History of Neurology - Anatomy and Physiology

Anatomy and Physiology

Along with most other sciences, the first real advances in neurology after the Greeks occur in the Renaissance. The invention of the printing press allowed the publication of anatomical textbooks, allowing the dissemination of knowledge. An early example is Johann Peyligk's Compendium philosophiae naturalis, published in Leipzig, Germany in 1499. This work contained 11 woodcuts, depicting the dura mater and pia mater as well as the ventricles.

A revolution took place in both neurology in particular and in anatomy in general when Andreas Vesalius published his De humani corporis fabrica in 1543. It includes detailed images depicting the ventricles, cranial nerves, pituitary gland, meninges, structures of the eye, the vascular supply to the brain and spinal cord, and an image of the peripheral nerves. Vesalius also exposed the non-existence structures that had been believed to be in the brain since Galen's (revered) work, such as the rete mirabile. Galen's dissections were all on animals – in particular, the rete mirabile is only well developed in ungulates. Vesalius, unlike many of his contemporaries, did not subscribe to the then common belief that the ventricles were responsible for brain function, arguing that many animals have similar systems of ventricles to those of humans, but had no true intelligence. It appears that he rarely removed the brain from the skull before cutting it, most of his diagrams showing the brain sitting inside a severed head.

Thomas Willis in 1664, published his Anatomy of the Brain, followed by Cerebral Pathology in 1676. He removed the brain from the cranium, and was able to describe it more clearly, setting forth the circle of Willis – the circle of vessels that enables arterial supply of the brain. He had some notions as to brain function, including a vague idea as to localization and reflexes, and described epilepsy, apoplexy and paralysis. As already mentioned, he used the word neurology.

A beginning of the understanding of disease came with the first morbid anatomists, morbid anatomical illustration, and the development of effective colour printing. Matthew Baillie (1761–1823) and Jean Cruveilher (1791–1874) illustrated the lesions in stroke, in 1799 and 1829 respectively.