The nervous system in colours: the tabulae pictae of G.F. d'Acquapendente (ca. 1533-1619)

Abstract

The appearance in The Journal of Headache and Pain of this paper on an important document of the history of brain anatomy could seem of marginal interest for a journal devoted to clinical and basic research on headache and pain. On the contrary, the knowledge of the remote development of our understanding of the nervous system can throw light on the development which followed in all the fields of neurologic interest. Modern neurology, and particularly neurophysiopathology and neuropharmacology, would be simply inconceivable without the notion of the neuron and of the synapses, and, before those, of the macroscopic morphology of the nervous system. Therefore, a glimpse into this fascinating moment of the Renaissance in which an outstanding advancement of neurological knowledge took place, documented by a pictorial representation actually a true brain imaging of exceptional beauty and scientific value, will not only please our eyes, but will also stimulate our interest in a better understanding of the present through the path of the past.

J Headache Pain (2006) 7:360366 DOI 10.1007/s10194-006-0340-0

HISTORY OF HEADACHE SECTION

Giorgio Zanchin Raffaele De Caro

The nervous system in colours: the tabulae pictae of G.F. dAcquapendente (ca. 15331619)

Received: 17 July 2006Accepted in revised form: 9 October 2006 Published online: 25 October 2006

Section Editor note

The appearance in The Journal of Headache and Pain of this paper on an important document of the history of brain anatomy could seem of marginal interest for a journal devoted to clinical and basic research on headache and pain.

On the contrary, the knowledge of the remote development of our understanding of the nervous system can throw light on the development which followed in all the fields of neurologic interest [13]. In other terms, and just to give an example, modern neurology, and particularly neurophysiopathology and neuropharmacology, would be simply inconceivable without the notion of the neuron and of the synapses, and, before those, of the macroscopic morphology of the nervous system. To rationally modify the software, in this case a clinical condition such as headache, in the favourable terms we desire, would not be possible without a scientific knowledge of the structure of the hardware, the nervous system, which today we are able to manipulate at a very subtle cellular, or even molecular, level. Therefore, a glimpse into this fascinating moment of the Renaissance in which an outstanding advancement of neurological knowledge took place, documented by a pictorial representation actually a true brain imaging of exceptional beauty and scientific value, will not only please our eyes, but will also stimulate our interest in a better understanding of the present through the path of the past.

Giorgio Zanchin

References

1. Zanchin G (2004) New additions to the History of Headache Section. J Headache Pain 5:260

2. Zanchin G (2004) Sources. J Headache Pain 5:2612643. Zanchin G (2006) Section Editor note. J Headache Pain 7:149150

Abstract Girolamo Fabrici dAcquapendente (ca.15331619), in his olograph will donated to the Signoria of Venice a rich collection of anatomical paintings, which are today preserved in the Marciana Library. The third volume of these tabulae pictae, entitled De Anatomia Capitis Cerebri Nervorum, deals with the nervous system and contains the only known illustrations by Fabrici regarding neuroanatomy. Despite the realisation of this splendid collection of 21 coloured paintings,

neither a systematic description nor an iconographic record regarding nervous structures were found to be published by Fabrici. For this reason, a thorough study of these plates is pivotal to a better understanding of the contribution made by dAcquapendente to the knowledge of the nervous system. Besides their aesthetic quality, Fabricis tabulae pictae appear as a unique document of exceptional scientific value, thanks to the unprecedented realism given to the anatomical structures by the innov-

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ative use of colours. These pictures represent the highest point reached by the 16th-century Paduan Medical School well demonstrating its aim for a sound naturalistic approach.

