Pregnancy Loss
Anatomy of Generation

Anatomy of Generation

Before the advent of modern technologies like the ultrasound, miscarried and aborted fetuses provided some of the very few glimpses inside the pregnant uterus. Pregnancy loss, whatever its personal meanings for women and their partners, offered physicians precious insight into the mysteries of human reproduction. The earliest recorded observation of a human embryo is in the Hippocratic corpus, a set of texts composed between the sixth and fourth centuries BCE. Hippocrates induced an abortion in a pregnant slave and described the six-day-old embryo. In the sixteenth and seventeenth centuries, as anatomical dissections assumed an increasingly prominent place in medical teaching and research, many physicians dissected fetuses.1 Looking at the accounts of these dissections can be jarring for the modern reader. What these anatomists saw or thought they saw, and the ways they interpreted their findings, are far removed from our current understanding of reproduction. One of the fundamental questions early modern anatomists sought to answer was: when does human life begin? At what point is a fetus human?

One of the earliest anatomists to investigate the human fetus was Gabriele Zerbi, professor of medicine at the University of Padua. In 1533, he published a large tome titled Book of the Anatomy of the Human Body.2 In the book’s last section, “on the generation of the embryo,” Zerbi reported on a series of observations of “aborted” fetuses. In this period, the term “aborted” (from the Latin aborto, “to bring forth prematurely”) could mean either a spontaneous abortion (what we would call a miscarriage) or a medically induced abortion. While his wording is ambiguous, the carefully controlled conditions Zerbi described are suggestive of an intentionally induced abortion. Zerbi noted that very young fetuses tended to dissolve when they were aborted; thus, he ensured that the abortion took place over cold water, after which he separated the fetus from other expelled material with a sieve.

According to Zerbi, at forty days the male fetus was only the size of an ant but had recognizably human features. It had genitals and eyes that were disproportionately large. Female fetuses did not have human form until ninety days. Further, he asserted that a male fetus of forty days was alive, because it could sense external stimuli. He had experimented with newly aborted male fetuses by pricking them with a sharp object and claimed he saw flinching.3

Zerbi’s observations of aborted fetuses may appear both shocking and implausible to a modern reader, but he was far from an outlier. European anatomists in the sixteenth and seventeenth centuries were fascinated by the processes of reproduction. Historian of medicine Katherine Park argues that interest in reproduction was central to the emergence of human dissection in late medieval Europe. Anatomists eagerly sought out female cadavers, using both licit and illicit means of procurement, to probe the mysteries of the uterus, that organ where human life began.4 They also dissected fetuses, stillborn infants, and young children.

Early modern understandings of reproduction drew upon Greco-Roman medical and philosophical writing, especially that of Aristotle, Hippocrates and Galen.5 One of the most important questions about reproduction that all three of these men addressed was when the fetus could be considered human. Or, to rephrase the question: at what point did the fetus have a human soul? According to Aristotle, this happened at the moment of conception. For Hippocrates and Galen, however, the fetus did not acquire a human soul until it had a human form. Male fetuses, which were stronger, hotter and more perfect, developed a human form faster than females, although the specific number of days each took was a subject of debate.

Medieval Muslim, Jewish, and Christian writers took up the subject of reproduction and expanded upon the work of the ancients. Medieval writers of all three Abrahamic faiths believed that each human soul was specially created by God and was immortal. Most of them adopted the Hippocratic and Galenic position that the embryo did not have a human soul until some time after conception. They agreed that this happened by divine fiat once the fetus had developed into a recognizably human form. They disagreed on how long this took, although all believed males developed faster than females. When the fetus had a human form, God gave it a rational soul, and from that point on it was human.

