anDreas Vesalius
D Hm cp Fb lb spm
th Fb f h Hm Bdy Daniel H. Garris on MalcolM H. Hast
a ad t f h 1543 d 1555 ed
CONTENTS
2
3 4 5 1
35 35
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36 37 37
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1
K O O B
39 40 40
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Three Forms of Joint 13 Κορωνόν αὐχὴν: Enarthrosis 13 Arthrodia 14 When Nature Formed Arthrodia 14 Ginglymus 14 When Nature Formed Ginglymus 14 In What Ways Double Joints Are Formed 14 Gomphosis 15 Γεθρο: Suture 15 Harmonia — Symphysis 16 Substances That Aid the Union of Bones: Ligaments 16 Flesh: Syssarcosis 16 Cartilage: Synchondrosis 16 Bones That Are Joined with the Aid of No Substance 16 Some Major Disagreements in This Chapter with the Opinions of Galen 16 Aix: Ginglymus (the Hinge Joint; 1555 Version) — Why Nature Sometimes Joined Two Bones with Several Joints —
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16 16 16 16 16 16 18 18 18 18 19
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63 63 64 64 64
CHAPTER
5
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45 45 45 46 46
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The STrucTure of The heAd: Why IT IS ShAped AS IT IS, And hoW 17 MAny confIgurATIonS IT hAS
The Head Was Formed for the Sake of the Eyes 18 How Nature Protected the Eyes 18 The Brain Is Located in the Head for the Sake of the Eyes, and the Other Senses on Account of the Brain 18 The Natural Shape of the Head 19 First, Second, and Third Unnatural Shapes 19 Fourth Unnatural Shape 19 Other Variations 19 Aix A: Natural Shapes of the Skull (1555 Version) — Aix B: Variant Shapes of the Head (End; Expanded 1555 Version) —
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22 22 23 23 23
67 67 68
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CHAPTER
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57
57 57 58 58
6
on The eIghT BoneS of The heAd And 20 25 The SuTureS connecTIng TheM
What Kind of Dwelling Nature Prepared for the Brain Why the Skull Is Not Made of Solid Bone The Use of Sutures Sutures of the Naturally Shaped Head The Coronal, Lambdoid, and Sagittal Sutures
26 26 26 26 26
31 31 31 32 32
The Heads of Men Do Not Always Differ from Those of Women Sutureless Heads Differences in Bones of Old, Young, and Juvenile Persons Sutures in Unnatural Heads The Scaly Seams of the Temples The Sutures Are Visible Also inside the Skull Why Squamous Agglutinations Do Not Resemble the Other Sutures Sutures Already Accounted For The Suture Surrounding the Eighth Bone of the Head Sutures between the Head and Other Bones Extensions of the Lambdoid Suture The Edge of the Cuneiform Bone In What Places the Suture around the Cuneiform Bone Occurs On a Passage in Galen’s De ossibus, and on the Suture between the Frontal Bone, the Bones of the Maxilla, and Others The Borders of the Vertex Bones The Borders of the Frontal Bone The Softest and Least Dense Part of the Skull The Borders of the Occipital Bone The Thickest Point of the Occiput Capitula of the Occipital Bone The Circumference of the Temporal Bones Mammillar y Processes The Cavity of the Temporal Bone The Process Resembling a Writer’s Stylus The Jugal Process of the Temporal Bone The Cuneiform Bone The Cuneiform Bone Is Not Perforated like a Sponge The Winglike Processes The Eighth Bone of the Head A Bone inside the Canine Skull Aix A: Why the Entire Brain Is Surrounded by Bones, and Why These Vary and Are Connected Chiefly by Sutures (1555 Version) Aix B: On the Occurrence of Cohesive Squamous Joints Inste ad of Sutures (1555 Version) Aix c: The Cuneiform or Sphenoid Bone (1555 Version) The Nature of the Middle Region of the Cuneiform Bone (1555 Version) Aix d: A Cartilage or Bone in the Brain (1555 Version)
26 27
32 33
27 27 27 27
— 33 33 33
28 28
34 —
28 28 28 28
34 34 34 34
28 29
34 35
29 30 30 30 30 30 31 31 31 31 31 31 32
36 36 36 37 37 37 38 38 38 38 38 39 39
32 32 32 32
— 41 41 —
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31
—
33
—
39
—
39
—
41
on The JugAl Bone, And The BoneS re SeMBlIng A rock ouTcroppIng
33
42
Names Are Assigned to Certain Areas of Bone As If They Were Entirely Separate
33
42
CHAPTER
73
73
5 5 5 1
7
3
3 4 5 1
73 73 73
74
74
The Jugal Bone The Use of the Jugal Bone How Nature Made Provision for the Temporal Muscles The Mansorius Muscle Originates at the Jugal Bone The Bones Resembling a Rocky Outcropping
CHAPTER
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76 77 77
77 78
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33 33
5 5 5 1
42 42
3 4 5 1
Ai A: First Two Paragraphs
91
of the Narr ative Section (1555 Version) What Part of the Skull Is Called the Upper Maxilla Why It Consists of Many Bones, Both Light and Hollow Ai B: How to Distinguish the Maxillary Bones (1555 Version)
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33
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91
33 33
— 43
91
8
The Cavity Made for the Organ of Hearing, and the Foramina Extending into It Nerves from the Fifth Pair to the Organ of Hearing The Anvil-Like Ossicle The Ossicle That Is Not unlike a Small Hammer Comparison of the Second Ossicle to the Femoral Bone The Use of Ossicles of the Organ of Hearing Marcus Antonius Genua and Wolfgang Hervort, Chiefly Responsible for My Undertaking and Completion of This Work Ai: First 32 Lines of the Chapter 8 Narrative (1555 Version)
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34
44
34 34 35
44 44 45
93 93
93 94
94 94 94
35 35
45 45
35
46
—
44
9
80
80 84
84 84 85 85 86 86 87 88 88 89
89
on The TWelve BoneS of The upper MAxIll A, IncludIng The BoneS of The noSe
Index of the First Figure of the Ninth Chapter and Its Characters Index of the Second Figure and Its Characters Why the Maxill a Consists of Several Bones, Both Hollow and Light Structura l System of the Maxill ary Bones Brief Enumeration of the Bones of the Maxilla How Many Bones Make Up the Eye Socket The First Bone of the Maxilla The Second Maxilla ry Bone Third Maxilla ry Bone Fourth Maxillary Bone The Fifth Bone of the Maxilla The Sixth Bone of the Maxilla There Are in All Twelve Bones of the Upper Maxilla Not Everything Thus Far Stated in This Chapter Fits the Opinions of Ga len; Some Items Are Enumerated at the End of the Chapter
—
49
—
49
on The loWer MAxIllA
43
54
