(THE
ANATOMY OF MASTER NICOLAUS, ca. 1150-1200)
from: George W. Corner, Anatomical Texts of the Earlier Middle Ages (Washington, D.C.:
Carnegie Institute, 1927;
N.Y.: AMS Press Reprint)
As
Galen advises, if anyone desires to know the arrangement of the internal and
external members of the human body, he must undertake the practice of anatomy.
Therefore let us consider what anatomy is and why it is so called, upon what
animals it was practiced by the ancients and upon which by the modern, and what
are their species and divisions. As we have it from Galen, anatomy is the
correct division of the animal members. The word is derived from ana, meaning
straight, and thomos, meaning division; whence anatomia, that is to say,
correct division of the members. Among the ancients dissection was practiced
upon both the living and the dead. The anatomists went to the authorities and
claimed prisoners condemned to death; they tied their hands and feet, and made
incisions first in the animal' or major principal members, in order to
understand fully the arrangement of the pia mater and dura mater, and how the
nerves arise there from. Next they made incisions in the spiritual members, in
order to learn how the heart is arranged and how the nerves, veins, and
arteries are interwoven. Afterward they examined the nutritive organs and
finally the genitalia or subordinate principal members. This was the method
practiced upon living bodies. A different method was used upon the dead; they
took a crucified corpse and fastened it with rope to a stake in a running
stream, with hands and feet tied, so that after a time the skin, flesh, fat,
and other superfluous parts were removed by the action of the water and the
arrangement of the internal members could clearly be observed. Thus Galen, a
remarkable physician of those times, composed two books of anatomy of the dead
and one of the living; but such treatment of the human body came to be
considered inhuman, especially by Catholics, and the practice of dissection was
transferred to animals. Now, some kinds of animals are much like man,
especially in outward aspect, for instance, monkeys and bears, while others,
such as the pig, are similar to man internally; and therefore the anatomists
chose the latter kind, and in particular the female pig, which shows the
greatest likeness to the human structure in all internal organs, including the
uterus.
Next
let us discuss the species and divisions of anatomy; and because its
classification depends upon members, let us see first what a member is. A
member is defined thus: It is a part of an animal which is firm and solid,
composed of similars or dissimilars, and assigned to some special function.
"Part of an animal" is specified in order to exclude branches, which
are not parts of animals but of trees, and also to exclude parts of wood and
stone. Note also that the term "part of an animal" may
The
classification of members is three-fold. First, they are either consimilar
or official. A consimilar member is one which is of the same nature throughout,
that is to say, of the same species or complexion. The latter phrase is
specified to allow for the case of the arteries, which consist of two layers,
one of which is not of the same species, although of the same complexion,
because all arteries are of one complexion, for every part of an artery is
arterial. The same applies to other members. The consimilar members are twelve
in number, namely, skin, flesh (caro), fat, muscle (musculus), lacerta,
bones, nerves, veins, arteries, ligaments, tendons, and medulla. [N.B.
The author appears to have listed muscular tissue three times, under caro,
musculus and lacerta].
An
official member is one which consists of various consimilars, such as the hand,
which consists of skin, flesh, veins, nerves, and the like. Again, some members
are principal, some on the other hand are derived from the principal members;
some have innate powers, others have both innate and inflowing powers. The
principal members are four, brain, heart, liver, and testes. The first three,
that is to say, brain, heart, and liver, are called principals (principalia),
because they maintain the individual in existence. No animal is to be found
which has not these three members, unless it be the acephalic animal which is
said to have no head and consequently lacks a brain. The testes are called
principal members because they maintain the species in existence by material
transmission. If there were not generative power in the testes, the human
species would perish and the same holds good for other species.
The
members derived from the principals are the nerves, veins, arteries, and
seminal ducts. All the nerves arise directly or indirectly from the brain, all
the arteries from the heart, all the veins from the liver. The seminal ducts,
both superior and inferior, arise from the testes; the superior are called
didymi, or dubious, because it is doubtful whether they are derived from the
kidneys or the testicles. The inferior are
The
third classification of the members is as follows: Some members are animal,
others spiritual, others nutritive, others generative. The animal members
are the brain, pia mater, dura mater, and the like. They are situated above
the epiglottis. The spiritual members, namely, the heart, the lung, and so
forth, are situated between the epiglottis and the diaphragm. The nutritive
members, namely, the liver, spleen, stomach, and the like, are between the
diaphragm and the kidneys. The genital members, namely, the testes and seminal
vessels, are below the kidneys.
The
brain, being the most important of the animal members, is surrounded by other
structures, either protective, expurgative, or subservient. It has as
protective structures the pia mater, dura mater, cranium, and overlying skin.
