The pedagogical value of autopsy

of terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided article is properly cited. " WHERE WE HAVE BEEN " Knowledge of human anatomy was acquired through dissections of the human body that may have begun as long as 4000 years ago, in Babylonian times. Later documentation was in Egyptian times (3000 BC-1600 BC), as exemplified with the Ebers and other papyri. Around 300 BC, the Greek physician, Herophilus (335-280 BC), wrote a treatise on human anatomy and Erasistratus (304-250 BC), his student and colleague at the medical school of Alexandria, produced the first description, albeit brief, of liver cirrhosis observing that the liver of a man who died with anasarca (" hydrops ") was " as hard as a rock " , contrasting it with the soft consistency of the liver of another man who died from the bite of a poisonous snake. This description is evidence of Erasistratus's ability, based on observation, to correlate the diseased organ with the consequence of its involvement and may be the first example of a clinicopathological correlation. The original writings of Herophilus and Erasistratus were lost and the first written record about autopsy dates from the 12th century work, the Gesta Regum Anglorum (" Deeds of the kings of the English "), by the English monk William of Malmesbury (1095-1143). William recounts the story of Sigurd I Magnusson, also known as the Crusader, King of Norway. In 1111, when Sigurd was returning from Jerusalem, many of his soldiers died in Constantinople. The hypothesis that death had occurred due to wine intake led to the opening of one of the bodies in an attempt to find the possible cause of death by studying the viscera. A century later, in 1286, Salimbene di Adam of Parma, a Franciscan friar, examined the heart of a patient who died from the plague, comparing it to the heart of a chicken thought to have been affected by the same disease. It is worth noting that Pope Innocent III, in 1209, had already recommended that all unexplained deaths should be evaluated by an experienced physician; this ruling reversed the church's position against violation of the corpse. However, it was only at the height of the Italian Renaissance that Antonio Benivieni (1443-1502), a physician to the most important families of Florence, began to regularly rely on autopsies to …