ANATOMY


ANATOMY. There is no systematic account of the anatomy of the human body in the Bible, although abundant use is made there of anatomical facts, metaphors, and expressions. Biblical anatomy is factual, empirical in the good sense of the word, and based on correct observation. Talmudic anatomy is inestimably richer; it is not free from fanciful distortions, but it reaches further and supplants the Greek theory of the "humors" with a rational explanation of the normal and pathological structure of the body. The details are sometimes astonishing in their accuracy, as in the description of the small cartilage rings in the structure of the trachea, discovered by Western anatomists only in the 18th century. At the same time, talmudic anatomy is deficient by omission, apparently because the subject was not studied systematically but only incidentally as far as it was necessary for the solving of halakhic problems. Side by side with fanciful notions, there are to be found in the Talmud the beginnings of a scientific method using postmortem examination and dissection of the bodies of animals. Like Greek anatomy, talmudic anatomy shows lack of precision in terminology, which is sometimes expressed through analogy and figures of speech. Graphic illustration is also lacking, since drawing was introduced in the study of anatomy only during the period approaching the Renaissance.

As in all ancient anatomical works, numerous terms are cited in the Bible for the bones: the lower part of the spinal column is called aẓeh (Lev. 3:9); the upper part of the pelvis kesalim; the loins are given a plural (ibid. 3:4), in accordance with their dual structure; the upper (cervical) part of the spinal column is described as mafreket (I Sam. 4:18) with its anatomical location, explaining the sudden death resulting from its fracture. Joints mentioned are the berekh ("knee"); karsol ("ankle," "malleolus"; Ps. 18:37; II Sam. 22:37); the term kaf ha-yarekh ("the hollow of the thigh") and its topographical connection with the gid ha-nasheh ("sinew of the thigh"; Gen. 32:33) have not been sufficiently defined. The term thigh entered Vesalius' Tabulae Anatomicae (Table 5), where it is labeled as the yarekh, femur, and also paḥad ha-yarekh (Table 6, according to Job 40:17). Even in Vesalius' time it was felt that the biblical word yarekh was used in various meanings and was not altogether clear.

The Bible makes frequent mention of internal organs of the body such as the pharynx (lo'a), the gullet (garon), the heart (lev), the liver (kaved) with the gallbladder (marah), the womb (reḥem), the stomach (kevah), the entrails (me'ayim), and the kidneys (kelayot). The yoteret ha-kaved or ha-yoteret al ha-kaved (in connection with the liver) is difficult to identify (Lev. 3:4), although the reference is probably to the mesentery, called by Tobias *Cohn the Physician "the covering membrane." The gidim ("sinews") in the Bible, as in Greek anatomy, denote both nerves and ligaments and sometimes even vessels. The gid ha-nasheh ("nerve of the thigh") is usually identified with the ischiadic nerve. The muscles are recognized as the parts furnishing power and movement: "his strength is in the muscles of his belly" (Job 40:16).

Talmudic scholars were much occupied with the regulations concerning ritually unclean meat, with physical disfigurement that disqualified a man for the priesthood, and with rules concerning the menstruous woman, defilement, and the like. This accounts for the anatomical knowledge so widespread among talmudists. The dissection of animal carcasses to ascertain their ritual fitness revealed important facts and prevented the development of fantastic notions. The Talmud even assumes the possibility of the investigation of the human body for forensic purposes (Ḥul. 11a). In Bekhorot 45a, Samuel relates that "the disciples of R. Ishmael boiled the corpse of a prostitute who had been condemned by the king to be burned; upon examination, they found that she had 252 [bones]." This investigation was carried out in order to ascertain the number of bones in the human body, since the remains of corpses defile an abode only if they constitute more than half the skeleton, i.e., most of the bones. The sages carried out the examinations themselves or relied on the testimony of a qualified physician (cf. Tosef. Oho. 4:2; Naz. 52a, "Todos the physician entered and all the physicians with him").

The Skeleton

The enumeration of 248 (רמ״ח) members (bones) in the human body is famous in rabbinic tradition (Oho. 1:8). This number does not correspond to the number of bones in the body of an adult, which amounts only to 200. From the number counted by Ishmael's pupils it may be inferred that the body they examined was that of a girl of 17. Supporting this explanation is the figure "six [members] of the key of the heart," i.e., the breastbone (sternum), of which there is only a single unit in an adult but which contains six points of ossification. The term "key of the heart" is to be explained by the inclusion of the two superior ribs in the morphological description of the breastbone: these two superior ribs are shorter and rounder, and their junction with the breastbone actually resembles a key. Accordingly, the rabbis of the Mishnah enumerate only 11 ribs instead of 12, the upper being already included in the "key of the heart." The figure 248 for the number of bones in the body also occurs in the writings of Abu-l-Qasim, the famous surgeon of the tenth century. It would seem that in this detail the Arabs were influenced by the Talmud rather than by the Greeks, since Hippocrates cites figures which are widely inaccurate (101, including the nails), while Galen gives no figure at all. The nomenclature of the bones in the Talmud is precise in its anatomical differentiation. The Mishnah distinguishes bet ween the foot (pissat ha-regel), the leg (shok), and the thigh or thighbone (yarekh, kulit). Corresponding to these are three joints by which the bones are joined to each other: the ankle (karsol), the knee joint (arkuvah), and the hip joint (katlit). Besides these precise anatomical details, mention is also made of the legendary bone known as the luz (the medieval os resurrectionis) said to be situated at the bottom of the spinal column. According to the legend, it could not be dissolved in water or burned by fire, "and from it man will blossom forth at the resurrection" (Eccles. R. 12:5, no. 1; Gen. R. 28:3).