The pia mater immediately surrounds the brain with its arterial net, and
shields it from the dura mater, which is cartillaginous and hard as cardboard.
This membrane is called pia mater because it surrounds the brain like a devoted
mother embracing her child. The dura mater guards the brain from the hardness
of the cranium. The name miringae is also applied to these two membranes.
The
skull and overlying skin protect the brain from external injury. As expurgative
members the brain has the eyes, ears, nostrils, and palate. Through the eyes it
is drained of black biliary humors as rheumy discharges; through the ears
its biliary humors are discharged as
yellow fluid; and through the nostrils and palate the brain is purged of phlegmatic
humors as rascationes (?). The brain has also subservient members, namely, the
nerves; for the animal spirits are carried by the nerves to all the members,
endowing them with sensation, motion, and what not.
The
heart, being the most important of the spiritual members, has certain members
which are protective, others expurgative, and others subservient. As defensive
members it has a kind of capsule which surrounds it and protects it against the
hardness of the ribs; and in turn it has the ribs, which protect it against
external injuries. For expurgative members it has the canals of the lung and
the trachea. The
The
liver, which is the most important of the organs of nutrition, is provided with
certain members which are protective, others expurgative, others subservient.
As protective members it has the zirbus and the siphac [medieval
Arabic terms for the omentum] which envelop it and
protect it from the hardness of the ribs; in turn the ribs protect it against
external injuries. It has several organs which drain off the various
superfluities formed in it, namely, the gallbladder draining it of excess bile;
the spleen draining it of excess black bile; the brain, heart, and stomach
draining off excess of phlegm; and the capillary veins and ureters, which carry
off the urine into the bladder. As subservient members the liver has the veins,
which provide it with nutrient blood.
The
testes also, as the most important of the generative organs, are provided with
certain members which are protective, others expurgative, others subservient.
As protective members they have the scrotum, the little pouch in which they
hang, which protects them against the pressure of the thighs, and in turn the
thighs protect them from external injury. As expurgative members they have the
emunctory vessels, which carry the sperm from the testes by the way of the
penis into the mint of conception. As subservient members they have the didymi,
which carry to the testes the raw materials from which they generate the sperm.
The
brain, which is the most important among the animal members, is, according to
some, of hot complexion; according to others, cold; according to others, moist;
in substance, subtle, thin, and soft; in color, white; in constitution, hollow
and spongy; in form, oblong with a degree of rotundity. It is covered by the
scalp and the skull, and is inclosed in two membranes. It has much of spirit
and much of marrow. It is mobile with a twofold mobility and divided into three
cells. According to Aristotle, it is hot of complexion. as Isaac testifies in
his work. De dietis universalibus, but according to Hippocrates it is cold (at
least as he seems to hint in the Prognostics, where he says that cold harms the
brain, spinal medulla, nerves, arteries, and consimilar members in general).
All agree that the brain is of moist complexion. In substance it is subtle
because of its subtle operations; it is thin and soft in order that it may
easily receive impressions and easily give up what it has received. It is white
in color, so that it may freely receive impressions of different colors, since
white is the most sensitive of colors. In constitution it is hollow and spongy,
that it may hold the wastes derived from condensation of vapors rising to the
brain, for if they were not detained
It is divided into three cells, the
cellula phantastica in the
anterior part of the head, the cellula logistica in the middle, the cellula
memorialis in the posterior part. In the cellula phantastica imagination is
said to have its seat, reason in the cellula logistica, memory in the cellula
memorialis. The first cell is hot and dry, having much spirit and a little
marrow; the second is hot and moist, having much spirits and much marrow; the
third is cold and dry, having little spirits and much marrow. The cellula
phantastica is hot and dry, having much spirits, for the following reason:
just as among the natural forces we find the attraction of nutriment by the
appetitive force aided by heat and dryness, so also among the animal forces
there is an attraction brought about by similar qualities, namely, heat and
dryness. This cell has much of spirits, to provide for the carrying oil of its
functions, and it has little marrow, in order not to impede the flow of spirits
in apprehending the nature of things. The cellula logistica is hot and moist
for the following reason : just as among the natural forces there is digestion
of what has been received, and separation of the purities from impurities of
the diet, by the action of heat and moisture, so also among the functions of
the mind there is a property of discrimination brought about by heat and
moisture, by which things received into the cellula phantastica are
distinguished, for instance, the true from the false, the honest from the
dishonest, merriment from sobriety, and other contrasting things. It has much
of spirits, in order that there may be full discrimination of ideas received;
it has much marrow, in order that the spirits depleted by these subtle
operations may be replenished. The cellula memorialis is cold and dry, for the
following reason: Just as among the natural functions, there is first an
attraction of nutriment by heat and dryness, and digestion by heat and
moisture, and then there must be retention by means of cold and dryness; so
likewise among the functions of the mind, besides the attraction of ideas to
the cellula phantastica by heat and dryness, and the separation of the true
from the false, and
On account of the three divisions of the brain the ancient philosophers called it the temple of the spirit, for the ancients had three chambers in their temples, first the vestibulum, then the consistorium, finally the apotheca. In the first the declarations were made in law cases; in the second the statements were sifted; in the third final sentence was laid down. The ancients said that the same processes occur in the temple of the spirit, that is brain. First we gather ideas into the cellula phantastica, in the second cell we think them over, in the third we lay down our thoughts; that is, we commit to memory.
