The Life's Work of J.M. Bourgery and N.H. Jacob

The Atlas of Human Anatomy and Surgery by J.M. Bourgery and N.H. Jacob. My copy pictured above is 19 x 13 x 4 inches, weighing 16 pounds, containing 3,750 anatomical figures for a total of 744 pages.

I came across an article online titled A Brief History of Surgeons, it cataloged the progression of surgical techniques over the centuries. It reminded me of what I consider to be the most remarkable anatomical text of the 19th century. The Atlas of Human Anatomy and Surgery by J.M. Bourgery and N.H. Jacob. I'm fortunate to have a facsimile reprint of the entire atlas (1st edition of course) printed in 2005. An unknown number of 1st edition prints were made and they are very difficult to find. The reason first edition prints are so special is due to their size, measuring 19 x 13 x 4 inches and weighing 16 pounds. The illustrations truly come to life with fold-out pages, further increasing the scale of the illustrations.

The text contains 8 volumes spanning osteology, syndesmology, myology, neurology, angiology, splanchnology, surgical anatomy, embryology, comparative anatomy, and microscopic anatomy. The volumes were worked on and published between 1831 and 1854 by Bourgery and Jacob, a staggering 23-year endeavor. It is truly a life's work considering the average age of a Frenchman at the time was 45.1 years old. Not only is the text exhaustive, covering all aspects of anatomy, but the lithographic illustrations are stunning. Every anatomical specimen is beautifully and painstakingly prepared with incredible craftsmanship.

What caught my eye the first time I saw this text was that they did not deidentify the faces of the specimens, Bourgery and Jacob took a strict naturalistic approach to their illustrations. I've featured a few illustrations end the end of this post to show you what I mean (sorry for the glare/shadows on the photos). Anatomical illustrations today, by contrast, are deidentified, and with good reason, to protect the subject's identity. Yet I strongly prefer Bourgery and Jacob's illustrations over any modern-day illustration. The illustrations feel real, they feel, important, that they ought to be shown the highest degree of respect and appreciation not only for the work undertaken by Bourgery and Jacob but also the service that the subject provided for future generations to study. My hope is that the anatomical specimens were consenting individuals, though it's not clear, given the time period it wouldn't be surprising if they were not.

It took hundreds if not thousands of years to de-taboo-ify the study of anatomy on human subjects. It was certainly not commonplace in the 19th century, most people still held strong reservations, and any affordances to dissect humans were under the pretext that they were low-status individuals, for example, criminals who didn't have much say in the matter. This is in stark contrast to where medicine is today regarding the consent of human dissection or autopsy. With that said, healthcare regulations and ethics often lag behind modernization. As someone that has spent some time in the healthcare tech industry, a growing concern is the consolidation of electronic health records. I will write a follow-up post related to this to avoid going down a rabbit hole here.

Now, back to Bourgery and Jacob's work. I've captured a few illustrations below, all of which show some portion of the face, so this is a very specific sample I have pulled, the other illustrations are equally impressive. All of the captions below are copies of the captions in the text (I did not create these captions):

Brain: Right paramedian sagittal section of the brain in situ and of the cerebellum.

Meninges: Right lateral view. Dura mater removed, showing the arachnoid and the pia mater and the superficial vessels.

Cranial Nerves: Vagus Nerve. Trajectory and branches of the vagus nerve (tenth cranial nerve pair). Relationships with the trigeminal, glossopharyngeal, accessory, hypoglossal nerves, with the cervical and brachial plexus and with the sympathetic trunk. Superior and recurrent laryngeal nerves; tracheal, bronchial, oesophageal, and cardiac branches; pharyngeal, pulmonary oesophageal, and celiac plexus; anterior and posterior vagal trunks; gastric, hepatic, celiac, and renal branches. View from the left side of the neck(head turned towards the right), and anterior, frontal view of the trunk (thoracic and abdominal cavities opened, heart and major vessels removed).

Nerves of the neck. Cervical plexus. Cervical plexus and its branches: punctum nervosum, lesser occipital, greater auricular, transverse cervical and supraclavicular nerves. Relationships with the facial nerve and the greater occipital nerve. Left lateral view (superficial layer).

Surgery of the nose. Repair of the whole nose (Italian method): Positioning of the brachial flap; Tagliacozzi's reduction apparatus.

For those interested in a dramatized perspective of the medical field in the early 1900s, only 50 years after the last volume of Bourgery and Jacob's atlas was published, I highly recommend The Knick. It's a two-season tv series (unfortunately cut short), taking place in New York City in 1900. Dr. Stanley Burns (owner of the largest private collection of early medical photography) served as the on-set medical advisor. We can see the same procedure seen in the lower portion of the above illustration by Bourgery and Jacob was reenacted in The Knick below.

A scene from The Knick of Abigail Alford receiving a procedure to address a nasal disfigurement.