If you were to take a class on anatomy in med school you would probably be told that the history of anatomy really begins in the Renaissance, when doctors and other luminaries like Leonardo da Vinci first started dissecting human bodies and documenting their findings. You might also learn that prior to this point, doctors worked with the anatomical theories of the ancient Greeks and Romans, whose knowledge was gleaned mostly from the bodies of animals and external observation. The ancient Egyptians, who are well known for cutting up dead bodies, might get a look in, but that would likely be it.
But, now, a new study claims that an ancient manuscript unearthed in a tomb in Southern China may well be the world’s oldest anatomical atlas. The article not only promises to revolutionize our understanding of the history of medicine, it also sheds light on the history and scientific foundations of acupuncture.
In an article in The Anatomical Record, Vivien Shaw and Isabelle Winder of Bangor University, UK, and Rui Diogo of Howard University published their findings about the Mawangdui manuscripts, a collection of philosophical and medical texts from Changsha in the Hunan province of South Central China. The texts are written on silk and were placed in the tomb of Chancellor Li Cang and his family before it was sealed in 168 BCE. They were rediscovered in the 1970s, but the previously unknown medical texts were somewhat overshadowed by the presence of other important discoveries, like the oldest copy of the I Ching. Because of this, Shaw, Winder, and Diogo are the first to treat these medical texts as evidence of ancient anatomy.
The Mawangdui texts, the authors argue, were written in the second-third century BCE and are roughly contemporaneous with now-lost Greek dissection-based anatomical texts. Of course, the approach taken in these Chinese texts is very different than the one we see in their Greek counterparts. Vivien Shaw said, “they looked at the body from the viewpoint of traditional Chinese Medicine, which is based on the philosophical concept of complementary opposites of yin and yang, familiar to those in the west who follow eastern spiritualism.”
The Mawangdui texts organize the body into eleven pathways, each of which has particular kinds of disease associated with it. Some of these, Isabel Winder said, map onto later acupuncture meridians, even though acupuncture and acupuncture points are nowhere mentioned. Historians had some evidence for the acupuncture meridians from other ancient Chinese texts, but those texts date to the third century CE and are, thus, roughly four hundred years younger than the ones from Mawangdui.
Their findings, said Shaw, not only “re-write a key part of Chinese history” and affirm that the Han dynasty was a period of widespread intellectual growth, they also provide medical foundations for acupuncture and change our understanding of how it originally worked.
“We believe,” she said, “that our interpretation of the text challenges the widespread belief that there is no scientific foundation for the ‘anatomy of acupuncture’, by showing that the earliest physicians writing about meridians were in fact describing the physical body.” Modern acupuncture, Shaw added, is grounded in the belief that it is the function of the meridian points that’s important. Originally, however, it seems that Chinese anatomists were interested in mapping the structure of the body. In other words, and regardless of whether or not we think these descriptions of the body are accurate, they are scientific. This means that acupuncture, which is often dismissed as more spiritual than scientific, is grounded in a carefully worked out ancient map of the body that was based on scientific observation.
The reason that the Mawangdui texts have been overlooked as an anatomical resource is because they date from a period when the principles of Confucianism were very much in vogue. Han-era China was governed by Confucian law, which maintained stability and structure through the maintenance of a rigid social structure. One element of this social hierarchy was what is called filial piety, in which children must respect and honor their parents. Venerating one’s ancestors did not include cutting up your dead parents. As Isabel Winder, one of the authors of the article, said “Confucian cultural practices … shunned dissection. However, [the evidence leads us to conclude] … that dissection was involved and that the authors [of these texts] would have had access to the bodies of criminals.”
This brings us to one of the grizzly secrets of the study of anatomy: to be any good at it you have to be examining actual human bodies. At the time, this was not just a Chinese practice. Herophilus of Chalcedon and his younger contemporary Erasistratus of Ceos, Greek-speaking doctors and medical authors working in Alexandria, Egypt in the first half of the third century BCE, were also dissecting cadavers on a routine basis. As in China (and, later, in 16th – 19th century Britain), the bodies used for these experiments were those of criminals. Shortly after Herophilus and Erasistratus died, however, dissection fell into disuse. Though there were some rogue doctors who seem to have been dissecting bodies on the sly it wasn’t until the 14th century, when the Italian Mondino de Luzzi publicly performed the first sanctioned dissection in a millennium, that it would begin again in earnest.
While dissection vastly improved medical science’s understanding of the workings of the human body, this doesn’t mean that those performing these experiments always accurately described what was in front of them. Leonardo da Vinci’s scientific drawings of the human body are widely admired for their accuracy, but he sometimes followed tradition rather than the evidence, depicting, as Roy Porter has written in his book The Greatest Benefit to Mankind, a five lobed liver. The human liver only has four lobes; the five-lobe theory was based on the dissection of dogs and pigs and goes back to Hippocrates. We should not assume, therefore, that dissection always deepens and improves medical understanding. It took two hundred years and the creative vision of 16th century anatomist Andreas Vesalius for many ancient medical theories to be questioned and revised.
In between the 3rd century BCE and the rediscovery of dissection in the 14th, European doctors were reliant on the works of famous Greek-speaking doctors Aristotle and Galen, who had only dissected animals. Galen had experience treating gladiators and would have seen the kinds of wounds that would have afforded the opportunity peek inside the body, but there was nothing exhaustive about his exploration of the human body. As a result, all kinds of errors—the five-lobed liver sketched by Da Vinci, for example—crept into Western medicine. So, if you’re thinking that Chinese medicine sounds unscientific and esoteric, bear in mind that for this 1200-year period of European history you may as well have been seeing a vet.
One of the major contributions of this study is the way that it challenges Eurocentric histories of science and medicine. Rui Diogo, whose lab helped perform the research, told The Daily Beast, that too often textbooks and scientific publications rehearse narratives in which white Europeans (from the Greeks and Romans onwards) make the ‘big discoveries’ and non-European cultures contribute nothing more than translations of Greek texts or esoteric unscientific knowledge. Discoveries like this one show both that there was a vibrant scientific culture in places like India, China, and Persia and also that medical schemes often dismissed as esoteric have real scientific foundations.