Next come the nerves. Of these,
some are sensory, others motor.
Having discussed the sensory nerves, we now take up the motor nerves. The motor nerves are those which primarily serve the motor function, only secondarily assisting in sensation, as, for instance, that of touch. All the motor nerves originate from the cellula memoralis, just as the sensory nerves arise from the cellula phantastica, although some say that the three species of sensory nerves, namely, sensory, gustatory, and olfactory, arise from the cellula phantastica and two other species, auditory and first tactile, arise from the posterior part. In the same way they say that some motor nerves, namely, those of the eyebrows and eyelids, arise from the anterior part, while others, namely, the motor nerves of the ears, lips, and other regions, arise from the posterior part. This seems, indeed, to be the meaning of Galen in the Tegni, where he says: "Ipso quoque pars anterior pluribus autem operativis, quem posterior pars pluribus operativis, paucioribus autem sensibilibus." Two other nerves arise from the posterior part, one of which goes to the right jaw, the other to the left. The one which goes to the right traverses the upper jaw and enters the lower and the one which goes to the left does the same. It should be remarked that in every kind of animal that jaw in which the motor nerve ends is the larger, except in the crocodile, in which the contrary condition occurs. The posterior part of the cranium is shaped like a Greek lambda, and is called commissura from com and mitto because the cranium and spine are put together or joined there.
The spine consists of 18 vertebrae, of which there are 6 cervical and 12 dorsal. The vertebra are all perforated to allow for descent of the two membranes, namely, pia mater and dura mater, and is formed like a horse's tail or like a willow switch. From the commissure of the cranium certain nerves originate which extend to the root of the tongue and are called motor nerves of the tongue, because they move the tongue in mastication and also in the production of speech, although the voice is not actually generated there, but these nerves by their motion modify the voice. Likewise, certain other nerves arise from the same commissure and pass through the whole length of the neck to the heart and which surround the sides of the heart; by means of these, animal spirits are goes carried to the heart to produce the emotions, such as anger, joy, sadness, and the like, for all the operations of the mind and soul originate in the, brain and terminate in the heart. Still other nerves begin in the same commissure and pass through the whole length of the neck to the upper orifice of the stomach, where they terminate; by these, animal spirits are borne to produce appetite, for appetite is composed of two forces namely, animal force and simple natural or appetitive force which flourishes by the action of warmth and dryness. Warmth dissolves and resolves superfluities and dryness consumes them. When the stomach perceives its own emptiness, its upper parts touch each other, and thus arises the desire to eat, as a result of tactile sense and of appetite; or, to put it in other words, by the action of animal force and of appetitive force. Other nerves arise from the sixth dorsal vertebra, counting from the upper end, that is, the neck, and these go to the lung and pass through the middle of the pulmonary region; thereafter they turn back and reach the tongue, whence they are called nervi reversivi. In some people they terminate at the proper distance, in some they fall short, in others they go too far. Those in whom they end at the proper distance are able to form all sounds of the voice; those in whom the nerves are too short cannot produce the letter "r" and are said to be tongue-tied; those in whom the nerves are too long cannot form the letter "s" and are said to lisp.
Also,
other nerves arise from the same vertebra and go to the sternum, where they
become superficial and connect the sternum with the spine, in order to bring
about inspiration and respiration. Still other nerves arising from the same
vertebra pass by way of the middle ribs to the inner side of the sternum, where
they join the flesh to form a muscle by which the air is gently expelled, as in
laughing; but other nerves arising from the same vertebra go as far as the
trachea or the lower part of tile throat, and join with flesh to form a muscle
by which air is forcibly expelled, as in coughing. From the same vertebra arise
nerves which pass to tile upper part of tile throat and join with flesh to form
a muscle by which vocal sounds are produced, not definite words, but merely
sounds. To form actual words, nine instruments are required, which are called
by the authors "the nine muses." These are the lung, pulmonary
canals, trachea, epiglottis, tongue, palate, the two upper and two lower
incisor teeth, and the two lips. From the junction of the dorsal and cervical
spine two nerves originate, one of which goes into the right arm, the other
into the left; they descend to the hands and there divide into five twigs, one
for each finger. Through these branches animal spirits are borne, primarily to
produce motion, but secondarily to cause sensation.
