The Contents and Controversies of a Seventeenth Century Anatomy Book

An earlier blog tells the story of Worcester Cathedral Library’s copy of “Microcosmographia, A Description of the Body of Man. Together with the Controversies and Figures thereto belonging”” written by Helkiah Crooke and published in 1616.

The title page of “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

Helkiah Crooke was born in Suffolk to a wealthy parish rector, studied at Cambridge University and gained his medical qualification in Leiden. He was admitted to the Royal College of Physicians in 1613 and later became a fellow and anatomy reader. He was appointed physician to the Royal Household of James I, and later Keeper of Royal Bethlem Hospital for the treatment of the mentally ill, from which he was sacked on the grounds of embezzlement, absenteeism and failing to treat his patients. Today he is best remembered for “Microcosmographia” , which Crooke tells the reader is “Published by the Kings Majesties especiall Direction and Warrant according to the first integrity, as it was originally written by the AUTHOR.”  The king referred to is James I, and his support was crucial because when parts of the work were printed and circulated prior to publication they caused widespread consternation, being deemed by many too offensive to be published. 

The skeletons of a woman and child from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

The Church was appalled. The Bishop of London, John King, objected on grounds of indecency, to both text and illustrations devoted to human reproduction, particularly the section on the female reproductive system. The Bishop appealed to the Royal College of Physicians, asking them to suppress the book, knowing that members of the college were offended on two further counts.

Physicians objected to English being used to disseminate knowledge which they considered their professional domain and should be properly conducted in Latin. Secondly, they were offended by Crooke’s introduction, in which he called the lowly class of surgeons “Members of the Physitians Commonwealth,” and implied that a surgeon’s knowledge of anatomy was likely to be better than that of a physician! The Royal College proposed that the Microcosmographia not be published at all, (with some compensation being offered for the costs incurred) or, that the section “Of the natural parts belonging to generation” be deleted.

Some anatomical instruments from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

In addition to the objections from the Church and the physicians, Microcosmographia was criticised by contemporary scholars who accused Crooke of plagiarism. It is true that the lavish anatomical illustrations do not show dissections or observations made by Crooke, but, as Crooke himself acknowledges, are copied from earlier works by Gaspar Bauhinus, Andreas Laurentius, and others, which Crooke quotes, but with full acknowledgement.

Called to account before the Royal College of Physicians, Crooke refused to comply with any of their demands. The College then tried to intimidate his publisher, threatening to burn the books.  They appointed two fellows to emend the offensive portions, but all to no avail.  Microcosmographia’s publisher was William Jaggard and his father had been a barber-surgeon in 16th century London. It is not too fanciful to think that this connection with the practice of surgery enabled Jaggard to take on the publication of a work that both he and its author knew would be highly controversial, although maybe he simply knew what would sell well.

 

“Outward and fore parts of the body”, from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

Despite (or because of) the controversy, the book was published with the author’s text unchanged. Furthermore, the illustrations in Microcosmographia were published in their original form, with the title page displaying a nude male and a partly dissected pregnant female figure in defiance of the College, or perhaps just to stimulate sales.

Aware of the criticisms of his book, Crooke starts with a long and careful preface in which he addresses the complaints. He is writing, he explains, a practical book which will be useful to surgeons in the practice of their craft. Surgeons, he explains, need to understand anatomy and how the body works in health and when diseased, consequently they need at least some “medical” (i.e. physicians’) knowledge. Despite their lack of “proper” education barber-surgeons who work “with the hand” (as opposed to the mind) must exert themselves to learn sufficient medicine for the good of their patients.  Consequently, Crooke says, he has written the book in English rather than Latin so that surgeons who have had little education would be able to benefit from it. Moreover, he points out that his book makes accessible to his barber-surgeon readers the works of earlier physicians by translating them into English. Far from stealing the work of others, he is making it available to a wide audience.

