Anatomy Models - Eighteenth Century

After World War I, there were significant changes in the doctor-patient relationship and the medical encounter became less collaborative. Medical knowledge was mediated by physicians and anatomical models were used to convey information to patients, while protecting them from the realities of the human body.

Rene Laennec, who invented the first stethoscope, commented that "no patient report could suffice to characterize disease, and that for a certain diagnosis, mediate auscultation is required."
(Porter, 1997)

Rene Laennec invented the first stethoscope in 1816 (Cambridge Illustrated History of Medicine, 1996)

Rene Laennec invented the first stethoscope in 1816 (after a painting by Chartran in the Sorbonne)
(Cambridge Illustrated History of Medicine, 1996)

Sir Thomas Lewis perfected the electrocardiogram in 1912 (Cambridge Illustrated History of Medicine, 1996)

Sir Thomas Lewis mastered the technology of the electrocardiogram in 1912, a device for recording the activity of the heart
(Cambridge Illustrated History of Medicine, 1996)

First operation performed under ether (anesthesia) in 1846, a painting by Robert C. Hinkley
(Cambridge Illustrated History of Medicine, 1996)

Label on the base of the Clay-Adams model (Museum of Science & Technology)
Clay-Adams label on the base of the model
(Museum of Science & Technology, Ottawa)

Decorative hand-painting to represent breast tissue - Clay-Adams model
(Museum of Science & Technology, Ottawa)

Anatomy models in the doctor's office

Post-war physicians had extensive and tactile experience with the human body - why have such a decorative model in the office? At $180, it was too expensive merely to serve as a marker to instill confidence or inspire awe in the patient - not when a white lab coat and stethoscope achieved the same effect.

Clay-Adams model in steel cabinet available for order from the 1938 catalogue

Steel cabinet to store anatomical models was available to order
(Clay-Adams Catalogue, 1938)

	20th Century New ways of diagnosing Changes in the doctor-patient relationship Monopoly over medical knowledge Clay-Adams model Anatomy models in the doctor's office	After World War I, there were significant changes in the doctor-patient relationship and the medical encounter became less collaborative. Medical knowledge was mediated by physicians and anatomical models were used to convey information to patients, while protecting them from the realities of the human body.
Rene Laennec, who invented the first stethoscope, commented that "no patient report could suffice to characterize disease, and that for a certain diagnosis, mediate auscultation is required." (Porter, 1997)	New ways of diagnosing Centuries of humoral medicine - diagnosis made by "reading" illness on the surface of the body (Young, 1993) Eighteenth century - diagnosis was an art of observation and the physician interpreted the patient's history (Porter, 1997) Over the nineteenth century - diagnostic innovations like the X-Ray and stethoscope appeared and doctors had access to what was going on inside the body, without relying on the patient. (Reiser, 1978)	Rene Laennec invented the first stethoscope in 1816 (after a painting by Chartran in the Sorbonne) (Cambridge Illustrated History of Medicine, 1996)
Sir Thomas Lewis mastered the technology of the electrocardiogram in 1912, a device for recording the activity of the heart (Cambridge Illustrated History of Medicine, 1996)	Changes in the doctor-patient relationship In every medical interaction there exists a contract - verbal or unspoken - in which the patient assumes of the healer an expert knowledge and anticipates the fulfillment of his or her expectations. Doctors can only be doctors when someone else agrees. (Outram, 1995) Over time, both doctor and patient came to rely on and trust in diagnostic technology for the answers to medical questions. Eventually, with the advent of radiological technology, the physician diagnosed in complete absence of the patient, and the relationship became less collaborative. (Reiser, 1978)	"A multitude of new facts and theories, of new methods and routines, so far absorb the physician's attention...that the personal relations seem to have become less important to the new and powerful technology of medical practice." -Dr L.J. Henderson, 1935
If one had not a personal experience with the value and promise of medical innovation, then reports were available from the highest source: In 1902, King Edward owed his life to the surgical treatment of his appendicitis. (Porter, 1997)	Monopoly over medical knowledge Expectations of what physicians could provide rose with the successes of anesthesia and antisepsis. Patients began to want a "technical fix" for every ailment. (Duffin, 2000) By demanding more, patients willingly allowed physicians to become the guardians of medical knowledge. As scientific medicine came to possess a monopoly over medical knowledge, the patient became distanced from the material of anatomy. more about medical monopoly & the professionalization of medicine	First operation performed under ether (anesthesia) in 1846, a painting by Robert C. Hinkley (Cambridge Illustrated History of Medicine, 1996)
Clay-Adams anatomy model made from papier-mache in the 1930s (Museum of Science & Technology, Ottawa)	Clay-Adams model The change from highly realistic anatomy models to decorative depictions is indicative of the changes in the balance of medical power and of new cultural beliefs about science and medicine in the twentieth century. The Clay-Adams model was produced by an American company in Japan in the 1930s. The exterior and interior are made of papier-mache, and are hand painted and lacquered. The Clay-Adams model is like an impressionist painting - from a distance the structures and organs look well-formed, but up close are hardly identifiable at all. Unlike the realistic wax models of the 18th and 19th centuries, twentieth-century models do not provoke an extreme reaction from viewers.	Clay-Adams label on the base of the model (Museum of Science & Technology, Ottawa) Decorative hand-painting to represent breast tissue - Clay-Adams model (Museum of Science & Technology, Ottawa)
Anatomy models in the doctor's office Post-war physicians had extensive and tactile experience with the human body - why have such a decorative model in the office? At $180, it was too expensive merely to serve as a marker to instill confidence or inspire awe in the patient - not when a white lab coat and stethoscope achieved the same effect. In the post-war medical paradigm, it was the responsibility of the medical professional to shoulder the reality of the biological body and mediate the horrors of medical knowledge in less threatening terms for the patient. This division of the medical world and the "normal" world is reflected in an item appearing in the 1938 Clay-Adams Catalogue - a metal cabinet for storing the anatomical model. Medical expertise is "locked away" from the patient and accessed through the doctor. Remember, the patient expects the physician to act as guardian over medical knowledge, and both the doctor and the patient agree on the terms of their contract.		Steel cabinet to store anatomical models was available to order (Clay-Adams Catalogue, 1938)