At
this point it should be noted for the sake of clearness that there are in the
human body two humeri, two homoplatae, two spatulae, two metafrenones, two
sides, two thoraces, and the sternum. The humerus is the highest part (of the
arm) next to the dorsal spine. The homoplata is a broad bone in the shoulder.
It is called homoplata from homos meaning bone, and platon, which means broad;
front the same word we get also platea, a broad way, and plato, having a broad
aspect. The spatula consists of the shoulder and the homoplata. The
metafrenones are certain bones in the back which reach as far laterally as the backbone
and as far upward as the thoraces. One is in the right side, the other in the
left. The thoraces are those anterior parts which contain the nipples; they
extend to the subcinctorium. The right side is opposite to
Several nerves arise from the cervical cord and leave the spine to enter the various regions mentioned above and the internal organs, namely, the stomach, liver, and the like, bearing animal spirits primarily to produce motion in them, and secondarily to produce tactile sensation. Two nerves arise at the end of the dorsal spine, one of which passes to the right leg and the other to the left; they descend the whole length of the thighs and lower legs into the feet and there divide according to tile number of the toes.
Through these nerves animal
spirits are borne to produce motion and sensation. Other nerves arise from the
spinal cord and pass through the spine to reach the chest and the perineum.
The
union of these nerves forms the penis in the male sex, and therefore this
organ is extremely sensitive and has even been called by some cauda nervorum.
In the female sex a similar concourse of nerves forms the foramen, or gateway,
or vagina. Another nerve arising from the spinal cord joins the vertebrum with
the scia and this is called ligamentum, or tenuntos, or zementis (different
people give it different names) ; sometimes this nerve becomes elongated and
then the vertebrum is loosened from the scia and sometimes the nerve breaks
suddenly and gives rise to sciatic pain. The scia is a certain hollow bone, and
the vertebrum a round bone seated in the hollow of the former, called vertebrum
from verto, to turn, because when a person moves it usually turns.
It
is usual at this point to classify the tissues according to their hardness.
Fat
is the softest tissue, flesh is next, then skin, then the sensory nerves, then
the motor nerves; after them comes that ligament or tenuntos which we have just
mentioned, then cartilage, and finally bone.
Having
described the animal members, let us proceed to the spiritual members, first
discussing the heart, which. is the most important among them. The heart is hot
and dry in complexion, solid and hard in substance, dense in constitution,
conical in form; with a pointed apex below and a broad base above; hollow
inside; having two auricles, right and left; motile with a twofold motion;
situated in the middle of the body, and surrounded by a capsule. It is hot in
complexion, to increase its motion, for hot things move swiftly, cold things
slowly. It is dry
Inside, the heart is hollow, to provide for ebullition of the blood and
generation of the vital spirits. It is enclosed in a capsule, for the sake of
protection from the hardness of the ribs. It is motile with a twofold motion,
namely, diastole and systole; note that diastole, elevatio, and thesis all have
the same meaning, while systole is identical with depressio and artheos or
arsis. There is a twofold cause of diastole of the heart, that is to say, an
efficient and a final cause. The efficient cause is the inspiration and
expiration of vital spirits and air; the final cause is the need of resting the
heart and of renewing the vital spirits. There is also a twofold cause of
systole. The efficient cause is the heart's heaviness or weight, for everything
heavy tends toward its center; the final cause is the need of ejecting wastes
produced by ebullition. The heart is placed in the center of the body for the
same reason for which the sun is placed in the center of the world, namely,
that its heat may be evenly distributed to all the lands; and accordingly the
heart is so placed that its heat may be evenly distributed to all members.
The
heart has two auricles, right and left, so that the vena cava entering the
right and leaving the left auricle may become arterial, for the vena cava is
made up of delicate venules which come from the vena ramosa.
