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© Military Pharmacy and Medicine • 2012 • 4 • 82 – 86anatomists-doctors, Herophilus and Erasistratos,worked there.In the Roman world, autopsies of human remainswere prohibited due to ethnic and religious reasons.Anatomy known from the writings of Galen(a doctor, who lived in the 2 nd century A.D.) isthat of animals: pigs and apes.In the Middle Ages, knowledge of anatomy wasbased on schematic pictures and writings by Hyppocratesand Galen. A papal or royal permissionwas required for performing an autopsy. A humanbeing was considered a microcosmos — reflectionof the surrounding macrocosmos [4].Thanks to artists, painters and sculptors, interestin human physique increased during renaissance.In the history of medicine, the 16th centuryis known as a “century of anatomists.” In 1543,Andreas Vesalius published his work: De humanicorporis fabrica libri septem, where he pointed outtwo hundred of Galen’s errors. This date is consideredthe border between medieval and modernanatomy. Vesalius’ drawings portray the skeletal,cardiovascular systems and musculature, with thecorpse depicted in a vertical position instead oflying down on the examination table [5].At the turn of the 15 th and 16 th century the firstanatomical theaters are created in Padua, Montpellierand Basil. They were particularly numerousin the 17 th century.In this publication, based on anthropologicaldata (acquired from archeological excavationsites), we will try to demonstrate how anatomicalstudies developed in the region of Poland andwhen they were commenced. We will try to comparethese data with written sources. Traces ofpost-mortem examinations found on the skullsand other parts of the skeleton prove that barbersand doctors were interested in how a humanbeing is built.Skulls found during archeological excavationswith openings encompassing the entire or almostentire skull vaults are examples of probable postmortemexaminations. We possess several suchskulls from Poland, but most of them are not preciselydated. It is difficult to unequivocally assesswhether these autopsies were anatomopathologicalor judicial.Review articleNames of the medics appear for the first timein the written sources from 13 th century. Therewere 25 medics and physicians noted during thattime. Wroclaw was the greatest medical centerof the 13 th century. There are several doctorsfrom this city mentioned in the published documents.There were also doctors in Cracow, Legnicaand Poznan. The number of qualified medicsincreased in the 14 th century. Written sourceslist doctors in Cracow, Wroclaw, Glogow, Bytom,Gniezno, Wloclawek as well as in Pomerania.Physicians focused around princely and bishops’courts, as well as Jagiellonian University in the15 th century [6].In the 14 th century, the first post-mortem examinationswere performed in Italy: Padua, Venice,Florence and in France: Montpellier. In renaissance,many artists, including Leonardo daVinci, were interested in studies on human anatomy.His biographers report that he witnessedautopsies in the Santa Maria Novella hospitaland perhaps performed some of them personally.He undertook the trouble to study all stagesof human development, beginning with infancyand ending with senescence. He describedthe skeletal, cardiovascular, nervous systemsand musculature [7].According to the written sources, the first knownpublic autopsy in Poland was performed in 1613in a village called Pruszcz, located near Gdansk,on a deformed newborn baby. In the 16 th century,a gymnasium in Gdansk was the only placewhere regular lectures on anatomy took place. In1580, a separate chair of anatomy and medicinewas formed in Gdansk [8]. The first autopsy wasperformed at the Jagiellonian University in Cracowby Rafal Jozef Czerwiakowski in 18 th century[9]. Thus, written data indicate that post-mortemexaminations were first performed in Poland atthe turn of 17 th and 18 th century.The first skull to be discussed was found inOpole, in a cemetery dated to the 14 th century.Articles by prof. Adam Paluch describe it as atrepanation skull [10, 11]. However, it stands outbetween other trepanation skulls due to orificedimensions and technique of its execution. Thisopening is particularly wide and was performedafter death. The skull was found during excavationsin the Opole Market Square and its features82 http://military.isl-journals.com
