Ex Libris RCPE Thomas Willis, London, 1664 Thomas Willis Willis and His Circle Thomas

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* All 3 277 40:277–9 Cerebri anatome 318 doi:10.4997/JRCPE.2010. Anatomist, Doctor Richard Richard Doctor Anatomist,

J R Coll Physicians Edinb 2010; © 2010 Royal College of of Physicians Edinburgh Therefore Therefore thenceforward I betook Opinions of others, nor suspicions and guesses on of my the own mind, but for the future to believe and ocular demonstrations: Nature Cerebri anatome, by playwright and the translator was published in Pordage, 1681. Samuel poet, I determined with my self seriously to enter thing, one presently this on rely to and course, upon a new not to pin my faith on the received the English quotations below from are this translation, of which the Sibbald Library has a copy. In his preface, Willis sets out intentions thus: his being laid aside, all delay Wherefore And here I made of the Labours of the most Learned Learned most the of Labours the of made I here And skilful highly and Physician Lower, for my help and Companion; Wit I willingly acknowledge to have the whose Knife and edge of both out searching better the for me to help an been the frame and offices of hidden before Bodies… myself myself wholly to the and study Anatomy: as of I did chiefly inquire into the offices and uses of the Brain and its nervous Appendix, I addicted myself to the opening of and Heads of especially, every kind [that of species] many … and so a firm is, and stable Basis might be laid, on what but which Schools, the in gained not had I than Physiologie only a more certain I had long the thought Pathologie upon, of the Brain might and be nervous built. stock, is the result of close collaboration: Although Willis is now best describe accurately known the details as of the the name, his bears that brain the of circular base the at anastomosis first arterial to Cerebri anatome was description also of the a anatomy much of nerves the than more brain had and previously accurate been cranial given. It comprehensive and is the satisfactory first account of the anatomy of the human gross Willis nervous was system. part of the circle of experimental philosophers in Oxford in the 1660s and was assisted interpretation in by others his of observations the and group, particularly Richard by Lower (1631–91) who would, five years later, publish his own great work on Willis the is circulation. generous in his acknowledgment of a great debt to the skill of Lower’s acknowledgements make it dissection; clear that indeed, although was the Willis driving and coordinating force, his generous Cerebri anatome anatome Cerebri

of ex libris RCPE Thomas Willis, London, 1664 Thomas Willis Willis and his circle Thomas

: Traité de Traité l’homme 2 of Thomas Willis and 1 Cerebri anatome Ex libris René Descartes. The approach of the Descartes two was books primarily is coherent account interested very of the function different. in of the brain providing relationship and to The the its result self. was a a dualist theory of a machine which functioned on mechanico-hydraulic principles as well as a soul which communicated with, was informed by and ultimately controlled the machine. It is not true that Descartes ignored cerebral anatomy – far from in it, fact – but he was willing to modify his account of the anatomy and even to invent unobserved structures as the theory required. Willis shared with Descartes the aim of understanding the understanding function for basis of a provide the to this normal extend to nervous wished system but also the pathology He of – believed the or diseased at brain. details the of examination meticulous that – hoped least of the anatomy of comparison the of human this with nervous animal system neuroanatomy provide would and such a basis. structure was paramount For and was not to be subject him, to observation of modification or invention real to fit any Willis theory. was truly an experimental philosopher in the William tradition Harvey; of for both men ‘ocular demonstration’ was absolutely paramount and not received authority, opinion or speculation. An excellent and translation of still a eminently number of readable Willis’s works, English including Studying the structure and function of the nervous system posed enormous problems from ancient times until well after the Renaissance. nervous system’s anatomy was difficult The central to fathom because, without it fixatives, rapidly becomes semi-fluid after death. Its function was even more partly obscure, because of appropriate method investigative other the lack of than observing any effects of gross anatomy lesions after even also, but function, on began to be unravelled in the teenth seven- century, the prevailing Galenic humoral theories made no predictions that were open to experimental the However, new test. experimental philo- rose century seventeenth the of sophers to the challenge. The year 1664 saw the publication of two books Cerebri anatome that greatly influenced system, thinking the about the nervous the ‘original’ the French version of the IML Donaldson

Figure 2 Wren’s figure of the base of the human brain, showing the arterial anastomosis, now called the Circle of Willis, and a number of the cranial nerves.

Another collaborator was the physician (Sir) Thomas Millington (1628–1704) who was a close friend of Willis and succeeded him as Sedelian Professor of Natural History in 1675. He later developed a lucrative London practice, and was very active in the Royal College of Physicians of London, becoming its president from 1696 until his death.