The
vena cava is so called either because it gathers much nutriment or because it
passes near several hollow organs such as the heart, lung, pulmonary canals, and
trachea. This vein, as it egresses from the dome of the liver, divides into two
branches, one of which goes upward and the other downward. The one which
courses upward passes through the middle of the diaphragm and enters the right
auricle of the heart; and then leaving the heart via the left auricle it takes
on a new layer derived from the substance of the heart and is called the aorta,
because all arteries arise from it. Note that the difference between a vein and
an artery is that the vein has one coat, the artery two. As the aorta leaves
the left auricle it divides into two branches, one of which goes upward, the
other downward. The one which goes downward descends to the stomach, liver, the
dome of the liver, the kidneys, and to the legs, where it finally reaches the
feet and divides into small branches to each digit. Through this artery vital
spirits and arterial blood are borne to
The
lung is a member firm and moist in complexion, soft and delicate in substance,
hollow and spongy in constitution, pennate in form, and motile with a twofold
motion. It is firm and moist, in order to withstand the warmth of the heart
and so that no lesion may be caused by the heat of its own motion. It is soft
and delicate in substance, so that it may be adapted to motion. It is hollow in
structure in order that inspired air may be retained for cooling the heart and
renewing the vital spirits. It is pennate in form, with seven lobes, of which
the upper four are necessary to life, for if they are perforated by rheumy
fluid from above the patient dies. The three lower lobes are less necessary to
life, since the patient does not quickly die if they are perforated by fluid
through stillicidium. The lung moves with a twofold motion, by which in
diastole there is expulsion of air into the heart and in systole there is a
discharge of wastes; and moreover, by this motion the lung is enabled to
flagellate the heart at frequent intervals, thereby cooling it, and therefore
it is called the flail of the heart.
The
trachea is an organ which is firm and dry in complexion, hard and solid in
substance, dense in constitution, long and round in shape. It arises in the
lung and terminates at the base of the tongue. It is firm and dry of
complexion, because firmness and dryness have a motion constricting the parts
(to the brain) and drying them and thus consolidating them, by which it can
better resist external injury. In substance it is hard and solid, and in
constitution it is dense, on account of the above-mentioned qualities and
for the same reason. In form it is
The
uvula is an organ situated in the palate above the trachea. It is red in color,
broad above, and conical or pointed below. It is called uvula because it is
shaped like an udder. It is the only outlet of the brain having an opening by
which it serves the animal and spiritual members. It is wide above and narrow
below; wide above in order that it may freely receive the excess phlegm, and
narrow below in order that the phlegm may not flow suddenly into the spiritual
organs and thus cause harm. The uvula has an opening continuous with the
nostrils, by means of which people sometimes for a joke put a thread in the
nose and spit it out from the mouth.
There
is also another organ, called epiglottis, which acts in conjunction with the
trachea and oesophagus, and is made in the shape of a finger. When food or
drink is taken into the oesophagus, the epiglottis opens and bends toward the
trachea and closes it. It does the opposite when one speaks, so that if a
person happens to speak while eating, something will run down his trachea and
impede the inspiration and expiration of air and must be gotten out the same
way; otherwise the patient would suffocate.
There
are also organs called glands, some large, others small, others medium-sized.
If rheumy humor reaches the larger glands it causes a disease called branchus
gaballina. If it flows to the smaller it causes branchus minor.
If it flows to
the medium-sized glands, it causes scrofula, which is so termed because
almost invariably more than one gland becomes enlarged just as a pig (scropha)
almost always gives birth to more than one foetus.
Having
discussed the spiritual members, let us speak next of the organs of nutrition,
and first of the liver, which is the most important.
The
oesophagus is fleshy inside and membranous outside; it is long, round, and
tubular, beginning at the base of the tongue and ending at the upper orifice of
the stomach, and it is the pathway of food and drink. It is called oesophagus
from ysos, which means "equal," and phagin, which means "to
eat;" for it receives food and drink equally and transports them to the
superior orifice of the stomach.
The
stomach is cold and dry in complexion, hard and solid in substance, dense in
constitution, long but more or less rounded in form, hollow and villous inside,
smooth and even outside. It is formed of two layers and has two openings, one
below and one above. In complexion it is cold and dry, because frigidity and
dryness are concentrating qualities and reduce parts to solidity. The stomach
is hard and solid and dense in constitution, so that it may retain the food and
drink while the first digestion is performed. It is long and rounded in shape,
because if it were markedly cavernous it would tend to retain undigested food.
It is villous inside, in order that what is taken into it may not be discharged
at once, but will be held and digested, and what is necessary will be retained.
