Introduction
When I first went to university as a teenager I went to study medicine. We had the chance to study holistic elective topics as part of the programme. I was drawn to aspects of medical history and advances in medical illustration. Given the use of the web was limited at this time, I created pages about sickle-cell disease and thalassaemia to become part of the self-directed learning syllabus.
Through both of these interests (and my studies in general) I learned of the importance of medical illustration, imaging and visual communication. Now I am studying illustration, medical illustration has remained on my mind as a possible avenue to pursue. I was curious to revisit this area as part of this research, particularly the crossover between history and technology.
I've broken down my research into a roughly chronological progression. I decided to revisit more traditional scientific illustration approaches first (which themselves were still influenced by technology, if not imaging specifically). Then I looked at how emergent imaging technologies influenced visual image-making.
Traditional Scientific Illustration
Medical Illustration
From the earliest times, humans have had an insatiable need to understand how our bodies work. To say that early understanding is crude would be an understatement! The earliest evidence of trephination is around 6000 BC [] but at that time is disputable whether this extreme technique was conducted for medical or spiritual reasons.
One of the first major advances we had in our understanding of anatomy and physiology was the work of the Greek physician Galen. However, his work was based primarily on surgical intervention and the dissection of apes and other mammals (as the dissection of dead bodies was forbidden in ancient Roman culture). This meant that it contained many incorrect observations and conclusions.
The first leap in our understanding came when Vesalius challenged Galen's thinking in the 16th century. Vesalius worked from direct observation of dissected cadavers, which to this day remains one of the most efficient ways to learn human anatomy.
In the previous century, paper came to Europe alongside copperplate engraving and woodcut printing. This allowed Vesalius's work to spread quickly and widely, influencing the understanding of the human condition forever. In what might seem to be a grotesque parody compared to modern medical illustration, Vesalius's illustrations were posed in classical poses of the Renaissance, giving the cadavers the look of elegant zombies!
In the 17th century, the printing process evolved again with lithography and engraving techniques used. The etching process allowed for the combination of spontaneity and delicate line work, as well as more familiar formal techniques. By the 19th century, anatomy was deeply rooted in formal education. The trend for romanticised depictions had faded away, and medical illustrations started to favour realistic, harsh, depictions of their subject matter.
With the advent of photography in the 1800s, one might have expected medical illustration to have died out in a similar way to fashion illustration in the 1950s. However, medical illustration remained an integral part of medical education. In the early 20th century the medical illustrator Max Brödel developed an artistic technique that seemed to capture the appeal of realism in photography with the visual communication power of illustration. His "carbon dust" approach set the standard for medical illustration in the early 20th century.
Botanical Illustration
Botanical illustration is not an area I have been as interested in, even though it sits in an equally important scientific niche to medical/scientific and natural history illustration.
Scientific botanical illustration emerged at a time when humans were gaining a deeper understanding and curiosity about the natural world. By the 1800s microscopes had developed to a point where they were considered reliable []. Scientific illustration started to include the microscopic, and botanical illustrators could now reliably interrogate the smallest parts of flora. Simple bifocal magnifiers remain a trusted part of the botanical illustrator's toolkit []. Largely, the medium used for botanical illustration in the scientific space seems limited to pen, ink and watercolour.
Scientific & Natural History
The other topic humans are fascinated by is natural history. This started as early as Paleolithic times, and cave paintings have been discovered that depict animals in reliable detail.
As we explored the world, we discovered new flora and fauna. Explorers and naturalists recorded their discoveries through illustrations. While they also retrieved specimens, they had a tendency to be unreliable by the time they got back to their home port. A combination of decomposition and preservation techniques would change the nature of the animal.
This is why, even today, natural history illustration is an integral part of our research and understanding of the natural world. By illustrating, we can record accurate life-size depictions of smaller animals which can be used as species comparison over time. Given that the medium used to depict the subject can change, there is always the risk that the colours recorded might not be an accurate representation []. The media used in scientific illustration seems to be more varied than botany. Depictions of extinct species like dinosaurs have been made in a variety of paint media while living species seem to favour pencil, ink and watercolour.
Photography
In 1837 Daguerre invented the first practical photography method. Until this point, all scientific visualisation had been limited to illustration. By the 1880s, photography had become reliable enough that science journals started to favour its use. This was down to time and cost as much as visual fidelity, but the journals were proponents of what they deemed the "mechanical objectivity" provided by photographs []. By creating technology to take photographs in quick succession it allowed scientists to understand animals in motion - breaking down movement into its constituent positions. This, of course, forms the basis of modern cinema and animation.