G. Zanchin ( )

Department of Neurosciences, Headache CenterUniversity of Padua Medical School, Via Giustiniani 2, I-35121 Padua, Italy Tel.: [phone]Fax: [phone]E-mail: [email protected]

R. De CaroDepartment of Human Anatomy and Physiology,University of Padua Medical School, Padua, Italy

Keywords Neuroscience anatomy

Anatomy in colour Fabrici

Renaissance Padua

Fabrici and his tabulae pictae

Born around 1533 in Acquapendente, a village in the countryside of Viterbo, Girolamo Fabrici dAcquapendente [1] was educated in Padua under the protection of the powerful Venetian family of Lippomano. In the same town he received his medical degree in 1559. He was called to the chair of Surgery, with the obbligo (i.e., with the charge of the additional teaching) of Anatomy in 1565. Fabrici retired in 1613 for health reasons, ending a career that lasted almost 50 years. He died six years later, in 1619, and was buried in S. Francescos church in Padua. dAcquapendente was the first one to realise a permanent anatomical theatre (1594), on which others were later modelled [2]; this theatre is still well preserved inside the Bo, the ancient palace of Padua University.

His life was devoted to research, teaching and clinical practice. His continuous commitment to research allowed him to write many works; unfortunately some of them among which are, as we will see further on, those dealing with the nervous system were never printed and are considered lost.

Apart from the Pentateuchos Cheirurgicum, printed in Frankfurt in 1592 without the authors permission, Fabricis works began to be published only in 1600. To remember just a few of them, in that year De formato foetu appeared and De visione, voce, auditu; followed in 1602 by De locutione et eius instrumentis; and a year later by De venarum ostiolis and De brutorum loquela. Among his accomplishments, he pioneered modern embryology and precisely described the valves of the veins, giving his pupil William Harvey (15781657) a strong anatomical argument to demonstrate the circular movement of the blood [3].

Fabrici planned an ambitious, comprehensive anatomical treatise, encompassing an atlas containing more than

300 hand-painted pictures representing in natural colour both human and animal structures. This Theatrum totius animalis fabricae, begun in 1591, and which should include his other publications as well (he refers to this project in De visione, voce, auditu [4]), was never completed. The anatomical paintings themselves were considered lost[5]. In 1910, an anatomist with a strong interest in the history of medicine, Giuseppe Sterzi, rediscovered the tables [6]. Curiously, these had always been part of the collection of the Marciana Library, where they were stored following their gift to the Serenissima Repubblica by dAcquapendente, as we read in his will [7].

In the Catalogus librorum Bibliothecae Venetae, edited by Giovanni Sozomeno at the beginning of the 17th century [8], Fabricis tabulae pictae are under the title Ab Aquapendente Hieronymus Fabricius Volumina VIII Icones ad Anatomiam, seu Zootomiam pertinentes continentia, curante eodem Auctore. The entire collection of 167 pictures is divided into eight volumes, accordingly to the anatomical subject:- De Anatomia Venarum Figure Varie, Marciana, Rari 110- De Anatomia Ossium Figure Varie, Marciana, Rari 111- De Anatomia Capitis Cerebri Nervorum Figure Varie, Marciana, Rari 112- De Anatomia Animalium Figure Varie, Marciana, Rari 113- De Partibus esternis Figure, Marciana, Rari 114- De Anathomia Thoracis et Parcium in Thorace Contentarum, Marciana, Rari 115- De Anatomia Musculorum Totius Corporis. Figure varie, Marciana, Rari 116- De Anatomia Abdominis et Parcium in Eo Contentarum F., Marciana, Rari 117.

We find 44 more pictures bound within three volumes, which are also part of the dAcquapendentes heritage: De

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locutione et eius instrumentis, De venarum ostiolis and De larynge voce instrumento. As a whole, in the Marciana Library there are 211 pictures. About 40 more have been identified elsewhere.