It is hollow in order that it may better contain food and drink. It is formed
of two layers, so that if one breaks from over-distention, the other will
still hold. It has two openings, one below, the other above. The lower opening
is cavernous and is directed toward the liver. The upper is nervous and is
turned toward the heart. The lower orifice is fleshy, in order that digestion
may profit by the qualities there located, because flesh is warm and moist, and
warmth and moisture greatly aid digestion. It has the liver below it like a
fire underneath a caldron; and thus the stomach is like a kettle of food, the
gall bladder is the cook, and the liver is the fire. The upper orifice is
nervous, so that it may feel its emptiness and become hungry, and when full it
may perceive its repletion and cease to hunger. The heart is above it in order
that it may aid digestion. We usually speak of a triple digestion, of which the
first step is the taking in of food and drink. The second is the
liquefaction of the juice in the liver, where the generation of the four humors
takes place; and the third is that of the blood in the veins, by which
ultimately flesh is created where flesh is needed, bone where bone is needed,
and so forth.
In
the human body there are six intestines. The first is called duodenum, the
second jejunum, the third orbus or monoculus or saccus (all these words have
the same meaning), the fourth ileum, the fifth colon, the sixth longaon.
The
first is called duodenum because it is as long as 12 fingers' breadths, the
second is called jejunum because in dead animals it is found empty; the next
part is called orbus because of its one aperture, and monoculus for the same
reason; it is also called saccus, because like a bag it has but one opening.
The ileum takes its name from yle, which means "confusion." because
that intestine is formed of complex
tangled coils. This intestine is the seat of iliac passion. The colon is called
"colander" because the feces are strained there; it is the seat of
colic passion. The longaon is so called
because it is attached along the spine. It terminates at the anus, and thus in
a certain chapter it is called "exit anus." But note that there is
really but one intestine, bearing different names in its different parts.
There
are eight mesenteric veins, of which the first arises in the fundus of the
stomach, the second from the pylorus, the third from the duodenum, and five
others from the jejunum. These eight veins unite near the hilum of the liver to
form a large vein called vena ramosa or lactea porta. The term
vena ramosa is
conventional rather than descriptive, however, just as the trachea arteria is
not arterial in fact but in name only.
Food is taken into the mouth and by aid of the tongue is masticated between the teeth; then it is carried by the oesophagus into the stomach. There it is modified by the action of heat and is changed into another essence. After this, the purer portion is partly retained by the stomach for its own nourishment, and the rest is carried to the hilum of the liver by that mesenteric vein which is connected to the fundus of the stomach. The impure portion descends to the pylorus and is again separated into pure and impure.
The pure portion is in
part carried to the hilum of the liver. The impure portion descends to the
duodenum and there it is further modified and the pure separated from the
impure, as we have described before. The impure portion is carried to the
jejunum and there the first digestion, which began in the stomach, is fully
completed, the pure nutriment being carried to the hilum by the five veins of
the jejunum. The impure remainder passes through the other intestines and is at
length rejected through the anus. The pure juice thus produced by digestion and
carried by the mesenteric veins is called succositas tisanaria, from
"ptisane," or barley water, because the juice resembles such a
decoction in color. The mesenteric veins are so called from the word media,
because it is by their mediation that this juice is carried to the hilum of the
liver; or else the derivation is from mensa, because the juice is carried by
them to the hilum as if to a table, so that the second digestion may be
performed there and the four humors generated.
Opinions
differ as to the generation of the four humors. Some say that the blood alone
is generated, in form as well as substance, in the liver; the other humors are
generated there in substance, but in other places as to form. If it be asked
why the blood alone is generated there in form as well as in substance, it must
be answered thus: the blood alone is the offspring, guardian, and conservator
of nature, for it nourishes, guards, conserves, and repairs the members. The
blood has also favorable qualities, such as fatness and moistness, which
promote digestion, and for this reason it is retained in the liver long enough
to be
The
same opinions are held about the urine. Some say that it is generated, in
substance, in the liver but being urinous and harmful to the liver, it is
immediately taken by the capillary veins to the vena chilis, and thence to the
kidneys, where it drains through the ureters into the bladder and there
receives its specific differentiation. Others say, on the contrary, that it is
generated in form as well as in substance in the liver, as we have said above
with regard to the humors.
The
liver is an organ which is warm and moist in complexion, delicate and soft in
substance, slight and spongy in composition, and lobate in form, having five
lobes. It is hollow within, but outwardly convex or crested, and formed like a
letter "C." It is protected by a capsule. It is warm and moist in complexion on
account of the second digestion, which
It is hollow
within, where the succositas tisanaria is collected, in order that the four
humors may be formed there. It is shaped like a letter "C," or like the new moon;
and the hilum of the liver is said to lie in the curvature. It is protected by
a capsule which serves to guard it from the hardness of the ribs. It is the
spiritual instrument of the second digestion, because the second digestion is
performed in it.
