Elsevier

The Lancet

Volume 362, Issue 9401, 20–27 December 2003, Pages 2110-2113
The Lancet

Department of Medical History
Virtual dissection: a lesson from the 18th century

https://doi.org/10.1016/S0140-6736(03)15114-8Get rights and content

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Josephinum Wax Models Museum

Anatomical wax modelling, which began in Italy in the early 15th century, reached its zenith in Florence in the 18th century.3 At the end of the 18th century, the Austrian emperor Joseph II visited Florence and commissioned a collection of wax models for the surgical academy in Vienna—Medizinisch-chirurgische Josephs-Akademie (Josephinum).8 Supervision of the project was entrusted to the famous Italian anatomist, Paolo Mascagni.8 The Josephinum collection was not merely a replica of the

Case 1: lymphatic vessels on the brain surface

The model showing lymphatic vessels covering the surface of the brain is an obvious example of overinterpretation in anatomy (model 251; figure 1). The lymphatic system was the focus of Paolo Mascagni's scientific interest, and the Josephinum collection was the first to include his findings.9, 10, 11 He made 28 models dealing with lymphatic drainage, including three full-size body models. He also developed mercury injections as a new technique to visualise lymph vessels.9 Mascagni was probably

Case 2: external carotid artery and brain vascularisation

Model 147 suggests that the brain is substantially irrigated through the external carotid artery (figure 2). The superficial temporal artery gives rise to the “deep” branches, which make anastomoses with the collaterals of the internal carotid artery. The arterial circle of Willis, accurately shown on four other models, is distorted and can hardly be recognised. This erroneous visualisation of the arteries of the brain is difficult to explain. The branching pattern of the carotid arteries is

Case 3: cervical plexus and face innervation

In model 288, the superficial branches of the cervical plexus run over the parotid gland to the greater part of facial region, almost up to the corner of the mouth (figure 3). Such visualisation is an obvious exaggeration. The facial branches of the greater auricular nerve are very few in number and tiny. They anastomosise with the stem of the facial nerve and its collateral branches and supply a part of the parotid region.12 Such a mistake is surprising, especially if we have in mind that

Case 4: rare anomaly of the accessory nerve

Model 277 depicts an extremely rare anatomical variation—a nerve piercing an artery: the cervical roots of the right accessory nerve run straight through the lumen of the right vertebral artery (figure 4). The accessory nerve is known to pass through the annulus in the internal jugular vein very rarely.16 In the wax model there is no annulus, but the nerve runs right through the arterial lumen. To the best of our knowledge, such an anomaly has not been described previously. The Florentine

A lesson for modern anatomy and clinical imaging

In the 18th century, anatomy was much more than just another part of the medical curriculum—it was the science.1 The Vienna collection of wax models certainly supports this view as a magnificent depiction, and as close as one can get to accuracy.10 Despite their scientific and artistic superiority, the Florence anatomists made mistakes. They saw structures that did not exist (lymphatics of the brain); they did not pay enough attention to something that they thought was irrelevant (deep vessels

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