Brain
The Brain
‘Among the various parts of an animated body which are subject to Anatomical disquisition, none is presumed to be easier or better known than the Brain; yet in the mean time, there is none less or more imperfectly understood’.
Thomas Willis, Dr. Willis’s practice of physick … Translated by
Samuel Pordage (London, 1684), p. 45.
Thomas Willis, Opera omnia (Geneva, 1680), portrait of Thomas Willis.
Worth not only owned this 1680 Genevan edition of the complete works of the famous English physician and natural philosopher Thomas Willis (1621–75); he also owned editions of his most influential books: a 1659 London edition of his Diatribæ duæ medico-philosophicæ, the work which had brought him to international attention; a London 1664 edition of his celebrated text on the brain: Cerebri anatome: cui accessit nervorum descriptio et usus and an Oxford 1667 edition of the related work Pathologiae cerebri, et nervosi generis specimen. In quo agitur de morbis convulsivis, et de scorbuto; an 1672 Oxford edition of his De anima brutorum and both parts of his Pharmaceutice rationalis (Oxford, 1674–5). Clearly Worth was a follower of Willis’ works on anatomy, physiology and chemistry. In possessing Willis’ Cerebri anatome, his Pathologiae cerebri and his De anima brutorum, Worth in effect owned what Martensen notes were ‘the first comprehensive books on the brain and nervous system to be published in Europe’.
Willis had studied at Oxford in the 1630s and 1640s, gaining his BA in 1639, MA in 1642, and BM in 1646. Initially attracted to chemical experiments, he became a member of the Oxford Experimental Philosophy Club and by the mid-1650s was recognised as one of the group’s leading lights. By 1660 he had turned his attention to studying the anatomy of the brain and was assisted in his dissections by Richard Lower (1631–91), whose work on the heart is discussed elsewhere in this online exhibition. His loyalty to the crown was rewarded in 1660 with his appointment to the Sedleian chair of natural philosophy at Oxford. Following this appointment Willis spent even more time on neuroanatomy. He died at London in 1675. 2021 marks the 400th anniversary of his birth and has been the occasion of a number of online initiatives, including a wonderful Quatercentenary of Thomas Willis’s Birth online project by the Department of Physiology, Anatomy and Genetics at the University of Oxford.
Thomas Willis, Cerebri anatome: cui accessit nervorum descriptio et usus (London, 1664), Figura prima: showing the base of the brain, including the circle of Willis.
This image from Willis’ Cerebri anatome depicts the base of the brain and shows the part of it named after Willis: the ‘circle of Willis’. Willis might not have been the first to identify the circular arterial anastomosis at the base of the brain but he was the first to provide a good image of it.[1] He was lucky that Sir Christopher Wren (1632–1723), better known as the architect of St Paul’s Cathedral, London, provided many of the images for the text. Willis noted his debt to Wren in the preface to Cerebri anatome (London, 1664): ‘Dr. Wren, was pleased out of his singular humanity, wherewith he abounds, to delineate with his own most skilful hands many Figures of the Brain and Skull, whereby the work might be more exact’.[2]
Willis provides the following key to this famous image:
The First Figure.
Shews the Basis of an humane Brain taken out of the Skull, with the Roots of the Vessels cut off.
AAAA, The anterior and posterior Lobes of the Brain quadripartite or divided into four parts.
BB, The Cerebel or little Brain in the hinder part of the Head.
CC, The long Marrow or Pith.
DD, The smelling Nerves or the first pair.
EE, The Optick or seeing Nerves the second pair.
FF, The moving Nerves of the Eyes the third pair.
GG, The pathetick Nerves of the Eyes, or the fourth pair.
HH, The fifth pair of Nerves.
II, The sixth pair of Nerves.
KKKK, The auditory or hearing Nerves, and their two processes on either side of them, the seventh pair.
LLIIII, The wandring pair, or the eigth pair, consisting of many Fibres.
MM, The Spinal Nerves coming from afar to the origine of the wandring pair.
