Ventricular anatomy: illustrations and concepts from antiquity to Renaissance

The localization of motor and sensory activities, the “rete mirabile” and the localization of the mental processes – the seat of the soul – in the ventricles or “cells” of the brain were ancient Greek concepts which were handed down to the middle ages. Although this last concept had not fully matured during classical antiquity its basic elements can be traced to Galen’s works. Even though there were dissections (mostly animal) and enough visual material, the concepts were passed through writings with rare medical illustrations. With the death of Galen in 199 anatomical dissection of either scientific or medical reasons was absent in both Europe and Islam for over a thousand years. It began again in thirteenth century Italy, first for forensic purposes and then as a way of illustrating Galen’s anatomical works for medical students [1]. As the Renaissance men began doing their own dissections, medieval physiology, passed through translations of Arab scholars, confronted with their anatomical dissections. Being not able to totally rid themselves from medieval learning there became a transitional period in which medieval physiology was superimposed upon Renaissance anatomy [2]. In this article we shall narrate ventricular anatomy from “the Alexandrian series” to the Renaissance transitional period; touching some other medieval concepts when relevant. The functional role of the ventricles began with Herophilus of Alexandria (ca 270). The uniqueness of the Alexandrian anatomy nexus is revealed by the fact that not only was human dissection first practiced in that city, but this was the first and virtually the only place where human vivisection was systematically carried out for scientific purposes. Both Herophilus and Erasistratus (ca 260) were particularly interested in the brain. They provided the first accurate and detailed description of the human brain including the ventricles [3–4]. Like Alcmaeon and the Hippocratic doctors before them, they had no question about the brain’s dominant role in sensation, thought, and movement. Herophilus claimed that the fourth ventricle was the “command center” and compared the cavity in the posterior floor of the fourth ventricle with the cavities in the pens that were in use in Alexandria at the time, and it is still called calamus scriptorius or sometimes calamus Herophili [5]. Anatomical illustrations were also first produced in Hellenistic Alexandria about 300 BC. The tradition, owing much to Herophilus and to Erasistratus has been traced by way of Byzantium to the medieval west. Figure 1 is a unique drawing around 1250 AD which according to Sudhoff may have originated in Salerno [6]. It is most probably a copy of original Alexandrian series and depicts the venous system. The text written Ventricular anatomy: illustrations and concepts from antiquity to Renaissance