They are painted with oil and tempera, unfortunately on relatively fragile paperboard instead of canvas [9]. The real-isation is clearly by different hands, as there are evident differences in style. Some artists have been proposed, among

Fig. 1 A Dorsal view of the brain with mild opening of the longitudinal cerebral fissure and downward pulling of the cerebellum, in order to show the corpus callosum (a) and the superior surface of the cerebellum, with depiction of the cerebellar vermis (b) and emispheres (c). Cerebellar folia are clearly delineated. At the level of the superior surface of the cerebellum, a major transverse sulcus (d) seems visible, which could correspond to the fissura prima, separating the anterior and posterior lobes. The dorsal aspect of the rostral mesencephalon (e) and caudal medulla oblongata (f) are also recognizable. Notice that the original painting is faithfully reproduced with its upside-down position of the encephalon. B Right view of the brain, sampled together with the dura mater (g), which has been cut from the medial aspect of the frontal lobe (h) to the lateral aspect of the temporo-parietal region and pulled posteriorly. A right sagittal section of the brain has been performed in order to show the right lateral ventricle (i). [Marciana, Rari. Table 112.3. Size 480x286 mm. Courtesy of the S. Marcos Library, Venice]

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them the Varotaris, father and son, but this is still an open debate. Girolamo Fabrici dAcquapendente wanted this as a sort of reference book of anatomical coloured preparations, depicted with great naturalism as a support to his

teaching, to be placed alongside the anatomically dissected part or to be used temporarily when this was not available.

At the end of the 16th century, in a period in which the monochrome xylographies of Vesalius remained an

Fig. 2. A Further phase of the section represented on the superior part of the table 112.5 [13]. After the section of corpus callosum (a), here also the fornix (b) has been cut on its anterior aspect and folded dorsally, whereas the tela choroidea (c) of the thirth ventricle has been left on site. On the right, the cerebral emisphere has been sectioned rostrally and therefore the white matter (d) is clearly shown; on the left, a deeper section puts in evidence the nucleus lenticularis (e) and the capsula interna (f). Clearly visible are the nucleus caudatus (g), the thalamus (h) and the sulcus terminalis (i). This picture is utmostly natural, particularly where it represents the chromatic features of the grey matter and of the white matter and its lucency. B A close-up detail of the basal nuclei after the corpus callosum has been completely cut away. The epiphysis can be recognized (l). The nucleus caudatus (g), the thalamus (h) and the sulcus terminalis (i) are well represented and their morphology is faithful. [Marciana, Rari. Table 112.8. Size 410x290 mm. Courtesy of the S. Marcos Library, Venice]

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example of unsurpassed beauty and naturalism, Fabrici deserves merit for having first established with his collection the outstanding relevance of the use of colour in anatomical images. We believe that this important prece-

dent, realised in the only possible way then available, that is by painting, stimulated the transition, over a few years, to the pioneering attempts to print coloured engravings.

Fig. 3 Demonstration of the cavities of the central nervous system. This preparation is original for its unusual point of view, and really daring. Indeed, in order to obtain a preparation of the whole central nervous system, the removal of the posterior aspect of the spine and of the skull had to be performed. After complete removal of the cerebellum, the fourth ventricle has been opened (a), as well, downward, the spinal cord, exhibiting the central channel (b). Upward, the posterior aspect of the mesencephalon has been cut, between the left and the right colliculi, to show the acqueduct (c). The dissection continues further upward: the floor of the third ventricle (d) is made visible after removal of the commissura posterior. On the right of the picture, a T shaped cut demonstrates the temporal (e) and the occipital (f) horns of the left lateral ventricle. The thalamus (g) is well represented together with the plexus choroideus (h) in the correspondance of the sulcus terminalis. [Marciana, Rari. Table 112.13. Size 432x580 mm. Courtesy of the S. Marcos Library, Venice]

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The first effort in this sense was that of Gaspare Aselli (15811626), who in 1627 published the first coloured xylographies, contained in the book De lactibus sive lacteis venis [10], where the discovery of lymphatics is reported. Current colour printing, however, would become possible only centuries later.

The tabulae pictae on the nervous system

The third volume of the tabulae pictae, entitled De Anatomia Capitis Cerebri Nervorum Figure Varie, deals with the nervous system and contains the only known illustrations by Fabrici regarding neuroanatomy. It consists of 21 tables (Marciana, Rari 112, 121) representing the meninges, the brain, the spinal cord, the cranial nerves, the spinal plexuses and the nerves of the limbs with their blood vessels and muscles.