“The lower belly”, partially dissected to show its internal structures, from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

He is aware of the objections to writing and illustrations of “the parts of generation” but explains that accuracy is necessary for surgery, that inaccuracy and ignorance are dangerous, and that he has justified his account with the King. For those unconvinced he is determined “To leaue these men to their contradictory and detracting spirits”

On the subject of the copied drawings, he points out that there are in his book  hundreds of accurate anatomical illustrations for surgeons to consult. These represent the work of many masters over several lifetimes, and it would have been impossible for him to have achieved so many dissections himself, particularly in England at this time when access to bodies was restricted.

His object was to produce a comprehensive, usable and academically informed guide for surgeons to use and for this purpose he collated all that seemed best to him from the work of earlier masters and the finest of their illustrations, together with his own critical appraisal. It is the opinion of this blogger that Crooke succeeds in his aim.

Blood vessels (veins) of the legs, from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

Microcosmographia is much more than an anatomy book. Its text attempts to present the opinions and theories of recognised masters in the field of medicine. Crooke discusses each man’s view and offers his own interpretation and conclusions in the light of contemporary (sixteenth century) work. The book is organised into chapters each dealing with a particular part of the body and its functions, and each section begins with discussion of the work of Galen, Hippocrates, Aristotle, Pliny, Epicurus and many others. Unlike a modern medical author, Crooke is at great pains to describe human anatomy and function in a Christian context. His title “Microcosmographia” reflects his view that the human body has a divine perfection much as does the Cosmos, although just on a smaller scale. He describes the organs of the body as analogous to the planets of the solar system and argues that the study of anatomy is the study of God’s work. At the end of each section Crooke adds a chapter on “Controversies” in which he poses questions. For example, where hunger originates and whether the womb does truly move around inside the body.

A head and skull, partially dissected to show structures of the brain, from “Microcosmographia”. Image copyright the Dean and Chapter of Worcester Cathedral (UK)

Crooke follows the classical theory of the “Four Humours” of Choler = fire; Sanguine = air; Phlegmatic = water; Melancholy = earth, but he ties these concepts to real body parts. For example, the gall bladder which produces bile, is the source of choler and the spleen the source of melancholy humour.

Writing just before Harvey’s treatise on the circulation of the blood, Crooke makes no sense of the beating of the heart or the function of arteries and veins. He knows about kidney stones and their removal; about tumours, infections and wound management but very little about what we would call physiology. His book has many examples of accurate observations which he cannot explain, such as why an injury on one side of the head leads to loss of function on the opposite side of the body, or how a neck injury can lead to loss of function in the legs but not the arms. Both are questions that a modern anatomy student can answer, but Crooke could not.

Microcosmographia was a popular success, brisk sales led to several further editions and Crooke became a wealthy man.  Frequently wrong, invariably opinionated, long, often repetitive and infused with seventeenth century religious and gender prejudice, Crooke’s Microcosmographia is nevertheless a fascinating work. Written in English (albeit the English of the King James bible) it remains accessible today. His text is clear and well organised, and the book presents medicine and surgery as it was emerging from medieval superstition into modern scientific enquiry. Worthy of a five-star Amazon review!

Diana Westmoreland

Bibliography

“Microcosmographia. A Description of the Body of Man. Together with the Controversies and Figures thereto belonging” written by Helkiah Crooke and published in 1616. (WCL UA12)

Dutch Anatomy and Clinical Medicine in 17th-Century Europe by Rina Knoeff (2020) http://ieg-ego.eu/en/threads/models-and-stereotypes/the-dutch-century/rina-knoeff-dutch-anatomy-and-clinical-medicine-in-17th-century-europe

A brief history of topographical anatomy. Susan Standring (2016) Wiley Online Library

Dictionary of National Biography, 1885-1900/Crooke, Helkiah. https://en.wikisource.org/wiki/Dictionary_of_National_Biography,_1885-1900/Crooke,_Helkiah

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