NN, The ninth pair consisting also of many Fibres, (which tending downwards, grow together into one Trunk) which arises a little above the process of the hinder part of the Head.
OO, The tenth pair tending downwards.
PP, The Trunk of the Carotidick Artery cut off where it is divided into the anterior and posterior Branch.
QQ, A Branch of it going in between two Lobes of the Brain.
R, The anterior Branches of the Carotides go away united, moving forward into the fissure or cleft of the Brain.
S, The posterior Branches of the Carotides united, and meeting with the Vertebral Trunk.
TTT, The Vertebral Arteries and their three Branches ascending.
V, The Branches of the Vertebrals growing together into one Trunk.
WW, The place designed where the Vertebrals and the Carotides are united, and either Branch ascends to the Choroidal infolding.
X, The Tunnel.
YY, Two Glandula’s or Kernels placed behind the Tunnel.
aaaa. The annulary Protuberance, which being sent from the Cerebel, embraces the stock of the long Marrow. [3]
Thomas Willis, Cerebri anatome: cui accessit nervorum descriptio et usus (London, 1664), Fig. IIII – opposite p. 51: an image of an open brain.
While Vesalius’s 25 illustrations of various brains, dura, skulls and vessels had been executed by woodcut, Willis’ depictions, drawn by Wren, were engraved in copper by a German-Dutch engraver working in the Oxford area.[4] O’Connor notes that the process worked as follows: first, the brain would be removed from the skull and sliced from the base upwards.[5] Willis and his colleagues would then examine the brain under a microscope and Wren would then draw the specimens for publication. Scatliff and Johnston suggest that fixation (preservation of the brain specimen using port wine), had likely taken place before Wren began his task. In the above image, Willis’ fourth image of the brain, they point to the darker colour of the cerebral hemispheres and cerebellum as an indication that external fixation using wine and vinegar had taken place.[6]
Remnant of wax model showing surface brain vasculature. Made by Desnoues of Paris in the 18th century. Courtesy of the Old Anatomy Museum, School of Medicine, Trinity College Dublin.
It was clear to anatomists that specimen preservation was an essential tool to further their research and educational goals. In addition to preserving structures in fluid, they tried to stabilise and replicated them. To do so they turned to ceroplasty, the craft of wax sculpture. Unlike plaster and stone, wax was easy to sculpt and allowed for the reproduction of more delicate structures than harder media. It had the added quality of being life-like, having a texture more akin to the body than plaster, while its relative stability allowed anatomists to store, procure, and share their models with ease.
This partial wax model of the surface of the brain was made by French surgeon Guillaume Desnoues (1650–1735), also referred as Denone, and Denoué in literature) and artist Francois de La Croix[7]. It was part of a storied collection of anatomical waxes bestowed to Trinity College Dublin by the Earl of Shelbourne circa 1739.[8]
The wax brain model above was deemed outdated by later anatomy professors and Desnoues’ collection was retired from its role in teaching at Dublin. In contrast, the preparation below was at the cutting-edge of anatomy of its time and retains educational value for anatomy students today. Trinity’s Professor of Anatomy Daniel J. Cunningham (1850-1909) had a keen interest in neurology and neuroanatomy as exemplified by his numerous publications on the subject. He delivered an address on cerebral topography at the Annual Meeting of the British Medical Association, in 1890:
‘I have selected as the subject of my address the field in which I have been most recently occupied, and to which my thoughts have been chiefly directed for the last two or three years. I refer to the fissures and convolutions of the cerebral hemispheres. It is, indeed, strange that this ground, apparently so limited and circumscribed, should still be capable of yielding rich results to anyone who devotes himself earnestly to the work. But such is, indeed, the case, notwithstanding the great advance that has been made in cerebral anatomy during the present century, and more especially during the last forty-five years.