Man Has the Shortest Jaw The Human Jaw Is Made Virtual ly from a Single Bone Two Processes on Both Sides of the Maxilla Picture of the Special Cartilage in the Joint of the Maxillae Foramina of the Maxilla Alveoli of the Teeth Breadth, Thinness, Depressions, and Rough Spots in the Posterior Area of the Jaw
43
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36 38
46 48
96 96 96
97 97 97
39 39 39 39 39 40 40 40 41 41
— — 48 — 48 50 50 51 52 52
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54 55
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56 57
45 45 46 46 46 46 46 46 46 46
57 57 57 57 57 57 58 58 58 58
47
59
99
Why a Description of the Foramina Is Undertaken 47
59
11
Key to the Figure of the Present Eleventh Chapter, and Its Characters The Teeth Have Sensation The Distinction between Teeth and the Other Bones The Number of Teeth The Canines Molars How Teeth Are Fixed in the Jaws Roots of the Teeth The Number of Teeth Sometimes Varies Wisdom Teeth (Genuini dentes) Hollow Space in Teeth Dental Epiphyses
CHAPTER
99
10
on The TeeTh, WhIch Are AlSo counTed AS BoneS
96
80
49 49
CHAPTER
95
CHAPTER
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CHAPTER
on The oS SIcleS ThAT enTer upon The conSTrucTIon of The orgAn 33 of heArIng
5 5 5 1
12
on The forAMInA of The heAd And The upper MAxIllA
1
K O O B
112
ON THE BONE RESEMBLING T H E G R E E K U P S I L O N¹ ��
KEY TO FIGURES AND CHAR ACTERS SET FORTH HERE The first figure of the present chapter represents the anterior face of the bone [corpus ossis hyoidei] resembling the letter υ [Greek upsilon], together with its lesser or more elevated sides [cornua minora] and the ossicles which are connected to them as far as the processes of the temporal bones that are shaped in the fashion of a stylus [processus styloidei]. The second figure shows the posterior region of the bone resembling an υ, along with the more elevated ribs [cornua]; but for the moment we have not drawn those ossicles which extend to the processes that resemble a stylus and are drawn in the previous figure.²
A, B, C 1 Larger and middle ossicle [corpus] of the hyoid bone, visible on its anterior side. A and B indicate the protuberant region of this surface. In between these characters appears the particular tubercle of this region, marked *. *. C indicates the transversely elongated depression discernible in the superior part of this middle ossicle. D 2 Posterior side of the larger ossicle [corpus], depressed and concave. E, F 1, 2 Lower sides [cornua majora] of the hyoid bone, which with the middle ossicle represent a figure like an υ. G 1, 2 Joint of the lower side [cornu majus] with the broader and larger ossicle of the hyoid bone.
F I R S T F I GU RE
01
02
An earlier version of this chapter was published in Medical History 37.1 (1993), pp. 3–36. Neither of these gures illustrates a typically human hyoid bone – a notable departure for a book which stresses human as opposed to animal anatomy. The left hyoid bone shown above (g. 1) has a canine feature in the chain of narrow ossicles (K, L, M, N) that extend in the dog to the styloid bone (in the human, this connec-
tion is made by the stylohyoid ligament). The right hyoid bone (g. 2) represents the posterior aspect of the same bone with L, M, N removed. Its lesser horns (I, K) appear nearly the same length as the greater horns (E, F), whereas in humans the lesser horns have only a fraction of the mass and length of the greater, and are altogether diff erent in shape. Vesalius is described as using “the larynx of an ox and of some other animals”
H 1, 2 Apex of the lower side, which is attached to the process of the laryngeal cartilage that resembles a shield [cornu superius cartilaginis thyroideae]. I, K 1, 2 Upper sides [cornua minora] of the hyoid bone, considerably thinner and more smoothly rounded than the lower ones. L, M, N 1 Three ossicles, very often³ joined to the upper sides [cornua minora]. Besides the fifth plate of the muscles at the letter L, several earlier illustrations of the twelfth chapter of the second book⁴ at A, B, C, and D further represent the hyoid bone.
SE CO ND F I G URE
in a 1540 anatomy lecture at Bologna “because, he said, in the hanged [human] subjects we cannot see the larynxes, for they are destroyed by the noose, but they are however quite di ff erent [in man and in animals]” (Eriksson, 1959, p. 285). The illustrations in this chapter appear to blend human and animal anatomy.
03
04
Lat. ut plurimum, perhaps “more often than not”; see preceding note. Possibly, these are nontypical, ossied portions of ligamentum stylohyoideum; more likely, this gure re ects features of the canine hyoid bone and apparatus, in which the cornu minus is connected to the pars tympanica and vagina processus styloidei by a series of ossicles (L = epihyoid, M = stylohyoid, N = tympanohyoid), unlike the ligamentum stylohyoideum of the human. An error in both editions; these illustrations appear in Ch. 21, Bk. II.
THE FABRIC OF THE HUMAN BODY
1
K O O B
R E T P A H C
13
LOCATION AND NA MES OF THE HYOID BONE
56
����� ������ the most prominent part of the larynx is a bone taken collectively for the sake of unity, but constructed of many different ossicles; some call it ὑψιλοειδές� from the shape of the letter υ, others more succinctly ὑοειδές; those without experience in dissection, misled by this term, have translated it in Galen as “the bone resembling a pig.”� This bone is named elsewhere λαμβδοειδές [“lambda-shaped”] from the look of the letter Λ; translators deceived by this name have become accustomed to render it as “the lambda-like suture of the head” (C, D in figs. 3 and 4, Ch. 6; B in the 3rd skeleton). But I for my part have recently removed errors of this sort from a version of Galen which both Italy and Germany published in Latin. Herophilus� is also said to have called this bone παραστάτης [“companion”], perhaps because it is located next to the tongue, or the laryn x, or the jaws, just as in the organs serving generation he calls cert ain items παραστάτης κιρσοειδής, “the varicose companion” [i.e. spermatic duct] (from δ to ε in figs. 22 and 23, Bk. V) , and παραστάτης ἀδενοειδής (ξ, B in the same figures), “the glandular companion.”� Moreover, there are some who, because it is located in the throat, have called it the φαρύγγετρον .� I have made it my practice throughout to name this “the bone resembling an υ,” or more succinctly “the hyoid.”
