The oldest anatomical treatise extant is an Egyptian papyrus probably written around 1600 BC. It shows that the heart, vessels, liver, spleen, kidneys, ureters and bladder were recognized, and that the blood-vessels were known to come from the heart. Other vessels are described, some carrying air, some mucus, while two to the right ear are said to carry the breath of life, and two to the left ear the breath of death. Imhotep in the 3rd dynasty is credited as the founder of ancient Egyptian medicine and as the original author of the Edwin Smith papyrus which included cures and ailments among anatomical observations (see Imhotep). The Edwin Smith papyrus is regarded as a copy of several earlier works. Some information contained in the Edwin Smith Papyrus dates as early as 3000 BC (Medicine In Ancient Egypt, page 1 and page 3).

Even the descriptions of wounds in the Iliad have been supposed adequate to prove that in the time of Homer mankind had distinct notions of the structure of the human body. Of the first it may be said that the rude information obtained by the slaughter of animals for sacrifice does not imply profound anatomical knowledge; and those who adduce the second as evidence are deceived by the language of the poet of the Trojan War, which, distinguishing certain parts by their ordinary Greek epithets, as afterwards used by Hippocrates, Galen and all anatomists, has been rather too easily supposed to prove that the poet had studied systematically the structure of the human frame.

Hippocrates

With not much greater justice has the cultivation of anatomical knowledge been ascribed to Hippocrates, who, because he is universally allowed to be the father of medicine, has also been thought to be the creator of the science of anatomy. Of the seven individuals of the family of the Heracleidae who bore this celebrated name, the second, who was the son of Heraclides and Phenarita, and grandson of the first Hippocrates, was indeed distinguished as a physician of great observation and experience, and the first who appreciated the value of studying accurately the phenomena, effects and terminations of disease. It does not appear, however, notwithstanding the vague and general panegyrics of J. Riolan, Bartholin, D. le Clerc, and A. Portal, that the anatomical knowledge of this illustrious person was either accurate or profound. Of the works ascribed to Hippocrates, five only are genuine. Most of them were written either by subsequent authors of the same name, or by one or other of the numerous impostors who took advantage of the zealous munificence of the Ptolemies, by fabricating works under that illustrious name. Of the few which are genuine, there is none expressly devoted to anatomy; and of his knowledge on this subject the only proofs are to be found in the exposition of his physiological opinions, and his medical or surgical instructions. From these it appears that Hippocrates had some accurate notions on osteology, but that of the structure of the human body in general his ideas were at once superficial and erroneous. In his book on injuries of the head, and in that on fractures, he shows that he knew the sutures of the cranium and the relative situation of the bones, and that he had some notion of the shape of the bones in general and of their mutual connections. Of the muscles, of the soft parts in general, and of the internal organs, his ideas are confused, indistinct and erroneous. The term fleps he seems, in imitation of the colloquial Greek, to have used generally to signify a blood-vessel, without being aware of the distinction of vein and artery; and the term arteria, or air-holder, is restricted to the windpipe. He appears to have been unaware of the existence of the nervous chords; and the term nerve is used by him, as by Grecian authors in general, to signify a sinew or tendon. On other points his views are so much combined with peculiar physiological doctrines, that it is impossible to assign them the character of anatomical facts; and even the works in which these doctrines are contained are with little probability to be ascribed to the second Hippocrates. If, however, we overlook this difficulty, and admit what is contained in the genuine Hippocratic writings to represent at least the sum of knowledge possessed by Hippocrates and his immediate descendants, we find that he represents the brain as a gland, from which exudes a viscid fluid; that the heart is muscular and of pyramidal shape, and has two ventricles separated by a partition, the fountains of life--and two auricles, receptacles of air; that the lungs consist of five ash-coloured lobes, the substance of which is cellular and spongy, naturally dry, but refreshed by the air; and that the kidneys are glands, but possess an attractive faculty, by virtue of which the moisture of the drink is separated and descends into the bladder. He distinguishes the bowels into colon and rectum.

