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A Prism by Which to See How Humans Came to Be: The Anatomical Record Explores the Many Dimensions of the Human Pelvis

2017; Wiley; Volume: 300; Issue: 4 Linguagem: Inglês

10.1002/ar.23560

1932-8494

Jeffrey T. Laitman, Kurt H. Albertine,

Anatomy and Medical Technology

An award-winning, comedy-drama series currently on American Television is “This Is Us.” It is not about extraordinary people, lectern-thumping politicians (heard enough of those!), silver-tongued lawyers, or doctors who can perform brain surgery in the morning and deliver a baby after lunch (love those shows). It is simply about regular people. What is so riveting is that the show constantly pivots to view events from the perspectives of the different characters. The “Us” is not presented as a unidirectional absolute, but, rather, as a metaphysical collective that is determined by the angle it is viewed from. The audience is shown that while there is reality, we can only view it through an ever-moving prism. Welcome to the human pelvis, and the prism through which science and scientists have viewed it over the decades. The beauty, and “purpose,” if such a word can ever be applied anatomically, to the pelvis, is truly in the eye of the beholder. And so it has likely been ever since anatomists started pondering how this oddly shaped bone came to be. This month's The Anatomical Record, Guest Edited by Karen Rosenberg of the University of Delaware and Jeremy DeSilva of Dartmouth College, picks up the gauntlet nature has set before us in an extraordinary Special Issue aptly titled, “The Human Pelvis.” Due to the many approaches and perspectives taken to understand the pelvis and its functions – including posture, locomotion, organ support, reproductive, and birth functions – the Special Issue contains many contributions and therefore will be published in two parts, with this month's covering “Anatomy, function and development” (DeSilva and Rosenberg, 2017, this issue) and next month, “Evolution.” Looking into our archives, we find that the energy and enthusiasm shown in this Special Issue has long been a hallmark of those exploring the many facets of the pelvis within The Anatomical Record. Indeed, some of our country's most respected (and often interesting!) anatomists, surgeons, physical anthropologists, and experimental zoologists, have studied, dissected, compared, measured, or experimented upon, the pelves of an array of species, and published their finding, in our journal. Among these papers is a beautifully illustrated 1909 paper on the anatomy and physiology of the hip joint by Arthur E. Hertzler (1909), an extraordinary physician, surgeon, anatomist, and professor from Kansas in the late 19th to mid 20th centuries. (As an aside, not only has the excellence of science in The Anatomical Record been continuous, so too has the diligence of our staff: the paper was marked “Received” on December 25th, 1908. Our Editorial Office was apparently open even on Christmas! There's a reason our journal has thrived for over 125 years). Hertzler began working on this topic when he was a medical student a decade earlier while at the Waldeyer Institute in Berlin (any anatomist that does not recognize this name, please leave) and, from comments in his paper, received advice and suggestions from Rudolph Virchow (ditto) on its preparation. Obviously, he wanted it to be pristine for publication in the respected, relatively new (our third volume) American journal. While publication in The Anatomical Record was undeniably a boost in the young Hertzler's career, what he became most known for was a widely popular autobiographical book, The Horse and Buggy Doctor (1938) that brought the world of medicine and doctoring of his time to the public at large. For those of us who can remember back to the 1960s and 70s, the character of “Doc Adams,” played by actor Milburn Stone, on the Western series “Gunsmoke,” is thought to be modeled after Hertzeler. Stone was a fellow Kansan who had known Hertzler and admired him greatly (even wrote the Introduction to the above book when it was reprinted in 1970). While TV actors may not have portrayed our other authors (so far), many were of equally great repute, at least in the realm of science. Of particular note, have been those who worked on experimental studies in a range of animals, seeking to uncover basic differences in sexual dimorphism, developmental trajectories, and inter-species variation. Most notable amongst these contributions is the work from another great “character” of science, beloved Yale Professor, mentor, master comparative anatomist, and trumpet-player par excellance, Edmund S. Crelin (the advisor of JL, who has no musical skills, a factor the above would constantly remind him of). Some of Crelin's experimental work on pelvic growth and development in The Anatomical Record are his studies on: rat pelvis response to estrogen (Crelin and Brightman, 1957); effect of the testis on shaping the pelvis in mice (Crelin and Blood, 1961); growth after autotransplanted inter-pubic joints in mice (Crelin, 1963); development of the pubic joint in mice (Crelin and Koch, 1965); development of bony sexual dimorphism in rats (Bernstein and Crelin, 1967); and assessment of development in the pelvis of free-tailed bats (Crelin and Newton, 1969). Crelin was by no means alone, however, in his experimental/comparative approaches to understand the pelvis, with many other studies appearing that spanned the century. These include: