THE VALUE OF ANATOMY

Abstract

The interesting address by Sir Berkeley Moynihan on The approach to published in the British Medical Journal of October 8th, 1927, emanating as it does from such an authoritative source as the President of the Royal College of Surgeons of England, commands the serious attention of those of us who are engaged in the teaching of anatomy. His strictures on the present day teaching of anatomy, supported as they are by Sir Arthur Keith, the distinguished curator of the same institution,1 surely constitute a challenge to all anatomists. Unless someone attempts to meet the charges they will pass for true, and the temple of anatomy will be destroyed and false gods may be set up in its stead. It is not quite clear whether the distinguished President, when he advised a limited study of anatomy, was directing his advice only to those who wished to specialize in surgery, or whether he wished his remarks to apply as well to the general undergraduate approach to the surgical side of the medical qualification. The mere fact that he addressed his words to undergraduates, and to those who are responsible for their teaching, leads one to believe that they were meant to apply in this case also, and that he is on the side of those who would restrict the opportunities for the study of anatomy. I venture to think that his views will not meet with the approval of all surgeons, but it is as an anatomist that I wish to challenge them, because I think that there is a great danger of the position of anatomy in the medical curriculum being still further jeopardized. It is already wedged in, in many schools, between the clamorous pre liminary sciences, that precede it, and the actively growing clinical subjects, such as bacteriology, that succeed it. The gravamen of the charge against anatomy would appear to be that anatomists do not teach sufficient func tion, for it cannot surely be maintained that they neglect this entirely. I do not think that it is fully realized what an enormous amount of knowledge of function is presented by anatomy without acknowledgement. An accurate know ledge of the attachment of muscles makes the functional result of their contraction obvious. Nay, more, as the surgeons must adinit, this is almost the sole means of explaining the displacement of the parts in a case of fracture, and a consideration of the relative anatomical position of the structures is the guide in treatment. So it is with the joints, the action of which is determined by the shape of the bony surf aces involved, and by the position of the ligaments, such as the hinge ligaments. There is no need to repeat platitudes . about the nerves and blood vessels. Suffice it to say that we seem to have inherited too easily a vast tradition of knowledge, which, like the art of walking, we do not appreciate till there is a danger of our losing it. The case must be different with regard to such organs as the kidney. The anatomist seems to me to have done his duty when he has located its position and relations and described its structure. It remains for someone with an