At age 15, William Cheselden apprenticed himself to a noted London surgeon. Seven years later, in 1709, he emerged as a surgeon himself. Unable to immediately develop a practice, he taught anatomy and eventually turned his class notes into a book, The Anatomy of the Humane Body. It was wildly successful, partially because it was in English rather than Latin, which was the norm at the time. The book proceeded through 13 editions and was the go-to source for surgical anatomy for a hundred years.

Based on his deep understanding of anatomy, Cheselden became an adept surgeon—setting fractures, removing cataracts, and especially extracting bladder stones. He devised a new approach to the bladder and could remove a stone in less than a minute after the initial incision. Since general anesthesia had yet to be discovered, the lightening-fast surgery not only shortened the patient’s agony but also reduced the procedure’s mortality incidence to a previously unbelievable 10%. Cheselden’s reputation spread, and he became the preeminent surgeon in England if not the world.

Further successes ensued. Queen Caroline appointed him as her personal surgeon. Cheselden was instrumental in persuading King George II to dissolve the two-hundred-year-old charter that had formed the Company of Barber-Surgeons. His circle of friends included Alexander Pope and Isaac Newton.

Cheselden is best remembered, however, by what might be considered a failure. Understanding that skill in surgery requires a thorough understanding of anatomy, in 1733 he published Osteographia, or the Anatomy of the Bones. This was the first and only volume of what he anticipated to be a three-volume set of anatomic illustrations. Osteographia took several years and £17,000 to complete. It was the first book devoted solely to bone anatomy. It sold only 97 copies. Yet Osteographia is a treasure of anatomy, artistry, and human culture.

In the Middle Ages, anatomical drawings were symbolic and crude. During the Renaissance, however, artists began to understand perspective and shading—techniques that were critical to rendering three-dimensional objects accurately onto paper. Even so, just a slight shift of the artist’s head or an urge to highlight a shadowed surface could distort the result. This was an outcome that Cheselden wanted to avoid. If surgeons were to have an absolutely accurate representation of the skeleton, the subtleties of each contour had to be perfect. Medical photography would not be available for another hundred years; and until then, dissections and drawings were the only ways to learn and to teach anatomy.

Under Cheselden’s guidance, two artists accomplished his aim of drawing with absolute accuracy. Unique at the time for medical illustration, they did so by suspending the bones from a tripod, which they placed in front of a large wooden box. It had a tiny hole in one end where light and an image of the bones could enter. The artist sat at the other end and traced the detailed features of each bone image on glass plates, which Cheselden then converted to engravings. Cheselden’s generation knew this box device as a camera obscura. Perhaps it is better known today as a pinhole camera—a giant one.

Osteographia ranks as one of the all-time great anatomy atlases in scope and elegance. The camera obscura, depicted on the book’s title page, signals the work’s accuracy. Its sensitivity and elegance become quickly evident when noting the exquisite detail of the drawings, their arrangement on each page, and the lack of overlying labels or lines. Cheselden posed a complete human skeleton on its knees with its hands in prayer. He did so to preserve the relative sizes of the bones while fitting the largest possible image onto one page. Cut-away images illustrate the interior structure of bone and the means by which bones grow longer.

Interspersed with depictions of normal anatomy are images of bone pathology. For instance, plates illustrate a skull riddled with syphilis, an arm bone showing the chronic effects off a gunshot injury, and shin bones distorted by fractures. All would be instructive to doctors. The text is sparse. Cheselden knew that the images could tell their own story.

For comparison, Cheselden included in Osteographia scattered images of other animals’ skeletons. The animals are naturally posed–a dog and cat snarl at one another, a bear claws the bark off a tree. It is obvious that Cheselden loved bone. Osteographia is his enduring legacy.  None the less, medical illustration was eventually superseded to a great extent by photography. In a way, Cheselden anticipated the change, because, after all, he used a camera (obscura) to enhance the accuracy of his drawings. 

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