Despite the realisation of this splendid collection of 21 coloured paintings, neither a systematic description nor an iconographic record regarding nervous structures were found to be published by Fabrici. According to our research[11], the only works in which dAcquapendente refers to the nervous system are the Pentateuchum Chirurgicum [12] and the Operationes chirurgicae, where he deals with clinical problems, head injuries and brain surgery respectively; and the treatise De visione voce auditu, in which the author limits his description to the nerves of the visual, phonatory and auditory apparatus; within its engravings, we find just the representation of the terminal portion of optic and oculomotor nerves, along with laryngeal nerves.

However, that Fabrici had composed neurological works is demonstrated by two lists of manuscripts, contained in the testament of 1615 and in a letter of 1622 written by the Rettori to the Riformatori dello Studio di Padova respectively. In the first list, three manuscripts that deal with neurological subjects are cited: De Capitis facultatibus, earumdemque actionibus, et proprio ac praecipuo actionum organo; De communibus Instrumentis, ut

puta Venis, Arteriis, et Nervis in totum corpus discurrentibus; and De instrumento Odoratus. In the last one, five are cited: De Cerebro, et Anatomia Cerebri; De fantasia; De Intelectu; De memoria; and De nervis. But, until now, these works have to be considered lost.

For this reason, a thorough study of these tabulae pictae is pivotal to better understanding the contribution made by dAcquapendente to the knowledge of the nervous system.

This work was realised by Fabrici as a document of high scientific value and of notable practical use: however, it should be noted that, until now, compared to aesthetic evaluations, paradoxically, neither descriptions of the morphological aspects nor analysis of the research contents of the tabulae pictae have ever been carried out. We already proposed, elsewhere [13], a detailed analysis of the anatomical structures of four tables of this neurologic collection (1121; 1122; 1125; 11210 of the volume De Anatomia Capitis Cerebri Nervorum Figure Varie). Here we present a further three tables (Figs. 13). A conclusive report on the entire neurological series is being completed.

Besides their aesthetic quality, Fabricis tabulae pictae appear as a unique document of exceptional scientific value, which will remain unsurpassed for centuries. Some representations of the topographical relationship between different parts of the nervous system are truly on the cutting edge, even today. Furthermore, thanks to the unprecedented realism given to the anatomical structures by the innovative use of colours, these pictures represent the highest iconographic achievement attained by the 16th-century Paduan Medical School, well demonstrating its aim for a sound naturalistic approach.

Acknowledgements The authors gratefully acknowledge the enthusiastic participation of Dr. Monica Panetto, V. Pinalis Library, Ancient Section, and Dr. Andrea Porzionato, Department of Human Anatomy and Physiology, University of Padua Medical School, in preparing this paper. We warmly thank Dr. Marino Zorzi, Director of S. Marcos Library, Venice, for making a direct examination of the plates possible and for kindly allowing their reproduction.

References

1. Favaro G (1922) On Girolamo Fabrici dAcquapendente: Contributi alla biografia di Girolamo Fabrici DAcquapendente. In: Memorie e documenti per la storia dellUniversit di Padova. La Garangola, Padova; Favaro G (1922) Linsegnamento anatomico di Girolamo Fabrici DAcquapendente.