MIDDLE OSSICLE OF THE HYOID BONE The human has this bone quite differently constructed than the quadrupeds which until now we have dissected,¹� and it is the broadest ossicle of the hyoid bone ( A , B, *, C in fig. 1, D in fig. 2), convex on the outside and jutting for ward with its own protuberance; but inside, or on the pos-
113
terior surface, it is concave. On the anterior, it is indented on top as in an elongated depression because the shape is suitable for it, and because of the muscles and ligaments attached to it. For into the upper depression are implanted the third and fourth muscles (R in the 4th table of muscles) [mm. mylohyoidei] peculiar to this bone; on the protuberance visible in this location, at the sides which are somewhat impressed in the area where it swells, the first two muscles [mm. sternohyoidei] peculiar to this bone make their insertion (S, T in the 4th table of muscles; the other muscles of this bone are Q [musculus stylohyoideus] and V [musculus omohyoideus]). From the hollow of the posterior side, the first two muscles [radix linguae] that move the tongue have their principal origin (D D in figs. 1 and 2, Ch. 19, Bk. II). Moreover, because the hyoid is convex on the outside but hollow inside, the muscles are also con veniently placed farther from the path of injuries coming from the outside. This larger ossicle [corpus ossis hyoidei], positioned slightly above the larynx, may be found by touch, but its sides [cornua] are a little more deeply hidden. With this wider ossicle, two others [cornua minora, cc. majora] are united on each side. ¹¹ One of these is lower, the other higher.
Bk. 1 Ch. 6 Fig. 3, 4 Bk. 1 Skeleton 3
Bk. 5 Fig. 22, 23
Bk. 1 Ch. 13 Fig. 1, 2
Bk. 2 Table 4
Bk. 2 Ch. 19 Fig. 1, 2
LOWER SIDES OF THE HYOID BONE Bk. 1 Ch. 38 Fig. 3, 4
The lower ossicle [cornu majus] is somewhat shorter and broader than the upper [cornu minus] (one is E, F in figs. 1 and 2, the other I, K ), and is connected to no other bone than the side (G in figs. 1 and 2) of the middle, wider ossicle of the hyoid bone, to which it is firmly attached by cartilage and cartilaginous ligament over a noteworthy breadth. The end of this bone (H in figs. 1 and 2) is joined [ligamentum thyrohyoideum laterale] to the superior process [cornu superius] of the laryngeal cartilage that looks like a shield [cartilago thyroidea] ( A , B in figs. 3 and 4, Ch. 38). We rightly call this lower ossicle or side, together
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
05
06
A fanciful compound unattested in LSJ or the TLG medical canon, combined from υ ψιλόν “short u” and -εἰδές “-like,” presumably because it is shaped like the Greek letter. An additional element could be ὕψι , “on high,” because it is situated above the larynx, high on the neck. Because, in Greek, hys or sus means “pig”; but there may also be a note of irony in this false etymology as Galen’s description of the larynx is based in part on pig anatomy. See May, 1968, p. 352, n. 32.
07
Herophilus of Chalcedon (4th–3rd cent. BC), the most important of the Greek anatomists in Alexandria who dissected human cadavers, is frequently cited by Galen. His contributions to nomenclature are noteworthy for their use of visual comparisons. The word παραστάτης generally means “companion,” or “bystander,” and is applied to the twin spermatic ducts as well as the hyoid bone conceived as the companion to the larynx; see May, 1968, p. 26.
08 09
For which see Galen, De usu partium 4.190.3ff . (May, 1968, p. 644). A variant reading for φαρύγγεθρον, or larynx, translated by LSJ as φάρυγξ , i.e. the “windpipe” or “pharynx,” but not in the sense suggested here, “pharynxbone.” The word is Hippocratic (De anatome 1.1); see also Galen, De libris propriis liber 19.28.1, PseudoGalen, Introductio seu medicus 14.721.5, Aretaeus (2nd cent. AD), De causis et signis acutorum morborum 1.7.1–4, 2.2.1.3, and Aëtius Amidenus (6th cent. AD), Iatricorum liber 2.92.24.
10
11
Vesalius’ handwritten comments on the 1555 edition delete this portion of the sentence. The 1555 edition adds: “We call these the sides of the hyoid bone with Avicenna, in his chapter ’On the Throat’.” Avicenna (980–1037) is the Arabian physician and philosopher whose Canon of Medicine had been considered authoritative since 1100, appearing in at least 60 complete or partial Latin editions between 1500 and 1674; see Siraisi (1987).
Bk. 5 Ch. 15 Fig. 25
224
On the Carpus We shall add an index explaining the six figures above together with their characters on the following page.
The first two figures apply not only to the present chapter but also to the three following, in which the parts of the hand are also explained. We shall call what Hippocrates named ἀκρόχειρ the top or end of the “hand,” that is, the part which lies between the forearm and the farthest [distalis] tip of the fingers and which we divide into carpus, metacarpus, and fingers. By “hand,” Hippocrates meant whatever comes between the scapulae and the end of the fingers and is subdivided into arm, forearm, and hand. Thus, fi fig of this chapter shows the inner [palmaris] surface of the bones of the hand. t cod includes the outer [dorsalis] surface of the same bones, appropriately drawn. The four subsequent figures are peculiar to this chapter and represent only the eight carpal bones in various aspects. t o idifid id shows the inner [palmaris] surface of the eight wrist bones, all together in place. t fo has the same bones drawn from their outer [dorsalis] aspect. t fif includes the upper part [p. proximalis] of the wrist bones, where they are articulated to the forearm. t ix displays the lower surface [pars distalis] of the wrist bones, to which the first bone of the thumb [os metacarpale I] and the four metacarpal bones [ossa metacarpalia II–V] are attached. The index of characters will be as follows. 1, 2, 3, 4, 5, 6, 7, 8 These eight numerals designate the eight bones of the carpus in all six of the present figures, if all were seen on the surface in which the wrist presents itself. Each bone is always identified with its own number, and in this way shows its name. We shall call the first bone [os scaphoideum] that which is marked 1, the second [os lunatum] the one marked 2. Thus, 1, 2, 3, and 4 mark the upper [proximalis] row of the eight wrist bones, these being the four higher or nearest to the forearm. 5, 6, 7, and 8 indicate the lower [distalia] bones, which are conterminous with the metacarpus.
