Origins of .... the postmortem examination in diagnosis.

"you may take notes for twenty years, from morning to night at the bedside of the sick, upon the diseases of the viscera, and all will be to you only a confusion of symptoms,-a train of incoherent phenomena. Open a few bodies, this obscurity will disappear." Bichat (c 1800)' Rituals related to the disposal of the dead date back to prehistoric times. They arose from religious beliefs and from a sense of duty to the dead. From the earliest primitive rituals, man has evolved a variety of means to deal with the dead body, based on religion, culture, and geographical conditions; culminating in rituals such as exposure of the bodies in caves, trees and towers; to burials, embalming, cannibalism , cremation, mummification, and head shrinking. For thousands of years, dissection of the bodies was done for reasons as varied as magico-religious, cultural and scientific. Currently , the words autopsy (see for oneself), necropsy (to look at the dead) and postmortem examination (often shortened to postmortem (PM)) are used interchangeably to describe the systematic examination of the dead body for medical, legal and scientific purposes. Traditionally, there has been a distinction between hospital or 'academic' autopsies on the one hand, and forensic, medicolegal, police surgeon, or coroners cases on the other. This distinction arose from the evolution of most medicolegal systems in which the investigation of deaths from natural causes was separated from the investigation of unnatural deaths. The knowledge of normal and abnormal anatomy derived from procedures with a magico-religious background such as foretelling the future (divination) by the study of animal entrails including the liver (hepatoscopy or haruspicy), a procedure that was known to be practised 3500 years ago in Babylon2; examination of slaughtered animals for signs of disease by Rabbis in the Talmudic period3; and the Egyptian process of mummification.4 As disease was viewed by the Egyptians as a manifestation of Magic or Divine intervention, examination of the dead was not used as a means of diagnosing cause of illness. Hippocrates (468-377 BC) linked causation of disease to natural (humours) rather than supernatural causes.2 'Health' was a state of balance between the four humours-phlegm, blood, yellow bile, and black bile.5 PMs were conducted as a tool for teaching anatomy by Herophilus (c 335-280 BC) who paid little attention to the morphological disturbances and still subscribed to the humoral theory of disease.2 Erasistratus (c 310-250 BC), however , carried …