Note
also that the eight mesenteric veins unite at the hilum of the liver and form a
large vein, called vena ramosa, for the reason (as Galen says in the Pantegni)
that before leaving the liver it is divided into five branches which go
separately into individual lobes of the liver. Note also that vena ramosa is a
conventional term, just as the trachea is nominally called trachea arteria.
>From the vena ramosa there arise certain five venules like hairs, which are
called capillary veins, and which leave via the hilum of the liver. As they
leave they unite and form the vena chilis, which lies close to the dorsal spine
from above downward. It is called vena chilis from kilos, which means
"juice." Through this vein juice is borne to the entire body.
The
vena chilis breaks up into three branches, two small and one large. The two
smaller reach and enter the kidneys, to which they carry the urine with the
blood. The blood which they carry there remains as nourishment for the kidneys,
while the urine is drained to the bladder through other veins called ureters,
or veins of the urine. Thereafter the urine passes down out of the bladder
through the penis and is discharged. Note also that the nutritive blood and
animal spirits are borne by all the veins generally. The larger branch of the
vena chilis goes to individual members, including the stomach, heart, brain,
and the lower members. Two veins called varicae also arise from the vena cava;
they go down as far as the backs of the knees and when they are cut obliquely
they make men varicose, that is, shut. From the vena chilis arise two other
veins called salvatellae one of which goes to the right foot, the other to
the left; terminating between the little toe and the next adjacent; when they
are incised they purge away black biliary blood. Four other veins called
saphenae arise from the vena chilis, two going to the right leg and two to the
left, down to the soles of the foot.. One is mesial, and the other lateral.
When the inner one is bled it relieves pains of the stomach, kidneys,
intestines, and uterus. Bleeding of the outer one relieves sciatica.
Five other
veins called haemorrhoidae arise from the same vein and terminate about the
pudendum; through these the black biliary blood flows, just as the
menstrual blood flows through the uterus.
A
number of slender veins like hairs arise from the vena ramosa and leave by way
of the crest of the liver. As they go out they unite and form a large vein
called vena cava.. This vein, as mentioned above, divides into two veins, one
of which goes upward, the other downward. The one which goes upward divides
into two branches, one of which passes from below into the right auricle of the
heart, as we said when we discussed the spiritual organs. The second and
remaining branch is divided into numerous branches, two of which pass to the
upper arms, one to the right and the other to the left. The one which goes to
the right divides into several branches, some of which ascend through the neck
and temples to the brain; others pass down the arm into the hand.
Three
of these latter are important, namely, the cephalic, median, and hepatic. The
cephalic vein is situated in the upper part of the arm; it is called cephalic
from cepha, which means "head," because it is incised for pain in the
head. The median is so called because it is midway between the cephalic and
hepatic; incision of this vein relieves pains of the whole body. The hepatic,
or basilic, or fundamentalis is so called because it arises from the foundation
of all veins, that is, the liver. The same statements apply to the
corresponding veins of the left arm.
Another
vein arises from the vena cava, crossing the middle of the lung and passing to
the right forearm. This 'when incised relieves asthma and other disorders of
the lung. Two veins arising from the same vein go via the spleen as far as the
axillae and are called vena tittilares, because when they are cut across they
cause a man to die in a fit of laughter. There are two other veins which pass
through the arms and terminate between the little finger and the middle finger.
These are called salvatellae, and incision of these is good for quartan fever,
mania, and melancholia. Two other veins arising from the vena cava go to the
ear and are called parotides, from para, which means "near," and
otis,
which signifies the organ of hearing, for they terminate near the organ of
hearing and thus reach the optic [! sic] or auditory nerve. For this reason overdistention of these veins leads to compression and stoppage of the optic nerve
and thus causes deafness; but such deafness is cured by flow of blood from the
nose. From the same vein certain veins arise and are distributed to the brain,
which are called "juveniles," because, as Hippocrates says, if they
are cut a man can no longer produce sperm. Other veins arising from the vena
cava ascend laterally along the trachea and are called venae organicae, or
pneumaticae, for when anyone tries to sing they become dilated and can be seen;
and if one becomes hoarse, drainage of humors through these veins clears up the
hoarseness. Note that all these veins unite at the brain, and in
conjunction
with the arteries form an arterial net, which immediately surrounds the brain.
The vena cava, as we said before, divides into two branches as it , leaves the liver, one of which goes upward, the other downward. The one which goes downward divides into numerous branches, some which go to the stomach, others to the intestines, others to the kidneys, others to the legs, just as we said of the vena chilis. Through these veins nutritive blood and animal spirits are carried to nourish and comfort the members.