1
2
As in the preceding chapter, Vesalius presents his illustrations with the proximal end down, contrary to the practice of his own time (e.g. Canano, Musculorum humani cor poris picturata dis sectio, c. 1541) and contrary to modern convention. In the text, however, the orientation is reversed: proximal bones are “upper,” and distal bones “lower.” Or more accurately χείρ ἄκρη, in On Fractures 9.2. In the 1543 Fab-
116
FIRST FIGURE
I, II, III, IIII
1, 2 The four metacarpal bones are marked in the first and second figures; there is no reason not to name them by the number written on them – unless one prefers to name them for the finger they support, and which they precede. a, B, C 1, 2 Three bones of the thumb [pollex] which we also call internodes. D, e, F 1, 2 Three bones of the index finger [index]; the same system applies to the other fingers as well. G 3, 6 Depression [facies articularis, basis metacarpalis I] of the fifth carpal bone [os trapezium], and surface to which the first bone [os metacarpale I] of the thumb is articulated. We measure the length of this depression transversely , b. 6 from to b in the sixth figure. The inc. 6 ternal [medialis] surface is marked c, d. 4, 6 the external [lateralis] d, which is also visible in the fourth figure. h 3, 4, 6 Surface [facies articularis] of the sixth carpal bone [os trapezoideum] to which the metacarpal bone supporting the index finger [index] is attached; on . 3, 4, 6 the fifth bone, marks the place
rica, Vesalius’ summa manus for “hand” imitates Galen’s ἄκρα χείρ, employed because Gk. χείρ can mean the arm or the hand and arm combined (LSJ II). Galen explains this usage at the beginning of Ch. 2 in Bk. 3 of De anatomicis administrationibus. The Latin term is something of an aectation, as manus is not ambiguous in the same way as the Greek term. Here as elsewhere in the 1555 edition, Vesalius substitutes manus for
3
4
[facies articularis, basis metacarpalis II] which the same metacarpal bone also touches. K 3, 4, 6 Place [facies] on the seventh wrist bone [os capitatum] to which the metacarpal bone supporting the middle finger [digitus medius] is attached. In k. 3, 4, 6 the same figures, k marks the place [facies articularis, basis metacarpalis III] where this metacarpal touches the sixth wrist bone. L 3, 4, 6 Place on the eighth carpal bone [os hamatum] to which the metacarpal bone [os metacarpale IV] leading to the ring finger [digitus anularis] is attached. M 3, 4, 6 Place on the eighth carpal bone to which the metacarpal bone [os metacarpale V] supporting the little finger [digitus minimus] is articulated.
summa manus. Vesalius’ digression on nomenclature was also deleted from this point in the later edition, and moved (with revisions) to the beginning of the narrative section. See n. 14 below. Brachiale & postbrachiale ac digitos. On the lack of a Latin word for “wrist” or adjectives based on Gk. karpos, see n. 2, Ch. 24. In all gures except the 4th, the number 5 has been engraved backward. The 1555 edition omits all
5 6
7
but the rst sentence of this section. The 1555 edition omits all that follows in this section. Os metacarpale I, phalanx proximalis, ph. distalis. Vesalius follows Galen in calling the rst metacarpal the rst phalanx of the thumb, while the other metacarpal bones are numbered I–IIII for the four ngers. Phalanx proximalis, ph. media, ph. distalis.
THE FABRIC OF THE HUMAN BODY
K O O B
1 25 R E T P A H C
225
�4
Bk. 5 Ch. 15 Fig. 25
THIRD FIGURE
Bk. 5 Ch. 15 Fig. 25
SECOND FIGURE Bk. 5 Ch. 15 Fig. 25
FOURTH FIGURE
n 1,
2 Ossicle [os sesamoideum] leaning
against the outer side of the ar ticulation of the eighth carpal bone to the metac arpal bone, by which the little finger is supported. O 2 [1], 3, 6 Process of the eighth carpal bone [hamulus ossis hamati] protruding into the inner area of the carpus. p 2 [1], 3, 6 Process [tuberculum ossis trapezii] of the fifth carpal bone from which originates the transverse ligament [retinaculum musculorum exorum] that makes its insertion into the process of the eighth bone marked O; it is covered by tendons from the forearm that go to the inner area of t he hand. Q 2 Upper epiphysis [basis metacarpalis II] of the metacarpal bone that supports the index finger [index]; it is articulated to the carpus [os trapezium, os trapezoideum].
r 2 Lower epiphysis [caput] of the metacarpal bone leading to the index finger, which forms the head that enters the depression of the first bone [phalanx proximalis] of the index finger. s 1, 2 Interval between the metacarpal bone leading to the index finger and the one that supports the middle finger. The same system of epiphyses and intervals holds for the other metacarpal bones. t 1, 2 In the first figure, the inner of two sesamoid bones placed before the inside of the second thumb joint is marked; in the second figure, the outer. V V 1 Two sesamoid ossicles placed in front of the joint of the index finger. X X 1 A single sesamoid ossicle, or rather like a mustard seed, placed upon the second joint of the index finger. Y 1 A single sesamoid ossicle, located on the third joint of the thumb. In the remaining fingers, the system is the same as with the index finger, though we have not shown the sesamoid ossicle of the second and third joints.
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
FIFTH FIGURE
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
SIXTH FIGURE
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
Musculus exor digitorum supercialis, tendines; m. exor digitorum profundus, tendines; m . exor pollicis longus, tendo 1555: “And which is much more 9 easily seen than the upper.” 10 The V on the left of this pair was recut in the 1555 edition. 11 X’s were recut below the 1st and 2nd interphalangeal joints in the 8
1555 edition, and the legend was rewritten as follows: “The lower X marks the sesamoid ossicle placed before the second joint of the index nger; the upper marks the ossicle given to the third joint of the index nger. The arrangement of these ossicles is the same in the other digits.”
12
13
Y is not visible at the interphalan-
geal joint of the thumb in either edition of the Fabrica, and the 1555 edition omits this entry altogether. In the hand, sesamoid bones embedded in tendons are found only on the palmar surface of the joints. Two (medial and later al) are constant at the metacarpophalangeal joint of the thumb; one is fre-
quently present at the metacarpophalangeal joint of the little nger and the index nger. Occasionally, sesamoid bones are found at the metacarpophalangeal joints of the middle and ring ngers, and at the interphalangeal joints of the thumb and index ngers (Gray, 1995, p. 736).