the early study by Spurling on extirpation of limb buds, and its effect on limb and pelvic morphology in chick embryos (1923); the study by Ruth (1932) on development of the mammalian pelvis; Whiston's (1940) study in birds of how the femur grows after experimental hip dislocation; Lowrance's (1968) study on linear growth in the rat pelvis; a study (1972) on the development of sexual dimorphism in the bony pelvis of squirrel monkeys by Phillip Gingerich, a 1974 Yale PhD graduate influenced by Crelin, who later became one of the most respected and influential vertebrate paleontologists of the late 20th century; Oelrich's observations on the pelvis and perineum of the male gorilla (1978); and Teguchi's (1989) and Uesugi et al's (1993) morphometric studies of sexual dimorphic development in mice. Many studies have appeared that focus directly on aspects of descriptive human anatomy of the pelvic/hip region itself. These include: Blaisdell's (1917) report of the anatomy of the sacro-uterine ligaments; Barnes’ (1921) study on the pelvic fascia; the work by Spector (1923) on reference models of the female pelvis; Smith's (1923) comparative study of the pelvis and levator ani muscles; those by Greulich and Thoms (1939) on dimensions of the pelvis in “white” females (1938) and their X-ray study on male pelvic variation; Gardner's (1948) study on the innervation of the hip joint; Roberts and colleagues (1964) work on pelvic fascia and relations to neural and vascular relationships; and Jones and Gonzalez's (1981) ultrasonographic study of lumbar spine angulation. The general topic of the relationship of pelvis/hip shape to posture and locomotion has long been a theme of many authors in The Anatomical Record. Indeed, publications by one of the pioneers of electromyography as a vehicle to understand muscle anatomy and physiology, the incomparable John V. Basmajian, graced our journal. Professor Basmajian was one of the premier physician-scientists of the second half of the 20th century; President of the American Association of Anatomists, parent body of this journal; and always a proud son of Canada who was given their highest recognition, “Officer of the Order of Canada,” for his research. His extraordinary book, Muscles Alive: Their Functions Revealed by Electromyography (1962), is considered a hallmark in the fields of anatomy, physiology, kinesiology, rehabilitation medicine, and biofeedback science, among others. (As an interesting aside, Basmajian and Crelin were friends and followed each other's work closely. Because Crelin did not like to travel, and became somewhat of a New Haven “recluse,” the gregarious and ever-kind Professor Basmajian would always find a way to visit Yale when he came “south of the border,” as he would say. What an extraordinary gift this was for us Yale graduate and medical students to listen to these giants of anatomy speak about their novel science.) Among the articles Basmajian published are: his classic description of the electromyography of two-joint muscles (Basmajian, 1957); his equally noted description of the electromyography and cinematography of the leg and foot (normal and flat) during walking (Gray and Basmajian, 1968); and his study on electromyography of the sartorius muscle (Johnson et al., 1972). As noted, many others have contributed their science on the interface of the pelvis/hip and lower/hind extremities to posture and locomotion. Some examples include: Evan's (1946) study of salamander locomotion; Haxton's (1947) comparative study of muscle differences of the pelvic limbs among bipeds and quadrupeds; the study by Milch (1961) on measurements of pelvi-femoral motion; Roberts’ (1963) examination of the locking mechanism of the hip; a study by David Burr and colleagues (Burr, 1982, on femoral mechanics in galagos and what such adaptations can tell us about leaping behaviors in primates. Burr is a noted anatomist and physical anthropologist who became one of the most respected musculoskeletal biologists of the latter part of the century and, like Basmajian, also President of the American Association of Anatomists. He is also a third cousin of the famous Aaron Burr, third Vice-President of United States under Jefferson, and dispatcher of Alexander Hamilton, which may explain why few have ever had the temerity to challenge Professor Burr in public!); and Suzuki and Tamate's (1988) study on distribution of myofiber types in sheep hip and thigh muscles. There are many other contributions that overlap onto questions of pelvic, hip, and locomotor evolution, but we will visit those within our next part of the Special Issue on “Evolution.” As is seen by our brief visit through the rich vault of The Anatomical Record, our journal has housed the efforts of some of the best and brightest who have approached the pelvis and the myriad of questions on how it came to be. While they have offered much, a journey into this world can remind one of the ancient Indian story of the blind men and the elephant, in which each felt a different part and came to a totally different conclusion as to what the animal looked like. Hopefully, through an undertaking such as our Special Issue, the good science from varied approaches and views will be both seen and appreciated by researchers who traditionally view the “elephant” from their distinct prism. As the real “Story of Us” encompasses much in this region, it is our hope that this very special, Special Issue will serve to introduce new perspectives and thoughts about a core feature of the human story.