© Military Pharmacy and Medicine • 2012 • 4 • 83 – 86indicate male sex of the deceased. Unfortunately,no postcranial skeleton was found [12].A large bone fragment was removed posthumouslyfrom the skull: a fragment of coronalsuture (coronal suture forms a border of the orifice,suture pattern is visible at the superior margin),part of the right parietal bone and a largefragment of left occipital bone, reaching all theway to the left temporal bone. Opening encompassesalmost entire sagittal suture (a fragmentof sagittal suture is visible as it joins with lambdoidsuture) and has the following dimensions:102x94mm (external lamina) and 95x84mm(internal lamina). Possibly, such large skull fragmentwas removed for bone amulets or a drinkinggoblet (such practice was known in the MiddleAges and previous eras). Thus, this procedurewas performed after persons’ death for magicalreasons. In Middle Ages, bones of the deadand pieces of their clothing were often used formagical or therapeutic purposes. They were usedfor bewitchments. We can present an exampleof such procedure from Lithuania, where fourfemale skulls (14 th -16 th century) were found withround orifices performed posthumously. Bonefragments serving as amulets were acquired thisway [13]. There is a suspicion that in folk medicine,human skull grated into powder, servedwith food or drinks, was considered treatmentfor some aliments [14].There is also another possible explanation. Suchlarge opening was done in order to look insidethe human head and curiosity was the reasonfor post-mortem examination. The margin ofthe orifice is uneven and jagged, particularly onthe right side, while the inferior orifice marginis evenly filed off. Part of calvaria was probablyremoved using a saw (sharp and smooth) and thebone was broken at the coronal suture.A canon from Opole, master Pawel, who servedas a town physician in 1261, was mentioned inpublished documents [15]. Opole lies near Wroclaw,which in the Middle Ages was the focus ofqualified physicians. The doctors acknowledgedin written sources practiced in Cracow, Bytomand Glogow in the 14 th century. Names of doctorswho practiced in Silesia were also preserved:Tomasz — the titular Bishop of Serepta, Jan ofGrodkow, Jan of Glogau. There were two centersMagdalena Cybulska at al.: Autopsy marks on anthropological material …of development of Polish medicine in the 14th-15 th century – Cracow and Wroclaw [9].The second skull in question (also containinga large opening) comes from the St. NicholasChurch in Torun. Skeletons found duringarcheological excavations are dated to 14th and18th century. A large, oval fragment of calvaria,including a fragment of left and right parietalbones and posterior part of frontal bone wereremoved from a male skull. Body of the sternumwas also cut with a sharp instrument, which maybe an evidence of attempted removal of internalorgans [16]. The person performing the autopsywas probably not very experienced in suchmaneuvers. Orifice margins are quite even, thus asharp tool with a smooth blade was possibly usedand tool marks are visible on the edges of theopening. Superior part of the skull (entire cranialvault) was sawn off, while the posterior portion offrontal bone lamina was broken off. In this case,the resected bone was found together with theskull and only the fragment of broken off frontalbone is lacking. The 15 th century documentsmention a doctor who practiced in the region ofTorun. This autopsy may be also related to theactivity of the Academic Gymnasium in Torun,which offered anatomy lectures. This facility wascreated in the 16th century, but its developmentfalls on the period of 17 th century.Similar skulls from 16 th and 18 th century bearingtraces of autopsies (the superior part of calvariawas also removed) were discovered at theexcavation site in Holy Spirit in Brzesc Kujawski(Kujawsko-Pomorskie Province). There were atotal of 5 such skulls excavated at cemeteries nearthe hospital and the church. An iron saw wasprobably used here to remove calvaria [17]. Functioningof the first hospital in Brzesc is dated to13 th -14 th century. Medieval hospitals functionedmainly as shelters, taking care of the poor andill travelers. With time, since renaissance, theygained increasingly more medical character.Another skull, which is an example of post-mortemexamination, was dug out from a cemeteryin Dabrowna (Warmia and Mazury Province)dated to 14 th -17 th century. It belonged to an adultmale. Calvaria was removed (part of frontal bone,large fragments of parietal bones, part of occipitalbone) using a metal saw — the cut ran over thehttp://military.isl-journals.com83
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