ON THE CARPUS
226
+
Bk. 1 Skeletons 1+
+
Bk. 1 Ch. 25 Fig. 1+
Bk. 2 Table 8
Bk. 2 Table 12
Bk. 1 Ch. 25 Fig. 2
Bk. 1 Ch. 25 Fig. 3, 4
Bk. 1 Ch. 25 Fig. 5
Bk. 1 Ch. 25 Fig. 6
THE CA RPUS IS CONSTRUCTED OF EIGHT BONES DIFFERING FROM EACH OTHER IN SHAPE ¹�
these surfaces are bound by ligaments;²� above (fig. 5), where the bones [ossa carpi proximalis] are joined to the forearm [radius, ulna], they are smooth and coated with cartilage, just as they are below (fig. 6) [ossa carpi distalis], where they are joined to the metacarpal bones [ligamenta carpometacarpalia dorsalia/palmaria] and the first bone of the thumb [articulatio carpometacarpalis pollicis] . Indeed, where the bones touch each other they are not everywhere rough and uneven or covered with ligaments, but smoothly fitted depressions are carved in all of them, lined with smooth, slippery cartilage, and they receive the tubercles or heads of the other bones, which are likewise smooth and covered with cartilage.²¹ Ligaments [ll. intercarpalia dorsalia, ll. intercarpalia palmaria, ll. intercarpalia interossea] or membranes come between none of the carpal bones except in the spaces [interossea] between the bones of the lower row [ossa carpi distalis], where a small amount of cartilaginous ligament – scarcely worth noticing – intervenes as if at a point, and where the lower bones are not so closely packed together as the upper.
�� ������ call the part of the hand ( V to Z in the skeletal figures; 1–8 in all the figures of this chapter) that is articulated to the forearm καρπός; we call it brachiale in imitation of Celsus.¹� It is constructed of eight bones separated in a double row. In people of mature years, these bones are hard and small, not porous inside, and filled with a slight amount of marrow like the epiphyses, not altogether lacking in marrow.¹� This is particularly so in the larger of these bones, as they are all of different size, shape, and location, nor is there one in the lot which at all resembles another: each one has some feature by which it can readily be distinguished from the others. But varied though they be, they are so harmoniously fitted to each other, and attain such a unity of composition, that their number is not very easy to discover. For unless you cut away the very strong cartilaginous ligaments [articulati- W H Y THER E A R E T WO RO W S ones carpi] (Δ in the 8th table of muscles, l in the 12th table) OF CARPAL BONES with which they are covered, as well as the membranes, and carefully scrape them off, they will all appear to be a single Nature constructed this justly, fashioning two rows of one,¹� or like Celsus you will believe they consist of an wrist bones particularly because the upper row [ossa carpi uncertain number.¹� proximalis] (1–4 in nearly all the figures) needed to be joined to the forearm in quite a different way than the lower row [ossa carpi distalis] (5–8 in all figures) needed to W HER E THE C A R P US IS COV ER ED W ITH be joined to the metacarpus and the first bone of the thumb. LIGAMENTS, AND WHERE BY CARTILAGE The carpus is articulated to these as separate and distinct They are all (compare figs. 1 and 2, then the 3rd to the 4th) bones, while it articulates with the forearm as to a single bound together (but not, as some think, fused) by these bone, so that the bones of the upper row are rightly articusinewy and cartilaginous bonds, forming two complete lated with each other more closely and intimately than the surfaces: convex on the outside [dorsalis], as much as is bones of the lower row, and without the intervention of useful to the hand, and hollow on the inside [palmaris], as any body.²² Anatomists believe this is the chief reason for concave as is convenient for this part of the hand.¹� Only the large number of wrist bones, adding as a secondary
Bk. 5 Ch. 15 Fig. 25
14 Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
The following – some of it transferred from the beginning of the 1543 gure legend – is added to the beginning of the 1555 narrative: “The part which we vulgarly call the brachium when we say that man is endowed with arms and legs, meaning everything from the scapula to the end of the ngers and the tips of the nails, was called the “hand” (or rather χείρ) by Hippocrates and often by Galen. What is called the manus by nearly all the Latins, and which we measure from the lowest end of the forearm and the loose joint attaching the hand to the forearm out to the end of the ngers, was called by Hippocrates ἀκρόχειρ, as if to say the “farthest” or “end hand.” This distinction, however tting for the
15
16 17
Greeks, cannot be of much use for those writing in Latin. We shall divide the hand only into wrist, metacarpus, and digits, and give each its own chapter. In the present we shall describe the part which is articulated to the forearm,” etc. See n. 1, Ch. 24, and Celsus 8.1.20–22, where manus and prima palmae pars are named as the location of the carpal bones. Brachiale does not occur in Celsus and is unattested in the OLD except in the sense of “bracelet, armlet.” 1555: “as has been thought by some.” Paraphras ed from Galen, De usu partium 3.121.11.: “… these bones are tted together so skilfully as to
18
19
leave nothing wanting for accuracy and perfection. In the rst place, although no one of the eight carpal bones greatly resembles any other in shape or size, they nevertheless achieve such close union in their articulations that it is hard to tell how many of them there are. In fact, unless you carefully scrape away the ligaments and strip o the protecting membranes, you will think they are all one bone.” (tr. May, 1968, p. 131). Celsus 8.1.21: “The rst part of the palm consists of many minute bones of which the number is uncertain …” (Loeb tr. by W.G. Spencer, p. 489). Cf. Galen, De usu partium 3.121.20.: “the carpus … is concave on its inner side as much as is suit-
able for the hand and convex on its outer side to the extent that this too is advantageous” (tr. May, 1968, pp. 131f.). 20 L. radiocarpale dorsale, l. radiocar pale palmare; l. ulnocarpale palmare; l. carpi radiatum; l. collaterale carpi ulnare, l. collaterale carpi radiale. Simplied as follows in 1555: 21 “… where the bones touch each other they have smooth depressions and heads covered with slippery cartilage, by which they are articulated to each other.” 22 The nal clause is rewritten in the 1555 version: “so that this dierence of articulation must also be considered the chief reason for the large number of carpal bones.”