It is true that we no longer look upon the cerebral convolutions as being disposed in an unmeaning disorder ; we no longer compare them to the coils of the small intestine. The labours of Leuret, Gratiolet, and Broca in France, Huschka, Bischoff, and Ecker, in Germany, and Huxley, Turner, and Flower in this country have taken us many stages beyond this. The descriptive anatomy of the human cerebrum is now very nearly complete; what still remains to be done is the establishment of our knowledge upon a proper morphological basis’.[9]
As the above excerpt implies, Cunningham was devoted in the study of the topographical anatomy of the brain. He was equally keen on passing on his knowledge to his students effectively and employed a variety of methods to do so.
Preserved dissections showing different anatomical structures of the adult brain including the Circle of Willis, and the cerebellum. Prepared by Professor of Anatomy Dr. Daniel John Cunningham in the late 19th century. Courtesy of the Old Anatomy Museum, School of Medicine, Trinity College Dublin.
In this preparation, Cunningham set four adult brains in plaster dissected to show the following: the base of the brain with the circle of Willis (upper left), the base of the brain with the superficial origins of the cranial nerve (upper right), the basal aspect of the brain with the cerebellum removed (lower left), and the brain dissected to show the thalamus (lower right). Cunningham included a specimen similar to the upper right brain above in his Stereoscopic studies of anatomy (1909) manual. He recognized that stereoscopic photography provided him with an innovative avenue to use the new technology of photography in his teachings. He printed the Stereoscopic Studies as a set of boxed loose plates, allowing students to hold each one up to a stereoscope viewing apparatus. Each specimen was photographed through two slightly different angles, so when viewed through a stereoscope, the viewer would perceive an image with a three-dimensional effect. The annotation on the plate reads:
‘Section I No. 13
CENTRAL NERVOUS SYSTEM.
BRAIN No. 3.
THE BASE OF THE BRAIN WITH THE SUPERFICIAL ORIGINS OF THE CRANIAL NERVE
The membranes and vessels have been removed from the base.
The figures indicate:
1. Olfactory peduncle with its roots and the commencement of the olfactory bulb (imperfect).
2. Optic nerve, springing from the optic chiasma and optic tract.
3. Oculomotor nerve, arising from the crus cerebri. The corpora albicantia are distinct in front, in the interpeduncular space.
4. Trochlear nerve, winding round the outer side of the crus.
5. Trigeminal nerve, springing by two roots, one large, sensory, the other small, motor, from the pons Varolii.
6. Abducens nerve, arising in the interval between the pons and medulla.
7. Facial nerve.
8. Auditory nerve, rising close to the facial, at the posterior border of the pons.
9 and 10. Glosso-pharyngeal and vagus nerves issuing from the side of the medulla, in the interval between the olive and the restiform body.
11. Spinal accessory nerve, arising by a series of rootlets from the side of the medulla and the upper cervical segments of the spinal cord.
12. Hypoglossal nerve, arising by numerous radicles from the front of the medulla oblongata, between the pyramid and the olive’.[10]
Cunningham was the first to employ spectroscopy in medical education. Following his example medical educators published several works in this format covering a wide array of disciplines, from anatomy and surgery to dermatology.[11]
Text: Dr Elizabethanne Boran, Librarian of the Edward Worth Library, Dublin, and Ms Evi Numen, Curator of the Old Anatomy Museum, Trinity College Dublin.
Sources
Alberti, Samuel, ‘Wax Bodies: Art and Anatomy in Victorian Medical Museums’, Museum History Journal, 2 (2009), 7-36.
Anon, ‘Thomas Willis (1621–1675), Journal of the American Medical Association, 186, no. 10 (1963), 948-949.
Arráez-Aybar, Luis-Alfonso et al., ‘Thomas Willis, a pioneer in translational research in anatomy (on the 350th anniversary of Cerebri anatome),’ Journal of Anatomy, 226 (2015), 289–300.
Cunningham, D. J. Stereoscopic studies of anatomy, prepared under authority of the University of Edinburgh by D. J. Cunningham, edited by David Waterston, M. H. Cryer, Frederick E. Neres. New rev. ed. (New York, 1905).
Cunningham, D. J., On cerebral anatomy: an address delivered at the opening of the Section of Anatomy and Physiology, at the Annual Meeting of the British Medical Association, held in Birmingham, July, 1890 (London, 1890).
