Illustrating Medicine

Grant’s Atlas of Anatomy transformed the teaching of human anatomy with a single-volume portable text that portrayed the body in a series of regions rather than systems, emphasized realistic illustration over textual description and used English rather than Latin for captions.

In the early 1940s highly skilled and predominantly female medical illustrators began creating the drawings for Grant’s Atlas using an innovative process that began with preserved specimens and used photography and tracings to create accurate and pedagogically astute illustrations that have been used to train generations of physicians. These working drawings survived fifty years of use in the publication process before they were returned by the publisher to the care of the community of medical illustrators from which they emanated.

The works in this exhibition are kept in the Division of Biomedical Communication of the University of Toronto and include drawings, some remnants of the process of creation such as photographs, transparencies and tracings. The drawings are highly valued by the medical illustrator community and are currently used in the teaching program to demonstrate still relevant past practices and techniques.


The Illustrators

Dorothy Foster Chubb was one of Canada’s early professionally trained medical illustrators. She was born in Hamilton Ontario in 1908. She worked with Maria Torrence Wishart (1893-1983) who had established the Department of Medical Art Service, a University of Toronto medical service department. Chubb then went to Baltimore where she was a student of Max Brodel in the Department of Art as Applied to Medicine at the Johns Hopkins University Medical School, the first program to formally train medical illustrators, where Wishart had also been a student. Chubb returned to Toronto as Wishart’s assistant. After her marriage she worked as a freelance artist for many outstanding surgeons of the era, and was well known for her accomplished carbon dust drawings. In 1941 Grant commissioned Dorothy Chubb to create the entire corpus of original works for the first edition of his Atlas of Anatomy. She completed most of the works in one year and they consequently show great visual and representational consistency.

Nancy Grahame Joy (1920-2013) was a renowned Canadian medical illustrator and educator. She became a student at the Ontario College of Art in 1939 and later attended classes with the medical students at the University of Toronto. She also studied at the University of Illinois at Chicago Department of Medical and Dental Illustration. She went on to study and work in the Art as Applied to Medicine program at the University of Toronto, where she worked with Maria Wishart. Between 1962 and 1985 Joy was Chair of the University of Toronto Department of Art as Applied to Medicine (established by Wishart in 1945); the program is now called Biomedical Communications. Under Joy’s tenure the diploma program evolved to become a Bachelor of Science program (it became a Master’s program in 1994). Joy was an esteemed artist who used pen and ink and half-tone watercolour techniques to achieve tonal gradation. She made significant contributions to Grant’s Method of Anatomy and Atlas of Anatomy.

Medical illustrators Elizabeth Blackstock, Eila Hopper Ross and Marguerite Drummond were accomplished medical illustrators who were associated with the University of Toronto Department of Medical Art Service and who also contributed to Grant’s Atlas of Anatomy.


J. C. B. Grant

Dr. John Charles Boileau Grant (1896-1973) was born and educated in Scotland. He worked at the University of Durham at Newcastle-on-Tyne in the laboratory of Robert Howden, one of the editors of Gray’s Anatomy. He served in World War I as a battlefield surgeon, which convinced him of the importance of rethinking how anatomy was taught to practitioners. After the war he became Professor and Head of Anatomy at the University of Manitoba Medical School. He was named Chair of Anatomy at the University of Toronto in 1930, where he and his assistants prepared dissections (many of them still available) for the Medical Museum. He published the first edition of his Method of Anatomy in 1937. In 1940 he published his Anatomy Dissector (later Grant’s Dissector). The first edition of his Atlas of Anatomy (now Grant’s Atlas of Anatomy) appeared in 1943. It was published by Baltimore publisher Williams and Wilkins during World War II when the supply of European-based textbooks was threatened. It was one of the first atlases of anatomy published in North America with illustrations done by North Americans, and it modernized and updated anatomical knowledge and teaching. The book was organized along the lines of regional anatomy and introduced realistic illustrations based on dissections, rather than composites. Grant retired from the University of Toronto in 1956 to become Curator of the Anatomy Museum, now called Grant’s Museum.


Grant’s Atlas of Anatomy

Medical atlases are used as part of the training of physicians to work with living human subjects. They are pedagogical tools used to familiarize medical personnel with the human body. Grant’s Atlas is a brilliant example of what is known as “regional anatomy.” At the turn of the twentieth century, representations of the body in medical atlases began to slowly shift as regional anatomy displaced “systems anatomy”, based upon examination of the human body system by system. Regional anatomy was particularly important in the training of surgeons who operate on a living body in a specific area and encounter the inter-relationship of all of the systems of the human body with each other in that area.

