the caption says "sol regarde l'estomach" - "the sun is looking at the stomach.
" And these larger captions over the bottom and the sides, what do they say? You have references to moments in the calendar and the opportunity to bleed the patient according to their individual temper, temperament.
So you bleed them as a treatment for something, but this is describing when to do it.
When to do it, exactly.
For example, when the moon is in Taurus, Virgo and Capricornus, it's good to bleed a melancholic.
OK, so this is sort of an introduction to medieval medicine as it relates to the stars and these ancient concepts.
Exactly, because the man is directly connected with all the parts of the universe.
Man is part of the great design of God.
In Galen's system, the influence of the planets is closely tied to his theory of the humours.
So, you have four humours, blood, phlegm, yellow bile and black bile.
The healthy body has all its humours in balance.
So, if you get an excess of black bile, for example, you might be subject to an onset of melancholy or madness of a kind.
There was nothing weird in that, actually.
It was both kind of scientific and totally in accordance with religious beliefs.
So, the medicine and the anatomy is really tied up with the theology.
This is a reminder of your own mortality.
Yes, exactly.
Anatomy IS theology in the Middle Ages, that's very clear.
So, condensed in this one anatomical image is an entire view of human existence.
And however odd Galen's humours might seem today, it was a sophisticated system of thought.
Galen's power, his enduring influence, lay in his explanations.
For centuries, scholars don't challenge him because he makes a lot of sense, he gives reasons for everything that happens in the human body.
His anatomy and his physiology, well, they just work.
If it ain't broke, don't fix it.
So, this is a branch of the median nerve, and we have The palmar cutaneous branch of the median nerve comes off in the forearm and runs along 'The underlying principle of Galen's approach to anatomy 'is first-hand investigation, 'and that is as important today as it was nearly 2,000 years ago.
' I studied anatomy for just a year when I was an undergraduate.
My tutors used to refer to this process as plumbing and carpentry.
I guess what they were referring to is how you can't really learn about how our bodies work unless you're willing to get your hands dirty and get stuck in and actually do dissection yourself.
And that is what the word "autopsy" means - to see for yourself.
Which is exactly the message of what Galen was doing, and what all the anatomists of the past were trying to teach their students.
In the middle of the 15th century, the course of anatomy changed.
With the fall of Constantinople in 1453, classical books started to flow into Europe, including, for the first time, original texts of Galen.
The influence on anatomy and its depiction in the art was transformative.
This is the moment when the history of anatomy undergoes a step change.
It's all happening in Italy.
By 1478, public dissections of human corpses have become popular annual events in Bologna.
At carnival time, it's the best show in town.
And in Florence at about this time, a young artist was developing what would be a lifelong fascination with the human form.
Leonardo da Vinci built on Galen's work and took anatomical art in a new direction.
He also fulfilled Galen's ambitions by dissecting actual human bodies himself.
The 15th century saw the birth of what we call art theory, where writers were saying, "this is what art should do.
" To represent nature rationally, you should understand what nature is.
The artist needed learning, and amongst that learning is the knowledge of the human body.
Anatomy being central to the portrayal of the human figure was well entrenched by the time Leonardo was an apprentice.
He saw visual representation as conveying almost everything you need to know about the world - what it looks like, how it functions, and so on.
So it's a terrifically demanding agenda.
He wanted painting, he wanted his anatomical drawings and all these things basically to say, this is how things are.
Not just what they look like, but how they work.
Most of what we know about Leonardo's anatomy comes from some 200 anatomical drawings and annotations that Leonardo made in his lifetime, and which are now held at Windsor Castle.
After his death in 1519, they were seen by very few people, but by 1690, they had been acquired by the British Royal family.
Now, we don't quite know how they got here, but they now belong to the Queen and form a core part of the Royal collection.
And I've been given the privilege of seeing them in the flesh here in the Royal library in Windsor.
And here they are, and I'm totally overwhelmed by how astonishing they are.