The knowledge possessed by the second Hippocrates was transmitted in various degrees of purity to the descendants and pupils, chiefly of the families of the Herachleidae, who succeeded him. Several of these, with feelings of grateful affection, appear to have studied to preserve the written memory of his instructions, and in this manner to have contributed to form part of that collection of treatises which have long been known to the learned world under the general name of the Hippocratic writings. Though composed, like the genuine remains of the physician of Cos, in the Ionian dialect, all of them differ from these in being more diffuse in style, more elaborate in form, and in studying to invest their anatomical and medical matter with the fanciful ornaments of the Platonic philosophy. Hippocrates had the merit of early recognizing the value of facts apart from opinions, and of those facts especially which lead to general results; and in the few genuine writings which are now extant it is easy to perceive that he has recourse to the simplest language, expresses himself in terms which, though short and pithy, are always precise and perspicuous, and is averse to the introduction of philosophical dogmas. Of the greater part of the writings collected under his name, on the contrary the general character is verboseness, prolixity and a great tendency to speculative opinions. For these reasons, as well as for others derived from internal evidence, while the Aphorisms, the Epidemics and the works above mentioned, bear distinct marks of being the genuine remains of Hippocrates, it is impossible to regard the book Peri fusios anthropou as entirely the composition of that physician; and it appears more reasonable to view it as the work of some one of the numerous disciples to whom the author had communicated the results of his observation, which they unwisely attempted to combine with the philosophy of the Platonic school and their own mysterious opinions.

Polybus

Among those who aimed at this distinction, the most fortunate in the preservation of his name is Polybus, the son-in-law of the physician of Cos. This person, who must not be confounded with the monarch of Corinth, immortalized by Sophocles in the tragic story of Oedipus, is represented as a recluse, severed from the world and its enjoyments, and devoting himself to the study of anatomy and physiology, and to the composition of works on these subjects. To him has been ascribed the whole of the book on the Nature of the Child and most of that On Man; both physiological treatises interspersed with anatomical sketches. His anatomical information, with which we are specially concerned, appears to have been rude and inaccurate, like that of his preceptor. He represents the large vessels of the body as consisting of four pairs; the first proceeding from the head by the back of the neck and spinal cord to the hips, lower extremities and outer ankle; the second, consisting of the jugular vessels (ai sfagitides), proceeding to the loins, thighs, hams and inner ankle; the third proceeding from the temples by the neck to the scapula and lungs, and thence by mutual intercrossings to the spleen and left kidney, and the liver and right kidney, and finally to the rectum; and the fourth from the fore-part of the neck to the upper extremities, the fore-part of the trunk, and the organs of generation.

This specimen of the anatomical knowledge of one of the most illustrious of the Hippocratic disciples differs not essentially from that of Syennesis, the physician of Cyprus, and Diogenes Apolloniates, the philosopher of Apollonia, two authors for the preservation of whose opinions we are indebted to Aristotle. They may be admitted as representing the state of anatomical knowledge among the most enlightened men at that time, and they only show how rude and erroneous were their ideas on the structure of the animal body. It may indeed, without injustice, be said that the anatomy of the Hippocratic school is not only erroneous, but fanciful and imaginary in often substituting mere supposition and assertion for what ought to be matter of fact. From this censure it is impossible to exempt even the name of Plato himself, for whom some notices in the Timaeus on the structure of the animal body, as taught by Hippocrates and Polybus, have procured a place in the history of the science.

Aristotle

Amidst the general obscurity in which the early history of anatomy is involved, only two leading facts may be admitted with certainty. The first is, that previous to the time of Aristotle there was no accurate knowledge of anatomy; and the second, that all that was known was derived from the dissection of the lower animals only. By the appearance of Aristotle this species of knowledge, which was hitherto acquired in a desultory and irregular manner, began to be cultivated systematically and with a definite object; and among the services which the philosopher of Stagira rendered to mankind, one of the greatest and most substantial is, that he was the founder of Comparative Anatomy, and was the first to apply its facts to the elucidation of zoology. The works of this ardent and original naturalist show that his zoological knowledge was extensive and often accurate; and from several of his descriptions it is impossible to doubt that they were derived from frequent personal dissection. Aristotle, who was born 384 years before the Christian era, or in the first year of the 99th Olympiad, was at the age of thirty-nine requested by Philip to undertake the education of his son Alexander. During this period it is said he composed several works on anatomy, which, however, are now lost. The military expedition of his royal pupil into Asia, by laying open the animal stores of that vast and little-known continent, furnished Aristotle with the means of extending his knowledge, not only of the animal tribes, but of their structure, and of communicating more accurate and distinct notions than were yet accessible to the world. A sum of 800 talents, and the concurrent aid of numerous intelligent assistants in Greece and Asia, were intended to facilitate his researches in composing a system of zoological knowledge; but it has been observed that the number of instances in which he was thus compelled to trust to the testimony of other observers led him to commit errors in description which personal observation might have enabled him to avoid.

