The Neuroanatomical Plates of Guido da Vigevano

Antonio Di Ieva, M.D.; Manfred Tschabitscher, M.D.; Francesco Prada, M.D.; Paolo Gaetani, M.D.; Enrico Aimar, M.D.; Patrizia Pisano, M.D.; Daniel Levi, M.D.; Nicola Nicassio, M.D.; Salvatore Serra, M.D.; Flavio Tancioni, M.D.; Massimo Arosio, M.D.; Riccardo Rodriguez Y Baena, M.D.

Disclosures

Neurosurg Focus. 2007;23(1):E15 

In This Article

Guido da Vigevano (1280--1349)

Guido da Vigevano, an Italian physician and engineer, was born in Vigevano, one of the most ancient Longobard cities in the Lombardy region (described in Wicker sheimer[17] as a "petite ville lombarde, qui au XIV siècle faisait partie du diocèse de Pavia."), sited between Milan and Pavia. He studied medicine in Bologna, learning anatomy from Mondino. He was the personal physician of Emperor Henry VII until that ruler's death in 1313; later on he was very close to the King of France, Philip VI, and from 1335 until her death in 1349 he was the personal physician of the Queen of France, Jeanne de Bourgogne. He wrote books about medicine, anatomy, hygiene, and "the art of war."[6,15]

In 1335, King Philip VI of France was planning a new crusade in the Holy Land. Guido, to strengthen his position with the king as his personal doctor and engineer, wrote and dedicated to him a "crusade book." In this there were nine folios advising the king on how to take care of his health during the journey, and 14 more folios advising him on military technology.[10,14] This booklet, titled "Tex aurus Regis Francie Aquisitionis Terre Sancte de ultra Mare," included instructions on prefabricated portable siege equipment in consideration of the difficulty in finding wood in the Holy Land, proposals for innovative body armors, and sketches of military apparatus.[9] In this precious manuscript it is possible to find drawings of many machines such as attack boats, pontoon bridges, and also two self-propelled battle wagons, one crank-driven and the other powered by a very sophisticated windmill on the back a wooden carriage.[10] This last one is considered to be the prototype of the first autovehicle in history; the word "automobilis," meaning "self" and "moving," was created in the 14th century by the Italian engineer Martini, who invented but never built a crankshaft-driven, four-wheeled vehicle.[1,13] King Philip never left for the Holy Land, however, and Guido's wonderful machinery was therefore never tested.[10]

Guido da Vigevano dedicated another book to Philip VI titled Anathomia Designata per Figures. Written in 1345, it included 24 anatomical plates, 18 of which have been lost. The plates numbered XI to XVI display the first neuroanatomical pictures and descriptions in the history of neuroscience.

Guido's purpose was to show human anatomy by means of schematic and systematic drawings of his dissections ("demonstrabo anathomiam corporis humani pa tenter et aperte, per figuras depinctas recte").[16]

The book is divided in four sections, as follows:

  • introduction;

  • description of the veins for bloodletting;

  • explanation of the drawings; and

  • appendix on the swelling of the uvula and palate.

In the third book, six plates (XI--XVI) are dedicated to the anatomy of the central nervous system. Five plates (XI--XV) show the head, meninges, and parts of brain, and the sixth (XVI) shows the spinal cord.

Plate XI (Fig. 1) shows the trephination of the head by means of a scalpel and a hammer to expose the brain and the two meninges known at the time, the dura and pia mater. Guido defines the meninges as "pellicula" (layer), the same definition found in the Anathomia Mondini.[17]

Figure 1.

Plates XII and XIII (Fig. 2, left and right sides of the panel) depict the removed cranial vault, on which it is possible to recognize an exaggerated depiction of frontoparietal and interparietal sutures (left side of panel),[17] and the external layer ("illa pellicula que vocatur dura mater" [right side of panel]). In plate XIV (Fig. 3, left side of panel) the dura mater has been removed, showing the internal layer covering the brain, the pia mater ("amota illa pellicula que vocatur dura mater, apparebit alia pellicula que vocatur pia mater, cerebrum cooperiens").

Figure 2.

Figure 3.

Plate XV (Fig. 3, right side of panel; Fig. 4) shows the "naked" brain ("cerebrum purum et discoopertum"), with out the meninges. On the surface of the brain it is possible to recognize some sulci and gyri, and five orifices (two in the anterior frontal region, representing the olfactory nerves, and three in the fronto-parietal region, representing the three ventricles).[17] Following his predecessors' theories (Galen, Avicenna, Mondino),[8] Guido writes that the ventricles are the seat of the soul ("ventriculi, in qui bus stat anima et spiritus"), and from there the soul, by means of the nerves, impresses motion to the peripheral organs and the whole of the body ("dantes sensum et mo tum toti corpori, mediantibus nervis, et ipsum spiritum portantibus toti corpori"). He describes the first ventricle as the seat of learning and imagination ("virtus apresensiva sive fantastica"), the second as the seat of the reason ("virtus raciocinativa"), the third as the seat of the memory ("virtus memorativa"). In this paragraph Guido re calls also some physiopathological theories elaborated by Avicenna in the Canon Medicine[2] about the causes of epi lepsy and apoplexy.

Figure 4.

Plate XVI (Fig. 5) shows the spinal cord and the origin of the spinal nerves (only 18 in number), bilaterally passing through the vertebral foramina to reach the whole body.[16]

Figure 5.

Plates XV (Fig. 4; detail of the head on the right side in Fig. 3) and XVI (Fig. 5) show a vague patterning of the cortical structure of the brain surface; as already noted by Yassargil,[18] these drawings are the earliest portrayals of the cerebral convolutions in the history of neuroscience.

In spite of their vagueness, Guido's plates have to be re garded as an important step in the history of medieval anatomy. If Mondino de' Luzzi can be rightly considered the "Restorer of Anatomy" from the darkness of Galen's dogmas, Guido's illustrations compelled scientists and ar tists to break free from Galen's dominating influence.[12] His work can be considered a milestone in the development of artistic anatomical illustrations as we know them today.

The trend he set was further advanced by artists of the caliber of Donatello (1386--1466), the first artist who dissected human bodies, Leonardo da Vinci (1452--1519), considered by Frank Netter as the "founder of physiologic anatomy,"[11] Michelangelo (1475--1564), to name but a few. It was also explored in the works of scientists such as Eustachius (ca. 1500--1574), Vesalius (1514--1564), and others.

In the Renaissance, three elements were crucial for the development and subsequent advancement of human anatomical studies: the recognition of anatomy as a distinct branch of medical science; the acceptance of human dissection as a scientific method for advancing the understanding of the anatomical structures; and the advancement of printing techniques, which allowed illustrations to be included alongside descriptive text.[12]

In this context, the figure of Guido da Vigevano can be considered a link between the Galenic anatomy of the pre-Mondino Middle Ages and the science of anatomical studies explored in the Renaissance. It represents a pivotal step in the development of anatomy not just as a philosophical subject but as a science.

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