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reason that it is difficult to hurt; they believe the wrist is made more resistant to injury because it is composed of many bones that break the force of objects that strike it by giving way, as we observe that a spear or arrow has more trouble penetrating loose targets than those that are taut.²³ At the same time, we notice that this strength and abundance of bones was constructed by Nature not least for a countless variety of motions of the hand. I shall now endeavor to explain what depressions and outgrowths the wrist bones have.²�
118
the cartilage [discus articularis] (T in figs. 1–3, and 8, Ch. 24) which we have written begins at the radius and chiefly separates the ulna from the carpus. But the outer side of the third bone also comes into contact with the sharp process [p. styloideus ulnae] (R in figs. 1, 2, 5, and 10, Ch. 24) of the epiphysis of the ulna when we incline the hand to the outside.²� At the same time, this third bone does not have a depression visually distinguishable in man that is made especially for the sharp process and lined with cartilage, since the process itself protrudes only along the side of the depression where the carpus is contained, acting in the same way as the brows of the other depressions, including NAMES OF THE CAR PAL BONES the apex (α in figs. 1, 2, and 7, Ch. 24) of the epiphysis of Four bones are located in the upper [proximalis] part of the the radius in this area.²� This is readily decided even by touch if, when the hand is bent to the inside, one tries to carpus, in the row that faces the forearm. To these we shall insert the tip of the thumb of the other hand between the assign appropriate names according to the order in which they are arranged, always naming the first [os scaphoi- carpus and the ulna. Therefore the first three carpal bones deum] (1 in the first five figures) the bone that constitutes are so joined together on their upper [proximalis] surface, the inner [lateral] side of the upper row; second [os luna- and so protrude, that they make up, as it were, a single head tum] (2 in the same figures), the one that follows this and of the wrist, smooth and covered with cart ilage, by which is more distant from the inside; third [os triquetrum] (3 in it is articulated to the forearm and is moved in many vigthe same figures), the one that is closest to the second orous motions as if formed of a single large bone.²� toward the outside [medial]; and fourth [os pisiforme] (4 in the same figures [figs. 1, 3, 5, and 6]), the one that occu- PECULIARITIES CL AIMED BY pies the outermost side.²� Similarly, we shall name the four THE FOURTH BONE bones of the lower [distalis] row (5–8 in all figures) the fifth, sixth, seventh, and eighth, and in this fashion we The fourth carpal bone [os pisiforme] (there is no need to shall approach the account of the individual bones. The identify the bones in the margin hereafter, as the numbers first, second, and third are very strongly and closely joined are obvious in nearly all the figures of this chapter) does together and linked in a single row as if they were a single not touch the ulna, but on its upper surface it admits the bone, forming the upper area of the carpus in such a way portion of the ligament of this joint [ligamentum ulnocarthat they are smoothly articulated into the depression pale palmare] which originates from the sharp process [facies articularis carpalis] of the radius and ulna as if they [p. styloideus] of the epiphysis of the ulna. The tendon were the head of a single long, wide bone. The first [os [musculus flexor carpi ulnaris, tendo] (δ in the 4th table of scaphoideum] and the second [os lunatum] are placed in a muscles) of the muscle which is reckoned the lower of those depression ( x , y in figs. 1 and 8, Ch. 24) carved in the epiph- flexing the wrist is attached to the upper surface of the ysis of the radius; the third [os triquetrum] leans against fourth bone. From its lower surface, the muscle [m. abduc-
+
Bk. 1 Ch. 25 Fig. 1+
Bk. 1 Ch. 25 Fig. 3, 5, 6
Bk. 1 Ch. 24 Fig. 1, 8
Bk. 1 Ch. 24 Fig. 2, 3
Bk. 1 Ch. 24 Fig. 5, 10
Bk. 1 Ch. 24 Fig. 7
Bk. 2 Table 4
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
23
See Galen, De usu partium 3.125.16.: “to protect the [carpal] system completely, it was better for it to consist of many bones, and further, of bones just as hard as they are; for by yielding at the joints to objec ts striking a gainst them, they break the force of the blows. It is in just this way that a dart or spear or any other weapon of the sort pierces a stretched hide more easily than one not under
24 25
tension, because the one oers resistance and the other by yielding a little deadens the force of the blows falling upon it.” (tr. May, 1968, p. 133). This sentence is omitted from the 1555 edition. In the anatomical position favored by modern convention, the hand is down with the palm facing forward, making Vesalius’ “outer” (medial) side the little nger side, and his “inner” side the lateral or thumb side.
26 27
Adduction or ulnar deviation. Vesalius’ point is that the styloid process of the ulna is not articular, as Galen had stated in De usu partium 3.133 and elsewhere (see n. 56, Ch. 24), but functions only as a structure corresponding to the styloid process of the radius, helping to contain the wrist bones within the articular capsule formed by the radius and ulna.
28
Cf. Galen, De usu partium 3.129.17–19: “It was necessary for [the bones of the carpus] to be almost like one bone, since they must act as one in articulating with the forearm and in taking part in many vigorous movements.” (tr. May, 1968, p. 135). This sentence is omitted from the 1555 Fabrica.
Bk. 5 Ch. 15 Fig. 25
Bk. 5 Ch. 15 Fig. 25
SECOND SKELETON
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THE FABRIC OF THE HUMAN BODY
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1
R E T P A H C
40
SKELETONS
325
Bk. 5 Ch. 15 Fig. 25
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330
INDEx OF CHARACTERS PLACED ON THE THREE FIgURES REPRESENTINg THE ENTIRE SKELETON The same characters are enerally inscribed on each of the three precedin fiures (which I call the complete fiures), thouh if one of them is peculiar to only one fiure, it will readily be noticed from the number which I shall now append to each character in the Inde, where for the most part I have endeavored simply to write the names of the bones, placin first those which I chiefly use in the main body of my tet, then the greek names, and after that the Latin names (if there are any others) accepted by the most approved authors, so that the order of names here will have some sinificance. Hebrew names will follow these, but also a few that are still Arabic, almost all taken from a Hebrew translation of Avicenna with the aid of a prominent physician and close friend of mine, Laz arus Hebraeus de Frieis (with whom I am accustomed to work on Avicenna). I t houht it proper to add a Latin transliteration to those names, because most of them occur in Arabic books translated into Latin. Similarly, other words that occur often in Latin t ranslations of the Arabic will for ood reason be placed net, alon with names which are read in the scholastic doctors (as they love to be called) and in the medical handbooks of our time.