The Digestive Organs

A remarkable passage is that which compares the salivary glands to springs of water and refers to them as "the conduit (ammat ha-mayim) that passes beneath the tongue" (Lev. R. 16:4). This is most interesting in view of the fact that the ducts of the salivary glands were not described with precision in scientific literature until the 16th and 17th centuries. The tongue (lashon) is described as enclosed by two walls – the jawbone (leset) and the flesh of the cheek (leḥi; Ar. 15b). The topography of the windpipe (kaneh) and the esophagus (veshet) is described correctly ("lest the food enter the windpipe before it reaches the esophagus" – Ta'an. 5b; Pes. 108a). In the esophagus two membranes were accurately distinguished: the outer or red muscular membrane, and the inner or white mucous one (Ḥul. 43a). Many structural details of the maw of the ruminants were also known to talmudists (Ḥul. 3:1). The digestive tract of the human being is described in a pseudo-scientific manner: "Ten organs minister to the body in the following phases of food absorption: from the mouth to the esophagus; from there to the first stomach where the food is ground; from there to the lower digestive tract of the maw; from there to the stomach; from there to the small intestine; from there to the colon ascendens; from there to the colon transversum; from there to the colon descendens; from there to the anus, and thence outward." This defective account, which is to be found in several midrashic versions (Lev R. 3:4; Eccles. R. 7:19, no. 3; et al.), is patently influenced by findings in animals. The liver was regarded as one of the ruling parts of the human body (Zohar, IV, 153a), the other two being the brain and the heart. The tarpesh above the liver, according to Maimonides, designates the diaphragm. The ḥaẓẓar ha-kaved ("courtyard of the liver"; Yoma 8:6) according to Preuss, is the part known as the lobus caudatus [?]. The eẓba ha-kaved ("finger of the liver"; Tam. 4:3) is identified by J.L. Katzenelsohn as the pancreas, although that structure was unknown in ancient anatomy as a special organ. The spleen is described in its various parts (Ḥul. 93a), its convex side being called dad ha-teḥol ("nipple of the spleen"). The membrane and the blood vessels of the hilus lienalis are also mentioned. The removal of the spleen by surgery is referred to in the Talmud (Sanh. 21b).

The Respiratory Organs

The upper part of the windpipe is called the gargeret (Ḥul. 3:1); the windpipe is composed of rings (ḥulyot), and sub-rings are also referred to, i.e., the ligaments joining the cartilage rings. There are descriptions of the ring cartilage called "the large ring," of the thyroid cartilage, called the kova ("helmet") together with its protruding part, ḥud ha-kova ("the point of the helmet"), and of its lower parts, shippu'ei kova ("the slopes of the helmet"). Identification was also made of the two small cartilages called ḥitin ("protuberances") at the end of the large ring. (These cartilages were not discovered in the West before Santorini in the 18th century.) The talmudists also correctly recognized the existence of three lobes in the right lung and two in the left. (Hippocrates enumerated three on each side.) They also described the serous membranes of the lung and of the bronchial tubes.

The Heart

The Talmud contains few details on the anatomy of the heart, since a wound in the heart generally caused the death of the animal before slaughtering. The position of the heart is given as on the left side of the body (Men. 36b), in contrast to Galen's statement that it was in the exact center of the chest. The heart is divided into chambers (Ḥul. 45b), but there is no trace of Aristotle's erroneous view, supported by Avicenna, of the existence of three chambers in the heart. The aorta is mentioned under the name of keneh ha-lev ("pipe of the heart") in Ḥullin 45b, and Maimonides adds mizrak gadol ("the aorta is the great fountain"). The two auricles are mentioned in Tikkunei Zohar (69): "There are two houses (battim) and two ears (udenin) in the heart."

The Genital Organs

IN THE MALE

The special terms for the membrum virile are eiver (BM 84a), eẓba (Pes. 112b), gid, ammah (Shab. 108b), shammash (Nid. 60b), etc. The term atarah ("crown") designating the part projecting behind the glans of the penis passed to Western anatomy as corona glandis. The (erroneous) view that "there are two ducts in the male, one to emit urine and the other semen, separated by a thin tissue" (Bek. 44b) was widely held in the Middle Ages, also among the Arabs, and was corrected only in the 16th century by Vesalius. The rabbis described the two membranes of the testicles (Ḥul. 45a) and the vas deferens (ḥutei beiẓah; Yev. 75b) and knew of the connection between erection of the penis (kishui) and the spinal cord, where disease prevents cohabitation.