Black and white engraving showing two standing fetal skeletons, holding hands, the larger one holding a bow and arrow.
An engraving from Felix Platter’s 1583 De corporis humani structura et usu libri III. (Felix Platter/Wellcome Collection | CC BY)

Zerbi’s experiments on aborted fetuses, his attempts to determine when the fetus had a human form and when it could move, were an attempt to see the earliest phases of human life with his own eyes, to verify or to correct what he had learned from the ancient Greeks. And he was not alone. The Dutch anatomist Volcher Coiter published An Anatomical Treatise on the Bones of an Aborted Fetus and of a Six-Months-Old Infant in 1573.6 In the introduction, Coiter stated that he had made sustained anatomical investigations of fetuses and children of various ages over the course of many years. As a medical student in Bologna, he obtained skeletons of miscarried fetuses and children, which he compared with those of adults. After one dissection, he described the forty-day-old male fetus as follows:

[gblockquote]The head was the size of a hazelnut and larger than the proportion of the rest of the body. The eyes bulged like a crab’s; [he had] nose, ears, arms, hands, legs, feet, and separate toes; [he had] a visible penis, underneath which the scrotum [was] the size of a millet seed. The upper parts [of the body were] larger than the lower, none of the bones [were] hard, but flexible whichever way they were directed. (p. 58)[/gblockquote]

He described another male fetus of similar age as being the length of a finger and having a complete human form, although its bones were still soft. Like Zerbi, Coiter engaged with the question of when a fetus acquired a human form, and thus when it received a soul. Other physicians followed. The Swiss physician Felix Platter included images of the skeletons of a two-month-old fetus and a newborn in his De corporis humani structura et usu of 1583.7

Another Swiss physician, Caspar Bauhin, included likenesses of fetuses of fourteen and twenty-five days in his Theatrum anatomicum of 1605.8 It is quite striking that he depicted these very young fetuses as fully formed human beings. All of these anatomists were interested in that magical moment when the fetus had a recognizably human form, although their data varied wildly — from fourteen days for Bauhin to forty for Zerbi and Coiter.

Illustration of a womb showing a very small, fully formed human form in the center with the umbilical cord running from it to the exterior wall of the womb.
An illustration by Swiss physician Caspar Bauhin depicting the likeness of a fetus between 14 and 25 days old imagining them as fully formed human beings. (Caspar Bauhin/Wellcome Collection | CC BY)

One perspective is conspicuously absent from the sixteenth- and seventeenth-century descriptions of fetal anatomy: that of women. Katharine Park and Monica Green both argue that in the later Middle Ages, male physicians increasingly claimed expertise in female reproductive physiology. Their expertise was based on familiarity with ancient texts, on observation of female patients, and on autopsies and dissections of female cadavers. Male knowledge of the female body was objective and authoritative. They denigrated women’s experientially-based knowledge of pregnancy and childbirth as subjective and superstitious.9

This trend is certainly apparent in anatomical writing of the sixteenth and seventeenth centuries. But while women didn’t actively participate in dissections of fetuses, there is no evidence that they disapproved. Park and Green both demonstrate that elite women increasingly consulted physicians, not midwives or other female practitioners, for advice on infertility and on preventing miscarriages. Both men and women valued the knowledge that male physicians gained through dissection of female and fetal cadavers.

Contemporaries did not view the dissections of fetuses and young children as transgressive or taboo. Contemporaries were undisturbed by the activities of anatomists, and there is considerable evidence that a public beyond physicians and medical students was interested in fetal anatomy. Realdo Columbo, an Italian anatomist, witnessed the dissection of a one-month-old fetus at the Roman Academy in front of “an assembly of illustrious men and nobles.”10 Columbo asserted that the dissection of the fetus revealed the wonders of God’s creation:

[gblockquote][I]n the generation of the human being, that is the fetus, the formation of nothing more wonderful can be imagined, nothing which appears to be equally a miracle of nature, nothing that more inflames the human race to love of the divine providence and wisdom. (p. 245)[/gblockquote]