1 2
1555: “toether with the various names of the bones.” 1555: “in which the complete structure of the bones is represented.” These skeletons may be compared to the three which constitute the latter half of Vesalius’ Tabulae anatomicae published in Venice, April 1538. The 1538 ure leends, printed on the same sheets as the woodcut ures, are a similar attempt to provide a greek, Latin, Arabic, and Hebrew nomenclature. But the 1538 ures are less profusely marked, with only 55 items marked in all three. See Siner and Rabin, 1946, pp. 18–44 for an etensive commentary on the 1538 nomenclature. Saunders and O’Malley (1950, p. 84) note rihtly that the Fabrica’s skeletal ures, probably of a 17- or 18-year-old male, contain errors of proportion. For eample, the thora is too short, the lumbar spine is too lon, and the entire torso is proportionally short. As already noted (see n. 3, Ch. 14, and n. 59, Ch. 16), several of the spinal curves are missin, perhaps reectin the practice of threadin the vertebrae over a riid iron bar – improperly bent to demonstrate curvature – durin
3 4
These are no less carefully to be considered than names received from the Latin authors. Bone is called ὀστέον by the greeks, os by the Latins, and by the Hebrews , hezem. Cartilae is χόνδρος , hascechusim. It will be convenient for us to bein the names of the bones with those of the head or skull, which the greeks call κράνιον, κόγχος , κύτος , κωδεία, σκαφίον. Many call the entire area of the bones of the head that surround the brain – made of eiht bones – calva, cerebri galea, and the like. Others so name only the area covered with hair. Its circle is called tkek haστεφάνη and περίδρομος ; moah, chederath hamoach; theca “case” and olla “jar” of the head, testa “shell” of the head, and scutella “pan” of the head, asoan. The sutures with which the bones of the head are joined toether are enerally called ῥαφαί, scelavim; senan, direzan, adoren, complosa “clapped toether.” A 2, 3 Coronal suture, στεφανιαία ; hachlilii, chascthii; arcualis “arcuate,” sutura puppis. B 2, 3 The suture [s. lambdoidea] resemblin the greek capital Λ , λαμβδοειδής, and ὑψιλοειδής from its resemblance to υ; lambdii; laude, hypsili, sutura prorae.
articulation of a skeleton, but due also to Vesalius’ idée xe about spinal curvature (see n. 42 and 49, Ch. 39). The result is that with the loss of the spinal curves the ribs are too horizontal and the normal anterior pelvic tilt is lessened. Althouh the ratio of the tibia to the femur is nearly normal, the upper etremity is proportionately too lon for the aial skeleton, with the bones of the forearm proportionately too lon for the humerus, and the upper etremity is not typically proportionate to the lower etremity. 1555: “but without eplainin how they work.” On attempts to identify Lazaro de Frieis, see O’Malley, 1964, p. 120. Siner and Rabin (1946, pp. lvi– lvii) note that de Frieis’ access to a 1491 Hebrew translation of Avicenna is an important factor distinuishin the Semitic vocabulary in the Fabrica from what was provided in the Tabulae of 1538. There is no reason to believe that Vesalius himself had more than a sketchy acquaintance with the Hebrew alphabet or any real knowlede of Semitic lanuaes. See Etziony (1945, 1946; a detailed
5
Saittal suture, ὀβολαία , ῥαβδοειδής. Suture runnin alon the lonitude of the head like a shaft, spit, or rod. checii, scefodii. Called nervalis especially when joined to the coronal suture; the place [brema] is called zeudech, particularly by Mesuë. D 2, 3 This joint [sutura squamosa], not resemblin a true suture, is named with its mate, the sutures joined to each other like scales, λεπιδοειδεῖς κροταφίαι , temporal, squamiform, chelaphiim, cortical, mendosae “false” sutures. The remainin sutures of the skull do not have their own names. As they are such, I need not return to them aain at reater lenth. α 2, 3 This bone [os parietale], toether with its mate, is called “the bone of the verte,” and likewise of the βρέγμα or κορυφή. There are some who call them “the bones of the sinciput”; hezem hachodchod ; nervalia, paria, arcualia; others call them iugalia and “parietal bones,” a name by which some call the temporal bones; the bones of reason or coitation. β 1, 2, 3 Frontal bone, μετώπον, called by some “the bone of the sinciput”; hezem hamezzech, the coronal, os puppis of the head, the os inverecundum “shameless bone,” the bone of common sense. C 3
study of the Hebrew terminoloy used by Vesalius), Fück (1955), Dannenfeldt (1955), Pines (1965), Bruman and S chröder (1979), Katchen (1984), and grafton (1993, vol. 1). For Hebrew and Arabic medical nomenclature, see Hyrtl (1879). In this translation , we oer occasional translations of the Latin terms; but a complete account of the greek, Hebrew, Arabic, and Latin nomenclature, such as the one noted above (n. 2) by Siner and Rabin, is beyond the scope of this commentary. The Hebrew words and their transliterations present their own diculties: (1) de Frieis’ knowlede of Hebrew and Arabic may have been sketchy; (2) the transcriber was unfamiliar with Hebrew; and (3) the typesetter, also unfamiliar with Hebrew, made numerous typoraphical errors. In this version, we have tried only to achieve a deree of consistency between the Hebrew and its transliteration, and where possible to ive the correct Hebrew spellin. We are rateful to Ahuvia Kahane and Mira Balber for their assistance in this task.
6
7 8
9 10
11
12
Os frontale (1), os parietale (2), os occipitale (1), os sphenoidale (1), os temporale (2), and os ethmoidale, lamina cribrosa (1; Vesalius’ 8th bone of the head). The 1555 edition describes the skull dierently: “as it occurs in cemeteries, or is commonly represented otherwise.” Like arcualis below, this meanin is postclassical. “Stern suture,” so called because it is arched like the curved stern of a sailin ship. The same attributive is iven to the frontal bone (β below). Another nautical metaphor, the “prow suture.” Johannes Mesuë the Elder (Yōḥannān ibn Māsawayh, d. 857), a collector and translator into Arabic of the greek medical classics; a Christian hospital director in Bahdad, he was also known as Janus Damascenus. 1555: “and all their structures .” The second edition also omits the last sentence of this item. Brema: the intersec tion of the saittal and coronal sutures.
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γ 2, 3 Bone of the occiput [os occipitale] or occipitium, ἰνίον, hezem
ζ 1, 2, 3 Process [p. mastoideus] of the tempo-
hahoreph; laude os, pyxis bone, prow bone, memory bone. There are some who also call it the “basilar bone” (because it makes up a lare portion of the head), even thouh this name is elsewhere iven to the cuneiform bone [os sphenoidale]. δ 2, 3 This bone [os temporale] and its mate are the bones of the temples, κροταφῶν, κορσῶν, κορρῶν λεπιδοειδῆ. Some also call them “stone-like”: λιθοειδή, lapidea, lapidosa; hazedahim, azzamoth haauniim; “bone of the ears,” even thouh the name could be applied to the two ossicles [ossicula auditoria] oin into the construction of the oran of hearin, , *. 2 marked and * on the pedestal upon which the second fiure rests its elbows, where [incus] marks the ossicle like an anvil or a molar, and * [malleus] the one that we compare to a little hammer or femoral bone. Since these ossicles were unknown to ancient professors of Anatomy, it is little wonder that they are also lackin in names. The bones of the temples are called by some those of the tympae, the mendosa or “false” bones, parietal, the hard or armalia bones. ε 2 Process [p. styloideus] in the temporal bone resemblin a stylus or needle: στυλοειδής, γραφοειδής, βελονοειδής, πλῆκτρον, calcar capitis; chemo marhezz; os calaminum “reed-like bone,” saggitale, clavale, acuale.