As I mentioned above, I half-expected scientific illustration to die off with the advent of photography. While the scientific journals had an economic case for photography, illustration remained an essential part of scientific research and education. I found a useful breakdown of why illustration still has value over photography []:
Illustration simplifies
It lets us see the inside
Archetype vs. holotype (recording the general aspects of a species)
No model needed
Makes the invisible visible
Describes processes
It’s kinder (can make graphic subjects palatable)
It adapts to the audience
Illustration is art (it creates an emotional connection for better recall)
Later, as photography evolved to be recorded digitally, it was easier than ever to integrate it into scientific equipment like telescopes. The Webb space telescope has allowed us to gather detailed information of the cosmos which is redefining our understanding of the universe. Yet the images we see on TV and other Media are in themselves illustrations. What the telescope records is largely invisible to the human eye. Through a careful transposition process, the Webb scientists are able to colourise the images into fantastic coloured illustrations []
X-Ray Imaging
X-Rays emerged from the field of photography, capturing a frequency of radiation not visible to the human eye. Because the particles travelled through organic objects we gained the ability to see inside the body without surgery. X-Ray photography by Rosalind Franklin was the key to the discovery of DNA.
While X-Ray images are largely used in a utilitarian manner, that hasn't stopped the translucent X-ray style from being widely incorporated into illustrations. X-rays photographs themselves have been turned into art in their own right, such as these colourised X-ray images by Dutch physicist Arie van't Riet:
CT & MRI Scan Imaging
Furthering the X-ray's ability to see inside our bodies, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans were developed in the 1960s and 70s respectively. They detect differently, but both operate on the principle of taking an image 'slice' through an object. When put together one can get a sense of the shape of the internal space, which is essential for detecting even the smallest physical anomaly as early as possible.
Whilst typically black and white like an X-Ray photograph, there are always opportunities to take the images further. In 2007 the above image won the International Science and Engineering Visualization Challenge. Taking multiple CT slices and carefully overlaying them before colourising them gives a picture of the nasal cavity as seen from below. It is effective as an image in both a practical and abstract sense. I think it meets many of the 9 criteria of medical illustration above and is beautiful in its own right.
My favourite interpretation of a scan is this series by Angela Palmer. Using CT and MRI scans of her head, she transposed the contours inside her head layer by layer. Then engraved them onto glad before assembling together to create a three-dimensional representation. It feels like an ink illustration built up from scrawling searching linework.
3D Illustrations
While imaging technologies help to understand the inner workings of an object. Putting that into a context that is easily communicated can be difficult. Digital images have found a place in medical illustration to augment imaging and photography []
Once you have the technology to scan an object layer by layer, it also creates other opportunities to rebuild that object in a three-dimensional manner. This can range from accurately modelling a subject to observe the relationship between aspects of its form,
to more artistic endeavours such as this example where a person decided to turn medical scans of their cranium into a decorative object!
I particularly liked this model of the internal structure of human lungs, which was 3D printed:
This artist took the idea in a different direction, taking CT scans of lungs and then creating a realistic digital image of a 3D sculpture encased in glass:
Accuracy, Impression and Representation
Taking all of the ways that imaging creates opportunities to visually communicate information, the skill of the illustrator is making choices about exactly what should be shown to the viewer in order to get the specific idea or information across.
The illustration above is a good example of how information can be represented anatomically-correctly, yet edited and humanised. The image does not present itself as grotesque or graphic. It is, pun intended, clinical. In an illustration like this, the detail and the relationships are important.
But like all illustrations, the target audience and market also influence choices. My impression is that in scientific illustration it is useful to be able to take on a number of stylistic approaches so that your illustrations can be targeted effectively.
When an item is aesthetically pleasing, it can be a focus for markets outside of scientific illustration. I think this is particularly true of botanical illustration. Here accuracy can still count, but greater liberties can be taken with the execution. They can be depicted more abstractly for impact, and still retain their delicate, intricate nature. Generating visual interest this way allows these illustrations to be used in markets like retail, hospitality, editorial and fine art.
Sometimes, an illustrator may want to communicate the idea of something over accurate details. One of my favourite illustrators for this is Merlin Evans. Like other examples in this learning log, she has a varied scientific portfolio that demonstrates clear and accurate scientific illustrations. However, the part that intrigues me the most is where she explores the inner world of people. She was the first illustrator that made me consider that medical illustration has as much to do why psychiatry and psychology as it does with the physical realm. I realised that when it came to this side of scientific illustration, the accuracy of the image's content was not nearly as important as how it accurately depicts the feeling of the malady, disability or condition.