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Girolamo Fabrici DAcquapendente. In: Scienziati e tecnologi. Dalle origini al 1875, vol I. Mondadori, Milan, pp 1821; Mucillo M (1993) Fabrici DAcquapendente, Girolamo. In: Dizionario Biografico degli Italiani, vol 43. Istituto della Enciclopedia Italiana, Rome, pp 768774; Stefanutti U (1994) Lopera scientifica di Girolamo Fabrici DAcquapendente (ca. 15331619). Ateneo Veneto

32:181188; Zanchin G, Premuda L (1997) Vita e opere di Girolamo Fabrici DAcquapendente. Med Secoli9.1:97108; Premuda L, Zanchin G (1997) Il pensiero scientifico di Girolamo Fabrici DAcquapendente. Med Secoli 9.1:109120; Adelmann HB (1942) The embryological treatises of Hieronymous Fabricius of Aquapendente. Cornell University Press, Ithaca, NY

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2. Zanchin G (2004) Il teatro anatomico di Padova. In: Olmi G (ed.) Rappresentare il corpo. Arte e Anatomia da Leonardo allIlluminismo. Bononia University Press, Bologna, pp 216222

3. Harvey W (1628) Exercitatio anatomica de motu cordis et sanguinis in animalibus. Sump. Guilielmi Fitzeri, Francofurti

4. Fabrici dAcquapendente G (1600) De visione, voce, auditu. Per Franciscum Bolzettam, Venetiis, c. ii v

5. In his Bibliotheca Anatomica Albrecht von Haller maintained that majus opus, totius animalis fabricae Theatrum molitus erat, et tabulas (Fabricius) paraverat supra trecentas, sed chartae interciderunt. von Haller A (1774) Bibliotheca Anatomica. Tiguri, apud Orell, Gessner, Fuessli, et socc, I, p 288

6. Sterzi G (1910) Le Tabulae Anatomicae ed i Codici marciani con note autografe di Hieronymus Fabricius ab Aquapendente. Anat Anz 35:338348

7. Favaro G (1922) Contributi alla biografia di Girolamo Fabrici DAcquapendente, pp 275296

8. Catalogus librorum Bibliothecae Venetae. Quae statutis diebus publice studiosorum commoditati aperietur (redegit Sozomenus). Sterzi G (1910) Le Tabulae Anatomicae ed i Codici marciani con note autografe di Hieronymus Fabricius ab Aquapendente. Anat Anz 35:342

9. Premuda L (1993) Storia delliconografia anatomica. Ciba Edizioni, Saronno, p 209

10. Aselli G (1627) De lactibus sive lacteis venis quarto vasorum mesaraicorum genere novo invento. Mediolani, apud Io. Baptista Bidellium

11. Fabricis works which have been examined in the Biblioteca V. Pinali Sezione antica, Padua:- De visione voce auditu (Venetiis 1600)- De formato foetu (Venetiis 1600)- De locutione et eius instrumentis (Patavii 1603)- De brutorum loquela (Patavii 1603)- De venarum ostiolis (Patavii 1603)- De formatione ovi et pulli (Patavii 1621)- Medicina practica (Parisiis 1634)- De vulneribus sclopetorum tractatus (Patavii 1643)- Opera chirurgica quorum pars prior pentateuchum chirurgicum posterior operationes chirurgicas continet (Patavii 1647)- De abusu cucurbitularum in febribus putridis dissertatio (Patavii 1647) In the Biblioteca Universitaria, Padua:- De musculi artificio. De ossium dearticulationibus (Vincentiae 1614)- De respiratione et eius instrumentis libri duo (Patavii 1615)- De motu locali animalium secundum tomum, nempe de gressu in genere (Patavii 1618)- De gula, ventriculo, intestinis tractatus (Patavii 1618)- De totius animalis integumentis opus-culum (Patavii 1618)

12. Consulted edition: Fabrici dAcquapendente G (1647) Opera Chirurgica quorum pars prior Pentateuchum Chirurgicum posterior Operationes chirurgicas continet. Impensis Francisci Bolzettae, Patavii

13. Zanchin G (2004) De Anatomia Capitis Cerebri Nervorum. Le tabulae pictae di Fabrici sul sistema nervoso. In: Rippa Bonati M, Pardo-Tomas J (eds) Il teatro dei corpi. Le Pitture colorate danatomia di Girolamo Fabrici dAcquapendente. Mediamed, Milan, pp 235245