13 14 15
16 17
18
Inion: protuberantia occipitalis externa. A pyxis is a small box for medicines. Os basilare ; in Enlish, “basilar” means pertainin to the base, particularly of the skull. In modern anatomy, the basilaris cranii is “a composite of the numerous bones which serve as a supportive oor and form the axis of the whole skull” (Dorland, 1994). Vesalius’ explanation may be an attempt to link the work with gk. basilikos, “royal,” because it makes up “a lare portion of the head.” The Latin term is not iven in the OLD. Os temporale, pars petrosa. “Bone at the palate,” e.. in De usu partium 3.934.4 (May, 1968, p. 547). galen does not distinuish between the palatine and sphenoid bones. E in the basis cranii externa in . 2 is the ala vomeris.
19
20
21
22
331
ral bone resemblin the nipple of a breast: μαστοειδής, mamillaris, hezem potmii. E 2, 3 Bone [os sphenoidale] compared to a wede, σφηνοειδής; it is defined by galen κατὰ τὴν ὑπερώαῃ ὀστοῦν (even thouh it scarcely touches the palate), πολύμορφον. Cuneiform bone of the palate, basillare (thouh they also so name the occipital bone), moscau hamoach; baxillare, paxillum, os colatorii, os cribratum, cavilla – thouh they call the talus the same thin. η 2 Area of the skull which we call stony, lapidosa [os temporale, pars petrosa]. θ 2 Processes of the sphenoid bone resemblin bats’ wins; πτερυγοειδεῖς , hezzem chenaphii. F 1, 2, 3 This area [arcus zyomaticus, commonly named the zyoma], and its mate on the other side, is called the “jual bones”: ζυγώματα, ζυγοειδῆ, ζυγώδη ; hazamoth hazogh. “Bones of a pair” and paria are names they also assin to the bones of the temples: “handles of the temporal bones,” [pars squamosa, processus zyomaticus] arcualia ossa. We have written no character on the twelve bones of the upper maxilla because they lack separate names, thouh the septum of the nostrils [vomer] is called by some the os cristae. Also, the upper maxilla [maxilla] is called γένυς and mandibula, halechi hahelion.
Os occipitale, pars basilaris , which articulates with os sphenoidale, corpus at the sphenooccipital synchondrosis. This charac ter is visible only in the skull lyin on the pedestal in both editions. The 1555 edition adds ψυζυγωδῆ and καγκρός , neither of which is attested in LSJ or the medical writers in TLg. The 1555 edition adds the followin: “The bone of the head numbered eihth [os ethmoidale] – compared to a sieve or strainer and by some to a spone, for that reason called ἠθμοειδές and σπογγοειδές and popularly named cristatum, ‘crested’ – appears nowhere in these three plates representin the entire structure of the bones, since it occurs only in the inner space of the skull, as shown in the eihth ure of the sixth chapter at A , B,
G 1,
These names are also iven to the lower maxilla [mandibula], marked G in the three fiures, which the translator of Haly Abbas specifically names the throat, faux . As a rule, sixteen teeth – ὀδόντος , scinaiim – are affixed in each jaw, of which the four middle or anterior ones are called incisorii [dentes incisivi]; τομεῖς, διχαστῆρες, κτένες, γελασῖνοι, risorii or “lauhin” teeth, quaterii; hamechatechim, quadrupli. They call the two middle teeth by themselves the duales. The tooth closest to the incisors on each side is called the caninus or “do” tooth; there are therefore two canines [dentes canini] in each jaw; κυνόδοντες ; chelauiim or metalehoth; “the bitin teeth,” mordentes; some also have called these risorii or “lauhin” teeth. The five followin these on each side are called “rinders,” molares; μυλέται, γόμφοι; molares, maxillares, paxillares. Cicero and others call genuini those that enerally row after puberty; by the greeks, they are called σωφρονιστήρες, κρατῆρες , οψίγονοι; by our people they are called teeth of sense and wisdom and cayseles; naghuid ; neguegidi, nanged , alhalm. The Hebrews call the molars tochanoh.
2, 3
Bk. 5 Ch. 15 Fig. 25
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A.
23
24
25
26
But perhaps, because it forms the septum of the nostrils [lamina perpendicularis ossis ethmoidalis] outside the space mentioned, one miht arue that it is seen to a deree.” Consistin of the concha nasalis inferior (2), os lacrimale (2), os nasale (2), maxilla (2), os zygomaticum (2), os palatinum (2), and vomer (1). This qualication is omitted from the 1555 edition because of the addition recorded in n. 22 above. The 1555 edition adds σιαγών (attested in Hippocrates, Epidemiorum libri, and elsewhere in 5thcent. greek) and γένος (unattested in this sense in LSJ). Usually a plural, fauces, in classical Latin. Haly Abbas was the name by which Europeans knew 'Alī ibn al-'Abbās al-Majūsī (d. c. 994), author of Kamil al-sina’a altibbiya, “The Complete Medical Art,” which
was twice translated into Latin: by Constantine the African (. 1080) under the title Liber pantegni, and by Stephen of Antioch in 1127 as the Liber regius. Best known as the Pantegni, it came to occupy a place in European medical literature second only to Avicenna’s Canon. See Vivian Nutton in Conrad et al., 1995, pp. 113f., and Bynum and Porter, 1993a, pp. 700f. Substitute “barbarian s” in the 1555 27 edition. 28 Dentes praemolares (2), dd. molares (3). 29 1555 adds mensales, “table teeth” (perhaps because they are relatively at-topped). 30 See n. 15, Ch. 11 on Cicero’s nomenclature in De natura deorum of the “cheek” teeth for all the molars. 1555 adds: “of intellect, serotini or 31 ‘late-comin,’ and aetatem com plentes, ‘ae-completin.’”
Bk. 5 Ch. 15 Fig. 25
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