Critque of Pure Anatomy !(Cunningham’s manual)
Cunningham manual for practical anatomy is outdated and irrelevant for present times
I understand there is a lot of nostalgic emotion attached to this book since generations of doctors in India and much of South Asia if not most of commonwealth started their medical careers with this much touted ‘Bible’ for anatomy.
With all due respect to the above claims from senior faculty and contemporaries alike, I feel it stopped serving the purpose or became too redundant and complicated for the average medical student.
Why is this so?
Although we can agree on the claim that human anatomy hasn’t been altered since what like 1–2 lac years ago, perhaps from the arrival of homo sapiens on the planet.
But what has changed is how we understand, what we remember, how easily we can assimilate and the tools that go with all of this.
Cunningham’s has been around for quite some time.
This specimen from Edinburgh claims to be a second edition copy from the very author published in 1896. That is to say the least 120 years ago. A lot of things changed in this century.
There wasn’t colour printing, more focus on imaging, no atlases, no multimedia, most of the whole deal of black and white. Even English as a language has evolved over the last century. Some nomenclature has changed with more transition to current spoken language rather than pure Latin or its derivatives.
I do understand that the editors over time tried to improve this, but I didn’t feel it could get far. For what it’s worth, it did stood the test of time for quite a while.
This image shows the year on year publication chart for the initial 8 editions till 1927. There after some lag did appear as much of western world and UK in particular probably decided to switch to newer and latest works on the same subject. This is evident from the fact that it took another 100 years to publish the 16th edition.
Even if we do wager the fact that anatomy didn’t change much and there appeared no need to alter the book for what it is, this still doesn’t explain the fact that the gap between 15th and the 16th edition is 32 years, that is one full generation of medical professionals.
Now, my dad went medical school in the 80’s and I had the opportunity to go through the books he read while at it. Things did change a lot. If not the anatomy, our understanding, the imaging, in situ appearances, operative images and so forth.
Even the current edition doesn’t appear to be taken seriously by the country of origin, since the publisher opted for an Indian editor which all the more substantiates the claim that the book is taken too seriously mostly in South Asia if not India.
With all due respect to the author and her experience at CMC Vellore, which is probably one the prestigious in India, the changes we expect from a book of such prestige in times of information age, cutting edge tech in tissue preservation and advanced imaging doesn’t fit the bill.
The images are same old since what I went through in medical school (that was 12 years ago), no representation of actual colour, language too verbose, practicality little as it had been a decade ago.
Even most of the reviews on the UK edition of Amazon are from India! The very country of origin for this book doesn’t look too keen on continuing the tradition. Guess this is more of colonial hangover or our inability to accept that change is what drives progress.
But again, I’m not here to judge anyone’s choices but to appeal to reason and facts.
Frankly, I feel that this book is being published and milked for what its worth with only one reason in mind. Passing MBBS year 1 in India with a background of faculty too afraid to change what exists for reasons beyond my comprehension other than the guesses I made prior.
This is what the publisher/author claims,
Seems far fetched to believe but again, publishing is a business and no business runs without proper marketing to rake in more money. Even if we do discount for the marketing strategies, this is what we end up with,
Same old black and white images from previous editions
Cartoonish caricatures of real life images
Perhaps this is to be taken for a “full colour artwork” as claimed above
A mediocre attempt to appeal to reality buried somewhere at the end of chapter
Perhaps the good old gentleman, Cunningham must be turning in his grave to see what has become of his magnum opus and may even feel ashamed for our weird perversion to hang on to old tech.
We took you seriously dear sir and in the process betrayed practical anatomy, a rather beautiful branch of medical science whose true importance I appreciate everyday personally being a practising surgeon.
Sources (in the order of appearance)
Cunningham’s Manual of Practical Anatomy VOL 3 Head and Neck