The first three books of the History of Animals, a treatise consisting of ten books, and the four books on the Parts of Animals, constitute the great monument of the Aristotelian Anatomy. From these we find that Aristotle was the first who corrected the erroneous statements of Polybus, Syennesis and Diogenes regarding the blood-vessels, which they made, as we have seen, to arise from the head and brain. These he represents to be two in number, placed before the spinal column, the larger on the right, the smaller on the left, which, he also remarks, is by some called aorta (aorte), the first time we observe that this epithet occurs in the history. Both he represents to arise from the heart, the larger from the largest upper cavity, the smaller or aorta from the middle cavity, but in a different manner and forming a narrower canal. He also distinguishes the thick, firm and more tendinous structure of the aorta from the thin and membranous structure of vein. In describing the distribution of the latter, however, he confounds the vena cava and pulmonary artery, and, as might be expected, he confounds the ramifications of the former with those of the arterial tubes in general. While he represents the lung to be liberally supplied with blood, he describes the brain as an organ almost destitute of this fluid. His account of the distribution of the aorta is wonderfully correct. Though he does not notice the coeliac, and remarks that the aorta sends no direct branches to the liver and spleen, he had observed the mesenteric, the renal and the common iliac arteries. It is nevertheless singular that though he remarks particularly that the renal branches of the aorta go to the substance and not the pelvis (koilia) of the kidney, he appears to mistake the ureters for branches of the aorta. Of the nerves (neura) he appears to have the most confused notions. Making them arise from the heart, which he says has nerves (tendons) in its largest cavity, he represents the aorta to be a nervous or tendinous vein (neuroder fleps.) By and by, afterwards saying that all the articulated bones are connected by nerves, he makes them the same as ligaments.

He distinguishes the windpipe or air-holder (arteria) from the oesophagus, because it is placed before the latter, because food or drink passing into it causes distressing cough and suffocation, and because there is no passage from the lung to the stomach. He knew the situation and use of the epiglottis, seems to have had some indistinct notions of the larynx, represents the windpipe to be necessary to convey air to and from the lungs, and appears to have a tolerable understanding of the structure of the lungs. He repeatedly represents the heart, the shape and site of which he describes accurately, to be the origin of the blood-vessels, in opposition to those who made them descend from the head; yet, though he represents it as full of blood and the source and fountain of that fluid, and even speaks of the blood flowing from the heart to the veins, and thence to every part of the body, he says nothing of the circular motion of the blood. The diaphragm he distinguishes by the name diazoma, and upozoma. With the liver and spleen, and the whole alimentary canal, he seems well acquainted. The several parts of the quadruple stomach of the ruminating animals are distinguished and named; and he even traces the relations between the teeth and the several forms of stomach, and the length or brevity, the simplicity or complication of the intestinal tube. Upon the same principles distinguishes the jejunum (e nestis), or the empty portion of the small intestines in animals (to enteron lepton), the caecum (tuflon ti kai ogkodes), the colon (to kolon), and the sigmoid flexure (stenoteron kai eligmenon.) The modern epithet of rectum is the literal translation of his description of the straight progress (euthu) of the bowel to the anus (proktos). He knew the nasal cavities and the passage from the tympanal cavity of the ear to the palate, afterwards described by B. Eustachius. He distinguishes as "partes similares" those structures, such as bone, cartilage, vessels, sinews, blood, lymph, fat, flesh, which, not confined to one locality, but distributed throughout the body generally, we now term the tissues or textures, whilst he applies the term "partes dissimilares" to the regions of the head, neck, trunk and extremities.

Next to Aristotle occur the names of Diocles of Carystus and Praxagoras of Cos, the last of the family of the Asclepiadae. The latter is remarkable for being the first who distinguished the arteries from the veins, and the author of the opinion that the former were air-vessels.

Timeline of Ancient Greek Medicine

Alexandrian school of anatomy

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