I've seen these dozens of times, but never in the flesh, and never so close.
These were drawn by Leonardo da Vinci himself into his notebook at the end of the 15th century.
And what you don't get to see unless you get really up close is the texture on these drawings, you can really see the crispness of the paper and the lines that he's drawn.
They are incredibly powerful images.
Probably the earliest real anatomical drawings we have by Leonardo of 1489 is a series of the skull.
He clearly got hold of a real skull and he drew the skull and sectioned it, which is itself very unusual, you know, actually going through at various points to see what the internal structure was, like a piece of architecture, almost.
On the basis of this dissection, Leonardo thought he could make sense of the ancient theory that the brain had three chambers.
In the first one, he had the imprensiva, the receptor of impressions, and the notion is it acts rather like a seal on wax.
Impressions are sort of impressed, literally, into this.
Then these are all passed on for coordinating into this central section which is the processing section.
Then, finally, at the end of the system, there is a flask which is called memory.
The theory, of course, is wrong, but Leonardo's belief in it emphasises how, like Galen, he was never satisfied with form alone.
He wanted to know how the body worked.
'Martin Clayton is head of prints 'and drawings at the Royal Collection Trust.
'He believes Leonardo was not only one of the greatest artists 'of his - or any - age, but a great scientist, too.
' This is one of the sheets compiled by Leonardo in the winter of 1510, in this case showing the facial muscles, two-stage dissection of the hand and the muscles of the shoulder.
It looks anatomically accurate to me.
It is.
All the muscles of the arm he got exactly right.
He didn't have any names for them, but he drew them so precisely you can identify them with muscles we would identify today.
He's investigating all of this first-hand.
He doesn't believe any structure until he's seen it himself, and because very little of this was written about in contemporary treatises, he's basically having to make it up from scratch, he's having to go in and find out what the body is like first-hand.
That's very much a sentiment that Galen expressed, that one had to get stuck in, do it yourself, in order to understand how the body was put together.
How much of the dissection did he actually do himself? As far as we can tell, he carried out most of it himself.
At the start of his career, he's not working with soft human tissue, he dissects birds, dogs, pigs, frogs, a monkey, and so on.
It's only a human skull that he manages to get hold of in 1489.
The late 15th century sees this explosion in anatomical investigation, of which Leonardo is just apart, and by 1509 he claims to have dissected 10 human corpses.
At the end of his life, he claims to have dissected 30, and the evidence of the surviving drawings does suggest that, you know, that's about right, probably 30 human corpses in the course of a five or six-year career.
'It was in Florence that Leonardo refined his skills 'as a master of anatomy.
'The Renaissance city he knew was a prosperous place of 50,000 people.
'The wealth it produced paid for a thriving artistic community.
'It's easy to see why Leonardo had become so interested in anatomy.
'Florence was buzzing with imaginative ideas 'about the human form and its creative potential.
' Analysis of the body, it was argued, could produce beautiful art.
In a sense, that's exactly what Leonardo achieves in his anatomical drawings.
He dissects a body and deconstructs the parts in order to reconstruct them as a perfect work of art.
Leonardo's drawings also share one important belief with his distant predecessor Galen.
Both men thought that to dissect the human body was to reveal the perfect work of God.
Leonardo, in his anatomy and everything else, believed absolutely in the argument from design.
The argument was that the machinery of nature - above all, the human body, which was the most perfect bit of nature - testifies to the presence of a divine creator.
People couldn't believe, and Leonardo above all couldn't believe, this wonderful machinery of the body wasn't designed to be as perfect as it could be.
The human body he saw as a microcosm, a little cosmos, and it mirrored the whole world.
Therefore, if you looked at branching systems, say the bronchi in the lungs, he'd see those as treelike, and he would say, this is not just a loose analogy, but they actually function in a similar way.
So he's seeing the human body as a microcosm of the macrocosm, the larger organisation of the cosmos.
Leonardo had begun his investigations into human anatomy in Milan.