Figure 1 Diagram of the distribution of some of the The third principal collaborator was Christopher Wren, cranial and spinal nerves and of the ‘wandering pair’ (vagi), recently (1661) appointed Savilian Professor of Astronomy; the accessory and phrenic nerves. Note the recurrent laryngeal nerves shown, correctly, looping round the he took part in the dissections and in the discussions, but subclavian artery on the right (black arrow) and the aortic his most striking contribution to the work was to draw arch on the left (blue arrow) and giving off cardiac branches. many of the illustrations for Cerebri anatome (Figure 2). His architectural renown was yet to come. After this when we entred upon a far more difficult task viz. the Anatomy of the Nerves [Figure 1] then But the other most renowned Man, Dr. Wren, was very much appeared the plainly to be admired skill of pleased out of his singular humanity, wherewith he this Man, as also his indefatigable Industry, and abounds, to delineate with his own most skilful hands unwearied Labour: For having prosecuted with a many Figures of the Brain and Skull, whereby the most exact search, all the divarications, wandering on work might be more exact. every side of the Nerve, how minute or small so ever, and immersed, and variously infolded within other Willis was under no illusions about the difficulty of Bodies, and so turning over the Labyrinths of the understanding the function of the nervous system; he is Branches, and shoots of every pair, far and near explicit about why this was so much more difficult than diffused, he drew out with his own hand the Schemes, understanding the functions of other organs: Images or Draughts of them and also of many passages of the Blood, as they appear in this Tract; For in most of the Viscera and Vessels, the Contents which indeed, that they might be faithfully and most and contained humors, as also their passages within exactly shewn, without any falsity or errour, he the larger Cavities of the containing parts, are caused, that no Table might contain scarce any line or discerned by the sight: But in the Brain and Nerves, history the most light passage, whose confirmation and exact neither the rushings on or impressions, viz. the habitude he had not found proved by the marks or Animal Spirits themselves, nor their traits or inspection of many Animals for that purpose killed. footsteps, can any ways be seen. Wherefore to

explicate the uses of the Brain, seems as difficult a with diligent care and great trust collected the task as to paint the Soul, of which it is commonly various appearances and Arguments of Observations said, That it understands all things but it self; for in by a manifold Dissection. truth, the unwearied labour of the Brain beholds or searches the hidden places of other Bodies, in the This he and his friends achieved magnificently. Cerebri mean time the oeconomy or regiment of its own anatome was a new departure in its precision and Family and Kingdom being wholly hid and unknown. thoroughness. The evidence of Lower’s meticulous skill in the dissection of the peripheral nervous system leaps Here one may imagine Willis thinking wistfully of William from the fine engravings. The results of the endeavours Harvey’s success in understanding the action of the of Willis’s circle do truly form the base from which the heart as the result of his observations and experiments. gross anatomy of the brain and spinal nervous system Willis had been a student in Oxford about the time that could be, and was, built. Harvey was briefly Warden of Merton College, early in the Civil War, although Harvey left Oxford in late 1646, Willis made other important contributions to medicine the year that Willis obtained his medical degree. and pathology. He realised that the circular anastomosis that now bears his name would provide an alternative Willis was a man notable for his religious observance in route for the cerebral blood supply if one carotid were to difficult times. Anglican services were held in secret at be obstructed. He distinguished between local and his home during the occupation of Oxford by the generalised epileptic attacks and proposed that epilepsy Parliamentarian army. He makes it quite explicit in the was caused by a sort of explosion of nervous activity. He dedication of Cerebri anatome to the Archbishop of described a type of palsy in which the degree of weakness Canterbury that natural philosophy and Christian varied with time and was made worse by fatigue – the theology are not to be seen as alternatives nor as disorder that we now recognise as myasthenia gravis. competitive. But, unlike Descartes, he does not speculate on the relationship of the soul to the body. His more For a brief account of Willis’s life and more information modest aspiration is: about the seventeenth-century physician and experimental anatomist, including more about his observations on the But what we profess to be performed by us in the cerebral arteries and the subjects of his other publications, following Tract, and hope for the future from the help the reader is referred to Symonds.4 or labour of others, is chiefly this; to wit, that we have not rashly described the parts themselves, of IML Donaldson, Honorary Librarian, RCPE which the Anatomy is instituted, but that we have (email: [email protected])

References NOTE

1 Willis T. Cerebri anatome, cui accessit nervorum descriptio et usus. * ‘Ocular demonstration’: Willis’s Latin is sed in posterum ex Naturae London: James Flesher, Joseph Martyn and James Allestry; 1664. & Aυτοψiας fide penderem (in future to put all [my] trust in 2 Donaldson IML. The Treatise of man (De homine) by René Nature and in my own observations). The 1681 translation’s use Descartes. J R Coll Physicians Edinb 2009; 39:375–6. of ‘ocular demonstration’, although it fits very well the idiom of 3 Willis T. The remaining medical works of that famous and renowned the time, is a little misleading for the modern reader. William physician Dr Thomas Willis. Transl. S Pordage. London: Dring, Harper, Harvey’s famous phrase on ‘ocular demonstration’ in the Leigh and Martyn; 1681. dedicatory letter to Dr Argent of the De motu cordis was: Sed iam 4 Symonds C. Thomas Willis, F.R.S. (1621–1675). Notes Rec R Soc per novem & amplius annos multis ocularibus demonstrationibus in Lond 1960; 15:91–7. doi:10.1098/rsnr.1960.0008 conspecto vestro confirmatam (For nine years and more now, I have shown the correctness [of my discovery] by visible demonstrations before your eyes). Harvey says that he has shown his results to others for them to observe and verify. Willis speaks of uncovering the truth for himself by his own observation, Aυτοψiας. history