IN THE FEMALE

Because of their attention to regulations concerning the menstruous woman, the talmudic scholars treated the female genitalia much more extensively. The language they used (for reasons of propriety) to designate them frequently causes great difficulty in understanding the anatomical details referred to. The Mishnah (Nid. 2:5) lists the chamber (ḥeder), antechamber (perozedor), upper chamber (aliyyah), and fallopian tube (adnexa). "The blood of the chamber defiles (the blood of the upper does not); that found in the antechamber defiles on account of uncertainty, since it is strongly probable that it comes from the source (uterus)." The Gemara (Nid. 17b) explains: "The chamber is within and the antechamber without, and the upper chamber is built over both and there is an open passage (lul) between the upper chamber and the antechamber; consequently, from the lul inward the blood in case of doubt (sefeko) is defiling; from the lul outward, it is in a state of purity." Ever since modern medical historiography came into existence, scholars have struggled to explain these halakhot. Abraham Hartog Israels identifies the "upper chamber" with the fallopian tube; Rosenbaum (see bibl.) identifies it with the adnexa uteri and the broad ligaments. Leibowitz' identification is that the "chamber" is the womb; the "antechamber" is the part nearest the cervix. But Preuss holds that the "antechamber" is the exterior portion of the female genitalia (vulva); the "upper chamber" is the vagina, which in present day Hebrew is called nartik. This conjecture is irreconcilable with the talmudic passage as a whole, since the vulva everywhere in the Talmud is called bet ha-toref, bet ha-setarim, bet ha-ḥiẓon (exterior chamber; hidden chamber; outer chamber), which also includes the labia. Katzenelson would identify the parts of the "antechamber" with the septum vesico-vaginale and the septum recto-vaginale. Nor is it at all clear what is meant by the term lul; it is perhaps to be identified with the cavity in the upper vagina: "from the lul inward" denotes the upper parts near the cervix; "from the lul outward," the lower parts of the vagina. In the anatomy of the female genitalia there is a place called in the Jerusalem Talmud bein ha-shinnayim ("between the teeth") or bet ha-shinnayim ("abode of the teeth"), which Rosenbaum identifies as the collum; Rashi says "within the womb are fleshy protuberances like teeth."

Other Organs

The Talmud does not deal much with the normal anatomy of the kidneys, but gives numerous accounts of kidney diseases. It contains descriptions of the membranes of the kidney, and refers to hilus renalis as ḥariẓ (Ḥul. 55b). It describes the outer and inner membranes (meninges) of the brain and recognizes the existence of motor centers in the spinal column. The Talmud records examinations of the spinal cord and of injuries to its membranes and marrow (Ḥul. 45b); it describes various kinds of morbid changes in the tissue and important details in its pathology such as softening (hamrakhah), dissolution (hamsasah), and softening (hitmazmezut) of the marrow; and mentions the fontanel: "the place where an infant's brain is soft" (rofes; Men. 37a). It recognized two hemispheres of the cerebellum over the large aperture at the base of the cranium "like two beans (polim) lying at the aperture of the cranium" (Hul. 45a–b). These are also described by R. Jeremiah in the case of a fowl: "He examined a fowl and found objects resembling two beans placed at the aperture of the cranium" – a fine example of comparative anatomy.

Middle Ages

In the Middle Ages and the Renaissance period, the Jewish physicians shared the anatomical opinions of their neighbors. Vesalius was, however, assisted in his work of the compilation of his Anatomical Tables in the 16th century by the Jew Lazarus (Lazaro) de *Frigeis. The reluctance of Jews to submit bodies for dissection led to complications and ill-feeling in the universities (e.g., at *Padua in the 17th–18th centuries; Eastern Europe in the 20th). The most outstanding Jewish physician of the Renaissance was *Amatus Lusitanus, who in the 16th century participated in the teaching of anatomy at the university at Ferrara. He first described the valves of the veins, exemplified on the azygos vein. Lusitanus identified these valves through opening 12 bodies, although he did not show their connection with the circulation of the blood.

Modern

Outstanding in the modern study of anatomy was Friedrich Gustav Jacob *Henle (1809–1885) who did important research on the skin, the intestinal tract, and the kidneys. Another important figure was Benedict *Stilling (1810–1879) who did pioneer research on the spinal cord.

BIBLIOGRAPHY:

M. Perlmann, Midrash Refu'ah (1926); J.L. Katzenelson, Ha-Talmud ve-Ḥokhmat ha-Refu'ah (1928); A.H. Israels, Dissertatio historico-medica exhibens collectanea ex Talmude Babylonico (1845); R.J. Wunderbar, Biblisch-talmudische Medicin, 2 vols. (1850–60); J.L. Katznelson, Die normale und pathologische Anatomie des Talmuds (1896); E. Rosenbaum, L'anatomie et la physiologie des organes génitaux de la femme (1901); J. Preuss, Biblisch-talmudische Medizin (1911).

[Joshua O. Leibowitz]


Source: Encyclopaedia Judaica. © 2008 The Gale Group. All Rights Reserved.