Downes, Kerry, ‘Wren, Sir Christopher (1632–1723), architect, mathematician, and astronomer’, ODNB, 2004.
Lemire, M., ‘Representation of the Human Body: The Colored Wax Anatomic Models of the 18th and 19th Centuries in the Revival of Medical Instruction’, Surgical and Radiologic Anatomy, 14, no. 4 (1992), 283-91.
Martensen, Robert L., ‘Willis, Thomas (1621–75), ODNB, 2004.
Meyer, Alfred, and Raymond Hierons, ‘Observations on the history of the ‘Circle of Willis’, Medical History, 6, no. 2 (1962), 119–130.
O’ Connor, J. P. B., ‘Thomas Willis and the background to Cerebri Anatome’, Journal of the Royal Society of Medicine, 96, (20003), 139–43.
Rubio, Roberto Rodriguez, Rina Di Bonaventura, Ioannis Kournoutas, Dania Barakat, Vera Vigo, Ivan El-Sayed, and Adib A Abla, ‘Stereoscopy in Surgical Neuroanatomy: Past, Present, and Future’, Operative Neurosurgery, 18, no. 2 (2019), 105-17.
Scatliff, J.H., and S. Johnston, ‘Andreas Vesalius and Thomas Willis: Their Anatomic Brain Illustrations and Illustrators’, AJNR Am J Neuroradiol, 35, no. 1 (2014), 19-22.
Talairach-Vielmas, Laurence, ‘Anatomical Models: A History of Disappearance?’, Histoire, médecine et santé (Online 5 Printemps 2014).
Willis, Thomas, Dr. Willis’s practice of physick … Translated by Samuel Pordage (London, 1684).
Wright, George Newenham, An Historical Guide to the City of Dublin, Illustrated by Engravings, and a Plan of the City, 2nd ed. (London, 1825).
[1] Meyer, Alfred, and Raymond Hierons, ‘Observations on the history of the ‘Circle of Willis’, Medical History, 6, no. 2 (1962), 119–130.
[2] Thomas Willis, Dr. Willis’s practice of physick … Translated by Samuel Pordage (London, 1684), preface. This translation is not in the Worth Library.
[3] Ibid., p. 51. This translation is not in the Worth Library.
[4] Scatliff, J.H., and S. Johnston, ‘Andreas Vesalius and Thomas Willis: Their Anatomic Brain Illustrations and Illustrators’, AJNR Am J Neuroradiol, 35, no. 1 (2014), 19, 21.
[5] O’ Connor, J. P. B., ‘Thomas Willis and the background to Cerebri Anatome’, Journal of the Royal Society of Medicine, 96, (20003), 141.
[6] Scatliff and Johnston, ‘Andreas Vesalius and Thomas Willis’, 21.
[7] Talairach-Vielmas, Laurence, ‘Anatomical Models: A History of Disappearance?’, Histoire, médecine et santé (Online 5 Printemps 2014).
[8] Wright, George Newenham, An Historical Guide to the City of Dublin, Illustrated by Engravings, and a Plan of the City, 2nd ed. (London, 1825).
[9] Cunningham, D. J., On cerebral anatomy: an address delivered at the opening of the Section of Anatomy and Physiology, at the Annual Meeting of the British Medical Association, held in Birmingham, July, 1890, (London, 1890).
[10] Cunningham, D. J., Stereoscopic studies of anatomy prepared under authority of the University of Edinburgh by D. J. Cunningham, edited by David Waterston, M. H. Cryer, Frederick E. Neres., New rev. ed. (New York, 1905), Section 1, no. 13.
[11] Rubio, Roberto Rodriguez, Rina Di Bonaventura, Ioannis Kournoutas, Dania Barakat, Vera Vigo, Ivan El-Sayed, and Adib A Abla, ‘Stereoscopy in Surgical Neuroanatomy: Past, Present, and Future’, Operative Neurosurgery, 18, no. 2 (2019), 105-17.