All the foregoing veins are found in both sexes; but there is another vein which is found only in women, called kiveris vena, that is, the female vein. This vein begins in the liver, and as it leaves it divides into two branches, one of which goes upward, the other downward. The one which goes downward divides into two branches, one of which enters the right horn of the uterus, the other the left; and through these branches the menstrual blood is carried into the uterus, to be discharged later through the portal of the uterus. The branch which goes upward divides into two branches, one of which goes to the right breast, the other to the left. When the os uteri closes after conception, the menstrual blood is retained and part of it is transported by these veins to the breasts, where it is modified and transsubstantiated into the essence of.the milk, which provident ministering nature provides and prepares as nutriment for the foetus when it sees the light. The remainder of the menstrual blood is taken to nourish the foetus while it is in the maternal uterus.
Enough has now been said about the more
important and better-known veins, but there are also in the human body infinite
numbers of veins which are unknown except to God alone, to whom nothing is
unknown. Note that the blood does not nourish while it is in the veins, but
oozes through the veins into the fountains. The fountains are hollow and
petrous regions in the body where the blood is modified by the action of
natural heat; here the third digestion is carried on and the bony materials are
changed (in substance and in form) into bone, the fleshy into flesh, skin-forming
substance into skin, and so forth.
Next
in order are the genital organs, among which the testes come first, as the
most important. The testes are hot and moist in complexion, delicate and soft
in substance, slight and spongy in composition, round and oblong in form.
In men they are large, in women small. In both sexes they generate sperm.
They are situated in the oscheum or testicular pouch. They are hot and moist
in complexion because these qualities
There are three different opinions as to the generation of the sperm; Hippocrates says that it is formed, in substance in the brain; Galen that it is formed in the liver; others say in the whole body. All these opinions seem to be more or less correct. The statement of Hippocrates was based for the most part upon what was said above, to the effect that a man with the venae juveniles cut can no longer form sperm. (The juveniles are certain veins which have a connection with the brain.) When Galen, on the other hand, spoke as he did, he was thinking chiefly of the origin of the sperm for all members get the nutriment from which they are formed from the liver, where it originates. The opinion of the others referred to the situation and essence of the sperm, for the testes possess an attachment to their cooperating organs, the nerves, veins, and arteries.
The uterus is cold and dry in complexion, fibrous and dense in composition, oblong and round in form. It is hollow and villous within smooth outside, divided into seven cells, and has two openings. It is cold and dry in complexion, in order that through these centripetal qualities it may acquire hardness and solidity. It is dense and fibrous, in order to resist the kicking of the foetus. It is round, in order to avoid angles in which harmful waste products might collect. It is oblong to accommodate the foetus. It has two orifices, one at the bottom, the other inside. The lower one is fleshy and less fibrous, the inner one more fibrous and less fleshy. The lower orifice is patent, the inner is patulous. There is a difference between these terms; "patent" is that which is sometimes open and sometimes not, while "patulous" is that. which is always open, although sometimes it closes. The lower orifice is called vulva, from volo vis, or from volvendo, or from valva which is a door, for it is the portal of the uterus. The uterus is divided into seven cavities, three on the right side, three on the left, the seventh in the middle. In these cavities the foetus is generated, but there are diverse opinions about its formation. Some say that male infants are generated in the right cavities females in the left, hermaphrodites in the middle. Others say that both males and females are generated on the right side and also on the left; but they also say that a male generated on the left side will be a weak and effeminate man, and conversely a female generated on the right will be mannish and rough. In the middle a so-called hermaphrodite will be generated, that is to say, a strange monster having both male and female organs.
There are others who
It
is customary to ask why women display more ardent desire after conception
than before, and the following is the reason usually assigned: Constantine
says that the os uteri is closed after conception. You are not to understand that
it is closed immediately after the injection of
the sperm from which the foetus is generated, but rather that it closes
during the time in which the foetus is growing; otherwise we should be contradicting
what has already been said. Twins are never generated from a single injection
of sperm; there must be two injections to generate twins, and so forth.
While
the foetus is growing, the inner opening, of the uterus contracts because
of the weight and closes so tightly that not even the point of a needle can
enter. The sensitive fibers touch each other, and feeling themselves empty
they have a joyous desire for repletion. Women wishing to satisfy this desire
receive the masculine sperm, but on account of the constriction in the region
the sperm cannot reach the sensitive fibers in large quantity. It comes about
thus that the cold and dry fibers, perceiving the sperm, which is warm and
moist