Regional anatomy divides the body into discrete areas or regions, exploring a specific region of the body from different angles and perspectives, highlighting the depths of our corporeal substrata, and showing the inter-relationship of different sections in each region. Regional anatomy is a part of what is known as “gross anatomy”—rather than presenting the body at a micro-molecular level, it produces what can be seen with the human eye. Grant’s approach was to offer an affordable and portable single-volume text, and vernacular rather than Latin captions in place of lengthy textual descriptions. The early Atlas introduced other innovations such as realistic illustrations rather than composites. Most of the images were based on dissections that were photographed. From these photographs a tracing was produced; from the tracing a drawing was done. The drawing could be a line drawing a carbon dust drawing or a watercolour, whichever was most appropriate for the subject. The original drawings include traces of instructions and communications from the printing processes of successive editions and various publications. Illustrating Medicine includes some rare examples of all the stages of production of the illustrations.

Medical illustrators continue to develop and use techniques of visual communication that are exemplified in the artistry of the early Grant’s Atlas illustrations, but they are also use digital technologies to generate images and animations at a micro-molecular level. Grant continued editing the Atlas through the 6th edition in 1972. The 7th (1978) and 8th (1983) editions were prepared under the direction of James Anderson. Anne Agur (University of Toronto, Division of Anatomy, Department of Surgery) began editing the Atlas with the 9th edition (1991 with Ming J. Lee). Agur currently edits the Atlas with Arthur F. Dalley; the latest edition is the 13th edition published in 2012.


The Illustrations

Although photographs were used in the creation of these drawings, the skill of the illustrators is absolutely essential to the production of an effective scientific illustration. Photography, before digital enhancement, produced too much information. A scientific illustration selectively isolates information and focuses on what is to be seen and communicated. Illustrating Medicine clearly demonstrates this relationship of photograph to drawing. The illustrators used tonal drawing to create a “better than photorealistic” ’”quality in each image so the image communicated to physicians is what they might see, or need to see, when performing a surgery or a dissection. Line drawings work well to indicate the schematic outlines of a region, and were used to draw venous systems or bones. Carbon dust drawings utilize a technique that is excellent for depicting soft tissues (muscles and fatty tissues). The exhibition draws attention to the different ways line drawings and drawing with tonal gradation were used to depict regional anatomy. Grant used colour in the initial Atlas to highlight different areas he wanted students to notice, and to clearly separate different regions within these systems. In the 1970’s most of the drawings were scanned and later colourized by the publishers. However, as illustrators and those who study the science of visual communications have pointed out, colour is not always essential to scientific communication. The colorization process was largely a marketing decision.

The publisher kept these original working drawings for many years where they survived fifty years of use in the publication process before being returned to the care of the community of medical illustrators at the University of Toronto from which they emanated. They are technically owned by the University of Toronto’s Department of Anatomy, but they are currently housed at the University of Toronto Mississauga in the Department of Biomedical Communication. Copyright is still owned by the publishing company Wolters Kluwer who bought the firm of Lippincott Williams & Wilkins in XX. In 2011 a grant from the Social Sciences and Humanities Research Council (SSHRC) allowed a team of researchers who collaborated with the illustrators to research the drawings, organize the materials into an archive, and scan the images (back and front to capture all the information) at high resolution, and create a digital database of the illustrations with metadata.


The Curators

Kim Sawchuk

Kim Sawchuk is a Professor in the Department of Communications, Concordia University where she holds a Concordia University Research Chair in Mobile Media Studies.

Nancy Marrelli

Nancy Marrelli is Archivist Emerita at Concordia University in Montreal and co-publisher of Véhicule Press.


Credits

  • The Illustrators: Dorothy Foster Chubb and Nancy Joy with Elizabeth Blackstock and Marguerite Drummond
  • Curators: Kim Sawchuk and Nancy Marrelli
  • Exhibition fabrication and consultation: Robert Prenovault
  • Graphic design: Antonia Hernández / MAT3RIAL
  • Curatorial assistant: Brietta O’Leary


Acknowledgements

The exhibition has been made possible because of the contributions of the Social Sciences and Humanities Research Council of Canada, The Department of Communication Studies, Faculty of Arts and Sciences- Concordia, The Mobile Media Lab, and the Media History Research Centre. We thank the Department of Biomedical Communication- University of Toronto Mississauga, The Division of Anatomy, University of Toronto and the staff of Wolters Kluwer (formerly Williams & Wilkins) for their ongoing support of the project.

The Illustrating Medicine SSHRC team includes Kim Sawchuk, Nicholas Woolridge, Nina Czegledy, Nancy Marrelli and Brian Sutherland. Mél Hogan, Margot Mackay and Dave Mazierski also contributed greatly to this project.