The Neuroanatomical Plates of Guido Da Vigevano

Neurosurg Focus 23 (1):E15, 2007 The neuroanatomical plates of Guido da Vigevano ANTONIO DI IEVA, M.D.,1 MANFRED TSCHABITSCHER, M.D.,2 FRANCESCO PRADA, M.D.,3 PAOLO GAETANI, M.D.,1 ENRICO AIMAR, M.D.,1 PATRIZIA PISANO, M.D.,1 DANIEL LEVI, M.D.,1 NICOLA NICASSIO, M.D.,1 SALVATORE SERRA, M.D.,1 FLAVIO TANCIONI, M.D.,1 MASSIMO AROSIO, M.D.,4 AND RICCARDO RODRIGUEZ Y BAENA, M.D.1 Departments of 1Neurosurgery and 4Anesthesiology, Istituto Clinico Humanitas IRCCS, 3Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico “C. Besta,” Milan, Italy; and 2Center of Anatomy and Cell Biology, Medical University of Vienna, Austria PGuido da Vigevano was an Italian physician and engineer who lived in the 13th and 14th centuries. He was the first scientist who used pictures to illustrate his anatomical descriptions, developing for the first time a close relationship between anatomical studies and artistic drawings. This was further developed in the Renaissance. In his textbook Anathomia are displayed six plates showing for the first time neuroanatomical structures and techniques: dissection of the head by means of trephination, and depictions of the meninges, cerebrum, and spinal cord. On the surface of the brain painting it is possible to recognize a vague pat- terning of cortical convolutions. Ventricles are also described and shown. This book constituted the first attempt in the history of neuroscience to illustrate an anatomical description with schematic pictures to achieve a better understanding of such complex structures. (DOI: 10.3171/FOC-07/07/E15) KEY WORDS • anatomical plate • Guido da Vigevano • Middle Ages • neuroanatomy “Anatomy to the surgeon is like the Sun for our planet.” more teutonico). The subsequent trade of relics and bones —R. F. Spetzler (engaged in especially by Neapolitan sailors) forced Pope Bonifacius VIII to promulgate the papal bull “De Sepol- HE WORD “ANATOMY” derives from the Greek word turis” in 1300 to prohibit the manipulation of human bod- “ana temnein,” which means “to cut up.” Anatomy ies.17 He did this despite the fact that Emperor Frederic II T is an ancient discipline that has always involved had promulgated a decree in 1240 by which dissections controversy. were tolerated. Subsequent popes promulgated other bulls that allowed Early Anatomists human dissections during the Lenten period, especially in 10 The first anatomists in history (Erasistratus, Herophilus women, who were believed to have no soul. During this of Calcedon, and so on) performed many dissections in period religious limitations and regulations on human dis- human beings, but for more than 1500 years Galenic the- sections were not clear, but it was often the common peo- ories, based on observations in animals, dominated the ple who were more against such practices than the author- study of human anatomy. It is known that Galen per- ities.7 formed dissections only in animals, especially apes, oxen, pigs, and sheep. His most important anatomical work, De Mondino de’Liucci (ca. 1270–1326) Anatomicis Administrationibus, was based on studies performed in monkeys (Macacus inuus). These observations The first officially sanctioned dissection in the Middle were then arbitrarily adapted to humans, leading to erro- Ages was performed at the University of Bologna by neous descriptions of the human anatomy.4 Mondino de’Liucci (or dei Luzzi) (ca. 1270–1326). He In the Middle Ages, autopsies and dissections in hu- completed his book Anathomia Mondini in 1316. This mans were a controversial and restricted practice, espe- was the first book entirely devoted to the structure and cially limited by religious and popular beliefs. During the function of the human body, and was used for teaching Crusades, dissections of cadavers were permitted only to anatomy for more than 200 years.5 Mondino personally remove the inner organs to carry and bury the remains performed many dissections in human cadavers, distanc- more easily in their native land (the so-called sepultura ing himself from the custom of the time, in which the dis- Neurosurg. Focus / Volume 23 / July, 2007 1 Unauthenticated | Downloaded 09/28/21 08:57 PM UTC A. Di Ieva et al. section was performed by a servant, also called a barber, under instructions from the master.4 With his work he created considerable criticism with respect to Galen’s theories. Mondino was therefore considered to be a “Restorer of Anatomy.”4 Nevertheless, the Anathomia Mondini was lacking drawings and pictures to explain the text. Guido da Vigevano (1280–1349), Mondino’s pupil, also performed dissections in cadavers, and his anatomy manuscript Anathomia, published in 1345, marked the be- ginning of a new trend that became increasingly wide- spread during the following centuries: the use of anatomical illustrations in textbooks.12 In his manuscript Guido da