The Image Series: Open Wombs

Series November 23, 2015 3:23 pm

The Image Series invites HASTS affiliates and guest authors to write freely about one image relevant to their work.  To contribute to this set, contact Lan Li at

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The image above was found with other anonymous, anatomical illustrations, at the end of an eighteenth-century manuscript of Tibb-i-Akbar. Though the illustrations seem to be separate from the Tibb-e-Akbar, the text itself was written in Persian in 1700 by Muhammad Muqim Arzani, a Sufi physician from Gilan.

When examining this anonymous, anatomical illustration, found appended to a manuscript of the Persian medical text Tibb-i-Akbar (1700), we see a woman holding open a flap of skin, inviting the reader to look inside. While the style of painting seems characteristic of much of the artwork produced under the Mughals in South Asia (see, for example, this image from an earlier “cookbook,” the Nimat-Nama (1550), which could have been written by physicians at Giyath Shahi’s court), the genre of body illustrations featuring a person holding open her body to expose her anatomy was an increasingly common mode of anatomical drawing in Italy during the 16th and 17th centuries, and displayed over a variety of media.

Look again the painting from Arzani’s Tibb-e-Akbar, this time along side a print from Spiegel and Casseri’s De formato foetu liber singularis (1626):

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Now the image does not appear so strange. Both women invite the reader to the look inside and each hold in her hand a fruiting plant. But let’s put aside for now the many interesting details included by the artists/engravers who produced these drawings/prints.

There are basic anatomical differences in the way the organs in the Mughal drawing fit together compared to those presented in Casseri’s prints and texts.  These differences help us reflect on the number of different trajectories that Galenic medicine encountered beyond a European context during a period of robust intellectual exchange between Europe and the Islamicate world.  One single way of presenting the body did not immediately win out across Italy to the Middle East to East Asia, which many scholars of early modern medicine are working to show.

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Other pages by the same artist also found in the Tibb-e-Akbar manuscript depict disembodied organs in detail, without the body.  For instance, notice illustrations of organs surrounding the figure, such as the heart and the lungs.

Turning our attention back to the organs of reproduction, illustrations of the uterus point to the “horns,” the ovaries, pubic hair, etc, along with a fetus at the center. The fetus is drawn in a highly stylized way, reminiscent of how adults appear in other Mughal art; it resembles a “person” more than it does a “baby.”  The artist, presumably, having seen babies before, did this intentionally and perhaps in keeping with the contemporary artistic mode of depicting humans.  Additionally, in contrast to the fetus shown in the Casseri print, the illustrated fetus in the Mughal-era text does not fill the womb in the close-up or in the full-length anatomical picture of the woman.

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But there are many anatomical similarities in the Italian and Mughal illustrations, the most striking of which is the umbilical cord of the fetus, featured prominently in both.

Ancient Greek medical texts offered dense descriptions of the umbilical cord (which grew increasingly technical over time), but the main gist of them is that the embryo breathes and takes in nutrition through the umbilical cord.  But the function of “breathing” is very different from our biomedical understanding of respiration.  To get a sense of this, read the following passages from an early Arabic translation of a Hippocratic text, On the Nature of the Child.  This text significantly influenced subsequent medical writings on fetal generation and sex differentiation (Lyons & Mattock, 1978; Ragab, 2015). What is interesting is that in these passages, the umbilicus is referred to with the same word as the navel (surrah):

“The thin white tissue visible… is on the middle of the navel, and nowhere else, because the spirit (rūh) paves a road for the soul (nafs) there.” (Lyons & Mattock, 51)

This passage appears after a long discussion of respiration (tanaffus), and the scholars who first translated this text into English (Lyons & Mattock) have interpreted nafs to mean the same thing as hawa’, or air. It is clear, however, that these are distinct processes, both involving the umbilical cord as the path for the passage of different substances. The kind of nutrition described in tandem with the way the fetus breathes, in which it is taking nutrition from air (hawa’), is strange to our modern sensibilities. It is also different from the passage below from the same text, in which nutrition is discussed in a way more familiar to us, where the fetus’s source of nutrition and food is connected to the mother:

“The nutrition of the fetus is derived from its mother’s nutrition as well, and it takes nutrition only through its navel.” (Lyons & Mattock, 70)

Many physicians who wrote books on medicine in Arabic and Persian saw themselves as participating in the same medical tradition as Hippocrates and Galen. Thus, they used the physiological terms first introduced by the Greeks–even when they worked these terms into entirely new physiological understandings. Some of the most relevant terms used by ancient and medieval writers describing the way the fetus uses its umbilical cord are:

English spirit soul
Arabic روح  (rūh) نفس (nafs)
Greek (pneuma) πνεύμα (psuche) ψυχή


This can get confusing, in part because the meaning of spirit and soul varies greatly with time in medical and philosophical discourses. As Nahyan Fancy has shown, everything about these terms, from what the soul and spirit were made of, to where they were in the body, to what they did there, was contested between the Greek Aristotle, the Roman Galen, the Persian Ibn Sīnā and the Arab Ibn al-Nafīs. (See Fancy 2013, pp 69-95)

However, as far as I can tell, none of these hugely influential figures disputed that the way the soul, air, spirit, nutrition, or anything else entered the fetus is through the umbilical cord. It would require a careful (perhaps dissertation-length) study of 17th-18th century medicine under the Mughals to know exactly why the illustrator(s) chose to draw each organ the way they did in the manual. The clarity and centrality in the depiction of the umbilical cord, however, is no doubt related to its long-standing role as the pathway of  life for the fetus, no matter how vast the differences in physicians’ understandings of what those life-giving processes were.


Illustrations from Tibb-e-Akbar and De formato foetu liber singularis come from the National Library of Medicine’s brilliant repository, Historical Anatomies on the Web.


Shireen Hamza is a PhD student at the History of Science department at Harvard. She studies the history of medicine in the early Islamic world, with interests in gender & sexuality, and the exchange of medical knowledge and technologies between languages and regions. Much has been done and remains to be done on how Arabic medical writings journeyed West, and she hopes also to trace these movements further East into South Asia and beyond.

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