A diorama showing two nearly intact standing fetal skeletons flanking a large rock adorned with branches and other parts of skeletons.
Dutch anatomist Frederick Ruysch created “dioramas” of posed fetal skeletons that he displayed in a museum in his home. This engraving of one such diorama dates to 1709. (Frederik Ruysch/Wellcome Collection | CC BY)

The Dutch anatomist Frederick Ruysch not only dissected numerous fetuses, which he claimed to have procured from midwives, but also created a whole series of “dioramas” in which he posed fetal skeletons among various preserved body parts. He displayed these dioramas in a museum in his house that was open to anyone who could pay the entry fee. Ruysch’s dioramas were meant to inspire contemplation on the brevity of life as much as they were intended to convey anatomical information. Visitors from all over Europe flocked to see them.11 Clearly the mysteries of human reproduction fascinated a broad swathe of early modern Europeans.

Pricking aborted fetuses with pins, dissecting them in public, and turning them into museum pieces all seem strange to modern sensibilities, especially in our current historical moment. In recent years fetal burial laws, which mandate burial or cremation for all miscarried or aborted fetuses, have been proposed or passed in several states. In 2015, there was a firestorm of controversy when an anti-abortion group released videos purporting to show Planned Parenthood staff arranging for the sale of fetal body parts to medical researchers. Even those who are pro-choice may find the early modern treatment of fetuses to be distasteful or macabre. But early modern anatomists, and the public who watched them work, read their texts and visited their museums, were motivated — at least in part — by a deep reverence for human life, a pious belief in the human soul, and a desire push our understanding of humanity further.

Notes

  1. Andrew Cunningham, The Anatomical Renaissance: The Resurrection of the Anatomical Projects of the Ancients (New York: Ashgate, 1997). Return to text.
  2. Gabriele Zerbi, Opus preclarum anathomie totius corporis humani et singulorum membrorum illius (Venice, 1533). This book was first published in 1502. Return to text.
  3. Zerbi, “De generatione embrionis,” in Opus preclarum anathomie totius corporis humani, fol. 14 verso. Return to text.
  4. Katharine Park, Secrets of Women: Gender, Generation, and the Origins of Human Dissection (New York: Zone Books, 2006). Return to text.
  5. Joan Cadden, Meanings of Sex Difference in the Middle Ages (Cambridge: Cambridge, 1993), esp. 88-104. Return to text.
  6. Volcher Coiter, “Ossium tum humani foetus adhuc in utero existentis, vel imperfecti abortus, tum infantis dimidium annum nati brevis historia atque explicatio” in Externarum et Internarum Principalium Humani Corporis Partium Tabulae (Noribergae, 1573), pp. 57 — 62.Return to text.
  7. Felix Platter, De corporis humani structura et usu, Liber tertius (Basel: Froben, 1583). Return to text.
  8. Caspar Bauhin, Theatrum anatomicum / novis figuris aeneis illustratum, et in lucem emissum opera et sumptibus Theodori de Bry (Frankfort: M. Becker, 1605). Return to text.
  9. Park, Secrets of Women and Monica H. Green, Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern Gynaecology (Oxford: Oxford University Press, 2008). Return to text.
  10. Realdo Columbo, De Re Anatomica, Libri XV (Venetiis: Ex Typographia Nicolai Beuilacquæ, 1559), p. 247. Return to text.
  11. Julie V. Hansen, “Resurrecting Death: Anatomical Art in the Cabinet of Dr. Frederick Ruysch” Art Bulletin 78, no. 4 (1996): 663-679. Return to text.

Kathleen Crowther is an associate professor in the Department of the History of Science at the University of Oklahoma. Her research interests include science, medicine, gender and religion in the early modern period. Her first book was Adam and Eve in the Protestant Reformation (Cambridge University Press, 2010). One of her current projects is an examination of anatomical studies of reproduction, including the anatomy of the male and female reproductive organs and of fetal development, in the sixteenth and seventeenth centuries.