Vigevano displayed for the first time six plates showing the head, brain, and spine. These pictures, although schematic and rudimentary, can be considered to be the first neuroanatomical drawings in the history of neuroscience. The years between 1280 and 1349 are considered to be pivotal in the history of medieval anatomy. The systematic anatomical drawings introduced by Guido da Vigevano in his textbook, although based on empirical and observa- tional concepts,3 set a milestone for further development of anatomical science, especially in the Renaissance. It is in this period that the marriage between science and the arts reached an apex with the publication in 1543 of the De Humani Corporis Fabrica by Andres Vesalius. This legendary work blended the study of human anatomy with the beauty of artistic drawings.4 FIG. 1. Plate XI shows trephination of the head by means of a Guido da Vigevano (1280–1349) scalpel and a hammer (from Wickersheimer E: L’Anatomie de Guido da Vigevano, an Italian physician and engineer, Guido de Vigevano, médecin de la reine Jeanne de Bourgogne was born in Vigevano, one of the most ancient Longobard (1345). Archiv für Geschichte der Medizin 7:1–25, 1913). cities in the Lombardy region (described in Wicker- sheimer17 as a “petite ville lombarde, qui au XIV siècle fai- sait partie du diocèse de Pavia.”), sited between Milan the prototype of the first autovehicle in history; the word and Pavia. He studied medicine in Bologna, learning “automobilis,” meaning “self” and “moving,” was created anatomy from Mondino. He was the personal physician of in the 14th century by the Italian engineer Martini, who Emperor Henry VII until that ruler’s death in 1313; later invented but never built a crankshaft-driven, four-wheeled on he was very close to the King of France, Philip VI, and vehicle.1,13 King Philip never left for the Holy Land, how- from 1335 until her death in 1349 he was the personal ever, and Guido’s wonderful machinery was therefore physician of the Queen of France, Jeanne de Bourgogne. never tested.10 He wrote books about medicine, anatomy, hygiene, and Guido da Vigevano dedicated another book to Philip VI “the art of war.”6,15 titled Anathomia Designata per Figures. Written in 1345, In 1335, King Philip VI of France was planning a new it included 24 anatomical plates, 18 of which have been crusade in the Holy Land. Guido, to strengthen his posi- lost. The plates numbered XI to XVI display the first neu- tion with the king as his personal doctor and engineer, roanatomical pictures and descriptions in the history of wrote and dedicated to him a “crusade book.” In this there neuroscience. were nine folios advising the king on how to take care of Guido’s purpose was to show human anatomy by his health during the journey, and 14 more folios advising means of schematic and systematic drawings of his dis- him on military technology.10,14 This booklet, titled “Tex- sections (“demonstrabo anathomiam corporis humani pa- aurus Regis Francie Aquisitionis Terre Sancte de ultra tenter et aperte, per figuras depinctas recte”).16 Mare,” included instructions on prefabricated portable The book is divided in four sections, as follows: siege equipment in consideration of the difficulty in find- 1) introduction; ing wood in the Holy Land, proposals for innovative body 2) description of the veins for bloodletting; armors, and sketches of military apparatus.9 In this pre- 3) explanation of the drawings; and cious manuscript it is possible to find drawings of many 4) appendix on the swelling of the uvula and palate. machines such as attack boats, pontoon bridges, and also In the third book, six plates (XI–XVI) are dedicated to two self-propelled battle wagons, one crank-driven and the anatomy of the central nervous system. Five plates the other powered by a very sophisticated windmill on the (XI–XV) show the head, meninges, and parts of brain, and back a wooden carriage.10 This last one is considered to be the sixth (XVI) shows the spinal cord. 2 Neurosurg. Focus / Volume 23 / July, 2007 Unauthenticated | Downloaded 09/28/21 08:57 PM UTC The neuroanatomical plates of Guido da Vigevano FIG. 4. Plate XV (detail of right side of Fig. 3). On the surface of the brain it is possible to recognize some sulci and gyri, and five orifices, two in the anterior frontal region, representing the olfacto- ry nerves, and three in the frontoparietal region, representing the three ventricles. It seems to be the earliest portrayal of cerebral convolutions in the history of neuroscience (from Wickersheimer [see FIG. 2. Plates XII (left side of panel) and XIII (right side of Fig. 1 legend]). panel) depict the removed cranial vault, on which it is possible to recognize the frontoparietal and interparietal sutures, and the exter- nal meningeal layer (from Wickersheimer [see Fig.

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