Moulage

Up until the 16th century, European scientists had little knowledge about human anatomy and anatomy of animals. Medical students of Bologna and Paris studied the books of Aristotle, Galen, and other Greek scholars. Four centuries after the invasion by the Arabs and the fall of Rome and Persia, many Greek books were translated into the Arabic language. European scientists then translated these Arabic books into the Latin and Greek languages. In the medical field, this led to a reliance on Galen as a medical authority in European countries. In European medical schools the professors of anatomy merely lectured from Galen, without any dissection of the human body, and Galen’s books were the only way to learn anatomy.

Anatomical moulages (torso)

Andreas Vesalius (1514–1564), a Flemish anatomist, was at first a "Galenist" at the University of Paris. When he moved to Italy and entered the University of Padua, he began dissecting human bodies. He studied many details of human anatomy and found that Galen made some anatomical mistakes. For example, Galen wrote that the sternum has seven segments, but Vesalius found it has three segments. Galen wrote that the bone of the arm is the longest bone in the human body, but Vesalius found that the bone of the thigh is actually the longest bone in human body. At age 25 Vesalius realized that the anatomical knowledge of Galen was derived from animal anatomy and therefore Galen had never dissected a human body.

In 1543 Vesalius wrote an anatomical masterwork named in Latin De humani corporis fabrica libri septem ("On the fabric of the human body in seven books"), or in short De Fabrica. The book included drawings of human females and males with their skins dissected.[4] These pictures greatly influenced the creation of future anatomical wax models. The anatomical pictures of Vesalius were followed by those of Johann Vesling ("Veslingius") and Hieronymus Fabricius. By 1600 Fabricius had gathered 300 anatomical paintings and made an anatomical atlas named the Tabulae Pictae. Giulio Cesare Casseri ("Casserius"), Spighelius, and William Harvey are other followers of the pictures of Andreas Vesalius.

The Tabulae anatomicae of Bartolomeo Eustachi ("Eustachius") (1552), printed in 1714, had a major effect on the history of anatomical wax models. This work so affected Pope Benedict XIV that he ordered construction of a museum of anatomy in Bologna In 1742, named Ercole Lelli and featuring anatomical wax models. Felice Fontana made cadaveric specimens into wax models by the casting method for anatomical teaching.[5]

The history of wax models is ancient. Wax anatomical models were first made by Gaetano Giulio Zummo (1656–1701) who first worked in Naples, then Florence, and finally Paris, where he was granted monopoly right by Louis XIV. Later, Jules Baretta (1834–1923) made more than 2000 wax models in Hospital Saint-Louis, Paris, where more than 4000 wax models were collected. While wax models were being made, he made pleasant conversations with the patients, sang songs or at times played the piano. Moulages were made for the education of dermatologists around the world, but were eventually replaced by color slides.

Modern moulage

Practical effects such as bullet hit squibs are sometimes used during training to enhance the realism. Here, squibs are embedded in the costume worn by the actor bursting out fake blood and smoke.

Moulage has evolved dramatically since its original intent. In modern terms, the word moulage refers to the use of "special effects makeup (SPFX) and casting or moulding techniques that replicate illnesses or wounds"[7] in simulation based techniques. Common examples include designing diabetic wounds, creating burns or other illness effects, like dermatological rashes[8][9] and gunshot wounds.[10]

Example of moulage on a manikin

These illness and injury effects are applied to training manikins or simulated or standardized patients for training or other purposes. Simulation staff attend training to learn these techniques. It is argued that the use of moulage in simulation improves realism or participant buy-in.[8] Moulage is an emerging field of research for paramedicine, radiography and medical education,[11][12][13] with researchers exploring how moulage contributes to learning in training. Military training utilises highly-authentic moulage techniques to desensitise to graphic wounds, prepare for battle, and treat injuries.[14] New advancements in the field include using tattooed injuries and moulage through augmented reality.[15] The level of authenticity required for moulage remains unclear.[7]

• Makeup
• EMS
• Objective Structured Clinical Examinations (OSCE)
• Theatrical blood

Wikimedia Commons has media related to Moulages.

• Sammlungen International Overview of moulage collections of the Charité Berlin
• Museum of Moulages, University of Zurich (English/ German)
• Jacobi, Eduard (1913) [1903]. Atlas der Hautkrankheiten [Atlas of Skin Diseases] (in German) (5th ed.). Berlin: Urban & Schwarzenberg. OCLC 250681193.
• "Search Our Collection". Museum of Health Care. Retrieved December 3, 2011.
• Gordon, Ken (December 3, 2011). "OSU clinical instructor crafts simulated injuries, giving nursing students a more realistic look at trauma". The Columbus Dispatch. Retrieved December 3, 2011.