But some of his most intriguing dissections took place when he was back in Florence in the first few years of the 16th century, and staying in a monastery.
And this is where he lived.
Leonardo returned to Florence in 1500, and the monks of the Basilica of Santissima Annunziata put him up while he worked just down the road.
By now, Leonardo was touching 50, and a celebrated artist.
He'd completed The Last Supper just a couple of years earlier.
Florence welcomed him back as a prince of the arts.
Now, it was one thing to celebrate the painter of The Last Supper, quite another the dissector of the recently deceased.
Autopsy was accepted in Italy at the time, there was an annual event in Bologna, but the type of private dissection that Leonardo practised was a dark art.
One of his improvised dissecting theatres was at the hospital of Santa Maria Nuova.
It's still here, at the heart of the city, and it's still a hospital today, as it was when Leonardo worked here in the early 1500s.
His excitement at what the human body revealed was tempered by a sense of horror.
Leonardo said there was a high price to pay for the rewards of dissection.
Quite apart from the skulduggery, the amateur dissector had to overcome his very natural repugnance and fear of spending the night, in Leonardo's words, "with corpses quartered and flayed and horrible to behold.
" He was constantly throwing open the doors of discovery, and one of the most remarkable dissections he performed was of an old man.
In the winter of 1507, Leonardo dissected the body of a man who had claimed to be 100 years old.
He met him at the hospital, where they sat and talked for a few hours.
The old man said he suffered no pain and that he wasn't feeling particularly unwell.
Just a few hours later, sitting on his bed, the old man passed peacefully away.
Leonardo was keen to find out what had caused, as he put it, so sweet a death.
He started his dissection, and the drawing that followed is one of the most remarkable in the Royal Collection.
It's also surprising, because it's androgynous.
This is a compendium, if you like, of everything Leonardo knows about the viscera to this date.
So many of the structures that you see depicted here are derived directly from his dissection of the centenarian.
The form of the liver, the hepatic vessels between the liver and the spleen, the spleen itself, the heart, the branching of the vessels - all of that is found in the notebook that Leonardo compiled as he was dissecting the old man.
That spleen looks enlarged to me.
Is that accurate? Well, the spleen is enlarged and the liver is a bit withered because the old man had cirrhosis, and he thought that's what normal anatomy looked like, because he'd not seen a spleen before.
And so, subsequently, he draws the spleen in this enlarged state.
The top half is from the old man directly, but the bottom half is somewhat different.
Yes, well, to study a uterus, he obviously needed to dissect a female, and, as far as we know, Leonardo had not dissected a female by this date.
So the form of the uterus is perfectly spherical, and, if you look carefully, you can see seven internal chambers, which is what Aristotle said were in the uterus.
These great horn-like structures going off to either side, uterine ligaments, they are derived from a dissection of a pregnant cow that Leonardo carried out about a year earlier.
It's very, very unfamiliar to me, this bottom half.
If you frame it like that, I wouldn't necessarily recognise that as human anatomy at all.
Well, he's still finding his way and he's doing the best he can with the information that he has at his disposal.
And some of it is imperfect, so you will find mixtures of very accurate parts with bits that still have a lot of work to do.
Leonardo died in France in 1519 at the age of 67.
He'd intended that his notebooks would form the basis of a huge treatise on anatomy, but he was always far too busy with other projects to compile it.
The drawings we are left with display a clarity and insight about our bodies which outshone any previous anatomical illustrations.
They also demonstrate Leonardo's commitment to Galen's ancient maxim - that real knowledge of the body can only be acquired by first-hand investigation.
Galen's incisive writings were the inspiration for all the anatomists who followed him.
While he was denied the chance to dissect human bodies, his successors did, and they transformed both anatomy and art.
In less than a century, anatomical illustrations had gone from being slightly crude depictions of what people thought that Galen meant to a highly sophisticated and beautiful artform with Leonardo.
From this point on, art and anatomy would be one.