Street Anatomy

Introducing the Father of Modern Medical Illustration

When I tell any sort of medical professional that I’m going to be a medical illustrator they immediately respond “Oh, like Netter?”  Frank Netter may be the most well known medical illustrator, but it was the German artist, Max Brodel (1870-1941), who established the profession in America and is considered to be the father of modern medical illustration.

Brodel received his formal art training at the Leipzig Academy of Fine Arts in Germany. In 1888, after graduating, he began creating anatomical and scientific illustrations for Dr. Carl Ludwig, the Director of the Institute of Physiology at the University of Leipzig. Brodel quickly learned that medical illustration was not easy without having a background in science or medicine.

I did not know then that the only way to plan a picture is to leave paper and pencil alone until the mind has grasped the meaning of the object. Copying a medical object is not medical illustrating. The camera copies as well, and often better, than the eye and hand, in medical drawing full comprehension must precede execution.¹

Through Dr. Ludwig, Brodel met Dr. Franklin P. Mall, an anatomist and future head of the anatomy department at the Johns Hopkins Medical School. Mall saw the talent and potential in the young Brodel and persuaded him to move to Baltimore, Maryland in 1894 to become an illustrator for the Johns Hopkins Medical School.

Working directly in the medical field, Max had no choice but to immerse himself in medicine. When he was not illustrating he spent most of his time reading medical texts, observing surgeries and dissecting cadavers. Here’s an interesting snippet on Max’s adventures in dissecting.

Brodel dissected human bodies without using gloves so he could fully understand his subjects. Brodel developed a streptococcus infection on the ulnar side of his left hand (fortunately not his dominant right hand) after mistakenly cutting himself while dissecting an infected cadaver. After four surgeries by the great neurosurgeon Harvey Cushing (1869-1939), and some recovery time, Brodel’s hand improved. Cushing studied surgery under the guidance of the father of American surgery, William Steward Halsted (1852-1922), at the Johns Hopkins Hospital. During recovery, Brodel was fascinated by the loss of sensation in his hand and took to studying ulnar nerve injury. With a pair of forceps, he applied light pressure to different areas on his hands to map out the areas of sensation loss due to ulnar nerve damage. After several drawings on “progress note” paper that physicians use to make notes on patients, Brodel drew the regions of the hand that are supplied by the ulnar nerve. A century later, we can still learn from Brodel’s misfortune.¹

Word of Brodel’s talent and the importance of medical illustration spread across the United States. Soon he received many offers to work at other universities. In 1911, in an effort to keep Brodel at Johns Hopkins, a new department was established called the Department of Art as Applied to Medicine. Brodel was asked to become the head. The purpose of the department was to formally train medical illustrators and establish medical illustration as a profession. Brodel worked hard to find a balance between medical knowledge and artistic skill, something that every medical illustrator to this day is trained to accomplish. Brodel went on to train many medical illustrators over the next 30 years, many of whom went on to establish medical illustration programs at other universities. One such student, Tom Jones, went on to establish the second medical illustration program in the country at the University of Illinois at Chicago in 1921. Jones later went on to establish the Association of Medical Illustrators (AMI) in 1945.

Sagital section of hypophysectomy procedure showing the Killian incision.

Brodel devised the method of using carbon dust to create a two tone technique that could capture the sparkling highlights that characterize wet, living tissue. Carbon dust involves using special paper coated with white layers of chalk or clay. Carbon dust is then layered on the paper in stages to create shadow and depth. The results are incredibly rich tonal images that capture form well. Erasers can then be used to lift out bright highlights and create great contrast.

Illustration of the musculature of bladder and urethra in 1911.

¹Read the excellent essay written on Brodel by Pia Pace-Asciak, B.A., H.B.Sc., M.A.Sc. here.

First medical illustrations commissioned for use in America

In my earlier post on the computer graphic artist, Cvetomir Georgiev, I showed you the 3D rendition he made of Jan van Rymsdyk’s The Anatomy of a Gravid Uterus. Rymsdyk was a Dutch born medical illustrator working in London. The Anatomy of a Gravid Uterus was the first notable illustration of his career. But, he also had another great accomplishment. Rymsdyk was commissioned to create a series of life-size anatomy paintings as teaching aides at a medical school in colonial Philadelphia. These paintings turned out to be the first medical illustrations ever commissioned for use in America. They are still on exhibit at the library of the Pennsylvania Hospital, America’s first hospital.

Interlude: Medical Visual

Broken bodies…

Illustrations of dissections in a series of original coloured plates, the size of life, representing the dissection of the human body. (1867)

Anatomist: George Viner Ellis (1812-1900)
Artist: George Henry Ford (1809-1876)

All of the figures are drawn life-size from actual dissections and are printed in colors with the object of making them as true to Nature as possible.

Spotlight: Karl Wesker

When I took Human Gross Anatomy I used a total of eight textbooks, flashcards, and anatomy resources on the internet to help drill all of the information into my head. But, the one book that I relied on and learned the most from was the Thieme (pronounced Tee-Ma) Atlas of Anatomy. The illustrations in this text are incredibly clear and crisp, unlike any other anatomy text I used. And the illustrations were accompanied by only the most pertinent details necessary to explain the anatomy.

This leads me into the Spotlight illustrator for this week, Karl Wesker. Based in Berlin, Germany, he created the majority of the 3,000 illustrations in the Thieme Atlas. He was trained as a printer and graphic designer, but was interested in painting and art and in learning as much as possible about anatomy. He has been illustrating for fine art and scientific publishing for over 10 years now.

It took a total of 8 years to complete the entire Thieme Atlas consisting of three textbooks and over 3,000 illustrations. The timeline for the project was estimated at a maximum of 4 years! But even after 8 years he is still fascinated by the human body.

Karl states that it is relatively simple to draw a dissection superficially without understanding what you are drawing. Any artist can copy form. This requires no deeper understanding of anatomy. For the Atlas of Anatomy, however, he needed to create illustrations that could be layered from outside to inside. This called for a complete understanding of gross anatomy and how structures relate to each other. Therefore, it was essential for him to go into the anatomy lab to take photos and sketch directly from cadavers.

Karl uses Adobe Photoshop, Macromedia Freehand, and a Wacom tablet to produce all of his illustrations. This allows him to create incredible detail and the layering effect seen in these illustrations.

Thank you Karl for allowing me to understand anatomy through your illustrations!

Read the entire interview with Karl here. Note: the interview is in German.

Interlude: Medical Visual

Excuse me, your exquisitely detailed skeleton is blocking my view of the rhinoceros.

Table 8

Tabulae sceleti et musculorum corporis humani (1747)

Anatomist: Bernard Siegfried Albinus (1697-1770)
Artist: Jan Wandelaar (1690-1759)

Albinus and Wandelaar are by far my favorite duo of anatomist and artist. When the Tabulae sceleti et musculorum corporis humani was published in 1747 there was a lot of controversy over the illustrations because of the artistry and use of fanciful irrelevant backgrounds. It was nearing the end of the era where art heavily influenced anatomical illustrations. There began a shift away from the use of fanciful landscapes towards a more accurate representation of anatomy. There was a need to make the anatomy itself beautiful and captivating. Critics of Albinus said that the superfluous elements in the illustrations compromised the accuracy of the anatomy. But, Albinus stuck behind his artist and denounced those critical of his illustrations.

Apart from the whimsical scenery in the illustrations, the anatomy was quite accurate. Albinus and Wandelaar accomplished this by devising a grid system in which nets where set up and placed between the artist and the cadaver. Wandelaar would then draw what he saw in each grid thereby ensuring proportionality and accuracy. Still I wonder why the rhino?