In this way, we are better able to help people communicate their lived experiences. Something that really appeals to me.
References
Amsen, E. (2021) The art technique that changed medical and scientific illustration, Forbes. Available at: https://www.forbes.com/sites/evaamsen/2021/08/27/the-art-technique-that-changed-medical-and-scientific-illustration/?sh=4f143b1b46f2 (Accessed: 04 August 2023).
Anatomy and Print Technology (2022) U.S. National Library of Medicine. Available at: https://www.nlm.nih.gov/hmd/research-tools/dream_anatomy_timeline.html (Accessed: 04 August 2023).
Artists (2015) Society of Botanical Artists. Available at: https://www.soc-botanical-artists.org/artists/ (Accessed: 04 August 2023).
Birch, S. (no date) 3D reconstruction of chinchilla, Wellcome Collection. Available at: https://wellcomecollection.org/works/usuvxu5g/images?id=ququ6mqb (Accessed: 04 August 2023).
Cohout, M. and Collier, J. (2019) Trepanation: Our ancestors’ idea of neurosurgery, Medical News Today. Available at: https://www.medicalnewstoday.com/articles/326281 (Accessed: 04 August 2023).
Coloured X-rays of animals and plants - in pictures (2014) The Guardian. Available at: https://www.theguardian.com/artanddesign/gallery/2014/jul/07/coloured-x-rays-of-animals-and-plants-in-pictures (Accessed: 04 August 2023).
Corl, F.M., Garland, M.R. and Fishman, E.K. (2000) ‘Role of computer technology in medical illustration’, American Journal of Roentgenology, 175(6), pp. 1519–1524. doi:10.2214/ajr.175.6.1751519.
Crouch, J. (no date) Body, jennifercrouch. Available at: https://jennifercrouch.com/BODY (Accessed: 04 August 2023).
Evans, M. (no date) Portfolio, Drawn to Medicine. Available at: https://www.drawntomedicine.com/new-page-2 (Accessed: 04 August 2023).
gabeffly (2019) Three 3d-printed heads from CT scans, Reddit. Available at: https://i.redd.it/nuxpeotlo2f21.jpg (Accessed: 04 August 2023).
Harper, L. (2021) Equipment: Magnifiers and scalpels, Lizzie Harper. Available at: https://lizzieharper.co.uk/2021/05/equipment-magnifiers-and-scalpels/ (Accessed: 04 August 2023).
How are Webb’s full-color images made? - webbtelescope.org (2023) Web Space Telescope. Available at: https://webbtelescope.org/contents/articles/how-are-webbs-full-color-images-made (Accessed: 04 August 2023).
Inecone (2018) YouTube. YouTube. Available at: https://www.youtube.com/watch?v=TbUyNIC66YI (Accessed: 04 August 2023).
Jędrzejewski, Z. (2022) CT Segmented Lungs, Artstation. Available at: https://www.artstation.com/zibiryst (Accessed: 04 August 2023).
Jobson, C. (2017) Layered MRI self-portraits engraved in glass sheets by Angela Palmer, Colossal. Available at: https://www.thisiscolossal.com/2012/10/layered-mri-self-portraits-engraved-in-glass-sheets-by-angela-palmer/ (Accessed: 04 August 2023).
Kreuger, A. (no date) Medical, Ava Krueger. Available at: https://www.avakruegerart.com/medical (Accessed: 04 August 2023).
Lewin, A. (no date) Watercolours & Collage | Angie Lewin, Angie Lewin. Available at: https://www.angielewin.co.uk/collections/original-work (Accessed: 04 August 2023).
Loureiro, I. (2022) Anatomy and biomedical illustration - isa loureiro scientific illustration, Isa Loureiro - Ilustración científica e infografía. Available at: https://www.isaloureiro.com/en/anatomy-biomedicine/ (Accessed: 04 August 2023).
McVicar, H. (no date) Portfolio, Hannah McVicar Illustration. Available at: https://www.hannahmcvicar.com/illustration (Accessed: 04 August 2023).
The Microscope (2019) Science Museum. Available at: https://www.sciencemuseum.org.uk/objects-and-stories/medicine/microscope (Accessed: 04 August 2023).
Pavid, K. (no date) Capturing colour: The art of scientific illustration, The Natural History Museum. Available at: https://www.nhm.ac.uk/discover/the-art-of-scientific-illustration.html (Accessed: 04 August 2023).
Window on the body: CT scans become art (2009) New Scientist. Available at: https://www.newscientist.com/gallery/dn17411-art-made-in-a-ct-scanner/ (Accessed: 04 August 2023).
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